Science.gov

Sample records for estimated health risks

  1. 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.

  2. Estimates of health risk from exposure to radioactive pollutants

    SciTech Connect

    Sullivan, R.E.; Nelson, N.S.; Ellett, W.H.; Dunning, D.E. Jr.; Leggett, R.W.; Yalcintas, M.G.; Eckerman, K.F.

    1981-11-01

    A dosimetric and health effects analysis has been performed for the Office of Radiation Programs of the Environmental Protection Agency (EPA) to assess potential hazards from radioactive pollutants. Contemporary dosimetric methods were used to obtain estimates of dose rates to reference organs from internal exposures due to either inhalation of contaminated air or ingestion of contaminated food, or from external exposures due to either immersion in contaminated air or proximity to contaminated ground surfaces. These dose rates were then used to estimate the number of premature cancer deaths arising from such exposures and the corresponding number of years of life lost in a cohort of 100,000 persons, all simultaneously liveborn and all going through life with the same risks of dying from competing causes. The risk of dying from a competing cause for a given year was taken to be the probability of dying from all causes as given in a recent actuarial life table for the total US population.

  3. Sensitivity of health risk estimates to air quality adjustment procedure

    SciTech Connect

    Whitfield, R.G.

    1997-06-30

    This letter is a summary of risk results associated with exposure estimates using two-parameter Weibull and quadratic air quality adjustment procedures (AQAPs). New exposure estimates were developed for children and child-occurrences, six urban areas, and five alternative air quality scenarios. In all cases, the Weibull and quadratic results are compared to previous results, which are based on a proportional AQAP.

  4. 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

  5. Estimating population health risk from low-level environmental radon

    SciTech Connect

    Fisher, D.R.

    1980-01-01

    Although incidence of respiratory cancer is directly related to inhalation of radon and radon daughters, the magnitude of the actual risk is uncertain for members of the general population exposed for long periods to low-level concentrations. Currently, any such estimate of the risk must rely on data obtained through previous studies of underground-miner populations. Several methods of risk analysis have resulted from these studies. Since the breathing atmospheres, smoking patterns, and physiology are different between miners and the general public, overestimates of lung cancer risk to the latter may have resulted. Strong evidence exists to support the theory of synergistic action between alpha radiation and other agents, and therefore a modified relative risk model was developed to predict lung cancer risks to the general public. The model considers latent period, observation period, age dependency, and inherent risks from smoking or geographical location. A test of the model showed excellent agreement with results of the study of Czechoslovakian uranium miners, for which the necessary time factors were available. The risk model was also used to predict lung cancer incidence among residents of homes on reclaimed Florida phosphate lands, and results of this analysis indicate that over the space of many years, the increased incidence of lung cancer due to elevated radon levels may be indisgtinguishable from those due to other causes.

  6. Using a relative health indicator (RHI) metric to estimate health risk reductions in drinking water.

    PubMed

    Alfredo, Katherine A; Seidel, Chad; Ghosh, Amlan; Roberson, J Alan

    2017-03-01

    When a new drinking water regulation is being developed, the USEPA conducts a health risk reduction and cost analysis to, in part, estimate quantifiable and non-quantifiable cost and benefits of the various regulatory alternatives. Numerous methodologies are available for cumulative risk assessment ranging from primarily qualitative to primarily quantitative. This research developed a summary metric of relative cumulative health impacts resulting from drinking water, the relative health indicator (RHI). An intermediate level of quantification and modeling was chosen, one which retains the concept of an aggregated metric of public health impact and hence allows for comparisons to be made across "cups of water," but avoids the need for development and use of complex models that are beyond the existing state of the science. Using the USEPA Six-Year Review data and available national occurrence surveys of drinking water contaminants, the metric is used to test risk reduction as it pertains to the implementation of the arsenic and uranium maximum contaminant levels and quantify "meaningful" risk reduction. Uranium represented the threshold risk reduction against which national non-compliance risk reduction was compared for arsenic, nitrate, and radium. Arsenic non-compliance is most significant and efforts focused on bringing those non-compliant utilities into compliance with the 10 μg/L maximum contaminant level would meet the threshold for meaningful risk reduction.

  7. Using spline models to estimate the varying health risks from air pollution across Scotland.

    PubMed

    Lee, Duncan

    2012-11-30

    The health risks associated with long-term exposure to air pollution are often estimated from small-area data by regressing the numbers of disease cases in each small area against air pollution concentrations and other covariates. The majority of studies in this field only estimate a single health risk for the entire region, whereas in fact the risks in each small area may vary because of differences in the exposure level and the extent to which the population are vulnerable to disease. This paper proposes a natural cubic spline model for estimating these varying health risks, which allows the risks to depend (potentially) non-linearly on additional risk factors. The methods are implemented within a Bayesian setting, with inference based on Markov chain Monte Carlo simulation. The approach is illustrated by presenting a study based in Scotland, which investigates the relationship between PM (10) concentrations and respiratory related hospital admissions. Copyright © 2012 John Wiley & Sons, Ltd.

  8. Estimating the return-on-investment from changes in employee health risks on the Dow Chemical Company's health care costs.

    PubMed

    Goetzel, Ron Z; Ozminkowski, Ronald J; Baase, Catherine M; Billotti, Gary M

    2005-08-01

    We sought to estimate the impact of corporate health-management and risk-reduction programs for The Dow Chemical Company by using a prospective return-on-investment (ROI) model. The risk and expenditure estimates were derived from multiple regression analyses showing relationships between worker demographics, health risks, and medical expenditures. A "break-even" scenario would require Dow to reduce each of 10 population health risks by 0.17% points per year over the course of 10 years. More successful efforts at reducing health risks in the population would produce a more significant ROI for the company. Findings from this study were incorporated into other components of a business case for health and productivity management, and these supported continued investments in health improvement programs designed to achieve risk reduction and cost savings.

  9. Health Risk Estimation for Unregulated DBPs in Chloraminated Drinking Water

    EPA Science Inventory

    Disinfection by-products (DBPs) are formed when natural organic matter (NOM) reacts with chemical oxidants in the water disinfection process. Halogenated DBPs are both cytotoxic and genotoxic, which have the potential to cause adverse health effects (1). Currently, 4 species of t...

  10. Prospective method for estimating occupational health risks in new energy technologies

    SciTech Connect

    Moskowitz, P D; Briggs, T; Ungers, L; Hamilton, L D

    1981-09-01

    In design, development, and acceptance of new energy technologies, concern for health and safety is increasingly important. Determining risks for emerging technologies is difficult because health statistics associated with these new alternatives are unavailable. Nevertheless boundaries on such risks must be determined to identify potentially significant hazards and to permit technology comparisons to be made. An approach to determining occupational health costs is to disaggregate labor requirements of an emerging industy by different worker classifications. Risks to workers can then be determined for these classifications from occupational health statistics of related industries. By summing risks for each worker classification, prospective estimates of individual and societal risk from an emerging technology can be developed. Although this approach identifies accident-related effects, it cannot be used to quantitate occupationally induced disease. An example of this method analyzing different photovoltaic fabrication alternatives is given. Individual vs. societal risk is considered in these analyses.

  11. Estimated human health risks of disposing of nonhazardous oil field waste in salt caverns

    SciTech Connect

    Tomasko, D.; Elcock, D.; Veil, J.

    1997-09-01

    Argonne National Laboratory (ANL) has completed an evaluation of the possibility that adverse human health effects (carcinogenic and noncarcinogenic) could result from exposure to contaminants released from nonhazardous oil field wastes (NOW) disposed in domal salt caverns. In this assessment, several steps were used to evaluate potential human health risks: identifying potential contaminants of concern, determining how humans could be exposed to these contaminants, assessing the contaminants` toxicities, estimating contaminant intakes, and, finally, calculating human cancer and noncancer risks.

  12. Estimates of global and regional potential health gains from reducing multiple major risk factors.

    PubMed

    Ezzati, Majid; Hoorn, Stephen Vander; Rodgers, Anthony; Lopez, Alan D; Mathers, Colin D; Murray, Christopher J L

    2003-07-26

    Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions. The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.

  13. 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

  14. Prevalence Estimates of Health Risk Behaviors of Immigrant Latino Men Who Have Sex with Men

    ERIC Educational Resources Information Center

    Rhodes, Scott D.; McCoy, Thomas P.; Hergenrather, Kenneth C.; Vissman, Aaron T.; Wolfson, Mark; Alonzo, Jorge; Bloom, Fred R.; Alegria-Ortega, Jose; Eng, Eugenia

    2012-01-01

    Purpose: Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain "hidden" from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM…

  15. Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors.

    PubMed

    Matthews, Derrick D; Blosnich, John R; Farmer, Grant W; Adams, Brian J

    2014-03-01

    Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as "not sure" also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations.

  16. 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. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Prevalence estimates of health risk behaviors of immigrant latino men who have sex with men.

    PubMed

    Rhodes, Scott D; McCoy, Thomas P; Hergenrather, Kenneth C; Vissman, Aaron T; Wolfson, Mark; Alonzo, Jorge; Bloom, Fred R; Alegría-Ortega, Jose; Eng, Eugenia

    2012-01-01

    Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain "hidden" from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina. A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS-weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008. A total of 190 Latino MSM was reached; the average age was 25.5 years and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively. Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern United States, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM. © 2011 National Rural Health Association.

  18. Prevalence Estimates of Health Risk Behaviors of Immigrant Latino Men Who Have Sex With Men

    PubMed Central

    Rhodes, Scott D.; McCoy, Thomas P.; Hergenrather, Kenneth C.; Vissman, Aaron T.; Wolfson, Mark; Alonzo, Jorge; Bloom, Fred R.; Alegría-Ortega, Jose; Eng, Eugenia

    2011-01-01

    Purpose Little is known about the health status of rural immigrant Latino men who have sex with men (MSM). These MSM comprise a subpopulation that tends to remain “hidden” from both researchers and practitioners. This study was designed to estimate the prevalence of tobacco, alcohol, and drug use, and sexual risk behaviors of Latino MSM living in rural North Carolina. Methods A community-based participatory research (CBPR) partnership used respondent-driven sampling (RDS) to identify, recruit, and enroll Latino MSM to participate in an interviewer-administered behavioral assessment. RDS weighted prevalence of risk behaviors was estimated using the RDS Analysis Tool. Data collection occurred in 2008. Results A total of 190 Latino MSM was reached; the average age was 25.5 years old and nearly 80% reported being from Mexico. Prevalence estimates of smoking everyday and past 30-day heavy episodic drinking were 6.5% and 35.0%, respectively. Prevalence estimates of past 12-month marijuana and cocaine use were 56.0% and 27.1%, respectively. Past 3-month prevalence estimates of sex with at least one woman, multiple male partners, and inconsistent condom use were 21.2%, 88.9%, and 54.1%, respectively. Conclusions Respondents had low rates of tobacco use and club drug use, and high rates of sexual risk behaviors. Although this study represents an initial step in documenting the health risk behaviors of immigrant Latino MSM who are part of a new trend in Latino immigration to the southeastern US, a need exists for further research, including longitudinal studies to understand the trajectory of risk behavior among immigrant Latino MSM. PMID:22236317

  19. The economic value of reducing environmental health risks: Contingent valuation estimates of the value of information

    SciTech Connect

    Krieger, D.J.; Hoehn, J.P.

    1999-05-01

    Obtaining economically consistent values for changes in low probability health risks continues to be a challenge for contingent valuation (CV) as well as for other valuation methods. One of the cited condition for economic consistency is that estimated values be sensitive to the scope (differences in quantity or quality) of a good described in a CV application. The alleged limitations of CV pose a particular problem for environmental managers who must often make decisions that affect human health risks. This paper demonstrates that a well-designed CV application can elicit scope sensitive values even for programs that provide conceptually complex goods such as risk reduction. Specifically, it finds that the amount sport anglers are willing to pay for information about chemical residues in fish varies systematically with informativeness--a relationship suggested by the theory of information value.

  20. Uncertainties in estimating health risks associated with exposure to ionising radiation.

    PubMed

    Preston, R Julian; Boice, John D; Brill, A Bertrand; Chakraborty, Ranajit; Conolly, Rory; Hoffman, F Owen; Hornung, Richard W; Kocher, David C; Land, Charles E; Shore, Roy E; Woloschak, Gayle E

    2013-09-01

    The information for the present discussion on the uncertainties associated with estimation of radiation risks and probability of disease causation was assembled for the recently published NCRP Report No. 171 on this topic. This memorandum provides a timely overview of the topic, given that quantitative uncertainty analysis is the state of the art in health risk assessment and given its potential importance to developments in radiation protection. Over the past decade the increasing volume of epidemiology data and the supporting radiobiology findings have aided in the reduction of uncertainty in the risk estimates derived. However, it is equally apparent that there remain significant uncertainties related to dose assessment, low dose and low dose-rate extrapolation approaches (e.g. the selection of an appropriate dose and dose-rate effectiveness factor), the biological effectiveness where considerations of the health effects of high-LET and lower-energy low-LET radiations are required and the transfer of risks from a population for which health effects data are available to one for which such data are not available. The impact of radiation on human health has focused in recent years on cancer, although there has been a decided increase in the data for noncancer effects together with more reliable estimates of the risk following radiation exposure, even at relatively low doses (notably for cataracts and cardiovascular disease). New approaches for the estimation of hereditary risk have been developed with the use of human data whenever feasible, although the current estimates of heritable radiation effects still are based on mouse data because of an absence of effects in human studies. Uncertainties associated with estimation of these different types of health effects are discussed in a qualitative and semi-quantitative manner as appropriate. The way forward would seem to require additional epidemiological studies, especially studies of low dose and low dose

  1. Operational Definitions of Sexual Orientation and Estimates of Adolescent Health Risk Behaviors

    PubMed Central

    Matthews, Derrick D.; Blosnich, John R.; Farmer, Grant W.; Adams, Brian J.

    2014-01-01

    Purpose Increasing attention to the health of lesbian, gay, and bisexual (LGB) populations comes with requisite circumspection about measuring sexual orientation in surveys. However, operationalizing these variables also requires considerable thought. This research sought to document the consequences of different operational definitions of sexual orientation by examining variation in health risk behaviors. Methods Using Massachusetts Youth Risk Behavior Survey data, we examined how operational definitions of sexual behavior and sexual identity influenced differences among three health behaviors known to disparately affect LGB populations: smoking, suicide risk, and methamphetamine use. Sexual behavior and sexual identity were also examined together to explore if they captured unique sources of variability in behavior. Results Estimates of health disparities changed as a result of using either sexual behavior or sexual identity. Youth who reported their sexual identity as “not sure” also had increased odds of health risk behavior. Disaggregating bisexual identity and behavior from same-sex identity and behavior frequently resulted in the attenuation or elimination of health disparities that would have otherwise been attributable to exclusively same-sex sexual minorities. Finally, sexual behavior and sexual identity explained unique and significant sources of variability in all three health behaviors. Conclusion Researchers using different operational definitions of sexual orientation could draw different conclusions, even when analyzing the same data, depending upon how they chose to represent sexual orientation in analyses. We discuss implications that these manipulations have on data interpretation and provide specific recommendations for best-practices when analyzing sexual orientation data collected from adolescent populations. PMID:25110718

  2. The estimation of consumer health risk associated with organochlorine xenobiotics in hard smoked cheese in Poland.

    PubMed

    Witczak, Agata; Pohoryło, Anna

    2015-01-01

    The aim of this study was to estimate the health risks associated with consumption of smoked cheeses, which are popular in Poland. The analysis covered polychlorinated biphenyl (PCB) indicator congeners (ndl-PCBs: PCB 28, PCB 52, PCB 101, PCB 138, PCB 153, PCB 180), dioxin-like PCBs (dl-PCBs): non-ortho (PCB 77, PCB 81, PCB 126, PCB 169) and mono-ortho (PCB 105, PCB 114, PCB 118, PCB 156, PCB 157), as well as organochlorine pesticides (OCPs: αHCH, βHCH, γHCH, heptachlor, aldrin, heptachlor epoxid isomer B, dieldrin, pp'DDE op'DDD, pp'DDT, pp'DDD, op'DDT, endrin). The pesticide residues detected in the examined cheese were below the maximum residues levels. The estimated daily intake [lifetime average daily dose (LADD)] referring to the sum of the compounds varied within 4.21 · 10(-7)-3.92 · 10(-6) mg · kg(-1) · day(-1) and was significantly lower than the tolerable daily intake/acceptable daily intake (TDI/ADI) for individual compounds. The health hazard quotient, being the exact measure of the magnitude of exposure potential or a quantifiable potential for developing non-carcinogenic health effects after an averaged exposure period, was also very low, ranging from 2.87 · 10(-6) to 5.32 · 10(-5). The obtained results confirmed that the intake of rennet cheese does not pose any consumer health risk in Poland.

  3. Quantitative microbial risk assessment combined with hydrodynamic modelling to estimate the public health risk associated with bathing after rainfall events.

    PubMed

    Eregno, Fasil Ejigu; Tryland, Ingun; Tjomsland, Torulv; Myrmel, Mette; Robertson, Lucy; Heistad, Arve

    2016-04-01

    This study investigated the public health risk from exposure to infectious microorganisms at Sandvika recreational beaches, Norway and dose-response relationships by combining hydrodynamic modelling with Quantitative Microbial Risk Assessment (QMRA). Meteorological and hydrological data were collected to produce a calibrated hydrodynamic model using Escherichia coli as an indicator of faecal contamination. Based on average concentrations of reference pathogens (norovirus, Campylobacter, Salmonella, Giardia and Cryptosporidium) relative to E. coli in Norwegian sewage from previous studies, the hydrodynamic model was used for simulating the concentrations of pathogens at the local beaches during and after a heavy rainfall event, using three different decay rates. The simulated concentrations were used as input for QMRA and the public health risk was estimated as probability of infection from a single exposure of bathers during the three consecutive days after the rainfall event. The level of risk on the first day after the rainfall event was acceptable for the bacterial and parasitic reference pathogens, but high for the viral reference pathogen at all beaches, and severe at Kalvøya-small and Kalvøya-big beaches, supporting the advice of avoiding swimming in the day(s) after heavy rainfall. The study demonstrates the potential of combining discharge-based hydrodynamic modelling with QMRA in the context of bathing water as a tool to evaluate public health risk and support beach management decisions. Copyright © 2016 Elsevier B.V. All rights reserved.

  4. Risk estimates for deterministic health effects of inhaled weapons grade plutonium.

    PubMed

    Scott, Bobby R; Peterson, Vern L

    2003-09-01

    Risk estimates for deterministic effects of inhaled weapons-grade plutonium (WG Pu) are needed to evaluate potential serious harm to (1) U.S. Department of Energy nuclear workers from accidental or other work-place releases of WG Pu; and (2) the public from terrorist actions resulting in the release of WG Pu to the environment. Deterministic health effects (the most serious radiobiological consequences to humans) can arise when large amounts of WG Pu are taken into the body. Inhalation is considered the most likely route of intake during work-place accidents or during a nuclear terrorism incident releasing WG Pu to the environment. Our current knowledge about radiation-related harm is insufficient for generating precise estimates of risk for a given WG Pu exposure scenario. This relates largely to uncertainties associated with currently available risk and dosimetry models. Thus, rather than generating point estimates of risk, distributions that account for variability/uncertainty are needed to properly characterize potential harm to humans from a given WG Pu exposure scenario. In this manuscript, we generate and summarize risk distributions for deterministic radiation effects in the lungs of nuclear workers from inhaled WG Pu particles (standard isotopic mix). These distributions were developed using NUREG/CR-4214 risk models and time-dependent, dose conversion factor data based on Publication 30 of the International Commission on Radiological Protection. Dose conversion factors based on ICRP Publication 30 are more relevant to deterministic effects than are the dose conversion factors based on ICRP Publication 66, which relate to targets for stochastic effects. Risk distributions that account for NUREG/CR-4214 parameter and model uncertainties were generated using the Monte Carlo method. Risks were evaluated for both lethality (from radiation pneumonitis) and morbidity (due to radiation-induced respiratory dysfunction) and were found to depend strongly on absorbed

  5. Health risk estimates for groundwater and soil contamination in the Slovak Republic: a convenient tool for identification and mapping of risk areas.

    PubMed

    Fajčíková, K; Cvečková, V; Stewart, A; Rapant, S

    2014-10-01

    We undertook a quantitative estimation of health risks to residents living in the Slovak Republic and exposed to contaminated groundwater (ingestion by adult population) and/or soils (ingestion by adult and child population). Potential risk areas were mapped to give a visual presentation at basic administrative units of the country (municipalities, districts, regions) for easy discussion with policy and decision-makers. The health risk estimates were calculated by US EPA methods, applying threshold values for chronic risk and non-threshold values for cancer risk. The potential health risk was evaluated for As, Ba, Cd, Cu, F, Hg, Mn, NO3 (-), Pb, Sb, Se and Zn for groundwater and As, B, Ba, Be, Cd, Cu, F, Hg, Mn, Mo, Ni, Pb, Sb, Se and Zn for soils. An increased health risk was identified mainly in historical mining areas highly contaminated by geogenic-anthropogenic sources (ore deposit occurrence, mining, metallurgy). Arsenic and antimony were the most significant elements in relation to health risks from groundwater and soil contamination in the Slovak Republic contributing a significant part of total chronic risk levels. Health risk estimation for soil contamination has highlighted the significance of exposure through soil ingestion in children. Increased cancer risks from groundwater and soil contamination by arsenic were noted in several municipalities and districts throughout the country in areas with significantly high arsenic levels in the environment. This approach to health risk estimations and visualization represents a fast, clear and convenient tool for delineation of risk areas at national and local levels.

  6. Waste management programmatic environmental impact statement methodology for estimating human health risks

    SciTech Connect

    Bergenback, B.; Blaylock, B.P.; Legg, J.L.

    1995-05-01

    The US Department of Energy (DOE) has produced large quantities of radioactive and hazardous waste during years of nuclear weapons production. As a result, a large number of sites across the DOE Complex have become chemically and/or radiologically contaminated. In 1990, the Secretary of Energy charged the DOE Office of Environmental Restoration and Waste management (EM) with the task of preparing a Programmatic Environmental Impact Statement (PEIS). The PEIS should identify and assess the potential environmental impacts of implementing several integrated Environmental Restoration (ER) and Waste Management (WM) alternatives. The determination and integration of appropriate remediation activities and sound waste management practices is vital for ensuring the diminution of adverse human health impacts during site cleanup and waste management programs. This report documents the PEIS risk assessment methodology used to evaluate human health risks posed by WM activities. The methodology presents a programmatic cradle to grave risk assessment for EM program activities. A unit dose approach is used to estimate risks posed by WM activities and is the subject of this document.

  7. The Preventable Risk Integrated ModEl and Its Use to Estimate the Health Impact of Public Health Policy Scenarios

    PubMed Central

    Scarborough, Peter; Harrington, Richard A.; Mizdrak, Anja; Zhou, Lijuan Marissa; Doherty, Aiden

    2014-01-01

    Noncommunicable disease (NCD) scenario models are an essential part of the public health toolkit, allowing for an estimate of the health impact of population-level interventions that are not amenable to assessment by standard epidemiological study designs (e.g., health-related food taxes and physical infrastructure projects) and extrapolating results from small samples to the whole population. The PRIME (Preventable Risk Integrated ModEl) is an openly available NCD scenario model that estimates the effect of population-level changes in diet, physical activity, and alcohol and tobacco consumption on NCD mortality. The structure and methods employed in the PRIME are described here in detail, including the development of open source code that will support a PRIME web application to be launched in 2015. This paper reviews scenario results from eleven papers that have used the PRIME, including estimates of the impact of achieving government recommendations for healthy diets, health-related food taxes and subsidies, and low-carbon diets. Future challenges for NCD scenario modelling, including the need for more comparisons between models and the improvement of future prediction of NCD rates, are also discussed. PMID:25328757

  8. Estimating the Influence of Oil and Gas Emissions on Urban Ozone and Associated Health Risks

    NASA Astrophysics Data System (ADS)

    Capps, S.; Nsanzineza, R.; Turner, M. D.; Henze, D. K.; Zhao, S.; Russell, M. G.; Hakami, A.; Milford, J. B.

    2015-12-01

    Tropospheric ozone (O3) degrades air quality, impacting human health and public welfare. The National Ambient Air Quality Standard (NAAQS) is designed to limit these impacts, but certain areas in the continental U.S. exceed this standard. Mitigating O3 NAAQS exceedances by designing emissions controls can be complicated in urban areas because of the long-range transport of ozone and its gaseous precursors as well as the complex mix of local emissions sources. Recent growth of unconventional oil and gas development near urban areas in Colorado, Texas, and the northeastern corridor has exacerbated this problem. To estimate the contribution of emissions from oil and gas development to urban O3 issues, we apply the CMAQ adjoint, which efficiently elucidates the relative influence of emissions sources on select concentration-based metrics. Specifically, the adjoint is used to calculate the spatially-specific relative contributions of emissions of oxides of nitrogen (NOx) and volatile organic compounds (VOCs) throughout the continental U.S. to O3 NAAQS exceedances and to ozone-related health risks in select urban areas. By evaluating these influences for different urban areas, including one in California that has been managing air quality with adjacent oil and gas development for a longer period of time, we are able to compare and contrast the emissions control strategies that may be more effective in particular regions. Additionally, the resulting relationships between emissions and concentrations provide a way to project ozone impacts when measurements provide refined estimates of emissions from this sector.

  9. Combining Radiation Epidemiology With Molecular Biology-Changing From Health Risk Estimates to Therapeutic Intervention.

    PubMed

    Abend, Michael; Port, Matthias

    2016-08-01

    The authors herein summarize six presentations dedicated to the key session "molecular radiation epidemiology" of the ConRad meeting 2015. These presentations were chosen in order to highlight the promise when combining conventional radiation epidemiology with molecular biology. Conventional radiation epidemiology uses dose estimates for risk predictions on health. However, combined with molecular biology, dose-dependent bioindicators of effect hold the promise to improve clinical diagnostics and to provide target molecules for potential therapeutic intervention. One out of the six presentations exemplified the use of radiation-induced molecular changes as biomarkers of exposure by measuring stabile chromosomal translocations. The remaining five presentations focused on molecular changes used as bioindicators of the effect. These bioindicators of the effect could be used for diagnostic purposes on colon cancers (genomic instability), thyroid cancer (CLIP2), or head and neck squamous cell cancers. Therapeutic implications of gene expression changes were examined in Chernobyl thyroid cancer victims and Mayak workers.

  10. Estimating high-risk castration resistant prostate cancer (CRPC) using electronic health records.

    PubMed

    Hernandez, Rohini K; Cetin, Karynsa; Pirolli, Melissa; Quigley, Jane; Quach, David; Smith, Paul; Stryker, Scott; Liede, Alexander

    2015-08-01

    Canadian guidelines define castration-resistant prostate cancer (CRPC) at high risk of developing metastases using PSA doubling time (PSADT) < 8 months, whereby men may be offered more frequent bone scans/imaging. We evaluated PSA data from nonmetastatic (M0) prostate cancer patients treated at urology and oncology clinics across the United States (US) to describe the proportion and characteristics of patients who met CRPC and high-risk criteria. We identified M0 prostate cancer patients aged = 18 years receiving androgen deprivation therapy (ADT) in 2011 from electronic health records (EHR), covering 129 urology and 64 oncology practices across the US. We estimated the proportion of prostate cancer patients with evidence of CRPC (consecutive rising PSAs) and subsets that may be at high risk (using several PSA and PSADT cut-points). Among 3121 M0 prostate cancer patients actively treated with ADT, 1188 (38%) had evidence of CRPC. Of these, 712 (60%) qualified as high risk in 2011 based on PSADT < 8 months (equivalent to = 8 months in these data). Men = 65 years were more likely to have evidence of CRPC than younger men, although younger men were more likely to have evidence of high-risk disease. CRPC was more common among men receiving ADT in the oncology setting than the urology setting (48% versus 37%). In this large EHR study with patient-level PSA data, 38% of men with M0 prostate cancer treated with ADT had CRPC. Approximately 60% of M0 CRPC patients may experience a PSADT of < 8 months. These findings require validation in a Canadian patient population.

  11. Use of health effect risk estimates and uncertainty in formal regulatory proceedings: a case study involving atmospheric particulates

    SciTech Connect

    Habegger, L.J.; Oezkaynak, A.H.

    1984-01-01

    Coal combustion particulates are released to the atmosphere by power plants supplying electrical to the nuclear fuel cycle. This paper presents estimates of the public health risks associated with the release of these particulates at a rate associated with the annual nuclear fuel production requirements for a nuclear power plan. Utilization of these risk assessments as a new component in the formal evaluation of total risks from nuclear power plants is discussed. 23 references, 3 tables.

  12. Exposures from indoor spraying of chlorpyrifos pose greater health risks to children than currently estimated.

    PubMed Central

    Davis, D L; Ahmed, A K

    1998-01-01

    Recent findings of indoor exposure studies of chlorpyrifos indicate that young children are at higher risks to the semivolatile pesticide than had been previously estimated [Gurunathan et al., Environ Health Perspect 106:9-16 (1998)]. The study showed that after a single broadcast use of the pesticide by certified applicators in apartment rooms, chlorpyrifos continued to accumulate on children's toys and hard surfaces 2 weeks after spraying. Based on the findings of this and other research studies, the estimated chlorpyrifos exposure levels from indoor spraying for children are approximately 21-119 times above the current recommended reference dose of 3 microg/kg/day from all sources. A joint agreement reached between the U.S. Environmental Protection Agency and the registrants of chlorpyrifos-based products will phase out a number of indoor uses of the pesticide, including broadcast spraying and direct uses on pets. While crack and crevice treatment of insects (such as cockroaches and termites) by chlorpyrifos will still continue, it appears prudent to explore other insect control options, including the use of baits, traps, and insect sterilants and growth regulators. To ensure global protection, adequate dissemination of appropriate safety and regulatory information to developing regions of the world is critical, where importation and local production of chlorpyrifos-based products for indoor uses may be significant. PMID:9618343

  13. Estimating the Tradeoff Between Risk Protection and Moral Hazard with a Nonlinear Budget Set Model of Health Insurance*

    PubMed Central

    Kowalski, Amanda E.

    2015-01-01

    Insurance induces a tradeoff between the welfare gains from risk protection and the welfare losses from moral hazard. Empirical work traditionally estimates each side of the tradeoff separately, potentially yielding mutually inconsistent results. I develop a nonlinear budget set model of health insurance that allows for both simultaneously. Nonlinearities in the budget set arise from deductibles, coinsurance rates, and stoplosses that alter moral hazard as well as risk protection. I illustrate the properties of my model by estimating it using data on employer sponsored health insurance from a large firm. PMID:26664035

  14. Impact of Pesticide Exposure Misclassification on Estimates of Related Risks in the Agricultural Health Study

    EPA Science Inventory

    Background: The Agricultural Health Study (AHS) is a prospective study of licensed pesticide applicators (largely fanners) and their spouses in Iowa and North Carolina. We evaluate the impact of occupational pesticide exposure misclassification on relative risks using data from t...

  15. Impact of Pesticide Exposure Misclassification on Estimates of Related Risks in the Agricultural Health Study

    EPA Science Inventory

    Background: The Agricultural Health Study (AHS) is a prospective study of licensed pesticide applicators (largely fanners) and their spouses in Iowa and North Carolina. We evaluate the impact of occupational pesticide exposure misclassification on relative risks using data from t...

  16. Estimated effect of ventilation and filtration on chronic health risks in U.S. offices, schools, and retail stores.

    PubMed

    Chan, W R; Parthasarathy, S; Fisk, W J; McKone, T E

    2016-04-01

    We assessed the chronic health risks from inhalation exposure to volatile organic compounds (VOCs) and particulate matter (PM2.5) in U.S. offices, schools, grocery, and other retail stores and evaluated how chronic health risks were affected by changes in ventilation rates and air filtration efficiency. Representative concentrations of VOCs and PM2.5 were obtained from available data. Using a mass balance model, changes in exposure to VOCs and PM2.5 were predicted if ventilation rate were to increase or decrease by a factor of two, and if higher efficiency air filters were used. Indoor concentrations were compared to health guidelines to estimate percentage exceedances. The estimated chronic health risks associated with VOC and PM2.5 exposures in these buildings were low relative to the risks from exposures in homes. Chronic health risks were driven primarily by exposures to PM2.5 that were evaluated using disease incidence of mortality, chronic bronchitis, and non-fatal stroke. The leading cancer risk factor was exposure to formaldehyde. Using disability-adjusted life years (DALYs) to account for both cancer and non-cancer effects, results suggest that increasing ventilation alone is ineffective at reducing chronic health burdens. Other strategies, such as pollutant source control and the use of particle filtration, should also be considered.

  17. [Medical insurance estimation of risks].

    PubMed

    Dunér, H

    1975-11-01

    The purpose of insurance medicine is to make a prognostic estimate of medical risk-factors in persons who apply for life, health, or accident insurance. Established risk-groups with a calculated average mortality and morbidity form the basis for premium rates and insurance terms. In most cases the applicant is accepted for insurance after a self-assessment of his health. Only around one per cent of the applications are refused, but there are cases in which the premium is raised, temporarily or permanently. It is often a matter of rough estimate, since the knowlege of the long-term prognosis for many diseases is incomplete. The insurance companies' rules for estimate of risk are revised at intervals of three or four years. The estimate of risk as regards life insurance has been gradually liberalised, while the medical conditions for health insurance have become stricter owing to an increase in the claims rate.

  18. Estimating the return on investment from a health risk management program offered to small Colorado-based employers.

    PubMed

    Goetzel, Ron Z; Tabrizi, Maryam; Henke, Rachel Mosher; Benevent, Richele; Brockbank, Claire V S; Stinson, Kaylan; Trotter, Margo; Newman, Lee S

    2014-05-01

    To determine whether changes in health risks for workers in small businesses can produce medical and productivity cost savings. A 1-year pre- and posttest study tracked changes in 10 modifiable health risks for 2458 workers at 121 Colorado businesses that participated in a comprehensive worksite health promotion program. Risk reductions were entered into a return-on-investment (ROI) simulation model. Reductions were recorded in 10 risk factors examined, including obesity (-2.0%), poor eating habits (-5.8%), poor physical activity (-6.5%), tobacco use (-1.3%), high alcohol consumption (-1.7%), high stress (-3.5%), depression (-2.3%), high blood pressure (-0.3%), high total cholesterol (-0.9%), and high blood glucose (-0.2%). The ROI model estimated medical and productivity savings of $2.03 for every $1.00 invested. Pooled data suggest that small businesses can realize a positive ROI from effective risk reduction programs.

  19. Measurement of natural radionuclides in Malaysian bottled mineral water and consequent health risk estimation

    SciTech Connect

    Priharti, W.; Samat, S. B.; Yasir, M. S.

    2015-09-25

    The radionuclides of {sup 226}Ra, {sup 232}Th and {sup 40}K were measured in ten mineral water samples, of which from the radioactivity obtained, the ingestion doses for infants, children and adults were calculated and the cancer risk for the adult was estimated. Results showed that the calculated ingestion doses for the three age categories are much lower than the average worldwide ingestion exposure of 0.29 mSv/y and the estimated cancer risk is much lower than the cancer risk of 8.40 × 10{sup −3} (estimated from the total natural radiation dose of 2.40 mSv/y). The present study concludes that the bottled mineral water produced in Malaysia is safe for daily human consumption.

  20. Measurement of natural radionuclides in Malaysian bottled mineral water and consequent health risk estimation

    NASA Astrophysics Data System (ADS)

    Priharti, W.; Samat, S. B.; Yasir, M. S.

    2015-09-01

    The radionuclides of 226Ra, 232Th and 40K were measured in ten mineral water samples, of which from the radioactivity obtained, the ingestion doses for infants, children and adults were calculated and the cancer risk for the adult was estimated. Results showed that the calculated ingestion doses for the three age categories are much lower than the average worldwide ingestion exposure of 0.29 mSv/y and the estimated cancer risk is much lower than the cancer risk of 8.40 × 10-3 (estimated from the total natural radiation dose of 2.40 mSv/y). The present study concludes that the bottled mineral water produced in Malaysia is safe for daily human consumption.

  1. A Comparison of National Estimates From the National Health Interview Survey and the Behavioral Risk Factor Surveillance System

    PubMed Central

    Nelson, David E.; Powell-Griner, Eve; Town, Machell; Kovar, Mary Grace

    2003-01-01

    Objectives. The purpose of this study was to compare national estimates from the National Health Interview Survey (NHIS) and the Behavioral Risk Factor Surveillance System (BRFSS). Methods. The authors compared data from the 2 surveys on smoking, height, weight, body mass index, diabetes, hypertension, immunization, lack of insurance coverage, cost as a barrier to medical care, and health status. Results. Overall national estimates were similar for 13 of the 14 measures examined. Small differences according to demographic characteristics were found for height and body mass index, with larger differences for health status. Conclusions. Although estimates differed within subgroups, the BRFSS provided national estimates comparable to those of the NHIS. BRFSS national data could provide rapidly available information to guide national policy and program decisions. PMID:12893624

  2. Estimation of the health risks associated with polychlorinated biphenyl (PCB) concentrations found onboard older U.S. Navy vessels.

    PubMed

    Still, K R; Arfsten, D P; Jederberg, W W; Kane, L V; Larcom, B J

    2003-10-01

    PCBs have been identified on surfaces and in component materials and equipment from inactive U.S. Navy nuclear submarines commissioned prior to 1970. Health risks associated with PCBs present onboard submarines were estimated for hypothetical crew members and shipyard workers. Median non-cancer hazard quotients for shipyard workers and submarine crew ranged between 0.4-54.6, with the highest quotients estimated for unprotected shipyard workers. Median cancer risk estimates ranged from 7.3 x 10(-6) to 1.1 x 10(-3) with the highest estimated risk calculated for unprotected shipyard workers. Our findings suggest that PCB surface concentrations found onboard inactive nuclear submarines commissioned prior to 1970 may be high enough to constitute a possible risk to the health of persons involved in dismantling of Navy submarines if PCB exposure is not minimized. Potential sources of uncertainty in our risk assessment include the correlation between PCB contamination levels on inactive versus active nuclear submarine vessels, the relationship between wipe sample concentrations and human exposure, dermal contact frequency with PCB-contaminated surfaces, carcinogenicity of PCBs in humans, and uncertainties inherent with the PCB cancer slope factor and oral RfD. Our findings support Navy policy that shipyard workers should wear personal protective equipment when PCB contamination is suspected or has been identified and that IH surveys should continue to identify sources of PCB contamination onboard vessels and reduce PCB contamination to concentrations that are reasonably achievable.

  3. The influence of spatial resolution on human health risk co-benefit estimates for global climate policy assessments.

    PubMed

    Shih, Hsiu-Ching; Crawford-Brown, Douglas; Ma, Hwong-wen

    2015-03-15

    Assessment of the ability of climate policies to produce desired improvements in public health through co-benefits of air pollution reduction can consume resources in both time and research funds. These resources increase significantly as the spatial resolution of models increases. In addition, the level of spatial detail available in macroeconomic models at the heart of climate policy assessments is much lower than that available in traditional human health risk modeling. It is therefore important to determine whether increasing spatial resolution considerably affects risk-based decisions; which kinds of decisions might be affected; and under what conditions they will be affected. Human health risk co-benefits from carbon emissions reductions that bring about concurrent reductions in Particulate Matter (PM10) emissions is therefore examined here at four levels of spatial resolution (Uniform Nation, Uniform Region, Uniform County/city, Health Risk Assessment) in a case study of Taiwan as one of the geographic regions of a global macroeceonomic model, with results that are representative of small, industrialized nations within that global model. A metric of human health risk mortality (YOLL, years of life lost in life expectancy) is compared under assessments ranging from a "uniform simulation" in which there is no spatial resolution of changes in ambient air concentration under a policy to a "highly spatially resolved simulation" (called here Health Risk Assessment). PM10 is chosen in this study as the indicator of air pollution for which risks are assessed due to its significance as a co-benefit of carbon emissions reductions within climate mitigation policy. For the policy examined, the four estimates of mortality in the entirety of Taiwan are 747 YOLL, 834 YOLL, 984 YOLL and 916 YOLL, under Uniform Taiwan, Uniform Region, Uniform County and Health Risk Assessment respectively; or differences of 18%, 9%, 7% if the HRA methodology is taken as the baseline. While

  4. Estimating Health Services Requirements

    NASA Technical Reports Server (NTRS)

    Alexander, H. M.

    1985-01-01

    In computer program NOROCA populations statistics from National Center for Health Statistics used with computational procedure to estimate health service utilization rates, physician demands (by specialty) and hospital bed demands (by type of service). Computational procedure applicable to health service area of any size and even used to estimate statewide demands for health services.

  5. Estimating Radiogenic Cancer Risks

    EPA Pesticide Factsheets

    This document presents a revised methodology for EPA's estimation of cancer risks due to low-LET radiation exposures developed in light of information that has become available, especially new information on the Japanese atomic bomb survivors.

  6. Estimation of human health risk associated with the consumption of pesticide-contaminated vegetables from Kumasi, Ghana.

    PubMed

    Akoto, Osei; Gavor, Sandra; Appah, Martin K; Apau, Joseph

    2015-05-01

    Analysis of pesticides consisting of 12 organophosphates (OPs), 10 organochlorines (OCs), and 6 pyrethroids in vegetables from Kumasi was conducted. Vegetable samples comprising 20 each of eggplants, okra, and tomatoes were analyzed. The method involves solvent extraction of pesticide residues followed by cleanup using silica gel. Residue analysis was carried out using a GC equipped with pulsed flame photometric detector for OP residues and electron capture detector for OC and pyrethroid residues. The results revealed that methamidophos exceeded the maximum residue limits (MRLs) in all vegetable commodities. Levels of malathion and dimethoate also exceeded the MRLs in eggplant and tomato samples. Endrin, α-endosulfan, γ-hexachlorocyclohexane (HCH), γ-chlordane, and heptachlor exceeded their MRLs in okra samples whereas methoxychlor, allethrin, and deltamethrin exceeded in eggplant samples. Health risk estimation revealed that dimethoate in tomato and endrin, heptachlor, γ-HCH, and γ-chlordane in okra could not pose potential toxicity to the consumer. The combined risk index showed no health risk to consumers due to intake of pyrethroid OC and OP residue on these vegetables. The overall risk index for combined pesticides due to consumption of all the vegetables was higher than 1, which signifies potential health risk to consumers. OPs were the major risk contributor for both eggplant and tomatoes which accounted for 87.78 and 95.84%, respectively, of the combined risk of pesticides in the vegetables. However, OC with 97.94% of the combined risk index was the major risk contributor for the okra. The carcinogenic risk of the OCs in okra was of no concern since their carcinogenic rates were below the acceptable risk level.

  7. Risk estimation to human health caused by the mercury content of Sushi and Sashimi sold in Japanese restaurants in Brazil.

    PubMed

    Alves, Jeanne Clécia; Lima de Paiva, Esther; Milani, Raquel Fernanda; Bearzoti, Eduardo; Morgano, Marcelo Antonio; Diego Quintaes, Késia

    2017-03-08

    Although fish is a healthy alternative for meat, it can be a vehicle for mercury (Hg), including in its most toxic organic form, methylmercury (MeHg). The objective of the present study was to estimate the risk to human health caused by the consumption of sushi and sashimi as commercialized by Japanese food restaurants in the city of Campinas (SP, Brazil). The total Hg content was determined by atomic absorption spectrometry with thermal decomposition and amalgamation, and the MeHg content calculated considering that 90% of the total Hg is in the organic form. The health risk was estimated from the values for the provisional tolerable weekly ingestion (PTWI) by both adults and children. The mean concentrations for total Hg were: 147.99, 6.13, and 3.42 µg kg(-1) in the tuna, kani, and salmon sushi samples, respectively, and 589.09, 85.09, and 11.38 µg kg(-1) in the tuna, octopus and salmon sashimi samples, respectively. The tuna samples showed the highest Hg concentrations. One portion of tuna sashimi exceeded the PTWI value for MeHg established for children and adults. The estimate of risk for human health indicated that the level of toxicity depended on the type of fish and size of the portion consumed.

  8. Estimation of bioaccessibility and potential human health risk of mercury in Chinese patent medicines.

    PubMed

    Liu, Lihong; Zhang, Yu; Yun, Zhaojun; He, Bin; Jiang, Guibin

    2016-01-01

    Mercury (Hg), mainly in cinnabar species, has been used in medicine for thousands of years in China, and worldwide concern has been raised on its toxicity. In this work, the amount of bioaccessible mercury in 16 Chinese patent medicines (CPMs) was measured by using an in vitro simulated digestion system, consisting of simulated gastric and intestinal fluid, to investigate the bioavailability of mercury in CPMs and evaluate its potential risk to human health. Total mercury and mercury in the gastrointestinal extracts were measured by inductively coupled plasma mass spectrometry (ICP-MS). The levels of total Hg in 16 CPMs ranged from not detected to 11.89 mg/g, with a mean value of 1.13 mg/g, while the extractable Hg ranged from not detected to 4.37 μg/g, with a mean value of 0.42 μg/g. Mercury bioaccessibility varied significantly in the investigated CPMs, depending on the ingredient. Compared to the CPMs without cinnabar (2.5%-30.9%), the percentage of mercury in the gastrointestinal supernatants for CPMs with cinnabar was quite a bit lower (0.037%). By comparing with the Food and Agricultural Organization/World Health Organization Joint Expert Committee on Food Additives (FAO/WHO) safety guideline, the average daily intake dose (ADD) of Hg in the medicines was then calculated to access the risk of mercury to human health from taking CPMs.

  9. Risk-based Estimate of Effect of Foodborne Diseases on Public Health, Greece

    PubMed Central

    Reij, Martine W.; Havelaar, Arie H.; Zwietering, Marcel H.; Gorris, Leon G.M.

    2011-01-01

    The public health effects of illness caused by foodborne pathogens in Greece during 1996–2006 was quantified by using publicly available surveillance data, hospital statistics, and literature. Results were expressed as the incidence of different disease outcomes and as disability-adjusted life years (DALY), a health indicator combining illness and death estimates into a single metric. It has been estimated that each year ≈370,000 illnesses/million inhabitants are likely caused because of eating contaminated food; 900 of these illnesses are severe and 3 fatal, corresponding to 896 DALY/million inhabitants. Ill-defined intestinal infections accounted for the greatest part of reported cases and 27% of the DALY. Brucellosis, echinococcosis, salmonellosis, and toxoplasmosis were found to be the most common known causes of foodborne illnesses, being responsible for 70% of the DALY. Overall, the DALY metric provided a quantitative perspective on the impact of foodborne illness that may be useful for prioritizing food safety management targets. PMID:21888782

  10. Estimating the Return on Investment From a Health Risk Management Program Offered to Small Colorado-Based Employers

    PubMed Central

    Goetzel, Ron Z.; Tabrizi, Maryam; Henke, Rachel Mosher; Benevent, Richele; Brockbank, Claire v. S.; Stinson, Kaylan; Trotter, Margo; Newman, Lee S.

    2015-01-01

    Objective To determine whether changes in health risks for workers in small businesses can produce medical and productivity cost savings. Methods A 1-year pre- and posttest study tracked changes in 10 modifiable health risks for 2458 workers at 121 Colorado businesses that participated in a comprehensive worksite health promotion program. Risk reductions were entered into a return-on-investment (ROI) simulation model. Results Reductions were recorded in 10 risk factors examined, including obesity (−2.0%), poor eating habits (−5.8%), poor physical activity (−6.5%), tobacco use (−1.3%), high alcohol consumption (−1.7%), high stress (−3.5%), depression (−2.3%), high blood pressure (−0.3%), high total cholesterol (−0.9%), and high blood glucose (−0.2%). The ROI model estimated medical and productivity savings of $2.03 for every $1.00 invested. Conclusions Pooled data suggest that small businesses can realize a positive ROI from effective risk reduction programs. PMID:24806569

  11. Estimating NOA Health Risks from Selected Construction Activities at the Calaveras Dam Replacement Project (CDRP)

    NASA Astrophysics Data System (ADS)

    Hernandez, D. W.

    2012-12-01

    The CDRP is a major construction project involving up to 400 workers using heavy earth moving equipment, blasting, drilling, rock crushing, and other techniques designed to move 7 million yards of earth. Much of this material is composed of serpentinite, blueschist, and other rocks that contain chrysotile, crocidolite, actinolite, tremolite, and Libby-class amphiboles. To date, over 1,000 personal, work area, and emission inventory related samples have been collected and analyzed by NIOSH 7400, NIOSH 7402, and CARB-AHERA methodology. Data indicate that various CDRP construction activities have the potential to generate significant mineral fibers and structures that could represent elevated on site and off site health risks. This presentation will review the Contractors air monitoring program for this major project, followed by a discussion of predictive methods to evaluate potential onsite and offsite risks. Ultimately, the data are used for planning control strategies designed to achieve a Project Action Level of 0.01 f/cc (one tenth the Cal/OSHA PEL) and risk-based offsite target levels.

  12. Risk estimates of mortality attributed to low concentrations of ambient fine particulate matter in the Canadian community health survey cohort.

    PubMed

    Pinault, Lauren; Tjepkema, Michael; Crouse, Daniel L; Weichenthal, Scott; van Donkelaar, Aaron; Martin, Randall V; Brauer, Michael; Chen, Hong; Burnett, Richard T

    2016-02-11

    Understanding the shape of the relationship between long-term exposure to ambient fine particulate matter (PM2.5) concentrations and health risks is critical for health impact and risk assessment. Studies evaluating the health risks of exposure to low concentrations of PM2.5 are limited. Further, many existing studies lack individual-level information on potentially important behavioural confounding factors. A prospective cohort study was conducted among a subset of participants in a cohort that linked respondents of the Canadian Community Health Survey to mortality (n = 299,500) with satellite-derived ambient PM2.5 estimates. Participants enrolled between 2000 and 2008 were followed to date of death or December 31, 2011. Cox proportional hazards models were used to estimate hazard ratios (HRs) for mortality attributed to PM2.5 exposure, adjusted for individual-level and contextual covariates, including smoking behaviour and body mass index (BMI). Approximately 26,300 non-accidental deaths, of which 32.5 % were due to circulatory disease and 9.1 % were due to respiratory disease, occurred during the follow-up period. Ambient PM2.5 exposures were relatively low (mean = 6.3 μg/m(3)), yet each 10 μg/m(3) increase in exposure was associated with increased risks of non-accidental (HR = 1.26; 95 % CI: 1.19-1.34), circulatory disease (HR = 1.19; 95 % CI: 1.07-1.31), and respiratory disease mortality (HR = 1.52; 95 % CI: 1.26-1.84) in fully adjusted models. Higher hazard ratios were observed for respiratory mortality among respondents who never smoked (HR = 1.97; 95 % CI: 1.24-3.13 vs. HR = 1.45; 95 % CI: 1.17-1.79 for ever smokers), and among obese (BMI ≥ 30) respondents (HR = 1.76; 95 % CI: 1.15-2.69 vs. HR = 1.41; 95 % CI: 1.04-1.91 for normal weight respondents), though differences between groups were not statistically significant. A threshold analysis for non-accidental mortality estimated a threshold concentration of 0

  13. Injury Risk Estimation Expertise

    PubMed Central

    Petushek, Erich J.; Ward, Paul; Cokely, Edward T.; Myer, Gregory D.

    2015-01-01

    Background: Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are currently no substantial data on group skill differences in observational screening of ACL injury risk. Purpose/Hypothesis: The purpose of this study was to compare various groups’ abilities to visually assess ACL injury risk as well as the associated strategies and ACL knowledge levels. The hypothesis was that sports medicine professionals would perform better than coaches and exercise science academics/students and that these subgroups would all perform better than parents and other general population members. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 428 individuals, including physicians, physical therapists, athletic trainers, strength and conditioning coaches, exercise science researchers/students, athletes, parents, and members of the general public participated in the study. Participants completed the ACL Injury Risk Estimation Quiz (ACL-IQ) and answered questions related to assessment strategy and ACL knowledge. Results: Strength and conditioning coaches, athletic trainers, physical therapists, and exercise science students exhibited consistently superior ACL injury risk estimation ability (+2 SD) as compared with sport coaches, parents of athletes, and members of the general public. The performance of a substantial number of individuals in the exercise sciences/sports medicines (approximately 40%) was similar to or exceeded clinical instrument-based biomechanical assessment methods (eg, ACL nomogram). Parents, sport coaches, and the general public had lower ACL-IQ, likely due to their lower ACL knowledge and to rating the importance of knee/thigh motion lower and weight and jump height higher. Conclusion: Substantial cross-professional/group differences in visual ACL

  14. Thirty-Day Postoperative Mortality Risk Estimates and 1-Year Survival in Veterans Health Administration Surgery Patients.

