PubMed Health⌕ Search

Biomedical subjects

R H McKnight

Publications and source records attributed to R H McKnight.

9 recordsLinked to original sources
PubMed2005

Using U.S. Poison Control Center records to identify bystander pesticide exposures: a one-year surveillance of four southeastern states.

The extent to which bystanders are exposed to pesticide applications is unknown. Systematic monitoring around spray areas is not routine. Quantifying exposures is extremely difficult. Persons inadvertently exposed to pesticides often do not know the chemical or quantity, and persons living near areas of frequent field spraying may receive multiple exposures. In the U.S., concerns about health consequences from these exposures may prompt calls to poison control centers. The goal of this study was to determine what surveillance poison control centers can provide on environmental pesticide exposures to bystanders. We searched the American Association of Poison Control Centers' 2001 electronic medical records for exposure reports involving persons from 129 agriculturally intensive counties in Kentucky, Tennessee, Louisiana, and Arkansas that implicated at least one of 54 generic classifications of agricultural chemicals. We abstracted 980 pesticide-related records. Narrative sections were reviewed to determine bystander status of the exposed person. Forty-six bystander exposures were identified from 32 events. Bystander ages ranged from 2 to 81 (median: 45; 16 females, 13 males). All pertinent information for bystander classification came from narrative sections of the record. 28% identified aircraft crop dusters as the pesticide source. The most implicated substance was malathion (30.4%), while 19.6% did not know the exposure substance. 73.9% of cases were symptomatic; 65.2% of the exposed persons were seen in or referred to a healthcare facility. No hospitalizations or deaths were reported. Although they may underestimate the true numbers, U.S. poison control center data can provide valuable information about bystander environmental pesticide exposures.

Adolescent↗
PubMed1998

Agricultural injuries among older Kentucky farmers: The Farm Family Health and Hazard Surveillance Study.

This population-based study reports the cumulative incidence of agricultural injuries during a 1-year period in a sample of 998 farmers aged 55 years and older living in Kentucky. A total of 98 farm-related injuries were reported among 88 older farmers for a crude injury rate of 9.03 injured farmers per 100 farmers (95% confidence interval (CI) = 7.03-11.03) over a 1-year period. The leading external causes of farm injury were falls (24.9%), machinery (22.5%), wood-cutting (14.6%), and animal-related events (14.3%). Farmers working on farms with beef cattle (alone) (odds ratio = 1.90; 95% CI = 1.02-3.55) or farms with beef cattle and tobacco (odds ratio = 2.15; 95% CI = 1.00-4.59) had a statistically significant increased risk for a farm-related injury. Farmers reporting a prior injury that limited their ability to farm were at increased risk for a farm-related injury. Approaches to using farm injury surveillance data for injury control programs in the state are discussed.

Accidents, Occupational↗
PubMed1996

Delay among the general public in telephoning a poison center.

Delay in seeking treatment for poisonings can hinder patient recovery. Our study examined delay in notifying a poison center about green tobacco sickness (GTS), a form of nicotine poisoning resulting from dermal contact with tobacco leaves. We conducted a follow-up survey of 55 cases of GTS reported by telephone to the kentucky Regional Poison Center in 1993. The "delay" group (38.2% of the cases) was defined as those callers who stated in the follow-up report that they should have phoned the poison center sooner than they did. Characteristics of the callers who delayed and the GTS patients they reported were compared with characteristics of the "non-delay" group. Delay was associated with callers' awareness of the poison center's expertise in agricultural poisonings and with age and sex of the patient. Our findings point to the need to target groups such as farmers with an educational campaign to make them more aware of the extent of the poison center's services and to encourage timely reporting of occupational poisonings.

Adolescent↗
PubMed1996

Seat belt use in Kentucky--a comparison of five measures.

Surveillance of seat belt use in Kentucky is of vital importance in the effort to reduce trauma from motor vehicle crashes. Self-report health surveys provide an important source for epidemiologic data on risk factors associated with non-use of seat belts. However, estimates of the prevalence of seat belt use derived from such surveys are consistently higher than estimates obtained from observational studies. In the 1993 Kentucky Health Survey, we introduced a new question designed to narrow the gap between observed and self-reported seat belt prevalence. The new question, which asked what percent of the time seat belts are worn, was compared with a "traditional" question, which asked persons to describe their frequency of seat belt use as "always," "nearly always," "sometimes," "seldom," or "never." Of the 652 persons answering both questions, 65.4% stated that they "always or nearly always" used a seat belt -- a prevalence which was close to that reported by two other 1993 self-report studies: the Kentucky Behavioral Risk Factor Surveillance System and the Kentucky Health Interview and Examination Study. However, only 44.8% claimed to wear a belt "100%" of the time -- a prevalence much closer to the 41% of Kentuckians observed to wear seat belts in the same year. We recommend that health surveys adopt this new question and accept nothing less than "100%" as defining a seat belt user. We also recommend that physicians use the new "percentage" question when counseling patients on seat belt use.

