Blood lead levels in children in Perth,Western Australia

Abstract: This study reports on an analysis of the lead concentrations in 123 venous blood samples collected from Perth children aged between two months and 17 years attending Princess Margaret Hospital. The overall geometric mean was 6.9 μg lead per 100 ml whole blood, with 95 per cent of results lying between 3.2 and 14.8 μg/100 ml. Among children under five years of age, those aged between 18 months and two years had the highest geometric mean blood lead (11.1 μg/100 ml). There were no consistent associations between geometric mean blood lead and area of residence, age group or sex. In this sample of Perth children, the mean blood lead concentration was lower than those reported in other studies. Less than 0.1 per cent of children of the age range studied would have been expected to have lead levels exceeding the NHMRC ‘level of concern’ (25 μg/100 ml) current at the time of the study. However, the recent adoption of goal of less than 10 μg/100 ml could mean that lead levels in up to 21 per cent of Perth children would now be regarded as excessive.     

A cost-effectiveness analysis of alcohol prevention targeting licensed premises

BACKGROUND: A multi-component alcohol prevention programme targeting licensed premises has been ongoing in Stockholm since 1996. An earlier study has established that this led to a 29% reduction in police-reported violence. The objective of the present study is to calculate the programme's cost-effectiveness from a societal perspective; the cost of implementation, the savings made as a result of fewer assaults, unlawful threats and violence towards officials, and the health gains in terms of quality-adjusted life-years (QALYs). METHODS: The costs included administration, studies of alcohol serving practices, community mobilization, responsible beverage service training and stricter alcohol law enforcement. For the purpose of estimating how the decrease in violence affected savings and health gains, a survey among victims of violence (N=604) was performed. RESULTS: The cost of the programme was estimated at Euro 796,000. The average cost of a violent crime was estimated at Euro 19,049, which implies overall savings of Euro 31.314 million related to the judicial system (78%), production losses (15%), health care issues (5%) and other damages (2%). Accordingly, the base case cost-saving ratio was 1:39. The average loss of health state weighting among the victims at 0.09 translates into 236 gained QALYs for society as a whole, which should be compared with the modest proportion of savings in the health sector. CONCLUSION: The most significant concern is the low response rate (35%), and caution needs to be exercised when interpreting our results. Yet, a reasonable conclusion is that the monetary and human benefits have been considerable.     

The accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area

OBJECTIVE: To examine the accuracy of coin-operated breath analysers installed in licensed premises in the Perth metropolitan area. METHOD: Two hundred licensed premises were contacted, which resulted in the location of 36 wall-mounted, coin-operated breath analysers. One instrument was removed prior to testing. These premises were then visited and the accuracy of the instruments was tested in situ using National Association of Testing Authorities Australia (NATA) certified 0.080% and 0.100% ethanol in nitrogen gas. RESULTS: The instruments were installed in the licensed premises as follows: 15 in the lounge bar, 10 in the main entrance, six in the public bar, two in the passageway to the toilets, and one in the male toilets. One licensed premise provided a handheld breath instrument. All instruments were accompanied by warning and operating instructions, but only five had any educational material. Only seven of the licensed premises had staff who had received any training in the operation of the wall-mounted instruments. Half of the licensees were unaware of the servicing requirements of the instruments. The testing found that only nine (25%) of the instruments provided acceptable results. CONCLUSION: The low level of accuracy of coin-operated breath analysers in the Perth metropolitan area is alarming and users should be informed of the potential inaccuracies. This paper, however, does not rule out that some wall-mounted breath analysing instruments may provide accurate results when properly maintained.     

A case-control study of childhood pedestrian injuries in Perth, Western Australia.

STUDY OBJECTIVES: To identify the determinants of childhood pedestrian injuries, taking the child's exposure to the road environment into account. DESIGN: This was a case-control study. SETTING AND PARTICIPANTS: The study was conducted in Perth, Western Australia between 1991 and 1993. Altogether 100 injured and 400 uninjured child pedestrians aged 1 to 14 years were studied. Aspects of the child's social and physical environments, measures of his or her behaviour, cognitive skills, and "habitual" exposure to the road environment, as well as his or her knowledge of road safety, were recorded. MAIN RESULTS: The likelihood of injury increased by 12% with each 10,000 vehicles per day increase in the volume of traffic (odds ratio (OR) 1.12, 95% confidence interval (CI) = 1.05, 1.19) on roads most frequently crossed. In addition, the presence of visual obstacles on the verge of the child's street of residence increased the likelihood of injury by more than 2.6 times (OR 2.68, 95% CI = 1.42, 5.02). In contrast, the absence of footpaths was associated with a 52% reduction in the likelihood of injury compared with the presence of footpaths on the child's street of residence (OR 0.48, 95% CI = 0.27, 0.87). CONCLUSION: The amount of exposure to the road environment and the nature of the road environment to which the child pedestrian was exposed partly influenced the likelihood of injury in children from low socioeconomic areas, male children, and children aged 13 to 14 years. Until now, the excess incidence of childhood pedestrian injuries in these subgroups of the population had not been explained because the child's exposure per se had not been examined.     

