Chemical mutagenesis: an emerging issue for public health.

Chemical mutagens are recognized as prevalent in the environment and a potential threat to the health of future generations. This paper presents an overview of chemical mutagenesis as an issue for public health. Several problems in the determination of risk to human populations are discussed, including difficulties of extrapolating scientific data to humans, the latency period between exposure and recognizable genetic damage, and the large number of chemicals which must be tested. Test systems are described. Possibilities of control through federal regulation are discussed.     

Identifying workers at risk for high health care expenditures: a short questionnaire.

The objective of this study was to create and measure the predictive accuracy of a brief questionnaire for screening new workers to identify those at increased risk for generating high health care insurance expenditures during the following year. Such an instrument could help health plans and providers intervene to mitigate the health risks of identified high-risk workers. We mailed a 53-item questionnaire to members of a "derivation cohort" (adult food processing workers, n = 15496) and obtained records of the eligible respondents' health insurance expenditures during the following year. Using multiple linear regression, we identified eight of the questions that predicted future expenditures most accurately, and created a formula to predict total expenditures from answers to these questions. To validate the formula's predictive accuracy, we used the eight-item questionnaire to survey two "validation cohorts" (transportation workers, n = 7445; and their dependents, n = 5562), inserted responses into the scoring formula, classified respondents into high-risk (top 10%) or low-risk (lower 90%) groupings, and then compared health insurance expenditures generated by the high- and low-risk groups during the following year. In the derivation cohort, age, sex, regular use of medications, frequent visits to physicians, and having arthritis, diabetes, cancer, or high cholesterol predicted future health care expenditures. In the worker and dependent validation cohorts, the respondents classified by the formula as high-risk generated insurance expenditures during the following year that were 2.4 and 1.8 times greater than those generated by the members of the low-risk groups (p < 0.001). An eight-item questionnaire and its scoring formula can identify high-risk groups of workers that will generate high health care expenditures during the following year. Healthcare organizations could use this questionnaire to help target new workers for care management and disease management interventions.     

Family health: an emerging paradigm for social workers

The profession of social work has, since its inception, stressed the importance of the family system in social treatment. Even though the family has always been central to effective social work intervention, the framing of the family system from a family health perspective is new to the field. The goal of this paper is to present the empirical grounding of family health and the implications of this emerging paradigm for social policy. Family health is built on the biopsychosocial model and emphasizes the importance of the role of the family system in the social functioning of individuals. Family health is defined (Pardeck and Yuen, 1999, p. 1) "as a state of holistic well-being of the family system. Family health is manifested by the development of, and continuous interaction among, the physical, mental, emotional, social, economic, cultural and spiritual dimensions of the family which results in the holistic well-being of the family and its members."     

新发和再肆虐虫媒病毒病是当前面临的重要公共卫生问题

虫媒病毒（Arbovirus）是指一些通过吸血的节肢动物叮咬敏感的脊椎动物而引起的自然疫源性疾病及人兽共患病的一群病毒。蚊虫和蜱是最重要的传播媒介,鸟类、蝙蝠、灵长类和家畜是最重要的脊椎动物宿主。目前,一些虫媒病毒仍在世界各地引起严重的传染病流行,甚至导致死亡以及巨大的经济损失,成为日益严重的世界性公共卫生问题。     

Smoking behavior among US Latinos: an emerging challenge for public health.

In this paper we review evidence on smoking and lung cancer among Latinos, including findings from several unpublished studies and technical reports. Recent surveys of smoking behavior in California, Texas, and New Mexico indicate a notable sex difference in smoking among Latinos, with Latino males smoking at least as frequently as White males, while Latino females report smoking rates considerably lower than White females. Our analysis of the 1979 and 1980 National Health Interview Surveys corroborates this finding and also indicates that this pattern holds true for subgroups of the Latino population, including country of origin. Taken together, these findings suggest that among Latino males rates of lung cancer and other cigarette-linked diseases may increase in the near future.     

Bedbug infestations in the news: a picture of an emerging public health problem in the United States

Bedbug (Cimex lectularis) infestations have become a major complaint in all but three states in the United States. Increasing infestations have also been reported in Asia, Australia, Europe, and Canada. Newspaper articles often herald the onset of a new health issue for the public, and they can be used for epidemiological tracking of increasing populations of irritating and potentially serious vectoring pests. This news coverage model is useful in validating the typical spread of a new contagious entity, or in predicting the waves of public reaction to the spread of a new pest or health problem. The authors' analysis covers the years 2001 to 2006, showing the incidence of bedbug news coverage from the East Coast, the Midwest, the South, and the West in the United States. Rural and urban examples are included in a four-year time frame starting with news in the Northeast and ending with an attempt to eradicate the pest from the state of Hawaii.     