    PubMed

    Smith, Tracy; Li, Xinli; Nylander, William; Gunnar, William

    2016-05-01

    For more than 2 decades, the Veterans Health Administration (VHA) has relied on risk-adjusted, postoperative, 30-day mortality data as a measure of surgical quality of care. Recently, the use of 30-day mortality data has been criticized based on a theory that health care professionals manage patient care to meet the metric and that other outcome metrics are available. To determine whether postoperative mortality data identify a delay in care to meet a 30-day mortality metric and to evaluate whether 30-day mortality risk score groups stratify survival patterns up to 365 days after surgery in surgical procedures assessed by the Veterans Affairs Surgical Quality Improvement Program (VASQIP). Patients undergoing VASQIP-assessed surgical procedures within the VHA from October 1, 2011, to September 30, 2013, were evaluated. Data on 365-day survival follow-up of 212 733 surgical cases using VHA Vital Status and admission records were obtained with 10 947 mortality events. Data analysis was conducted from September 3, 2014, to November 9, 2015. Survival up to 365 days after surgery for the overall cohort divided into 10 equal groups (deciles). There were 10 947 mortality events identified in a cohort of 212 733 surgical patients. The mean probability of death was 1.03% (95% CI, 1.01%-1.04%). Risk estimate groups in the 212 733 surgical cases analyzed showed significantly different postoperative survival, with consistency beyond the time frame for which they were developed. The lowest risk decile had the highest 365-day survival probability (99.74%; 95% CI, 99.66%-99.80%); the highest risk decile had the lowest 365-day survival probability (72.04%; 95% CI, 71.43%-72.64%). The 9 lowest risk deciles had linear survival curves from 0 to 365 postoperative days, with the highest risk decile having early survival risk and becoming more linear after the first 180 days. Survival curves between 25 and 35 days were consistent for all risk deciles and showed no evidence that

  15. Estimation of the cardiovascular risk using World Health Organization/International Society of Hypertension (WHO/ISH) risk prediction charts in a rural population of South India

    PubMed Central

    Ghorpade, Arun Gangadhar; Shrivastava, Saurabh RamBihariLal; Kar, Sitanshu Sekhar; Sarkar, Sonali; Majgi, Sumanth Mallikarjuna; Roy, Gautam

    2015-01-01

    Background: World Health Organization/International Society of Hypertension (WHO/ISH) charts have been employed to predict the risk of cardiovascular outcome in heterogeneous settings. The aim of this research is to assess the prevalence of Cardiovascular Disease (CVD) risk factors and to estimate the cardiovascular risk among adults aged >40 years, utilizing the risk charts alone, and by the addition of other parameters. Methods: A cross-sectional study was performed in two of the villages availing health services of a medical college. Overall 570 subjects completed the assessment. The desired information was obtained using a pre-tested questionnaire and participants were also subjected to anthropometric measurements and laboratory investigations. The WHO/ISH risk prediction charts for the South-East Asian region was used to assess the cardiovascular risk among the study participants. Results: The study covered 570 adults aged above 40 years. The mean age of the subjects was 54.2 (±11.1) years and 53.3% subjects were women. Seventeen percent of the participants had moderate to high risk for the occurrence of cardiovascular events by using WHO/ISH risk prediction charts. In addition, CVD risk factors like smoking, alcohol, low High-Density Lipoprotein (HDL) cholesterol were found in 32%, 53%, 56.3%, and 61.5% study participants, respectively. Conclusion: Categorizing people as low (<10%)/moderate (10%-20%)/high (>20%) risk is one of the crucial steps to mitigate the magnitude of cardiovascular fatal/non-fatal outcome. This cross-sectional study indicates that there is a high burden of CVD risk in the rural Pondicherry as assessed by WHO/ISH risk prediction charts. Use of WHO/ISH charts is easy and inexpensive screening tool in predicting the cardiovascular event PMID:26340393

  16. Study on the flood simulation techniques for estimation of health risk in Dhaka city, Bangladesh

    NASA Astrophysics Data System (ADS)

    Hashimoto, M.; Suetsugi, T.; Sunada, K.; ICRE

    2011-12-01

    Although some studies have been carried out on the spread of infectious disease with the flooding, the relation between flooding and the infectious expansion has not been clarified yet. The improvement of the calculation precision of inundation and its relation with the infectious disease, surveyed epidemiologically, are therefore investigated in a case study in Dhaka city, Bangladesh. The inundation was computed using a flood simulation model that is numerical 2D-model. The "sensitivity to inundation" of hydraulic factors such as drainage channel, dike, and the building occupied ratio was examined because of the lack of digital data set related to flood simulation. Each element in the flood simulation model was incorporated progressively and results were compared with the calculation result as inspection materials by the inundation classification from the existing study (Mollah et al., 2007). The results show that the influences by ''dyke'' and "drainage channel" factors are remarkable to water level near each facility. The inundation level and duration have influence on wide areas when "building occupied ratio" is also considered. The correlation between maximum inundation depth and health risk (DALY, Mortality, Morbidity) was found, but the validation of the inundation model for this case has not been performed yet. The flood simulation model needs to be validated by observed inundation depth. The drainage facilities such as sewer network or the pumping system will be also considered in the further research to improve the precision of the inundation model.

  17. Estimation of canine intestinal parasites in Córdoba (Spain) and their risk to public health.

    PubMed

    Martínez-Moreno, F J; Hernández, S; López-Cobos, E; Becerra, C; Acosta, I; Martínez-Moreno, A

    2007-01-19

    The prevalence of gastrointestinal parasites in dogs was studied in the province of Córdoba (southern Spain), with special attention to those parasites that can be transmitted to man. The experiment was completed with the examination of soil samples from public parks and city gardens. The study was carried out over a population of 1800 animals entered in the Control Animal Centre (CECA) by coprological methods, and within this group, 300 dogs were sacrificed and necropsied. The prevalence of any intestinal parasitic infection was 71.33%. The following parasites of the gastrointestinal tract were recorded: Isospora canis (22%), Isospora (Cystoisospora) spp. (10.22%), Sarcocystis (2.5%), Hammondia/Neospora (1.94%), Giardia canis (1%), Dipylidium caninum (13.2%), Taenia hydatigena (7.66%), Taenia pisiformis (4%), Uncinaria stenocephala (33.27%), Toxascaris leonina (14.94%), Toxocara canis (17.72%) and Trichuris vulpis (1.66%). Related to public health, it is important to point out the presence of T. canis only in puppies younger than one year and Uncinaria, more frequent in adult dogs. Soil samples of parks revealed the presence of eggs of Toxocara, and it suggests the existence of real risk for human infection.

  18. Using physiologically based pharmacokinetic models to estimate the health risk of mixtures of trihalomethanes from reclaimed water.

    PubMed

    Niu, Zhiguang; Zang, Xue; Zhang, Ying

    2015-03-21

    To estimate the health risk of mixture of trihalomethanes (THMs) from reclaimed water during toilet flushing, the interaction-based Hazard Index (HI(interaction-based)) and the mixture carcinogenic risk (CRM) according to tissue dose were conducted through the integrated use of both the exposure concentrations model and the physiologically based pharmacokinetic (PBPK) model of THMs. Monte Carlo simulations were employed to implement the probabilistic risk analysis and sensitivity analysis. Nine samples were analyzed, which were collected from J Water Reclamation Plant (JWRP) in Tianjin of China. The results indicated that the mean HI(interaction-based) (=0.85) was lower than the acceptable risk level (=1). The probability that the HI(interaction-based) exceeded the acceptable risk level is 22.97%. For carcinogenic risk, the CRM ranges from 9.41×10(-7) to 3.54×10(-5), with a mean of 5.49×10(-6). Moreover, the probability of exceeding the acceptable risk level (1×10(-6)) is near 100%. And the values of HI(interaction-based) from sample no. 1, 5, and 7 exceeded 1, while the values of CRM for all samples exceeded 1×10(-6). Consequently, the reclaimed water used for flushing toilets should be paid more attention, though non-carcinogenic effect is relatively small. Furthermore, the concentrations of DBCM had greater impact on both the carcinogenic and non-carcinogenic risk based on sensitivity analysis. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Radon estimation in water resources of Mandi - Dharamshala region of Himachal Pradesh, India for health risk assessments

    NASA Astrophysics Data System (ADS)

    Kumar, Gulshan; Kumari, Punam; Kumar, Mukesh; Kumar, Arvind; Prasher, Sangeeta; Dhar, Sunil

    2017-07-01

    The present study deals with the radon estimation in 40 water samples collected from different natural resources and radium content in the soils of Mandi-Dharamshala Region. Radon concentration is determined by using RAD-7 detector and radium contents of the soil in vicinity of water resources is as well measured by using LR-115 type - II detector, which is further correlated with radon concentration in water samples. The potential health risks related with 222Rn have also been estimated. The results show that the radon concentrations within the range of 1.51 to 22.7Bq/l with an average value of 5.93 Bq/l for all type of water samples taken from study area. The radon concentration in water samples is found lower than 100Bq/l, the exposure limit of radon in water recommended by the World Health Organization. The calculated average effective dose of radon received by the people of study area is 0.022 mSv/y with maximum of 0.083 mSv/y and minimum 0.0056 mSv/y. The total effective dose in all sites of the studied area is found to be within the safe limit (0.1 mSv/year) recommended by World Health Organization. The average value of radium content in the soil of study area is 6.326 Bq/kg.

  20. Lifetime risk of stroke and impact of hypertension: estimates from the adult health study in Hiroshima and Nagasaki.

    PubMed

    Takahashi, Ikuno; Geyer, Susan M; Nishi, Nobuo; Ohshita, Tomohiko; Takahashi, Tetsuya; Akahoshi, Masazumi; Fujiwara, Saeko; Kodama, Kazunori; Matsumoto, Masayasu

    2011-05-01

    Very few reports have been published on lifetime risk (LTR) of stroke by blood pressure (BP) group. This study included participants in the Radiation Effects Research Foundation Adult Health Study who have been followed up by biennial health examinations since 1958. We calculated the LTR of stroke for various BP-based groups among 7847 subjects who had not been diagnosed with stroke before the index age of 55 years using cumulative incidence analysis adjusting for competing risks. By 2003, 868 subjects had suffered stroke (512 (58.9%) were women and 542 (62.4%) experienced ischemic stroke). BP was a significant factor in determining risk of stroke for men and women, with distributions of cumulative risk for stroke significantly different across BP groups. The LTR of all-stroke for normotension (systolic BP/diastolic BP < 120/80 mm Hg), prehypertension (120-139/80-89 mm Hg), stage 1 hypertension (140-159/90-99 mm Hg) and stage 2 hypertension (> 160/100 mm Hg) were 13.8-16.9-25.8-25.8% in men and 16.0-19.9-24.0-30.5% in women, respectively (P < 0.001 among BP groups in both sexes). The estimates did not differ significantly (P = 0.16) between normotensive and prehypertensive subjects. One in five Japanese atomic bomb survivor subjects experienced stroke over their lifetime from the age of 55 years. Long-term stroke risks were elevated in those with hypertension (> 140/90 mm Hg) at any of the index ages of 45, 55, 65 and 75 years.

  1. Biased Exposure-Health Effect Estimates from Selection in Cohort Studies: Are Environmental Studies at Particular Risk?

    PubMed

    Weisskopf, Marc G; Sparrow, David; Hu, Howard; Power, Melinda C

    2015-11-01

    The process of creating a cohort or cohort substudy may induce misleading exposure-health effect associations through collider stratification bias (i.e., selection bias) or bias due to conditioning on an intermediate. Studies of environmental risk factors may be at particular risk. We aimed to demonstrate how such biases of the exposure-health effect association arise and how one may mitigate them. We used directed acyclic graphs and the example of bone lead and mortality (all-cause, cardiovascular, and ischemic heart disease) among 835 white men in the Normative Aging Study (NAS) to illustrate potential bias related to recruitment into the NAS and the bone lead substudy. We then applied methods (adjustment, restriction, and inverse probability of attrition weighting) to mitigate these biases in analyses using Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Analyses adjusted for age at bone lead measurement, smoking, and education among all men found HRs (95% CI) for the highest versus lowest tertile of patella lead of 1.34 (0.90, 2.00), 1.46 (0.86, 2.48), and 2.01 (0.86, 4.68) for all-cause, cardiovascular, and ischemic heart disease mortality, respectively. After applying methods to mitigate the biases, the HR (95% CI) among the 637 men analyzed were 1.86 (1.12, 3.09), 2.47 (1.23, 4.96), and 5.20 (1.61, 16.8), respectively. Careful attention to the underlying structure of the observed data is critical to identifying potential biases and methods to mitigate them. Understanding factors that influence initial study participation and study loss to follow-up is critical. Recruitment of population-based samples and enrolling participants at a younger age, before the potential onset of exposure-related health effects, can help reduce these potential pitfalls. Weisskopf MG, Sparrow D, Hu H, Power MC. 2015. Biased exposure-health effect estimates from selection in cohort studies: are environmental studies at

  2. Biased Exposure–Health Effect Estimates from Selection in Cohort Studies: Are Environmental Studies at Particular Risk?

    PubMed Central

    Sparrow, David; Hu, Howard; Power, Melinda C.

    2015-01-01

    Background The process of creating a cohort or cohort substudy may induce misleading exposure–health effect associations through collider stratification bias (i.e., selection bias) or bias due to conditioning on an intermediate. Studies of environmental risk factors may be at particular risk. Objectives We aimed to demonstrate how such biases of the exposure–health effect association arise and how one may mitigate them. Methods We used directed acyclic graphs and the example of bone lead and mortality (all-cause, cardiovascular, and ischemic heart disease) among 835 white men in the Normative Aging Study (NAS) to illustrate potential bias related to recruitment into the NAS and the bone lead substudy. We then applied methods (adjustment, restriction, and inverse probability of attrition weighting) to mitigate these biases in analyses using Cox proportional hazards models to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Results Analyses adjusted for age at bone lead measurement, smoking, and education among all men found HRs (95% CI) for the highest versus lowest tertile of patella lead of 1.34 (0.90, 2.00), 1.46 (0.86, 2.48), and 2.01 (0.86, 4.68) for all-cause, cardiovascular, and ischemic heart disease mortality, respectively. After applying methods to mitigate the biases, the HR (95% CI) among the 637 men analyzed were 1.86 (1.12, 3.09), 2.47 (1.23, 4.96), and 5.20 (1.61, 16.8), respectively. Conclusions Careful attention to the underlying structure of the observed data is critical to identifying potential biases and methods to mitigate them. Understanding factors that influence initial study participation and study loss to follow-up is critical. Recruitment of population-based samples and enrolling participants at a younger age, before the potential onset of exposure-related health effects, can help reduce these potential pitfalls. Citation Weisskopf MG, Sparrow D, Hu H, Power MC. 2015. Biased exposure–health effect estimates

  3. Health Risk Management for Bioenvironmental Engineering

    DTIC Science & Technology

    2013-06-01

    Health Risk Management ( HRM ). HRM is a decision-making process to evaluate and...4.1 Health Risk Management Interface HRM and RM decisions are based on operations and scenarios; therefore, an HRA may provide a COA that interferes... health risk estimate HRM health risk management OEH occupational and environmental health PH Public Health PPE personal protective

  4. Quantitative microbial risk assessment to estimate health risks attributable to water supply: can the technique be applied in developing countries with limited data?

    PubMed

    Howard, Guy; Pedley, Steve; Tibatemwa, Sarah

    2006-03-01

    In the 3rd edition of its Guidelines for Drinking-Water Quality (2004) (GDWQ) the World Health Organization (WHO) promotes the use of risk assessment coupled with risk management for the control of water safety in drinking water supplies. Quantitative microbial risk assessment (QMRA) provides a tool for estimating the disease-burden from pathogenic microorganisms in water using information about the distribution and occurrence of the pathogen or an appropriate surrogate. This information may then be used to inform decisions about appropriate management of the water supply system. Although QMRA has been used to estimate disease burden from water supplies in developed countries, the method has not been evaluated in developing countries where relevant data may be scarce. In this paper, we describe a simplified risk assessment procedure to calculate the disease burden from three reference pathogens--pathogenic Escherichia coli, Cryptosporidium parvum and rotavirus--in water supplies in Kampala, Uganda. The study shows how QMRA can be used in countries with limited data, and that the outcome can provide valuable information for the management of water supplies.

  5. Estimating the Impact of Adherence to and Persistence with Atypical Antipsychotic Therapy on Health Care Costs and Risk of Hospitalization.

    PubMed

    Jiang, Yawen; Ni, Weiyi

    2015-09-01

    To estimate the impact of adherence to and persistence with atypical antipsychotics on health care costs and risk of hospitalization by controlling potential sources of endogeneity. Retrospective cohort study using medical and pharmacy claims data. Humana health care insurance database. A total of 32,374 patients with a diagnosis of schizophrenia or bipolar disorder and who had a prescription for noninjectable atypical antipsychotics (aripiprazole, asenapine, clozapine, iloperidone, lurasidone, olanzapine, paliperidone, quetiapine, risperidone, or ziprasidone), after a washout period of at least 180 days during which there was no use of any atypical antipsychotics, between January 2007 and June 2013. The effects of adherence (proportion of days covered by all atypical antipsychotic prescription fills) to and persistence (time from initiation to discontinuation of therapy) with atypical antipsychotics on outcomes (all-cause total health care costs, medication costs, medical services costs, and inpatient admissions) were examined. To exclude potential bias due to mutual causality between drug use patterns and health care utilization, the effects of adherence and persistence measured in the first year on outcomes measured in the second year were investigated. Instrumental variable regressions using reimbursement rate and mail order as instrumental variables were conducted to correct potential endogeneity due to omitted variable bias. Being adherent decreased total costs by $19,497 (p<0.05), increased medication costs by $8194 (p<0.001), decreased medical services costs by $27,664 (p<0.001), and reduced hospitalization risk by 27% (p<0.001). Being persistent decreased individual total costs by $23,927 (p<0.05), increased medication costs by $10,278 (p<0.001), and decreased medical services costs by $34,178 (p<0.001). We could not identify a significant association between persistence and the risk of hospitalization. Good adherence to and persistence with atypical

  6. Estimating exposure and dose to characterize health risks: the role of human tissue monitoring in exposure assessment.

    PubMed Central

    Sexton, K; Callahan, M A; Bryan, E F

    1995-01-01

    Exposure assessment is an integral part of health risk characterization. Exposure assessments typically address three critical aspects of exposure: the number of people exposed to the environmental toxicant, at specific concentrations, for the time period of interest; the resulting dose; and the relative contribution of important sources and pathways to exposure/dose. Because historically both "point-of-contact" measurements and information about dose and related pharmacokinetic processes have been lacking, exposure assessments have had to rely on construction of "scenarios" to estimate exposure and dose. This could change, however, as advances in development of biologic markers of exposure and dose make it possible to measure and interpret toxicant concentrations in accessible human tissues. The increasing availability of "biomarkers," coupled with improvements in pharmacokinetic understanding, present opportunities to estimate ("reconstruct") exposure from measurements of dose and knowledge of intake and uptake parameters. Human tissue monitoring, however, is not a substitute for more traditional methods of measuring exposure, but rather a complementary approach. A combination of exposure measurements and dose measurements provides the most credible scientific basis for exposure assessment. PMID:7635107

  7. Benefits transfer of willingness to pay estimates and functions for health-risk reductions: a cross-country study.

    PubMed

    Brouwer, Roy; Bateman, Ian J

    2005-05-01

    This paper provides a first application of the techniques of benefits transfer to the health economics literature. These techniques seek to transfer the value of some good from one 'survey' context to a new 'policy' context so avoiding the need for new valuation surveys each time a new policy question arises. Two approaches to benefits transfer are assessed: the simple transfer of mean values and the transferral of value functions. We develop a new methodology for the latter approach in which value functions are iteratively built up from theoretical principles with transfer errors being tested each time a new variable is added. Through a novel application of advanced statistical tests we show that this approach outperforms the transferral of statistically driven Best-fit functions. The case study presented focuses upon the transfer of contingent valuation (CV) willingness to pay (WTP) estimates and associated value functions for reducing the health risks associated with solar ultraviolet (UV) exposure. Common format studies are conducted in four countries with transfers between all of these being undertaken. By calculating errors in predicted versus actual values across countries we show that, when transferring between similar contexts, simple mean-value transfers outperform more complex value function transfers (with the magnitude of the former errors being encouragingly small). However, this result is reversed when transfers are undertaken across dissimilar contexts where value functions partially adjust for these differences. In summary these findings provide support and guidance for future applications.

  8. Role of assessment components and recent adverse outcomes in risk estimation and prediction: Use of the Short Term Assessment of Risk and Treatability (START) in an adult secure inpatient mental health service.

    PubMed

    O'Shea, Laura E; Dickens, Geoffrey L

    2016-06-30

    The Short Term Assessment of Risk and Treatability is a structured judgement tool used to inform risk estimation for multiple adverse outcomes. In research, risk estimates outperform the tool's strength and vulnerability scales for violence prediction. Little is known about what its'component parts contribute to the assignment of risk estimates and how those estimates fare in prediction of non-violent adverse outcomes compared with the structured components. START assessment and outcomes data from a secure mental health service (N=84) was collected. Binomial and multinomial regression analyses determined the contribution of selected elements of the START structured domain and recent adverse risk events to risk estimates and outcomes prediction for violence, self-harm/suicidality, victimisation, and self-neglect. START vulnerabilities and lifetime history of violence, predicted the violence risk estimate; self-harm and victimisation estimates were predicted only by corresponding recent adverse events. Recent adverse events uniquely predicted all corresponding outcomes, with the exception of self-neglect which was predicted by the strength scale. Only for victimisation did the risk estimate outperform prediction based on the START components and recent adverse events. In the absence of recent corresponding risk behaviour, restrictions imposed on the basis of START-informed risk estimates could be unwarranted and may be unethical.

  9. Health risks of obesity

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000348.htm Health risks of obesity To use the sharing features on ... also have an increased risk of these conditions. Risk Factors Having a risk factor does not mean ...

  10. InterCardioRisk: a novel online tool for estimating doses of ionising radiation to occupationally-exposed medical staff and their associated health risks.

    PubMed

    Moriña, David; Grellier, James; Carnicer, Adela; Pernot, Eileen; Ryckx, Nick; Cardis, Elisabeth

    2016-09-01

    Those working in interventional cardiology and related medical procedures are potentially subject to considerable exposure to x-rays. Two types of tissue of particular concern that may receive considerable doses during such procedures are the lens of the eye and the brain. Ocular radiation exposure results in lens changes that, with time, may progress to partial or total lens opacification (cataracts). In the early stages, such opacities do not result in visual disability; the severity of such changes tends to increase progressively with dose and time until vision is impaired and cataract surgery is required. Scattered radiation doses to the eye lens of an interventional cardiologist in typical working conditions can exceed 34 μGy min(-1) in high-dose fluoroscopy modes and 3 μGy per image during image acquisition (instantaneous rate values) when radiation protection tools are not used. A causal relation between exposure to ionising radiation and increased risk of brain and central nervous system tumours has been shown in a number of studies. Although absorbed doses to the brain in interventional cardiology procedures are lower than those to the eye lens by a factor between 3.40 and 8.08 according to our simulations, doses to both tissues are among the highest occupational radiation doses documented for medical staff whose work involves exposures to x-rays. We present InterCardioRisk, a tool featuring an easy-to-use web interface that provides a general estimation of both cumulated absorbed doses experienced by medical staff exposed in the interventional cardiology setting and their estimated associated health risks. The tool is available at http://intercardiorisk.creal.cat.

  11. Estimates of radiogenic cancer risks.

    PubMed

    Puskin, J S; Nelson, C B

    1995-07-01

    A methodology recently developed by the U.S. EPA for estimating the carcinogenic risks from ionizing radiation is described. For most cancer sites, the risk model is one in which age-specific, relative risk coefficients are obtained by taking a geometric mean of the coefficients derived from the atomic bomb survivor data using two different methods for transporting risks from the Japanese to the U.S. population. The risk models are applied to estimate organ-specific risks per unit dose for a stationary population with mortality rates governed by 1980 U.S. vital statistics. With the exception of breast cancer, low-LET radiogenic cancer risk estimates are reduced by a factor of 2 at low doses and dose rates compared to acute high dose exposure conditions. For low dose (or dose rate) conditions, the risk of inducing a premature cancer death from uniform, whole body, low-LET irradiation is calculated to be 5.1 x 10(-2) Gy-1. Neglecting nonfatal skin cancers, the corresponding incidence risk is 7.6 x 10(-2) Gy-1. High-LET (alpha particle) risks are presumed to increase linearly with dose and to be independent of dose rate. High-LET risks are estimated to be 20 times the low-LET risks estimated under low dose rate conditions, except for leukemia and breast cancer where RBEs of 1 and 10 are adopted, respectively.

  12. Estimating Terrorism Risk

    DTIC Science & Technology

    2005-01-01

    preparedness by addressing unique planning, equipment, training, and exercise needs of large urban areas (DHS, 2004). Al- though there appears to be agreement ...reasonable minimum standards for community preparedness. Until these questions are answered, allocating home- land security resources based on risk is the...and threats are correlated with population density. There are practical benefits for using simple risk indicators such as those based upon population

  13. Estimates of associated outdoor particulate matter health risk and costs reductions from alternative building, ventilation and filtration scenarios.

    PubMed

    Sultan, Zuraimi M

    2007-05-01

    Although many studies have reported calculations of outdoor particulate matter (PM) associated externalities using ambient data, there is little information on the role buildings, their ventilation and filtration play. This study provides the framework to evaluate the health risk and cost reduction of building, ventilation and filtration strategies from outdoor PM pollution on a nationwide level and applied it to a case study in Singapore. Combining Indoor Air Quality (IAQ) and time weighted exposure models, with established concentration-response functions and monetary valuation methods, mortality and morbidity effects of outdoor PM on the population of Singapore under different building, ventilation and filtration strategies were estimated. Different interventions were made to compare the effects from the current building conditions. The findings demonstrate that building protection effect reduced approximately half the attributable health cases amounting to US$17.7 billion due to PM pollution when compared to levels computed using outdoor data alone. For residential buildings, nationwide adoption of natural ventilation from current state is associated with 28% higher cases of mortality and 13 to 38% higher cases for different morbidities, amounting to US$6.7 billion. The incurred cost is negligible compared to energy costs of air-conditioning. However, nationwide adoption of closed residence and air-conditioning are associated with outcomes including fewer mortality (10 and 6% respectively), fewer morbidities (8 and 4% respectively) and economic savings of US$1.5 and 0.9 billion respectively. The related savings were about a factor of 9 the energy cost for air-conditioning. Nationwide adoption of mechanical ventilation and filtration from current natural ventilation in schools is associated with fewer asthma hospital admissions and exacerbations; although the economic impact is not substantial. Enhanced workplace filtration reduces the mortality and morbidity

  14. Counting children at risk: exploring a method to estimate the number of children exposed to parental mental illness using adult health survey data.

    PubMed

    Bassani, Diego Garcia; Padoin, Cintia Vontobel; Veldhuizen, Scott

    2008-11-01

    Children exposed to parental psychiatric disorders have an increased risk of several psychiatric disorders, impaired development, behavioural problems, injuries, physical illness and mortality. Even though this high-risk group has been shown to benefit from health promotion and preventive interventions, estimates of the size of the population at risk are not available. Estimating the number of exposed children using adult survey data will likely generate valuable information for health policy, planning, and advocacy. In this paper, the authors present a method to indirectly estimate the size of this population using secondary data. A Canadian adult health survey and the Census were combined to estimate the prevalence of exposure of children less than 12 years to parental and non-parental psychiatric disorders. A method to combine census and survey data is presented and tested under varying degrees of data availability. Results are compared to the actual number of children exposed to parental psychiatric disorders and discussed. The most accurate estimates were obtained when the most complete survey was combined with relatively detailed census information. Incomplete survey simulations produced substantial underestimates of the prevalence of exposure even when combined with detailed census information.

  15. Estimating the budget impact of new technologies added to the National List of Health Services in Israel: stakeholders' incentives for adopting a financial risk-sharing mechanism.

    PubMed

    Hammerman, Ariel; Greenberg, Dan

    2009-01-01

    The Israeli National List of Health Services (NLHS) is updated annually according to a government allocated budget. The estimated annual cost of each new technology added to this list is based on budget-impact estimations provided by the HMOs and the manufacturers. The HMOs argue that once a new technology is reimbursed, extensive marketing efforts by industry expands demand and renders the allocated budget insufficient. Industry claims that HMOs, in order to secure a sufficient budget, tend to over-estimate the number of target patients. We provide a framework for a financial risk-sharing mechanism between HMOs and the industry, which may be able to balance these incentives and result in more accurate early budget-impact estimates. To explore the current stakeholders' incentives and behaviors under the existing process of updating the NLHS, and to examine the possible incentives for adopting a financial risk-sharing mechanism on early budget-impact estimations. According to the financial risk-sharing mechanism, HMOs will be partially compensated by the industry if actual use of a technology is substantially higher than what was projected. HMOs will partially refund the government for a budget that was not fully used. To maintain profits, we assume that the industry will present a more realistic budget-impact analysis. HMOs will be less apprehensive of technology promotion, as they would be compensated in case of budget under-estimation. In case of over-estimation of technology use, the budget re-allocated will be used to enlarge the NLHS which is in the best interest of the health technology industry. Our proposed risk-sharing mechanism is expected to counter balance incentives and disincentives that currently exist in adopting new health technologies in the Israeli healthcare system.

  16. Risk Estimation Modeling and Feasibility Testing for a Mobile eHealth Intervention for Binge Drinking Among Young People: The D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults) Project.

    PubMed

    Carrà, Giuseppe; Crocamo, Cristina; Schivalocchi, Alessandro; Bartoli, Francesco; Carretta, Daniele; Brambilla, Giulia; Clerici, Massimo

    2015-01-01

    Binge drinking is common among young people but often relevant risk factors are not recognized. eHealth apps, attractive for young people, may be useful to enhance awareness of this problem. We aimed at developing a current risk estimation model for binge drinking, incorporated into an eHealth app--D-ARIANNA (Digital-Alcohol RIsk Alertness Notifying Network for Adolescents and young adults)--for young people. A longitudinal approach with phase 1 (risk estimation), phase 2 (design), and phase 3 (feasibility) was followed. Risk/protective factors identified from the literature were used to develop a current risk estimation model for binge drinking. Relevant odds ratios were subsequently pooled through meta-analytic techniques with a random-effects model, deriving weighted estimates to be introduced in a final model. A set of questions, matching identified risk factors, were nested in a questionnaire and assessed for wording, content, and acceptability in focus groups involving 110 adolescents and young adults. Ten risk factors (5 modifiable) and 2 protective factors showed significant associations with binge drinking and were included in the model. Their weighted coefficients ranged between -0.71 (school proficiency) and 1.90 (cannabis use). The model, nested in an eHealth app questionnaire, provides in percent an overall current risk score, accompanied by appropriate images. Factors that mostly contribute are shown in summary messages. Minor changes have been realized after focus groups review. Most of the subjects (74%) regarded the eHealth app as helpful to assess binge drinking risk. We could produce an evidence-based eHealth app for young people, evaluating current risk for binge drinking. Its effectiveness will be tested in a large trial.

  17. 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.

  18. Estimating the effect of lay knowledge and prior contact with pulmonary TB patients, on health-belief model in a high-risk pulmonary TB transmission population.

    PubMed

    Zein, Rizqy Amelia; Suhariadi, Fendy; Hendriani, Wiwin

    2017-01-01

    The research aimed to investigate the effect of lay knowledge of pulmonary tuberculosis (TB) and prior contact with pulmonary TB patients on a health-belief model (HBM) as well as to identify the social determinants that affect lay knowledge. Survey research design was conducted, where participants were required to fill in a questionnaire, which measured HBM and lay knowledge of pulmonary TB. Research participants were 500 residents of Semampir, Asemrowo, Bubutan, Pabean Cantian, and Simokerto districts, where the risk of pulmonary TB transmission is higher than other districts in Surabaya. Being a female, older in age, and having prior contact with pulmonary TB patients significantly increase the likelihood of having a higher level of lay knowledge. Lay knowledge is a substantial determinant to estimate belief in the effectiveness of health behavior and personal health threat. Prior contact with pulmonary TB patients is able to explain the belief in the effectiveness of a health behavior, yet fails to estimate participants' belief in the personal health threat. Health authorities should prioritize males and young people as their main target groups in a pulmonary TB awareness campaign. The campaign should be able to reconstruct people's misconception about pulmonary TB, thereby bringing around the health-risk perception so that it is not solely focused on improving lay knowledge.

  19. Estimating the effectiveness of health-risk communications with propensity-score matching: application to arsenic groundwater contamination in four US locations.

    PubMed

    Leidner, Andrew J

    2014-01-01

    This paper provides a demonstration of propensity-score matching estimation methods to evaluate the effectiveness of health-risk communication efforts. This study develops a two-stage regression model to investigate household and respondent characteristics as they contribute to aversion behavior to reduce exposure to arsenic-contaminated groundwater. The aversion activity under study is a household-level point-of-use filtration device. Since the acquisition of arsenic contamination information and the engagement in an aversion activity may be codetermined, a two-stage propensity-score model is developed. In the first stage, the propensity for households to acquire arsenic contamination information is estimated. Then, the propensity scores are used to weight observations in a probit regression on the decision to avert the arsenic-related health risk. Of four potential sources of information, utility, media, friend, or others, information received from a friend appears to be the source of information most associated with aversion behavior. Other statistically significant covariates in the household's decision to avert contamination include reported household income, the presence of children in household, and region-level indicator variables. These findings are primarily illustrative and demonstrate the usefulness of propensity-score methods to estimate health-risk communication effectiveness. They may also be suggestive of areas for future research.

  20. Estimating the Effectiveness of Health-Risk Communications with Propensity-Score Matching: Application to Arsenic Groundwater Contamination in Four US Locations

    PubMed Central

    Leidner, Andrew J.

    2014-01-01

    This paper provides a demonstration of propensity-score matching estimation methods to evaluate the effectiveness of health-risk communication efforts. This study develops a two-stage regression model to investigate household and respondent characteristics as they contribute to aversion behavior to reduce exposure to arsenic-contaminated groundwater. The aversion activity under study is a household-level point-of-use filtration device. Since the acquisition of arsenic contamination information and the engagement in an aversion activity may be codetermined, a two-stage propensity-score model is developed. In the first stage, the propensity for households to acquire arsenic contamination information is estimated. Then, the propensity scores are used to weight observations in a probit regression on the decision to avert the arsenic-related health risk. Of four potential sources of information, utility, media, friend, or others, information received from a friend appears to be the source of information most associated with aversion behavior. Other statistically significant covariates in the household's decision to avert contamination include reported household income, the presence of children in household, and region-level indicator variables. These findings are primarily illustrative and demonstrate the usefulness of propensity-score methods to estimate health-risk communication effectiveness. They may also be suggestive of areas for future research. PMID:25349622

  1. Estimating risks of perinatal death.

    PubMed

    Smith, Gordon C S

    2005-01-01

    The relative and absolute risks of perinatal death that are estimated from observational studies are used frequently in counseling about obstetric intervention. The statistical basis for these estimates therefore is crucial, but many studies are seriously flawed. In this review, a number of aspects of the approach to the estimation of the risk of perinatal death are addressed. Key factors in the analysis include (1) the definition of the cause of the death, (2) differentiation between antepartum and intrapartum events, (3) the use of the appropriate denominator for the given cause of death, (4) the assessment of the cumulative risk where appropriate, (5) the use of appropriate statistical tests, (6) the stratification of analysis of delivery-related deaths by gestational age, and (7) the specific features of multiple pregnancy, which include the correct determination of the timing of antepartum stillbirth and the use of paired statistical tests when outcomes are compared in relation to the birth order of twin pairs.

  2. Estimating the accumulation of chemicals in an estuarine food web: A case study for evaluation of future ecological and human health risks

    SciTech Connect

    Iannuzzi, T.J.; Finley, B.L.

    1995-12-31

    A model was constructed and calibrated for estimating the accumulation of sediment associated nonionic organic chemicals, including selected PCBs and PCDD/Fs, in a simplified food web of the tidal Passaic River, New Jersey. The model was used to estimate concentrations of several chemicals in infaunal invertebrates, forage fish, blue crab, and adult finfish in the River as part of a screening-level risk assessment that was conducted during the preliminary phase of a CERCLA Remedial Investigation/Feasibility Study (RI/FS). Subsequent tissue-residue data were collected to evaluate the performance of the model, and to calibrate the model for multiple chemicals of concern in the River. A follow-up program of data collection was designed to support a more detailed risk assessment. The objectives of calibrating the model are to supplement the extant tissue-residue data that is available for risk assessment, and to evaluate future scenarios of bioaccumulation (and potential ecological and human health risk) under various future conditions in the River. Results to-date suggest that the model performs well for the simplified food web that exists in the Passaic River. A case study was constructed to demonstrate the application of the model for future predictions of ecological risk. These preliminary results suggest that the model is sufficiently sensitive and accurate for estimating variations of bioaccumulation under varying degrees of source control or other future conditions.

  3. Risk estimation using probability machines

    PubMed Central

    2014-01-01

    Background Logistic regression has been the de facto, and often the only, model used in the description and analysis of relationships between a binary outcome and observed features. It is widely used to obtain the conditional probabilities of the outcome given predictors, as well as predictor effect size estimates using conditional odds ratios. Results We show how statistical learning machines for binary outcomes, provably consistent for the nonparametric regression problem, can be used to provide both consistent conditional probability estimation and conditional effect size estimates. Effect size estimates from learning machines leverage our understanding of counterfactual arguments central to the interpretation of such estimates. We show that, if the data generating model is logistic, we can recover accurate probability predictions and effect size estimates with nearly the same efficiency as a correct logistic model, both for main effects and interactions. We also propose a method using learning machines to scan for possible interaction effects quickly and efficiently. Simulations using random forest probability machines are presented. Conclusions The models we propose make no assumptions about the data structure, and capture the patterns in the data by just specifying the predictors involved and not any particular model structure. So they do not run the same risks of model mis-specification and the resultant estimation biases as a logistic model. This methodology, which we call a “risk machine”, will share properties from the statistical machine that it is derived from. PMID:24581306

  4. Estimating the association between metabolic risk factors and marijuana use in U.S. adults using data from the continuous National Health and Nutrition Examination Survey.

    PubMed

    Thompson, Christin Ann; Hay, Joel W

    2015-07-01

    More research is needed on the health effects of marijuana use. Results of previous studies indicate that marijuana could alleviate certain factors of metabolic syndrome, such as obesity. Data on 6281 persons from National Health and Nutrition Examination Survey from 2005 to 2012 were used to estimate the effect of marijuana use on cardiometabolic risk factors. The reliability of ordinary least squares (OLS) regression models was tested by replacing marijuana use as the risk factor of interest with alcohol and carbohydrate consumption. Instrumental variable methods were used to account for the potential endogeneity of marijuana use. OLS models show lower fasting insulin, insulin resistance, body mass index, and waist circumference in users compared with nonusers. However, when alcohol and carbohydrate intake substitute for marijuana use in OLS models, similar metabolic benefits are estimated. The Durbin-Wu-Hausman tests provide evidence of endogeneity of marijuana use in OLS models, but instrumental variables models do not yield significant estimates for marijuana use. These findings challenge the robustness of OLS estimates of a positive relationship between marijuana use and fasting insulin, insulin resistance, body mass index, and waist circumference. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Assessment of impact of urbanisation on background radiation exposure and human health risk estimation in Kuala Lumpur, Malaysia.

    PubMed

    Sanusi, M S M; Ramli, A T; Hassan, W M S W; Lee, M H; Izham, A; Said, M N; Wagiran, H; Heryanshah, A

    2017-07-01

    Kuala Lumpur has been undergoing rapid urbanisation process, mainly in infrastructure development. The opening of new township and residential in former tin mining areas, particularly in the heavy mineral- or tin-bearing alluvial soil in Kuala Lumpur, is a contentious subject in land-use regulation. Construction practices, i.e. reclamation and dredging in these areas are potential to enhance the radioactivity levels of soil and subsequently, increase the existing background gamma radiation levels. This situation is worsened with the utilisation of tin tailings as construction materials apart from unavoidable soil pollutions due to naturally occurring radioactive materials in construction materials, e.g. granitic aggregate, cement and red clay brick. This study was conducted to assess the urbanisation impacts on background gamma radiation in Kuala Lumpur. The study found that the mean value of measured dose rate was 251±6nGyh(-1) (156-392nGyh(-1)) and 4 times higher than the world average value. High radioactivity levels of (238)U (95±12Bqkg(-1)), (232)Th (191±23Bqkg(-1),) and (40)K (727±130Bqkg(-1)) in soil were identified as the major source of high radiation exposure. Based on statistical ANOVA, t-test, and analyses of cumulative probability distribution, this study has statistically verified the dose enhancements in the background radiation. The effective dose was estimated to be 0.31±0.01mSvy(-1) per man. The recommended ICRP reference level (1-20mSvy(-1)) is applicable to the involved existing exposure situation in this study. The estimated effective dose in this study is lower than the ICRP reference level and too low to cause deterministic radiation effects. Nevertheless based on estimations of lifetime radiation exposure risks, this study found that there was small probability for individual in Kuala Lumpur being diagnosed with cancer and dying of cancer. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

    conservative and nonconservative assumptions on the probability results. We discuss the methods necessary to assess mission risks once exploration mission scenarios are characterized. Preliminary efforts have produced results that are commensurate with earlier qualitative estimates of risk probabilities in this and other operational contexts, indicating that our approach may be usefully applied in support of the development of human health and performance standards for long-duration space exploration missions. This approach will also enable mission-specific probabilistic risk assessments for space exploration missions.

  7. Exploration Health Risks: Probabilistic Risk Assessment

    NASA Technical Reports Server (NTRS)

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

    2006-01-01

    conservative and nonconservative assumptions on the probability results. We discuss the methods necessary to assess mission risks once exploration mission scenarios are characterized. Preliminary efforts have produced results that are commensurate with earlier qualitative estimates of risk probabilities in this and other operational contexts, indicating that our approach may be usefully applied in support of the development of human health and performance standards for long-duration space exploration missions. This approach will also enable mission-specific probabilistic risk assessments for space exploration missions.

  8. Risk Estimation Methodology for Launch Accidents.

    SciTech Connect

    Clayton, Daniel James; Lipinski, Ronald J.; Bechtel, Ryan D.

    2014-02-01

    As compact and light weight power sources with reliable, long lives, Radioisotope Power Systems (RPSs) have made space missions to explore the solar system possible. Due to the hazardous material that can be released during a launch accident, the potential health risk of an accident must be quantified, so that appropriate launch approval decisions can be made. One part of the risk estimation involves modeling the response of the RPS to potential accident environments. Due to the complexity of modeling the full RPS response deterministically on dynamic variables, the evaluation is performed in a stochastic manner with a Monte Carlo simulation. The potential consequences can be determined by modeling the transport of the hazardous material in the environment and in human biological pathways. The consequence analysis results are summed and weighted by appropriate likelihood values to give a collection of probabilistic results for the estimation of the potential health risk. This information is used to guide RPS designs, spacecraft designs, mission architecture, or launch procedures to potentially reduce the risk, as well as to inform decision makers of the potential health risks resulting from the use of RPSs for space missions.

  9. 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…

  10. 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…

  11. 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.

  12. Measurement and estimated health risks of volatile organic compounds and polychlorinated biphenyls in air at the Hanford Site

    SciTech Connect

    Patton, G.W.; Cooper, A.T.; Blanton, M.L.

    1994-10-01

    A variety of radioactive and nonradioactive chemicals have been released in effluent streams and discharged to waste disposal facilities during the nuclear materials production period at the Hanford Site. Extensive environmental surveillance for radioactive materials has occurred at Hanford; however, only limited information is available on the types and concentrations of organic pollutants potentially present. This report describes work performed to provide the Hanford Site Surface Environmental Surveillance Project with representative air concentration data for volatile organic compounds and polychlorinated biphenyls (PCBs). US Environmental Protection Agency (USEPA) volatile organic compound sampling methods evaluated for Hanford Site use were carbon-based adsorbent traps (TO-2) and Summa air canisters (TO-14). Polychlorinated biphenyls were sampled using USEPA method (TO-4), which uses glass fiber filters and polyurethane foam adsorbent beds to collect the PCBs. This report also presents results for environmental surveillance samples collected for volatile organic compound and PCB analyses from 1990 to 1993. All measured air concentrations of volatile organic compounds and PCBs were well below applicable maximum allowable concentration standards for air contaminants. Because of the lack of ambient air concentration standards, a conservative estimate is provided of the potential human health impacts from exposure to the ambient air concentrations measured on the Hanford Site.

  13. Quantitative cancer risk estimation for formaldehyde

    SciTech Connect

    Starr, T.B. )

    1990-03-01

    Of primary concern are irreversible effects, such as cancer induction, that formaldehyde exposure could have on human health. Dose-response data from human exposure situations would provide the most solid foundation for risk assessment, avoiding problematic extrapolations from the health effects seen in nonhuman species. However, epidemiologic studies of human formaldehyde exposure have provided little definitive information regarding dose-response. Reliance must consequently be placed on laboratory animal evidence. An impressive array of data points to significantly nonlinear relationships between rodent tumor incidence and administered dose, and between target tissue dose and administered dose (the latter for both rodents and Rhesus monkeys) following exposure to formaldehyde by inhalation. Disproportionately less formaldehyde binds covalently to the DNA of nasal respiratory epithelium at low than at high airborne concentrations. Use of this internal measure of delivered dose in analyses of rodent bioassay nasal tumor response yields multistage model estimates of low-dose risk, both point and upper bound, that are lower than equivalent estimates based upon airborne formaldehyde concentration. In addition, risk estimates obtained for Rhesus monkeys appear at least 10-fold lower than corresponding estimates for identically exposed Fischer-344 rats. 70 references.

  14. 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.

  15. Characterising the individual health risk in infants exposed to organochlorine pesticides via breast milk by applying appropriate margins of safety derived from estimated daily intakes.

    PubMed

    Hernik, A; Góralczyk, K; Struciński, P; Czaja, K; Korcz, W; Minorczyk, M; Lyczewska, M; Ludwicki, J K

    2014-01-01

    Milk secretion being an important way of elimination of organochlorine pesticides (OCPs) poses a concern due to potential risk for breastfed infants. This study aims to provide a tool for assessing such risks to infants exposed to OCPs (through accumulation in the mother's body), using calculated individual margins of safety (MoS). Selected OCPs included; p,p'-DDT, p,p'-DDD, p,p'-DDE, β-HCH, γ-HCH and HCB which were analysed in 28 samples of maternal milk. The highest intakes were recorded for p,p'-DDE (at 2.90 μg kg(-1)bw d(-1)) whilst the lowest was for γ-HCH, (at 0.019 μg kg(-1)bwd(-1)). For the risk characterisation purposes MoSs were calculated for the compounds for which toxicological reference values (e.g. ADI, TDI) were adopted. The MoS for average ∑DDT concentrations was found to be relatively low (2.82) somewhat similar to that for HCB at 7.08, and for γ-HCH, the MoS was substantially higher at 263.1. This, however does not take into account the extremely high individual concentrations. Thus, it was decided to calculate estimated daily intake (EDI) values based on OCP levels in individual milk samples. MoS levels of <1 (meaning unacceptable risk) were noted both for HCB in one sample as well as for ∑DDT in 3 samples indicating likely threats to infant's health. The lowest MoS noted for γ-HCH equalled to 60.6, indicating that this compound was not a threat to the health of any of the breastfed infants from the study group.

  16. Estimated inventory of radionuclides in Former Soviet Union Naval Reactors dumped in the Kara Sea and their associated health risk

    SciTech Connect

    Mount, M.E.; Layton, D.W.; Schwertz, N.L.; Anspaugh, L.R.; Robison, W.L.

    1993-05-01

    Radionuclide inventories have bin estimated for the reactor cores, reactor components, and primary system corrosion products in the former Soviet Union naval reactors dumped at the Abrosimov Inlet, Tsivolka Inlet, Stepovoy Inlet, Techeniye Inlet, and Novaya Zemlya Depression sites in the Kara Sea between 1965 and 1988. For the time of disposal, the inventories are estimated at 17 to 66 kCi of actinides plus daughters and 1695 to 4782 kCi of fission products in the reactor cores, 917 to 1127 kCi of activation products in the reactor components, and 1.4 to 1.6 kCi of activation products in the primary system corrosion products. At the present time, the inventories are estimated to have decreased to 6 to 24 kCi of actinides plus daughters and 492 to 540 kCi of fission products in the reactor cores, 124 to 126 kCi of activation products in the reactor components, and 0.16 to 0.17 kCi of activation products in the primary system corrosion products. All actinide activities are estimated to be within a factor of two.

  17. Improving Infant Exposure and Health Risk Estimates: Using Serum Data to Predict Polybrominated Diphenyl Ether Concentrations in Breast Milk

    EPA Science Inventory

    Women in the United States have breast milk concentrations of polybrominated diphenyl ethers (PBDEs) that are among the highest in the world, leading to concerns over the potential health implications to breastfeeding infants during critical stages of growth and development. Deve...

  18. Improving Infant Exposure and Health Risk Estimates: Using Serum Data to Predict Polybrominated Diphenyl Ether Concentrations in Breast Milk

    EPA Science Inventory

    Women in the United States have breast milk concentrations of polybrominated diphenyl ethers (PBDEs) that are among the highest in the world, leading to concerns over the potential health implications to breastfeeding infants during critical stages of growth and development. Deve...

  19. Estimated Dietary Intake of Radionuclides and Health Risks for the Citizens of Fukushima City, Tokyo, and Osaka after the 2011 Nuclear Accident

    PubMed Central

    Murakami, Michio; Oki, Taikan

    2014-01-01

    The radionuclides released from the Fukushima Daiichi nuclear power plant in 2011 pose a health risk. In this study, we estimated the 1st-year average doses resulting from the intake of iodine 131 (131I) and cesium 134 and 137 (134Cs and 137Cs) in drinking water and food ingested by citizens of Fukushima City (∼50 km from the nuclear power plant; outside the evacuation zone), Tokyo (∼230 km), and Osaka (∼580 km) after the accident. For citizens in Fukushima City, we considered two scenarios: Case 1, citizens consumed vegetables bought from markets; Case 2, citizens consumed vegetables grown locally (conservative scenario). The estimated effective doses of 134Cs and 137Cs agreed well with those estimated through market basket and food-duplicate surveys. The average thyroid equivalent doses due to ingestion of 131I for adults were 840 µSv (Case 1) and 2700 µSv (Case 2) in Fukushima City, 370 µSv in Tokyo, and 16 µSv in Osaka. The average effective doses due to 134Cs and 137Cs were 19, 120, 6.1, and 1.9 µSv, respectively. The doses estimated in this study were much lower than values reported by the World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation, whose assessments lacked validation and full consideration of regional trade in foods, highlighting the importance of including regional trade. The 95th percentile effective doses were 2–3 times the average values. Lifetime attributable risks (LARs) of thyroid cancers due to ingestion were 2.3–39×10−6 (Case 1) and 10–98×10−6 (Case 2) in Fukushima City, 0.95–14×10−6 in Tokyo, and 0.11–1.3×10−6 in Osaka. The contributions of LARs of thyroid cancers due to ingestion were 7.5%–12% of all exposure (Case 1) and 12%–30% (Case 2) in Fukushima City. PMID:25390339

  20. Estimated dietary intake of radionuclides and health risks for the citizens of Fukushima City, Tokyo, and Osaka after the 2011 nuclear accident.

    PubMed

    Murakami, Michio; Oki, Taikan

    2014-01-01

    The radionuclides released from the Fukushima Daiichi nuclear power plant in 2011 pose a health risk. In this study, we estimated the 1st-year average doses resulting from the intake of iodine 131 (131I) and cesium 134 and 137 (134Cs and 137Cs) in drinking water and food ingested by citizens of Fukushima City (∼50 km from the nuclear power plant; outside the evacuation zone), Tokyo (∼230 km), and Osaka (∼580 km) after the accident. For citizens in Fukushima City, we considered two scenarios: Case 1, citizens consumed vegetables bought from markets; Case 2, citizens consumed vegetables grown locally (conservative scenario). The estimated effective doses of 134Cs and 137Cs agreed well with those estimated through market basket and food-duplicate surveys. The average thyroid equivalent doses due to ingestion of 131I for adults were 840 µSv (Case 1) and 2700 µSv (Case 2) in Fukushima City, 370 µSv in Tokyo, and 16 µSv in Osaka. The average effective doses due to 134Cs and 137Cs were 19, 120, 6.1, and 1.9 µSv, respectively. The doses estimated in this study were much lower than values reported by the World Health Organization and the United Nations Scientific Committee on the Effects of Atomic Radiation, whose assessments lacked validation and full consideration of regional trade in foods, highlighting the importance of including regional trade. The 95th percentile effective doses were 2-3 times the average values. Lifetime attributable risks (LARs) of thyroid cancers due to ingestion were 1.7-37×10-6 (Case 1) and5.6-79×10-6 (Case 2) in Fukushima City, 0.73-13×10-6 in Tokyo, and 0.04-0.49×10- 6 in Osaka. The contributions of LARs of thyroid cancers due to ingestion were 5.4%-11% of all exposure (Case 1) and 11%-25% (Case 2) in Fukushima City [corrected].

