Reported incidence of occupational asthma in the United Kingdom, 1989-90.

STUDY OBJECTIVE--To estimate the incidence of occupational asthma seen by respiratory and occupational physicians in the UK in 1989 and 1990. DESIGN--New cases of occupational asthma were taken from a national reporting scheme, the Surveillance of Work-related and Occupational Respiratory Disease Project (SWORD). Estimates of the working population from the Labour Force Survey were used to calculate reported incidence by age group, sex, occupation, and region. SETTING--The SWORD project is a scheme for the reporting of new cases of work-related respiratory disease by thoracic and occupational physicians from throughout the UK which began in 1989. PATIENTS--In 1989 and 1990, of 4229 cases reported, 1085 (26%) were in patients with occupational asthma. MAIN RESULTS--Only half the reported cases were attributed to agents prescribed under the Industrial Injuries Scheme. There was considerable diversity in risk by occupation, with highest annual rates in welders, solderers, and electronic assemblers (175/million), laboratory workers (188/million), metal treaters (267/million), bakers (334/million), plastics workers (337/million), chemical processors (364/million), and spray painters (658/million). Crude rates in men were higher than in women, but rates within occupations were similar in both sexes. Rates of disease rose with age; adjustment for occupation increased the gradient. Regional differences were only partly explained by diversity of industry and were probably mainly due to variation in levels of ascertainment and reporting. CONCLUSIONS--Asthma is the most commonly reported occupational lung disease in the UK. The incidence in the general population is unknown, but it was estimated that the incidence of new cases seen by respiratory and occupational physicians was about three times that reported. High relative risks were found in a number of occupations in which effective control of the work environment is urgently required.     

Accidental firearm fatalities in North Carolina, 1976-80.

All accidental gunshot fatalities in North Carolina were reviewed for the years 1976-80. There were 210 cases, of which 94 were self-inflicted and 116 were inflicted by others. Young white males predominated as victims, 31 per cent under the age of 15. Sixty-five per cent of the accidents occurred in the home and 18 per cent occurred in rural, "hunting" locations. Forty-one per cent of the cases involved shotguns, 39 per cent involved handguns, and 16 per cent, rifles. Sixteen per cent of the accidents involved children playing with guns and 14 per cent involved dropped or mishandled weapons. During the same period, there were 2,553 suicides and 2,509 homicides by firearm. Gunshot fatalities are an important American public health problem.     

Traumatic occupational fatalities in the U.S. and Australian construction industries

The occupational injury experience of the U.S. and Australian construction industries for 1988–1991 was compared to identify similarities and differences in risk and to share information vital for planning strategies for prevention. There were 4,158 deaths in the U.S. and 264 in the Australian construction industries. Workers in both countries, particularly laborers, were at high risk, with mean annual rates of 13.8/100,000 and 11.6, respectively, more than double the national averages. Falls, motor vehicles, electrocutions, and machinery were the leading causes of death in both countries, and accounted for 69% of the fatalities in the U.S. and 71% in Australia. International collaborations focusing injury and fatality prevention efforts on the common leading causes and high risk groups, and sharing successful prevention experiences between countries could save the lives of many construction workers world wide. © 1996 Wiley-Liss Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Farm-related fatalities involving children in Australia, 1989-92

OBJECTIVE: To describe the types of and circumstances surrounding unintentional farm-related fatal injuries involving children aged less than 15 years in Australia. METHODS: Information concerning 115 deaths were obtained from inspection of coronial files for the period 1989-92. RESULTS: Children less than 15 years made up 20% of all unintentional farm-related fatalities in Australia, with children less than 5 years representing 63% of all child fatalities. The majority of children were fatally injured while bystanders to farm work and equipment used on the farm (including dams), with drowning the most common mechanism of the fatal incident for children aged both 5 years or less and 5-9 years. Vehicle accidents were common for children aged 10-14 years. CONCLUSIONS: Children are exposed to various hazards in the farming environment and as such are at risk of being injured. IMPLICATIONS: This study has highlighted a number of particular hazards for children on farms, with drowning, transport and tractor-related injuries of particular concern. A national strategy for child safety on farms has been developed by Farmsafe Australia aimed at providing a nationally co-ordinated plan for improving child safety on farms.     

Influenza--United States, 1989-90 and 1990-91 seasons.

During the 1989-90 influenza season, 98% of all influenza viruses isolated in the United States and reported to CDC were influenza A. Almost all those that were antigenically characterized were similar to influenza A/Shanghai/11/87(H3N2), a component of the 1989-90 influenza vaccine. Regional and widespread influenza activity began to be reported in late December 1989, peaked in mid-January 1990, and declined rapidly through early April 1990. Most of the outbreaks reported to CDC were among nursing-home residents. Considerable influenza-associated mortality was reflected in the percentage of deaths due to pneumonia and influenza (P&I) reported through the CDC 121 Cities Surveillance System from early January through early April. More than 80% of all reported P&I deaths were among persons greater than or equal to 65 years. In contrast to the predominance of influenza A during 1989-90, during the 1990-91 influenza season 86% of all influenza virus isolations reported were influenza B. Widespread influenza activity was reported from mid-January through April 1991, with regional activity extending into May. Outbreaks were reported primarily among schoolchildren, and no evidence of excess influenza-associated mortality was found. Almost all the influenza B isolates tested were related to influenza B/Yamagata/16/88, a component of the 1990-91 influenza vaccine, but were antigenically closer to B/Panama/45/90, a minor variant.     

