PubMed · 13611428
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H B LEVY. 1958. Home accident programs.. https://pubmed.ncbi.nlm.nih.gov/13611428/
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BACKGROUND: Alcohol-related diseases and injuries pose a significant burden on hospital emergency departments (EDs). Recognized limitations of self-reported data suggest that previous single-year national studies may have underestimated the magnitude of this burden. METHODS: Data were obtained from the National Hospital Ambulatory Medical Care Survey for 1992 through 2000. Thirty-seven alcohol-related diagnoses and their corresponding alcohol-attributable fractions (AAFs) were used to estimate the number of ED visits attributable to alcohol. Diagnoses with an AAF of 1 were analyzed by age, sex, and race. Disposition to inpatient settings and alcohol screening also were examined. RESULTS: During these 9 years, there were an estimated 68.6 million (95% confidence interval [CI], 65.6 million to 71.7 million) ED visits attributable to alcohol, a rate of 28.7 (95% CI, 27.1-30.3) per 1000 US population. The number of alcohol-related visits increased 18% during this period. Visit rates for diagnoses with AAFs of 1 were highest for those who were aged 30 through 49 years, male, and black. From 1992 to 2000, these disparities remained stable for age group but significantly changed for sex (+22%) and race (-76%). Most patients with diagnoses with AAFs of 1 were not admitted to an inpatient unit, and the percentage of patients who underwent blood alcohol concentration testing was substantially lower than corresponding AAFs. CONCLUSIONS: Alcohol-related ED visits are approximately 3 times higher than previous estimates determined by physician documentation or patient disclosure of alcohol involvement. Rising trends, changing disparities, and suboptimal ED management of such visits are a call to action.
We estimated the amount of oil remaining in Prince William Sound, Alaska, 12 yr after the 1989 Exxon Valdez spill to assess its importance as a long-term reservoir of toxic hydrocarbons. We found oil on 78 of 91 beaches randomly selected according to their oiling history. Surface oiling was recorded for randomly placed quadrats, which were then excavated and examined for subsurface oil. The cumulative area of beach contaminated by surface or subsurface oil was estimated at 11.3 ha. Surface oil varied little with tide height, but subsurface oil was more prevalent at the middle tide heights. The mass of remaining subsurface oil is conservatively estimated at 55 600 kg. Analysis of terpanes indicated that over 90% of the surface oil and all of the subsurface oil was from the Exxon Valdez and that Monterey Formation oil deposited after the 1964 Alaska earthquake accounted for the remaining surface oil. These results indicate that oil from the Exxon Valdez remains by far the largest reservoir of biologically available polycyclic aromatic hydrocarbons on beaches impacted by the spill and that biota dependent on these beaches risk continued exposure.
BACKGROUND: Children raised on farms are exposed to many hazardous types of machinery. The objective of this study was to describe the magnitude of non-fatal and fatal farm machinery injuries in Alberta children and adolescents (0-17 years) for the years 1990-1997. To date, there have been no published studies of pediatric farm injuries in Western Canada. METHODS: Data were collected through the Canadian Agricultural Injury Surveillance Program (CAISP). Death certificates and hospital charts were audited to provide enhanced information about the circumstances of injuries related to farm machinery for farm persons aged 17 years and younger. RESULTS: A total of 302 farm machinery injuries were recorded for the years 1990-1997. Of these, 14 resulted in death. All-terrain vehicles (ATVs) were the most common cause of injury (n = 76), followed by tractors (n = 72), and power take-offs (n = 15). The predominant injury mechanism was entanglement (n = 69), followed by falls from machines (n = 57), and being pinned/struck by a machine (n = 49). The median length of hospital stay for injuries was 2.0 days. Males (median = 2.0 days) had significantly longer hospital stays than females (median = 1.0 days). There were significantly more injuries reported during the summer and autumn than during the winter and spring. Those injured in the autumn were significantly older (median = 13.0 years) than children injured in the spring (median = 9.0 years). Injury rates dropped significantly during the study period from 119.9/100,000 per year in 1990 to 50.7/100,000 in 1997. CONCLUSIONS: While injury rates have dropped, the number of injuries occurring to children on Alberta farms is of concern. The large number of ATV related injuries suggests that preventative strategies need to be focused in this area. Am. J. Ind. Med. 45:177-185, 2004.