  1. Overeating: the health risks.

    PubMed

    Prentice, A M

    2001-11-01

    Overeating is a relative term. It refers to the consumption of an energy intake that is inappropriately large for a given energy expenditure, thus, leading to obesity. There are several key environmental and cultural factors that have converged in the past few decades to markedly increase the risk of both active and passive (inadvertent) overeating. Chief among these are the increased availability and promotion of cheap energy-dense diets (usually high in fat) and the transition toward extremely sedentary lifestyles. The importance of considering these factors together must be stressed. Data ranging from highly controlled metabolic studies to large-scale epidemiological and ecological analysis illustrate the strong interactions between diet and physical activity in relationship to the over-consumption of energy. Overeating of certain specific dietary components may also lead to health risks. Obvious examples are saturated and trans-fatty acids. More recently attention has switched to high glycemic foods and to n-6 fatty acids. Theories that excess consumption of these may be independent risk factors for obesity and ill health remain controversial but merit closer examination and additional research. The main barriers to changing widely prevalent overeating include the following: public and corporate ignorance about the effects of energy-dense diets in inducing passive over-consumption, commercial willfulness concerning energy density and portion sizes, and public ignorance about the profound health effects of inactive lifestyles. These represent key targets for the design of public health initiatives.

  2. Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

    Cancer.gov

    These model-based estimates use two surveys, the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS). The two surveys are combined using novel statistical methodology.

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

    PubMed

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

    2015-08-14

    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.

  4. 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

  5. Auditory risk estimates for youth target shooting

    PubMed Central

    Meinke, Deanna K.; Murphy, William J.; Finan, Donald S.; Lankford, James E.; Flamme, Gregory A.; Stewart, Michael; Soendergaard, Jacob; Jerome, Trevor W.

    2015-01-01

    Objective To characterize the impulse noise exposure and auditory risk for youth recreational firearm users engaged in outdoor target shooting events. The youth shooting positions are typically standing or sitting at a table, which places the firearm closer to the ground or reflective surface when compared to adult shooters. Design Acoustic characteristics were examined and the auditory risk estimates were evaluated using contemporary damage-risk criteria for unprotected adult listeners and the 120-dB peak limit suggested by the World Health Organization (1999) for children. Study sample Impulses were generated by 26 firearm/ammunition configurations representing rifles, shotguns, and pistols used by youth. Measurements were obtained relative to a youth shooter’s left ear. Results All firearms generated peak levels that exceeded the 120 dB peak limit suggested by the WHO for children. In general, shooting from the seated position over a tabletop increases the peak levels, LAeq8 and reduces the unprotected maximum permissible exposures (MPEs) for both rifles and pistols. Pistols pose the greatest auditory risk when fired over a tabletop. Conclusion Youth should utilize smaller caliber weapons, preferably from the standing position, and always wear hearing protection whenever engaging in shooting activities to reduce the risk for auditory damage. PMID:24564688

  6. 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

  7. Ozone Health Risk Assessment for Selected Urban Areas

    EPA Pesticide Factsheets

    The health risk assessment described in this report estimated various health effects associated with O3 exposures as well as the reduced risks for one O3 season associated with just meeting the current O3 NAAQS.

  8. A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

    PubMed

    Dionisio, Kathie L; Chang, Howard H; Baxter, Lisa K

    2016-11-25

    Exposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of air pollution and health. ZIP-code level estimates of exposure for six pollutants (CO, NOx, EC, PM2.5, SO4, O3) from 1999 to 2002 in the Atlanta metropolitan area were used to calculate spatial, population (i.e. ambient versus personal), and total exposure measurement error. Empirically determined covariance of pollutant concentration pairs and the associated measurement errors were used to simulate true exposure (exposure without error) from observed exposure. Daily emergency department visits for respiratory diseases were simulated using a Poisson time-series model with a main pollutant RR = 1.05 per interquartile range, and a null association for the copollutant (RR = 1). Monte Carlo experiments were used to evaluate the impacts of correlated exposure errors of different copollutant pairs. Substantial attenuation of RRs due to exposure error was evident in nearly all copollutant pairs studied, ranging from 10 to 40% attenuation for spatial error, 3-85% for population error, and 31-85% for total error. When CO, NOx or EC is the main pollutant, we demonstrated the possibility of false positives, specifically identifying significant, positive associations for copollutants based on the estimated type I error rate. The impact of exposure error must be considered when interpreting results of copollutant epidemiologic models, due to the possibility of attenuation of main pollutant RRs and the increased probability of false positives when measurement error is present.

  9. Estimation of exposure to dietary acrylamide based on mercapturic acids level in urine of Polish women post partum and an assessment of health risk.

    PubMed

    Mojska, Hanna; Gielecińska, Iwona; Zielińska, Aleksandra; Winiarek, Joanna; Sawicki, Włodzimierz

    2016-01-01

    We determined metabolites of acrylamide and glycidamide concentrations (AAMA and GAMA, respectively) in urine of 93 women within the first days after delivery, using LC-MS/MS. The median AAMA and GAMA levels in urine were 20.9 μg/l (2.3÷399.0 μg/l) and 8.6 μg/l (1.3÷85.0 μg/l), respectively. In smokers we found significantly (P<0.01) higher levels of metabolites in comparison with the non-smoking women. As demonstrated by the 24-h dietary recall, acrylamide intake was low (median: 7.04 μg/day). Estimated exposure to acrylamide based on AAMA and GAMA levels in the whole group of women was 0.16 μg/kg b.w./day (1.15 μg/kg b.w./day, P95). We found significantly (P<0.05) higher exposure in women who consumed higher amount of acrylamide in the diet (≥10 μg/day vs <10 μg/day). A weak but significant positive correlation between acrylamide intake calculated on the basis of urinary levels of AAMA and GAMA and estimated on the basis of 24-h dietary recall (r=0.26, P<0.05) was found. The estimated margin of exposure values were below 10 000 and ranged from 156 for 95th percentile to 1938 for median acrylamide intake. Our results have shown that even a low dietary acrylamide intake may be associated with health risk.

  10. 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.

  11. 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…

  12. IMPROVED RISK ESTIMATES FOR CARBON TETRACHLORIDE

    SciTech Connect

    Benson, Janet M.; Springer, David L.

    1999-12-31

    Carbon tetrachloride has been used extensively within the DOE nuclear weapons facilities. Rocky Flats was formerly the largest volume consumer of CCl4 in the United States using 5000 gallons in 1977 alone (Ripple, 1992). At the Hanford site, several hundred thousand gallons of CCl4 were discharged between 1955 and 1973 into underground cribs for storage. Levels of CCl4 in groundwater at highly contaminated sites at the Hanford facility have exceeded 8 the drinking water standard of 5 ppb by several orders of magnitude (Illman, 1993). High levels of CCl4 at these facilities represent a potential health hazard for workers conducting cleanup operations and for surrounding communities. The level of CCl4 cleanup required at these sites and associated costs are driven by current human health risk estimates, which assume that CCl4 is a genotoxic carcinogen. The overall purpose of these studies was to improve the scientific basis for assessing the health risk associated with human exposure to CCl4. Specific research objectives of this project were to: (1) compare the rates of CCl4 metabolism by rats, mice and hamsters in vivo and extrapolate those rates to man based on parallel studies on the metabolism of CCl4 by rat, mouse, hamster and human hepatic microsomes in vitro; (2) using hepatic microsome preparations, determine the role of specific cytochrome P450 isoforms in CCl4-mediated toxicity and the effects of repeated inhalation and ingestion of CCl4 on these isoforms; and (3) evaluate the toxicokinetics of inhaled CCl4 in rats, mice and hamsters. This information has been used to improve the physiologically based pharmacokinetic (PBPK) model for CCl4 originally developed by Paustenbach et al. (1988) and more recently revised by Thrall and Kenny (1996). Another major objective of the project was to provide scientific evidence that CCl4, like chloroform, is a hepatocarcinogen only when exposure results in cell damage, cell killing and regenerative proliferation. In

  13. Benzene risk estimation using radiation equivalent coefficients.

    PubMed

    Nakayama, Aki; Isono, Tomomi; Kikuchi, Takuro; Ohnishi, Iichiro; Igarashi, Junichiro; Yoneda, Minoru; Morisawa, Shinsuke

    2009-03-01

    We estimated benzene risk using a novel framework of risk assessment that employed the measurement of radiation dose equivalents to benzene metabolites and a PBPK model. The highest risks for 1 microg/m(3) and 3.2 mg/m(3) life time exposure of benzene estimated with a linear regression were 5.4 x 10(-7) and 1.3 x 10(-3), respectively. Even though these estimates were based on in vitro chromosome aberration test data, they were about one-sixth to one-fourteenth that from other studies and represent a fairly good estimate by using radiation equivalent coefficient as an "internal standard."

  14. Human health risks from metals and metalloid via consumption of food animals near gold mines in Tarkwa, Ghana: estimation of the daily intakes and target hazard quotients (THQs).

    PubMed

    Bortey-Sam, Nesta; Nakayama, Shouta M M; Ikenaka, Yoshinori; Akoto, Osei; Baidoo, Elvis; Yohannes, Yared Beyene; Mizukawa, Hazuki; Ishizuka, Mayumi

    2015-01-01

    Heavy metal and metalloid contamination in food resulting from mining is of major concern due to the potential risk involved. Food consumption is the most likely route of human exposure to metals. This study was therefore to assess metals in different organs and different animal species near gold mines used for human consumption (free-range chicken, goat and sheep) in Tarkwa, Ghana, and to estimate the daily intake and health risk. The concentrations of Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Cd, and Pb were measured with an inductively coupled plasma-mass spectrometer and Hg analysis was done using the mercury analyzer. Principal component analysis of the results showed a clear separation between chicken, grouped on one side, and the ruminants clustered on another side in both offal and muscle. Interestingly, As, Cd, Hg, Mn and Pb made one cluster in the offal of chicken. Chicken muscle also showed similar distribution with As, Hg and Pb clustered together. The daily intake of metals (μg/kg body weight/day) were in the following ranges; As [0.002 (kidneys of goat and sheep)-0.19 (chicken gizzard)], Cd [0.003 (chicken muscle)-0.55 (chicken liver)], Hg [0.002 (goat muscle)-0.29 (chicken liver)], Pb [0.01 (muscles and kidneys of goat and sheep)-0.96 (chicken gizzard)] and Mn [0.13 (goat kidney)-8.92 (sheep liver)]. From the results, daily intakes of As, Cd, Hg, Pb and Mn in these food animals were low compared to the provisional tolerable daily intake guidelines. The THQs although less than one, indicated that contributions of chicken gizzard and liver to toxic metal exposure in adults and especially children could be significant.

  15. 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.

  16. 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.

  17. Assessing Your Weight and Health Risk

    MedlinePlus

    ... Health Professional Resources Assessing Your Weight and Health Risk Assessment of weight and health risk involves using ... risk for developing obesity-associated diseases or conditions. Risk Factors for Health Topics Associated With Obesity Along ...

  18. A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

    EPA Science Inventory

    BackgroundExposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of a...

  19. A simulation study to quantify the impacts of exposure measurement error on air pollution health risk estimates in copollutant time-series models.

    EPA Science Inventory

    BackgroundExposure measurement error in copollutant epidemiologic models has the potential to introduce bias in relative risk (RR) estimates. A simulation study was conducted using empirical data to quantify the impact of correlated measurement errors in time-series analyses of a...

  20. Data Sources for the Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

    Cancer.gov

    The model-based estimates of important cancer risk factors and screening behaviors are obtained by combining the responses to the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS).

  1. Estimates of community exposure and health risk to sulfur dioxide from power plant emissions using short-term mobile and stationary ambient air monitoring.

    PubMed

    Shepherd, Mark A; Haynatzki, Gleb; Rautiainen, Risto; Achutan, Chandran

    2015-10-01

    To estimate plausible health effects associated with peak sulfur dioxide (SO₂) levels from three coal-fired power plants in the Baltimore, Maryland, area, air monitoring was conducted between June and September 2013. Historically, the summer months are periods when emissions are highest. Monitoring included a 5-day mobile and a subsequent 61-day stationary monitoring study. In the stationary monitoring study, equipment was set up at four sites where models predicted and mobile monitoring data measured the highest average concentrations of SO₂. Continuous monitors recorded ambient concentrations each minute. The 1-min data were used to calculate 5-min and 1-hr moving averages for comparison with concentrations from clinical studies that elicited lung function decrement and respiratory symptoms among asthmatics. Maximum daily 5-min moving average concentrations from the mobile monitoring study ranged from 70 to 84 ppb (183-220 µg/m³), and maximum daily 1-hr moving average concentrations from the mobile monitoring study ranged from 15 to 24 ppb (39-63 µg/m³). Maximum 5-min moving average concentrations from stationary monitoring ranged from 39 to 229 ppb (102-600 µg/m³), and maximum daily 1-hr average concentrations ranged from 15 to 134 ppb (40-351 µg/m³). Estimated exposure concentrations measured in the vicinity of monitors were below the lowest levels that have demonstrated respiratory symptoms in human clinical studies for healthy exercising asthmatics. Based on 5-min and 1-hr monitoring, the exposure levels of SO₂ in the vicinity of the C.P. Crane, Brandon Shores, and H.A. Wagner power plants were not likely to elicit respiratory symptoms in healthy asthmatics. Mobile and stationary air monitoring for SO2 were conducted to quantify short-term exposure risk, to the surrounding community, from peak emissions of three coal-fired power plants in the Baltimore area. Concentrations were typically low, with only a few 5-min averages higher than levels

  2. Exposure Estimation and Interpretation of Occupational Risk: Enhanced Information for the Occupational Risk Manager

    PubMed Central

    Waters, Martha; McKernan, Lauralynn; Maier, Andrew; Jayjock, Michael; Schaeffer, Val; Brosseau, Lisa

    2015-01-01

    The fundamental goal of this article is to describe, define, and analyze the components of the risk characterization process for occupational exposures. Current methods are described for the probabilistic characterization of exposure, including newer techniques that have increasing applications for assessing data from occupational exposure scenarios. In addition, since the probability of health effects reflects variability in the exposure estimate as well as the dose-response curve—the integrated considerations of variability surrounding both components of the risk characterization provide greater information to the occupational hygienist. Probabilistic tools provide a more informed view of exposure as compared to use of discrete point estimates for these inputs to the risk characterization process. Active use of such tools for exposure and risk assessment will lead to a scientifically supported worker health protection program. Understanding the bases for an occupational risk assessment, focusing on important sources of variability and uncertainty enables characterizing occupational risk in terms of a probability, rather than a binary decision of acceptable risk or unacceptable risk. A critical review of existing methods highlights several conclusions: (1) exposure estimates and the dose-response are impacted by both variability and uncertainty and a well-developed risk characterization reflects and communicates this consideration; (2) occupational risk is probabilistic in nature and most accurately considered as a distribution, not a point estimate; and (3) occupational hygienists have a variety of tools available to incorporate concepts of risk characterization into occupational health and practice. PMID:26302336

  3. Discharge-based QMRA for estimation of public health risks from exposure to stormwater-borne pathogens in recreational waters in the United States.

    PubMed

    McBride, Graham B; Stott, Rebecca; Miller, Woutrina; Bambic, Dustin; Wuertz, Stefan

    2013-09-15

    This study is the first to report a quantitative microbial risk assessment (QMRA) on pathogens detected in stormwater discharges-of-concern, rather than relying on pathogen measurements in receiving waters. The pathogen concentrations include seven "Reference Pathogens" identified by the U.S. EPA: Cryptosporidium, Giardia, Salmonella, Norovirus, Rotavirus, Enterovirus, and Adenovirus. Data were collected from 12 sites representative of seven discharge types (including residential, commercial/industrial runoff, agricultural runoff, combined sewer overflows, and forested land), mainly during wet weather conditions during which times human health risks can be substantially elevated. The risks calculated herein therefore generally apply to short-term conditions (during and just after rainfall events) and so the results can be used by water managers to potentially inform the public, even for waters that comply with current criteria (based as they are on a 30-day mean risk). Using an example waterbody and mixed source, pathogen concentrations were used in QMRA models to generate risk profiles for primary and secondary water contact (or inhalation) by adults and children. A number of critical assumptions and considerations around the QMRA analysis are highlighted, particularly the harmonization of the pathogen concentrations measured in discharges during this project with those measured (using different methods) during the published dose-response clinical trials. Norovirus was the most dominant predicted health risk, though further research on its dose-response for illness (cf. infection) is needed. Even if the example mixed-source concentrations of pathogens had been reduced 30 times (by inactivation and mixing), the predicted swimming-associated illness rates - largely driven by Norovirus infections - can still be appreciable. Rotavirus generally induced the second-highest incidence of risk among the tested pathogens while risks for the other Reference Pathogens

  4. Children at health risks.

    PubMed

    Sekar, H R

    1992-01-01

    In India, 69% of the children of the working class die, most of whom are child laborers. Economic pressure forces parents to make their children work. Employers want child workers because they can manipulate them and pay them low wages, thereby ensuring their viability. The caste system induces social inequality, inheritance invokes cultural inequality, and patriarchal socialization is responsible for gender inequality, all of which perpetuates exploitation of children by employers. In Sivakasi, an estimated 125,000 children make up the child labor force, comprising 30% of the entire labor force. 75% are from the lowest castes. 90% of child workers are girls because they are more obedient and accept even lower wages than boys, and girls need to save for their dowry. Girls often suffer verbal and physical abuse. Like their parents who were also child workers, child workers are illiterate and work long hours. A small rich elite in Sivakasi controls most of the trading and industrial capital, educational institutions, and voluntary organizations. Employers' agents give parents a loan and use their children's labor as security. Each day, they bring child workers to Sivakasi in factory buses from villages to work at least 12 hour days. They work under hazardous conditions, e.g., working with toxic chemicals. Coughing, sore throat, dizziness, methemoglobinemia, and anemia are common effects of ingestion or inhalation of chlorate dust. Inhalation of sulphur dust causes respiratory infections, eye infections, and chronic lung diseases (e.g., asthma). Fires and explosions are common risks for working children. Factory management seldom undertake fire prevention measures. An extensive survey of the problem of child labor is needed in Sivakasi before systematic planning to protect children could be done. Overall development, especially agricultural development, is needed. Parents, employers, enforcement authorities, trade unions, and social groups need to be sensitized to the

  5. Resources for global risk assessment: The International Toxicity Estimates for Risk (ITER) and Risk Information Exchange (RiskIE) databases

    SciTech Connect

    Wullenweber, Andrea Kroner, Oliver; Kohrman, Melissa; Maier, Andrew; Dourson, Michael; Rak, Andrew; Wexler, Philip; Tomljanovic, Chuck

    2008-11-15

    The rate of chemical synthesis and use has outpaced the development of risk values and the resolution of risk assessment methodology questions. In addition, available risk values derived by different organizations may vary due to scientific judgments, mission of the organization, or use of more recently published data. Further, each organization derives values for a unique chemical list so it can be challenging to locate data on a given chemical. Two Internet resources are available to address these issues. First, the International Toxicity Estimates for Risk (ITER) database ( (www.tera.org/iter)) provides chronic human health risk assessment data from a variety of organizations worldwide in a side-by-side format, explains differences in risk values derived by different organizations, and links directly to each organization's website for more detailed information. It is also the only database that includes risk information from independent parties whose risk values have undergone independent peer review. Second, the Risk Information Exchange (RiskIE) is a database of in progress chemical risk assessment work, and includes non-chemical information related to human health risk assessment, such as training modules, white papers and risk documents. RiskIE is available at (http://www.allianceforrisk.org/RiskIE.htm), and will join ITER on National Library of Medicine's TOXNET ( (http://toxnet.nlm.nih.gov/)). Together, ITER and RiskIE provide risk assessors essential tools for easily identifying and comparing available risk data, for sharing in progress assessments, and for enhancing interaction among risk assessment groups to decrease duplication of effort and to harmonize risk assessment procedures across organizations.

  6. Resources for global risk assessment: the International Toxicity Estimates for Risk (ITER) and Risk Information Exchange (RiskIE) databases.

    PubMed

    Wullenweber, Andrea; Kroner, Oliver; Kohrman, Melissa; Maier, Andrew; Dourson, Michael; Rak, Andrew; Wexler, Philip; Tomljanovic, Chuck

    2008-11-15

    The rate of chemical synthesis and use has outpaced the development of risk values and the resolution of risk assessment methodology questions. In addition, available risk values derived by different organizations may vary due to scientific judgments, mission of the organization, or use of more recently published data. Further, each organization derives values for a unique chemical list so it can be challenging to locate data on a given chemical. Two Internet resources are available to address these issues. First, the International Toxicity Estimates for Risk (ITER) database (www.tera.org/iter) provides chronic human health risk assessment data from a variety of organizations worldwide in a side-by-side format, explains differences in risk values derived by different organizations, and links directly to each organization's website for more detailed information. It is also the only database that includes risk information from independent parties whose risk values have undergone independent peer review. Second, the Risk Information Exchange (RiskIE) is a database of in progress chemical risk assessment work, and includes non-chemical information related to human health risk assessment, such as training modules, white papers and risk documents. RiskIE is available at http://www.allianceforrisk.org/RiskIE.htm, and will join ITER on National Library of Medicine's TOXNET (http://toxnet.nlm.nih.gov/). Together, ITER and RiskIE provide risk assessors essential tools for easily identifying and comparing available risk data, for sharing in progress assessments, and for enhancing interaction among risk assessment groups to decrease duplication of effort and to harmonize risk assessment procedures across organizations.

  7. Submarine tower escape decompression sickness risk estimation.

    PubMed

    Loveman, G A M; Seddon, E M; Thacker, J C; Stansfield, M R; Jurd, K M

    2014-01-01

    Actions to enhance survival in a distressed submarine (DISSUB) scenario may be guided in part by knowledge of the likely risk of decompression sickness (DCS) should the crew attempt tower escape. A mathematical model for DCS risk estimation has been calibrated against DCS outcome data from 3,738 exposures of either men or goats to raised pressure. Body mass was used to scale DCS risk. The calibration data included more than 1,000 actual or simulated submarine escape exposures and no exposures with substantial staged decompression. Cases of pulmonary barotrauma were removed from the calibration data. The calibrated model was used to estimate the likelihood of DCS occurrence following submarine escape from the United Kingdom Royal Navy tower escape system. Where internal DISSUB pressure remains at - 0.1 MPa, escape from DISSUB depths < 200 meters is estimated to have DCS risk < 6%. Saturation at raised DISSUB pressure markedly increases risk, with > 60% DCS risk predicted for a 200-meter escape from saturation at 0.21 MPa. Using the calibrated model to predict DCS for direct ascent from saturation gives similar risk estimates to other published models.

  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 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)

  10. The Problem With Estimating Public Health Spending.

    PubMed

    Leider, Jonathon P

    2016-01-01

    Accurate information on how much the United States spends on public health is critical. These estimates affect planning efforts; reflect the value society places on the public health enterprise; and allows for the demonstration of cost-effectiveness of programs, policies, and services aimed at increasing population health. Yet, at present, there are a limited number of sources of systematic public health finance data. Each of these sources is collected in different ways, for different reasons, and so yields strikingly different results. This article aims to compare and contrast all 4 current national public health finance data sets, including data compiled by Trust for America's Health, the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), and the Census, which underlie the oft-cited National Health Expenditure Account estimates of public health activity. In FY2008, ASTHO estimates that state health agencies spent $24 billion ($94 per capita on average, median $79), while the Census estimated all state governmental agencies including state health agencies spent $60 billion on public health ($200 per capita on average, median $166). Census public health data suggest that local governments spent an average of $87 per capita (median $57), whereas NACCHO estimates that reporting LHDs spent $64 per capita on average (median $36) in FY2008. We conclude that these estimates differ because the various organizations collect data using different means, data definitions, and inclusion/exclusion criteria--most notably around whether to include spending by all agencies versus a state/local health department, and whether behavioral health, disability, and some clinical care spending are included in estimates. Alongside deeper analysis of presently underutilized Census administrative data, we see harmonization efforts and the creation of a standardized expenditure reporting system as a way to

  11. Estimating the spatial distribution of acute undifferentiated fever (AUF) and associated risk factors using emergency call data in India. A symptom-based approach for public health surveillance.

    PubMed

    Kauhl, Boris; Pilot, Eva; Rao, Ramana; Gruebner, Oliver; Schweikart, Jürgen; Krafft, Thomas

    2015-01-01

    The System for Early-warning based on Emergency Data (SEED) is a pilot project to evaluate the use of emergency call data with the main complaint acute undifferentiated fever (AUF) for syndromic surveillance in India. While spatio-temporal methods provide signals to detect potential disease outbreaks, additional information about socio-ecological exposure factors and the main population at risk is necessary for evidence-based public health interventions and future preparedness strategies. The goal of this study is to investigate whether a spatial epidemiological analysis at the ecological level provides information on urban-rural inequalities, socio-ecological exposure factors and the main population at risk for AUF. Our results displayed higher risks in rural areas with strong local variation. Household industries and proximity to forests were the main socio-ecological exposure factors and scheduled tribes were the main population at risk for AUF. These results provide additional information for syndromic surveillance and could be used for evidence-based public health interventions and future preparedness strategies.

  12. Health Risk Assessment of Chemical Mixtures | Science ...

    EPA Pesticide Factsheets

    The implementation of Superfund requires a methodology for estimating health risk from multi-chemical contamination at ambient levels. Most often, the chemical composition of these mixtures is poorly characterized, exposure data are uncertain and toxicologic data on the known components of the mixture are limited. However, a potential human health hazard may exist and the U.S.EPA, state and local governments need to be able to assess the total hazard in order to make decisions on appropriate action. This report describes a procedure for assessing the risks from chemical mixtures that includes options when different kinds of data are available. Good-quality information on the mixture of concern or a similar mixture should always be used. Less desirable, but still useful approach, is to utilize data on components and their interactions. The quality of exposure and toxicity data must be determined and the uncertainties involved in each risk assessment must be thoroughly discussed. ater contamination is briefly discussed since it is of vital concern as the primary exposure medium for chemical mixtures. The methodology for estimating the human health risk from single chemicals, both carcinogens and systemic toxicants, is reviewed as it forms the basis for the assessment of mixtures. The Implementation of Superfund requires a methodology for estimating health risk from multi-chemical contamination at ambient levels. Most often, the chemical composition of these mix

  13. Geosciences help to protect human health: estimation of the adsorbed radiation doses while flight journeys, as important step to radiation risk assessment

    NASA Astrophysics Data System (ADS)

    Chernov, Anatolii; Shabatura, Olexandr

    2016-04-01

    Estimation of the adsorbed radiation dose while flight journeys is a complex problem, which should be solved to get correct evaluation of equivalent effective doses and radiation risk assessment. Direct measurements of the adsorbed dose in the aircrafts during regional flights (3-10 hours) has shown that the radiation in the plane may increase 10-15 times (to 2-4 mSv/h) compared to the values on the surface of the Earth (0.2-0.5 mSv/h). Results of instrumental research confirmed by the other investigations. It is a fact that adsorbed doses per year while flight journeys are less than doses from medical tests. However, while flight journeys passengers get the same doses as nuclear power plant staff, people in zones of natural radiation anomalies and so should be evaluated. According to the authors' research, flight journeys are safe enough, when solar activity is normal and if we fly under altitude of 18 km (as usual, while intercontinental flights). Most of people travel by plane not so often, but if flight is lasting in dangerous periods of solar activity (powerful solar winds and magnetic field storms), passengers and flight crew can adsorb great amount of radiation doses. People, who spend more than 500 hours in flight journeys (pilots, business oriented persons', government representatives, etc.) get amount of radiation, which can negatively influence on health and provoke diseases, such as cancer. Authors consider that problem actual and researches are still going on. It is revealed, that radiation can be calculated, using special equations. Great part of radiation depends on very variable outer-space component and less variable solar. Accurate calculations of doses will be possible, when we will take into account all features of radiation distribution (time, season of year and exact time of the day, duration of flight), technical features of aircraft and logistics of flight (altitude, latitude). Results of first attempts of radiation doses modelling confirmed

  14. [Estimation of risk areas for hepatitis A].

    PubMed

    Braga, Ricardo Cerqueira Campos; Valencia, Luís Iván Ortiz; Medronho, Roberto de Andrade; Escosteguy, Claudia Caminha

    2008-08-01

    This study estimated hepatitis A risk areas in a region of Duque de Caxias, Rio de Janeiro State, Brazil. A cross-sectional study consisting of a hepatitis A serological survey and a household survey were conducted in 19 census tracts. Of these, 11 tracts were selected and 1,298 children from one to ten years of age were included in the study. Geostatistical techniques allowed modeling the spatial continuity of hepatitis A, non-use of filtered drinking water, time since installation of running water, and number of water taps per household and their spatial estimation through ordinary and indicator kriging. Adjusted models for the outcome and socioeconomic variables were isotropic; risk maps were constructed; cross-validation of the four models was satisfactory. Spatial estimation using the kriging method detected areas with increased risk of hepatitis A, independently of the urban administrative area in which the census tracts were located.

  15. Health risks of counterfeit pharmaceuticals.

    PubMed

    ten Ham, Martijn

    2003-01-01

    Pharmaceutical products are not exempt from the practice of counterfeiting. In recent years, many reports have become available demonstrating the presence of fake medicines on the market. Several studies have demonstrated that they are quite often of bad quality. It is estimated that 5% of all world trade in branded goods is counterfeit, leading to huge financial losses for the pharmaceutical industry. But much more important, from a public health point of view, is that history has shown that such products may lead to a great health risk. The essence of counterfeit products and the reason they are so dangerous is the complete absence of quality control, since they are often indistinguishable from the genuine product. The existence of counterfeit drugs has long been ignored both by the pharmaceutical industry and by drug regulatory authorities. At present initiatives are being taken, nationally and internationally, to curb counterfeiting. It is now realised that a strong regulatory agency is essential, but the initiatives can only be successful if all parties concerned actively co-operate.

  16. Fatality risk estimation for Replacement Tritium Facility

    SciTech Connect

    Kim, K.S.

    1994-09-01

    Prompt and latent cancer fatality risks are estimated in this report for the operation of the Replacement Tritium Facility (RTF) at the Savannah River Site (SRS). The purpose of this report is to demonstrate that: (1) the calculated fatality risk for the RTF operation is well within the quantitative Nuclear Safety Goals established by the Department of Energy (DOE) and (2) a simple point estimate method can produce results comparable to those of more detailed calculation utilizing computer codes and protocols developed for Probabilistic Risk Assessment (PRA) of nuclear power reactors. Point estimates of prompt and cancer fatality risks are performed using a simple mathematical formalism derived from the complementary cumulative distribution function (CCDF) of consequences. The protocol of establishing CCDF is based on a successive summation of event frequencies. The consequences (i.e., calculated individual radiation doses at site boundary) and associated event frequencies are available from the RTF Final Safety Analysis Report (FSAR). The results indicate that calculated prompt fatality and cancer fatality risks due to RTF operation are 0 and 1.5 {times} 10{sup {minus}9}/yr, respectively, well below the DOE`s Safety Goals of 5 {times} 10{sup {minus}7}/yr (prompt fatality) and 2 {times} 10{sup {minus}6}/yr (cancer fatality). The agreement between the point estimate method and the PRA method is very good considering the differences in assumptions between the two methods (i.e., additional earthquake-induced scenarios).

  17. 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.

  18. Population-based absolute risk estimation with survey data

    PubMed Central

    Kovalchik, Stephanie A.; Pfeiffer, Ruth M.

    2013-01-01

    Absolute risk is the probability that a cause-specific event occurs in a given time interval in the presence of competing events. We present methods to estimate population-based absolute risk from a complex survey cohort that can accommodate multiple exposure-specific competing risks. The hazard function for each event type consists of an individualized relative risk multiplied by a baseline hazard function, which is modeled nonparametrically or parametrically with a piecewise exponential model. An influence method is used to derive a Taylor-linearized variance estimate for the absolute risk estimates. We introduce novel measures of the cause-specific influences that can guide modeling choices for the competing event components of the model. To illustrate our methodology, we build and validate cause-specific absolute risk models for cardiovascular and cancer deaths using data from the National Health and Nutrition Examination Survey. Our applications demonstrate the usefulness of survey-based risk prediction models for predicting health outcomes and quantifying the potential impact of disease prevention programs at the population level. PMID:23686614

  19. 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.

  20. Pregnancy - health risks

    MedlinePlus

    ... drugs, stop drinking alcohol, and limit caffeine and coffee. Talk to your health care provider about any medicines you may be taking to see if they can affect your unborn baby. Eat a well-balanced diet ...

  1. Spatial ascariasis risk estimation using socioeconomic variables.

    PubMed

    Valencia, Luis Iván Ortiz; Fortes, Bruno de Paula Menezes Drumond; Medronho, Roberto de Andrade

    2005-12-01

    Frequently, disease incidence is mapped as area data, for example, census tracts, districts or states. Spatial disease incidence can be highly heterogeneous inside these areas. Ascariasis is a highly prevalent disease, which is associated with poor sanitation and hygiene. Geostatistics was applied to model spatial distribution of Ascariasis risk and socioeconomic risk events in a poor community in Rio de Janeiro, Brazil. Data were gathered from a coproparasitologic and a domiciliary survey in 1550 children aged 1-9. Ascariasis risk and socioeconomic risk events were spatially estimated using Indicator Kriging. Cokriging models with a Linear Model of Coregionalization incorporating one socioeconomic variable were implemented. If a housewife attended school for less than four years, the non-use of a home water filter, a household density greater than one, and a household income lower than one Brazilian minimum wage increased the risk of Ascariasis. Cokriging improved spatial estimation of Ascariasis risk areas when compared to Indicator Kriging and detected more Ascariasis very-high risk areas than the GIS Overlay method.

  2. Evaluating Health Risk Models

    PubMed Central

    2010-01-01

    SUMMARY Interest in targeted disease prevention has stimulated development of models that assign risks to individuals, using their personal covariates. We need to evaluate these models and quantify the gains achieved by expanding a model to include additional covariates. This paper reviews several performance measures and shows how they are related. Examples are used to show that appropriate performance criteria for a risk model depend upon how the model is used. Application of the performance measures to risk models for hypothetical populations and for US women at risk of breast cancer illustrate two additional points. First, model performance is constrained by the distribution of risk-determining covariates in the population. This complicates the comparison of two models when applied to populations with different covariate distributions. Second, all summary performance measures obscure model features of relevance to its utility for the application at hand, such as performance in specific subgroups of the population. In particular, the precision gained by adding covariates to a model can be small overall, but large in certain subgroups. We propose new ways to identify these subgroups and to quantify how much they gain by measuring the additional covariates. Those with largest gains could be targeted for cost-efficient covariate assessment. PMID:20623821

  3. The cost of lifestyle health risks: obesity.

    PubMed

    Long, D Adam; Reed, Roger; Lehman, Gregg

    2006-03-01

    The objective of this study was to provide employers interested in lifestyle health initiatives a resource for estimating their members' obesity-related costs stratified by demographics and business sector. Claims-level medical costs attributable to obesity are estimated. Data come from 61 U.S. employers' health plan members' claims experienced between January 2000 and December 2004. Diagnosed, nondrug medical expenses attributable to obesity account for 21.3% of lifestyle and 2.8% of all medical costs for those aged 19 to 64 years. Obesity costs for children under 19 years are negligible. Up to age 64 years, females' obesity costs markedly exceed males'. At particular risk for high obesity costs are women, those aged 55 to 64 years, and healthcare sector members. Obesity is a costly lifestyle health risk and self-insured employers should take action with or without policy aid such as the HeLP Act S2558.

  4. Risk estimation in partial duration series

    NASA Astrophysics Data System (ADS)

    Rasmussen, Peter Funder; Rosbjerg, Dan

    1989-11-01

    The estimation of design floods is, in practice, often based on small samples of data, which may cause a severe uncertainty. For a particular version of the partial duration series (exponentially distributed exceedances and Poissonian occurrence times) the distribution of the T-year design estimate xˆT is derived along with the distribution of RT; defined as the true risk of exceeding xˆT within a given disposal period. For a fixed flood level the distributions of the return period estimator Tˆ and the estimator of the risk in lifetime Rˆ are also presented. Analytical closed-form expressions for mean value and standard deviation are derived for these variables, except for Tˆ, which does not possess moments. The concept of "expected risk" is introduced, and an analytical expression describing this property is derived. A risk-based design technique, which is essentially different from the traditional procedure, is presented, and its applicability is verified using Monte Carlo simulation.

  5. Estimating the re-identification risk of clinical data sets

    PubMed Central

    2012-01-01

    Background De-identification is a common way to protect patient privacy when disclosing clinical data for secondary purposes, such as research. One type of attack that de-identification protects against is linking the disclosed patient data with public and semi-public registries. Uniqueness is a commonly used measure of re-identification risk under this attack. If uniqueness can be measured accurately then the risk from this kind of attack can be managed. In practice, it is often not possible to measure uniqueness directly, therefore it must be estimated. Methods We evaluated the accuracy of uniqueness estimators on clinically relevant data sets. Four candidate estimators were identified because they were evaluated in the past and found to have good accuracy or because they were new and not evaluated comparatively before: the Zayatz estimator, slide negative binomial estimator, Pitman’s estimator, and mu-argus. A Monte Carlo simulation was performed to evaluate the uniqueness estimators on six clinically relevant data sets. We varied the sampling fraction and the uniqueness in the population (the value being estimated). The median relative error and inter-quartile range of the uniqueness estimates was measured across 1000 runs. Results There was no single estimator that performed well across all of the conditions. We developed a decision rule which selected between the Pitman, slide negative binomial and Zayatz estimators depending on the sampling fraction and the difference between estimates. This decision rule had the best consistent median relative error across multiple conditions and data sets. Conclusion This study identified an accurate decision rule that can be used by health privacy researchers and disclosure control professionals to estimate uniqueness in clinical data sets. The decision rule provides a reliable way to measure re-identification risk. PMID:22776564

  6. Almost efficient estimation of relative risk regression

    PubMed Central

    Fitzmaurice, Garrett M.; Lipsitz, Stuart R.; Arriaga, Alex; Sinha, Debajyoti; Greenberg, Caprice; Gawande, Atul A.

    2014-01-01

    Relative risks (RRs) are often considered the preferred measures of association in prospective studies, especially when the binary outcome of interest is common. In particular, many researchers regard RRs to be more intuitively interpretable than odds ratios. Although RR regression is a special case of generalized linear models, specifically with a log link function for the binomial (or Bernoulli) outcome, the resulting log-binomial regression does not respect the natural parameter constraints. Because log-binomial regression does not ensure that predicted probabilities are mapped to the [0,1] range, maximum likelihood (ML) estimation is often subject to numerical instability that leads to convergence problems. To circumvent these problems, a number of alternative approaches for estimating RR regression parameters have been proposed. One approach that has been widely studied is the use of Poisson regression estimating equations. The estimating equations for Poisson regression yield consistent, albeit inefficient, estimators of the RR regression parameters. We consider the relative efficiency of the Poisson regression estimator and develop an alternative, almost efficient estimator for the RR regression parameters. The proposed method uses near-optimal weights based on a Maclaurin series (Taylor series expanded around zero) approximation to the true Bernoulli or binomial weight function. This yields an almost efficient estimator while avoiding convergence problems. We examine the asymptotic relative efficiency of the proposed estimator for an increase in the number of terms in the series. Using simulations, we demonstrate the potential for convergence problems with standard ML estimation of the log-binomial regression model and illustrate how this is overcome using the proposed estimator. We apply the proposed estimator to a study of predictors of pre-operative use of beta blockers among patients undergoing colorectal surgery after diagnosis of colon cancer. PMID

  7. Estimating health expenditure shares from household surveys

    PubMed Central

    Brooks, Benjamin PC; Hanlon, Michael

    2013-01-01

    Abstract Objective To quantify the effects of household expenditure survey characteristics on the estimated share of a household’s expenditure devoted to health. Methods A search was conducted for all country surveys reporting data on health expenditure and total household expenditure. Data on total expenditure and health expenditure were extracted from the surveys to generate the health expenditure share (i.e. fraction of the household expenditure devoted to health). To do this the authors relied on survey microdata or survey reports to calculate the health expenditure share for the particular instrument involved. Health expenditure share was modelled as a function of the survey’s recall period, the number of health expenditure items, the number of total expenditure items, the data collection method and the placement of the health module within the survey. Data exists across space and time, so fixed effects for territory and year were included as well. The model was estimated by means of ordinary least squares regression with clustered standard errors. Findings A one-unit increase in the number of health expenditure questions was accompanied by a 1% increase in the estimated health expenditure share. A one-unit increase in the number of non-health expenditure questions resulted in a 0.2% decrease in the estimated share. Increasing the recall period by one month was accompanied by a 6% decrease in the health expenditure share. Conclusion The characteristics of a survey instrument examined in the study affect the estimate of the health expenditure share. Those characteristics need to be accounted for when comparing results across surveys within a territory and, ultimately, across territories. PMID:23825879

  8. Estimating Terrorist Risk with Possibility Theory

    SciTech Connect

    J.L. Darby

    2004-11-30

    This report summarizes techniques that use possibility theory to estimate the risk of terrorist acts. These techniques were developed under the sponsorship of the Department of Homeland Security (DHS) as part of the National Infrastructure Simulation Analysis Center (NISAC) project. The techniques have been used to estimate the risk of various terrorist scenarios to support NISAC analyses during 2004. The techniques are based on the Logic Evolved Decision (LED) methodology developed over the past few years by Terry Bott and Steve Eisenhawer at LANL. [LED] The LED methodology involves the use of fuzzy sets, possibility theory, and approximate reasoning. LED captures the uncertainty due to vagueness and imprecision that is inherent in the fidelity of the information available for terrorist acts; probability theory cannot capture these uncertainties. This report does not address the philosophy supporting the development of nonprobabilistic approaches, and it does not discuss possibility theory in detail. The references provide a detailed discussion of these subjects. [Shafer] [Klir and Yuan] [Dubois and Prade] Suffice to say that these approaches were developed to address types of uncertainty that cannot be addressed by a probability measure. An earlier report discussed in detail the problems with using a probability measure to evaluate terrorist risk. [Darby Methodology]. Two related techniques are discussed in this report: (1) a numerical technique, and (2) a linguistic technique. The numerical technique uses traditional possibility theory applied to crisp sets, while the linguistic technique applies possibility theory to fuzzy sets. Both of these techniques as applied to terrorist risk for NISAC applications are implemented in software called PossibleRisk. The techniques implemented in PossibleRisk were developed specifically for use in estimating terrorist risk for the NISAC program. The LEDTools code can be used to perform the same linguistic evaluation as

  9. Methodology for the Model-based Small Area Estimates of Cancer Risk Factors and Screening Behaviors - Small Area Estimates

    Cancer.gov

    This model-based approach uses data from both the Behavioral Risk Factor Surveillance System (BRFSS) and the National Health Interview Survey (NHIS) to produce estimates of the prevalence rates of cancer risk factors and screening behaviors at the state, health service area, and county levels.

  10. 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.

  11. Estimating and Mapping the Population at Risk of Sleeping Sickness

    PubMed Central

    Franco, José R.; Paone, Massimo; Diarra, Abdoulaye; Ruiz-Postigo, José Antonio; Fèvre, Eric M.; Mattioli, Raffaele C.; Jannin, Jean G.

    2012-01-01

    Background Human African trypanosomiasis (HAT), also known as sleeping sickness, persists as a public health problem in several sub-Saharan countries. Evidence-based, spatially explicit estimates of population at risk are needed to inform planning and implementation of field interventions, monitor disease trends, raise awareness and support advocacy. Comprehensive, geo-referenced epidemiological records from HAT-affected countries were combined with human population layers to map five categories of risk, ranging from “very high” to “very low,” and to estimate the corresponding at-risk population. Results Approximately 70 million people distributed over a surface of 1.55 million km2 are estimated to be at different levels of risk of contracting HAT. Trypanosoma brucei gambiense accounts for 82.2% of the population at risk, the remaining 17.8% being at risk of infection from T. b. rhodesiense. Twenty-one million people live in areas classified as moderate to very high risk, where more than 1 HAT case per 10,000 inhabitants per annum is reported. Discussion Updated estimates of the population at risk of sleeping sickness were made, based on quantitative information on the reported cases and the geographic distribution of human population. Due to substantial methodological differences, it is not possible to make direct comparisons with previous figures for at-risk population. By contrast, it will be possible to explore trends in the future. The presented maps of different HAT risk levels will help to develop site-specific strategies for control and surveillance, and to monitor progress achieved by ongoing efforts aimed at the elimination of sleeping sickness. PMID:23145192

  12. Estimated Autism Risk and Older Reproductive Age

    PubMed Central

    King, Marissa D.; Fountain, Christine; Dakhlallah, Diana

    2009-01-01

    Objectives. We sought to estimate the risk for autism associated with maternal and paternal age across successive birth cohorts. Methods. We linked birth records and autism diagnostic records from the California Department of Developmental Services for children born in California between 1992 and 2000 to calculate the risk associated with maternal and paternal age for each birth cohort as well as for the pooled data. Results. The categorical risks associated with maternal age over 40 years ranged from a high of 1.84 (95% confidence interval [CI] = 1.37, 2.47) to a low of 1.27 (95% CI = 0.95, 1.69). The risk associated with paternal age ranged from 1.29 (95% CI = 1.03, 1.6) to 1.71 (95% CI = 1.41, 2.08). Conclusions. Pooling data across multiple birth cohorts inflates the risk associated with paternal age. Analyses that do not suffer from problems produced by pooling across birth cohorts demonstrated that advanced maternal age, rather than paternal age, may pose greater risk. Future research examining parental age as a risk factor must be careful to avoid the paradoxes that can arise from pooling data, particularly during periods of social demographic change. PMID:19608957

  13. GUIDANCE FOR CONDUCTING HEALTH RISK ...

    EPA Pesticide Factsheets

    While some potential environmental hazards involve significant exposure to only a single compound, most instances of environmental contamination involve concurrent or sequential exposures to a mixture of compounds that may induce similar or dissimilar effects over exposure periods ranging from short-term to lifetime. Multichemical exposures are ubiquitous, including air and soil pollution from municipal incinerators, leakage from hazardous waste facilities and uncontrolled waste sites, and drinking water containing chemical substances formed during disinfection. To address concerns over health risks from multichemical exposures, EPA issued Guidelines for Health Risk from Exposure to Chemical Mixtures in 1986. Those Guidelines described broad concepts related to mixtures exposure and toxicity and included few specific procedures. Since then, EPA has published additional mixtures guidance documents such as 1989 guidance for the Superfund program on hazardous waste and the 1990 Technical Support Document on Health Risk Assessment of Chemical Mixtures. Because the science of environmental risk assessment continues to evolve, EPA's Risk Assessment Forum established a Technical Work Panel to ensure that the advances in the area of chemical mixtures health risk assessment are reflected in the Agency's guidance materials. This document has been developed by the Technical Work Panel to supplement the earlier guidances and is organized according to the type of data avail

  14. Potential human health risks from toxic metals, polycyclic aromatic hydrocarbons, polychlorinated biphenyls, and organochlorine pesticides via canned fish consumption: estimation of target hazard quotients.

    PubMed

    El Morsy, Fadia A M; El-Sadaawy, Manal M; Ahdy, Hoda H H; Abdel-Fattah, Laila M; El-Sikaily, Amany M; Khaled, Azza; Tayel, Fathi M T

    2013-01-01

    Canned fish (tuna and sardine) of different geographical regions were collected randomly from supermarkets and were analyzed for heavy metal contents (Hg, Cd and Pb) polycyclic aromatic hydrocarbons, polychlorinated biphenyls, and pesticides. Canned fish samples (two brands of sardines, six brands of tuna) that were purchased from Egyptian cities between 2009 and 2010, represent four countries (Morocco, Republic of Yemen, Indonesia and Thailand). Health risks on humans via dietary intake of seafood were assessed by the target hazard quotients (THQs), potential non-carcinogenic and carcinogenic effects. The contents of trace metals in canned tuna and canned sardines were found as: 0.149-0.218 μg/g for Cd; 0.312-0.937 μg/g for Pb and 0.053-0.022 μg/g for Hg. Canned sardines fluctuated between 0.55 and 1.82, 1.08 and 1.64, 11.91 and 26.24 ng/g for total HCHs, Total cyclodienes and DDTs respectively while the corresponding concentrations in canned tuna were 0.24-1.85, 0.24-1‥85 and 6.56-49.73 ng/g, respectively. Total PCBs fluctuated between 21.75 and 55.10 for canned sardines and 8.56-208.11 ng/g for canned tuna. On the other hand the total PAHs fluctuated between 0.006-9.775 and 1.556-2.686 ng/g for tuna and sardines. From the human health point of view, there is no adverse health effect for both PAHs and heavy metals content on consumers.

  15. Preoperative Evaluation: Estimation of Pulmonary Risk.

    PubMed

    Lakshminarasimhachar, Anand; Smetana, Gerald W

    2016-03-01

    Postoperative pulmonary complications (PPCs) are common after major non-thoracic surgery and associated with significant morbidity and high cost of care. A number of risk factors are strong predictors of PPCs. The overall goal of the preoperative pulmonary evaluation is to identify these potential, patient and procedure-related risks and optimize the health of the patients before surgery. A thorough clinical examination supported by appropriate laboratory tests will help guide the clinician to provide optimal perioperative care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Is risk attitude outcome specific within the health domain?

    PubMed

    van der Pol, Marjon; Ruggeri, Matteo

    2008-05-01

    The aim of this study is to examine whether individuals' risk attitude for life years differ from their risk attitude for quality of life. The study also investigates two different framing effects, an order and sequence effect, and the interaction between risk attitude and time preferences. The results showed that individuals tended to be risk averse with respect to the gamble involving risk of immediate death and risk seeking with respect to the other health gambles. Varying the order of the questions or the sequence of full health and ill-health did not seem to systematically bias the estimates.

  17. Prevention through health risk management.

    PubMed

    Friedman, G M

    1992-08-01

    Risk can lead to catastrophe. Risk-management systems are highly effective in preventing the catastrophes of fire, earthquakes, and work-site injuries. No such effective systems are present to prevent health and social problems. A practical, cost-effective system to manage risk in children is being developed by the nonprofit Arizona Health Evaluation and Longevity Planning (HELP) Foundation. Information regarding such risk is collected in the school setting. This voluntary information comes from the administration, the school nurse, physical fitness testing, blood testing by the local hospital, self-esteem instruments, and parent, teacher, and child questionnaires. The HELP Foundation then develops an individual child and class risk profile that is presented to the teacher, school nurse, principal, and parent. Those involved with each child then prioritize, plan, and implement programs and activities to manage the identified risk(s). Risks is tracked throughout the child's school career by periodic reassessment. Evaluation of change in problem outcome will be a natural extension of the process.

  18. 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.

  19. Bias of health estimates obtained from chronic disease and risk factor surveillance systems using telephone population surveys in Australia: results from a representative face-to-face survey in Australia from 2010 to 2013.

