PubMed Health⌕ Search

Biomedical subjects

R J Waxweiler

Publications and source records attributed to R J Waxweiler.

At least 19 recordsLinked to original sources
PubMed1997

Injuries to rescue workers following the Oklahoma City bombing.

The objective of this study was to identify and describe physical injuries to rescue workers in the aftermath of the Oklahoma City bombing. Data were obtained from medical records from 16 hospital emergency departments and specialty clinics in the Oklahoma City area, and reported visits to medical providers at the bombing site. Participants were rescue personnel from the Oklahoma City Fire Department, the mutual aid fire stations in the Oklahoma City area, the Federal Emergency Management Agency's Urban Search and Rescue teams, and military personnel stationed near Oklahoma City. All participants were involved in the rescue and recovery operation. The two main outcome measures were (1) the number, types, and rates of injuries; and (2) comparisons of case-finding methods, including medical chart review and telephone interview. The most common injuries were strains and sprains (21.4%), foreign bodies in eyes (14.5%), and laceration/crush/puncture wounds (18.4%). Of the four case-finding mechanisms, telephone interviews following the event identified the largest number of cases (84.5%). Most injuries were minor; some injuries such as chemical burns were preventable. The potential utility of other data collection mechanisms is considered.

Eye Foreign Bodies↗
PubMed1995

Trends in death associated with traumatic brain injury, 1979 through 1992. Success and failure.

OBJECTIVE: To report updated national trends in traumatic brain injury deaths from 1979 through 1992. DESIGN: Retrospective analysis of Multiple Cause-of-Death Public Use Data Tapes from the National Center for Health Statistics. All deaths associated with traumatic brain injury were identified, the underlying causes of death were categorized, and the annual rates were calculated per 100,000 US residents. PATIENTS: Residents of the United States who died with traumatic brain injury from 1979 through 1992. RESULTS: An average of 52,000 US residents die each year with traumatic brain injuries. The brain injury-associated death rate declined 22% from 24.6 per 100,000 US residents in 1979 to 19.3 per 100,000 US residents in 1992. Firearm-related rates increased 13% from 1984 through 1992, undermining a 25% decline in motor vehicle-related rates for the same period. Firearms surpassed motor vehicles as the largest single cause of death associated with traumatic brain injury in 1990. CONCLUSIONS: These data highlight the success of efforts to prevent traumatic brain injury due to motor vehicles and failure to prevent such injuries due to firearms. The increasing importance of penetrating injury has important implications for research, treatment, and prevention of traumatic brain injury in the United States.

Accidental Falls↗
PubMed1991

Incidence rates of firearm injuries in Galveston, Texas, 1979-1981.

Firearm injury mortality rates have been characterized in various settings, but little is known of the total magnitude of firearm injury, including morbidity. The authors determined population-based incidence rates of firearm injury among residents of Galveston, Texas, from 1979-1981 by using police, emergency department, hospital, emergency medical services, medical examiner, and vital records to identify 239 firearm injury cases. Vital records, medical examiner, and police records each identified more than 95% of the fatalities, but police records (sensitivity = 98%) were better than emergency department or hospital records (sensitivity = 82% and 28%, respectively) for identifying all nonfatal cases. The annual age-adjusted incidence rate of firearm injury was 128 per 100,000 persons. Black males, with the highest firearm injury rate (459 per 100,000 persons), were injured at 46 times the rate of white females (10 per 100,000 persons). The overall case fatality rate was 30%, including 25% of the assaults/homicides, 81% of the parasuicides/suicides, and 0% of the unintentional injuries. On the basis of the case fatality rates, an estimated 140,000 firearm injuries occur in the United States annually. The case fatality rate for penetrating head injuries was 80% versus 48% for chest injuries and 6% for all other parts of the body. The results are discussed with respect to policy recommendations for reducing firearm injuries.

Adolescent↗
PubMed1990

Measuring the impact of trauma care on survival: rates of preventable death, effectiveness, and efficacy.

This paper focuses on the appropriateness of outcome measures to evaluate trauma care. The preventable death rate (PDR), based on the study of deceased patients only, has been the traditional measure of the impact of trauma care on improving the survival of patients with severe trauma. Another measure frequently used in other ares of evaluation research is the effectiveness rate--i.e. the survival rate in the total population of severe trauma patients. Because both the PDR and the effectiveness rate vary with the proportion of patients who would die even under conditions of optimal care, these two measures can be misleading. We illustrate their inadequacy by using published data on the impact of regionalization of trauma care. We propose the use of a third outcome measure of the impact of trauma care on survival, the efficacy rate--i.e. the survival rate among severe trauma patients with a potential for survival. Evaluation of trauma care should also measure outcomes other than survival and need not be restricted to patients with the most severe trauma. Evaluation of trauma care therefore requires outcome measures, such as the efficacy rate, which are based on the population at risk of manifesting the outcome of interest.

Emergency Medical Services↗
PubMed1990

The incidence of fall injury events among the elderly in a defined population.

Falls are a leading cause of death from injury among older persons in the United States, and about one in three older persons falls each year. Yet, reliable estimates of the incidence of fall injury events in a population-based setting are not readily available. Therefore, the authors analyzed population-based surveillance data, between July 1985 and June 1987, from the Study to Assess Falls Among the Elderly, Miami Beach, Florida. The rate of fall injury events coming to acute medical attention increased exponentially with age for both elderly men and women (predominantly white), reaching a high for those aged 85 years or more of 138.5 per 1,000 for males and 158.8 per 1,000 for females. Compared with males, females had a higher incidence of fractures other than skull. Males were nearly twice as likely to die, however, following a fall injury event than were females. Of those fall injury events identified through the surveillance system, about 42% resulted in hospital admission. The mean length of hospital stay was 11.6 days overall and was 15.5 days for hip fracture, 9.8 days for skull fracture/intracranial injury, 11.2 days for all other fractures, and 9.1 days for all other injuries. About 50% of fall injury events that occurred at home and required hospital admission resulted in a person being discharged to a nursing home.