Alcohol consumption by refuse collection workers: a problem of public health]

A total of 485 workers were interviewed employed by the municipal urban refuse collection corporation of Venice; 87.6% consumed alcoholic beverages, 24.5% of whom exceeded 1 litre of wine per day. Only 9.7% of the interviewees thought that an acceptable alcohol consumption level should not exceed 1 litre, whereas more than 23% thought that 2 or more litres of wine per day was not harmful. The variables associated with a high alcohol consumption in this working community were mainly: level of education and of specific knowledge about alcohol and long-term residence in the historical centre of Venice. The authors discuss the possible factors connected with the type of job which could influence the incentive to drink and the public hygiene actions that could be taken. The need for community medicine programmes is emphasized.     

Drake Chemical Workers' Health Registry Study: I. Notification and medical surveillance of a group of workers at high risk of developing bladder cancer

A medical surveillance program and epidemiologic study of 408 former workers of the Drake Chemical Company (now a Superfund waste site) was established in 1986. The Drake Health Registry Study was initiated because these workers had probable past exposures to beta-naphthylamine (BNA), a potent bladder carcinogen. The registry is widely viewed as a model for notification of workers at high risk of disease due to past occupational exposures. By the 40th month, 90% of the 366 living workers had been notified of the existence of the registry; 262 had been enrolled in the annual or semi-annual screening for bladder cancer. Among these, 27 persons have had abnormal screening results indicating moderate to high risk of bladder cancer and have been made eligible for further diagnostic tests. While no invasive bladder tumors were found among 18 persons completing the extended diagnostic evaluation, two diagnoses of moderate to severe dysplasia have been made. The registry has also identified three living and three deceased cases of bladder cancer in the cohort; a mortality analysis showed a 20- to 30-fold excess of bladder cancer. An incidence projection, based on the six identified cases, reveals that between six and ten new bladder cancer cases are likely to occur among the Drake cohort over the next 20 year period.     

Age-related eye diseases: an emerging challenge for public health professionals

In April 2004, The Eye Disease Prevalence Research Group published a series of articles that included age-specific estimates for the prevalence of low vision and blindness in whites, African Americans, and Hispanics living in the United States. Also included were age-, sex-, and ethnic-specific incidences of the following age-related eye diseases: diabetic retinopathy, macular degeneration, cataracts, and glaucoma. We reviewed the group's series of articles and highlighted key findings on the overall prevalence of and risk factors for age-related eye diseases, as well as opportunities to preserve and restore vision. We examined publications that show the public health impact of age-related eye diseases and the importance of projected increases in prevalence of low vision and blindness. Approximately 1 in 28 Americans aged older than 40 years is affected by low vision or blindness. Among community-dwelling adults, the prevalence of low vision and blindness increases dramatically with age in all racial and ethnic groups. Whites have higher rates of macular degeneration than African Americans, but glaucoma is more common among older African Americans. Between 2000 and 2020, the prevalence of blindness is expected to double. Age-related eye diseases are costly to treat, threaten the ability of older adults to live independently, and increase the risk for accidents and falls. To prevent vision loss and support rehabilitative services for people with low vision, it is imperative for the public health community to address the issue through surveillance, public education, and coordination of screening, examination, and treatment.     

Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age

Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.     

Child maltreatment in Canada: an understudied public health problem

Child maltreatment is a major public health problem associated with impairment in childhood, adolescence, and extending throughout the lifespan. Within Canada, high-quality child maltreatment studies have been conducted and are critical for informing prevention and intervention efforts. However, compared to other parts of the world (e.g., United States, United Kingdom, the Netherlands, and Mexico), the number of studies conducted in Canada is far fewer and the data used to study this important public health problem are less diverse. Importantly, to date, representative data on child maltreatment from the general population at the national level in Canada do not exist. This means that many questions regarding child maltreatment in Canada remain unanswered. To advance our understanding of child maltreatment in Canada and to make significant strides towards protecting Canadian children and families, research using Canadian data is essential. To begin to meet these important public health goals, we need to invest in collecting high-quality, nationally representative Canadian data on child maltreatment. Solutions for the barriers and challenges for the inclusion of child maltreatment data into nationally representative Canadian surveys are provided.     

Homicide in New Zealand: an increasing public health problem

Abstract: Injury purposely inflicted by other persons is a significant public health problem as well as a criminal problem. It accounts for approximately 3 per cent of all deaths from injury in New Zealand. National injury mortality data for the period 1978 to 1987, supplemented by reference to files of the Coroner's Court and the High Court, were used to identify the characteristics of victims of homicide, the nature of the injuries they sustained, and the circumstances in which the injuries were inflicted. The mortality rate from homicide for the 10-year period was 1.6 per 100 000 persons per year. A significant increase in the rate of homicide was identified. The rates for males were higher (2.0) than those for females (1.2), with those 20 to 24 years of age most at risk. Maori had higher rates than non-Maori. Homicides were most frequently committed with cutting and piercing instruments, and most commonly occurred in private homes. Homicides were most likely to occur on Fridays or Saturdays, between the hours of 6 p.m. and 6 a.m. In 55 per cent of homicides the victim and assailant were known to one another. Unemployment, membership of ethnic minority groups, availability of weapons, the private nature of interactions in the home, alcohol consumption, and stress in personal relationships were all identified as factors associated with homicide in the decade under study. The implications of these findings for the prevention of injury from assault are discussed.