    PubMed

    Dal Grande, Eleonora; Chittleborough, Catherine R; Campostrini, Stefano; Taylor, Anne W

    2016-04-18

    Emerging communication technologies have had an impact on population-based telephone surveys worldwide. Our objective was to examine the potential biases of health estimates in South Australia, a state of Australia, obtained via current landline telephone survey methodologies and to report on the impact of mobile-only household on household surveys. Data from an annual multi-stage, systematic, clustered area, face-to-face population survey, Health Omnibus Survey (approximately 3000 interviews annually), included questions about telephone ownership to assess the population that were non-contactable by current telephone sampling methods (2006 to 2013). Univariable analyses (2010 to 2013) and trend analyses were conducted for sociodemographic and health indicator variables in relation to telephone status. Relative coverage biases (RCB) of two hypothetical telephone samples was undertaken by examining the prevalence estimates of health status and health risk behaviours (2010 to 2013): directory-listed numbers, consisting mainly of landline telephone numbers and a small proportion of mobile telephone numbers; and a random digit dialling (RDD) sample of landline telephone numbers which excludes mobile-only households. Telephone (landline and mobile) coverage in South Australia is very high (97%). Mobile telephone ownership increased slightly (7.4%), rising from 89.7% in 2006 to 96.3% in 2013; mobile-only households increased by 431% over the eight year period from 5.2% in 2006 to 27.6% in 2013. Only half of the households have either a mobile or landline number listed in the telephone directory. There were small differences in the prevalence estimates for current asthma, arthritis, diabetes and obesity between the hypothetical telephone samples and the overall sample. However, prevalence estimate for diabetes was slightly underestimated (RCB value of -0.077) in 2013. Mixed RCB results were found for having a mental health condition for both telephone samples. Current

  20. 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.

  1. Estimation of thyroid doses and health risks resulting from the intake of radioactive iodine in foods and drinking water by the citizens of Tokyo after the Fukushima nuclear accident.

    PubMed

    Murakami, Michio; Oki, Taikan

    2012-06-01

    The release of radioactive materials from the Fukushima nuclear power plant after the Great East Japan Earthquake on 11 March 2011 poses health risks. In this study, the intake of iodine 131 (I-131) in drinking water and foods (milk, dairy products, and vegetables) by citizens of Tokyo was estimated. The effects of countermeasures (restrictions on the distribution of foods and the distribution of bottled water for infants) on reducing intake were also evaluated. The average thyroid equivalent doses without countermeasures from 21 March 2011 were 0.42 mSv in adults, 1.49 mSv in children, and 2.08 mSv in infants. Those with countermeasures were 0.28, 0.97, and 1.14 mSv respectively, reductions of 33%, 35%, and 45%. Drinking water contributed more to intake by adults and children than foods. The intake of I-131 within the first 2 weeks was more than 80% of the estimated intake, owing to its short half-life, indicating that rapid countermeasures are important in reducing intake. The average risks of cancer incidence and mortality due to I-131 for infants were estimated to be 3×10(-5) and 0.2×10(-5), respectively, lower than the annual risks of traffic accidents, naturally occurring radioactive material (potassium 40), and environmental pollutants such as diesel exhaust particles.

  2. Levels and sources of volatile organic compounds including carbonyls in indoor air of homes of Puertollano, the most industrialized city in central Iberian Peninsula. Estimation of health risk.

    PubMed

    Villanueva, Florentina; Tapia, Araceli; Amo-Salas, Mariano; Notario, Alberto; Cabañas, Beatriz; Martínez, Ernesto

    2015-08-01

    Twenty nine organic air pollutants including carbonyl compounds, alkanes, aromatic hydrocarbons and terpenes were measured in the indoor environment of different houses together with the corresponding outdoor measurements in Puertollano, the most industrialized city in central Iberian Peninsula. VOCs were sampled during 8 weeks using Radiello(®) passive samplers, and a questionnaire on potential VOCs sources was filled out by the occupants. The results show that formaldehyde and hexanal was the most abundant VOCs measured in indoor air, with a median concentration of 55.5 and 46.4μgm(-3), respectively followed by butanal (29.1μgm(-3)), acetone (28.4μgm(-3)) and acetaldehyde (21.4μgm(-3)). After carbonyls, n-dodecane (13.1μgm(-3)) and terpenes (α-pinene, 13.4μgm(-3) and limonene, 13.4μgm(-3)) were the compounds with higher median concentrations. The indoor/outdoor (I/O) ratios demonstrated that sources in the indoor environment are prevailing for most of the investigated VOCs especially for limonene, α-pinene, hexanal, formaldehyde, pentanal, acetaldehyde, o-xylene, n-dodecane and acetone with I/O ratio >6. Multiple linear regressions were applied to investigate the indoor VOC determinants and Spearman correlation coefficients were used to establish common sources between VOCs. Finally, the lifetime cancer risk associated to formaldehyde, acetaldehyde and benzene exposure was estimated and they varied from 7.8×10(-5) to 4.1×10(-4) for formaldehyde, from 8.6×10(-6) to 3.5×10(-5) for acetaldehyde and from 2.0×10(-6) to 1.5×10(-5) for benzene. For formaldehyde, the attributed risk in most sampled homes was two orders of magnitude higher than the one (10(-6)) proposed as acceptable by risk management bodies. Copyright © 2015 Elsevier GmbH. All rights reserved.

  3. 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.

  4. HEALTH RISK ISSUES FOR OXYGENATES

    EPA Science Inventory

    A substantial database exists on the inhalation toxicity of MTBE, but exposure information and health effects data for non-inhalation routes of exposure are limited. In addition, several issues complicate the interpretation of the avaialble data in assessing the healt risks of M...

  5. Health Information–Seeking Behaviors, Health Indicators, and Health Risks

    PubMed Central

    Mays, Darren; Weaver, Stephanie Sargent; Hopkins, Gary L.; Eroğlu, Doğan; Bernhardt, Jay M.

    2010-01-01

    Objectives. We examined how different types of health information–seeking behaviors (HISBs)—no use, illness information only, wellness information only, and illness and wellness information combined—are associated with health risk factors and health indicators to determine possible motives for health information seeking. Methods. A sample of 559 Seattle–Tacoma area adults completed an Internet-based survey in summer 2006. The survey assessed types of HISB, physical and mental health indicators, health risks, and several covariates. Covariate-adjusted linear and logistic regression models were computed. Results. Almost half (49.4%) of the sample reported HISBs. Most HISBs (40.6%) involved seeking a combination of illness and wellness information, but both illness-only (28.6%) and wellness-only (30.8%) HISBs were also widespread. Wellness-only information seekers reported the most positive health assessments and the lowest occurrence of health risk factors. An opposite pattern emerged for illness-only information seekers. Conclusions. Our findings reveal a unique pattern of linkages between the type of health information sought (wellness, illness, and so on) and health self-assessment among adult Internet users in western Washington State. These associations suggest that distinct health motives may underlie HISB, a phenomenon frequently overlooked in previous research. PMID:20558794

  6. 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.

  7. Estimated Levels of Environmental Contamination and Health Risk Assessment for Herbicides and Insecticides in Surface Water of Ceará, Brazil.

    PubMed

    Sousa, Anayla S; Duaví, Wersângela C; Cavalcante, Rivelino M; Milhome, Maria Aparecida L; do Nascimento, Ronaldo F

    2016-01-01

    Methodology using solid phase extraction and high performance liquid chromatography (SPE-C18/HPLC-DAD) was applied to pesticide determinations in ten water reservoirs in the semidarid region of northeastern Brazil. The validated method was suitable for determination of herbicides and insecticide in surface water. The recovery efficiency of atrazine, methyl-parathion and simazine was approximately 70%. The method also showed good linearity and selectivity with correlation coefficients (R) greater than 0.99. The limits of detection were below the maximum residue limits (MRLs) established by government agencies. Studied reservoirs showed presence of atrazine at mean levels from 7.0 to 15.0 µg/L. Simazine and methyl parathion were not detected during the period. The atrazine levels measured from this semiarid region are of the same magnitude as those found in regions with moderate to high agricultural activity. According to detected atrazine concentrations, the annual health risk to humans was insignificant. However, the control of herbicides is important to maintain the quality of water in the reservoirs of Ceará, Brazil.

  8. The quantitative estimation of IT-related risk probabilities.

    PubMed

    Herrmann, Andrea

    2013-08-01

    How well can people estimate IT-related risk? Although estimating risk is a fundamental activity in software management and risk is the basis for many decisions, little is known about how well IT-related risk can be estimated at all. Therefore, we executed a risk estimation experiment with 36 participants. They estimated the probabilities of IT-related risks and we investigated the effect of the following factors on the quality of the risk estimation: the estimator's age, work experience in computing, (self-reported) safety awareness and previous experience with this risk, the absolute value of the risk's probability, and the effect of knowing the estimates of the other participants (see: Delphi method). Our main findings are: risk probabilities are difficult to estimate. Younger and inexperienced estimators were not significantly worse than older and more experienced estimators, but the older and more experienced subjects better used the knowledge gained by knowing the other estimators' results. Persons with higher safety awareness tend to overestimate risk probabilities, but can better estimate ordinal ranks of risk probabilities. Previous own experience with a risk leads to an overestimation of its probability (unlike in other fields like medicine or disasters, where experience with a disease leads to more realistic probability estimates and nonexperience to an underestimation).

  9. Estimates of endemic waterborne risks from community-intervention studies.

    PubMed

    Calderon, Rebecca L; Craun, Gunther F

    2006-01-01

    The nature and magnitude of endemic waterborne disease are not well characterized in the United States. Epidemiologic studies of various designs can provide an estimate of the waterborne attributable risk along with other types of information. Community drinking water systems frequently improve their operations and may change drinking water treatment and their major source of water. In the United States, many of these treatment changes are the result of regulations promulgated under the Safe Drinking Water Act. A community-intervention study design takes advantage of these "natural" experiments to assess changes in health risks. In this paper, we review the community-intervention studies that have assessed changes in waterborne gastroenteritis risks among immunocompetent populations in industrialized countries. Published results are available from two studies in Australia, one study in the United Kingdom, and one study in the United States. Preliminary results from two other US studies are also available. Although the current information is limited, the risks reported in these community-intervention studies can help inform the national estimate of endemic waterborne gastroenteritis. Information is provided about endemic waterborne risks for unfiltered surface water sources and a groundwater under the influence of surface water. Community-intervention studies with recommended study modifications should be conducted to better estimate the benefits associated with improved drinking water treatment.

  10. Relating space radiation environments to risk estimates

    NASA Technical Reports Server (NTRS)

    Curtis, Stanley B.

    1993-01-01

    A number of considerations must go into the process of determining the risk of deleterious effects of space radiation to travelers. Among them are (1) determination of the components of the radiation environment (particle species, fluxes and energy spectra) which will encounter, (2) determination of the effects of shielding provided by the spacecraft and the bodies of the travelers which modify the incident particle spectra and mix of particles, and (3) determination of relevant biological effects of the radiation in the organs of interest. The latter can then lead to an estimation of risk from a given space scenario. Clearly, the process spans many scientific disciplines from solar and cosmic ray physics to radiation transport theeory to the multistage problem of the induction by radiation of initial lesions in living material and their evolution via physical, chemical, and biological processes at the molecular, cellular, and tissue levels to produce the end point of importance.

  11. Climate-informed flood risk estimation

    NASA Astrophysics Data System (ADS)

    Troy, T.; Devineni, N.; Lima, C.; Lall, U.

    2013-12-01

    Currently, flood risk assessments are typically tied to a peak flow event that has an associated return period and inundation extent. This method is convenient: based on a historical record of annual maximum flows, a return period can be calculated with some assumptions about the probability distribution and stationarity. It is also problematic in its stationarity assumption, reliance on relatively short records, and treating flooding as a random event disconnected from large-scale climate processes. Recognizing these limitations, we have developed a new approach to flood risk assessment that connects climate variability, precipitation dynamics, and flood modeling to estimate the likelihood of flooding. To provide more robust, long time series of precipitation, we used stochastic weather generator models to simulate the rainfall fields. The method uses a k-nearest neighbor resampling algorithm in conjunction with a non-parametric empirical copulas based simulation strategy to reproduce the temporal and spatial dynamics, respectively. Climate patterns inform the likelihood of heavy rainfall in the model. For example, ENSO affects the likelihood of wet or dry years in Australia, and this is incorporated in the model. The stochastic simulations are then used to drive a cascade of models to predict flood inundation. Runoff is generated by the Variable Infiltration Capacity (VIC) model, fed into a full kinematic wave routing model at high resolution, and the kinematic wave is used as a boundary condition to predict flood inundation using a coupled storage cell model. Combining the strengths of a stochastic model for rainfall and a physical model for flood prediction allows us to overcome the limitations of traditional flood risk assessment and provide robust estimates of flood risk.

  12. Risk analysis for environmental health triage.

    PubMed

    Bogen, Kenneth T

    2005-10-01

    The Homeland Security Act mandates the 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 the 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.

  13. 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.

  14. Impact of using different SCORE tables for estimating cardiovascular risk.

    PubMed

    Brotons, Carlos; Moral, Irene; Soriano, Núria; Cuixart, Lluís; Osorio, Dimelza; Bottaro, David; Puig, Mireia; Joaniquet, Xavier; Marcos, Albert; Casasa, Albert

    2014-02-01

    In Spain, various SCORE tables are available to estimate cardiovascular risk: tables for low-risk countries, tables calibrated for the Spanish population, and tables that include high-density lipoprotein values. The aim of this study is to assess the impact of using one or another SCORE table in clinical practice. In a cross-sectional study carried out in two primary health care centers, individuals aged 40 to 65 years in whom blood pressure and total cholesterol levels were recorded between March 2010 and March 2012 were selected. Patients with diabetes or a history of cardiovascular disease were excluded. Cardiovascular risk was calculated using SCORE for low-risk countries, SCORE with high-density lipoprotein cholesterol, and the calibrated SCORE. Cardiovascular risk was estimated in 3716 patients. The percentage of patients at high or very high risk was 1.24% with SCORE with high-density lipoprotein cholesterol, 4.73% with the low-risk SCORE, and 15.44% with the calibrated SCORE (P<.01). Treatment with lipid-lowering drugs would be recommended in 10.23% of patients using the calibrated SCORE, 3.12% of patients using the low-risk SCORE, and 0.67% of patients using SCORE with high-density lipoprotein cholesterol. The calibrated SCORE table classifies a larger number of patients at high or very high risk than the SCORE for low-risk countries or the SCORE with high-density lipoprotein cholesterol. Therefore, its use would imply treating more patients with lipid-lowering medication. Validation studies are needed to assess the most appropriate SCORE table for use in our setting. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  15. Assessing uncertainty in published risk estimates using ...

    EPA Pesticide Factsheets

    Introduction: The National Research Council recommended quantitative evaluation of uncertainty in effect estimates for risk assessment. This analysis considers uncertainty across model forms and model parameterizations with hexavalent chromium [Cr(VI)] and lung cancer mortality as an example. The objective is to characterize model uncertainty by evaluating estimates across published epidemiologic studies of the same cohort.Methods: This analysis was based on 5 studies analyzing a cohort of 2,357 workers employed from 1950-74 in a chromate production plant in Maryland. Cox and Poisson models were the only model forms considered by study authors to assess the effect of Cr(VI) on lung cancer mortality. All models adjusted for smoking and included a 5-year exposure lag, however other latency periods and model covariates such as age and race were considered. Published effect estimates were standardized to the same units and normalized by their variances to produce a standardized metric to compare variability within and between model forms. A total of 5 similarly parameterized analyses were considered across model form, and 16 analyses with alternative parameterizations were considered within model form (10 Cox; 6 Poisson). Results: Across Cox and Poisson model forms, adjusted cumulative exposure coefficients (betas) for 5 similar analyses ranged from 2.47 to 4.33 (mean=2.97, σ2=0.63). Within the 10 Cox models, coefficients ranged from 2.53 to 4.42 (mean=3.29, σ2=0.

  16. Anger and health risk behaviors

    PubMed Central

    Cuţov, M

    2010-01-01

    The present paper makes a research about negative effects of anger and hostile conduct on peoples' health status. We have studied scientific articles published between 2000 and 2010, that did not contradict our initial assumption. The literature demonstrates that anger, wheatear suppressed or expressed, can determine various diseases, it can influence the conduct of people suffering from bulimia nervosa or it can be the cause of the growing number of car accidents. In order to avoid these risks, the intervention should not be limited to medication, but it should also involve a psychological help that should insist on ways of dealing with anger without exposing the person to any kind of risk for his health or wellbeing. PMID:21254733

  17. Measuring perinatal mental health risk.

    PubMed

    Johnson, M; Schmeid, V; Lupton, S J; Austin, M-P; Matthey, S M; Kemp, L; Meade, T; Yeo, A E

    2012-10-01

    The purpose of this review was to critically analyse existing tools to measure perinatal mental health risk and report on the psychometric properties of the various approaches using defined criteria. An initial literature search revealed 379 papers, from which 21 papers relating to ten instruments were included in the final review. A further four papers were identified from experts (one excluded) in the field. The psychometric properties of six multidimensional tools and/or criteria were assessed. None of the instruments met all of the requirements of the psychometric properties defined. Some had used large sample sizes but reported low positive predictive values (Antenatal Risk Questionnaire (ANRQ)) or insufficient information regarding their clinical performance (Antenatal Routine Psychosocial Assessment (ARPA)), while others had insufficient sample sizes (Antenatal Psychosocial Health Assessment Tool, Camberwell Assessment of Need-Mothers and Contextual Assessment of Maternity Experience). The ANRQ has fulfilled the requirements of this analysis more comprehensively than any other instrument examined based on the defined rating criteria. While it is desirable to recommend a tool for clinical practice, it is important that clinicians are made aware of their limitations. The ANRQ and ARPA represent multidimensional instruments commonly used within Australia, developed within large samples with either cutoff scores or numbers of risk factors related to service outcomes. Clinicians can use these tools, within the limitations presented here, to determine the need for further intervention or to refer women to mental health services. However, the effectiveness of routine perinatal psychosocial assessment continues to be debated, with further research required.

  18. Variance computations for functional of absolute risk estimates.

    PubMed

    Pfeiffer, R M; Petracci, E

    2011-07-01

    We present a simple influence function based approach to compute the variances of estimates of absolute risk and functions of absolute risk. We apply this approach to criteria that assess the impact of changes in the risk factor distribution on absolute risk for an individual and at the population level. As an illustration we use an absolute risk prediction model for breast cancer that includes modifiable risk factors in addition to standard breast cancer risk factors. Influence function based variance estimates for absolute risk and the criteria are compared to bootstrap variance estimates.

  19. Variance computations for functional of absolute risk estimates

    PubMed Central

    Pfeiffer, R.M.; Petracci, E.

    2011-01-01

    We present a simple influence function based approach to compute the variances of estimates of absolute risk and functions of absolute risk. We apply this approach to criteria that assess the impact of changes in the risk factor distribution on absolute risk for an individual and at the population level. As an illustration we use an absolute risk prediction model for breast cancer that includes modifiable risk factors in addition to standard breast cancer risk factors. Influence function based variance estimates for absolute risk and the criteria are compared to bootstrap variance estimates. PMID:21643476

  20. Software risk estimation and management techniques at JPL

    NASA Technical Reports Server (NTRS)

    Hihn, J.; Lum, K.

    2002-01-01

    In this talk we will discuss how uncertainty has been incorporated into the JPL software model, probabilistic-based estimates, and how risk is addressed, how cost risk is currently being explored via a variety of approaches, from traditional risk lists, to detailed WBS-based risk estimates to the Defect Detection and Prevention (DDP) tool.

  1. Approach for Estimating Exposures and Incremental Health ...

    EPA Pesticide Factsheets

    Approach for Estimating Exposures and Incremental Health Effects from Lead During Renovation, Repair, and Painting Activities in Public and Commercial Buildings” (Technical Approach Document). Also available for public review and comment are two supplementary documents: the detailed appendices for the Technical Approach Document and a supplementary report entitled “Developing a Concentration-Response Function for Pb Exposure and Cardiovascular Disease-Related Mortality.” Together, these documents describes an analysis for estimating exposures and incremental health effects created by renovations of public and commercial buildings (P&CBs). This analysis could be used to identify and evaluate hazards from renovation, repair, and painting activities in P&CBs. A general overview of how this analysis can be used to inform EPA’s hazard finding is described in the Framework document that was previously made available for public comment (79 FR 31072; FRL9910-44). The analysis can be used in any proposed rulemaking to estimate the reduction in deleterious health effects that would result from any proposed regulatory requirements to mitigate exposure from P&CB renovation activities. The Technical Approach Document describes in detail how the analyses under this approach have been performed and presents the results – expected changes in blood lead levels and health effects due to lead exposure from renovation activities.

  2. Health Tip: Know Your Risk for Obesity

    MedlinePlus

    ... 166114.html Health Tip: Know Your Risk for Obesity Here's what makes it more likely To use ... Diana Kohnle Wednesday, May 31, 2017 (HealthDay News) -- Obesity is linked to an increased risk for heart ...

  3. Health Risks of an Inactive Lifestyle

    MedlinePlus

    ... may develop a hormonal imbalance What are the health risks of an inactive lifestyle? Having an inactive ... the more sedentary you are, the higher your health risks are. How can I get started with ...

  4. Injury Risk Estimation Expertise: Interdisciplinary Differences in Performance on the ACL Injury Risk Estimation Quiz.

    PubMed

    Petushek, Erich J; Ward, Paul; Cokely, Edward T; Myer, Gregory D

    2015-11-01

    Simple observational assessment of movement is a potentially low-cost method for anterior cruciate ligament (ACL) injury screening and prevention. Although many individuals utilize some form of observational assessment of movement, there are currently no substantial data on group skill differences in observational screening of ACL injury risk. The purpose of this study was to compare various groups' abilities to visually assess ACL injury risk as well as the associated strategies and ACL knowledge levels. The hypothesis was that sports medicine professionals would perform better than coaches and exercise science academics/students and that these subgroups would all perform better than parents and other general population members. Cross-sectional study; Level of evidence, 3. A total of 428 individuals, including physicians, physical therapists, athletic trainers, strength and conditioning coaches, exercise science researchers/students, athletes, parents, and members of the general public participated in the study. Participants completed the ACL Injury Risk Estimation Quiz (ACL-IQ) and answered questions related to assessment strategy and ACL knowledge. Strength and conditioning coaches, athletic trainers, physical therapists, and exercise science students exhibited consistently superior ACL injury risk estimation ability (+2 SD) as compared with sport coaches, parents of athletes, and members of the general public. The performance of a substantial number of individuals in the exercise sciences/sports medicines (approximately 40%) was similar to or exceeded clinical instrument-based biomechanical assessment methods (eg, ACL nomogram). Parents, sport coaches, and the general public had lower ACL-IQ, likely due to their lower ACL knowledge and to rating the importance of knee/thigh motion lower and weight and jump height higher. Substantial cross-professional/group differences in visual ACL injury risk estimation exist. The relatively profound differences in injury

  5. [Health risks of oral contraceptives].

    PubMed

    Meier, Christoph R

    2011-06-01

    smoking is also an important contributing factor to an increased VTE risk for women using OC. It is important that doctors and pharmacists inform new users of OC about potential health risks of OC use, and that the personal and family history of previous health risks is assessed thoroughly in order to rule out that important and relevant contraindications are present when a women starts taking OC.

  6. 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

  7. A simulation study to determine the attenuation and bias in health risk estimates due to exposure measurement error in bi-pollutant models

    EPA Science Inventory

    To understand the combined health effects of exposure to ambient air pollutant mixtures, it is becoming more common to include multiple pollutants in epidemiologic models. However, the complex spatial and temporal pattern of ambient pollutant concentrations and related exposures ...

  8. A simulation study to determine the attenuation and bias in health risk estimates due to exposure measurement error in bi-pollutant models

    EPA Science Inventory

    To understand the combined health effects of exposure to ambient air pollutant mixtures, it is becoming more common to include multiple pollutants in epidemiologic models. However, the complex spatial and temporal pattern of ambient pollutant concentrations and related exposures ...

  9. 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.

  10. Integrated Uncertainty Analysis for Ambient Pollutant Health Risk Assessment: A Case Study of Ozone Mortality Risk.

    PubMed

    Smith, Anne E; Glasgow, Garrett

    2017-05-18

    The U.S. Environmental Protection Agency (EPA) uses health risk assessment to help inform its decisions in setting national ambient air quality standards (NAAQS). EPA's standard approach is to make epidemiologically-based risk estimates based on a single statistical model selected from the scientific literature, called the "core" model. The uncertainty presented for "core" risk estimates reflects only the statistical uncertainty associated with that one model's concentration-response function parameter estimate(s). However, epidemiologically-based risk estimates are also subject to "model uncertainty," which is a lack of knowledge about which of many plausible model specifications and data sets best reflects the true relationship between health and ambient pollutant concentrations. In 2002, a National Academies of Sciences (NAS) committee recommended that model uncertainty be integrated into EPA's standard risk analysis approach. This article discusses how model uncertainty can be taken into account with an integrated uncertainty analysis (IUA) of health risk estimates. It provides an illustrative numerical example based on risk of premature death from respiratory mortality due to long-term exposures to ambient ozone, which is a health risk considered in the 2015 ozone NAAQS decision. This example demonstrates that use of IUA to quantitatively incorporate key model uncertainties into risk estimates produces a substantially altered understanding of the potential public health gain of a NAAQS policy decision, and that IUA can also produce more helpful insights to guide that decision, such as evidence of decreasing incremental health gains from progressive tightening of a NAAQS. © 2017 Society for Risk Analysis.

  11. 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...

  12. 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...

  13. 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...

  14. 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.

  15. Cancer Risk Estimates from Space Flight Estimated Using Yields of Chromosome Damage in Astronaut's Blood Lymphocytes

    NASA Technical Reports Server (NTRS)

    George, Kerry A.; Rhone, J.; Chappell, L. J.; Cucinotta, F. A.

    2011-01-01

    To date, cytogenetic damage has been assessed in blood lymphocytes from more than 30 astronauts before and after they participated in long-duration space missions of three months or more on board the International Space Station. Chromosome damage was assessed using fluorescence in situ hybridization whole chromosome analysis techniques. For all individuals, the frequency of chromosome damage measured within a month of return from space was higher than their preflight yield, and biodosimetry estimates were within the range expected from physical dosimetry. Follow up analyses have been performed on most of the astronauts at intervals ranging from around 6 months to many years after flight, and the cytogenetic effects of repeat long-duration missions have so far been assessed in four individuals. Chromosomal aberrations in peripheral blood lymphocytes have been validated as biomarkers of cancer risk and cytogenetic damage can therefore be used to characterize excess health risk incurred by individual crewmembers after their respective missions. Traditional risk assessment models are based on epidemiological data obtained on Earth in cohorts exposed predominantly to acute doses of gamma-rays, and the extrapolation to the space environment is highly problematic, involving very large uncertainties. Cytogenetic damage could play a key role in reducing uncertainty in risk estimation because it is incurred directly in the space environment, using specimens from the astronauts themselves. Relative cancer risks were estimated from the biodosimetry data using the quantitative approach derived from the European Study Group on Cytogenetic Biomarkers and Health database. Astronauts were categorized into low, medium, or high tertiles according to their yield of chromosome damage. Age adjusted tertile rankings were used to estimate cancer risk and results were compared with values obtained using traditional modeling approaches. Individual tertile rankings increased after space

  16. 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.

  17. Uncertainty of Calculated Risk Estimates for Secondary Malignancies After Radiotherapy

    SciTech Connect

    Kry, Stephen F. . E-mail: sfkry@mdanderson.org; Followill, David; White, R. Allen; Stovall, Marilyn; Kuban, Deborah A.; Salehpour, Mohammad

    2007-07-15

    Purpose: The significance of risk estimates for fatal secondary malignancies caused by out-of-field radiation exposure remains unresolved because the uncertainty in calculated risk estimates has not been established. This work examines the uncertainty in absolute risk estimates and in the ratio of risk estimates between different treatment modalities. Methods and Materials: Clinically reasonable out-of-field doses and calculated risk estimates were taken from the literature for several prostate treatment modalities, including intensity-modulated radiotherapy (IMRT), and were recalculated using the most recent risk model. The uncertainties in this risk model and uncertainties in the linearity of the dose-response model were considered in generating 90% confidence intervals for the uncertainty in the absolute risk estimates and in the ratio of the risk estimates. Results: The absolute risk estimates of fatal secondary malignancy were associated with very large uncertainties, which precluded distinctions between the risks associated with the different treatment modalities considered. However, a much smaller confidence interval exists for the ratio of risk estimates, and this ratio between different treatment modalities may be statistically significant when there is an effective dose equivalent difference of at least 50%. Such a difference may exist between clinically reasonable treatment options, including 6-MV IMRT versus 18-MV IMRT for prostate therapy. Conclusion: The ratio of the risk between different treatment modalities may be significantly different. Consequently risk models and associated risk estimates may be useful and meaningful for evaluating different treatment options. The calculated risk of secondary malignancy should be considered in the selection of an optimal treatment plan.

  18. Global Building Inventory for Earthquake Loss Estimation and Risk Management

    USGS Publications Warehouse

    Jaiswal, Kishor; Wald, David; Porter, Keith

    2010-01-01

    We develop a global database of building inventories using taxonomy of global building types for use in near-real-time post-earthquake loss estimation and pre-earthquake risk analysis, for the U.S. Geological Survey’s Prompt Assessment of Global Earthquakes for Response (PAGER) program. The database is available for public use, subject to peer review, scrutiny, and open enhancement. On a country-by-country level, it contains estimates of the distribution of building types categorized by material, lateral force resisting system, and occupancy type (residential or nonresidential, urban or rural). The database draws on and harmonizes numerous sources: (1) UN statistics, (2) UN Habitat’s demographic and health survey (DHS) database, (3) national housing censuses, (4) the World Housing Encyclopedia and (5) other literature.

  19. Health expenditure estimation and functional form: applications of the generalized gamma and extended estimating equations models.

    PubMed

    Hill, Steven C; Miller, G Edward

    2010-05-01

    Health-care expenditure regressions are used in a wide variety of economic analyses including risk adjustment and program and treatment evaluations. Recent articles demonstrated that generalized gamma models (GGMs) and extended estimating equations (EEE) models provide flexible approaches to deal with a variety of data problems encountered in expenditure estimation. To date there have been few empirical applications of these models to expenditures. We use data from the US Medical Expenditure Panel Survey to compare the bias, predictive accuracy, and marginal effects of GGM and EEE models with other commonly used regression models in a cross-validation study design. Health-care expenditure distributions vary in the degree of heteroskedasticity, skewness, and kurtosis by type of service and population. To examine the ability of estimators to address a range of data problems, we estimate models of total health expenditures and prescription drug expenditures for two populations, the elderly and privately insured adults. Our findings illustrate the need for researchers to examine their assumptions about link functions: the appropriate link function varies across our four distributions. The EEE model, which has a flexible link function, is a robust estimator that performs as well, or better, than the other models in each distribution.

  20. The transition to widowhood and the social regulation of health: consequences for health and health risk behavior.

    PubMed

    Williams, Kristi

    2004-11-01

    This study estimates the effects of the transition to widowhood on changes in the social regulation of health and examines the consequences of this association for health and health risk behavior following spousal death. Analysis of longitudinal data from the Changing Lives of Older Couples Study tests the following hypotheses: (a) Widowed individuals experience greater declines in health regulation over time than their married counterparts and (b) the extent to which widowhood undermines health and increases health risk behavior depends on whether it is accompanied by a decline in health regulation. Compared with their continually married counterparts, those who experience the transition to widowhood report a significant decline in the frequency of health reminders and health assistance received from others. The decline in the frequency of health regulation has important consequences for health behavior and health outcomes. Widowhood undermines health and increases health risk behaviors only when it is accompanied by a decline in health regulation. Widowed individuals who experience increases in health regulation show improvements in health and declines in health risk behavior. Interventions targeted at improving the health habits of widowed individuals by mobilizing health-related support systems may be effective at minimizing the negative health consequences of spousal loss.

  1. 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.

  2. Estimating summary measures of health: a structured workbook approach.

    PubMed

    Flanagan, William; Boswell-Purdy, Jane; Le Petit, Christel; Berthelot, Jean-Marie

    2005-05-11

    BACKGROUND: Summary measures of health that combine mortality and morbidity into a single indicator are being estimated in the Canadian context for approximately 200 diseases and conditions. To manage the large amount of data and calculations for this many diseases, we have developed a structured workbook system with easy to use tools. We expect this system will be attractive to researchers from other countries or regions of Canada who are interested in estimating the health-adjusted life years (HALYs) lost to premature mortality and year-equivalents lost to reduced functioning, as well as population attributable fractions (PAFs) associated with risk factors. This paper describes the workbook system using cancers as an example, and includes the entire system as a free, downloadable package. METHODS: The workbook system was developed in Excel and runs on a personal computer. It is a database system that stores data on population structure, mortality, incidence, distributions of cases entering a multitude of health states, durations of time spent in health states, preference scores that weight for severity, life table estimates of life expectancies, and risk factor prevalence and relative risks. The tools are Excel files with embedded macro programs. The main tool generates workbooks that estimate HALY, one per disease, by copying data from the database into a pre-defined template. Other tools summarize the HALY results across diseases for easy analysis. RESULTS: The downloadable zip file contains the database files initialized with Canadian data for cancers, the tools, templates and workbooks that estimate PAF and a user guide. The workbooks that estimate HALY are generated from the system at a rate of approximately one minute per disease. The resulting workbooks are self-contained and can be used directly to explore the details of a particular disease. Results can be discounted at different rates through simple parameter modification. CONCLUSION: The structured

  3. Estimating summary measures of health: a structured workbook approach

    PubMed Central

    Flanagan, William; Boswell-Purdy, Jane; Le Petit, Christel; Berthelot, Jean-Marie

    2005-01-01

    Background Summary measures of health that combine mortality and morbidity into a single indicator are being estimated in the Canadian context for approximately 200 diseases and conditions. To manage the large amount of data and calculations for this many diseases, we have developed a structured workbook system with easy to use tools. We expect this system will be attractive to researchers from other countries or regions of Canada who are interested in estimating the health-adjusted life years (HALYs) lost to premature mortality and year-equivalents lost to reduced functioning, as well as population attributable fractions (PAFs) associated with risk factors. This paper describes the workbook system using cancers as an example, and includes the entire system as a free, downloadable package. Methods The workbook system was developed in Excel and runs on a personal computer. It is a database system that stores data on population structure, mortality, incidence, distributions of cases entering a multitude of health states, durations of time spent in health states, preference scores that weight for severity, life table estimates of life expectancies, and risk factor prevalence and relative risks. The tools are Excel files with embedded macro programs. The main tool generates workbooks that estimate HALY, one per disease, by copying data from the database into a pre-defined template. Other tools summarize the HALY results across diseases for easy analysis. Results The downloadable zip file contains the database files initialized with Canadian data for cancers, the tools, templates and workbooks that estimate PAF and a user guide. The workbooks that estimate HALY are generated from the system at a rate of approximately one minute per disease. The resulting workbooks are self-contained and can be used directly to explore the details of a particular disease. Results can be discounted at different rates through simple parameter modification. Conclusion The structured

  4. Do the risk factors for type 2 diabetes mellitus vary by location? A spatial analysis of health insurance claims in Northeastern Germany using kernel density estimation and geographically weighted regression.

    PubMed

    Kauhl, Boris; Schweikart, Jürgen; Krafft, Thomas; Keste, Andrea; Moskwyn, Marita

    2016-11-03

    The provision of general practitioners (GPs) in Germany still relies mainly on the ratio of inhabitants to GPs at relatively large scales and barely accounts for an increased prevalence of chronic diseases among the elderly and socially underprivileged populations. Type 2 Diabetes Mellitus (T2DM) is one of the major cost-intensive diseases with high rates of potentially preventable complications. Provision of healthcare and access to preventive measures is necessary to reduce the burden of T2DM. However, current studies on the spatial variation of T2DM in Germany are mostly based on survey data, which do not only underestimate the true prevalence of T2DM, but are also only available on large spatial scales. The aim of this study is therefore to analyse the spatial distribution of T2DM at fine geographic scales and to assess location-specific risk factors based on data of the AOK health insurance. To display the spatial heterogeneity of T2DM, a bivariate, adaptive kernel density estimation (KDE) was applied. The spatial scan statistic (SaTScan) was used to detect areas of high risk. Global and local spatial regression models were then constructed to analyze socio-demographic risk factors of T2DM. T2DM is especially concentrated in rural areas surrounding Berlin. The risk factors for T2DM consist of proportions of 65-79 year olds, 80 + year olds, unemployment rate among the 55-65 year olds, proportion of employees covered by mandatory social security insurance, mean income tax, and proportion of non-married couples. However, the strength of the association between T2DM and the examined socio-demographic variables displayed strong regional variations. The prevalence of T2DM varies at the very local level. Analyzing point data on T2DM of northeastern Germany's largest health insurance provider thus allows very detailed, location-specific knowledge about increased medical needs. Risk factors associated with T2DM depend largely on the place of residence of the

  5. Estimates of Preventability and Their Relation to Health Behavior.

    ERIC Educational Resources Information Center

    Poole, Gary D.

    It was hypothesized that a person's estimates of the preventability of health problems would be related to health behaviors such that a person who engages in healthful behavior should make higher estimates of preventability. A study was conducted to investigate the relationship between causal attribution of health problems and health-related…

  6. Health risk of chrysotile revisited.

    PubMed

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

    2013-02-01

    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.

  7. 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

  8. [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.

  9. Assessing Human Health Risk from Pesticides

    EPA Pesticide Factsheets

    EPA protects human health and the environment by evaluating the risk associated with pesticides before allowing them to be used in the United States. Learn about the tools and processes used in risk assessment for pesticides.

  10. Health Risk Appraisal Use at Headquarters

    NASA Technical Reports Server (NTRS)

    Borcherding, Donald

    1997-01-01

    Specific topics which relate to the NASA Health Risk Appraisal (HRA) include: (1) What is a HRA?; (2) Risk factors; (3) Program use at NASA Headquarters; (4) An alternative approach; (5) Group HRA reports; and (6) Future considerations and conclusion.

  11. Health Risk Appraisal Use at Headquarters

    NASA Technical Reports Server (NTRS)

    Borcherding, Donald

    1997-01-01

    Specific topics which relate to the NASA Health Risk Appraisal (HRA) include: (1) What is a HRA?; (2) Risk factors; (3) Program use at NASA Headquarters; (4) An alternative approach; (5) Group HRA reports; and (6) Future considerations and conclusion.

  12. Risking Life and Limb: Estimating a Measure of Medical Care Economic Risk and Considering its Implications.

    PubMed

    Abramowitz, Joelle; O'Hara, Brett; Morris, Darcy Steeg

    2017-04-01

    This paper considers the risk of incurring future medical expenditures in light of a family's resources available to pay for those expenditures as well as their choice of health insurance. We model non-premium medical out-of-pocket expenditures and use the estimates from our model to develop a prospective measure of medical care economic risk estimating the proportion of families who are at risk of incurring high non-premium out-of-pocket medical care expenses in relation to its resources. We further use the estimates from our model to compare the extent to which different types of insurance mitigate the risk of incurring non-premium expenditures by providing for increased utilization of medical care. We find that while 21.3% of families lack the resources to pay for the median expenditures for their insurance type, 42.4% lack the resources to pay for the 99(th) percentile of expenditures for their insurance type. We also find the mediating effect of insurance on non-premium expenditures to outweigh the associated premium expense for expenditures above $1804 for employer-sponsored insurance and $4337 for direct purchase insurance for those younger than age 65; and above $12 118 of expenditures for Medicare supplementary plans for those aged 65 or older. Published 2016. This article is a U.S. Government work and is in the public domain in the USA.

  13. Relating space radiation environments to risk estimates

    SciTech Connect

    Curtis, S.B.

    1991-10-01

    This lecture will provide a bridge from the physical energy or LET spectra as might be calculated in an organ to the risk of carcinogenesis, a particular concern for extended missions to the moon or beyond to Mars. Topics covered will include (1) LET spectra expected from galactic cosmic rays, (2) probabilities that individual cell nuclei in the body will be hit by heavy galactic cosmic ray particles, (3) the conventional methods of calculating risks from a mixed environment of high and low LET radiation, (4) an alternate method which provides certain advantages using fluence-related risk coefficients (risk cross sections), and (5) directions for future research and development of these ideas.

  14. Relating space radiation environments to risk estimates

    SciTech Connect

    Curtis, S.B.

    1991-10-01

    This lecture will provide a bridge from the physical energy or LET spectra as might be calculated in an organ to the risk of carcinogenesis, a particular concern for extended missions to the moon or beyond to Mars. Topics covered will include (1) LET spectra expected from galactic cosmic rays, (2) probabilities that individual cell nuclei in the body will be hit by heavy galactic cosmic ray particles, (3) the conventional methods of calculating risks from a mixed environment of high and low LET radiation, (4) an alternate method which provides certain advantages using fluence-related risk coefficients (risk cross sections), and (5) directions for future research and development of these ideas.

  15. 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

  16. Kalman Filter Constraint Tuning for Turbofan Engine Health Estimation

    NASA Technical Reports Server (NTRS)

    Simon, Dan; Simon, Donald L.

    2005-01-01

    Kalman filters are often used to estimate the state variables of a dynamic system. However, in the application of Kalman filters some known signal information is often either ignored or dealt with heuristically. For instance, state variable constraints are often neglected because they do not fit easily into the structure of the Kalman filter. Recently published work has shown a new method for incorporating state variable inequality constraints in the Kalman filter, which has been shown to generally improve the filter s estimation accuracy. However, the incorporation of inequality constraints poses some risk to the estimation accuracy as the Kalman filter is theoretically optimal. This paper proposes a way to tune the filter constraints so that the state estimates follow the unconstrained (theoretically optimal) filter when the confidence in the unconstrained filter is high. When confidence in the unconstrained filter is not so high, then we use our heuristic knowledge to constrain the state estimates. The confidence measure is based on the agreement of measurement residuals with their theoretical values. The algorithm is demonstrated on a linearized simulation of a turbofan engine to estimate engine health.

  17. Estimation of radiation cancer risk in CT-KUB

    NASA Astrophysics Data System (ADS)

    Karim, M. K. A.; Hashim, S.; Bakar, K. A.; Bradley, D. A.; Ang, W. C.; Bahrudin, N. A.; Mhareb, M. H. A.

    2017-08-01

    The increased demand for computed tomography (CT) in radiological scanning examinations raises the question of a potential health impact from the associated radiation exposures. Focusing on CT kidney-ureter-bladder (CT-KUB) procedures, this work was aimed at determining organ equivalent dose using a commercial CT dose calculator and providing an estimate of cancer risks. The study, which included 64 patients (32 males and 32 females, mean age 55.5 years and age range 30-80 years), involved use of a calibrated CT scanner (Siemens-Somatom Emotion 16-slice). The CT exposures parameter including tube potential, pitch factor, tube current, volume CT dose index (CTDIvol) and dose-length product (DLP) were recorded and analyzed using CT-EXPO (Version 2.3.1, Germany). Patient organ doses, including for stomach, liver, colon, bladder, red bone marrow, prostate and ovaries were calculated and converted into cancer risks using age- and sex-specific data published in the Biological Effects of Ionizing Radiation (BEIR) VII report. With a median value scan range of 36.1 cm, the CTDIvol, DLP, and effective dose were found to be 10.7 mGy, 390.3 mGy cm and 6.2 mSv, respectively. The mean cancer risks for males and females were estimated to be respectively 25 and 46 out of 100,000 procedures with effective doses between 4.2 mSv and 10.1 mSv. Given the increased cancer risks from current CT-KUB procedures compared to conventional examinations, we propose that the low dose protocols for unenhanced CT procedures be taken into consideration before establishing imaging protocols for CT-KUB.

  18. Assessment of possible impact of a health promotion program in Korea from health risk trends in a longitudinally observed cohort

    PubMed Central

    Park, J; Jee, SH; Edington, DW

    2004-01-01

    Background Longitudinally observed cohort data can be utilized to assess the potential for health promotion and healthcare planning by comparing the estimated risk factor trends of non-intervened with that of intervened. The paper seeks (1) to estimate a natural transition (patterns of movement between states) of health risk state from a Korean cohort data using a Markov model, (2) to derive an effective and necessary health promotion strategy for the population, and (3) to project a possible impact of an intervention program on health status. Methods The observed transition of health risk states in a Korean employee cohort was utilized to estimate the natural flow of aggregated health risk states from eight health risk measures using Markov chain models. In addition, a reinforced transition was simulated, given that a health promotion program was implemented for the cohort, to project a possible impact on improvement of health status. An intervened risk transition was obtained based on age, gender, and baseline risk state, adjusted to match with the Korean cohort, from a simulated random sample of a US employee population, where a health intervention was in place. Results The estimated natural flow (non-intervened), following Markov chain order 2, showed a decrease in low risk state by 3.1 percentage points in the Korean population while the simulated reinforced transition (intervened) projected an increase in low risk state by 7.5 percentage points. Estimated transitions of risk states demonstrated the necessity of not only the risk reduction but also low risk maintenance. Conclusions The frame work of Markov chain efficiently estimated the trend, and captured the tendency in the natural flow. Given only a minimally intense health promotion program, potential risk reduction and low risk maintenance was projected. PMID:15538950

  19. Health Risk Assessments for Alumina Refineries

    PubMed Central

    Coffey, Patrick S.

    2014-01-01

    Objective: To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Methods: Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. Results: The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10−6. Conclusions: The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries. PMID:24806721

  20. Health risk assessments for alumina refineries.

    PubMed

    Donoghue, A Michael; Coffey, Patrick S

    2014-05-01

    To describe contemporary air dispersion modeling and health risk assessment methodologies applied to alumina refineries and to summarize recent results. Air dispersion models using emission source and meteorological data have been used to assess ground-level concentrations (GLCs) of refinery emissions. Short-term (1-hour and 24-hour average) GLCs and annual average GLCs have been used to assess acute health, chronic health, and incremental carcinogenic risks. The acute hazard index can exceed 1 close to refineries, but it is typically less than 1 at neighboring residential locations. The chronic hazard index is typically substantially less than 1. The incremental carcinogenic risk is typically less than 10(-6). The risks of acute health effects are adequately controlled, and the risks of chronic health effects and incremental carcinogenic risks are negligible around referenced alumina refineries.

  1. Risk behaviours and self rated health in Russia 1998

    PubMed Central

    Carlson, P

    2001-01-01

    OBJECTIVES—As self rated health and mortality represent different dimensions of public health and as risk behaviours have been closely related to mortality, we wanted to examine whether (poor) self rated health on the one hand and risk behaviours on the other can be attributed to different causes.
METHODS—The Taganrog household survey (1998) was conducted in the form of face to face interviews and included 1009 people and their families. To estimate health differences and differences in risk behaviours between groups, logistic regressions were performed.
RESULTS—In Taganrog between 1993/94 and 1998, changes in self rated health seem to have been much more dramatic than changes in smoking and different in direction from changes in heavy alcohol consumption. Moreover, self rated "poor" health was especially common among those whose economic situation was worse in 1998 than 10 years before. However, having a poorer economy during the period 1988-1998, does not seem to have affected drinking or smoking habits significantly.
CONCLUSIONS—Self rated health seems to be closely related to three indicators of economic circumstances. Risk behaviours are probably important for the poor state of public health in Russia, but may be less sensitive to the economic aspects of the transition than is self rated health.


Keywords: self rated health; risk behaviours PMID:11604437

  2. Estimating Wisconsin Asthma Prevalence Using Clinical Electronic Health Records and Public Health Data

    PubMed Central

    Tomasallo, Carrie D.; Hanrahan, Lawrence P.; Tandias, Aman; Chang, Timothy S.; Cowan, Kelly J.

    2014-01-01

    Objectives. We compared a statewide telephone health survey with electronic health record (EHR) data from a large Wisconsin health system to estimate asthma prevalence in Wisconsin. Methods. We developed frequency tables and logistic regression models using Wisconsin Behavioral Risk Factor Surveillance System and University of Wisconsin primary care clinic data. We compared adjusted odds ratios (AORs) from each model. Results. Between 2007 and 2009, the EHR database contained 376 000 patients (30 000 with asthma), and 23 000 (1850 with asthma) responded to the Behavioral Risk Factor Surveillance System telephone survey. AORs for asthma were similar in magnitude and direction for the majority of covariates, including gender, age, and race/ethnicity, between survey and EHR models. The EHR data had greater statistical power to detect associations than did survey data, especially in pediatric and ethnic populations, because of larger sample sizes. Conclusions. EHRs can be used to estimate asthma prevalence in Wisconsin adults and children. EHR data may improve public health chronic disease surveillance using high-quality data at the local level to better identify areas of disparity and risk factors and guide education and health care interventions. PMID:24228643

  3. [Aflatoxins--health risk factors].

    PubMed

    Miliţă, Nicoleta Manuela; Mihăescu, Gr; Chifiriuc, Carmen

    2010-01-01

    Aflatoxins are secondary metabolites produced by a group of strains, mainly Aspergillus and Penicillium species. These mycotoxins are bifurano-coumarin derivatives group with four major products B1, B2, G1 and G2 according to blue or green fluorescence emitted in ultraviolet light and according to chromatographic separation. After metabolism of aflatoxin B1 and B2 in the mammalian body, result two metabolites M1 and M2 as hydroxylated derivatives of the parent compound. Aflatoxins have high carcinogenic potential, the most powerful carcinogens in different species of animals and humans. International Agency for Research on Cancer has classified aflatoxin B1 in Group I carcinogens. The target organ for aflatoxins is the liver. In chronic poisoning, aflatoxin is a risk to health, for a long term causing cancer (hepatocellular carcinoma), and in acute intoxications aflatoxin is lethal. This work purpose to discuss aflatoxins issue: the synthesis, absorption and elimination of aflatoxins, the toxicity mechanisms, and measures to limit the content of aflatoxins in food

  4. The impact of the Citibank, NA, health management program on changes in employee health risks over time.

    PubMed

    Ozminkowski, R J; Goetzel, R Z; Smith, M W; Cantor, R I; Shaughnessy, A; Harrison, M

    2000-05-01

    This study estimated the impact of the Citibank Health Management Program on changes in health risks among Citibank employees. McNemar chi-squared tests compared the probability of being at high risk for poor health when the first and last health-risk appraisal surveys were taken. Logistic regression controlled for baseline differences in subsequent analyses when those who participated in more intensive program features were compared with those who participated in less intensive features. Declines in risk were noted for 8 of 10 risk categories. Most changes were small, except those related to exercise habits, seatbelt use, and stress levels. For nine health risk categories, those who participated in more intensive program services were significantly more likely than others to reduce their health risks. Thus, the Citibank Health Management Program was associated with significant reductions in health risk.

  5. 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

  6. Optimal Allocation for the Estimation of Attributable Risk,

    DTIC Science & Technology

    control studies . Various optimal strategies are examined using alternative exposure-specific disease rates. Odd Ratio, Relative Risk and Attributable Risk....This paper derives an expression for the optimum sampling allocation under the minimum variance criterion of the estimated attributable risk for case

  7. 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…

  8. 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…

  9. The Health Risks of Weight Loss.

    ERIC Educational Resources Information Center

    Berg, Frances M.

    This report compiles scientific evidence and statistics on the health risks of weight loss interventions and is intended to help both professionals and consumers cope in healthful ways with the complex dilemmas of weight. The publication is organized into six chapters: (1) "Risks of Losing Weight"; (2) "Effectiveness of…

  10. [Estimation of absolute risk for fracture].

    PubMed

    Fujiwara, Saeko

    2009-03-01

    Osteoporosis treatment aims to prevent fractures and maintain the QOL of the elderly. However, persons at high risk of future fracture cannot be effectively identified on the basis of bone density (BMD) alone, although BMD is used as an diagnostic criterion. Therefore, the WHO recommended that absolute risk for fracture (10-year probability of fracture) for each individual be evaluated and used as an index for intervention threshold. The 10-year probability of fracture is calculated based on age, sex, BMD at the femoral neck (body mass index if BMD is not available), history of previous fractures, parental hip fracture history, smoking, steroid use, rheumatoid arthritis, secondary osteoporosis and alcohol consumption. The WHO has just announced the development of a calculation tool (FRAX: WHO Fracture Risk Assessment Tool) in February this year. Fractures could be prevented more effectively if, based on each country's medical circumstances, an absolute risk value for fracture to determine when to start medical treatment is established and persons at high risk of fracture are identified and treated accordingly.

  11. Political risk in fair market value estimates

    SciTech Connect

    Gruy, H.J.; Hartsock, J.H.

    1996-09-01

    Political risk arises from unstable governments, commercial establishments and infrastructure as well as labor unrest. All these factors vary from country to country and from time to time. Banks and insurance companies quantify these risks, but they are reluctant to divulge their opinions for fear of alienating possible customers that have been assigned a high risk. An investment in a fixed property such as an oil and gas lease, concession or other mineral interest is subject to political risk. No one will deny that money to be received several years in the future has a greater value today in a country with a stable government, stable tax regime, a sound economy and reliable labor force than in a Third World country where a revolution is brewing. Even in stable countries, the risk of tax law changes, exorbitant environmental production regulations and cleanup costs may vary. How do these factors affect fair market value and how are these calculations made? An important consideration discussed in this paper is the treatment of capital investments.

