If we want more evidence-based practice, we need more practice-based evidence.*
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If we want more evidence-based practice, we need more practice-based evidence.* |
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Chapter 16 Table of Contents OVERVIEW
HEADLINES, TIMELINES, & MILESTONES STUDY QUESTIONS, ACTIVITIES, AND EXERCISES Communities can organize their programs and environmental standards and controls most efficiently around settings in which people live, work and play. Housing and worksites remain private preserves in most societies, but community, state and national governments have as much responsibility to assure their safety in construction and structural maintenance as they do for public recreational environments and open roads. The objective of this chapter, besides those stated at the beginning of the chapter, is to understand the commonalities and differences among and between environmental settings as they must be regulated to protect health. Our look at epidemiology of housing and health leads to the conclusion that crowding and lead paint are less problematic today than in the past, but indoor pollution and homelessness are greater problems than in past decades. The section on occupational health identifies the epidemiology of workplace hazards and various strategies for their reduction, including educational, technological, legislative, regulatory, economic, and health service measures. The issues in recreational environments center on smoking in public places, swimming pool and boat safety, and the sanitation of hot tubs. HEADLINES, TIMELINES, & MILESTONES Employers offering more smoking cessation support following CMS decision. Wall Street Journal, Apr 26, 2005. Senator Harkin introduces Healthy Workforce bill. Apr 22, 2005. congressvote.html W.Va. Health Workers Report Most Serious On-Job Injuries. July 16, 2003Rhode Island to Press Its Lawsuit on Lead Paint. Off-the-Job Drinking Predicts Later On-the-Job Injury. Sept. 16, 2002California Needle Safety Law Will Go Into Effect July 1. SAN FRANCISCO (SF Chronicle, June 18, 1999). The California state Occupational Safety and Health Standards Board approved the first US state regulation requiring the use of safety needles to protect health care workers from potentially deadly infections.OSHA to Consider New Needle Rules. WASHINGTON (AP, May 21, 1999) – The Occupational Safety and Health Administration will consider requiring hospitals and health care facilities to use safety devices that could reduce needlestick injuries to workers. OSHA Administrator Charles N. Jeffress said Thursday that the agency, this fall, will being considering whether new requirements on safety devices are necessary to reduce potentially dangerous needlestick injuries to the nation's 5.6 million health care workers. The announcement coincided with the release of an OSHA report, based on comments from 400 health care workers and facilities, that said safety devices aren't being used widely enough to substantially reduce the 590,000 needlestick injuries each year.New Mosquito Killer Hitting Market . EAST GREENWICH, R.I. (AP, Mar 16, 1999) - Bruce Wigton was swatting mosquitoes during a fishing trip in 1990 when he began to plot his revenge against the bloodsucking bugs. Nine years later, Wigton has come up with the Mosquito Magnet, a device that lures mosquitoes to what they think is a hemoglobin snack, but instead sucks them into a bag where they die. American Biophysics, which has worked with the U.S. Department of Agriculture in developing the product, is selling the Mosquito Magnet to resorts in Florida and the Caribbean. The next step is completing the design of a smaller, cheaper unit that "the average person can get into his back yard," said Wigton, chairman and director of research and development at the East Greenwich-based company. See full story:
Report: Salad Bar Spawned E. Coli. OMAHA, Neb. (AP, Mar. 10, 1999) - An E. coli bacteria outbreak that sickened 10 people has been traced to a restaurant salad bar, health officials said. At least eight additional cases may be linked to the Golden Corral restaurant in Kearney, 185 miles west of Omaha. Five people, including a 79-year-old woman and a 6-year-old boy, were hospitalized, although none was critically ill. The confirmed cases all involved E. coli O157:H7, state health department spokeswoman Marla Augustine said Tuesday. That particular strain attacks the digestive tract and, in severe cases, can cause kidney failure and death. The suspected source was contaminated lettuce in the salad bar, said Mike Kutch, president of Tri-Golden Management of Evergreen, Colo., which owns the restaurant. "Once (the outbreak) was brought to our attention, we've been cooperating with the health department," said Kutch. "It's a bad thing to happen." State Epidemiologist Thomas Safranek said all those sickened were in the Kearney area during the weekend of Feb. 26-28.Is Big Better When It Comes to Housing (Universal Press Syndicate March 14, 1998). What's in a Number? Demographics Tell a Multifold Investing Tale. (International Herald Tribune April 6,1997). Basis statistics tell tales of what is going on in the work-force. The number of working women has stalled in the 1990s and this has an impact on the economy. All the Comforts of Home. (AARP Bulletin October 1996). More and more people are working at home. It is difficult to estimate how many people are spending more work time at home, but experts agree that the number is growing fast.