Heat-related fatalities in North Carolina

We used medical examiner's records to identify heat-related fatalities (N=161) that occurred during the period January 1, 1977, to December 31, 2001, in North Carolina. Estimates of the population at risk were derived from US census data. Annual fatality rates increased with increases in average summer temperature and with the number of days per year at 90 degrees F or higher. Of the occupational heat-related fatalities (n=40), 45% occurred among farm laborers, many of whom died unnoticed and without medical attention.     

Work-related fatalities in the agricultural production and services sectors, 1980-1989

A total of 6,727 workers died of work-related injuries in the agricultural production and agricultural services sectors between 1980 and 1989, as established by data from the National Institute for Occupational Safety and Health (NIOSH) National Traumatic Occupational Fatalities (NTOF) surveillance system. The agricultural production sector accounted for the higher fatality rate (22.9 deaths per 100,000 workers), due largely to deaths caused by machinery and motor vehicles. The leading cause of death in the agricultural services sector was being struck by falling objects, primarily trees. Fatality rates were highest in the East South Central United States and lowest in the New England states. Blacks had the highest fatality rate (26.4 deaths per 100,000 workers) while workers other than white or black had the lowest rate (18.9 per 100,000 workers). Males were at higher risk of death than females, with the 65 years of age and older male group having the highest rate (60.5 deaths per 100,000 workers). Males 16-24 years of age exhibited the largest decrease in their average annual fatality rate during the 10-year period, down to 7.2 from 20.6 deaths per 100,000 workers. Possible reasons for this decrease are suggested.     

Farm-related fatalities among children in California, 1980 to 1989.

To evaluate farm-related deaths among children in California and to identify specific risk factors, this study used death certificate tapes to identify 40 farm-related deaths among children under age 15 in California for 1980 to 1989. Mortality rates and odds ratios for cause-specific unintentional farm deaths were calculated. While California's farm-related mortality rate was lower than those in the midwestern states studied, the rate for Hispanic boys was 70% higher than that for non-Hispanics. The odds of death from machinery (81.3), animals (10.1), electricity (5.2), and nontraffic motor vehicles (3.4) were significantly greater than those in nonfarm locations; those from drowning were significantly lower (0.2). Specific factors associated with the lower California mortality rate need to be identified.     

Arbovirus surveillance in South Carolina, 1996-98

Arboviruses isolated and identified from mosquitoes in South Carolina (USA) are described, including new state records for eastern equine encephalitis virus (EEE), St. Louis encephalitis virus (SLE), Flanders virus, Tensaw virus (TEN), and a variant of Jamestown Canyon virus (JC). Mosquitoes were collected at 52 locations in 30 of 46 South Carolina counties beginning in June 1996, and ending in October 1998, and tested for arboviruses. Of 1,329 mosquito pools tested by virus isolation (85,806 mosquitoes representing 34 mosquito species or complexes), 15 pools were positive. Virus isolations included EEE from 1 pool each of Anopheles crucians complex and Culex erraticus; a variant of JC from 1 pool of An. crucians complex; a California serogroup virus from 1 pool of Aedes atlanticus/tormentor; TEN from 5 pools of An. crucians complex and 1 pool each of Culex salinarius and Psorophora ciliata; Flanders virus from 1 pool of Culiseta melanura; and Potosi virus from 1 pool each of Aedes vexans, Coquillettidia perturbans, and Psorophora columbiae. Of 300 mosquito pools tested by antigen-capture assay for EEE and SLE (14,303 mosquitoes representing 16 mosquito species or complexes), 21 were positive for EEE and I was positive for SLE. Positive EEE mosquito pools by antigen-capture assay included An. crucians complex (14 pools), Anopheles punctipennis (1 pool), Anopheles quadrimaculatus (1 pool), Cq. perturbans (4 pools), and Cs. melanura (1 pool). One pool of Cx. salinarius was positive for SLE by antigen-capture assay. Arbovirus-positive mosquito pools were identified from 12 South Carolina counties, all located in the Atlantic Coastal Plain, and from 4 of 8 Carolina bays surveyed.     

Pregnancy-induced hypertension in North Carolina, 1988 and 1989.