Accidental Falls↗
PubMed1990

Magnitude and patterns of family and intimate assault in Atlanta, Georgia, 1984. Collaborative Working Group for the Study of Family and Intimate Assaults in Atlanta.

A sample of police incident reports was used to examine the magnitude and patterns of family and intimate assault involving weapon use or threat, bodily force, or verbal threat of assault in a defined urban population during 1984. More than half of the incidents involved partners (spousal and nonspousal), about a fourth involved prior or estranged partners, and the remainder involved family members and relatives. The 1984 rate of nonfatal family and intimate assault was estimated at 837 per 100,000 population--the fatal rate was 7 per 100,000 population. Fatal and nonfatal victimization rates for blacks and other races were three times the rates for whites. Fatal incidents predominantly involved handguns, and nonfatal incidents most often involved bodily force. Most nonfatal victims (66%) and some perpetrators (13%) suffered physical injuries. Data on prior police contacts suggest that family and intimate assaults occur within a context of repeated violence. Information about prior incidents might contribute to preventive efforts by identifying people at high risk of being victims or perpetrators.

Cross-Sectional Studies↗
PubMed1989

Lung cancer mortality among nonsmoking uranium miners exposed to radon daughters.

Radon daughters, both in the workplace and in the household, are a continuing cause for concern because of the well-documented association between exposure to radon daughters and lung cancer. To estimate the risk of lung cancer mortality among nonsmokers exposed to varying levels of radon daughters, 516 white men who never smoked cigarettes, pipes, or cigars were selected from the US Public Health Service cohort of Colorado Plateau uranium miners and followed up from 1950 through 1984. Age-specific mortality rates for nonsmokers from a study of US veterans were used for comparison. Fourteen deaths from lung cancer were observed among the nonsmoking miners, while 1.1 deaths were expected, yielding a standardized mortality ratio of 12.7 with 95% confidence limits of 8.0 and 20.1. These results confirm that exposure to radon daughters in the absence of cigarette smoking is a potent carcinogen that should be strictly controlled.

Adult↗
PubMed1989

Increases in premature mortality due to homicide--United States, 1968-1985.

From 1968 to 1985, the rate of homicide in the United States has increased 44%. Its relative impact on premature mortality, as measured by the percentage of years of potential life lost (YPLL) before age 65 from all causes of death due to homicide, has nearly doubled (93% increase). This increase calls attention to the emerging importance of interpersonal violence relative to all public health problems affecting persons under 65 years of age. The percentage of YPLL from all causes of death due to homicide increased in each race/sex group and for both firearm and nonfirearm means of homicide. The increase in homicide YPLL was traced mainly to an increase in the number of homicide deaths and, to a smaller extent, to a decrease in the average age at death of homicide victims.

Black or African American↗
PubMed1988

A retrospective cohort mortality study of males mining and milling attapulgite clay.

To evaluate the possible health effects of occupational exposure to a nonasbestos mineral fiber, a cohort of 2,302 males employed for at least 1 month between 1940 and 1975 at an attapulgite (clay fiber) mining and milling facility was followed through 1975. A significant deficit of mortality (SMR = 43, 90% CI 23-76) from nonmalignant respiratory disease (NMRD) was observed for the cohort based on age-, calendar year-, and race-specific rates for U.S. males. A marked deficit of NMRD was seen regardless of presumed dust exposure level, induction-latency period, or duration employed. A statistically significant excess of mortality from lung cancer was observed among whites (SMR = 193, 90% CI 121-293), but a deficit occurred among nonwhites (SMR = 53, 90% CI 21-112). Lung cancer risk in either race was not altered substantially with presumed dust exposure level, induction-latency period, or duration employed with one exception-those employed for at least 5 years in high-exposure-level jobs.

Dust↗
PubMed1988

Case-control study of lung cancer in civilian employees at the Portsmouth Naval Shipyard, Kittery, Maine.

Case-control analysis of deaths due to lung cancer (International Classification of Diseases, Eighth Revision, code 162) among persons who worked at the Portsmouth Naval Shipyard, Kittery, Maine, between 1952 and 1977 found elevated odds ratios for exposures to ionizing radiation, asbestos, and welding byproducts. The radiation-related excess was statistically significant in persons with cumulative lifetime exposures of 1.0-4.999 rem. When asbestos and welding histories were combined into a single risk factor, odds ratios for the combined exposure were significantly elevated for two of three duration-of-exposure categories examined. Further analysis of data on radiation exposure, controlling for exposures to asbestos and welding, found reductions in initial estimates of radiation risk at all levels of radiation exposure. This reduction suggests that radiation workers were more heavily exposed to asbestos and/or welding fumes than were other workers and that those exposures confounded the observed association between radiation and lung cancer. Analysis of mortality by time since first exposure to radiation revealed no pattern of progressive increase as latency increased. By contrast, odds ratios for asbestos/welding increased with latency. Data on cigarette smoking and socioeconomic status were not available. The results of this study do not preclude a possible association between radiation exposure at the Portsmouth Naval Shipyard and excess mortality from lung cancer. However, they provide no evidence in support of such a relation.

Asbestos↗