  12. Chemical Risk Assessment: Traditional vs Public Health ...

    EPA Pesticide Factsheets

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environmentally-induced diseases related to chemical exposure. However, traditional chemical risk assessment is faced with multiple challenges with respect to predicting and preventing disease in human populations, and epidemiological studies increasingly report observations of adverse health effects at exposure levels predicted from animal studies to be safe for humans. This discordance reinforces concerns about the adequacy of contemporary risk assessment practices (Birnbaum, Burke, & Jones, 2016) for protecting public health. It is becoming clear that to protect public health more effectively, future risk assessments will need to use the full range of available data, draw on innovative methods to integrate diverse data streams, and consider health endpoints that also reflect the range of subtle effects and morbidities observed in human populations. Given these factors, there is a need to reframe chemical risk assessment to be more clearly aligned with the public health goal of minimizing environmental exposures associated with disease. Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. Chemical risk assessments

  13. Risk communication for public health emergencies.

    PubMed

    Glik, Deborah C

    2007-01-01

    This review defines crisis risk communication, traces its origins to a number of applied fields, and then shows how basic principles have become incorporated into emergency preparedness and risk communication for public health. Literature from four different disciplines that inform crisis risk communications are reviewed. These are (a) environmental risk communication, (b) disaster management, (c) health promotion and communication, and (d) media and communication studies. Current curricula and training materials are briefly reviewed. Although this literature review suggests much progress has been made to incorporate and disseminate crisis risk communication principles into public health practice, and case studies suggest that public health workers have gained skills and experience, this emerging field still lacks in-depth evaluation of the effectiveness of event-specific crisis risk communication efforts.

  14. The Management Standards Indicator Tool and the estimation of risk.

    PubMed

    Bevan, A; Houdmont, J; Menear, N

    2010-10-01

    The Health & Safety Executive's (HSE) Indicator Tool offers a measure of exposure to psychosocial work conditions that may be linked to stress-related outcomes. The HSE recommends that Indicator Tool data should be used as a basis for discussions concerned with the identification of psychosocial work conditions that might warrant prioritization for intervention. However, operational constraints may render discussions difficult to convene and, when they do take place, the absence of information on harms associated with exposures can make it difficult to identify intervention priorities. To examine (i) the utility of the Indicator Tool for the identification of a manageable number of psychosocial work conditions as intervention candidates and (ii) whether administration of a measure of stress-related outcomes alongside the Indicator Tool can facilitate the identification of intervention priorities. One thousand and thirty-eight employees in the London region of the Her Majesty's Prison Service completed the Indicator Tool and a measure of psychological well-being. Odds ratios were calculated to estimate the risk of impairment to well-being associated with exposure to psychosocial work conditions. The Indicator Tool identified 34 psychosocial work conditions as warranting improvement. Intervention priority was given to those working conditions that were both reported to be poor by ≥50% of respondents and associated with risk of impairment to well-being. This method allowed for the identification of four areas. Augmentation of the Indicator Tool with a measure of stress-related outcomes and the calculation of simple risk estimation statistics can assist the prioritization of intervention candidates.

  15. Non-parametric estimation of spatial variation in relative risk.

    PubMed

    Kelsall, J E; Diggle, P J

    We consider the problem of estimating the spatial variation in relative risks of two diseases, say, over a geographical region. Using an underlying Poisson point process model, we approach the problem as one of density ratio estimation implemented with a non-parametric kernel smoothing method. In order to assess the significance of any local peaks or troughs in the estimated risk surface, we introduce pointwise tolerance contours which can enhance a greyscale image plot of the estimate. We also propose a Monte Carlo test of the null hypothesis of constant risk over the whole region, to avoid possible over-interpretation of the estimated risk surface. We illustrate the capabilities of the methodology with two epidemiological examples.

  16. Parametric Estimation in a Recurrent Competing Risks Model.

    PubMed

    Taylor, Laura L; Peña, Edsel A

    2013-01-01

    A resource-efficient approach to making inferences about the distributional properties of the failure times in a competing risks setting is presented. Efficiency is gained by observing recurrences of the competing risks over a random monitoring period. The resulting model is called the recurrent competing risks model (RCRM) and is coupled with two repair strategies whenever the system fails. Maximum likelihood estimators of the parameters of the marginal distribution functions associated with each of the competing risks and also of the system lifetime distribution function are presented. Estimators are derived under perfect and partial repair strategies. Consistency and asymptotic properties of the estimators are obtained. The estimation methods are applied to a data set of failures for cars under warranty. Simulation studies are used to ascertain the small sample properties and the efficiency gains of the resulting estimators.

  17. Oak mortality risk factors and mortality estimation

    Treesearch

    Stephen R. Shifley; Zhaofei Fan; John M. Kabrick; Randy G. Jensen

    2006-01-01

    Managers are often concerned about oak mortality in maturing mixed-oak forests, but they often lack explicit information about mortality risk for oaks that differ in species, size, crown class, competitive status, and growth rate. In eastern North America, tree species in the red oak group (Quercus Section Lobatae) are typically...

  18. A generic computerized method for estimate of familial risks.

    PubMed Central

    Colombet, Isabelle; Xu, Yigang; Jaulent, Marie-Christine; Desages, Daniel; Degoulet, Patrice; Chatellier, Gilles

    2002-01-01

    Most guidelines developed for cancers screening and for cardiovascular risk management use rules to estimate familial risk. These rules are complex, difficult to memorize, and need to collect a complete pedigree. This paper describes a generic computerized method to estimate familial risks and its implementation in an internet-based application. The program is based on 3 generic models: a model of the family; a model of familial risk; a display model for the pedigree. The model of family allows to represent each member of the family and to construct and display a family tree. The model of familial risk is generic and allows easy update of the program with new diseases or new rules. It was possible to implement guidelines dealing with breast and colorectal cancer and cardiovascular diseases prevention. First evaluation with general practitioners showed that the program was usable. Impact on quality of familial risk estimate should be more documented. PMID:12463810

  19. Categorizing sources of risk and the estimated magnitude of risk.

    PubMed

    Aragonés, Juan Ignacio; Moyano, Emilio; Talayero, Fernando

    2008-05-01

    The social perception of risk is considered a multidimensional task, yet little attention has been paid to the cognitive components that organize sources of risk, despite their having been discovered in various research studies. This study attempts to concretely analyze the cultural dimension involved in those processes. In the first phase, we tried to discover to what extent sources of risk are organized into the same categories by people from different countries. In order to do so, two groups of participants were formed: 60 Spanish psychology students and 60 Chilean psychology students classified 43 sources of risk into different groups according to the criteria they found appropriate. The two samples classified risk into identical groups: acts of violence, drugs, electricity and home appliances, household chemicals, chemicals in the environment, public construction projects, transportation, sports, and natural disasters. In a second study, 100 Spanish and 84 Chilean students were asked to evaluate the magnitude of the damage incurred by 17 sources of risk. In both groups, it was observed that the evaluation of damage resulting from each source of risk was affected by its category.

  20. Assessment of Methods for Estimating Risk to Birds from ...

    EPA Pesticide Factsheets

    The U.S. EPA Ecological Risk Assessment Support Center (ERASC) announced the release of the final report entitled, Assessment of Methods for Estimating Risk to Birds from Ingestion of Contaminated Grit Particles. This report evaluates approaches for estimating the probability of ingestion by birds of contaminated particles such as pesticide granules or lead particles (i.e. shot or bullet fragments). In addition, it presents an approach for using this information to estimate the risk of mortality to birds from ingestion of lead particles. Response to ERASC Request #16

  1. Using health inspection scores to assess risk in food services.

    PubMed

    Lee, Ji-Eun; Almanza, Barbara A; Nelson, Douglas C; Ghiselli, Richard F

    2009-03-01

    This study gathered health inspectors' opinions about appropriate weightings of critical, noncritical, and repeat violations under the current food inspection system, and developed a classification of violations for high-, medium-, and low-risk restaurants. Results showed that health inspectors thought that the appropriate weights were five points for a critical violation, one point for a noncritical violation, and double points for a repeat violation. In addition, health inspectors thought that the maximum numbers of critical violations for a high-, medium-, and low-risk category were 2.05, 3.02, and 4.83, respectively, and for noncritical violations, 4.59, 7.30, and 10.37, respectively. A paired t-test was used to compare these values with estimations based on the traditional health inspection scoring system. Results indicate that the maximum number of critical violations for medium risk and maximum numbers of noncritical violations for low-, medium-, or high-risk restaurants were significantly different between health inspectors' opinions and mathematical estimations. Health inspectors appear to be stricter than the traditional health inspection scoring system about violations, particularly repeat violations, and their importance in enforcement of food safety.

  2. Estimation of Health Benefits From a Local Living Wage Ordinance

    PubMed Central

    Bhatia, Rajiv; Katz, Mitchell

    2001-01-01

    Objectives. This study estimated the magnitude of health improvements resulting from a proposed living wage ordinance in San Francisco. Methods. Published observational models of the relationship of income to health were applied to predict improvements in health outcomes associated with proposed wage increases in San Francisco. Results. With adoption of a living wage of $11.00 per hour, we predict decreases in premature death from all causes for adults aged 24 to 44 years working full-time in families whose current annual income is $20 000 (for men, relative hazard [RH] = 0.94, 95% confidence interval [CI] = 0.92, 0.97; for women, RH = 0.96, 95% CI = 0.95, 0.98). Improvements in subjectively rated health and reductions in the number of days sick in bed, in limitations of work and activities of daily living, and in depressive symptoms were also predicted, as were increases in daily alcohol consumption. For the offspring of full-time workers currently earning $20 000, a living wage predicts an increase of 0.25 years (95% CI = 0.20, 0.30) of completed education, increased odds of completing high school (odds ratio = 1.34, 95% CI = 1.20, 1.49), and a reduced risk of early childbirth (RH = 0.78, 95% CI = 0.69, 0.86). Conclusions. A living wage in San Francisco is associated with substantial health improvement. PMID:11527770

  3. Estimation of health benefits from a local living wage ordinance.

    PubMed

    Bhatia, R; Katz, M

    2001-09-01

    This study estimated the magnitude of health improvements resulting from a proposed living wage ordinance in San Francisco. Published observational models of the relationship of income to health were applied to predict improvements in health outcomes associated with proposed wage increases in San Francisco. With adoption of a living wage of $11.00 per hour, we predict decreases in premature death from all causes for adults aged 24 to 44 years working full-time in families whose current annual income is $20,000 (for men, relative hazard [RH] = 0.94, 95% confidence interval [CI] = 0.92, 0.97; for women, RH = 0.96, 95% CI = 0.95, 0.98). Improvements in subjectively rated health and reductions in the number of days sick in bed, in limitations of work and activities of daily living, and in depressive symptoms were also predicted, as were increases in daily alcohol consumption. For the offspring of full-time workers currently earning $20,000, a living wage predicts an increase of 0.25 years (95% CI = 0.20, 0.30) of completed education, increased odds of completing high school (odds ratio = 1.34, 95% CI = 1.20, 1.49), and a reduced risk of early childbirth (RH = 0.78, 95% CI = 0.69, 0.86). A living wage in San Francisco is associated with substantial health improvement.

  4. Crowdfunding our health: Economic risks and benefits.

    PubMed

    Renwick, Matthew J; Mossialos, Elias

    2017-10-01

    Crowdfunding is an expanding form of alternative financing that is gaining traction in the health sector. This article presents a typology for crowdfunded health projects and a review of the main economic benefits and risks of crowdfunding in the health market. We use evidence from a literature review, complimented by expert interviews, to extend the fundamental principles and established theories of crowdfunding to a health market context. Crowdfunded health projects can be classified into four types according to the venture's purpose and funding method. These are projects covering health expenses, fundraising health initiatives, supporting health research, or financing commercial health innovation. Crowdfunding could economically benefit the health sector by expanding market participation, drawing money and awareness to neglected health issues, improving access to funding, and fostering project accountability and social engagement. However, the economic risks of health-related crowdfunding include inefficient priority setting, heightened financial risk, inconsistent regulatory policies, intellectual property rights concerns, and fraud. Theorized crowdfunding behaviours such as signalling and herding can be observed in the market for health-related crowdfunding. Broader threats of market failure stemming from adverse selection and moral hazard also apply. Many of the discussed economic benefits and risks of crowdfunding health campaigns are shared more broadly with those of crowdfunding projects in other sectors. Where crowdfunding health care appears to diverge from theory is the negative externality inefficient priority setting may have towards achieving broader public health goals. Therefore, the market for crowdfunding health care must be economically stable, as well as designed to optimally and equitably improve public health. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Estimating Fire Risks at Industrial Nuclear Facilities

    SciTech Connect

    Coutts, D.A.

    1999-07-12

    The Savannah River Site (SRS) has a wide variety of nuclear production facilities that include chemical processing facilities, machine shops, production reactors, and laboratories. Current safety documentation must be maintained for the nuclear facilities at SRS. Fire Risk Analyses (FRAs) are used to support the safety documentation basis. These FRAs present the frequency that specified radiological and chemical consequences will be exceeded. The consequence values are based on mechanistic models assuming specific fire protection features fail to function as designed.

  6. Estimating Risk: Stereotype Amplification and the Perceived Risk of Criminal Victimization

    ERIC Educational Resources Information Center

    Quillian, Lincoln; Pager, Devah

    2010-01-01

    This paper considers the process by which individuals estimate the risk of adverse events, with particular attention to the social context in which risk estimates are formed. We compare subjective probability estimates of crime victimization to actual victimization experiences among respondents from the 1994 to 2002 waves of the Survey of Economic…

  7. [Work and mental health: risk groups].

    PubMed

    Vézina, M; Gingras, S

    1996-01-01

    Analysis of the Quebec Health survey identified those Quebec industrial sectors and professions in which workers are at risk of higher psychological distress and lower psychological well-being. Risk levels were measured by odds ratio, controlling for: health status, sex, social support and stressful life events. Results show that those at risk are blue collar workers and less qualified workers of traditional sectors. Lower job latitude could explain those results. Results show that risk of mental health problems is significantly higher in the following industrial sectors: leather, chemicals, paint and varnish industries; urban bus transport and taxi; shoe, clothing and textile retail stores; department stores; restaurant services; insurance and public administration (excluding defence). Risk of mental health problems is higher in the following professions road transport (excluding truck drivers); textile, leather, fur manufacturing and repairing; housekeeping and maintenance; painters, tapestry-workers, insulation and waterproofing, food and beverages sector; data processors; editors and university professors.

  8. New approaches in human health risk assessment

    PubMed Central

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu). PMID:27974141

  9. An estimation of Canada's public health physician workforce.

    PubMed

    Russell, Margaret L; McIntyre, Lynn

    2009-01-01

    Public health emergency planning includes a consideration of public health human resource requirements. We addressed the hypothetical question: How many public health physicians could Canada mobilize in the event of a public health emergency? We used the 2004 National Physician Survey (NPS) to estimate the number of public health physicians in Canada. Using weighting to account for non-response, we estimated the numbers and population estimates of public health physicians who were active versus 'in reserve'. We explored the impact of using diverse definitions of public health physician based upon NPS questions on professional activity, self-reported degrees and certifications, and physician database classifications. Of all Canadian physicians, an estimated 769 (1.3%) are qualified to practice public health by virtue of degrees and certifications relevant to public health, of whom 367 (48%) also report active 'community medicine/public health' practice. Even among Canada's 382 Community Medicine specialists, only 60% report active public health practice. The estimation of the size of Canada's public health physician workforce is currently limited by the lack of a clear definition and appropriate monitoring. It appears that, even with a reserve public health physician workforce that would almost double its numbers, Canada's available workforce is only 40% of projected requirements. Public health emergency preparedness planning exercises should clearly delineate public health physician roles and needs, and action should be taken accordingly to enhance the numbers of Canadian public health physicians and their capacity to meet these requirements.

  10. 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.

  11. Estimation of the Disease Burden Attributable to 11 Risk Factors in Hubei Province, China: A Comparative Risk Assessment

    PubMed Central

    Cui, Fangfang; Zhang, Lan; Yu, Chuanhua; Hu, Songbo; Zhang, Yunquan

    2016-01-01

    In order to estimate the health losses caused by common risk factors in the Hubei province, China, we calculated the deaths and disability-adjusted life years (DALYs) attributable to 11 risk factors. We estimated the exposure distributions of risk factors in Hubei Province in 2013 from the monitoring system on chronic disease and related risk factors, combined with relative risk (RR) in order to calculate the population attributable fraction. Deaths and DALYs attributed to the selected risk factors were then estimated together with cause-specific deaths and DALYs. In total, 53.39% of the total deaths and 36.23% of the total DALYs in Hubei were a result of the 11 selected risk factors. The top five risk factors were high blood pressure, smoking, high body mass index, diet low in fruits and alcohol use, accounting for 14.68%, 12.57%, 6.03%, 3.90% and 3.19% of total deaths, respectively, and 9.41%, 7.22%, 4.42%, 2.51% and 2.44% of total DALYs, respectively. These risk factors, especially high blood pressure, smoking and high body mass index, significantly influenced quality of life, causing a large number of deaths and DALYs. The burden of chronic disease could be substantially reduced if these risk factors were effectively controlled, which would allow people to enjoy healthier lives. PMID:27669279

  12. Risk communication for environmental health hazards.

    PubMed

    Wiedemann, P M; Schütz, H

    1999-08-01

    Starting with the analysis of communication problems in the field of therapeutical and environmental risks the special requirements and challenges of communicating environmental health risks will be outlined. Important problems of this type of risk communication include: (1) The political context which imposes a new role structure upon the doctor and the people involved, (2) the special importance of credibility of scientific statements, given the limited understanding of health risks related to the environment, and (3) the strong emotional component and therefore the conflict-proneness of communication.

  13. 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.

  14. Estimating Risk: Stereotype Amplification and the Perceived Risk of Criminal Victimization

    PubMed Central

    QUILLIAN, LINCOLN; PAGER, DEVAH

    2010-01-01

    This paper considers the process by which individuals estimate the risk of adverse events, with particular attention to the social context in which risk estimates are formed. We compare subjective probability estimates of crime victimization to actual victimization experiences among respondents from the 1994 to 2002 waves of the Survey of Economic Expectations (Dominitz and Manski 2002). Using zip code identifiers, we then match these survey data to local area characteristics from the census. The results show that: (1) the risk of criminal victimization is significantly overestimated relative to actual rates of victimization or other negative events; (2) neighborhood racial composition is strongly associated with perceived risk of victimization, whereas actual victimization risk is driven by nonracial neighborhood characteristics; and (3) white respondents appear more strongly affected by racial composition than nonwhites in forming their estimates of risk. We argue these results support a model of stereotype amplification in the formation of risk estimates. Implications for persistent racial inequality are considered. PMID:20686631

  15. Thinking Concretely Increases the Perceived Likelihood of Risks: The Effect of Construal Level on Risk Estimation.

    PubMed

    Lermer, Eva; Streicher, Bernhard; Sachs, Rainer; Raue, Martina; Frey, Dieter

    2016-03-01

    Recent findings on construal level theory (CLT) suggest that abstract thinking leads to a lower estimated probability of an event occurring compared to concrete thinking. We applied this idea to the risk context and explored the influence of construal level (CL) on the overestimation of small and underestimation of large probabilities for risk estimates concerning a vague target person (Study 1 and Study 3) and personal risk estimates (Study 2). We were specifically interested in whether the often-found overestimation of small probabilities could be reduced with abstract thinking, and the often-found underestimation of large probabilities was reduced with concrete thinking. The results showed that CL influenced risk estimates. In particular, a concrete mindset led to higher risk estimates compared to an abstract mindset for several adverse events, including events with small and large probabilities. This suggests that CL manipulation can indeed be used for improving the accuracy of lay people's estimates of small and large probabilities. Moreover, the results suggest that professional risk managers' risk estimates of common events (thus with a relatively high probability) could be improved by adopting a concrete mindset. However, the abstract manipulation did not lead managers to estimate extremely unlikely events more accurately. Potential reasons for different CL manipulation effects on risk estimates' accuracy between lay people and risk managers are discussed.

  16. Security Events and Vulnerability Data for Cybersecurity Risk Estimation.

    PubMed

    Allodi, Luca; Massacci, Fabio

    2017-08-01

    Current industry standards for estimating cybersecurity risk are based on qualitative risk matrices as opposed to quantitative risk estimates. In contrast, risk assessment in most other industry sectors aims at deriving quantitative risk estimations (e.g., Basel II in Finance). This article presents a model and methodology to leverage on the large amount of data available from the IT infrastructure of an organization's security operation center to quantitatively estimate the probability of attack. Our methodology specifically addresses untargeted attacks delivered by automatic tools that make up the vast majority of attacks in the wild against users and organizations. We consider two-stage attacks whereby the attacker first breaches an Internet-facing system, and then escalates the attack to internal systems by exploiting local vulnerabilities in the target. Our methodology factors in the power of the attacker as the number of "weaponized" vulnerabilities he/she can exploit, and can be adjusted to match the risk appetite of the organization. We illustrate our methodology by using data from a large financial institution, and discuss the significant mismatch between traditional qualitative risk assessments and our quantitative approach. © 2017 Society for Risk Analysis.

  17. Probability based models for estimation of wildfire risk

    Treesearch

    Haiganoush Preisler; D. R. Brillinger; R. E. Burgan; John Benoit

    2004-01-01

    We present a probability-based model for estimating fire risk. Risk is defined using three probabilities: the probability of fire occurrence; the conditional probability of a large fire given ignition; and the unconditional probability of a large fire. The model is based on grouped data at the 1 km²-day cell level. We fit a spatially and temporally explicit non-...

  18. Revised Human Health Risk Assessment on Chlorpyrifos

    EPA Pesticide Factsheets

    We have revised our human health risk assessment and drinking water exposure assessment for chlorpyrifos that supported our October 2015 proposal to revoke all food residue tolerances for chlorpyrifos. Learn about the revised analysis.

  19. 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.

  20. Misrepresentation of health risks by mass media.

    PubMed

    Bomlitz, Larisa J; Brezis, Mayer

    2008-06-01

    Mass media are a leading source of health information for general public. We wished to examine the relationship between the intensity of media coverage for selected health topics and their actual risk to public health. Mass media reports in the United States on emerging and chronic health hazards (severe acute respiratory syndrome (SARS), bioterrorism, West Nile Fever, AIDS, smoking and physical inactivity) were counted for the year 2003, using LexisNexis database. The number of media reports for each health risk was correlated with the corresponding death rate as reported by the Centers for Disease Control and Prevention. The number of media reports inversely correlated with the actual number of deaths for the health risks evaluated. SARS and bioterrorism killed less than a dozen people in 2003, but together generated over 100 000 media reports, far more than those covering smoking and physical inactivity, which killed nearly a million Americans. Emerging health hazards are over-reported in mass media by comparison to common threats to public health. Since premature mortality in industrialized societies is most often due to well-known risks such as smoking and physical inactivity, their under-representation on public agendas may cause suboptimal prioritization of public health resources.

  1. Air pollution and health risks due to vehicle traffic

    PubMed Central

    Zhang, Kai; Batterman, Stuart

    2014-01-01

    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

  2. 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

  3. The relationship between modifiable health risks and health care expenditures. An analysis of the multi-employer HERO health risk and cost database.

    PubMed

    Goetzel, R Z; Anderson, D R; Whitmer, R W; Ozminkowski, R J; Dunn, R L; Wasserman, J

    1998-10-01

    This investigation estimates the impact of ten modifiable health risk behaviors and measures and their impact on health care expenditures, controlling for other measured risk and demographic factors. Retrospective two-stage multivariate analyses, including logistic and linear regression models, were used to follow up 46,026 employees from six large health care purchasers for up to 3 years after they completed an initial health risk appraisal. These participants contributed 113,963 person-years of experience. Results show that employees at high risk for poor health outcomes had significantly higher expenditures than did subjects at lower risk in seven of ten risk categories: those who reported themselves as depressed (70% higher expenditures), at high stress (46%), with high blood glucose levels (35%), at extremely high or low body weight (21%), former (20%) and current (14%) tobacco users, with high blood pressure (12%), and with sedentary lifestyle (10%). These same risk factors were found to be associated with a higher likelihood of having extremely high (outlier) expenditures. Employees with multiple risk profiles for specific disease outcomes had higher expenditures than did those without these profiles for the following diseases: heart disease (228% higher expenditures), psychosocial problems (147%), and stroke (85%). Compared with prior studies, the results provide more precise estimates of the incremental medical expenditures associated with common modifiable risk factors after we controlled for multiple risk conditions and demographic confounders. The authors conclude that common modifiable health risks are associated with short-term increases in the likelihood of incurring health expenditures and in the magnitude of those expenditures.

  4. Risk segmentation in Chilean social health insurance.

    PubMed

    Hidalgo, Hector; Chipulu, Maxwell; Ojiako, Udechukwu

    2013-01-01

    The objective of this study is to identify how risk and social variables are likely to be impacted by an increase in private sector participation in health insurance provision. The study focuses on the Chilean health insurance industry, traditionally dominated by the public sector. Predictive risk modelling is conducted using a database containing over 250,000 health insurance policy records provided by the Superintendence of Health of Chile. Although perceived with suspicion in some circles, risk segmentation serves as a rational approach to risk management from a resource perspective. The variables that have considerable impact on insurance claims include the number of dependents, gender, wages and the duration a claimant has been a customer. As shown in the case study, to ensure that social benefits are realised, increased private sector participation in health insurance must be augmented by regulatory oversight and vigilance. As it is clear that a "community-rated" health insurance provision philosophy impacts on insurance firm's ability to charge "market" prices for insurance provision, the authors explore whether risk segmentation is a feasible means of predicting insurance claim behaviour in Chile's private health insurance industry.

  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. 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. Health risk assessment of groundwater arsenic pollution in southern Taiwan.

    PubMed

    Liang, Ching-Ping; Wang, Sheng-Wei; Kao, Yu-Hsuan; Chen, Jui-Sheng

    2016-12-01

    Residents of the Pingtung Plain, Taiwan, use groundwater for drinking. However, monitoring results showed that a considerable portion of groundwater has an As concentration higher than the safe drinking water regulation of 10 μg/L. Considering residents of the Pingtung Plain continue to use groundwater for drinking, this study attempted to evaluate the exposure and health risk from drinking groundwater. The health risk from drinking groundwater was evaluated based on the hazard quotient (HQ) and target risk (TR) established by the US Environmental Protection Agency. The results showed that the 95th percentile of HQ exceeded 1 and TR was above the safe value of threshold value of 10(-6). To illustrate significant variability of the drinking water consumption rate and body weight of each individual, health risk assessments were also performed using a spectrum of daily water intake rate and body weight to reasonably and conservatively assess the exposure and health risk for the specific subgroups of population of the Pingtung Plain. The assessment results showed that 0.01-7.50 % of the population's HQ levels are higher than 1 and as much as 77.7-93.3 % of the population being in high cancer risk category and having a TR value >10(-6). The TR estimation results implied that groundwater use for drinking purpose places people at risk of As exposure. The government must make great efforts to provide safe drinking water for residents of the Pingtung Plain.

  8. 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

  9. Sociocultural perspectives on threats, risks, and health

    Treesearch

    Patricia L. Winter; Jonathan W. Long; Frank K. Lake

    2014-01-01

    Sociocultural perspectives on threats, risks, and health are explored in this chapter. The authors begin with a discussion of the linkages between well-being in the Sierra Nevada ecosystem and public health and well-being to set the context of socioecological resilience. This is followed by a summary of how trust and confidence influence the management of threats and...

  10. "Light" Tobacco Products Pose Heavy Health Risks

    MedlinePlus

    ... For Consumers Home For Consumers Consumer Updates "Light" Tobacco Products Pose Heavy Health Risks Share Tweet Linkedin ... restricting the words “light,” “low,” and “mild” from tobacco products now on the market, as health officials ...

  11. A score for measuring health risk perception in environmental surveys.

    PubMed

    Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta

    2015-09-15

    In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Assessing the risk of Legionnaires' disease: the inhalation exposure model and the estimated risk in residential bathrooms.

    PubMed

    Azuma, Kenichi; Uchiyama, Iwao; Okumura, Jiro

    2013-02-01

    Legionella are widely found in the built environment. Patients with Legionnaires' disease have been increasing in Japan; however, health risks from Legionella bacteria in the environment are not appropriately assessed. We performed a quantitative health risk assessment modeled on residential bathrooms in the Adachi outbreak area and estimated risk levels. The estimated risks in the Adachi outbreak approximately corresponded to the risk levels exponentially extrapolated into lower levels on the basis of infection and mortality rates calculated from actual outbreaks, suggesting that the model of Legionnaires' disease in residential bathrooms was adequate to predict disease risk for the evaluated outbreaks. Based on this model, the infection and mortality risk levels per year in 10 CFU/100 ml (100 CFU/L) of the Japanese water quality guideline value were approximately 10(-2) and 10(-5), respectively. However, acceptable risk levels of infection and mortality from Legionnaires' disease should be adjusted to approximately 10(-4) and 10(-7), respectively, per year. Therefore, a reference value of 0.1 CFU/100 ml (1 CFU/L) as a water quality guideline for Legionella bacteria is recommended. This value is occasionally less than the actual detection limit. Legionella levels in water system should be maintained as low as reasonably achievable (<1 CFU/L).

  13. Estimating cancer risks to adults undergoing body CT examinations.

    PubMed

    Huda, Walter; He, Wenjun

    2012-06-01

    The purpose of the study is to estimate cancer risks from the amount of radiation used to perform body computed tomography (CT) examination. The ImPACT CT Patient Dosimetry Calculator was used to compute values of organ doses for adult body CT examinations. The radiation used to perform each examination was quantified by the dose-length product (DLP). Patient organ doses were converted into corresponding age and sex dependent cancer risks using data from BEIR VII. Results are presented for cancer risks per unit DLP and unit effective dose for 11 sensitive organs, as well as estimates of the contribution from 'other organs'. For patients who differ from a standard sized adult, correction factors based on the patient weight and antero-posterior dimension are provided to adjust organ doses and the corresponding risks. At constant incident radiation intensity, for CT examinations that include the chest, risks for females are markedly higher than those for males, whereas for examinations that include the pelvis, risks in males were slightly higher than those in females. In abdominal CT scans, risks for males and female patients are very similar. For abdominal CT scans, increasing the patient age from 20 to 80 resulted in a reduction in patient risks of nearly a factor of 5. The average cancer risk for chest/abdomen/pelvis CT examinations was ∼26 % higher than the cancer risk caused by 'sensitive organs'. Doses and radiation risks in 80 kg adults were ∼10 % lower than those in 70 kg patients. Cancer risks in body CT can be estimated from the examination DLP by accounting for sex, age, as well as patient physical characteristics.

  14. Quantitative estimation in Health Impact Assessment: Opportunities and challenges

    SciTech Connect

    Bhatia, Rajiv; Seto, Edmund

    2011-04-15

    Health Impact Assessment (HIA) considers multiple effects on health of policies, programs, plans and projects and thus requires the use of diverse analytic tools and sources of evidence. Quantitative estimation has desirable properties for the purpose of HIA but adequate tools for quantification exist currently for a limited number of health impacts and decision settings; furthermore, quantitative estimation generates thorny questions about the precision of estimates and the validity of methodological assumptions. In the United States, HIA has only recently emerged as an independent practice apart from integrated EIA, and this article aims to synthesize the experience with quantitative health effects estimation within that practice. We use examples identified through a scan of available identified instances of quantitative estimation in the U.S. practice experience to illustrate methods applied in different policy settings along with their strengths and limitations. We then discuss opportunity areas and practical considerations for the use of quantitative estimation in HIA.

  15. Interactive graphics for expressing health risks: development and qualitative evaluation.

    PubMed

    Ancker, Jessica S; Chan, Connie; Kukafka, Rita

    2009-01-01

    Recent findings suggest that interactive game-like graphics might be useful in communicating probabilities. We developed a prototype for a risk communication module, focusing on eliciting users' preferences for different interactive graphics and assessing usability and user interpretations. Feedback from five focus groups was used to design the graphics. The final version displayed a matrix of square buttons; clicking on any button allowed the user to see whether the stick figure underneath was affected by the health outcome. When participants used this interaction to learn about a risk, they expressed more emotional responses, both positive and negative, than when viewing any static graphic or numerical description of a risk. Their responses included relief about small risks and concern about large risks. The groups also commented on static graphics: arranging the figures affected by disease randomly throughout a group of figures made it more difficult to judge the proportion affected but often was described as more realistic. Interactive graphics appear to have potential for expressing risk magnitude as well as the feeling of risk. This affective impact could be useful in increasing perceived threat of high risks, calming fears about low risks, or comparing risks. Quantitative studies are planned to assess the effect on perceived risks and estimated risk magnitudes.

  16. Estimating the Contribution of Selected Risk Factors in Attributable Burden to Stroke in Iran

    PubMed Central

    Karami, M; Soori, H; Monfared, A Bahadori

    2012-01-01

    Background: Knowledge of the magnitude of avoidable burden by risk factors is needed for health policy, priority setting, and preventing stroke. The aim of this study was to estimate the contribution of selected risk factors including hypertension, overweight, obesity, tobacco use, and physical inactivity to the attributable burden of stroke in Iran. Methods: The World Health Organization Comparative Risk Assessment (CRA) methodology was employed to calculate the Potential Impact Fraction (PIF) and percentage of avoidable burden of stroke, which attributed to its risk factors among Iranian adults in 2009. Prevalence of risk factors was obtained from the 5th STEPS survey of chronic disease risk factors which conducted in 2009. PIF was estimated on both theoretical minimum and feasible minimum risk. A simulation procedure incorporating sources of uncertainty was used to estimate the uncertainties for the attributable burden. Results: About 15.7% (95% uncertainty intervals: 5.8- 23.5) of attributable Disability Adjusted Life Years (DALYs) to stroke in adult males and 15.8% (95% uncertainty intervals: 5.8- 23.5) in adult females are avoidable after changing the current prevalence (16.0% and 16.1% for males and females, respectively) of hypertension to 10% in both sexes. Conclusion: This work highlighted the important role of hypertension and overweight. Accordingly, policy makers are advised to consider these risk factors once implementing interventional program in Iran. PMID:23113182

  17. 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

  18. Health Risks of Food Oxidation.

    PubMed

    Estévez, Mario; Li, Zhuqing; Soladoye, Olugbenga P; Van-Hecke, Thomas

    The impact of dietary habits on our health is indisputable. Consumer's concern on aging and age-related diseases challenges scientists to underline the potential role of food on the extension and guarantee of lifespan and healthspan. While some dietary components and habits are generally regarded as beneficial for our health, some others are being found to exert potential toxic effects and hence, contribute to the onset of particular health disorders. Among the latter, lipid and protein oxidation products formed during food production, storage, processing, and culinary preparation have been recently identified as potentially harmful to humans. Upon intake, food components are further degraded and oxidized during the subsequent digestion phases and the pool of compounds formed in the lumen is in close contact with the lamina propria of the intestines. Some of these oxidation products have been found to promote inflammatory conditions in the gut (i.e., bowel diseases) and are also reasonably linked to the onset of carcinogenic processes. Upon intestinal uptake, some species are distributed by the bloodstream causing an increase in oxidative stress markers and impairment of certain physiological processes through alteration of specific gene expression pathways. This chapter summarizes the most recent discoveries on this topic with particular stress on challenges that we face in the near future: understanding the molecular basis of disease, the suitability of using living animals vs in vitro model systems and the necessity of using massive genomic techniques and versatile mass spectrometric technology. © 2017 Elsevier Inc. All rights reserved.

  19. The prevention of health risks in Cuba.

    PubMed

    Guttmacher, S

    1987-01-01

    Cuba still has a double burden of health risks. It must contend with some risks to health that persist in underdeveloped rural areas, and it must also deal with the risk factors associated with modern, urban living conditions. The economic and social changes fostered in the postrevolutionary period have reduced the relative importance of the first set of factors, but the changes have also introduced or intensified a myriad of factors derived from their own successes. In this article, the risk factors of greatest concern in contemporary Cuba are described, and the strategies adopted to combat these risk factors, together with the ways in which such strategies are shaped by Cuba's social and economic development are discussed.

  20. Estimating costs of mental health and substance abuse coverage.

    PubMed

    Frank, R G; McGuire, T G

    1995-01-01

    The cost of expanding mental health and substance abuse treatment coverage is a major impediment to reforming insurance coverage for these types of conditions. The recent experience with national health care reform offers a case study in cost estimation for mental health and substance abuse coverage. The impact of managed care and the cost of expanding coverage to currently uninsured persons introduced uncertainty into predictions. This paper critically reviews that experience and draws lessons for estimating future costs of policy initiatives.

  1. [Theory of health risks: dispute of disciplines].

    PubMed

    Timm, J

    2009-12-01

    Since the Age of Enlightenment, risk as a term in philosophy has played an important role in explaining human's actions and decisions. Theoretical foundations deal with two different definitions: risk as a scientific term quantifiable by probability and size of associated damage - or risk as an individual or social construct influencing decisions and actions. Health risks have always been in the focus of both concepts with relevant theoretical and practical consequences. This contribution attempts to give a brief introduction, which will be expanded and deepened by the other articles of this volume.

  2. On cancer risk estimation of urban air pollution.

    PubMed Central

    Törnqvist, M; Ehrenberg, L

    1994-01-01

    The usefulness of data from various sources for a cancer risk estimation of urban air pollution is discussed. Considering the irreversibility of initiations, a multiplicative model is preferred for solid tumors. As has been concluded for exposure to ionizing radiation, the multiplicative model, in comparison with the additive model, predicts a relatively larger number of cases at high ages, with enhanced underestimation of risks by short follow-up times in disease-epidemiological studies. For related reasons, the extrapolation of risk from animal tests on the basis of daily absorbed dose per kilogram body weight or per square meter surface area without considering differences in life span may lead to an underestimation, and agreements with epidemiologically determined values may be fortuitous. Considering these possibilities, the most likely lifetime risks of cancer death at the average exposure levels in Sweden were estimated for certain pollution fractions or indicator compounds in urban air. The risks amount to approximately 50 deaths per 100,000 for inhaled particulate organic material (POM), with a contribution from ingested POM about three times larger, and alkenes, and butadiene cause 20 deaths, respectively, per 100,000 individuals. Also, benzene and formaldehyde are expected to be associated with considerable risk increments. Comparative potency methods were applied for POM and alkenes. Due to incompleteness of the list of compounds considered and the uncertainties of the above estimates, the total risk calculation from urban air has not been attempted here. PMID:7821292

  3. Concentrations and potential health risks of metals in lip products.

    PubMed

    Liu, Sa; Hammond, S Katharine; Rojas-Cheatham, Ann

    2013-06-01

    Metal content in lip products has been an issue of concern. 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. 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. 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. 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.

  4. 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

  5. Occupational and consumer risk estimates for nanoparticles emitted by laser printers

    NASA Astrophysics Data System (ADS)

    Hänninen, Otto; Brüske-Hohlfeld, Irene; Loh, Miranda; Stoeger, Tobias; Kreyling, Wolfgang; Schmid, Otmar; Peters, Annette

    2010-01-01

    Several studies have reported laser printers as significant sources of nanosized particles (<0.1 μm). Laser printers are used occupationally in office environments and by consumers in their homes. The current work combines existing epidemiological and toxicological evidence on particle-related health effects, measuring doses as mass, particle number and surface area, to estimate and compare the potential risks in occupational and consumer exposure scenarios related to the use of laser printers. The daily uptake of laser printer particles was estimated based on measured particle size distributions and lung deposition modelling. The obtained daily uptakes (particle mass 0.15-0.44 μg d-1; particle number 1.1-3.1 × 109 d-1) were estimated to correspond to 4-13 (mass) or 12-34 (number) deaths per million persons exposed on the basis of epidemiological risk estimates for ambient particles. These risks are higher than the generally used definition of acceptable risk of 1 × 10-6, but substantially lower than the estimated risks due to ambient particles. Toxicological studies on ambient particles revealed consistent values for lowest observed effect levels (LOELs) which were converted into equivalent daily uptakes using allometric scaling. These LOEL uptakes were by a factor of about 330-1,000 (mass) and 1,000-2,500 (particle surface area) higher than estimated uptakes from printers. This toxicological assessment would indicate no significant health risks due to printer particles. Finally, our study suggests that particle number (not mass) and mass (not surface area) are the most conservative risk metrics for the epidemiological and toxicological risks presented here, respectively.

  6. Space Radiation and Risks to Human Health

    NASA Technical Reports Server (NTRS)

    Huff, Janice L.

    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.

  7. From mechanisms to risk estimation--bridging the chasm.

    PubMed

    Curtis, S B; Hazelton, W D; Luebeck, E G; Moolgavkar, S H

    2004-01-01

    We have a considerable amount of work ahead of us to determine the importance of the wealth of new information emerging in the fields of sub-cellular, cellular and tissue biology in order to improve the estimation of radiation risk at low dose and protracted dose-rate. In this paper, we suggest that there is a need to develop models of the specific health effects of interest (e.g., carcinogenesis in specific tissues), which embody as much of the mechanistic (i.e., biological) information as is deemed necessary. Although it is not realistic to expect that every radiation-induced process should or could be included, we can hope that the major factors that shape the time dependence of evolution of damage can be identified and quantified to the point where reasonable estimations of risk can be made. Regarding carcinogenesis in particular, the structure of the model itself plays a role in determining the relative importance of various processes. We use a specific form of a multi-stage carcinogenic model to illustrate this point. We show in a review of the application of this model to lung cancer incidence and mortality in two exposed populations that for both high- and low-LET radiation, there is evidence of an "inverse dose-rate" or protraction effect. This result could be of some considerable importance, because it would imply that risk from protracted exposure even to low-LET radiation might be greater than from acute exposure, an opinion not currently held in the radiation protection community. This model also allows prediction of the evolution of the risk over the lifetimes of the exposed individuals. One inference is that radiation-induced initiation (i.e., the first cellular carcinogenic event(s) occurring in normal tissue after the passage of the radiation) may not be the driving factor in the risk, but more important may be the effects of the radiation on already-initiated cells in the tissue. Although present throughout the length of the exposure, radiation

  8. Estimate capital for operational risk using peak over threshold method

    NASA Astrophysics Data System (ADS)

    Saputri, Azizah Anugrahwati; Noviyanti, Lienda; Soleh, Achmad Zanbar

    2015-12-01

    Operational risk is inherent in bank activities. To cover this risk a bank reserves a fund called as capital. Often a bank uses Basic Indicator approach (BIA), Standardized Approach (SA), or Advanced Measurement Approach (AMA) for estimating the capital amount. BIA and SA are less-objective in comparison to AMA, since BIA and SA use non-actual loss data while AMA use the actual one. In this research, we define the capital as an OpVaR (i.e. the worst loss at a given confidence level) which will be estimated by Peak Over Threshold Method.

  9. Studies on the extended Techa river cohort: cancer risk estimation

    SciTech Connect

    Kossenko, M M.; Preston, D L.; Krestinina, L Y.; Degteva, M O.; Startsev, N V.; Thomas, T; Vyushkova, O V.; Anspaugh, L R.; Napier, Bruce A. ); Kozheurov, V P.; Ron, E; Akleyev, A V.

    2001-12-01

    Initial population-based studies of riverside residents were begun in the late 1950s and in 1967 a systematic effort was undertaken to develop a well-defined fixed cohort of Techa river residents, to carry out ongoing mortality and (limited) clinical follow-up of this cohort, and to provide individualized dose estimates for cohort members. Over the past decade, extensive efforts have been made to refine the cohort definition and improve both the follow-up and dosimetry data. Analyses of the Techa river cohort can provide useful quantitative estimates of the effects of low dose rate, chronic external and internal exposures on cancer mortality and incidence and non-cancer mortality rates. These risk estimates complement quantitative risk estimates for acute exposures based on the atomic bomb survivors and chronic exposure risk estimates from worker studies, including Mayak workers and other groups with occupational radiation exposures. As the dosimetry and follow-up are refined it may also be possible to gain useful insights into risks associated with 90Sr exposures.

  10. Methods to Develop Inhalation Cancer Risk Estimates for ...

    EPA Pesticide Factsheets

    This document summarizes the approaches and rationale for the technical and scientific considerations used to derive inhalation cancer risks for emissions of chromium and nickel compounds from electric utility steam generating units. The purpose of this document is to discuss the methods used to develop inhalation cancer risk estimates associated with emissions of chromium and nickel compounds from coal- and oil-fired electric utility steam generating units (EGUs) in support of EPA's recently proposed Air Toxics Rule.

  11. Estimating transport fatality risk from past accident data.

    PubMed

    Evans, Andrew W

    2003-07-01

    This paper examines the statistical properties of estimates of fatal accident rates, mean fatalities per accident, and fatality rates when these estimates are based on past accident data. The statistical properties are illustrated by two long-term transport fatal accident datasets from Great Britain, the principal one for railways and the other for roads, chosen to provide a statistical contrast. In both modes, the accident rates have fallen substantially over the long term. Two statistical estimates of current accident and fatality rates are presented for each dataset, one based only on recent data and the other based on estimates of long-term trends. The trend-based estimate is preferred for train accidents because this makes maximum use of the limited and variable data; the recent data are preferred for road accidents because this avoids unnecessary dependence on modelling the trends. For train accidents, the estimated fatality rate based on past accidents is compared with an estimate produced by the railway industry using a risk model. The statistical estimate is less than half the industry's estimate, and the paper concludes that the statistical estimate is to be preferred.

  12. Adolescent Health Risk Profiles: The Co-Occurrence of Health Risks among Females and Males.

    ERIC Educational Resources Information Center

    Zweig, Janine M.; Lindberg, Laura Duberstein; McGinley, Karen Alexander

    2001-01-01

    Examines the interrelationships among adolescent health risk behaviors using data from the National Longitudinal Study of Adolescent Health for 12,955 adolescents. Findings show distinct differences for males and females in risk profile, but few distinctions between profiles based on socioeconomic characteristics. (SLD)

  13. Estimation of the multiple sclerosis risk in population living on contaminated territories after the Chornobyl catastrophe.

    PubMed

    Kolosynska, O O

    2013-01-01

    Multiple sclerosis (MS) is one of the most socially important and challenging issues in a today's neuroscience. There are estimated to be over 20,000 such patients in Ukraine of which at least 2.5 thousand being the Chornobyl accident survivors. All of them require substantial direct state and indirect expenses for their care and maintenance. To estimate and calculate the risk values of MS in population living in contaminated areas after the Chornobyl accident compared to other population groups. Data provided by the State institution "Centre for Medical Statistics Ministry of Health of Ukraine" and data set from the specialized medical publications were the primary sources of information about the incidence of MS in different regions of Ukraine. Statistical and analytical research methods were applied. Calculation of the MS risk was performed according to the method of R. Fletcher et al. The MS risk estimation and calculations of parameters were made for population of areas contaminated after the Chornobyl accident compared to other population groups. Relative risk, additional risk and population risk values of the MS morbidity appeared being higher among the population under the impact of risk factors such as living in areas of contamination than in patients without no impact of unfavorable factors in the same area. Received results point to the need of in-depth study of problem with the purpose of development and application of medical and organizational arrangements focused on the health care optimization for specified population. Kolosynska O.O., 2013.

  14. Smoking as a risk factor in the health of women.

    PubMed

    Seltzer, V

    2003-09-01

    It is estimated that more than 200 million women smoke worldwide. It is also estimated that if current smoking rates among men and women persist worldwide, by 2025, 9% of the world's deaths and disabilities will be related to tobacco use. Smoking is associated with an increased risk of cardiovascular disease, cancer (lung, cervix, pancreas, kidney, bladder, esophagus, pharynx), pulmonary disorders, cerebrovascular disease, and many other health risks. Smoking also adversely affects fertility and reproductive outcomes. Although a greater percentage of women smoke in developed than in developing countries, women in developing countries appear to be initiating smoking habits in increasing numbers. If current trends persist, the adverse effects of smoking on women's health clearly will continue to escalate.

  15. Synthetic-fuel plants: potential tumor risks to public health.

    PubMed

    Moskowitz, P D; Morris, S C; Fischer, H; Thode, H C; Hamilton, L D

    1985-09-01

    This article quantifies potential public health risks from tumor-producing pollutants emitted from two synthetic-fuel plants (direct liquefaction--Exxon Donor Solvent: and indirect liquefaction--Lurgi Fischer-Tropsch) located at a representative site in the eastern United States. In these analyses gaseous and aqueous waste streams were characterized; exposures via inhalation, terrestrial and aquatic food chains, and drinking water supplies were modeled. Analysis suggested that emissions of "polycyclic aromatic hydrocarbons," "aromatic amines," "neutral N, O, S heterocyclics," "nitriles," and "other trace elements" pose the largest quantifiable risks to public health. Data and analysis for these pollutant categories should be refined to more accurately match compound-specific estimated exposure levels with tumorigenic potency estimates. Before these results are used for regulatory purposes, more detailed analysis for selected pollutant classes are needed, and more sophisticated aquatic exposure models must be developed. Also, differences in geographic scales among the environmental transport models used need to be rectified.

  16. 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.

  17. Health risk behaviors among young adults with spina bifida

    PubMed Central

    Soe, Minn M; Swanson, Mark E; Bolen, Julie C; Thibadeau, Judy K; Johnson, Natalie

    2015-01-01

    AIM Persons with spina bifida who adopt unhealthy lifestyles could be at increased risk of adverse health outcomes because the presence of spina bifida may magnify this risk. We estimated overall and age-specific prevalence of selected health risk behaviors (HRBs) in young people with spina bifida and examined the association between HRBs and depression. METHOD We performed analyses on data obtained from individuals with spina bifida (n=130; mean age 23y SD 4y 5mo; 64 males, 66 females; 64% lumbosacral lesion; 77% with shunt) who participated in a population-based survey conducted by the Arkansas Spinal Cord Commission in 2005. RESULTS Compared with national estimates, young people with spina bifida tend to eat less healthy diets, do less exercise, and engage inmore sedentary activities. Respondents were less likely to use substances (alcohol, tobacco, illegal drugs), which peaked among 25 to 31 year olds. About 90% saw a doctor in the previous year. Nearly one half reported mild or major depressive symptoms. In the logistic regression analysis after controlling for potential confounders (age, sex, ethnic group, education, employment, marital status, living arrangement, level of lesion, presence of shunt, mobility, self-rated health and healthcare utilization), major depressive symptoms were associated with current alcohol drinking (adjusted odds ratio: 4.74; 95% CI 1.18–19.04). INTERPRETATION Young adults with spina bifida exhibit unhealthy behaviors that continue into their late 20s. The findings highlight the need to increase awareness of their health risk profiles in the spina bifida community and show opportunities for mental health and health risk screening and counseling by healthcare providers. PMID:22937873

  18. Lifestyle and health-related risk factors and risk of cognitive aging among older veterans.

    PubMed

    Yaffe, Kristine; Hoang, Tina D; Byers, Amy L; Barnes, Deborah E; Friedl, Karl E

    2014-06-01

    Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.

  19. Health risk associated with airborne asbestos.

    PubMed

    Pawełczyk, Adam; Božek, František

    2015-07-01

    The following paper presents an assessment of health risks associated with air polluted with respirable asbestos fibers in towns of southwest Poland. The aim of the work was to determine whether or not any prevention measures are necessary in order to reduce the level of exposure to the pollutant. The risk assessment was carried out based on the air analyses and the latest asbestos toxicity data published by the Environmental Protection Agency (US EPA), USA and Office of Environmental Health Hazard Assessment (OEHHA). It was found that in some sites, the concentration of the asbestos fibers exceeded the acceptable levels, which should be a reason of special concern. The highest concentration of asbestos was found in town centers during the rush hours. In three spots, the calculated maximum health risk exceeded 1E-04 which is considered too high according to the adopted standards. So far, it has not yet been possible to find a reasonable method of ensuring the hazard reduction.

  20. The association of health risks with workers' compensation costs.

    PubMed

    Musich, S; Napier, D; Edington, D W

    2001-06-01

    The purpose of this study was to investigate the association between health risks and workers' compensation (WC) costs. The 4-year study used Health Risk Appraisal data and focused on 1996-to-1999 WC costs among Xerox Corporation's long-term employees. High WC costs were related to individual health risks, especially Health Age Index (a measure of controllable risks), smoking, poor physical health, physical inactivity, and life dissatisfaction. WC costs increased with increasing health risk status (low-risk to medium-risk to high-risk). Low-risk employees had the lowest costs. In this population, 85% of WC costs could be attributed to excess risks (medium- or high-risk) or non-participation. Among those with claims, a savings of $1238 per person per year was associated with Health Risk Appraisal participation. Addressing WC costs by focusing on employee health status provides an important additional strategy for health promotion programs.