WEB PAGES AND INFORMATION SOURCES
Journals Marsalek, Jiri; Sztruhar, Daniel; Giulianelli, Mario; Urbonas, Ben (Eds.). Enhancing Urban Environment by Environmental Upgrading and Restoration. New York, Springer, 2005. Cullen, M. R. (1999). Personal Reflections on Occupational Health in the Twentieth Century: Spiraling to the Future. ANNUAL REVIEW OF PUBLIC HEALTH 20: 1-14. Geyer, S., & Peter, R. (1999). Occupational health. Occupational status and all-cause mortality. A study with health insurance data from Nordrhein-Westfalen, Germany. EUROPEAN JOURNAL OF PUBLIC HEALTH 9 (2): 114-118. Farm Worker Illness Following Exposure to Carbofuran and Other Pesticides --- Fresno County, California, 1998. MORBIDITY AND MORTALITY WEEKLY REPORTS, February 19, 1999/Vol. 48/No. 6. Go to: http://www.cdc.gob/mmwr/preview/mmwrhtml/00056485.htm Spira, A. & Multigner, L. (August 1998). Debate. Environmental factors and male infertility. The effect of industrial and agricultural pollution on human spermatogenesis, HUMAN REPRODUCTION, 13(8):2041-2042.
Tisdale, J.A., Sofge, C.W. Observations from the CDC: Women and Work: Highlights of NIOSH Research. JOURNAL OF WOMEN’S HEALTH. AUG 01 1998 v 7 n 6: 651-59. Wynn, M. & Wynn, A. Fortification of Grain Products with Folate: Should Britain Follow the American Example. NUTRITION AND HEALTH. 1998 v 12 n 3, 147. When Cancer Comes To Work. Business & Health. JUL 01 1998 v 16 n 7, 34.
Diamond, Jared. (2005). Collapse: How Societies Choose to Fail or Succeed. New York: Viking Books, 560 pp. $29.95. The review by Troy Jollimore in the San Francisco Chronicle, Jan. 9, 2005, p. E1, is titled: "How societies commit suicide," and features the book author's "guided tour of failed human societies that will motivate us, he hopes, not only to try to save our own society from catastrophic collapse, but will also provide us with the knowledge and insight to succeed." Diamond is also the author of the Pulitzer Prize-winning best seller, "Guns, Germs and Steel." This book reviews the collapse of societies such as the failed societies of Easter, Henderson, and Pitcairn islands, the Norse population of Greenland, and the most recent societal collapse of Rwanda. He points to the ecological collapse the precedes and accompanies the societal collapse, and how some other societies are at a crossroad in their own survival ecologically and socially, namely China, Australia, and Haiti, which contrasts starkly from the success of the Dominican Republic at the other end of the same island of Hispanola. Wallace, R., & Wallace, D. (1999). A Plague on Your Houses: How New York Was Burned Down and National Public Health Crumbled. New York & London: Verso Press.
Other References Frankish, C.J., & Green, L.W. (1999). Worksite Smoking Cessation Interventions. Chap. 6 in Green, L.W., Frankish, C.J., McGowan, P., Ratner, P., Bottorff, J., Lovato, C.Y., Shoveller, J., Johnson, J., Williamson, D. (Eds.), SMOKING CESSATION: A SYNTHESIS OF THE LITERATURE ON PROGRAM EFFECTIVENESS. Vancouver: University of British Columbia Institute of Health Promotion Research, for the BC Ministry of Health. Achievements in Public Health, 1900--1999: Improvements in Workplace Safety --- United States, 1900--1999. Morbidity and Mortality Weekly Reports 48(22), June 11, 1999.http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4822a1.htm At the beginning of this century, workers in the United States faced remarkably high health and safety risks on the job. Through efforts by individual workers, unions, employers, government agencies, scientists such as Dr. Alice Hamilton (see box, page 462), and others, considerable progress has been made in improving these conditions. Despite these successes, much work remains, with the goal for all workers being a productive and safe working life and a retirement free from long-term consequences of occupational disease and injury. Using the limited data available, this report documents large declines in fatal occupational injuries during the 1900s, highlights the mining industry as an example of improvements in worker safety, and discusses new challenges in occupational safety and health. References cited: 1. Eastman C. Work-accidents and the law. New York, New York: Russell Sage Foundation, Charities Publications Committee, 1910. 2. Bureau of Labor Statistics, US Department of Labor. Table A-1. Fatal occupational injuries by industry and event or exposure, 1997. Available at http://www.bls.gov/cfoi/cfb0103.pdf . Accessed June 9, 1999. 3. National Safety Council. Accident facts, 1998 edition. Itasca, Illinois: National Safety Council, 1998. 4. Corn JK. Response to occupational health hazards: a historical perspective. New York, New York: Nostrand Reinhold, 1992. 