Adult↗
PubMed1995

Smokeless tobacco use among adults in Kentucky: 1994.

We assessed the 1994 prevalence of smokeless tobacco use among Kentucky adults > or = 18 years of age. 649 adults, contacted through a statewide random digit dialing procedure, completed an 18-minute telephone survey which included questions on current and former use of chewing tobacco and snuff. Overall, 4.5% of the sample (95% confidence interval [CI] = 2.95%-6.15%) claimed to currently use smokeless tobacco. Among males, 9.9% (95% CI = 6.1%-13.3%) claimed to currently use smokeless tobacco. Use of chewing tobacco exceeded snuff use by 2 to 1. No women were current users of either chewing tobacco or snuff. A typical current user was male, was over 45 years of age, did not graduate from high school, and lived in a rural or Appalachian county of Kentucky. Former users comprised 17.3% of the sample; all but one of these were male. By the year 2000, the overall prevalence of smokeless tobacco must be reduced by half if Kentucky is to meet its public health objective that no more than 2% of Kentuckians use smokeless tobacco.

Adolescent↗
PubMed1994

Detection of green tobacco sickness by a regional poison center.

This study describes epidemiological patterns of Green Tobacco Sickness (GTS) reported to a regional poison center July 24 through September 24, 1991, and investigates the feasibility of using such a center to expand the understanding of GTS. Records from the Kentucky Regional Poison Center (KRPC) for 1991 were searched for exposure reports containing 1 of 3 agents likely to be implicated in GTS. The search identified 104 exposure reports, which were examined, coded and analyzed. Of these, we determined that 78 were likely to represent GTS cases. Of the 78 persons with suspected GTS, 78% were male, 1/2 were aged 22 or younger, 1/4 were 17 or younger, and dermal contact was the usual reported route of exposure. Calls to the KRPC originated in residences (51.0%) and in health care facilities (47.7%). Nearly 1/3 of the calls mentioned more than 1 symptomatic person; exposure reports for these people were categorized as clusters. There were 10 clusters, each containing 2-4 persons. Almost 1/4 of all persons with suspected GTS were admitted to a hospital. This study demonstrates that a regional poison center can be used to expand understanding of GTS.

Adolescent↗
PubMedDate not supplied

Spatial and temporal clustering of an occupational poisoning: the example of green tobacco sickness.

Nicotine poisonings in tobacco farm workers (Green Tobacco Sickness, GTS) reported to the Kentucky Regional Poison Center during 1991 were assessed for spatial, temporal and space-time clustering. Among 62 index cases, 10 had worked with others who also reported GTS that day. Analysis of index cases, using Best and Rayner's V(2), showed significant cyclic clustering by hour of day the report was received (p = 9 x 10(-9)); chi-square revealed significant spatial clustering by agricultural district (p = 0.0002). Space-time clustering was detected using the E-M-M statistic (p = 0.008); however, the space-by-time interaction of Rao's chi-square goodness-of-fit statistic did not detect space-time clustering (p = 0.32).

Adolescent↗
PubMedDate not supplied

Finding homes without smoke detectors: one step in planning burn prevention programs.

Residential fires are the leading cause of burn-related deaths in the United States. Smoke detectors could save many of these lives. A 1993 telephone survey of 661 Kentucky households included questions on residential smoke detectors. Statewide, 16.4% of households did not possess a functioning smoke detector; however, in nonmetropolitan Appalachian counties, 30.5% of households lacked detectors. Characteristics associated with lack of a functioning smoke detector, as determined by multivariate logistic regression, were as follows: living in a nonapartment dwelling (odds ratio [OR] = 4.14, 95% confidence interval [CI] = 1.42 to 12.01); having an annual household income of $20,000 or less (OR = 2.34, CI = 1.49 to 3.68); being unmarried (OR = 1.73, CI = 1.12 to 2.69); living alone (OR = 1.69, CI = 1.02 to 2.80); and living in a nonmetropolitan county (OR = 1.68, CI = 1.05 to 2.69). Knowledge of these population-based characteristics can assist planners of burn prevention programs to target at-risk populations.

Adult↗