PubMed Health⌕ Search

Biomedical subjects

L B Lave

Publications and source records attributed to L B Lave.

At least 19 recordsLinked to original sources
PubMed1992

Epidemiology of insulin-using commercial motor vehicle drivers. Major variability of state licensing requirements in the U.S.

OBJECTIVE: Licensing agencies in many areas, including the U.S., prohibit insulin-using individuals from driving CMVs or large trucks. This study examined the debate over the risks of licensing insulin-using individuals to drive CMVs as an occupation, and the variations in regulations of different states. RESEARCH DESIGN AND METHODS: As part of an ongoing review of the regulations governing interstate commerce in the U.S., we surveyed all 50 states and Washington, D.C. to determine the regulations concerning intrastate driving. We received responses from 48 states and D.C., representing 95% of the U.S. population. RESULTS: Only 9 states reported preventing insulin users from acquiring a CMV license, whereas 39 states and D.C. permitted licensing within state boundaries. Of the states allowing insulin users to drive, 26 placed special requirements on CMV licensing. CONCLUSIONS: The results indicate that, despite a standardized U.S. federal law for driving across states, enormous variability exists in the policies for driving within states, ranging from no restrictions to a complete ban on CMV driving for insulin users.

Automobile Driving↗
PubMed1991

Public perception of the risks of floods: implications for communication.

Floods in the U.S. kill an average of 162 people each year and cause $3.4 billion in property damage. Flood control programs have been successful in lowering, but not eliminating, the risks to lives and property. Since the late 1960s, the federal government has emphasized flood insurance as a primary tool for improving location and flood-proofing decisions, as well as for reimbursing flood losses. Since only 12.7% of houses in flood plain areas are covered by flood insurance, the program has been ineffective. We interviewed people living in three communities that had recently been flooded. Most people had little knowledge of the cause of floods or what could be done to prevent damage. People who work and who are better educated know more and are more likely to have flood insurance. Current government publications about flood risks are not likely to be understood by those at risk. There is little effective communication about the nature and magnitude of the risks and what individuals can do to protect their lives and property and lower their financial risks. The risk management program should both emphasize communication and enforcement of the current law requiring people at risk who hold federally funded loans to be insured.

Communication↗
PubMed1990

Risk analysis and risk management.

During the past several decades, the public has given increasing attention to environmental problems and increased their demands that these problems be solved. During this period, the difficulty and costs of solving the problems have become apparent. Environmental abatement programs must be effective in achieving the desired goals and efficient in achieving them at low cost. Risk analysis is necessary to quantify the benefits of proposed solutions in order to make them effective and efficient. The necessity for performing risk assessment stems from a presidential executive order, from a Supreme Court Decision, and from the public's demand for information about the extent of possible danger from a hazard, rather than knowing simply that it is a hazard. The science of risk analysis is an an early stage and so there are many uncertainties concerning interpretation of the estimates. This approach has sharpened the scientific questions and hastened improvements in scientific understanding. Risk analysis is most helpful when the analysis reflects the science, without intrusion of the risk assessor's values or attempts to force a risk management outcome by skewing the risk analysis.

Carcinogens↗
PubMed1990

Value-of-information analysis of testing strategies: estimating the effect of uncertainty about the proportion of chemicals that are true human carcinogens.

Choosing a cost-effective strategy for classifying chemicals as human carcinogens and non-carcinogens depends upon the costs of false positives (carcinogens erroneously treated as non-carcinogenic) and false negatives (non-carcinogens erroneously treated as carcinogenic); upon the accuracy (sensitivity and specificity) of the classification strategy; and upon the underlying proportion of carcinogens in the population of chemicals to be classified. If these values are known, value-of-information analyses can indicate the most cost-effective among three strategies: classify as carcinogenic without testing, classify as non-carcinogenic without testing, or choose the most cost-effective test and classify on the basis of the test result. When some or all of the values are uncertain, the analysis becomes more complex, but still helps to guide decisions among the three classification strategies.

Animals↗
PubMed1987

Health and safety risk analyses: information for better decisions.

Knowing the nature and magnitude of health and safety risks is helpful in setting priorities as well as in making decisions about pursuing recreational activities, foods, jobs, and other aspects of everyday living. "Risk-risk" situations require a choice among risky alternatives. "How safe" situations involve a more general choice as to how much of other desired activities to sacrifice for increased safety. "How safe" situations are inherently more difficult to manage, because they are subject to fuzzy thinking and rhetoric. The large uncertainties of current estimates must be conveyed explicitly to arrive at sensible decisions.

Accident Prevention↗
PubMed1987

Injury as externality: an economic perspective of trauma.

Economists emphasize the costs in dollars or other desirable outcomes of additional safety in contrast to safety experts who remind people to design safe products and operate them safely. Society loses emotionally and financially from traumatic injury. The emotional loss must be balanced against allowing individuals free choice and encouraging them to develop judgment. Individuals are viewed as making their own best safety decisions, although they must have good information and face the correct indentives. Currently, society subsidizes risk taking in many ways, thereby discouraging safety. Health and life insurance ought to be required along with liability insurance, to correct the incentives to drivers. In addition, regulation is required to deal with physical externalities.

Cost-Benefit Analysis↗
PubMed1987

Initial effects of the New York State auto safety belt law.

New York State began enforcing a mandatory automobile safety belt use law on January 1, 1985. We present a preliminary analysis of its effect on fatalities and injuries. Applying a Poisson statistical model to pre- and post-law belt usage rates together with counts of fatalities and injuries in 12 metropolitan areas, we estimate the first six months' application of the law averted 220 fatal, 1,500 severe, 4,600 moderate, and 2,600 light injuries across the state. The Poisson approach gives estimates of injuries averted considerably greater than simple year to year comparisons, indicating that media announcements have understated the efficacy of requiring safety belt usage.

Accident Prevention↗
PubMed1985

Improving the management of environmental health.

Environmental health regulation has been developed on the premise that both problems and solutions are obvious, requiring only attention and commitment. The result has been impossible legislative goals and frenetic, unfocused agency efforts to deal with too many issues. Preventing all environmental health problems is impossible and not the best approach; instead, attention ought to be shifted toward reacting quickly to problems before irreversible, severe health damage has occurred. Rather than having regulatory agencies attempt to manage all problems, they should be focused on exemplifying goals and productive approaches, and on handling a few major issues. Regulatory agencies should be managing the nonregulatory institutions to ensure that they are effective in dealing with the myriad issues that the agencies will never be able to handle. The inherent limitations of federal regulatory agencies must be recognized to restructure environmental health management to be more effective in lowering risks while being efficient, administratively simple, and more equitable.

Environmental Health↗
PubMed1979

Characteristics of individuals who identify a regular source of medical care.

Having a source where medical services are regularly received is an antecedent to securing high quality medical care; it facilitates access and indicates that the individual is not alienated from the health care delivery system. In this paper we develop models to characterize individuals, both children and adults, who claim a regular source of care. The models are estimated using a logit analysis (since the dependent variable is 0-1) applied to survey data on residents of East Palo Alto, California. These data indicate that in this low-income, predominately black population the most important factor influencing whether a child will have a regular source of medical care is whether the parents have a regular source. For adults, the anticipated need for care (as measured by health status), time in community, and sex were all found to be important. The type of individual least likely to have a regular source of care is a low-income, unmarried male who is in good health and is a recent arrival to the community. The individuals most likely to need easy access to medical care and continuity of care are most likely to have a regular source of care, and vice versa.

Adult↗