A survey of contraceptive use and unplanned pregnancy in Perth,Western Australia

Abstract: Contraceptive use and unplanned pregnancy were studied in a stratified cluster sample of 1 511 couples with women aged 16 to 44 years resident in metropolitan Perth in 1988. Twenty-one couples were excluded from analysis owing to missing data. The proportion of couples using contraception was 76.8 per cent (1 144 of 1 490), and all but three of the remaining couples gave a reason for nonuse. Among users, surgical sterilisation made up 42.3 per cent (484 of 1 144) of all methods, with a slight predominance of tubal ligation over vasectomy. Oral contraceptives accounted for just over half of nonsurgical methods. Comparisons with a Victorian survey performed in 1978 suggested that surgical methods and condom use may have increased, whereas use of oral contraceptives and intrauterine devices may have fallen. Unplanned pregnancies conceived during the 12 months before the interview affected 3.4 percent (51 of 1 490) of respondents. The incidence of unplanned pregnancy was four times higher in couples with inconsistent usage patterns of contraception.     

Public opinion on alcohol service at licensed premises: a population survey in Stockholm, Sweden 1999-2000

OBJECTIVE: In 1996, a community alcohol-prevention program focusing on licensed premises was initiated in Stockholm, Sweden. As a part of this initiative, a study has been conducted to investigate the public opinion in Stockholm on different strategies to reduce problems related to alcohol service at licensed premises. METHOD: A random sample of 1000 people resident in Stockholm County, within the age-group 18-65 years was selected. A postal questionnaire was sent out during the time-period November 1999 and January 2000 (response rate 59%). The questionnaire included questions on background factors, and support for various strategies to reduce intoxication and to prevent violence at licensed premises. The impact of each background factor on level of support for each strategy was analyzed using logistic regression. RESULTS: We found an overall strong support for licensed premises to practice responsible beverage service to reduce intoxication, whereas strategies to reduce availability (e.g., increased alcohol price, reduced open hours) were unpopular. The level of support differed by background factor. Frequent alcohol consumers, men, young people (< or =30 years), and frequent visitors to licensed premises, were less supportive. CONCLUSION: There is strong popular support for licensed premises to practice responsible beverage service and for stricter enforcement of existing legislation by local authorities.     

A survey of infertility,surgical sterility and associated reproductive disability in Perth,Western Australia

Abstract: Infertility, surgical sterility and associated reproductive disability were studied in a stratified cluster sample of 1511 couples with women aged 16 to 44 years resident in metropolitan Perth in 1988. Sixteen couples were omitted from analysis because of missing data. The proportion of couples affected by current infertility was 3.5 per cent (53 of 1 495), and 67.9 per cent of these (36 of 53) had a reproductive disability, meaning that they were unable to achieve their desired level of reproductive function. Those affected by surgical sterility accounted for 37.1 per cent (555 of 1 495), and of these couples 2.0 per cent (11 of 555) had a reproductive disability. Empirically, the prevalence of both infertility and reproductive disability peaked at ages 30 to 34 years in the female partner. Of the factors studied, infertility was associated with surgery for a ruptured appendix, a history of pelvic inflammatory disease and number of sexual partners. In 10 of the 47 couples with reproductive disability, contraceptive sterilisation had been a cause of later regret. Most other cases were due to infertility. Almost one half of couples with reproductive disability had sought treatment. The affected couples had at least one child from the current union in 23 of the 47 cases of reproductive disability. The results support the need for development of a strategy to prevent infertility and other causes of reproductive disability.     

Factors contributing to the severity of childhood pedestrian injury in Perth, Western Australia.

Pedestrian-motor vehicle collisions that involved children aged 0 to 14 years in Perth, Western Australia were examined for the period 1980-1989 in order to identify factors which contribute to the severity of injury. Nearly half (49%) of the 1,282 children injured during this period required hospitalization, with a further 46% of the children requiring some form of medical treatment. Multivariate analysis indicated that children aged 0 to four years had a higher risk of sustaining a severe injury compared with children aged five to nine and ten to 14 years, with relative risks of 1.6 and 1.7 respectively. A greater proportion of more severe injuries occurred after 3 pm. Injuries tended to be more severe when the collision occurred on a highway or main road, and when the child was actually on the road at the point of impact. Further research on more comprehensive datasets, which consider the child's behavior at the time of injury as well as driver attributes, will provide greater insight into factors contributing to the severity of injury.     

Community attitudes to bans on smoking in licensed premises

Abstract: Information about public attitudes to the restriction of smoking in licensed premises could provide an impetus for a campaign to address the failure of the industry to improve the health of its employees and the public. A probability sample of 816 people was surveyed to determine community attitudes to the introduction of bans on smoking in licensed premises. A total ban on smoking was supported by 20 per cent and provision of special smoking areas by 65 per cent, and 15 per cent wanted no bans. More-educated people, white-collar workers, nonsmokers and those who went to licensed premises less than weekly were more likely to support bans than were the less educated, blue-collar workers, smokers, and those who went to licensed premises at least weekly. The less educated, smokers and those who went to licensed premises at least weekly were most likely to perceive that the introduction of smoking bans would reduce their patronage of licensed premises. Nonsmokers and those with more than 12 years of education were more likely to report that their patronage would increase if bans were introduced than were smokers and the less educated. The introduction of bans on smoking in licensed premises would result in only a small loss of patronage after accounting for potential increases from supporters of bans. The effect of the bans is likely to be felt most strongly among the less educated, smokers and regular patrons.     

