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The epidemiology of nonfatal injuries among U.S. children and youth
Formaldehyde Exposure in the Funeral Industry. R. E. Korczynski, Appl. Occup. Environ.
Hyg. 9(B), 575. An assessment of formaldehyde exposure was conducted among embalmers in the funeral industry in the province of Manitoba, Canada. The occupational exposure limit is defined by the American Conference of Governmental Industrial Hygienists’ threshold limit value-ceiling of 0.37 mg/m3 (0.3 ppm). Personal and area midget impingers were used to monitor the embalming procedure. Samples were analyzed according to the National Institute for Occupational Safety and Health Method 3500. Thirty-six embalmings were monitored in 18 chapels. Personal formaldehyde exposures of embalmers during an intact body preparation (~1 hour) ranged from 0.12 to 5.64 mg/m3 [arithmetic mean (AM) = 0.78, standard deviation (SD) = 1.06, number (N) = 241. During an autopsy preparation (~2 hours>), exposures ranged from 0.11 to 4.13 mg/m3 (AM = 0.80, SD = 0.96, N = 24). Student’s r-test did not present a significant difference (p > 0.05) between the two types of body preparations. Concentration for area samples ranged from 0.05 to 8.37 mg/m3 (AM = 0.61, SD = 1.24, N = 72). Health effects identified by some embalmers included irritation of the mucous membranes and chest tightness. Most embalmers are immunized with the hepatitis B vaccine. Universal precautions against infectious agents were not strictly adhered to in most embalmings. An upgrading of engineering controls, improved work practices, and use of personal protective equipment was required in the majority of funeral chapels. The principle of down-draft ventilation was adapted to some existing morgue tables. Compliance under the Canadian Workplace Hazardous Materials Information System Legislation was reviewed. In conclusion, the majority of embalmers operating funeral chapels in Manitoba were being overexposed to airborne formaldehyde according to the standard.
Public Safety Hospitalizations for Near Drowning in California: Incidence and Costs. A. A. Ellis C
R. B. Trent. American Journal of Public Health, August 1995, 8.5(B). 198
California hospital discharge data for 1991 were examined to describe persons hospitalized for near drownings (i.e., a submersion incident for which the victim was admitted to a hospital). Among residents with near-drowning injuries, there were 865 discharges, regardless of outcome (rate = 2.8/100,000); 785 persons survived the hospitalization, and 80 (9%) did not. Swimming pools were the most common submersion site (62%). Highest rates per 100,000 were found among males (3.6), Blacks (3.6), and children l-5 years old (18.4). Charges for the initial hospitalization (excluding physicians’ fees) amounted to $11.4 million. The state government’s share of these charges was $5.4 million, with Medi-Cal expected to pay $4.1 million. Blacks, males, Medi-Cal recipients, and young children are most at risk and should be targeted for prevention programs. The Epidemiology of Nonfatal Iqjuries Among U.S. Children and Youth. I? C. Scheidf, Y. Harel. A. C. Trumble, D. H. Jones, M. D. Overpeck, & P E. Bijul: American Journal of Public Health, July 1995, 85(7), 932-938. Objective: National data are not routinely available regarding the incidence of and associated risk factors for nonfatal injuries in children and youth. The Child Health Supplement to the 1988 National Health Interview Survey provided an opportunity to determine accurate national estimates of childhood injury morbidity by demographic factors, location, external cause, nature of injury, and other factors. Method: The closest adult for 17,110 sampled children was asked whether the child had an injury, accident, or poisoning during the preceding 12 months and about the cause, location, and consequences of the event. An analyses for potential under reporting from 12 months of recall provided adjustments of annual rates to those for a 1-month recall period. Results: On the basis of 2772 reported injuries, the national estimated annual rate for children O-17 years of age was 27 per 100 children after adjustment to l-month recall. Boys experienced significantly higher rates than girls (risk ratio [RR] = 1.52,95% confidence interval [CI] = 1.37, 1.68), and adolescents experienced the highest overall rate (38 per 100 children) and proportion of serious injuries. Journal
of Safety Research
Conclusions: Approximately one-fourth of U.S. children experience a medically attended injury each year, but the risks vary considerably depending on the characteristics of subgroups and the injury cause. Educating Preschoolers About Sun Safety. L. J. Loescher, J. Emerson, A. Taylor, D. H. Christensen, & M. McKinney. American Journal of Public Health, July 1995, 85(7), 939-943.