INTRODUCTION. Pregnancy-induced hypertension (PIH) is a highly prevalent pregnancy complication with adverse effects on maternal and infant health. Epidemiologic research concerning its etiology is limited. METHODS. Birth records from North Carolina for the period 1988 through 1989 included an indication of the presence of PIH. The risk of PIH was examined in relation to several maternal characteristics and exposures, including reproductive history, demographic characteristics, and tobacco use during pregnancy. Risk ratio estimates, adjusted for confounders, were calculated contrasting PIH among exposed vs unexposed women. RESULTS. The overall risk of PIH was 43.1 per 1000 births, with multiple pregnancies, nulliparity, and advanced maternal age associated with markedly increased risks. Tobacco use was inversely associated with PIH, and Blacks and Whites were at virtually equal risk. CONCLUSIONS. Problems in diagnosis and classification impede research in this area, with birth certificates limited in quality and breadth of information. Nonetheless, several patterns emerged that are worthy of further epidemiologic evaluation using more sophisticated designs.     

Medical-examiner-reported fatal occupational injuries, North Carolina, 1978-1984

Fatal occupational injuries are a major public health problem in the U.S. Utilizing a medical examiner database from North Carolina, 1,233 fatal work-related injuries were identified in a 7-year time period. Twelve percent of these deaths were in out-of-state residents. For men, highest risk industries were forestry/fishery, agriculture, trade, and transportation/public utilities/communications. Only 4% of deaths occurred in women. The most common manner of death in women was homicide. Highest-risk industries for women were agriculture, trade, and transportation/public utilities/communications. Of 902 decedents tested, alcohol was found in 11%, and 7% had levels at or above 100 mg%. Because of its completeness, the North Carolina Medical Examiner System is a useful tool to use in the surveillance of fatal occupational injuries.     

Fire- and flame-related occupational fatalities in the United States, 1980-1994

The National Traumatic Occupational Fatalities surveillance system recorded 1518 fire- and flame-related occupational fatalities among the civilian workforce in the United States between 1980 and 1994. The fatalities resulted from 1221 separate incidents, of which 122 involved more than one victim and accounted for 419 of 1518 deaths. Nearly 4 of 10 fatalities resulting from a multiple-victim fire were workers in the manufacturing industry. Similarly, the highest frequency of fatalities in single-victim events, over one fourth, were in manufacturing. For one fourth of the fatalities within each event category, the usual occupation of the deceased was a precision production, craft, and repair worker. Although this study sheds light on selected characteristics of these fatalities, additional research on the causal factors associated with single- and multiple-victim events is needed to present specific recommendations for prevention efforts.     

Assessment of occupational exposure to cadmium in The Netherlands, 1980-1989.

One thousand five hundred fifty urine samples and 1,295 blood samples, collected from 919 workers, were analyzed for cadmium (Cd). The workers were employed at 16 different types of workplaces. In about 7.5% of the samples, the concentration of Cd exceeded the biological limit values proposed by the Dutch Expert Committee for Occupational Standards. Levels higher than these values were measured in both urine samples and blood samples of workers involved in electrochemical plating, in production of Cd-stabilizers and enamels, and in soldering with silver-cadmium solder. Significantly higher concentrations of beta 2-microglobulin (MG) were found in urine samples with CdU greater than 10 micrograms/g creatinine. Cd levels in urine increased with age.     

Dengue type 1 epidemic with haemorrhagic manifestations in Fiji, 1989-90.

A dengue type 1 epidemic occurred in Fiji between July 1989 and July 1990. Virus isolation in C6/36 cell cultures and Toxorhynchites mosquitos yielded 36 strains. Of the 3686 cases recorded by the Ministry of Health, 60% involved indigenous Fijians and 37%, Indians. A house-to-house survey revealed that a large majority of patients had classical dengue symptoms and 8% reported haemorrhagic manifestations. Among the children and adults hospitalized for dengue, 43% had haemorrhagic manifestations, including epistaxis, gingival bleeding, haematemesis, melaena and haematuria. A total of 15 patients with haemorrhagic manifestations and/or shock died, 10 of whom were aged 0-15 years; the diagnoses were confirmed in four cases by virus isolation or serology.     

Traumatic work related fatalities in commercial fishermen in Australia.

OBJECTIVES--To describe the types and circumstances of traumatic work related fatalities in Australian commercial fishermen. METHODS--Work related traumatic fishing fatalities were studied as part of a larger study of all work related traumatic fatalities in Australia from 1982 to 1984. Data on 47 cases were obtained from inspection of coroners' files. RESULTS--The incidence of fatality of 143/100,000 person-years was 18 times higher than the incidence of fatality for the entire workforce, and considerably higher than that of the mining and agricultural workforces. 68% of decedents drowned and 13% died from physical trauma. Rough weather, non-seaworthy vessels, inadequate use of personal flotation devices, and inexperience were associated with many of the fatal incidents. DISCUSSION--Improved vessel and equipment maintenance, better training of workers, greater use of personal flotation devices, and development of improved clothing and personal flotation devices are recommended.