Prevalence and acceptability of public health initiatives in licensed premises

OBJECTIVES: To determine the prevalence and acceptability of public health initiatives in licensed premises. METHODS: Licensees/managers of all 333 licensed premises in the Hunter Region of NSW were interviewed to assess the practice of, and interest in undertaking public health initiatives relating to: responsible service of alcohol; environmental tobacco smoke; healthy-food choices; skin, breast and cervical cancer prevention; and the prevention of HIV/AIDS. RESULTS: Ninety eight percent of contacted premises participated in the study. Approximately two-thirds of premises reported having a responsible service of alcohol policy and training their staff in responsible service. One third of premises reported the provision of healthy food choices and smoke-free areas. Initiatives concerned with the prevention of cancer and HIV/AIDS were practised by less than 25% of premises. Between 41% and 85% of premises expressed an interest in undertaking all but two initiatives. Almost all interested premises accepted the offer of resources to facilitate adoption of public health initiatives. CONCLUSIONS: The study suggests that licensed premises are already involved in a number of public health initiatives, and that they appear willing to consider the introduction of a wide range of such initiatives. IMPLICATIONS: The prevalence of public health initiatives in licensed premises, and the extent of interest expressed by licensees/managers in undertaking such initiatives suggests that both a need and an opportunity exist for public health and other agencies to be more actively involved in disseminating appropriate services in this setting.     

The reduction of intoxication and disorder in premises licensed to serve alcohol: An exploratory randomised controlled trial

Background  

Licensed premises offer a valuable point of intervention to reduce alcohol-related harm.     

Still there's no food! Food insecurity in a refugee population in Perth, Western Australia

Aim:  To identify food insecurity and examine its association with socio-demographic factors in a group of newly arrived refugees.
Methods:  Structured questionnaire based around the same question asked during the National Nutrition Survey (1995). The questionnaire was administered to a service-based sample of clients accessing early intervention services. Fifty-one individuals who were newly arrived refugees, resident in Australia for less than 12 months and who were receiving torture and trauma counselling.
Results:  Thirty-six individuals (71% of sample) reported running out of food. This percentage was much greater than the 5.2% recorded across all social and economic groups in the 1995 National Nutrition Survey. The most common reasons for running out of food were related to large household bills, late welfare payments, poor household skills, sending money 'home', transport issues and poor budgeting skills.
Conclusion:  Food insecurity in refugees in Perth, Western Australia is comparable to the rates of food insecurity found in this population in other parts of the developed world. There are, however, significant ramifications for the development of intervention strategies as well as policy implications. For refugees, focusing on community food security strategies will assist in building community capacity, facilitate the retention of cultural integrity, restore and maintain dignity, and will be instrumental in ensuring both short- and long-term health.     

The evolution of local food environments within established neighbourhoods and new developments in Perth,Western Australia

Temporal changes in the location of food outlets can result in disparities in the availability and access of food across geographic areas, contributing to health inequalities. This study used mixed linear models to investigate how the location of food outlets around the home evolved over time with respect to area-level socio-economic status (SES) and urban design within established neighbourhoods and new residential developments. Food outlet data (supermarket/greengrocers, convenience stores, café restaurants and takeaway/fast food) were sourced from commercial database listings (SENSIS Pty. Ltd.) in 2004, 2006, 2007, and 2011. Using 2468 addresses from the RESIDential Environments Project (RESIDE), in Perth, Western Australia (WA), a count of each food outlet type and percentage of healthy food outlets within a 1.6 km road network buffer around the home, along with the road network distance to nearest food outlet were generated relative to each address at each time point. Proximity to and count of all food outlets increased over time in both new developments and established neighbourhoods. However, unhealthy food outlets were always in greater numbers and proximity to the home. The percentage of healthy food outlets was significantly greater in established neighbourhoods compared to new developments at all four time points. There were significantly more food outlets, and within closer proximity to the home, in established neighbourhoods compared to new developments at each time point. In established neighbourhoods, there were more convenience stores, takeaway/fast food and café restaurants, a lower percentage of healthy food outlets, and closer proximity to convenience stores in lower compared to high SES areas. In new developments there were significantly less supermarket/greengrocers, a lower percentage of healthy food outlets and greater proximity to takeaway/fast food and café restaurants in low compared to high SES areas. New developments designed according to the WA government's “Liveable Neighbourhoods Community Design Guidelines” policy had significantly more of all food outlets compared to other new developments. As such, people living in new developments, and low SES areas of Perth, may be disadvantaged with poorer access to healthy food outlets and greater exposure to unhealthy food outlets. Future urban planning and policy should focus on providing incentives that support the early development of supermarkets and healthy food outlets within new developments and low SES areas of Perth.     

孕妇对孕妇学校健康教育需求的调查

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