  1. Health Service Areas (HSAs) - Small Area Estimates

    Cancer.gov

    Health Service Areas (HSAs) are a compromise between the 3000 counties and the 50 states. An HSA may be thought of as an area that is relatively self-contained with respect to hospital care and may cross over state boundries.

  2. Estimating Acceptability of Financial Health Incentives

    ERIC Educational Resources Information Center

    Bigsby, Elisabeth; Seitz, Holli H.; Halpern, Scott D.; Volpp, Kevin; Cappella, Joseph N.

    2017-01-01

    A growing body of evidence suggests that financial incentives can influence health behavior change, but research on the public acceptability of these programs and factors that predict public support have been limited. A representative sample of U.S. adults (N = 526) were randomly assigned to receive an incentive program description in which the…

  3. 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

  4. Estimating Costs for Army Materiei Health Hazards.

    DTIC Science & Technology

    1997-03-01

    associated with Army materiel, it can be used in other areas of preventive medi- cine . The model estimates total medical costs based on the determination of a...ber 1996. Biblio . 1 Leutwyler, Kristin. "The Price of Prevention." Scientific American. April 1995. Logistics Management Institute...Hearing Loss Cases and Compensation for Veterans—1986-1994. Aberdeen Proving Ground, MD, Unpublished, undated. Biblio . 2 Bibliography U.S. Army

  5. 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.

  6. On the estimation of risk associated with an attenuation prediction

    NASA Technical Reports Server (NTRS)

    Crane, R. K.

    1992-01-01

    Viewgraphs from a presentation on the estimation of risk associated with an attenuation prediction is presented. Topics covered include: link failure - attenuation exceeding a specified threshold for a specified time interval or intervals; risk - the probability of one or more failures during the lifetime of the link or during a specified accounting interval; the problem - modeling the probability of attenuation by rainfall to provide a prediction of the attenuation threshold for a specified risk; and an accounting for the inadequacy of a model or models.

  7. 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.

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

    PubMed

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

    2016-01-01

    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. 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. 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. 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.

  9. The economic costs of radiation-induced health effects: Estimation and simulation

    SciTech Connect

    Nieves, L.A.; Tawil, J.J.

    1988-08-01

    This effort improves the quantitative information available for use in evaluating actions that alter health risks due to population exposure to ionizing radiation. To project the potential future costs of changes in health effects risks, Pacific Northwest Laboratory (PNL) constructed a probabilistic computer model, Health Effects Costs Model (HECOM), which utilizes the health effect incidence estimates from accident consequences models to calculate the discounted sum of the economic costs associated with population exposure to ionizing radiation. Application of HECOM to value-impact and environmental impact analyses should greatly increase the quality of the information available for regulatory decision making. Three major types of health effects present risks for any population sustaining a significant radiation exposure: acute radiation injuries (and fatalities), latent cancers, and impairments due to genetic effects. The literature pertaining to both incidence and treatment of these health effects was reviewed by PNL and provided the basis for developing economic cost estimates. The economic costs of health effects estimated by HECOM represent both the value of resources consumed in diagnosing, treating, and caring for the patient and the value of goods not produced because of illness or premature death due to the health effect. Additional costs to society, such as pain and suffering, are not included in the PNL economic cost measures since they do not divert resources from other uses, are difficult to quantify, and do not have a value observable in the marketplace. 83 refs., 3 figs., 19 tabs.

  10. Uncertainties in Estimates of the Risks of Late Effects from Space Radiation

    NASA Technical Reports Server (NTRS)

    Cucinotta, F. A.; Schimmerling, W.; Wilson, J. W.; Peterson, L. E.; Saganti, P.; Dicelli, J. F.

    2002-01-01

    The health risks faced by astronauts from space radiation include cancer, cataracts, hereditary effects, and non-cancer morbidity and mortality risks related to the diseases of the old age. Methods used to project risks in low-Earth orbit are of questionable merit for exploration missions because of the limited radiobiology data and knowledge of galactic cosmic ray (GCR) heavy ions, which causes estimates of the risk of late effects to be highly uncertain. Risk projections involve a product of many biological and physical factors, each of which has a differential range of uncertainty due to lack of data and knowledge. Within the linear-additivity model, we use Monte-Carlo sampling from subjective uncertainty distributions in each factor to obtain a Maximum Likelihood estimate of the overall uncertainty in risk projections. The resulting methodology is applied to several human space exploration mission scenarios including ISS, lunar station, deep space outpost, and Mar's missions of duration of 360, 660, and 1000 days. The major results are the quantification of the uncertainties in current risk estimates, the identification of factors that dominate risk projection uncertainties, and the development of a method to quantify candidate approaches to reduce uncertainties or mitigate risks. The large uncertainties in GCR risk projections lead to probability distributions of risk that mask any potential risk reduction using the "optimization" of shielding materials or configurations. In contrast, the design of shielding optimization approaches for solar particle events and trapped protons can be made at this time, and promising technologies can be shown to have merit using our approach. The methods used also make it possible to express risk management objectives in terms of quantitative objective's, i.e., the number of days in space without exceeding a given risk level within well defined confidence limits.

  11. Estimating the risk of rabies transmission to humans in the U.S.: a Delphi analysis.

    PubMed

    Vaidya, Sagar A; Manning, Susan E; Dhankhar, Praveen; Meltzer, Martin I; Rupprecht, Charles; Hull, Harry F; Fishbein, Daniel B

    2010-05-26

    In the United States, the risk of rabies transmission to humans in most situations of possible exposure is unknown. Controlled studies on rabies are clearly not possible. Thus, the limited data on risk has led to the frequent administration of rabies post-exposure prophylaxis (PEP), often in inappropriate circumstances. We used the Delphi method to obtain an expert group consensus estimate of the risk of rabies transmission to humans in seven scenarios of potential rabies exposure. We also surveyed and discussed the merits of recommending rabies PEP for each scenario. The median risk of rabies transmission without rabies PEP for a bite exposure by a skunk, bat, cat, and dog was estimated to be 0.05, 0.001, 0.001, and 0.00001, respectively. Rabies PEP was unanimously recommended in these scenarios. However, rabies PEP was overwhelmingly not recommended for non-bite exposures (e.g. dog licking hand but unavailable for subsequent testing), estimated to have less than 1 in 1,000,000 (0.000001) risk of transmission. Our results suggest that there are many common situations in which the risk of rabies transmission is so low that rabies PEP should not be recommended. These risk estimates also provide a key parameter for cost-effective models of human rabies prevention and can be used to educate health professionals about situation-specific administration of rabies PEP.

  12. Comparing the Health Effects of Ambient Particulate Matter Estimated Using Ground-Based versus Remote Sensing Exposure Estimates

    PubMed Central

    Jerrett, Michael; Turner, Michelle C.; Beckerman, Bernardo S.; Pope, C. Arden; van Donkelaar, Aaron; Martin, Randall V.; Serre, Marc; Crouse, Dan; Gapstur, Susan M.; Krewski, Daniel; Diver, W. Ryan; Coogan, Patricia F.; Thurston, George D.; Burnett, Richard T.

    2016-01-01

    Background: Remote sensing (RS) is increasingly used for exposure assessment in epidemiological and burden of disease studies, including those investigating whether chronic exposure to ambient fine particulate matter (PM2.5) is associated with mortality. Objectives: We compared relative risk estimates of mortality from diseases of the circulatory system for PM2.5 modeled from RS with that for PM2.5 modeled using ground-level information. Methods: We geocoded the baseline residence of 668,629 American Cancer Society Cancer Prevention Study II (CPS-II) cohort participants followed from 1982 to 2004 and assigned PM2.5 levels to all participants using seven different exposure models. Most of the exposure models were averaged for the years 2002–2004, and one RS estimate was for a longer, contemporaneous period. We used Cox proportional hazards regression to estimate relative risks (RRs) for the association of PM2.5 with circulatory mortality and ischemic heart disease. Results: Estimates of mortality risk differed among exposure models. The smallest relative risk was observed for the RS estimates that excluded ground-based monitors for circulatory deaths [RR = 1.02, 95% confidence interval (CI): 1.00, 1.04 per 10 μg/m3 increment in PM2.5]. The largest relative risk was observed for the land-use regression model that included traffic information (RR = 1.14, 95% CI: 1.11, 1.17 per 10 μg/m3 increment in PM2.5). Conclusions: We found significant associations between PM2.5 and mortality in every model; however, relative risks estimated from exposure models using ground-based information were generally larger than those estimated using RS alone. Citation: Jerrett M, Turner MC, Beckerman BS, Pope CA III, van Donkelaar A, Martin RV, Serre M, Crouse D, Gapstur SM, Krewski D, Diver WR, Coogan PF, Thurston GD, Burnett RT. 2017. Comparing the health effects of ambient particulate matter estimated using ground-based versus remote sensing exposure estimates. Environ Health

  13. Reconstruction of financial networks for robust estimation of systemic risk

    NASA Astrophysics Data System (ADS)

    Mastromatteo, Iacopo; Zarinelli, Elia; Marsili, Matteo

    2012-03-01

    In this paper we estimate the propagation of liquidity shocks through interbank markets when the information about the underlying credit network is incomplete. We show that techniques such as maximum entropy currently used to reconstruct credit networks severely underestimate the risk of contagion by assuming a trivial (fully connected) topology, a type of network structure which can be very different from the one empirically observed. We propose an efficient message-passing algorithm to explore the space of possible network structures and show that a correct estimation of the network degree of connectedness leads to more reliable estimations for systemic risk. Such an algorithm is also able to produce maximally fragile structures, providing a practical upper bound for the risk of contagion when the actual network structure is unknown. We test our algorithm on ensembles of synthetic data encoding some features of real financial networks (sparsity and heterogeneity), finding that more accurate estimations of risk can be achieved. Finally we find that this algorithm can be used to control the amount of information that regulators need to require from banks in order to sufficiently constrain the reconstruction of financial networks.

  14. Impact of UKPDS risk estimation added to a first subjective risk estimation on management of coronary disease risk in type 2 diabetes - An observational study.

    PubMed

    Wind, Anne E; Gorter, Kees J; van den Donk, Maureen; Rutten, Guy E H M

    2016-02-01

    To investigate the impact of the UKPDS risk engine on management of CHD risk in T2DM patients. Observational study among 139 GPs. Data from 933 consecutive patients treated with a maximum of two oral glucose lowering drugs, collected at baseline and after twelve months. GPs estimated the CHD risk themselves and afterwards they calculated this with the UKPDS risk engine. Under- and overestimation were defined as a difference >5 percentage points difference between both calculations. The impact of the UKPDS risk engine was assessed by measuring differences in medication adjustments between the over-, under- and accurately estimated group. In 42.0% the GP accurately estimated the CHD risk, in 32.4% the risk was underestimated and in 25.6% overestimated. Mean difference between the estimated (18.7%) and calculated (19.1%) 10 years CHD risk was -0.36% (95% CI -1.24 to 0.52). Male gender, current smoking and total cholesterol level were associated with underestimation. Patients with an subjectively underestimated CHD risk received significantly more medication adjustments. Their UKPDS 10 year CHD risk did not increase during the follow-up period, contrary to the other two groups of patients. The UKPDS risk engine may be of added value for risk management in T2DM. Copyright © 2015 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  15. The Boehringer Ingelheim employee study (Part 2): 10-year cardiovascular diseases risk estimation.

    PubMed

    Kempf, K; Martin, S; Döhring, C; Dugi, K; Haastert, B; Schneider, M

    2016-10-01

    Cardiovascular disease (CVD) may cause an economic burden to companies, but CVD risk estimations specific to working populations are lacking. To estimate the 10-year CVD risk in the Boehringer Ingelheim (BI) employee cohort and analyse the potential effect of hypothetical risk reduction interventions. We estimated CVD risk using the Framingham (FRS), PROCAM (PRS) and Reynolds (RRS) risk scores, using cross-sectional baseline data on BI Pharma employees collected from 2005 to 2011. Results were compared using Fisher's exact and Wilcoxon tests. The predictive ability of the score estimates was assessed using receiver-operating characteristics analyses. Among the 4005 study subjects, we estimated 10-year CVD risks of 35% (FRS), 9% (PRS) and 6% (RRS) for men and 10% (FRS), 4% (PRS) and 1% (RRS) for women. One hundred and thirty-four (6%) men and 111 (6%) women employees had current CVD. The best predictors of prevalent CVD were the FRS and the RRS for men [area-under-the-curve 0.62 (0.57-0.67) for both]. A hypothetical intervention that would improve systolic blood pressure, HbA1c (for diabetes), C-reactive protein, triglycerides and total and high-density lipoprotein cholesterol by 10% each would potentially reduce expected CVD cases by 36-41% in men and 30-45% in women, and if smoking cessation is incorporated, by 39-45% and 30-55%, respectively, depending on the pre-intervention risk score. There was a substantial risk of developing CVD in this working cohort. Occupational health programmes with lifestyle interventions for high-risk individuals may be an effective risk reduction measure. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Ventricular fibrillation risk estimation for conducted electrical weapons: critical convolutions.

    PubMed

    Kroll, Mark W; Lakkireddy, Dhanunjaya; Rahko, Peter S; Panescu, Dorin

    2011-01-01

    The TASER® Conducted Electrical Weapon (CEW) is used by law enforcement agencies about 900 times per day worldwide and has been shown to reduce suspect and officer injuries by about 65%. However, since a CEW delivers rapid electrical pulses through injected probes, the risk of inducing ventricular fibrillation (VF) has been considered. Animal studies have shown that the tip of the probe must come within a few millimeters of the surface of the heart for the CEW to induce VF in a typical animal application. Early calculations of the CEW VF risk in humans used sophisticated 3-D chest models to determine the size of the probe landing areas that had cardiac tissue within a given distance of the inner surface of the ribs. This produced a distribution of area (cm(2)) vs. mm of depth. Echocardiography was then used to determine the shortest distance from the skin surface to the cardiac surface. This produced a population distribution of skin-to-heart (STH) distances. These 2 distributions were then convolved to arrive at a probability of inducing VF for a typical human CEW application. With 900, 000 probe-mode field uses to date, epidemiological results have shown that these initial VF risk estimates were significant overestimates. We present model refinements that take into account the gender and body-mass-index (BMI) of the target demographics and produce VF risk estimates concordant with the epidemiological results. The risk of VF is estimated at 0.4 per million uses with males.

  17. Another look at the (im-)precision of individual risk estimates made using actuarial risk assessment instruments.

    PubMed

    Hart, Stephen D; Cooke, David J

    2013-01-01

    We investigated the precision of individual risk estimates made using actuarial risk assessment instruments (ARAIs) by discussing some major conceptual issues and then illustrating them by analyzing new data. We used a standard multivariate statistical procedure, logistic regression, to create a new ARAI based on data from a follow-up study of 90 adult male sex offenders. We indexed predictive precision at the group level using confidence intervals for group mean probability estimates, and at the individual level using prediction intervals for individual probability estimates. Consistent with past research, ARAI scores were moderately and significantly predictive of failure in the aggregate, but group probability estimates had substantial margins of error and individual probability estimates had very large margins of error. We conclude that, without major advances in our understanding of the causes of violence, ARAIs cannot be used to estimate the specific probability or absolute likelihood of future violence with any reasonable degree of precision or certainty. The implications for conducting violence risk assessments in forensic mental health are discussed.

  18. 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

  19. Neoplastic potential of gastric irradiation. IV. Risk estimates

    SciTech Connect

    Griem, M.L.; Justman, J.; Weiss, L.

    1984-12-01

    No significant tumor increase was found in the initial analysis of patients irradiated for peptic ulcer and followed through 1962. A preliminary study was undertaken 22 years later to estimate the risk of cancer due to gastric irradiation for peptic ulcer disease. A population of 2,049 irradiated patients and 763 medically managed patients has been identified. A relative risk of 3.7 was found for stomach cancer and an initial risk estimate of 5.5 x 10(-6) excess stomach cancers per person rad was calculated. A more complete follow-up is in progress to further elucidate this observation and decrease the ascertainment bias; however, preliminary data are in agreement with the Japanese atomic bomb reports.

  20. Estimated long-term health effects

    SciTech Connect

    Cardis, F.; Okeanov, A.E.; Likthariev, I.; Prisyazhniuk; Anspaugh, L.R.; Mabuchi, K.; Ivanov, V.K.

    1996-04-01

    Apart from the dramatic increase in thyroid cancer in those exposed as children, there is no evidence to date of a major public health impact of the radiation exposure from the Chernobyl accident in the three most affected countries. Although some increases in the frequency of cancer in exposed populations have been reported, these results are difficult to interpret, mainly because of differences in the intensity and method of follow-up between exposed populations and the general population to which they are compared. If the experience of atomic bomb survivors and of other exposed populations is applicable, the major radiological impact of the accident will be cancer and the total lifetime numbers of excess cancers will be greatest among the liquidators and among the residents of contaminated territories, of the order of 2,000 to 2,500. These increases would be difficult to detect epidemiologically against an expected background number of 41,500 and 433,000 respectively (size of the exposed populations: 200,000 and 3,700,000, respectively). It is noted, however, that the exposures received by populations exposed as a result of Chernobyl are different (in type and pattern) from those of atomic bomb survivors. Predictions derived from these populations are therefore uncertain. Indeed, the extent of the increase in thyroid cancer incidence in persons exposed as children was not foreseen. In addition, only ten years have passed since the accident. It is essential therefore that monitoring of the health of the population be continued in order to assess the public health impact of the accident, even if, apart from leukemia among liquidators, little detectable increase of cancers due to radiation from the Chernobyl accident is expected.

  1. Health Watch exposure estimates: do they underestimate benzene exposure?

    PubMed

    Glass, D C; Gray, C N; Jolley, D J; Gibbons, C; Sim, M R

    2005-05-30

    A nested case-control study found that the excess of leukemia, identified among the male members of the Health Watch cohort, was associated with benzene exposure. Exposure had been retrospectively estimated for each individual occupational history using an algorithm in a relational database. Benzene exposure measurements, supplied by Australian petroleum companies, were used to estimate exposure for specific tasks. The tasks carried out within each job, the products handled, and the technology used, were identified from structured interviews with contemporary colleagues. More than half of the subjects started work after 1965 and had an average exposure period of 20 years. Exposure was low; nearly 85% of the cumulative exposure estimates were at or below 10 ppm-years. Matched analyses showed that leukemia risk increased with increasing cumulative benzene exposures and with increasing exposure intensity of the highest-exposed job. Non-Hodgkin lymphoma and multiple myeloma were not associated with benzene exposure. A reanalysis reported here, showed that for the 7 leukemia case-sets with greater than 16 ppm-years cumulative exposure, the odds ratio was 51.9 (5.6-477) when compared to the 2 lowest exposed categories combined to form a new reference category. The addition of occasional high exposures, e.g. as a result of spillages, increased exposure for 25% of subjects but for most, the increase was less than 5% of total exposure. The addition of these exposures reduced the odds ratios. Cumulative exposures did not range as high as those in comparable studies; however, the recent nature of the cohort and local handling practices can explain these differences.

  2. Health literacy and its association with perception of teratogenic risks and health behavior during pregnancy.

    PubMed

    Lupattelli, Angela; Picinardi, Marta; Einarson, Adrienne; Nordeng, Hedvig

    2014-08-01

    Investigate the association between health literacy and perception of medication risk, beliefs about medications, use and non-adherence to prescribed pharmacotherapy during pregnancy, and whether risk perception and beliefs may mediate an association between health literacy and non-adherence. This multinational, cross-sectional, internet-based study recruited pregnant woman between 1 October 2011 and 29 February 2012. Data on maternal socio-demographics, medication use, risk perception, beliefs, and non-adherence were collected via an on-line questionnaire. Health literacy was measured via a self-assessment scale. Mann-Whitney U test, Spearman's rank correlation, Generalized Estimating Equations and mediation analysis were utilized. 4999 pregnant women were included. Low-health literacy women reported higher risk perception for medications, especially penicillins (Rho: -0.216) and swine flu vaccine (Rho: -0.204) and more negative beliefs about medication. Non-adherence ranged from 19.2% (high-health literacy) to 25.0% (low-health literacy). Low-health literacy women were more likely to be non-adherent to pharmacotherapy than their high-level counterparts (adjusted OR: 1.30; 95% CI: 1.02-1.66). Risk perception and beliefs appeared to mediate the association between health literacy and non-adherence. Health literacy was significantly associated with maternal health behaviors regarding medication non-adherence. Clinicians should take time to inquire into their patients' ability to understand health information, perception and beliefs, in order to promote adherence during pregnancy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Mobile Applications for Type 2 Diabetes Risk Estimation: a Systematic Review.

    PubMed

    Fijacko, Nino; Brzan, Petra Povalej; Stiglic, Gregor

    2015-10-01

    Screening for chronical diseases like type 2 diabetes can be done using different methods and various risk tests. This study present a review of type 2 diabetes risk estimation mobile applications focusing on their functionality and availability of information on the underlying risk calculators. Only 9 out of 31 reviewed mobile applications, featured in three major mobile application stores, disclosed the name of risk calculator used for assessing the risk of type 2 diabetes. Even more concerning, none of the reviewed applications mentioned that they are collecting the data from users to improve the performance of their risk estimation calculators or offer users the descriptive statistics of the results from users that already used the application. For that purpose the questionnaires used for calculation of risk should be upgraded by including the information on the most recent blood sugar level measurements from users. Although mobile applications represent a great future potential for health applications, developers still do not put enough emphasis on informing the user of the underlying methods used to estimate the risk for a specific clinical condition.

  4. Estimating Non-stationary Flood Risk in a Changing Climate

    NASA Astrophysics Data System (ADS)

    Yu, X.; Cohn, T. A.; Stedinger, J. R.

    2015-12-01

    Flood risk is usually described by a probability distribution for annual maximum streamflow which is assumed not to change with time. Federal, state and local governments in the United States are demanding guidance on flood frequency estimates that account for climate change. If a trend exists in peak flow series, ignoring it could result in large quantile estimator bias, while trying to estimate a trend will increase the flood quantile estimator's variance. Thus the issue is, what bias-variance tradeoff should we accept? This paper discusses approaches to flood frequency analysis (FFA) when flood series have trends. GCMs describe how annual runoff might vary over sub-continental scales, but this information is nearly useless for FFA in small watersheds. A LP3 Monte Carlo analysis and a re-sampling study of 100-year flood estimation (25- and 50-year projections) compares the performance of five methods: FFA as prescribed in national guidelines (Bulletin 17B), assumes the flood series is stationary and follows a log-Pearson type III (LP3) distribution; Fitting a LP3 distribution with time-varying parameters that include future trends in mean and perhaps variance, where slopes are assumed known; Fitting a LP3 distribution with time-varying parameters that capture future trends in mean and perhaps variance, where slopes are estimated from annual peak flow series; Employing only the most recent 30 years of flood records to fit a LP3 distribution; Applying a safety factor to the 100-year flood estimator (e.g. 25% increase). The 100-year flood estimator of method 2 has the smallest log-space mean squared error, though it is unlikely that the true trend would be known. Method 3 is only recommended over method 1 for large trends (≥ 0.5% per year). The 100-year flood estimators of method 1, 4, and 5 often have poor accuracy. Clearly, flood risk assessment will be a challenge in an uncertain world.

  5. A simple procedure for estimating pseudo risk ratios from exposure to non-carcinogenic chemical mixtures.

    PubMed

    Scinicariello, Franco; Portier, Christopher

    2016-03-01

    Non-cancer risk assessment traditionally assumes a threshold of effect, below which there is a negligible risk of an adverse effect. The Agency for Toxic Substances and Disease Registry derives health-based guidance values known as Minimal Risk Levels (MRLs) as estimates of the toxicity threshold for non-carcinogens. Although the definition of an MRL, as well as EPA reference dose values (RfD and RfC), is a level that corresponds to "negligible risk," they represent daily exposure doses or concentrations, not risks. We present a new approach to calculate the risk at exposure to specific doses for chemical mixtures, the assumption in this approach is to assign de minimis risk at the MRL. The assigned risk enables the estimation of parameters in an exponential model, providing a complete dose-response curve for each compound from the chosen point of departure to zero. We estimated parameters for 27 chemicals. The value of k, which determines the shape of the dose-response curve, was moderately insensitive to the choice of the risk at the MRL. The approach presented here allows for the calculation of a risk from a single substance or the combined risk from multiple chemical exposures in a community. The methodology is applicable from point of departure data derived from quantal data, such as data from benchmark dose analyses or from data that can be transformed into probabilities, such as lowest-observed-adverse-effect level. The individual risks are used to calculate risk ratios that can facilitate comparison and cost-benefit analyses of environmental contamination control strategies.

  6. Sensitivity of risk estimates to wildlife bioaccumulation factors in ecological risk assessment

    SciTech Connect

    Karustis, C.G.; Brewer, R.A.

    1995-12-31

    The concept of conservatism in risk assessment is well established. However, overly conservative assumptions may result in risk estimates that incorrectly predict remediation goals. Therefore, realistic assumptions should be applied in risk assessment whenever possible. A sensitivity analysis was performed on conservative (i.e. bioaccumulation factor = 1) and scientifically-derived wildlife bioaccumulation factors (BAFs) utilized to calculate risks during a terrestrial ecological risk assessment (ERA). In the first approach, 100% bioaccumulation of contaminants was assumed to estimate the transfer of contaminants through the terrestrial food chain. In the second approach, scientifically-derived BAFs were selected from the literature. For one of the measurement species selected, total risks calculated during the first approach were higher than those calculated during the second approach by two orders of magnitude. However, potential risks due to individual contaminants were not necessarily higher using the conservative approach. Potential risk due to contaminants with low actual bioaccumulation were exaggerated while potential risks due to contaminants with greater than 100% bioaccumulation were underestimated. Therefore, the use of a default of 100% bioaccumulation (BAF = 1) for all contaminants encountered during an ERA could result in cases where contaminants are incorrectly identified as risk drivers, and the calculation of incorrect ecological risk-based cleanup goals. The authors suggest using site-specific or literature-derived BAFs whenever possible and realistic BAF estimates, based upon factors such as log K{sub ow}, when BAFs are unavailable.

  7. Estimation of myocardial volume at risk from CT angiography

    NASA Astrophysics Data System (ADS)

    Zhu, Liangjia; Gao, Yi; Mohan, Vandana; Stillman, Arthur; Faber, Tracy; Tannenbaum, Allen

    2011-03-01

    The determination of myocardial volume at risk distal to coronary stenosis provides important information for prognosis and treatment of coronary artery disease. In this paper, we present a novel computational framework for estimating the myocardial volume at risk in computed tomography angiography (CTA) imagery. Initially, epicardial and endocardial surfaces, and coronary arteries are extracted using an active contour method. Then, the extracted coronary arteries are projected onto the epicardial surface, and each point on this surface is associated with its closest coronary artery using the geodesic distance measurement. The likely myocardial region at risk on the epicardial surface caused by a stenosis is approximated by the region in which all its inner points are associated with the sub-branches distal to the stenosis on the coronary artery tree. Finally, the likely myocardial volume at risk is approximated by the volume in between the region at risk on the epicardial surface and its projection on the endocardial surface, which is expected to yield computational savings over risk volume estimation using the entire image volume. Furthermore, we expect increased accuracy since, as compared to prior work using the Euclidean distance, we employ the geodesic distance in this work. The experimental results demonstrate the effectiveness of the proposed approach on pig heart CTA datasets.

  8. 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…

  9. 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…

  10. Competing risk bias in Kaplan-Meier risk estimates can be corrected.

    PubMed

    van Walraven, Carl; Hawken, Steven

    2016-02-01

    Kaplan-Meier (KM) analyses are frequently used to measure outcome risk over time. These analyses overestimate risk whenever competing events are present. Many published KM analyses are susceptible to such competing risk bias. This study derived and validated a model that predicted true outcome risk based on the biased KM risk. We simulated survival data sets having a broad range of 1-year true outcome and competing event risk. Unbiased true outcome risk estimates were calculated using the cumulative incidence function (CIF). Multiple linear regression was used to determine the independent association of CIF-based true outcome risk with the biased KM risk and the proportion of all outcomes that were competing events. The final model found that both the biased KM-based risk and the proportion of all outcomes that were competing events were strongly associated with CIF-based risk. In validation populations that used a variety of distinct survival hazard functions, the model accurately predicted the CIF (R(2) = 1). True outcome risk can be accurately predicted from KM estimates susceptible to competing risk bias. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Exploring perceptions of cancer risk, neighborhood environmental risks, and health behaviors of blacks.

    PubMed

    Rice, LaShanta J; Brandt, Heather M; Hardin, James W; Ingram, Lucy Annang; Wilson, Sacoby M

    2015-06-01

    Cancer risk perceptions and cancer worry are shaped by race/ethnicity, and social, economic, and environmental factors, which in turn shape health decision-making. A paucity of studies has explored risk perceptions and worry in metropolitan areas with disparate environmental conditions and cancer outcomes. This study examined perceptions of cancer risk, neighborhood environmental health risks, and risk-reducing health behaviors among Blacks. A 59-item survey was administered to respondents in Metropolitan Charleston, South Carolina from March to September 2013. A convenience sample of males and females was recruited at local venues and community events. Descriptive statistics, bivariate analyses (Chi square tests), and logistic regression models were estimated using SAS 9.3 software. Respondents (N = 405) were 100% Black, 81% female (n = 323), and ranged from 18 to 87 years of age (M = 49.55, SD = 15.27). Most respondents reported lower perceptions of cancer risk (37%) and equated their cancer beliefs to direct or indirect (i.e. personal or family) experiences. Low perceived cancer risk (absolute risk) was significantly associated (p < .05) with non-alcohol consumption, having a colon cancer screening test, being female, and being age 25-44 or 45-64. Cancer worry was significantly associated (p < .05) with being a current smoker, having a "fair" diet, non-alcohol consumption, and having any colon cancer screening test. Perceived cancer risk is an important indicator of health behaviors among Blacks. Direct or indirect experiences with cancer and/or the environment and awareness of family history of cancer may explain cancer risk perceptions.

  12. 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.

  13. Improving online risk assessment with equipment prognostics and health monitoring

    SciTech Connect

    Coble, Jamie B.; Liu, Xiaotong; Briere, Chris; Ramuhalli, Pradeep

    2016-03-26

    The current approach to evaluating the risk of nuclear power plant (NPP) operation relies on static probabilities of component failure, which are based on industry experience with the existing fleet of nominally similar light water reactors (LWRs). As the nuclear industry looks to advanced reactor designs that feature non-light water coolants (e.g., liquid metal, high temperature gas, molten salt), this operating history is not available. Many advanced reactor designs use advanced components, such as electromagnetic pumps, that have not been used in the US commercial nuclear fleet. Given the lack of rich operating experience, we cannot accurately estimate the evolving probability of failure for basic components to populate the fault trees and event trees that typically comprise probabilistic risk assessment (PRA) models. Online equipment prognostics and health management (PHM) technologies can bridge this gap to estimate the failure probabilities for components under operation. The enhanced risk monitor (ERM) incorporates equipment condition assessment into the existing PRA and risk monitor framework to provide accurate and timely estimates of operational risk.

  14. Dust concentrations and respiratory risks in coalminers: key risk estimates from the British Pneumoconiosis Field Research

    PubMed Central

    Soutar, C; Hurley, J; Miller, B; Cowie, H; Buchanan, D

    2004-01-01

    To help inform the setting of dust control standards in coalmines, this brief review summarises the most recent and reliable exposure-response relations, for damaging respiratory effects, derived from the Pneumoconiosis Field Research (PFR). Collecting data over 38 years in the British coal industry, this was a programme of prospective research on the respiratory health of coal miners, characterised by regular health surveys and detailed measurements of dust and silica concentrations in the workplace. Exposure-response relations are presented for coal workers' simple pneumoconiosis category II, progressive massive fibrosis, defined deficits of lung function (FEV1), and category II silicosis. This simplified overview provides a guide to the most recent and most reliable estimates from the PFR of dust-related risks of substantial pulmonary disease, and to the magnitude of the effects. Control of dust sufficient to prevent category II simple pneumoconiosis should prevent most cases of progressive massive fibrosis and most dust related large lung function deficits. Where the dust contains high proportions of silica, control to low levels is essential, and even quite brief excursions of silica to high levels must be avoided. PMID:15150385

  15. Supplementary Guidance for Conducting Health Risk ...

    EPA Pesticide Factsheets

    This document is a supplement to the EPA Guidelines for the Health Risk Assessment of Chemical Mixtures of 1986. The 1986 Guidelines represent the Agency's science policy and are a procedural guide for evaluating data on the health risks from exposures to chemical mixtures. The emphasis is on dose response and risk characterization. The principles and concepts put forth in the Guidelines remain in effect. However, where the Guidelines describe broad principles and include few specific procedures, the present guidance is a supplement that is intended to provide more detail on these principles and their applications.After an overview of the background and scope, this supplementary guidance puts forth the risk assessment paradigm for mixtures. This paradigm begins with problem formulation, then briefly discusses hazard identification, dose-response assessment, exposure, and risk characterization. The document is organized according to the type of data available. Procedures are described for assessment using data on the mixture of concern, data on a toxicologically similar mixture, and data on the mixture component chemicals. The state of the science varies dramatically for these three approaches. The whole-mixture procedures are most advanced for assessing carcinogenic risk, mainly because of the long use of in vitro mutagenicity tests to indicate carcinogenic potency. In vitro test procedures for noncancer endpoints are still in the pionee

  16. Maternal mental health and risk of child protection involvement: mental health diagnoses associated with increased risk.

    PubMed

    O'Donnell, Melissa; Maclean, Miriam J; Sims, Scott; Morgan, Vera A; Leonard, Helen; Stanley, Fiona J

    2015-12-01

    Previous research shows that maternal mental illness is an important risk factor for child maltreatment. This study aims to quantify the relationship between maternal mental health and risk of child maltreatment according to the different types of mental health diagnoses. The study used a retrospective cohort of children born in Western Australia between 1990 and 2005, with deidentified linked data from routine health and child protection collections. Nearly 1 in 10 children (9.2%) of mothers with a prior mental health contact had a maltreatment allegation. Alternatively, almost half the children with a maltreatment allegation had a mother with a mental health contact. After adjusting for other risk factors, a history of mental health contacts was associated with a more than doubled risk of allegations (HR=2.64, 95% CI 2.50 to 2.80). Overall, all mental health diagnostic groups were associated with an increased risk of allegations. The greatest risk was found for maternal intellectual disability, followed by disorders of childhood and psychological development, personality disorders, substance-related disorders, and organic disorders. Maltreatment allegations were substantiated at a slightly higher rate than for the general population. Our study shows that maternal mental health is an important factor in child protection involvement. The level of risk varies across diagnostic groups. It is important that mothers with mental health issues are offered appropriate support and services. Adult mental health services should also be aware and discuss the impact of maternal mental health on the family and children's safety and well-being. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  17. Estimating the risk of a scuba diving fatality in Australia.

    PubMed

    Lippmann, John; Stevenson, Christopher; McD Taylor, David; Williams, Jo

    2016-12-01

    There are few data available on which to estimate the risk of death for Australian divers. This report estimates the risk of a scuba diving fatality for Australian residents, international tourists diving in Queensland, and clients of a large Victorian dive operator. Numerators for the estimates were obtained from the Divers Alert Network Asia-Pacific dive fatality database. Denominators were derived from three sources: Participation in Exercise, Recreation and Sport Surveys, 2001-2010 (Australian resident diving activity data); Tourism Research Australia surveys of international visitors to Queensland 2006-2014 and a dive operator in Victoria 2007-2014. Annual fatality rates (AFR) and 95% confidence intervals (95% CI) were calculated using an exact binomial test. Estimated AFRs were: 0.48 (0.37-0.59) deaths per 100,000 dives, or 8.73 (6.85-10.96) deaths per 100,000 divers for Australian residents; 0.12 (0.05-0.25) deaths per 100,000 dives, or 0.46 (0.20-0.91) deaths per 100,000 divers for international visitors to Queensland; and 1.64 (0.20-5.93) deaths per 100,000 dives for the dive operator in Victoria. On a per diver basis, Australian residents are estimated to be almost twenty times more likely to die whilst scuba diving than are international visitors to Queensland, or to lower than fourfold on a per dive basis. On a per dive basis, divers in Victoria are fourteen times more likely to die than are Queensland international tourists. Although some of the estimates are based on potentially unreliable denominator data extrapolated from surveys, the diving fatality rates in Australia appear to vary by State, being considerably lower in Queensland than in Victoria. These estimates are similar to or lower than comparable overseas estimates, although reliability of all such measurements varies with study size and accuracy of the data available.

  18. NRC committee provides new risk estimates for exposure to radon

    SciTech Connect

    Not Available

    1988-03-01

    A new set of age-specific estimates describing the increased risk of lung cancer following exposure to radon was released in January by a National Research Council committee. The revised estimates result from new statistical techniques used to analyze previously collected data. In a study jointly sponsored by the Environmental Protection Agency (EPA) and the Nuclear Regulatory Commission, the committee concluded that lifetime exposure to one working level month (WLM) of radon per year, a standard measure used by radiation experts, increases an individual's chances of dying from lung cancer by 1.5 times compared with someone exposed only to background levels of radon. The committee estimated that, for every 1 million people exposed over a lifetime to one WLM of radon, about 350 additional deaths would occur due to lung cancer. The committee found that lung cancer risks associated with radon increased with increasing length of exposure. Moreover, it said that 15 years after exposure to radon has ended, the risk of lung cancer from the exposure declines to half the original risk.

  19. Incidence of online health information search: a useful proxy for public health risk perception.

    PubMed

    Liang, Bo; Scammon, Debra L

    2013-06-17

    ) and public health funds (P=.02)-have significant effects on Web searches for queries related to the flu. After controlling for the number of reported disease cases and Internet access rate by state, we estimate the contribution of social factors to the public health risk perception levels by state (R(2)=23.37%). The interaction effects between flu incidence and social factors for our search terms did not add to the explanatory power of our regression models (R(2)<1%). Our study suggests a practical way to measure the public's health risk perception for certain diseases using online information search volume by state. The social environment influences public risk perception regardless of disease incidence. Thus, monitoring the social variables can be very helpful in being ready to respond to the public's behavior in dealing with public health threats.

  20. Refining estimates of public health spending as measured in national health expenditure accounts: the Canadian experience.

    PubMed

    Ballinger, Geoff

    2007-01-01

    The recent focus on public health stemming from, among other things, severe acute respiratory syndrome and avian flu has created an imperative to refine health-spending estimates in the Canadian Health Accounts. This article presents the Canadian experience in attempting to address the challenges associated with developing the needed taxonomies for systematically capturing, measuring, and analyzing the national investment in the Canadian public health system. The first phase of this process was completed in 2005, which was a 2-year project to estimate public health spending based on a more classic definition by removing the administration component of the previously combined public health and administration category. Comparing the refined public health estimate with recent data from the Organization for Economic Cooperation and Development still positions Canada with the highest share of total health expenditure devoted to public health than any other country reporting. The article also provides an analysis of the comparability of public health estimates across jurisdictions within Canada as well as a discussion of the recommendations for ongoing improvement of public health spending estimates. The Canadian Institute for Health Information is an independent, not-for-profit organization that provides Canadians with essential statistics and analysis on the performance of the Canadian health system, the delivery of healthcare, and the health status of Canadians. The Canadian Institute for Health Information administers more than 20 databases and registries, including Canada's Health Accounts, which tracks historically 40 categories of health spending by 5 sources of finance for 13 provincial and territorial jurisdictions. Until 2005, expenditure on public health services in the Canadian Health Accounts included measures to prevent the spread of communicable disease, food and drug safety, health inspections, health promotion, community mental health programs, public

  1. 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

  2. Risk assessment in diabetes management: how do general practitioners estimate risks due to diabetes?

    PubMed Central

    Häussler, Bertram; Fischer, Gisela C; Meyer, Sibylle; Sturm, Diethard

    2007-01-01

    Objectives To evaluate the ability of general practitioners (GPs) in Germany to estimate the risk of patients with diabetes developing complications. Methods An interview study using a structured questionnaire to estimate risks of four case vignettes having diabetes‐specific complications within the next 10 years, risk reduction and life expectancy potential. A representative random sample of 584 GPs has been drawn, of which 150 could be interviewed. We compared GPs' estimates among each other (intraclass correlation coefficient (ICC) and Cohen's (multirater‐) κ) and with risks for long‐term complications generated by the multifactor disease model “Mellibase”, which is a knowledge‐based support system for medical decision management. Results The risk estimates by GPs varied widely (ICC 0.21 95% CI (0.13 to 0.36)). The average level of potential risk reduction was between 47% and 70%. Compared with Mellibase values, on average, the GPs overestimated the risk threefold. Mean estimates of potential prolongation of life expectancy were close to 10 years for each patient, whereas the Mellibase calculations ranged from 3 to 10 years. Conclusions Overestimation could lead to unnecessary care and waste of resources. PMID:17545348

  3. [A study on estimating health workers requirement (author's transl)].

    PubMed

    Park, I H

    1980-11-01

    4 metholological approaches to the assessment of future demand for health manpower are considered: health needs, service targets, health demand, and ratio of health manpower to population. The service targets approach appears to be the most appropriate for family planning and maternal and child health services. Once targets are determined, they are converted into manpower requirements on the basis of personnel ratios and productivity assumptions. Requirements for family planning workers are estimated by the fertility decline approach, based on national demographic targets established in quantitative terms. Actual number of family planning workers are estimated at 2619 in 1981 (over 14% of current workers in the field) and 2214 in 1986. To meet the established minimum requirements on the maternal and child health program (3 antepartum contacts and direct or indirect services at delivery), more than 4500 workers will be needed during 1981-86. (Author's modified)

  4. Effect of arrangement of stick figures on estimates of proportion in risk graphics.

    PubMed

    Ancker, Jessica S; Weber, Elke U; Kukafka, Rita

    2011-01-01

    Health risks are sometimes illustrated with stick figures, with a certain proportion colored to indicate they are affected by the disease. Perception of these graphics may be affected by whether the affected stick figures are scattered randomly throughout the group or arranged in a block. . To assess the effects of stick-figure arrangement on first impressions of estimates of proportion, under a 10-s deadline. . Questionnaire. Participants and Setting. Respondents recruited online (n = 100) or in waiting rooms at an urban hospital (n = 65). Intervention. Participants were asked to estimate the proportion represented in 6 unlabeled graphics, half randomly arranged and half sequentially arranged. Measurements. Estimated proportions. . Although average estimates were fairly good, the variability of estimates was high. Overestimates of random graphics were larger than overestimates of sequential ones, except when the proportion was near 50%; variability was also higher with random graphics. Although the average inaccuracy was modest, it was large enough that more than one quarter of respondents confused 2 graphics depicting proportions that differed by 11 percentage points. Low numeracy and educational level were associated with inaccuracy. Limitations. Participants estimated proportions but did not report perceived risk. . Randomly arranged arrays of stick figures should be used with care because viewers' ability to estimate the proportion in these graphics is so poor that moderate differences between risks may not be visible. In addition, random arrangements may create an initial impression that proportions, especially large ones, are larger than they are.

  5. Effect of Arrangement of Stick Figures on Estimates of Proportion in Risk Graphics

    PubMed Central

    Ancker, Jessica S.; Weber, Elke U.; Kukafka, Rita

    2017-01-01

    Background Health risks are sometimes illustrated with stick figures, with a certain proportion colored to indicate they are affected by the disease. Perception of these graphics may be affected by whether the affected stick figures are scattered randomly throughout the group or arranged in a block. Objective To assess the effects of stick-figure arrangement on first impressions of estimates of proportion, under a 10-s deadline. Design Questionnaire. Participants and Setting Respondents recruited online (n = 100) or in waiting rooms at an urban hospital (n = 65). Intervention Participants were asked to estimate the proportion represented in 6 unlabeled graphics, half randomly arranged and half sequentially arranged. Measurements Estimated proportions. Results Although average estimates were fairly good, the variability of estimates was high. Overestimates of random graphics were larger than overestimates of sequential ones, except when the proportion was near 50%; variability was also higher with random graphics. Although the average inaccuracy was modest, it was large enough that more than one quarter of respondents confused 2 graphics depicting proportions that differed by 11 percentage points. Low numeracy and educational level were associated with inaccuracy. Limitations Participants estimated proportions but did not report perceived risk. Conclusions Randomly arranged arrays of stick figures should be used with care because viewers’ ability to estimate the proportion in these graphics is so poor that moderate differences between risks may not be visible. In addition, random arrangements may create an initial impression that proportions, especially large ones, are larger than they are. PMID:20671209

  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. Cardiovascular health status and health risk assessment method of preference among worksite employees.

    PubMed

    Marschke, Lisa M; Allen, George J; Coble, Denis A; Zellner, Scott R; Klein, Randi; Aiudi, Barbara; Murphy, Donna; Pescatello, Linda S

    2006-01-01

    We investigated whether employees (n = 62) selecting a self-report Health Risk Assessment (HRA) would be at increased CVD risk compared to employees (n = 114) choosing an HRA with measurement of cardiovascular (CVD) health indicators. Participants were mostly middle-aged (44.1 +/- 0.8 yr) men (71.6%) displaying borderline features of the cardiometabolic syndrome. Although there were no significant differences between the groups regarding their measured CVD health status or self-reported lifestyle habits, employees in both groups consistently over-stated their level of cardiovascular health. Contrary to reports in the literature, cardiovascular health status did not appear to influence employee HRA method of preference.Editors' Strategic Implications: These findings await replication in other samples, both more diverse and less self-selected. Nonetheless, the authors' methods and their conclusions about workers' over-estimation of their health and the lack of differences across assessment methods will be useful to employers, health professionals, and all practitioners with an interest in health risk assessments.

  8. Estimating Skin Cancer Risk: Evaluating Mobile Computer-Adaptive Testing

    PubMed Central

    Djaja, Ngadiman; Janda, Monika; Olsen, Catherine M; Whiteman, David C

    2016-01-01

    Background Response burden is a major detriment to questionnaire completion rates. Computer adaptive testing may offer advantages over non-adaptive testing, including reduction of numbers of items required for precise measurement. Objective Our aim was to compare the efficiency of non-adaptive (NAT) and computer adaptive testing (CAT) facilitated by Partial Credit Model (PCM)-derived calibration to estimate skin cancer risk. Methods We used a random sample from a population-based Australian cohort study of skin cancer risk (N=43,794). All 30 items of the skin cancer risk scale were calibrated with the Rasch PCM. A total of 1000 cases generated following a normal distribution (mean [SD] 0 [1]) were simulated using three Rasch models with three fixed-item (dichotomous, rating scale, and partial credit) scenarios, respectively. We calculated the comparative efficiency and precision of CAT and NAT (shortening of questionnaire length and the count difference number ratio less than 5% using independent t tests). Results We found that use of CAT led to smaller person standard error of the estimated measure than NAT, with substantially higher efficiency but no loss of precision, reducing response burden by 48%, 66%, and 66% for dichotomous, Rating Scale Model, and PCM models, respectively. Conclusions CAT-based administrations of the skin cancer risk scale could substantially reduce participant burden without compromising measurement precision. A mobile computer adaptive test was developed to help people efficiently assess their skin cancer risk. PMID:26800642

  9. Estimating radiation risk induced by CT screening for Korean population

    NASA Astrophysics Data System (ADS)

    Yang, Won Seok; Yang, Hye Jeong; Min, Byung In

    2017-02-01

    The purposes of this study are to estimate the radiation risks induced by chest/abdomen computed tomography (CT) screening for healthcare and to determine the cancer risk level of the Korean population compared to other populations. We used an ImPACT CT Patient Dosimetry Calculator to compute the organ effective dose induced by CT screening (chest, low-dose chest, abdomen/pelvis, and chest/abdomen/pelvis CT). A risk model was applied using principles based on the BEIR VII Report in order to estimate the lifetime attributable risk (LAR) using the Korean Life Table 2010. In addition, several countries including Hong Kong, the United States (U.S.), and the United Kingdom, were selected for comparison. Herein, each population exposed radiation dose of 100 mSv was classified according to country, gender and age. For each CT screening the total organ effective dose calculated by ImPACT was 6.2, 1.5, 5.2 and 11.4 mSv, respectively. In the case of Korean female LAR, it was similar to Hong Kong female but lower than those of U.S. and U.K. females, except for those in their twenties. The LAR of Korean males was the highest for all types of CT screening. However, the difference of the risk level was negligible because of the quite low value.

  10. Estimating Skin Cancer Risk: Evaluating Mobile Computer-Adaptive Testing.

    PubMed

    Djaja, Ngadiman; Janda, Monika; Olsen, Catherine M; Whiteman, David C; Chien, Tsair-Wei

    2016-01-22

    Response burden is a major detriment to questionnaire completion rates. Computer adaptive testing may offer advantages over non-adaptive testing, including reduction of numbers of items required for precise measurement. Our aim was to compare the efficiency of non-adaptive (NAT) and computer adaptive testing (CAT) facilitated by Partial Credit Model (PCM)-derived calibration to estimate skin cancer risk. We used a random sample from a population-based Australian cohort study of skin cancer risk (N=43,794). All 30 items of the skin cancer risk scale were calibrated with the Rasch PCM. A total of 1000 cases generated following a normal distribution (mean [SD] 0 [1]) were simulated using three Rasch models with three fixed-item (dichotomous, rating scale, and partial credit) scenarios, respectively. We calculated the comparative efficiency and precision of CAT and NAT (shortening of questionnaire length and the count difference number ratio less than 5% using independent t tests). We found that use of CAT led to smaller person standard error of the estimated measure than NAT, with substantially higher efficiency but no loss of precision, reducing response burden by 48%, 66%, and 66% for dichotomous, Rating Scale Model, and PCM models, respectively. CAT-based administrations of the skin cancer risk scale could substantially reduce participant burden without compromising measurement precision. A mobile computer adaptive test was developed to help people efficiently assess their skin cancer risk.

  11. Radiation-Induced Second Cancer Risk Estimates From Radionuclide Therapy

    NASA Astrophysics Data System (ADS)

    Bednarz, Bryan; Besemer, Abigail

    2017-09-01

    The use of radionuclide therapy in the clinical setting is expected to increase significantly over the next decade. There is an important need to understand the radiation-induced second cancer risk associated with these procedures. In this study the radiation-induced cancer risk in five radionuclide therapy patients was investigated. These patients underwent serial SPECT imaging scans following injection as part of a clinical trial testing the efficacy of a 131Iodine-labeled radiopharmaceutical. Using these datasets the committed absorbed doses to multiple sensitive structures were calculated using RAPID, which is a novel Monte Carlo-based 3D dosimetry platform developed for personalized dosimetry. The excess relative risk (ERR) for radiation-induced cancer in these structures was then derived from these dose estimates following the recommendations set forth in the BEIR VII report. The radiation-induced leukemia ERR was highest among all sites considered reaching a maximum value of approximately 4.5. The radiation-induced cancer risk in the kidneys, liver and spleen ranged between 0.3 and 1.3. The lifetime attributable risks (LARs) were also calculated, which ranged from 30 to 1700 cancers per 100,000 persons and were highest for leukemia and the liver for both males and females followed by radiation-induced spleen and kidney cancer. The risks associated with radionuclide therapy are similar to the risk associated with external beam radiation therapy.

  12. Estimation of earthquake risk curves of physical building damage

    NASA Astrophysics Data System (ADS)

    Raschke, Mathias; Janouschkowetz, Silke; Fischer, Thomas; Simon, Christian

    2014-05-01

    In this study, a new approach to quantify seismic risks is presented. Here, the earthquake risk curves for the number of buildings with a defined physical damage state are estimated for South Africa. Therein, we define the physical damage states according to the current European macro-seismic intensity scale (EMS-98). The advantage of such kind of risk curve is that its plausibility can be checked more easily than for other types. The earthquake risk curve for physical building damage can be compared with historical damage and their corresponding empirical return periods. The number of damaged buildings from historical events is generally explored and documented in more detail than the corresponding monetary losses. The latter are also influenced by different economic conditions, such as inflation and price hikes. Further on, the monetary risk curve can be derived from the developed risk curve of physical building damage. The earthquake risk curve can also be used for the validation of underlying sub-models such as the hazard and vulnerability modules.

  13. Attributable Risk Estimate of Severe Psoriasis on Major Cardiovascular Events

    PubMed Central

    Mehta, Nehal N.; Yu, YiDing; Pinnelas, Rebecca; Krishnamoorthy, Parasuram; Shin, Daniel B.; Troxel, Andrea B.; Gelfand, Joel M.