5. CDC. Fatal occupational injuries--United States, 1980-1994. MMWR 1998;47:297-302. 6. Stout NA, Jenkins EL, Pizatella TJ. Occupational injury mortality rates in the United States: changes from 1980 to 1989. AmJ Public Health 1996;86:73-7. 7. Skow ML, Kim AG, Duel M. Creating a safer environment in U.S. coal mines: the Bureau of Mines methane control program, 1964-79. Washington, DC: US Department of the Interior, Bureau of Mines, May 1981 (report no. 5-81). 8. Bonnie RJ, Fulco CE, Liverman CT, eds. Reducing the burden of injury: advancing prevention and treatment. Washington, DC:Institute of Medicine, National Academy Press, 1999. 9. National Institute for Occupational Safety and Health. Assessing occupational safety and health training: a literature review. Cincinnati, Ohio: US Department of Health and Human Services, CDC, 1998; DHHS publication no. (NIOSH)98-145. 10. National Institute for Occupational Safety and Health. Preventing homicide in the workplace. Cincinnati, Ohio: US Department of Health and Human Services, CDC, 1993; DHHS publication no. (NIOSH)93-109. 11. National Institute for Occupational Safety and Health. Traumatic occupational injury research needs and priorities. Cincinnati, Ohio: US Department of Health and Human Services, CDC, 1998; DHHS publication no. (NIOSH)98-134. Foodborne Botulism Associated With Home-Canned Bamboo Shoots -- Thailand, 1998. Morbidity and Mortality Weekly Report 48 (21), June 4, 1999 http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4821a1.htmOn April 13, 1998, the Field Epidemiology Training Program in the Thailand Ministry of Public Health (TMPH) was informed of six persons with sudden onset of cranial nerve palsies suggestive of botulism who were admitted to a provincial hospital in northern Thailand. To determine the cause of the cluster, TMPH initiated an investigation on April 14. This report summarizes the results of the investigation, which indicate that the outbreak was caused by foodborne botulism from home-canned bamboo shoots. References cited: 1. Shapiro RL, Hatheway C, Swerdlow DL. Botulism in the United States:a clinical and epidemiologic review. Ann Intern Med 1998;129:221-8. 2. St. Louis ME. Botulism. In: Evans AS, Brachman PS, eds. Bacterial infections of humans: epidemiology and control. 2nd ed. New York, New York: Plenum Medical, 1991:115-26. 3. Villar RG, Shapiro RL, Busto S, et al. Outbreak of type A botulism and development of a botulism surveillance and antitoxin release system in Argentina. JAMA 1999;281:1334-8,1340. 4. Shapiro RL, Hatheway C, Becher J, Swerdlow DL. Botulism surveillance and emergency response: a public health strategy for a global challenge. JAMA 1997;278:433-5. STUDY QUESTIONS, ACTIVITIES, AND EXERCISES STUDY QUESTIONS, ACTIVITIES, AND EXERCISES 1. Indoor pollution. Plan a community program to address the problems of a) inadequate ventilation in well insulated homes, and b) improper indoor storage of household and garden chemicals. In addition to the list of indoor pollutants listed in the first boxed issue, consider others like diesel and gasoline fumes, car exhaust and carbon monoxide from attached garages, lawn and garden pesticides, bleaches and cleaning materials, pest strips, insecticides, and chemicals for jacuzzis and swimming pools. 2. Deinstitutionalized mental patients. Determine the incidence and prevalence of homelessness in your community and then identify available shelters, half-way houses, and referral services. Does your community provide adequate housing for battered women? abused children? the elderly? the migrant worker? What recreational facilities are there for children and adults? 3. The economics of housing. What kind of housing is provided in your community for the poor and those without shelter? Who manages low-income housing and shelters? What is the lived experience of these places? What are the qualifications to live in them? Contacting an organization such as Habitat for Humanity (information at the end of this chapter) to explore other kinds of housing alternatives. 4. Housing and preparedness. Natural and human causes of building destruction can be explored to better understand safety features of homes, offices and other structures. Where are the safest places to be indoors in the event of an earthquake, tornado or hurricane? Why? Where should smoke detectors be placed in homes to be most effective? Locate smoke detectors at home to determine if there is adequate placement. 5. Occupational environments. What are the major employers in your community and the kinds of occupational health concerns that result? Contact the occupational health and safety officer at one of these organizations to understand how occupational health is assured at their organization.
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