Objectives: This feasibility study examined whether a sun safety curriculum designed for and administered to preschoolers affects their cognition (knowledge, comprehension, application) regarding sun safety. Methods: Twelve classes of 4- to 5-yearolds were recruited from local preschools and randomly assigned to an intervention group or a control group. The intervention group received an investigator-developed sun safety curriculum. The control group did not. Children in both groups were tested at the beginning of the study about their cognition related to sun safety. They then received posttests 2 and 7 weeks following the pretest. Results: The curriculum had a significant effect on the knowledge (P = .Ol) and comprehension (P = .006) components of cognition. The application component of cognition was not significantly changed by the curriculum. Conclusions: A structured curriculum was found to be an efficacious means of enhancing knowledge and comprehension of sun safety in preschool children. At the preoperational development stage, however, children may not be able to apply such knowledge and comprehension. Unintentional Carbon Monoxide Poisoning in Colorado, 1%6-1991. M. Cook, I? A. Simon, &
R. E. Hoffman, American Journal of Public Health, July 1995, 85(7), 988-990. Unintentional carbon monoxide poisonings were identified through death certificates, by hyperbaric chambers, and by laboratories required to report carboxyhemoglobin levels greater than 12%. From 1986 to 1991,981 cases were reported, including 174 deaths. Deaths
Fall 1996Niolume 27/Number 3
most often resulted from fire-related carbonmonoxide intoxication (36.2%), followed by motor-vehicle exhaust (34.5%), and furnaces (10.3%). Among nonfatal cases, furnaces were the leading source of carbon monoxide exposure (44.3%). followed by motor vehicle exhaust (22.8%). The importance of furnaces and other home heating devices in carbon monoxide intoxication may be underappreciated if only mortality data are examined. Surveillance of carbon monoxide-related morbiditv is a useful adjunct to mortality surveillance in guiding prevention efforts. Audibility Apartment
Problems Buildings.
with Fire Alarms in G. Pro& C. Luroche,
& J. C. Latour, Proceedings of the Human Factors and Ergonomics Society 39th Annual Meeting - 1995, 98%993. A previous study of apartment building evacuation drills showed that as many as 25% of the occupants mentioned not hearing the fire alarm from inside their apartments. A new experiment was developed to observe evacuation drills and to measure the sound level of the tire alarms in three high-rise apartment buildings. These buildings, built during the 198Os, met the local building regulations regarding the provision of fire alarms at the time of construction. Each building contained approximately 200 apartments, with l-4 persons per apartment. For each building, the printed fire safety procedures stated that all occupants should leave the building or move to an area of refuge, upon hearing the building fire alarm. During each evacuation drill, video cameras were located in corridors and staircases to record the movement time and behavior of occupants. Using a digital audio tape recorder, precise sound samples of the fire alarm and background noise were taken from different locations in the buildings. Analyses of the alarm sound spectrum and levels were performed. Results confirm the sub jective assessment of occupants who mentioned not hearing the fire alarm in specific locations of the building. It was also found that, in some other areas, the alarm was overpowering. The impact of alarm audibility on fire safety is discussed.
199
Hyg. 9(B), 575. An assessment of formaldehyde exposure was conducted among embalmers in the funeral industry in the province of Manitoba, Canada. The occupational exposure limit is defined by the American Conference of Governmental Industrial Hygienists’ threshold limit value-ceiling of 0.37 mg/m3 (0.3 ppm). Personal and area midget impingers were used to monitor the embalming procedure. Samples were analyzed according to the National Institute for Occupational Safety and Health Method 3500. Thirty-six embalmings were monitored in 18 chapels. Personal formaldehyde exposures of embalmers during an intact body preparation (~1 hour) ranged from 0.12 to 5.64 mg/m3 [arithmetic mean (AM) = 0.78, standard deviation (SD) = 1.06, number (N) = 241. During an autopsy preparation (~2 hours>), exposures ranged from 0.11 to 4.13 mg/m3 (AM = 0.80, SD = 0.96, N = 24). Student’s r-test did not present a significant difference (p > 0.05) between the two types of body preparations. Concentration for area samples ranged from 0.05 to 8.37 mg/m3 (AM = 0.61, SD = 1.24, N = 72). Health effects identified by some embalmers included irritation of the mucous membranes and chest tightness. Most embalmers are immunized with the hepatitis B vaccine. Universal precautions against infectious agents were not strictly adhered to in most embalmings. An upgrading of engineering controls, improved work practices, and use of personal protective equipment was required in the majority of funeral chapels. The principle of down-draft ventilation was adapted to some existing morgue tables. Compliance under the Canadian Workplace Hazardous Materials Information System Legislation was reviewed. In conclusion, the majority of embalmers operating funeral chapels in Manitoba were being overexposed to airborne formaldehyde according to the standard.