    2011-01-01

    Background Recent studies suggest that psoriasis, particularly if severe, may be a risk factor for major adverse cardiac events such as myocardial infarction, stroke, and mortality from cardiovascular disease. We compared the risk of major adverse cardiac events between patients with psoriasis and the general population and estimated the attributable risk of severe psoriasis. Methods We performed a cohort study in the General Practice Research Database. Severe psoriasis was defined as receiving a psoriasis diagnosis and systemic therapy (N=3,603). Up to 4 patients without psoriasis were selected from the same practices and start dates for each patient with psoriasis (N=14,330). Results Severe psoriasis was a risk factor for major adverse cardiac events (hazard ratio 1.53; 95% confidence interval 1.26, 1.85) after adjusting for age, gender, diabetes, hypertension, tobacco use and hyperlipidemia. After fully adjusted analysis, severe psoriasis conferred an additional 6.2% absolute risk of 10-year major adverse cardiac events. Conclusions Severe psoriasis confers an additional 6.2% absolute risk of 10-year rate of major adverse cardiac events compared to the general population. This potentially has important therapeutic implications for cardiovascular risk stratification and prevention in patients with severe psoriasis. Future prospective studies are needed to validate these findings. PMID:21787906

  14. A Review of Expertise and Judgment Processes for Risk Estimation

    SciTech Connect

    R. L. Boring

    2007-06-01

    A major challenge of risk and reliability analysis for human errors or hardware failures is the need to enlist expert opinion in areas for which adequate operational data are not available. Experts enlisted in this capacity provide probabilistic estimates of reliability, typically comprised of a measure of central tendency and uncertainty bounds. While formal guidelines for expert elicitation are readily available, they largely fail to provide a theoretical basis for expertise and judgment. This paper reviews expertise and judgment in the context of risk analysis; overviews judgment biases, the role of training, and multivariate judgments; and provides guidance on the appropriate use of atomistic and holistic judgment processes.

  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. Survey of mental health nurses' attitudes towards risk assessment, risk assessment tools and positive risk.

    PubMed

    Downes, C; Gill, A; Doyle, L; Morrissey, J; Higgins, A

    2016-04-01

    WHAT IS KNOWN ON THE SUBJECT?: Risk assessment and safety planning are a core aspect of the role of the mental health nurse. Conflicting views exist on the value of risk assessment tools. Few studies have examined mental health nurses' attitudes towards risk, including use of tools and the role of positive risk in recovery. WHAT THE PAPER ADDS TO EXISTING KNOWLEDGE?: Mental health nurses view risk assessment as a core dimension of their role and not merely an exercise to fulfil organizational clinical safety and governance obligations. The majority of nurses hold positive attitudes towards therapeutic or positive risk, and consider creative risk taking as vital to people's recovery. The majority of nurses believe that risk assessment tools facilitate professional decision making, however, some are concerned that tools may negatively impact upon therapeutic relationships. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Ongoing education on the use of risk assessment tools is required to minimize views that their use is incompatible with therapeutic engagement, and to enable nurses to develop confidence to engage with positive risk and to allow service users make decisions and take responsibility. Introduction Risk assessment and safety planning are considered core components of the role of the mental health nurse; however, little is known about nurses' attitudes towards risk assessment, use of tools to assess risk or therapeutic risk taking. Aim This study aimed to explore mental health nurses' attitudes towards completing risk assessments, use of tools as an aid, and therapeutic or positive risk. Method An anonymous survey which included 13 attitudinal statements, rated on a five-point Likert scale, was completed by 381 mental health nurses working in adult services in Ireland. Findings Findings indicate strong support for the practice of risk assessment in mental health practice. The vast majority of nurses believe that risk assessment tools facilitate professional

  17. Reporting of health estimates prior to GATHER: a scoping review.

    PubMed

    Cokljat, Mia; Henderson, James; Paterson, Angus; Rudan, Igor; Stevens, Gretchen A

    2017-01-01

    Generating estimates of health indicators at the global, regional, and country levels is increasingly in demand in order to meet reporting requirements for global and country targets, such as the sustainable development goals (SDGs). However, such estimates are sensitive to availability of input data, underlying analytic assumptions, variability in statistical techniques, and often have important limitations. From a user perspective, there is often a lack of transparency and replicability. In order to define best practices in reporting data and methods used to calculate health estimates, the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) working group developed a minimum checklist of 18 items that must be reported within each study publishing health estimates, so that users may make an assessment of the quality of the estimate. We conducted a scoping review to assess the state of reporting amongst a cross-sectional sample of studies published prior to the publication of GATHER. We generated a sample of UN reports and journal articles through a combination of a Medline search and hand-searching published health estimates. From these studies we extracted the percentage of studies correctly reporting each item on the checklist, the proportion of items reported per study (the GATHER performance score), and how this score varied depending on study type. The average proportion of items reported per study was 0.47, and the poorest-performing items related to documentation and availability of input data, availability of the statistical code used and the subsequent output data, and a complete detailed description of all the steps of the data analysis. Methods for health estimates are not currently fully reported, and the implementation of the GATHER guidelines will improve the availability of information required to make an assessment of study quality.

  18. 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

  19. Remote sensing techniques for vegetation moisture and fire risk estimation

    NASA Astrophysics Data System (ADS)

    Dasgupta, Swarvanu

    This dissertation is aimed at evaluating and improving remote sensing techniques for vegetation moisture and fire risk estimation. Empirical retrievals of vegetation moisture using liquid water absorption based spectral indices such as the NDWI (Normalized Difference Water Index) and NDII (Normalized Difference Infrared Index) may have uncertainties, since these indices cannot fully normalize the reflectance variability due to other biophysical, biochemical, soil and illumination viewing geometry factors. Coupled leaf-canopy reflectance models, National Fire Danger Rating System data and the FARSITE fire behavior model were used to estimate the effect of Live Fuel Moisture Content (LFMC) retrieval uncertainties on fire spread rate predictions. The uncertainty estimation was focused on the Okefenokee National Wildlife Refuge where errors in LFMC retrievals using NDWI and NDII were shown to result in considerable fire spread rate prediction errors at lower LFMC levels. Soil reflectance contamination driven by soil moisture variability was identified as a problem causing errors in Vegetation Water Content (VWC) retrievals over low vegetation conditions. Analysis of canopy reflectance simulations from coupled soil-leaf-canopy reflectance models revealed that VWC isolines were curved and did not converge at the origin of the 1.64mum--0.86mum space. These were identified as causes for the soil moisture contamination of the spectral index NDII. As an improvement strategy an origin transformed NDII, called the SANDII (Soil Adjusted NDII) was designed to minimize soil contamination. Further separate regression models between VWC and the SANDII for different soil moisture classes were proposed to account for the curved nature of VWC isolines. The new technique which requires categorical soil moisture information was shown to reduce VWC estimation errors by about 20% over grassland conditions. The approach was supported using data collected over pastures during the Soil

  20. A Monte Carlo analysis of health risks from PCB-contaminated mineral oil transformer fires.

    PubMed

    Eschenroeder, A Q; Faeder, E J

    1988-06-01

    The objective of this study is the estimation of health hazards due to the inhalation of combustion products from accidental mineral oil transformer fires. Calculations of production, dispersion, and subsequent human intake of polychlorinated dibenzofurans (PCDFs) provide us with exposure estimates. PCDFs are believed to be the principal toxic products of the pyrolysis of polychlorinated biphenyls (PCBs) sometimes found as contaminants in transformer mineral oil. Cancer burdens and birth defect hazard indices are estimated from population data and exposure statistics. Monte Carlo-derived variational factors emphasize the statistics of uncertainty in the estimates of risk parameters. Community health issues are addressed and risks are found to be insignificant.

  1. [Professional risks of oral health care delivery].

    PubMed

    Eijkman, M A J; de Baat, C

    2009-05-01

    Hazards are an integral part of health care delivery and the associated logistics. Currently, the general opinion seems to be that health care delivery should be risk-free. Care consumers seem to be becoming more conscious of their 'rights' to receive adequate care. If the care delivered is not consistent with their expectations, people are aware of the feasibility of claiming their 'rights' and suing their doctor. Significant questions in this respect are what people can reasonably expect, when one can speak of failure or negligence, and in which circumstances a negative outcome is a standard hazard which should be accepted.

  2. 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

  3. 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.

  4. Estimate of the risks of disposing nonhazardous oil field wastes into salt caverns

    SciTech Connect

    Tomasko, D.; Elcock, D.; Veil, J.

    1997-12-31

    Argonne National Laboratory (ANL) has completed an evaluation of the possibility that adverse human health effects (carcinogenic and noncarcinogenic) could result from exposure to contaminants released from nonhazardous oil field wastes (NOW) disposed in domal salt caverns. Potential human health risks associated with hazardous substances (arsenic, benzene, cadmium, and chromium) in NOW were assessed under four postclosure cavern release scenarios: inadvertent cavern intrusion, failure of the cavern seal, failure of the cavern through cracks or leaky interbeds, and a partial collapse of the cavern roof. To estimate potential human health risks for these scenarios, contaminant concentrations at the receptor were calculated using a one-dimensional solution to an advection/dispersion equation that included first order degradation. Assuming a single, generic salt cavern and generic oil-field wastes, the best-estimate excess cancer risks ranged from 1.7 {times} 10{sup {minus}12} to 1.1 {times} 10{sup {minus}8} and hazard indices (referring to noncancer health effects) ranged from 7 {times} 10{sup {minus}9} to 7 {times} 10{sup {minus}4}. Under worse-case conditions in which the probability of cavern failure is 1.0, excess cancer risks ranged from 4.9 {times} 10{sup {minus}9} to 1.7 {times} 10{sup {minus}5} and hazard indices ranged from 7.0 {times} 10{sup {minus}4} to 0.07. Even under worst-case conditions, the risks are within the US Environmental Protection Agency (EPA) target range for acceptable exposure levels. From a human health risk perspective, salt caverns can, therefore, provide an acceptable disposal method for NOW.

  5. 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…

  6. Health risk appraisals in Swedish occupational health services

    PubMed Central

    Grooten, Wilhelmus Johannes Andreas; Müller, Mira; Forsman, Mikael; Kjellberg, Katarina; Toomingas, Allan; Björn Olov, Ång; Svartengren, Magnus

    2016-01-01

    BACKGROUND: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided. OBJECTIVES: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction. METHODS: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n = 272) and employees that participated in a single session (HRA-S) (n = 104). Associations between feedback and individual status concerning life style were assessed with Cohen’s kappa (k). RESULTS: The employees received mainly information and advice for improvement on health and lifestyle issues (89–100%), while advice for improvement of working conditions was less common (15–59%). The feedback provided on life style was not based on individual status (k < 0.4), except for smoking and risky alcohol consumption (k > 0.55). A great majority of employees reported good overall satisfaction with their HRAs. CONCLUSIONS: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors. PMID:28059808

  7. Risk estimation based on chromosomal aberrations induced by radiation

    NASA Technical Reports Server (NTRS)

    Durante, M.; Bonassi, S.; George, K.; Cucinotta, F. A.

    2001-01-01

    The presence of a causal association between the frequency of chromosomal aberrations in peripheral blood lymphocytes and the risk of cancer has been substantiated recently by epidemiological studies. Cytogenetic analyses of crew members of the Mir Space Station have shown that a significant increase in the frequency of chromosomal aberrations can be detected after flight, and that such an increase is likely to be attributed to the radiation exposure. The risk of cancer can be estimated directly from the yields of chromosomal aberrations, taking into account some aspects of individual susceptibility and other factors unrelated to radiation. However, the use of an appropriate technique for the collection and analysis of chromosomes and the choice of the structural aberrations to be measured are crucial in providing sound results. Based on the fraction of aberrant lymphocytes detected before and after flight, the relative risk after a long-term Mir mission is estimated to be about 1.2-1.3. The new technique of mFISH can provide useful insights into the quantification of risk on an individual basis.

  8. Estimation of tuberculosis risk on a commercial airliner.

    PubMed

    Ko, Gwangpyo; Thompson, Kimberly M; Nardell, Edward A

    2004-04-01

    This article estimates the risk of tuberculosis (TB) transmission on a typical commercial airliner using a simple one box model (OBM) and a sequential box model (SBM). We used input data derived from an actual TB exposure on an airliner, and we assumed a hypothetical scenario that a highly infectious TB source case (i.e., 108 infectious quanta per hour) travels as a passenger on an 8.7-hour flight. We estimate an average risk of TB transmission on the order of 1 chance in 1,000 for all passengers using the OBM. Applying the more realistic SBM, we show that the risk and incidence decrease sharply in a stepwise fashion in cabins downstream from the cabin containing the source case assuming some potential for airflow from more contaminated to less contaminated cabins. We further characterized spatial variability in the risk within the cabin by modeling a previously reported TB outbreak in an airplane to demonstrate that the TB cases occur most likely within close proximity of the source TB patient.

  9. Risk estimation based on chromosomal aberrations induced by radiation

    NASA Technical Reports Server (NTRS)

    Durante, M.; Bonassi, S.; George, K.; Cucinotta, F. A.

    2001-01-01

    The presence of a causal association between the frequency of chromosomal aberrations in peripheral blood lymphocytes and the risk of cancer has been substantiated recently by epidemiological studies. Cytogenetic analyses of crew members of the Mir Space Station have shown that a significant increase in the frequency of chromosomal aberrations can be detected after flight, and that such an increase is likely to be attributed to the radiation exposure. The risk of cancer can be estimated directly from the yields of chromosomal aberrations, taking into account some aspects of individual susceptibility and other factors unrelated to radiation. However, the use of an appropriate technique for the collection and analysis of chromosomes and the choice of the structural aberrations to be measured are crucial in providing sound results. Based on the fraction of aberrant lymphocytes detected before and after flight, the relative risk after a long-term Mir mission is estimated to be about 1.2-1.3. The new technique of mFISH can provide useful insights into the quantification of risk on an individual basis.

  10. [Cyanobacteria, their toxins and health risks].

    PubMed

    Thébault, L; Lesne, J; Boutin, J P

    1995-01-01

    Cyanobacteria (blue-green algae) commonly occur in fresh and brackish water where they produce blooms under certain environmental and climatic conditions. Since some species produce neurotoxins, hepatotoxins, cytotoxins, and endotoxins, blooms can be hazardous for animal and human health. Several cases of human cyanobacterial poisoning have been documented, but accurate assessment of the risk is difficult for lack of knowledge concerning exposure levels and the incidence of this kind of poisoning. Most human cases have been reported after oral consumption of contaminated drinking water or swimming in recreation waters where blooms have occurred. Further study is needed to evaluate and manage this risk, especially in regions dependent on surface water for drinking and recreational water areas. This is especially true in tropical and intertropical areas where climatic conditions promote occurrence of cyanobacteria blooms and nothing is known of the impact on public health.

  11. Improved risk estimates for carbon tetrachloride. 1998 annual progress report

    SciTech Connect

    Benson, J.M.; Springer, D.L.; Thrall, K.D.

    1998-06-01

    'The overall purpose of these studies is to improve the scientific basis for assessing the cancer risk associated with human exposure to carbon tetrachloride. Specifically, the toxicokinetics of inhaled carbon tetrachloride is being determined in rats, mice and hamsters. Species differences in the metabolism of carbon tetrachloride by rats, mice and hamsters is being determined in vivo and in vitro using tissues and microsomes from these rodent species and man. Dose-response relationships will be determined in all studies. The information will be used to improve the current physiologically based pharmacokinetic model for carbon tetrachloride. The authors will also determine whether carbon tetrachloride is a hepatocarcinogen only when exposure results in cell damage, cell killing, and regenerative cell proliferation. In combination, the results of these studies will provide the types of information needed to enable a refined risk estimate for carbon tetrachloride under EPA''s new guidelines for cancer risk assessment.'

  12. Methodology for estimating extreme winds for probabilistic risk assessments

    SciTech Connect

    Ramsdell, J.V.; Elliott, D.L.; Holladay, C.G.; Hubbe, J.M.

    1986-10-01

    The US Nuclear Reguulatory Commission (NRC) assesses the risks associated with nuclear faciliies using techniques that fall under a generic name of Probabilistic Risk Assessment. In these assessments, potential accident sequences are traced from initiating event to final outcome. At each step of the sequence, a probability of occurrence is assigned to each available alternative. Ultimately, the probability of occurrence of each possible outcome is determined from the probabilities assigned to the initiating events and the alternative paths. Extreme winds are considered in these sequences. As a result, it is necessary to estimate extreme wind probabilities as low as 10/sup -7/yr/sup -1/. When the NRC staff is called on to provide extreme wind estimates, the staff is likely to be subjected to external time and funding constraints. These constraints dictate that the estimates be based on readily available wind data. In general, readily available data will be limited to the data provided by the facility applicant or licensee and the data archived at the National Climatic Data Center in Asheville, North Carolina. This report describes readily available data that can be used in estimating extreme wind probabilities, procedures of screening the data to eliminate erroneous values and for adjusting data to compensate for differences in data collection methods, and statistical methods for making extreme wind estimates. Supporting technical details are presented in several appendices. Estimation of extreme wind probabilities at a given location involves many subjective decisions. The procedures described do not eliminate all of the subjectivity, but they do increase the reproducibility of the analysis. They provide consistent methods for determining probabilities given a set of subjective decisions. By following these procedures, subjective decisions can be identified and documented.

  13. Estimating rural households' willingness to pay for health insurance.

    PubMed

    Asgary, Ali; Willis, Ken; Taghvaei, Ali Akbar; Rafeian, Mojtaba

    2004-10-01

    In many developing countries limited health budgets are a serious problem. Innovative ways to raise funds for the provision of health services, for example, through health care insurance, have a high priority. Health care insurance for rural households shields such patients from unexpected high costs of care. However, there are questions about whether, and how much, rural households are willing to pay to purchase such insurance, as well as the factors determining willingness to pay. In recent years the Iranian government has tried to improve health and medical services to rural areas through a health insurance program. This study was conducted to estimate rural households' demand and willingness to pay for health insurance. A contingent valuation method (CVM) was applied using an iterative bidding game technique. Data has been collected from a sample of 2,139 households across the country.

  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. Estimating the risks of cancer mortality and genetic defects resulting from exposures to low levels of ionizing radiation

    SciTech Connect

    Buhl, T.E.; Hansen, W.R.

    1984-05-01

    Estimators for calculating the risk of cancer and genetic disorders induced by exposure to ionizing radiation have been recommended by the US National Academy of Sciences Committee on the Biological Effects of Ionizing Radiations, the UN Scientific Committee on the Effects of Atomic Radiation, and the International Committee on Radiological Protection. These groups have also considered the risks of somatic effects other than cancer. The US National Council on Radiation Protection and Measurements has discussed risk estimate procedures for radiation-induced health effects. The recommendations of these national and international advisory committees are summarized and compared in this report. Based on this review, two procedures for risk estimation are presented for use in radiological assessments performed by the US Department of Energy under the National Environmental Policy Act of 1969 (NEPA). In the first procedure, age- and sex-averaged risk estimators calculated with US average demographic statistics would be used with estimates of radiation dose to calculate the projected risk of cancer and genetic disorders that would result from the operation being reviewed under NEPA. If more site-specific risk estimators are needed, and the demographic information is available, a second procedure is described that would involve direct calculation of the risk estimators using recommended risk-rate factors. The computer program REPCAL has been written to perform this calculation and is described in this report. 25 references, 16 tables.

  16. Diving in Contaminated Water: Health Risk Matrix

    DTIC Science & Technology

    2006-10-01

    health effects if they are present in high concentrations. Some of the metals are insoluble ( mercury , lead) and are associated with particles. Therefore...risk associated with that parameter is really low (for example, copper and mercury ). However, divers have to keep in mind that they may encounter higher...levels if they dive in special areas (areas severely affected by mining activities in the case of copper and mercury ). As research and monitoring

  17. Estimating risks of heat strain by age and sex: a population-level simulation model.

    PubMed

    Glass, Kathryn; Tait, Peter W; Hanna, Elizabeth G; Dear, Keith

    2015-05-18

    Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan's man model "MANMO") to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions.

  18. Estimating Risks of Heat Strain by Age and Sex: A Population-Level Simulation Model

    PubMed Central

    Glass, Kathryn; Tait, Peter W.; Hanna, Elizabeth G.; Dear, Keith

    2015-01-01

    Individuals living in hot climates face health risks from hyperthermia due to excessive heat. Heat strain is influenced by weather exposure and by individual characteristics such as age, sex, body size, and occupation. To explore the population-level drivers of heat strain, we developed a simulation model that scales up individual risks of heat storage (estimated using Myrup and Morgan’s man model “MANMO”) to a large population. Using Australian weather data, we identify high-risk weather conditions together with individual characteristics that increase the risk of heat stress under these conditions. The model identifies elevated risks in children and the elderly, with females aged 75 and older those most likely to experience heat strain. Risk of heat strain in males does not increase as rapidly with age, but is greatest on hot days with high solar radiation. Although cloudy days are less dangerous for the wider population, older women still have an elevated risk of heat strain on hot cloudy days or when indoors during high temperatures. Simulation models provide a valuable method for exploring population level risks of heat strain, and a tool for evaluating public health and other government policy interventions. PMID:25993102

  19. Expedition health and safety: a risk assessment.

    PubMed Central

    Anderson, S R; Johnson, C J

    2000-01-01

    Little has been published on the risks of participating in an expedition. A questionnaire survey was conducted to quantify those risks and to determine how expedition organizers plan for medical mishaps. 246 expeditions, taking 2381 participants to more than one hundred countries, were studied retrospectively. 65 expeditions (26%) reported no medical incidents; the remaining 181 reported 835 in 130,000 man-days (6.4 per 1000 man-days). 59% of the medical incidents seen on expeditions were preventable, one-third of these being due to gastrointestinal upsets. 78% of medical incidents were classified as minor and only 5% (40) as serious. There was no excess of serious incidents in any particular organizational group or environment. The findings of this survey suggest that the health risks of participating in a well-planned expedition are similar to those encountered during normal active life. PMID:11198684

  20. Seismic Risk Assessment and Loss Estimation for Tbilisi City

    NASA Astrophysics Data System (ADS)

    Tsereteli, Nino; Alania, Victor; Varazanashvili, Otar; Gugeshashvili, Tengiz; Arabidze, Vakhtang; Arevadze, Nika; Tsereteli, Emili; Gaphrindashvili, Giorgi; Gventcadze, Alexander; Goguadze, Nino; Vephkhvadze, Sophio

    2013-04-01

    The proper assessment of seismic risk is of crucial importance for society protection and city sustainable economic development, as it is the essential part to seismic hazard reduction. Estimation of seismic risk and losses is complicated tasks. There is always knowledge deficiency on real seismic hazard, local site effects, inventory on elements at risk, infrastructure vulnerability, especially for developing countries. Lately great efforts was done in the frame of EMME (earthquake Model for Middle East Region) project, where in the work packages WP1, WP2 , WP3 and WP4 where improved gaps related to seismic hazard assessment and vulnerability analysis. Finely in the frame of work package wp5 "City Scenario" additional work to this direction and detail investigation of local site conditions, active fault (3D) beneath Tbilisi were done. For estimation economic losses the algorithm was prepared taking into account obtained inventory. The long term usage of building is very complex. It relates to the reliability and durability of buildings. The long term usage and durability of a building is determined by the concept of depreciation. Depreciation of an entire building is calculated by summing the products of individual construction unit' depreciation rates and the corresponding value of these units within the building. This method of calculation is based on an assumption that depreciation is proportional to the building's (constructions) useful life. We used this methodology to create a matrix, which provides a way to evaluate the depreciation rates of buildings with different type and construction period and to determine their corresponding value. Finally loss was estimated resulting from shaking 10%, 5% and 2% exceedance probability in 50 years. Loss resulting from scenario earthquake (earthquake with possible maximum magnitude) also where estimated.

  1. Do the Health Benefits of Cycling Outweigh the Risks?

    PubMed Central

    de Hartog, Jeroen Johan; Boogaard, Hanna; Nijland, Hans; Hoek, Gerard

    2010-01-01

    Background Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions, decreased greenhouse gas emissions, and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. Objective We describe whether the health benefits from the increased physical activity of a modal shift for urban commutes outweigh the health risks. Data sources and extraction We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies. Data synthesis We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We have expressed mortality impacts in life-years gained or lost, using life table calculations. For individuals who shift from car to bicycle, we estimated that beneficial effects of increased physical activity are substantially larger (3–14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8–40 days lost) and the increase in traffic accidents (5–9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and greenhouse gas emissions and traffic accidents. Conclusions On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport. PMID:20587380

  2. New mercury treaty exposes health risks.

    PubMed

    Bender, Michael; Lymberidi-Settimo, Elena; Groth, Edward

    2014-02-01

    More than a decade in the making, a new, legally binding treaty on mercury will be adopted by governments in the fall of 2013. The treaty's objective is to protect human health and the environment from anthropogenic mercury emissions through a range of provisions - including an article devoted to reducing exposure to mercury. Global emissions have increased since 2005, with the environmental health burden increasingly shifting to developing countries. Time is of the essence to reduce pollution because (i) exposure risk to mercury is much greater than previously thought and (ii) mercury already in the environment can be re-emitted via processes in the natural cycle, resulting in a longer lag time before pollution reduction can have a demonstrable effect on the food chain. Health professionals can assist in reducing exposure, choosing mercury-free products and urging governments to ratify the treaty as quickly as possible so that it can take effect.

  3. Heel spur radiotherapy and radiation carcinogenesis risk estimation.

    PubMed

    Surenkok, Serdar; Dirican, Bahar; Beyzadeoglu, Murat; Oysul, Kaan

    2006-10-01

    Radiotherapy is a nonsurgical alternative therapy of painful heel spur patients. Nonetheless, cancer induction is the most important somatic effect of ionizing radiation. This study was designed to evaluate the carcinogenesis risk factor in benign painful heel spur patients treated by radiotherapy. Between 1974 and 1999, a total of 20 patients received mean 8.16 Gy total irradiation dose in two fractions. Thermoluminescent dosimeters (TLD(100)) were placed on multiple phantom sites in vivo within the irradiated volume to verify irradiation accuracy and carcinogenesis risk factor calculation. The 20 still-alive patients, who had a minimum 5-year and maximum 29-year follow-up (mean 11.9 years), have been evaluated by carcinogenic radiation risk factor on the basis of tissue weighting factors as defined by the International Commission on Radiological Protection Publication 60. Reasonable pain relief has been obtained in all 20 patients. The calculated mean carcinogenesis risk factor is 1.3% for radiation portals in the whole group, and no secondary cancer has been clinically observed. Radiotherapy is an effective treatment modality for relieving pain in calcaneal spur patients. The estimated secondary cancer risk factor for irradiation of this benign lesion is not as high as was feared.

  4. Competing risk bias was common in Kaplan-Meier risk estimates published in prominent medical journals.

    PubMed

    van Walraven, Carl; McAlister, Finlay A

    2016-01-01

    Risk estimates from Kaplan-Meier curves are well known to medical researchers, reviewers, and editors. In this study, we determined the proportion of Kaplan-Meier analyses published in prominent medical journals that are potentially biased because of competing events ("competing risk bias"). We randomly selected 100 studies that had at least one Kaplan-Meier analysis and were recently published in prominent medical journals. Susceptibility to competing risk bias was determined by examining the outcome and potential competing events. In susceptible studies, bias was quantified using a previously validated prediction model when the number of outcomes and competing events were given. Forty-six studies (46%) contained Kaplan-Meier analyses susceptible to competing risk bias. Sixteen studies (34.8%) susceptible to competing risk cited the number of outcomes and competing events; in six of these studies (6/16, 37.5%), the outcome risk from the Kaplan-Meier estimate (relative to the true risk) was biased upward by 10% or more. Almost half of Kaplan-Meier analyses published in medical journals are susceptible to competing risk bias and may overestimate event risk. This bias was found to be quantitatively important in a third of such studies. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. How Many Significant Figures are Useful for Public Risk Estimates?

    NASA Astrophysics Data System (ADS)

    Wilde, Paul D.; Duffy, Jim

    2013-09-01

    This paper considers the level of uncertainty in the calculation of public risks from launch or reentry and provides guidance on the number of significant digits that can be used with confidence when reporting the analysis results to decision-makers. The focus of this paper is the uncertainty in collective risk calculations that are used for launches of new and mature ELVs. This paper examines the computational models that are used to estimate total collective risk to the public for a launch, including the model input data and the model results, and characterizes the uncertainties due to both bias and variability. There have been two recent efforts to assess the uncertainty in state-of-the-art risk analysis models used in the US and their input data. One assessment focused on launch area risk from an Atlas V at Vandenberg Air Force Base (VAFB) and the other focused on downrange risk to Eurasia from a Falcon 9 launched from Cape Canaveral Air Force Station (CCAFS). The results of these studies quantified the uncertainties related to both the probability and the consequence of the launch debris hazards. This paper summarizes the results of both of these relatively comprehensive launch risk uncertainty analyses, which addressed both aleatory and epistemic uncertainties. The epistemic uncertainties of most concern were associated with probability of failure and the debris list. Other major sources of uncertainty evaluated were: the casualty area for people in shelters that are impacted by debris, impact distribution size, yield from exploding propellant and propellant tanks, probability of injury from a blast wave for people in shelters or outside, and population density. This paper also summarizes a relatively comprehensive over-flight risk uncertainty analysis performed by the FAA for the second stage of flight for a Falcon 9 from CCAFS. This paper is applicable to baseline collective risk analyses, such as those used to make a commercial license determination, and

  6. Defining Arthritis for Public Health Surveillance: Methods and Estimates in Four US Population Health Surveys.

    PubMed

    Murphy, Louise B; Cisternas, Miriam G; Greenlund, Kurt J; Giles, Wayne; Hannan, Casey; Helmick, Charles G

    2017-03-01

    To determine the variability of arthritis prevalence in 4 US population health surveys. We estimated annualized arthritis prevalence in 2011-2012, among adults age ≥20 years, using 2 definition methods, both based on self-report: 1) doctor-/health care provider-diagnosed arthritis in the Behavioral Risk Factor Surveillance Survey (BRFSS), National Health and Nutrition Examination Survey (NHANES), National Health Interview Survey (NHIS), and Medical Expenditure Panel Survey (MEPS); and 2) three arthritis definitions based on International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) criteria in MEPS (National Arthritis Data Workgroup on Arthritis and Other Rheumatic Conditions [NADW-AORC], Clinical Classifications Software [CCS], and Centers for Disease Control and Prevention [CDC]). Diagnosed arthritis prevalence percentages using the surveys were within 3 points of one another (BRFSS 26.2% [99% confidence interval (99% CI) 26.0-26.4], MEPS 26.1% [99% CI 25.0-27.2], NHIS 23.5% [99% CI 22.9-24.1], NHANES 23.0% [99% CI 19.2-26.8]), and those using ICD-9-CM were within 5 percentage points of one another (CCS 25.8% [99% CI 24.6-27.1]; CDC 28.3% [99% CI 27.0-29.6]; and NADW-AORC 30.7% [99% CI 29.4-32.1]). The variation in the estimated number (in millions) affected with diagnosed arthritis was 7.8 (BRFSS 58.5 [99% CI 58.1-59.1], MEPS 59.3 [99% CI 55.6-63.1], NHANES 51.5 [99% CI 37.2-65.5], and NHIS 52.6 [99% CI 50.9-54.4]), and using ICD-9-CM definitions it was 11.1 (CCS 58.7 [99% CI 54.5-62.9], CDC 64.3 [99% CI 59.9-68.6], and NADW 69.9 [99% CI 65.2-74.5]). Most (57-70%) reporting diagnosed arthritis also reported ICD-9-CM arthritis; respondents reporting diagnosed arthritis were older than those meeting ICD-9-CM definitions. Proxy response status affected arthritis prevalence differently across surveys. Public health practitioners and decision makers are frequently charged with choosing a single number to represent arthritis

  7. Changes in cardiovascular disease risk and behavioural risk factors before the introduction of a health check programme in England.

    PubMed

    Alageel, Samah; Wright, Alison J; Gulliford, Martin C

    2016-10-01

    A population-based programme of health checks was introduced for adults in England in 2011 for the primary prevention of cardiovascular diseases (CVD) and risk factors management. The aim was to evaluate changes in cardiovascular risk and behavioural risk factors in a health check eligible population in England from 1994 to 2013, by using repeated cross-sectional design using seven surveys of the Health Survey for England. Measures included traditional CVD risk factors and behavioural risk factors. Linear trends were estimated allowing for sampling design. The surveys comprised 49,805 adults aged 45 to 74years; 30,639 were free from cardiovascular comorbidity; 16,041 (52%) had complete data for quantitative risk factors. Between 1994 and 2013, systolic blood pressure decreased by 3.1 (95% confidence interval 2.5 to 3.6) mmHg per decade in men and 5.0 (4.5 to 5.5) in women. Total cholesterol decreased by 0.20 (0.16 to 0.24) mmol/l per decade in men; 0.23 (0.19 to 0.26) in women. Smoking declined by 6% (5% to 8%) per decade in men; 7% (6% - 8%) in women. The proportion with CVD-risk ≥20% declined by 6.8% per decade in men; 2.4% in women. Multiple behavioural risk factors were strongly associated with estimated CVD-risk, but improving trends in traditional CVD risk factors were inconsistent with increasing indicators of adiposity. Long-term declines in traditional risk factors contributed to reductions in estimated CVD-risk prior to the introduction of a health check programme. Behaviour change interventions for multiple risk factor exposures remain a key area for future research.

  8. Chemical Risk Assessment: Traditional vs Public Health Perspectives

    EPA Science Inventory

    Preventing adverse health impacts from exposures to environmental chemicals is fundamental to protecting individual and public health. When done efficiently and properly, chemical risk assessment enables risk management actions that minimize the incidence and impacts of environme...

  9. Improving Estimation of Ground Casualty Risk From Reentering Space Objects

    NASA Technical Reports Server (NTRS)

    Ostrom, Chris L.

    2017-01-01

    A recent improvement to the long-term estimation of ground casualties from reentering space debris is the further refinement and update to the human population distribution. Previous human population distributions were based on global totals with simple scaling factors for future years, or a coarse grid of population counts in a subset of the world's countries, each cell having its own projected growth rate. The newest population model includes a 5-fold refinement in both latitude and longitude resolution. All areas along a single latitude are combined to form a global population distribution as a function of latitude, creating a more accurate population estimation based on non-uniform growth at the country and area levels. Previous risk probability calculations used simplifying assumptions that did not account for the ellipsoidal nature of the Earth. The new method uses first, a simple analytical method to estimate the amount of time spent above each latitude band for a debris object with a given orbit inclination and second, a more complex numerical method that incorporates the effects of a non-spherical Earth. These new results are compared with the prior models to assess the magnitude of the effects on reentry casualty risk.

  10. Improving Estimation of Ground Casualty Risk from Reentering Space Objects

    NASA Technical Reports Server (NTRS)

    Ostrom, C.

    2017-01-01

    A recent improvement to the long-term estimation of ground casualties from reentering space debris is the further refinement and update to the human population distribution. Previous human population distributions were based on global totals with simple scaling factors for future years, or a coarse grid of population counts in a subset of the world's countries, each cell having its own projected growth rate. The newest population model includes a 5-fold refinement in both latitude and longitude resolution. All areas along a single latitude are combined to form a global population distribution as a function of latitude, creating a more accurate population estimation based on non-uniform growth at the country and area levels. Previous risk probability calculations used simplifying assumptions that did not account for the ellipsoidal nature of the earth. The new method uses first, a simple analytical method to estimate the amount of time spent above each latitude band for a debris object with a given orbit inclination, and second, a more complex numerical method that incorporates the effects of a non-spherical Earth. These new results are compared with the prior models to assess the magnitude of the effects on reentry casualty risk.

  11. Nonlinear Memory and Risk Estimation in Financial Records

    NASA Astrophysics Data System (ADS)

    Bunde, Armin; Bogachev, Mikhail I.

    It is well known that financial data sets are multifractal and governed by nonlinear correlations. Here we are interested in the daily returns of a financial asset and in the way the occurrence of large gains or losses is triggered by the nonlinear memory. To this end, we study the statistics of the return intervals between gains (or losses) above a certain threshold Q. In the case of i.i.d. random numbers the probability density function (pdf) of the return intervals decays exponentially and the return intervals are uncorrelated. Here we show that the nonlinear correlations lead to a power law decay of the pdf and linear long-term correlations between the return intervals that are described by a power-law decay of the corresponding autocorrelation function. From the pdf of the return intervals one obtains the risk function W Q (t; Δt), which is the probability that within the next Δt units of time at least one event above Q occurs, if the last event occurred t time units ago. We propose an analytical estimate of W Q and show explicitly that the proposed method is superior to the conventional precursory pattern recognition technique widely used in signal analysis, which requires considerable fine-tuning and is difficult to implement. We also show that the estimation of the Value at Risk, which is a standard tool in finances, can be improved considerably compared with previous estimates.

  12. Estimating twin concordance for bivariate competing risks twin data.

    PubMed

    Scheike, Thomas H; Holst, Klaus K; Hjelmborg, Jacob B

    2014-03-30

    For twin time-to-event data, we consider different concordance probabilities, such as the casewise concordance that are routinely computed as a measure of the lifetime dependence/correlation for specific diseases. The concordance probability here is the probability that both twins have experienced the event of interest. Under the assumption that both twins are censored at the same time, we show how to estimate this probability in the presence of right censoring, and as a consequence, we can then estimate the casewise twin concordance. In addition, we can model the magnitude of within pair dependence over time, and covariates may be further influential on the marginal risk and dependence structure. We establish the estimators large sample properties and suggest various tests, for example, for inferring familial influence. The method is demonstrated and motivated by specific twin data on cancer events with the competing risk death. We thus aim to quantify the degree of dependence through the casewise concordance function and show a significant genetic component.

  13. Estimation of unit risk for coke oven emissions

    SciTech Connect

    Moolgavkar, S.H.; Luebeck, E.G.; Anderson, E.L.

    1998-12-01

    In 1984, based on epidemiological data on cohorts of coke oven workers, USEPA estimated a unit risk for lung cancer associated with continuous exposure from birth to 1 {micro}g/m{sup 3} of coke oven emissions, of 6.2 {times} 10{sup {minus}4}. This risk assessment was based on information on the cohorts available through 1966. Follow-up of these cohorts has now been extended to 1982 and, moreover, individual job histories, which were not available in 1984, have been constructed. In this study, lung cancer mortality in these cohorts of coke oven workers with extended follow-up was analyzed using standard techniques of survival analysis and a new approach based on the two stage clonal expansion model of carcinogenesis. The latter approach allows the explicit consideration of detailed patterns of exposure of each individual in the cohort. The analyses used the extended follow-up data through 1982 and the detailed job histories now available. Based on these analyses, the best estimate of unit risk is 1.5 {times} 10{sup {minus}4} with 95% confidence interval = 1.2 {times} 10{sup {minus}4}--1.8 {times} 10{sup {minus}4}.

  14. Sleep Characteristics, Mental Health, and Diabetes Risk

    PubMed Central

    Boyko, Edward J.; Seelig, Amber D.; Jacobson, Isabel G.; Hooper, Tomoko I.; Smith, Besa; Smith, Tyler C.; Crum-Cianflone, Nancy F.

    2013-01-01

    OBJECTIVE Research has suggested that a higher risk of type 2 diabetes associated with sleep characteristics exists. However, studies have not thoroughly assessed the potential confounding effects of mental health conditions associated with alterations in sleep. RESEARCH DESIGN AND METHODS We prospectively assessed the association between sleep characteristics and self-reported incident diabetes among Millennium Cohort Study participants prospectively followed over a 6-year time period. Surveys are administered approximately every 3 years and collect self-reported data on demographics, height, weight, lifestyle, features of military service, sleep, clinician-diagnosed diabetes, and mental health conditions assessed by the PRIME-MD Patient Health Questionnaire and the PTSD Checklist–Civilian Version. Statistical methods for longitudinal data were used for data analysis. RESULTS We studied 47,093 participants (mean 34.9 years of age; mean BMI 26.0 kg/m2; 25.6% female). During 6 years of follow-up, 871 incident diabetes cases occurred (annual incidence 3.6/1,000 person-years). In univariate analyses, incident diabetes was significantly more likely among participants with self-reported trouble sleeping, sleep duration <6 h, and sleep apnea. Participants reporting incident diabetes were also significantly older, of nonwhite race, of higher BMI, less likely to have been deployed, and more likely to have reported baseline symptoms of panic, anxiety, posttraumatic stress disorder, and depression. After adjusting for covariates, trouble sleeping (odds ratio 1.21 [95% CI 1.03–1.42]) and sleep apnea (1.78 [1.39–2.28]) were significantly and independently related to incident diabetes. CONCLUSIONS Trouble sleeping and sleep apnea predict diabetes risk independent of mental health conditions and other diabetes risk factors. PMID:23835691

  15. Estimating the mental health costs of racial discrimination.

    PubMed

    Elias, Amanuel; Paradies, Yin

    2016-11-29

    Racial discrimination is a pervasive social problem in several advanced countries such as the U.S., U.K., and Australia. Public health research also indicates a range of associations between exposure to racial discrimination and negative health, particularly, mental health including depression, anxiety, and post-traumatic stress disorder (PTSD). However, the direct negative health impact of racial discrimination has not been costed so far although economists have previously estimated indirect non-health related productivity costs. In this study, we estimate the burden of disease due to exposure to racial discrimination and measure the cost of this exposure. Using prevalence surveys and data on the association of racial discrimination with health outcomes from a global meta-analysis, we apply a cost of illness method to measure the impact of racial discrimination. This estimate indicates the direct health cost attributable to racial discrimination and we convert the estimates to monetary values based on conventional parameters. Racial discrimination costs the Australian economy 235,452 in disability adjusted life years lost, equivalent to $37.9 billion per annum, roughly 3.02% of annual gross domestic product (GDP) over 2001-11, indicating a sizeable loss for the economy. Substantial cost is incurred due to increased prevalence of racial discrimination as a result of its association with negative health outcomes (e.g. depression, anxiety and PTSD). This implies that potentially significant cost savings can be made through measures that target racial discrimination. Our research contributes to the debate on the social impact of racial discrimination, with implications for policies and efforts addressing it.

  16. Estimated Demand for Women's Health Services by 2020

    PubMed Central

    Dall, Timothy M.; Chakrabarti, Ritashree; Storm, Michael V.; Elwell, Erika C.

    2013-01-01

    Abstract Objective To estimate the demand for women's health care by 2020 using today's national utilization standards. Methods This descriptive study incorporated the most current national data resources to design a simulation model to create a health and economic profile for a representative sample of women from each state. Demand was determined utilizing equations about projected use of obstetrics-gynecology (ob-gyn) services. Applying patient profile and health care demand equations, we estimated the demand for providers in 2010 in each state for comparison with supply based on the 2010 American Medical Association Masterfile. U.S. Census Bureau population projections were used to project women's health care demands in 2020. Results The national demand for women's health care is forecast to grow by 6% by 2020. Most (81%) ob-gyn related services will be for women of reproductive age (18–44 years old). Growth in demand is forecast to be highest in states with the greatest population growth (Texas, Florida), where supply is currently less than adequate (western United States), and among Hispanic women. This increase in demand by 2020 will translate into a need for physicians or nonphysician clinicians, which is clinically equivalent to 2,090 full-time ob-gyns. Conclusion Using today's national norms of ob-gyn related services, a modest growth in women's health care demands is estimated by 2020 that will require a larger provider workforce. PMID:23829185

  17. Leukemia risk associated with benzene exposure in the pliofilm cohort. II. Risk estimates.

    PubMed

    Paxton, M B; Chinchilli, V M; Brett, S M; Rodricks, J V

    1994-04-01

    The detailed work histories of the individual workers composing the Pliofilm cohort represent a unique resource for estimating the dose-response for leukemia that may follow occupational exposure to benzene. In this paper, we report the results of analyzing the updated Pliofilm cohort using the proportional hazards model, a more sophisticated technique that uses more of the available exposure data than the conditional logistic model used by Rinsky et al. The more rigorously defined exposure estimates derived by Paustenbach et al. are consistent with those of Crump and Allen in giving estimates of the slope of the leukemogenic dose-response that are not as steep as the slope resulting from the exposure estimates of Rinsky et al. We consider estimates of 0.3-0.5 additional leukemia deaths per thousand workers with 45 ppm-years of cumulative benzene exposure to be the best estimates currently available of leukemia risk from occupational exposure to benzene. These risks were estimated in the proportional hazards model when the exposure estimates of Crump and Allen or of Paustenbach et al. were used to derive a cumulative concentration-by-time metric.

  18. Genetic risk models: Influence of model size on risk estimates and precision.

    PubMed

    Shan, Ying; Tromp, Gerard; Kuivaniemi, Helena; Smelser, Diane T; Verma, Shefali S; Ritchie, Marylyn D; Elmore, James R; Carey, David J; Conley, Yvette P; Gorin, Michael B; Weeks, Daniel E

    2017-05-01

    Disease risk estimation plays an important role in disease prevention. Many studies have found that the ability to predict risk improves as the number of risk single-nucleotide polymorphisms (SNPs) in the risk model increases. However, the width of the confidence interval of the risk estimate is often not considered in the evaluation of the risk model. Here, we explore how the risk and the confidence interval width change as more SNPs are added to the model in the order of decreasing effect size, using both simulated data and real data from studies of abdominal aortic aneurysms and age-related macular degeneration. Our results show that confidence interval width is positively correlated with model size and the majority of the bigger models have wider confidence interval widths than smaller models. Once the model size is bigger than a certain level, the risk does not shift markedly, as 100% of the risk estimates of the one-SNP-bigger models lie inside the confidence interval of the one-SNP-smaller models. We also created a confidence interval-augmented reclassification table. It shows that both more effective SNPs with larger odds ratios and less effective SNPs with smaller odds ratios contribute to the correct decision of whom to screen. The best screening strategy is selected and evaluated by the net benefit quantity and the reclassification rate. We suggest that individuals whose upper bound of their risk confidence interval is above the screening threshold, which corresponds to the population prevalence of the disease, should be screened. © 2017 WILEY PERIODICALS, INC.

  19. Economics of disaster risk, social vulnerability, and mental health resilience.

    PubMed

    Zahran, Sammy; Peek, Lori; Snodgrass, Jeffrey G; Weiler, Stephan; Hempel, Lynn

    2011-07-01

    We investigate the relationship between exposure to Hurricanes Katrina and/or Rita and mental health resilience by vulnerability status, with particular focus on the mental health outcomes of single mothers versus the general public. We advance a measurable notion of mental health resilience to disaster events. We also calculate the economic costs of poor mental health days added by natural disaster exposure. Negative binomial analyses show that hurricane exposure increases the expected count of poor mental health days for all persons by 18.7% (95% confidence interval [CI], 7.44-31.14%), and by 71.88% (95% CI, 39.48-211.82%) for single females with children. Monthly time-series show that single mothers have lower event resilience, experiencing higher added mental stress. Results also show that the count of poor mental health days is sensitive to hurricane intensity, increasing by a factor of 1.06 (95% CI, 1.02-1.10) for every billion (U.S.$) dollars of damage added for all exposed persons, and by a factor of 1.08 (95% CI, 1.03-1.14) for single mothers. We estimate that single mothers, as a group, suffered over $130 million in productivity loss from added postdisaster stress and disability. Results illustrate the measurability of mental health resilience as a two-dimensional concept of resistance capacity and recovery time. Overall, we show that natural disasters regressively tax disadvantaged population strata. © 2011 Society for Risk Analysis.

  20. Do the health benefits of cycling outweigh the risks?

    PubMed

    Hartog, Jeroen Johan de; Boogaard, Hanna; Nijland, Hans; Hoek, Gerard

    2011-12-01

    Although from a societal point of view a modal shift from car to bicycle may have beneficial health effects due to decreased air pollution emissions and increased levels of physical activity, shifts in individual adverse health effects such as higher exposure to air pollution and risk of a traffic accident may prevail. We have summarized the literature for air pollution, traffic accidents, and physical activity using systematic reviews supplemented with recent key studies. We quantified the impact on all-cause mortality when 500,000 people would make a transition from car to bicycle for short trips on a daily basis in the Netherlands. We estimate that beneficial effects of increased physical activity are substantially larger (3-14 months gained) than the potential mortality effect of increased inhaled air pollution doses (0.8-40 days lost) and the increase in traffic accidents (5-9 days lost). Societal benefits are even larger because of a modest reduction in air pollution and traffic accidents. On average, the estimated health benefits of cycling were substantially larger than the risks relative to car driving for individuals shifting their mode of transport.

  1. A Methodological Approach to Small Area Estimation for the Behavioral Risk Factor Surveillance System.

    PubMed

    Pierannunzi, Carol; Xu, Fang; Wallace, Robyn C; Garvin, William; Greenlund, Kurt J; Bartoli, William; Ford, Derek; Eke, Paul; Town, G Machell

    2016-07-14

    Public health researchers have used a class of statistical methods to calculate prevalence estimates for small geographic areas with few direct observations. Many researchers have used Behavioral Risk Factor Surveillance System (BRFSS) data as a basis for their models. The aims of this study were to 1) describe a new BRFSS small area estimation (SAE) method and 2) investigate the internal and external validity of the BRFSS SAEs it produced. The BRFSS SAE method uses 4 data sets (the BRFSS, the American Community Survey Public Use Microdata Sample, Nielsen Claritas population totals, and the Missouri Census Geographic Equivalency File) to build a single weighted data set. Our findings indicate that internal and external validity tests were successful across many estimates. The BRFSS SAE method is one of several methods that can be used to produce reliable prevalence estimates in small geographic areas.

  2. A Methodological Approach to Small Area Estimation for the Behavioral Risk Factor Surveillance System

    PubMed Central

    Xu, Fang; Wallace, Robyn C.; Garvin, William; Greenlund, Kurt J.; Bartoli, William; Ford, Derek; Eke, Paul; Town, G. Machell

    2016-01-01

    Public health researchers have used a class of statistical methods to calculate prevalence estimates for small geographic areas with few direct observations. Many researchers have used Behavioral Risk Factor Surveillance System (BRFSS) data as a basis for their models. The aims of this study were to 1) describe a new BRFSS small area estimation (SAE) method and 2) investigate the internal and external validity of the BRFSS SAEs it produced. The BRFSS SAE method uses 4 data sets (the BRFSS, the American Community Survey Public Use Microdata Sample, Nielsen Claritas population totals, and the Missouri Census Geographic Equivalency File) to build a single weighted data set. Our findings indicate that internal and external validity tests were successful across many estimates. The BRFSS SAE method is one of several methods that can be used to produce reliable prevalence estimates in small geographic areas. PMID:27418213

  3. Risk cross sections and their application to risk estimation in the galactic cosmic-ray environment

    NASA Technical Reports Server (NTRS)

    Curtis, S. B.; Nealy, J. E.; Wilson, J. W.; Chatterjee, A. (Principal Investigator)

    1995-01-01

    Radiation risk cross sections (i.e. risks per particle fluence) are discussed in the context of estimating the risk of radiation-induced cancer on long-term space flights from the galactic cosmic radiation outside the confines of the earth's magnetic field. Such quantities are useful for handling effects not seen after low-LET radiation. Since appropriate cross-section functions for cancer induction for each particle species are not yet available, the conventional quality factor is used as an approximation to obtain numerical results for risks of excess cancer mortality. Risks are obtained for seven of the most radiosensitive organs as determined by the ICRP [stomach, colon, lung, bone marrow (BFO), bladder, esophagus and breast], beneath 10 g/cm2 aluminum shielding at solar minimum. Spectra are obtained for excess relative risk for each cancer per LET interval by calculating the average fluence-LET spectrum for the organ and converting to risk by multiplying by a factor proportional to R gamma L Q(L) before integrating over L, the unrestricted LET. Here R gamma is the risk coefficient for low-LET radiation (excess relative mortality per Sv) for the particular organ in question. The total risks of excess cancer mortality obtained are 1.3 and 1.1% to female and male crew, respectively, for a 1-year exposure at solar minimum. Uncertainties in these values are estimated to range between factors of 4 and 15 and are dominated by the biological uncertainties in the risk coefficients for low-LET radiation and in the LET (or energy) dependence of the risk cross sections (as approximated by the quality factor). The direct substitution of appropriate risk cross sections will eventually circumvent entirely the need to calculate, measure or use absorbed dose, equivalent dose and quality factor for such a high-energy charged-particle environment.

  4. Risk cross sections and their application to risk estimation in the galactic cosmic-ray environment

    NASA Technical Reports Server (NTRS)

    Curtis, S. B.; Nealy, J. E.; Wilson, J. W.; Chatterjee, A. (Principal Investigator)

    1995-01-01

    Radiation risk cross sections (i.e. risks per particle fluence) are discussed in the context of estimating the risk of radiation-induced cancer on long-term space flights from the galactic cosmic radiation outside the confines of the earth's magnetic field. Such quantities are useful for handling effects not seen after low-LET radiation. Since appropriate cross-section functions for cancer induction for each particle species are not yet available, the conventional quality factor is used as an approximation to obtain numerical results for risks of excess cancer mortality. Risks are obtained for seven of the most radiosensitive organs as determined by the ICRP [stomach, colon, lung, bone marrow (BFO), bladder, esophagus and breast], beneath 10 g/cm2 aluminum shielding at solar minimum. Spectra are obtained for excess relative risk for each cancer per LET interval by calculating the average fluence-LET spectrum for the organ and converting to risk by multiplying by a factor proportional to R gamma L Q(L) before integrating over L, the unrestricted LET. Here R gamma is the risk coefficient for low-LET radiation (excess relative mortality per Sv) for the particular organ in question. The total risks of excess cancer mortality obtained are 1.3 and 1.1% to female and male crew, respectively, for a 1-year exposure at solar minimum. Uncertainties in these values are estimated to range between factors of 4 and 15 and are dominated by the biological uncertainties in the risk coefficients for low-LET radiation and in the LET (or energy) dependence of the risk cross sections (as approximated by the quality factor). The direct substitution of appropriate risk cross sections will eventually circumvent entirely the need to calculate, measure or use absorbed dose, equivalent dose and quality factor for such a high-energy charged-particle environment.

  5. Spatio-temporal population estimates for risk management

    NASA Astrophysics Data System (ADS)

    Cockings, Samantha; Martin, David; Smith, Alan; Martin, Rebecca

    2013-04-01

    Accurate estimation of population at risk from hazards and effective emergency management of events require not just appropriate spatio-temporal modelling of hazards but also of population. While much recent effort has been focused on improving the modelling and predictions of hazards (both natural and anthropogenic), there has been little parallel advance in the measurement or modelling of population statistics. Different hazard types occur over diverse temporal cycles, are of varying duration and differ significantly in their spatial extent. Even events of the same hazard type, such as flood events, vary markedly in their spatial and temporal characteristics. Conceptually and pragmatically then, population estimates should also be available for similarly varying spatio-temporal scales. Routine population statistics derived from traditional censuses or surveys are usually static representations in both space and time, recording people at their place of usual residence on census/survey night and presenting data for administratively defined areas. Such representations effectively fix the scale of population estimates in both space and time, which is unhelpful for meaningful risk management. Over recent years, the Pop24/7 programme of research, based at the University of Southampton (UK), has developed a framework for spatio-temporal modelling of population, based on gridded population surfaces. Based on a data model which is fully flexible in terms of space and time, the framework allows population estimates to be produced for any time slice relevant to the data contained in the model. It is based around a set of origin and destination centroids, which have capacities, spatial extents and catchment areas, all of which can vary temporally, such as by time of day, day of week, season. A background layer, containing information on features such as transport networks and landuse, provides information on the likelihood of people being in certain places at specific times

  6. 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.

  7. Occupational risk in health care and research.

    PubMed

    Vecchio, Daniela; Sasco, Annie J; Cann, Cristina I

    2003-04-01

    Working in the health care and research sectors has been linked to various hazards. Studies published in the peer-reviewed literature that are pertinent to the exposures or diseases relevant to these fields were reviewed. The most important exposures include infectious agents, formaldehyde, anesthetic agents, antineoplastic drugs, and ethylene oxide. The best-documented evidence is that of infectious risk primarily among clinical personnel. Monitoring studies of persons occupationally exposed to anesthetics clearly demonstrate behavioral effects, possible risk of reproductive problems, as well as cytogenetic effects of unknown significance. The latter two impairments are also observed among those exposed to antineoplastic drugs and ethylene oxide. Exposure to formaldehyde appears to be associated with nasopharyngeal tumors. Whereas increased risk of cancer of certain sites, particularly the brain and lymphohematopoietic system, is found among research and health care personnel, no specific exposure has been linked to these neoplasms. Although some results are inconsistent, continued environmental and biological monitoring will allow better assessment of exposures and of implemented protection measures. Copyright 2003 Wiley-Liss, Inc.

  8. 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.

  9. Estimation of value at risk and conditional value at risk using normal mixture distributions model

    NASA Astrophysics Data System (ADS)

    Kamaruzzaman, Zetty Ain; Isa, Zaidi

    2013-04-01

    Normal mixture distributions model has been successfully applied in financial time series analysis. In this paper, we estimate the return distribution, value at risk (VaR) and conditional value at risk (CVaR) for monthly and weekly rates of returns for FTSE Bursa Malaysia Kuala Lumpur Composite Index (FBMKLCI) from July 1990 until July 2010 using the two component univariate normal mixture distributions model. First, we present the application of normal mixture distributions model in empirical finance where we fit our real data. Second, we present the application of normal mixture distributions model in risk analysis where we apply the normal mixture distributions model to evaluate the value at risk (VaR) and conditional value at risk (CVaR) with model validation for both risk measures. The empirical results provide evidence that using the two components normal mixture distributions model can fit the data well and can perform better in estimating value at risk (VaR) and conditional value at risk (CVaR) where it can capture the stylized facts of non-normality and leptokurtosis in returns distribution.

  10. Tracking Psychosocial Health in Adults with Epilepsy—Estimates from the 2010 National Health Interview Survey

    PubMed Central

    Kobau, R; Cui, W; Kadima, N; Zack, MM; Sajatovic, M; Kaiboriboon, K; Jobst, B

    2015-01-01

    Objective This study provides population-based estimates of psychosocial health among U.S. adults with epilepsy from the 2010 National Health Interview Survey. Methods Multinomial logistic regression was used to estimate the prevalence of the following measures of psychosocial health among adults with and those without epilepsy: 1) the Kessler-6 scale of Serious Psychological Distress; 2) cognitive limitation; the extent of impairments associated with psychological problems; and work limitation; 3) Social participation; and 4) the Patient Reported Outcome Measurement Information System Global Health scale. Results Compared with adults without epilepsy, adults with epilepsy, especially those with active epilepsy, reported significantly worse psychological health, more cognitive impairment, difficulty in participating in some social activities, and reduced health-related quality of life (HRQOL). Conclusions These disparities in psychosocial health in U.S. adults with epilepsy serve as baseline national estimates of their HRQOL, consistent with Healthy People 2020 national objectives on HRQOL. PMID:25305435

  11. [The risk management in health personnel tuberculosis].

    PubMed

    Lo Cascio, G; Lo Cascio, N; Picciotto, D

    2007-01-01

    Within work environment and even more among health service areas, to deepen the monitoring efforts and awareness of the workers in order to accomplish a more effective and fast response against morbidity indexes and prevalence of tbc, constitute the necessary prerequisite for any subsequent action of prevention and control. On the other hand, one of the employer's obligations toward a health facility is to identify professionally exposed subjects (Legislative Decree 626/94 art.78), and perform risk assessment. Continuous report from various hospitals concerning suspicious contacts between employees and patients affected by tbc further increase the threat. At AOUP in Palermo from 2003 to May 2007, 39 cases of suspected contact between employees and patients affected by tbc were reported to the 'Staff Union for Health Related Issues' by various hospital departments and the 'Office of the Medical Competent', 34 of these reported cases have pulmonary involvement. The above mentioned situation made necessary to launch an effective program capable of addressing the risks of tbc in both circumstances of suspected or certain contact and during normal work activities.

  12. 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.

  13. Challenges in Obtaining Estimates of the Risk of Tuberculosis Infection During Overseas Deployment.

    PubMed

    Mancuso, James D; Geurts, Mia

    2015-12-01

    Estimates of the risk of tuberculosis (TB) infection resulting from overseas deployment among U.S. military service members have varied widely, and have been plagued by methodological problems. The purpose of this study was to estimate the incidence of TB infection in the U.S. military resulting from deployment. Three populations were examined: 1) a unit of 2,228 soldiers redeploying from Iraq in 2008, 2) a cohort of 1,978 soldiers followed up over 5 years after basic training at Fort Jackson in 2009, and 3) 6,062 participants in the 2011-2012 National Health and Nutrition Examination Survey (NHANES). The risk of TB infection in the deployed population was low-0.6% (95% confidence interval [CI]: 0.1-2.3%)-and was similar to the non-deployed population. The prevalence of latent TB infection (LTBI) in the U.S. population was not significantly different among deployed and non-deployed veterans and those with no military service. The limitations of these retrospective studies highlight the challenge in obtaining valid estimates of risk using retrospective data and the need for a more definitive study. Similar to civilian long-term travelers, risks for TB infection during deployment are focal in nature, and testing should be targeted to only those at increased risk. © The American Society of Tropical Medicine and Hygiene.

  14. Multiple Imputation for Estimating the Risk of Developing Dementia and Its Impact on Survival

    PubMed Central

    Yu, Binbing; Saczynski, Jane S.; Launer, Lenore J.

    2011-01-01

    Summary Dementia, Alzheimer’s disease in particular, is one of the major causes of disability and decreased quality of life among the elderly and a leading obstacle to successful aging. Given the profound impact on public health, much research has focused on the age-specific risk of developing dementia and the impact on survival. Early work has discussed various methods of estimating age-specific incidence of dementia, among which the illness-death model is popular for modeling disease progression. In this article we use multiple imputation to fit multi-state models for survival data with interval censoring and left truncation. This approach allows semi-Markov models in which survival after dementia may depend on onset age. Such models can be used to estimate the cumulative risk of developing dementia in the presence of the competing risk of dementia-free death. Simulations are carried out to examine the performance of the proposed method. We analyze data from the Honolulu Asia Aging Study to estimate the age-specific and cumulative risks of dementia and to examine the effect of major risk factors on dementia onset and death. PMID:20976693

  15. Challenges in Obtaining Estimates of the Risk of Tuberculosis Infection during Overseas Deployment

    PubMed Central

    Mancuso, James D.; Geurts, Mia

    2015-01-01

    Estimates of the risk of tuberculosis (TB) infection resulting from overseas deployment among U.S. military service members have varied widely, and have been plagued by methodological problems. The purpose of this study was to estimate the incidence of TB infection in the U.S. military resulting from deployment. Three populations were examined: 1) a unit of 2,228 soldiers redeploying from Iraq in 2008, 2) a cohort of 1,978 soldiers followed up over 5 years after basic training at Fort Jackson in 2009, and 3) 6,062 participants in the 2011–2012 National Health and Nutrition Examination Survey (NHANES). The risk of TB infection in the deployed population was low—0.6% (95% confidence interval [CI]: 0.1–2.3%)—and was similar to the non-deployed population. The prevalence of latent TB infection (LTBI) in the U.S. population was not significantly different among deployed and non-deployed veterans and those with no military service. The limitations of these retrospective studies highlight the challenge in obtaining valid estimates of risk using retrospective data and the need for a more definitive study. Similar to civilian long-term travelers, risks for TB infection during deployment are focal in nature, and testing should be targeted to only those at increased risk. PMID:26416114

  16. [Ionizing and non-ionizing radiation (comparative risk estimations)].

    PubMed

    Grigor'ev, Iu G

    2012-01-01

    The population has widely used mobile communication for already more than 15 years. It is important to note that the use of mobile communication has sharply changed the conditions of daily exposure of the population to EME We expose our brain daily for the first time in the entire civilization. The mobile phone is an open and uncontrollable source of electromagnetic radiation. The comparative risk estimation for the population of ionizing and non-ionizing radiation was carried out taking into account the real conditions of influence. Comparison of risks for the population of ionizing and non-ionizing radiation leads us to a conclusion that EMF RF exposure in conditions of wide use of mobile communication is potentially more harmful than ionizing radiation influence.

  17. Estimating Worker Risk Levels Using Accident/Incident Data

    SciTech Connect

    Kenoyer, Judson L.; Stenner, Robert D.; Andrews, William B.; Scherpelz, Robert I.; Aaberg, Rosanne L.

    2000-09-26

    The purpose of the work described in this report was to identify methods that are currently being used in the Department of Energy (DOE) complex to identify and control hazards/risks in the workplace, evaluate them in terms of their effectiveness in reducing risk to the workers, and to develop a preliminary method that could be used to predict the relative risks to workers performing proposed tasks using some of the current methodology. This report describes some of the performance indicators (i.e., safety metrics) that are currently being used to track relative levels of workplace safety in the DOE complex, how these fit into an Integrated Safety Management (ISM) system, some strengths and weaknesses of using a statistically based set of indicators, and methods to evaluate them. Also discussed are methods used to reduce risk to the workers and some of the techniques that appear to be working in the process of establishing a condition of continuous improvement. The results of these methods will be used in future work involved with the determination of modifying factors for a more complex model. The preliminary method to predict the relative risk level to workers during an extended future time period is based on a currently used performance indicator that uses several factors tracked in the CAIRS. The relative risks for workers in a sample (but real) facility on the Hanford site are estimated for a time period of twenty years and are based on workforce predictions. This is the first step in developing a more complex model that will incorporate other modifying factors related to the workers, work environment and status of the ISM system to adjust the preliminary prediction.

  18. Managing risk: clinical decision-making in mental health services.

    PubMed

    Muir-Cochrane, Eimear; Gerace, Adam; Mosel, Krista; O'Kane, Debra; Barkway, Patricia; Curren, David; Oster, Candice

    2011-01-01

    Risk assessment and management is a major component of contemporary mental health practice. Risk assessment in health care exists within contemporary perspectives of management and risk aversive practices in health care. This has led to much discussion about the best approach to assessing possible risks posed by people with mental health problems. In addition, researchers and commentators have expressed concern that clinical practice is being dominated by managerial models of risk management at the expense of meeting the patient's health and social care needs. The purpose of the present study is to investigate the risk assessment practices of a multidisciplinary mental health service. Findings indicate that mental health professionals draw on both managerial and therapeutic approaches to risk management, integrating these approaches into their clinical practice. Rather than being dominated by managerial concerns regarding risk, the participants demonstrate professional autonomy and concern for the needs of their clients.

  19. Respiratory health risks among nonmetal miners

    SciTech Connect

    Short, S.R.; Petsonk, E.L. )

    1993-01-01

    The risks of occupational respiratory disease faced by nonmetal miners are the focus of this review. An understanding of the respiratory risks requires an understanding of the minerology of the ground and rock around the materials being mined. Relevant exposures encompass radon gas and deisel fumes, as well as mineral and rock dusts, including free silica. The types of materials mined and their associated health effects are examined, including the silicates (fibrous silicates such as asbestos, asbestiform fibrous minerals such as wollastonite and fuller's earth, and nonfibrous silicates such as talc and kaolin), sedimentary precipitates such as phosphates, potash, gypsum, and salt, as well as hydrocarbon-containing sedimentary rock such as oil shale. 56 refs.

  20. Respiratory health risks among nonmetal miners.

    PubMed

    Short, S R; Petsonk, E L

    1993-01-01

    The risks of occupational respiratory disease faced by nonmetal miners are the focus of this review. An understanding of the respiratory risks requires an understanding of the minerology of the ground and rock around the materials being mined. Relevant exposures encompass radon gas and deisel fumes, as well as mineral and rock dusts, including free silica. The types of materials mined and their associated health effects are examined, including the silicates (fibrous silicates such as asbestos, asbestiform fibrous minerals such as wollastonite and fuller's earth, and nonfibrous silicates such as talc and kaolin), sedimentary precipitates such as phosphates, potash, gypsum, and salt, as well as hydrocarbon-containing sedimentary rock such as oil shale.

  1. Probabilities and health risks: a qualitative approach.

    PubMed

    Heyman, B; Henriksen, M; Maughan, K

    1998-11-01

    Health risks, defined in terms of the probability that an individual will suffer a particular type of adverse health event within a given time period, can be understood as referencing either natural entities or complex patterns of belief which incorporate the observer's values and knowledge, the position adopted in the present paper. The subjectivity inherent in judgements about adversity and time frames can be easily recognised, but social scientists have tended to accept uncritically the objectivity of probability. Most commonly in health risk analysis, the term probability refers to rates established by induction, and so requires the definition of a numerator and denominator. Depending upon their specification, many probabilities may be reasonably postulated for the same event, and individuals may change their risks by deciding to seek or avoid information. These apparent absurdities can be understood if probability is conceptualised as the projection of expectation onto the external world. Probabilities based on induction from observed frequencies provide glimpses of the future at the price of acceptance of the simplifying heuristic that statistics derived from aggregate groups can be validly attributed to individuals within them. The paper illustrates four implications of this conceptualisation of probability with qualitative data from a variety of sources, particularly a study of genetic counselling for pregnant women in a U.K. hospital. Firstly, the official selection of a specific probability heuristic reflects organisational constraints and values as well as predictive optimisation. Secondly, professionals and service users must work to maintain the facticity of an established heuristic in the face of alternatives. Thirdly, individuals, both lay and professional, manage probabilistic information in ways which support their strategic objectives. Fourthly, predictively sub-optimum schema, for example the idea of AIDS as a gay plague, may be selected because

  2. Residential metal contamination and potential health risks of ...

    EPA Pesticide Factsheets

    Potosí, Bolivia, is the site of centuries of historic and present-day mining of the Cerro Rico Mountain, known for its rich polymetallic deposits, and was the site of large-scale Colonial era silver refining operations, both of which have left a legacy of pollution. In this study, trace elements were quantified in adobe brick, dirt floor, and surface dust samples from 49 houses. Mean concentrations of total mercury (Hg), lead (Pb), and arsenic (As) were statistically significantly greater than concentrations measured in Sucre, Bolivia, a non-mining town used as a reference site, and exceeded US-based soil screening levels that are designed to be protective of human health. Adobe brick samples were analyzed for bioaccessible concentrations of elements using a simulated gastric fluid (GF) extraction. Mean GF extractable concentrations of Hg, As, and Pb were 0.841, 14.9, and 30.2 percent of the total concentration, respectively. Total and GF extractable concentrations of these elements were used to estimate exposure and potential health risks to children following incidental ingestion of adobe brick particles. Risks were assessed using a range of potential ingestion rates (50-1000 mg/day). Although the majority of households have total Hg, As, and Pb concentrations that represent a potential health risk, fewer are of concern when GF extractable concentrations are considered at lower ingestion rates. For Hg, only a small percentage of the sampled houses have GF ex

  3. Residential metal contamination and potential health risks of ...

    EPA Pesticide Factsheets

    Potosí, Bolivia, is the site of centuries of historic and present-day mining of the Cerro Rico Mountain, known for its rich polymetallic deposits, and was the site of large-scale Colonial era silver refining operations, both of which have left a legacy of pollution. In this study, trace elements were quantified in adobe brick, dirt floor, and surface dust samples from 49 houses. Mean concentrations of total mercury (Hg), lead (Pb), and arsenic (As) were statistically significantly greater than concentrations measured in Sucre, Bolivia, a non-mining town used as a reference site, and exceeded US-based soil screening levels that are designed to be protective of human health. Adobe brick samples were analyzed for bioaccessible concentrations of elements using a simulated gastric fluid (GF) extraction. Mean GF extractable concentrations of Hg, As, and Pb were 0.841, 14.9, and 30.2 percent of the total concentration, respectively. Total and GF extractable concentrations of these elements were used to estimate exposure and potential health risks to children following incidental ingestion of adobe brick particles. Risks were assessed using a range of potential ingestion rates (50-1000 mg/day). Although the majority of households have total Hg, As, and Pb concentrations that represent a potential health risk, fewer are of concern when GF extractable concentrations are considered at lower ingestion rates. For Hg, only a small percentage of the sampled houses have GF ex

  4. [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)

  5. Health and safety risks in production agriculture.

    PubMed

    Von Essen, S G; McCurdy, S A

    1998-10-01

    Production agriculture is associated with a variety of occupational illnesses and injuries. Agricultural workers are at higher risk of death or disabling injury than most other workers. Traumatic injury commonly occurs from working with machinery or animals. Respiratory illness and health problems from exposures to farm chemicals are major concerns, and dermatoses, hearing loss, certain cancers, and zoonotic infections are important problems. Innovative means of encouraging safe work practices are being developed. Efforts are being made to reach all groups of farmworkers, including migrant and seasonal workers, farm youth, and older farmers.

  6. Health and safety risks in production agriculture.

    PubMed Central

    Von Essen, S G; McCurdy, S A

    1998-01-01

    Production agriculture is associated with a variety of occupational illnesses and injuries. Agricultural workers are at higher risk of death or disabling injury than most other workers. Traumatic injury commonly occurs from working with machinery or animals. Respiratory illness and health problems from exposures to farm chemicals are major concerns, and dermatoses, hearing loss, certain cancers, and zoonotic infections are important problems. Innovative means of encouraging safe work practices are being developed. Efforts are being made to reach all groups of farmworkers, including migrant and seasonal workers, farm youth, and older farmers. PMID:9795581

  7. Miniature Biosensor with Health Risk Assessment Feedback

    NASA Technical Reports Server (NTRS)

    Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

    2016-01-01

    Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

  8. U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

    SciTech Connect

    Blaylock, B.P.; Legg, J.; Travis, C.C.; Simek, M.A.; Sutherland, J.; Scofield, P.A.

    1995-06-01

    This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

  9. Human health risk assessment from exposure to trihalomethanes in Canadian cities.

    PubMed

    Chowdhury, Shakhawat; Hall, Kevin

    2010-07-01

    Lifetime exposure to trihalomethanes (THMs) through ingestion, inhalation and dermal contacts may pose risks to human health. Current approaches may under predict THMs exposure by using THMs in cold water during showering and bathing. Warming of chlorinated water during showering may increase THMs formation through reactions between organics and residual chlorine, which can increase human health risks. In this study, THMs concentrations in shower water were estimated using THMs rate increase model. Using cold water THMs, exposure through ingestion was estimated, while THMs exposure during showering was estimated using THMs in warm water. Human health cancer risks and additional expenses for 20 most populated Canadian cities from exposure to THMs were estimated. Inhalation and dermal contact during showering contributed 30% to 50% of total cancer risks, while risks from inhalation and dermal contacts were comparable for all cities. Overall cancer risks were estimated between 7.2 x 10(-6) and 6.4 x 10(-5) for these cities. Cancer incidents were estimated highest for Montreal (94/year) followed by Toronto (53/year), which may require additional medical expenses of 18.8 and 10.7 million dollars/year for Montreal and Toronto respectively. Cancer risks from exposure to THMs can be controlled by reducing THMs in water supply and varying shower stall volume, shower duration and air exchange rate in shower stall. Copyright 2010 Elsevier Ltd. All rights reserved.

  10. Cardiovascular Risk among Older Women in a Havana Health Area.

    PubMed

    Armas, Nurys Bárbara; Hernández, Yesenia de la Caridad; Dueñas, Alfredo F; García, Reynaldo de la Noval; Castillo, Antonio

    2008-04-01

    Introduction Cardiovascular morbidity and mortality increase in women after menopause. Various scoring models assess qualitative risk of cardiovascular disease. The Framingham Heart Study global risk score is among the most widely used. Objective Determine level of coronary heart disease risk among women aged ≥60 years in a Havana health catchment area (geographic area whose residents are served by the M�rtires del Corynthia Polyclinic, in the Plaza de la Revoluci�n municipality of Havana). Methods A descriptive, cross-sectional study was conducted in 2006. Universe: all women (3,396) aged ≥60 years in the catchment area, attended at the primary care level by the Polyclinic and 42 neighborhood family doctor-and-nurse offices. Equal probability sample: 1,082 women meeting the inclusion criteria, chosen through single-stage cluster sampling considering a <10% error margin for estimates for this parameter, a 95% confidence interval (CI) and a design effect of 1.5. Absolute frequencies and percentages were calculated to summarize the qualitative data obtained. Results were presented as tables. Results The most common cardiovascular risk factors found in this study were: physical inactivity, 74.9%; hypertension (HTN), 70.6%; abdominal obesity, 53%; reported family history of coronary heart disease (CHD), 41.8%; diabetes mellitus (DM), 21.8%; and cigarette smoking, 17.2%. Scoring according to number of risk factors present in each individual, 79.3% of these women fell into the high- or moderate-risk categories. Conclusion The large number of women categorized as high- or moderate-risk for coronary heart disease in this population emphasizes the need for preventive actions aimed at reducing these figures. Cardiovascular diseases, vascular diseases, ischemic heart disease, coronary heart disease, postmenopause, woman, aged, risk factors, risk assessment, hypertension, high blood pressure, lifestyle, diabetes mellitus, obesity, abdominal adipose tissue, body mass

  11. Combined methodology for estimating dose rates and health effects from exposure to radioactive pollutants

    SciTech Connect

    Dunning, D.E. Jr.; Leggett, R.W.; Yalcintas, M.G.

    1980-12-01

    The work described in the report is basically a synthesis of two previously existing computer codes: INREM II, developed at the Oak Ridge National Laboratory (ORNL); and CAIRD, developed by the Environmental Protection Agency (EPA). The INREM II code uses contemporary dosimetric methods to estimate doses to specified reference organs due to inhalation or ingestion of a radionuclide. The CAIRD code employs actuarial life tables to account for competing risks in estimating numbers of health effects resulting from exposure of a cohort to some incremental risk. The combined computer code, referred to as RADRISK, estimates numbers of health effects in a hypothetical cohort of 100,000 persons due to continuous lifetime inhalation or ingestion of a radionuclide. Also briefly discussed in this report is a method of estimating numbers of health effects in a hypothetical cohort due to continuous lifetime exposure to external radiation. This method employs the CAIRD methodology together with dose conversion factors generated by the computer code DOSFACTER, developed at ORNL; these dose conversion factors are used to estimate dose rates to persons due to radionuclides in the air or on the ground surface. The combination of the life table and dosimetric guidelines for the release of radioactive pollutants to the atmosphere, as required by the Clean Air Act Amendments of 1977.

  12. Effect of Change in Systolic Blood Pressure Between Clinic Visits on Estimated 10-Year Cardiovascular Disease Risk

    PubMed Central

    Ye, Siqin; Wang, Y. Claire; Shimbo, Daichi; Newman, Jonathan D.; Levitan, Emily B.; Muntner, Paul

    2014-01-01

    Background Systolic blood pressure (SBP) often varies between clinic visits within individuals, which can affect estimation of cardiovascular disease (CVD) risk. Methods and Results We analyzed data from participants with two clinic visits separated by a median of 17 days in the Third National Health and Nutrition Examination Survey (n=808). Ten-year CVD risk was calculated with SBP obtained at each visit using the Pooled Cohort Equations. The mean age of participants was 46.1 years and 47.3% were male. The median SBP difference between the two visits was −1 mmHg (1st – 99th percentiles: −23 to 32 mmHg). The median estimated 10-year CVD risk was 2.5% and 2.4% at the first and second visit, respectively (1st – 99th percentiles −5.2% to +7.1%). Meaningful risk reclassification (i.e., across the guideline recommended 7.5% threshold for statin initiation) occurred in 12 (11.3%) of 106 participants whose estimated CVD risk was between 5% to 10%, but only in 2 (0.3%) of 702 participants who had a 10-year estimated CVD risk of <5% or >10%. Conclusions SBP variability can affect CVD risk estimation, and can influence statin eligibility for individuals with an estimated 10-year CVD risk between 5% and 10%. PMID:24462238

  13. Measuring the relationship between employees' health risk factors and corporate pharmaceutical expenditures.

    PubMed

    Burton, Wayne N; Chen, Chin-Yu; Conti, Daniel J; Schultz, Alyssa B; Edington, Dee W

    2003-08-01

    This study demonstrates the relationship between self-reported health risk factors on a health risk appraisal and pharmaceutical expenditures for a large employer. A total of 3554 employees who were participants in a pharmacy benefit plan for the entire year of 2000 completed a health risk appraisal. As the number of self-reported health risk factors increased from zero to six or more, corporate pharmaceutical costs increased in a stepwise manner: US dollars 345, 443, 526, 567, 750, 754, and 1121 US dollars, respectively. After controlling for age, gender, and the number of self-reported diseases, each additional risk factor was associated with an average annual increase in pharmacy claims costs of 76 US dollars per employee. Specific health risks were associated with significantly higher expenditures. The results provide estimates of incremental expenditures associated with common, potentially modifiable risk factors. Pharmaceutical expenditures should be considered by corporations in their estimates of total health-related costs and in prioritizing disease management initiatives based on health risk appraisal data.

  14. 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.

  15. Worldwide Exposures to Cardiovascular Risk Factors and Associated Health Effects: Current Knowledge and Data Gaps.

    PubMed

    Tzoulaki, Ioanna; Elliott, Paul; Kontis, Vasilis; Ezzati, Majid

    2016-06-07

    Information on exposure to, and health effects of, cardiovascular disease (CVD) risk factors is needed to develop effective strategies to prevent CVD events and deaths. Here, we provide an overview of the data and evidence on worldwide exposures to CVD risk factors and the associated health effects. Global comparative risk assessment studies have estimated that hundreds of thousands or millions of CVD deaths are attributable to established CVD risk factors (high blood pressure and serum cholesterol, smoking, and high blood glucose), high body mass index, harmful alcohol use, some dietary and environmental exposures, and physical inactivity. The established risk factors plus body mass index are collectively responsible for ≈9.7 million annual CVD deaths, with high blood pressure accounting for more CVD deaths than any other risk factor. Age-standardized CVD death rates attributable to established risk factors plus high body mass index are lowest in high-income countries, followed by Latin America and the Caribbean; they are highest in the region of central and eastern Europe and central Asia. However, estimates of the health effects of CVD risk factors are highly uncertain because there are insufficient population-based data on exposure to most CVD risk factors and because the magnitudes of their effects on CVDs in observational studies are likely to be biased. We identify directions for research and surveillance to better estimate the effects of CVD risk factors and policy options for reducing CVD burden by modifying preventable risk factors.

  16. Estimating the risks of smoking, air pollution, and passive smoke on acute respiratory conditions

    SciTech Connect

    Ostro, B.D. )

    1989-06-01

    Five years of the annual Health Interview Survey, conducted by the National Center for Health Statistics, are used to estimate the effects of air pollution, smoking, and environmental tobacco smoke on respiratory restrictions in activity for adults, and bed disability for children. After adjusting for several socioeconomic factors, the multiple regression estimates indicate that an independent and statistically significant association exists between these three forms of air pollution and respiratory morbidity. The comparative risks of these exposures are computed and the plausibility of the relative risks is examined by comparing the equivalent doses with actual measurements of exposure taken in the homes of smokers. The results indicate that: (1) smokers will have a 55-75% excess in days with respiratory conditions severe enough to cause reductions in normal activity; (2) a 1 microgram increase in fine particulate matter air pollution is associated with a 3% excess in acute respiratory disease; and (3) a pack-a-day smoker will increase respiratory restricted days for a nonsmoking spouse by 20% and increase the number of bed disability days for young children living in the household by 20%. The results also indicate that the estimates of the effects of secondhand smoking on children are improved when the mother's work status is known and incorporated into the exposure estimate.

  17. Leptospirosis in American Samoa – Estimating and Mapping Risk Using Environmental Data

    PubMed Central

    Lau, Colleen L.; Clements, Archie C. A.; Skelly, Chris; Dobson, Annette J.; Smythe, Lee D.; Weinstein, Philip

    2012-01-01

    Background The recent emergence of leptospirosis has been linked to many environmental drivers of disease transmission. Accurate epidemiological data are lacking because of under-diagnosis, poor laboratory capacity, and inadequate surveillance. Predictive risk maps have been produced for many diseases to identify high-risk areas for infection and guide allocation of public health resources, and are particularly useful where disease surveillance is poor. To date, no predictive risk maps have been produced for leptospirosis. The objectives of this study were to estimate leptospirosis seroprevalence at geographic locations based on environmental factors, produce a predictive disease risk map for American Samoa, and assess the accuracy of the maps in predicting infection risk. Methodology and Principal Findings Data on seroprevalence and risk factors were obtained from a recent study of leptospirosis in American Samoa. Data on environmental variables were obtained from local sources, and included rainfall, altitude, vegetation, soil type, and location of backyard piggeries. Multivariable logistic regression was performed to investigate associations between seropositivity and risk factors. Using the multivariable models, seroprevalence at geographic locations was predicted based on environmental variables. Goodness of fit of models was measured using area under the curve of the receiver operating characteristic, and the percentage of cases correctly classified as seropositive. Environmental predictors of seroprevalence included living below median altitude of a village, in agricultural areas, on clay soil, and higher density of piggeries above the house. Models had acceptable goodness of fit, and correctly classified ∼84% of cases. Conclusions and Significance Environmental variables could be used to identify high-risk areas for leptospirosis. Environmental monitoring could potentially be a valuable strategy for leptospirosis control, and allow us to move from disease

  18. Public health risk of antimicrobial resistance transfer from companion animals.

    PubMed

    Pomba, Constança; Rantala, Merja; Greko, Christina; Baptiste, Keith Edward; Catry, Boudewijn; van Duijkeren, Engeline; Mateus, Ana; Moreno, Miguel A; Pyörälä, Satu; Ružauskas, Modestas; Sanders, Pascal; Teale, Christopher; Threlfall, E John; Kunsagi, Zoltan; Torren-Edo, Jordi; Jukes, Helen; Törneke, Karolina

    2017-04-01

    Antimicrobials are important tools for the therapy of infectious bacterial diseases in companion animals. Loss of efficacy of antimicrobial substances can seriously compromise animal health and welfare. A need for the development of new antimicrobials for the therapy of multiresistant infections, particularly those caused by Gram-negative bacteria, has been acknowledged in human medicine and a future corresponding need in veterinary medicine is expected. A unique aspect related to antimicrobial resistance and risk of resistance transfer in companion animals is their close contact with humans. This creates opportunities for interspecies transmission of resistant bacteria. Yet, the current knowledge of this field is limited and no risk assessment is performed when approving new veterinary antimicrobials. The objective of this review is to summarize the current knowledge on the use and indications for antimicrobials in companion animals, drug-resistant bacteria of concern among companion animals, risk factors for colonization of companion animals with resistant bacteria and transmission of antimicrobial resistance (bacteria and/or resistance determinants) between animals and humans. The major antimicrobial resistance microbiological hazards originating from companion animals that directly or indirectly may cause adverse health effects in humans are MRSA, methicillin-resistant Staphylococcus pseudintermedius, VRE, ESBL- or carbapenemase-producing Enterobacteriaceae and Gram-negative bacteria. In the face of the previously recognized microbiological hazards, a risk assessment tool could be applied in applications for marketing authorization for medicinal products for companion animals. This would allow the approval of new veterinary medicinal antimicrobials for which risk levels are estimated as acceptable for public health. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For

  19. Residential building codes, affordability, and health protection: a risk-tradeoff approach.

    PubMed

    Hammitt, J K; Belsky, E S; Levy, J I; Graham, J D

    1999-12-01

    Residential building codes intended to promote health and safety may produce unintended countervailing risks by adding to the cost of construction. Higher construction costs increase the price of new homes and may increase health and safety risks through "income" and "stock" effects. The income effect arises because households that purchase a new home have less income remaining for spending on other goods that contribute to health and safety. The stock effect arises because suppression of new-home construction leads to slower replacement of less safe housing units. These countervailing risks are not presently considered in code debates. We demonstrate the feasibility of estimating the approximate magnitude of countervailing risks by combining the income effect with three relatively well understood and significant home-health risks. We estimate that a code change that increases the nationwide cost of constructing and maintaining homes by $150 (0.1% of the average cost to build a single-family home) would induce offsetting risks yielding between 2 and 60 premature fatalities or, including morbidity effects, between 20 and 800 lost quality-adjusted life years (both discounted at 3%) each year the code provision remains in effect. To provide a net health benefit, the code change would need to reduce risk by at least this amount. Future research should refine these estimates, incorporate quantitative uncertainty analysis, and apply a full risk-tradeoff approach to real-world case studies of proposed code changes.

  20. An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database.

    PubMed

    Unni, S; Yao, Y; Milne, N; Gunning, K; Curtis, J R; LaFleur, J

    2015-02-01

    Many of the clinical risk factors used in fracture risk assessment (FRAX) calculator are available in electronic medical record (EMR) databases and are good sources of osteoporosis risk factor information. The EPIC EMR database showed a lower prevalence of FRAX risk factors and, consequently, proportion of patients who would be deemed "high risk." The FRAX tool is underutilized for osteoporosis screening. Many of the clinical risk factors for FRAX may be available in EMR databases and may enable health systems to perform fracture risk assessments. We intended to identify variables in an EMR database for calculating FRAX score in a cohort of postmenopausal women, to estimate absolute fracture risk, and to determine the proportions of women whose absolute fracture risks exceed the National Osteoporosis Foundation (NOF) thresholds. Our cohort was selected using an EMR database with demographic, inpatient, outpatient, and clinical information for female patients age≥50 in a family practice, internal medicine, or obstetrics/gynecology clinic in 2007-2008. The latest physician encounter was the index date. Variables, problem and medication lists, diagnosis codes, and histories from the EMR were used to populate the 11 clinical risk factor variables used in the FRAX. These risk factor prevalence and treatment-eligible proportions were compared to those of published epidemiology studies. The study included 345 patients. Mean (SD) 10-year risk for any major fracture was 11.1% (6.8) when bone mineral density (BMD) was used and 11.2% (6.5) when BMI was used. About 10.1% of the cohort exceeded the NOF's 20% major fracture risk threshold and 32.5% exceeded the NOF's 3% hip fracture risk threshold when BMD was used. Overall, the number of treatment-eligible patients was slightly lower when FRAX was calculated using BMD versus BMI (13.6 and 36.8%). Our cohort using EMR data most likely underestimated the mean 10-year probability of any major fracture compared to other cohorts

  1. Time-to-Compromise Model for Cyber Risk Reduction Estimation

    SciTech Connect

    Miles A. McQueen; Wayne F. Boyer; Mark A. Flynn; George A. Beitel

    2005-09-01

    We propose a new model for estimating the time to compromise a system component that is visible to an attacker. The model provides an estimate of the expected value of the time-to-compromise as a function of known and visible vulnerabilities, and attacker skill level. The time-to-compromise random process model is a composite of three subprocesses associated with attacker actions aimed at the exploitation of vulnerabilities. In a case study, the model was used to aid in a risk reduction estimate between a baseline Supervisory Control and Data Acquisition (SCADA) system and the baseline system enhanced through a specific set of control system security remedial actions. For our case study, the total number of system vulnerabilities was reduced by 86% but the dominant attack path was through a component where the number of vulnerabilities was reduced by only 42% and the time-to-compromise of that component was increased by only 13% to 30% depending on attacker skill level.

  2. 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.

  3. 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

  4. BACKGROUND RADIATION MEASUREMENTS AND CANCER RISK ESTIMATES FOR SEBINKARAHISAR, TURKEY.

    PubMed

    Kurnaz, Asli

    2013-07-19

    This paper presents the measurement results of environmental radioactivity levels for Şebinkarahisar district (uranium-thorium area), Giresun, Turkey. The radioactivity concentrations of (238)U, (232)Th, (40)K and the fission product (137)Cs in soil samples collected from 73 regions from the surroundings of the study area were determined. In situ measurements of the gamma dose rate in air were performed in the same 73 locations where the soil samples were collected using a portable NaI detector. Also the mean radioactivity concentrations of (238)U, (232)Th and (40)K in rock samples collected from 50 regions were determined. The mean estimated cancer risk value was found. The seasonal variations of the indoor radon activity concentrations were determined in the 30 dwellings in the study area. In addition, the mean gross alpha, gross beta and radon activities in tap water samples were determined in the same 30 dwellings. The excess lifetime cancer risk was calculated using the risk factors of International Commission on Radiological Protection and Biological Effects of Ionizing Radiation. Radiological maps of the Şebinkarahisar region were composed using the results obtained from this study.

  5. Estimating risk of cancer associated with radiation exposure from 64-slice computed tomography coronary angiography.

    PubMed

    Einstein, Andrew J; Henzlova, Milena J; Rajagopalan, Sanjay

    2007-07-18

    Computed tomography coronary angiography (CTCA) has become a common diagnostic test, yet there are little data on its associated cancer risk. The recent Biological Effects of Ionizing Radiation (BEIR) VII Phase 2 report provides a framework for estimating lifetime attributable risk (LAR) of cancer incidence associated with radiation exposure from a CTCA study, using the most current data available on health effects of radiation. To determine the LAR of cancer incidence associated with radiation exposure from a 64-slice CTCA study and to evaluate the influence of age, sex, and scan protocol on cancer risk. Organ doses from 64-slice CTCA to standardized phantom (computational model) male and female patients were estimated using Monte Carlo simulation methods, using standard spiral CT protocols. Age- and sex-specific LARs of individual cancers were estimated using the approach of BEIR VII and summed to obtain whole-body LARs. Whole-body and organ LARs of cancer incidence. Organ doses ranged from 42 to 91 mSv for the lungs and 50 to 80 mSv for the female breast. Lifetime cancer risk estimates for standard cardiac scans varied from 1 in 143 for a 20-year-old woman to 1 in 3261 for an 80-year-old man. Use of simulated electrocardiographically controlled tube current modulation (ECTCM) decreased these risk estimates to 1 in 219 and 1 in 5017, respectively. Estimated cancer risks using ECTCM for a 60-year-old woman and a 60-year-old man were 1 in 715 and 1 in 1911, respectively. A combined scan of the heart and aorta had higher LARs, up to 1 in 114 for a 20-year-old woman. The highest organ LARs were for lung cancer and, in younger women, breast cancer. These estimates derived from our simulation models suggest that use of 64-slice CTCA is associated with a nonnegligible LAR of cancer. This risk varies markedly and is considerably greater for women, younger patients, and for combined cardiac and aortic scans.

  6. 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.

  7. Kalman Filtering with Inequality Constraints for Turbofan Engine Health Estimation

    NASA Technical Reports Server (NTRS)

    Simon, Dan; Simon, Donald L.

    2003-01-01

    Kalman filters are often used to estimate the state variables of a dynamic system. However, in the application of Kalman filters some known signal information is often either ignored or dealt with heuristically. For instance, state variable constraints (which may be based on physical considerations) are often neglected because they do not fit easily into the structure of the Kalman filter. This paper develops two analytic methods of incorporating state variable inequality constraints in the Kalman filter. The first method is a general technique of using hard constraints to enforce inequalities on the state variable estimates. The resultant filter is a combination of a standard Kalman filter and a quadratic programming problem. The second method uses soft constraints to estimate state variables that are known to vary slowly with time. (Soft constraints are constraints that are required to be approximately satisfied rather than exactly satisfied.) The incorporation of state variable constraints increases the computational effort of the filter but significantly improves its estimation accuracy. The improvement is proven theoretically and shown via simulation results. The use of the algorithm is demonstrated on a linearized simulation of a turbofan engine to estimate health parameters. The turbofan engine model contains 16 state variables, 12 measurements, and 8 component health parameters. It is shown that the new algorithms provide improved performance in this example over unconstrained Kalman filtering.

  8. 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.

  9. Estimating the compensating differential for employer-provided health insurance.

    PubMed

    Miller, Richard D

    2004-03-01

    The theory of wage differentials argues that workers must pay for employer-provided group health insurance coverage through lower wages or reductions in other fringe benefits. This paper uses data from the 1988-90 Consumer Expenditure Survey (CEX) to estimate the wage-health insurance trade-off for male workers between the ages of 25 and 55. A fixed-effects model, which takes advantage of the rotating panel design of the CEX, is used to control for unobservable worker characteristics that are positively related with all forms of compensation, including wage earnings and health insurance coverage. I find a compensating differential for health insurance equal to roughly 10 to 11 percent of wages. Some caution is advised here due to the fact that I was unable to control for other fringe benefits, the most important being paid vacation and sick leave.

  10. [Health risk among workers employed in rubber footwear plant].

    PubMed

    Szubert, Z; Wilczyńska, U; Sobala, W

    2001-01-01

    The aim of the study was to assess the health risk of workers performing specific jobs in the process of the rubber footwear production by defining the cause and length of temporary work disability, as well as mortality causes and level. The analysis was carried out in the groups of workers performing the following jobs: mixing, mill operation, pressing and vulcanizing (A); semi-product preparation and calendaring (B); finishing and sorting (C); production of polyvinyl chloride footwear (D); and auxiliary works (E). The sickness absence study covered all workers (208 men and 315 women) employed in a large rubber footwear company and performing all above-listed jobs in 1995. Standardized sick days ratio was used to analyze the risk of temporary work disability. Mortality rate was estimated on the basis of the results of the cohort study performed in the same company among workers who had worked at least three months during the years 1945-1985. The follow-up continued until 31 December 1997. The present study included sub-cohorts composed of 5628 men and 7197 women, performing jobs listed above. The results of both studies indicated the enhanced risk of cardiovascular diseases among workers employed in the basic phases of the production process. The increased risk of the diseases of the digestive system was observed in men and women employed in: finishing, sorting and packing of the products (group C); in men involved in mixing, pressing and vulcanizing (group A); and in women engaged in auxiliary works (group E). In addition, the enhanced risk of sickness absence due to the diseases of the respiratory, digestive, or genitourinary systems was related to the enhanced risk of death from malignant neoplasms in a given site. The analysis showed that the temporary work disability may be regarded as a parameter useful in early assessment of health effects of the work environmental hazards.

  11. 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.

  12. [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.

  13. National job-exposure matrix in analyses of census-based estimates of occupational cancer risk.

    PubMed

    Pukkala, Eero; Guo, Johannes; Kyyrönen, Pentti; Lindbohm, Marja-Liisa; Sallmén, Markku; Kauppinen, Timo

    2005-04-01

    The aim of this study was to increase the understanding of the alternative exposure metrics and analysis methods in studies applying job-exposure matrices in analyses of health outcomes, the association between crystalline silica and cancer being used as an example. Observed and expected numbers of cancer cases during 1971-1995 among Finns born in 1906-1945 were calculated for 393 occupational categories, as defined in the 1970 population census. According to the Finnish Cancer Registry, there were 43 433 lung and 21 444 prostate cancer cases. The Finnish job-exposure matrix (FINJEM) provided estimates of the proportion of exposed persons and the mean level of exposure among the exposed in each occupation. The most comprehensive exposure metric included period- and age-specific estimates of exposure and an estimate of occupational stability, but also remarkably simpler metrics gave significantly elevated estimates of the risk ratio (RR) between 1.36 and 1.50 for lung cancer for occupations with the highest estimated cumulative silica exposure (> or = 10 mg/m3-years), allowing a lag time of 20 years. It proved important to adjust the risk ratios at least for the socioeconomic status and occupational exposure to asbestos. The risk ratios for prostate cancer were close to 1.0 in every model. The results showed that the FINJEM-based analysis was able to replicate the well-known association between exposure to crystalline silica and lung cancer. The FINJEM-based method gives valid results, and it can be used to analyze large sets of register-based data on health outcomes.

  14. Biomechanical Indices for Rupture Risk Estimation in Abdominal Aortic Aneurysms.

    PubMed

    Leemans, Eva L; Willems, Tineke P; van der Laan, Maarten J; Slump, Cornelis H; Zeebregts, Clark J

    2017-04-01

    To review the use of biomechanical indices for the estimation of abdominal aortic aneurysm (AAA) rupture risk, emphasizing their potential use in a clinical setting. A search of the PubMed, Embase, Scopus, and Compendex databases was made up to June 2015 to identify articles involving biomechanical analysis of AAA rupture risk. Outcome variables [aneurysm diameter, peak wall stress (PWS), peak wall shear stress (PWSS), wall strain, peak wall rupture index (PWRI), and wall stiffness] were compared for asymptomatic intact AAAs vs symptomatic or ruptured AAAs. For quantitative analysis of the pooled data, a random effects model was used to calculate the standard mean differences (SMDs) with the 95% confidence interval (CI) for the biomechanical indices. The initial database searches yielded 1894 independent articles of which 19 were included in the analysis. The PWS was significantly higher in the symptomatic/ruptured group, with a SMD of 1.11 (95% CI 0.93 to 1.26, p<0.001). Likewise, the PWRI was significantly higher in the ruptured or symptomatic group, with a SMD of 1.15 (95% CI 0.30 to 2.01, p=0.008). After adjustment for the aneurysm diameter, the PWS remained higher in the ruptured or symptomatic group, with a SMD of 0.85 (95% CI 0.46 to 1.23, p<0.001). Less is known of the wall shear stress and wall strain indices, as too few studies were available for analysis. Biomechanical indices are a promising tool in the assessment of AAA rupture risk as they incorporate several factors, including geometry, tissue properties, and patient-specific risk factors. However, clinical implementation of biomechanical AAA assessment remains a challenge owing to a lack of standardization.

  15. A new method to quantify the health risks from sources of perfluoroalkyl substances, combined with PMF and risk assessment models.

    PubMed

    Xu, Jiao; Shia, Guo-Liang; Guo, Chang-Sheng; Wang, Hai-Ting; Tian, Ying-Ze; Huangfu, Yan-Qi; Zhang, Yuan; Feng, Yin-Chang; Xu, Jian

    2017-08-18

    A hybrid model based on Positive Matrix Factorization (PMF) and Health Risk Assessment Model for assessing risks associated with sources of perfluoroalkyl substances (PFASs) in water was for the first time established, and applied at Dianchi Lake to test its applicability. The new method contains two stages: (1) The sources to PFASs were apportioned by PMF model and (2) the contribution of health risks from each source was calculated by the new hybrid model. Two factors were extracted by PMF, with Factor 1 identified as aqueous fire-fighting foams (AFFFs) source, and Factor 2 as fluoropolymer (FP) manufacturing and processing & perfluorooctanoic acid production source. Health risk of PFASs in the water assessed by Health Risk Assessment Model was 9.54 × 10(-7) a(-1) on average, showing no obvious adverse effects to human health. The two sources' risks estimated by the new hybrid model ranged from 2.95 × 10(-10) to 6.60 × 10(-6) a(-1) and from 1.64 × 10(-7) to 1.62 × 10(-6) a(-1) respectively. The new hybrid model can provide useful information on the health risks of PFASs sources, which is helpful for pollution control and environmental management. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  16. A framework for estimating radiation-related cancer risks in Japan from the 2011 Fukushima nuclear accident.

    PubMed

    Walsh, L; Zhang, W; Shore, R E; Auvinen, A; Laurier, D; Wakeford, R; Jacob, P; Gent, N; Anspaugh, L R; Schüz, J; Kesminiene, A; van Deventer, E; Tritscher, A; del Rosarion Pérez, M

    2014-11-01

    We present here a methodology for health risk assessment adopted by the World Health Organization that provides a framework for estimating risks from the Fukushima nuclear accident after the March 11, 2011 Japanese major earthquake and tsunami. Substantial attention has been given to the possible health risks associated with human exposure to radiation from damaged reactors at the Fukushima Daiichi nuclear power station. Cumulative doses were estimated and applied for each post-accident year of life, based on a reference level of exposure during the first year after the earthquake. A lifetime cumulative dose of twice the first year dose was estimated for the primary radionuclide contaminants ((134)Cs and (137)Cs) and are based on Chernobyl data, relative abundances of cesium isotopes, and cleanup efforts. Risks for particularly radiosensitive cancer sites (leukemia, thyroid and breast cancer), as well as the combined risk for all solid cancers were considered. The male and female cumulative risks of cancer incidence attributed to radiation doses from the accident, for those exposed at various ages, were estimated in terms of the lifetime attributable risk (LAR). Calculations of LAR were based on recent Japanese population statistics for cancer incidence and current radiation risk models from the Life Span Study of Japanese A-bomb survivors. Cancer risks over an initial period of 15 years after first exposure were also considered. LAR results were also given as a percentage of the lifetime baseline risk (i.e., the cancer risk in the absence of radiation exposure from the accident). The LAR results were based on either a reference first year dose (10 mGy) or a reference lifetime dose (20 mGy) so that risk assessment may be applied for relocated and non-relocated members of the public, as well as for adult male emergency workers. The results show that the major contribution to LAR from the reference lifetime dose comes from the first year dose. For a dose of 10 mGy in

  17. Deployment Related Risk of Incident Mental Health Conditions Among Aeromedical Evacuation Crewmembers

    DTIC Science & Technology

    2015-09-01

    Alliance on Mental Illness estimates that up to 33% of qualified individuals are turned down for a job due to a psychiatric label (Williamson & Mulhall...RISK OF INCIDENT MENTAL HEALTH CONDITIONS AMONG AEROMEDICAL EVACUATION CREWMEMBERS by Jennifer P. Howland September 2015 Thesis Advisor...DATE September 2015 3. REPORT TYPE AND DATES COVERED Master’s thesis 4. TITLE AND SUBTITLE DEPLOYMENT RELATED RISK OF INCIDENT MENTAL HEALTH

  18. Adolescents' Perceptions of Health Risks, Social Risks, and Benefits Differ Across Tobacco Products.

    PubMed