Public Safety Hospitalizations for Near Drowning in California: Incidence and Costs. A. A. Ellis C
R. B. Trent. American Journal of Public Health, August 1995, 8.5(B). 198
California hospital discharge data for 1991 were examined to describe persons hospitalized for near drownings (i.e., a submersion incident for which the victim was admitted to a hospital). Among residents with near-drowning injuries, there were 865 discharges, regardless of outcome (rate = 2.8/100,000); 785 persons survived the hospitalization, and 80 (9%) did not. Swimming pools were the most common submersion site (62%). Highest rates per 100,000 were found among males (3.6), Blacks (3.6), and children l-5 years old (18.4). Charges for the initial hospitalization (excluding physicians’ fees) amounted to $11.4 million. The state government’s share of these charges was $5.4 million, with Medi-Cal expected to pay $4.1 million. Blacks, males, Medi-Cal recipients, and young children are most at risk and should be targeted for prevention programs. The Epidemiology of Nonfatal Iqjuries Among U.S. Children and Youth. I? C. Scheidf, Y. Harel. A. C. Trumble, D. H. Jones, M. D. Overpeck, & P E. Bijul: American Journal of Public Health, July 1995, 85(7), 932-938. Objective: National data are not routinely available regarding the incidence of and associated risk factors for nonfatal injuries in children and youth. The Child Health Supplement to the 1988 National Health Interview Survey provided an opportunity to determine accurate national estimates of childhood injury morbidity by demographic factors, location, external cause, nature of injury, and other factors. Method: The closest adult for 17,110 sampled children was asked whether the child had an injury, accident, or poisoning during the preceding 12 months and about the cause, location, and consequences of the event. An analyses for potential under reporting from 12 months of recall provided adjustments of annual rates to those for a 1-month recall period. Results: On the basis of 2772 reported injuries, the national estimated annual rate for children O-17 years of age was 27 per 100 children after adjustment to l-month recall. Boys experienced significantly higher rates than girls (risk ratio [RR] = 1.52,95% confidence interval [CI] = 1.37, 1.68), and adolescents experienced the highest overall rate (38 per 100 children) and proportion of serious injuries. Journal
of Safety Research
Conclusions: Approximately one-fourth of U.S. children experience a medically attended injury each year, but the risks vary considerably depending on the characteristics of subgroups and the injury cause. Educating Preschoolers About Sun Safety. L. J. Loescher, J. Emerson, A. Taylor, D. H. Christensen, & M. McKinney. American Journal of Public Health, July 1995, 85(7), 939-943.
Objectives: This feasibility study examined whether a sun safety curriculum designed for and administered to preschoolers affects their cognition (knowledge, comprehension, application) regarding sun safety. Methods: Twelve classes of 4- to 5-yearolds were recruited from local preschools and randomly assigned to an intervention group or a control group. The intervention group received an investigator-developed sun safety curriculum. The control group did not. Children in both groups were tested at the beginning of the study about their cognition related to sun safety. They then received posttests 2 and 7 weeks following the pretest. Results: The curriculum had a significant effect on the knowledge (P = .Ol) and comprehension (P = .006) components of cognition. The application component of cognition was not significantly changed by the curriculum. Conclusions: A structured curriculum was found to be an efficacious means of enhancing knowledge and comprehension of sun safety in preschool children. At the preoperational development stage, however, children may not be able to apply such knowledge and comprehension. Unintentional Carbon Monoxide Poisoning in Colorado, 1%6-1991. M. Cook, I? A. Simon, &
R. E. Hoffman, American Journal of Public Health, July 1995, 85(7), 988-990. Unintentional carbon monoxide poisonings were identified through death certificates, by hyperbaric chambers, and by laboratories required to report carboxyhemoglobin levels greater than 12%. From 1986 to 1991,981 cases were reported, including 174 deaths. Deaths
Fall 1996Niolume 27/Number 3
most often resulted from fire-related carbonmonoxide intoxication (36.2%), followed by motor-vehicle exhaust (34.5%), and furnaces (10.3%). Among nonfatal cases, furnaces were the leading source of carbon monoxide exposure (44.3%). followed by motor vehicle exhaust (22.8%). The importance of furnaces and other home heating devices in carbon monoxide intoxication may be underappreciated if only mortality data are examined. Surveillance of carbon monoxide-related morbiditv is a useful adjunct to mortality surveillance in guiding prevention efforts. Audibility Apartment
Problems Buildings.
with Fire Alarms in G. Pro& C. Luroche,
& J. C. Latour, Proceedings of the Human Factors and Ergonomics Society 39th Annual Meeting - 1995, 98%993. A previous study of apartment building evacuation drills showed that as many as 25% of the occupants mentioned not hearing the fire alarm from inside their apartments. A new experiment was developed to observe evacuation drills and to measure the sound level of the tire alarms in three high-rise apartment buildings. These buildings, built during the 198Os, met the local building regulations regarding the provision of fire alarms at the time of construction. Each building contained approximately 200 apartments, with l-4 persons per apartment. For each building, the printed fire safety procedures stated that all occupants should leave the building or move to an area of refuge, upon hearing the building fire alarm. During each evacuation drill, video cameras were located in corridors and staircases to record the movement time and behavior of occupants. Using a digital audio tape recorder, precise sound samples of the fire alarm and background noise were taken from different locations in the buildings. Analyses of the alarm sound spectrum and levels were performed. Results confirm the sub jective assessment of occupants who mentioned not hearing the fire alarm in specific locations of the building. It was also found that, in some other areas, the alarm was overpowering. The impact of alarm audibility on fire safety is discussed.
199