The value of comparing mortality of Guillain-Barré syndrome across different regions.

OBJECTIVE: To study the clinical profile of Guillain-Barré syndrome (GBS) patients who died in 4 Asian countries in order to understand factors underlying any variation in mortality. METHODS: Retrospectively reviewed medical records of GBS patients who died in 7 hospitals from 4 Asian countries between 2001 and 2012. Baseline characteristics, timing and causes of death were recorded. RESULTS: A total of 16 out of 261 GBS patients died. The overall mortality rate was 6%, with a range of 0 to 13%. The leading causes of death were respiratory infections, followed by myocardial infarction. The median age of our patients was 77 years. Half of the patients required mechanical ventilation and almost all had significant concomitant illnesses. A disproportionate number of patients in the Hong Kong cohort died (13%). Patients with advanced age, fewer antecedent respiratory infections and need for mechanical ventilation were at most risk. Most deaths occurred during the plateau phase of GBS and on the general ward after having initially received intensive care. CONCLUSIONS: There is considerable variability in mortality of GBS among different Asian cohorts. Although the risks factors for mortality were similar to Western cohorts, the timing and site of death differed. This allows specific measures to be implemented to improve GBS care in countries with higher mortality.

Management, disposal and recycling of waste industrial organic solvents in Hong Kong.

An attempt has been made to establish a mass balance of industrial organic solvents in Hong Kong. It is estimated that only a small portion, less than 4%, of all the organic solvents consumed in Hong Kong are collected as waste solvents and properly treated, while the remainder are used either in the formulation of solvent containing products, or are lost to the environment through vapour emissions, leaks and spills, or dumped illegally. It was found that solvent recycling has been a common practice in some industries but the existing level of solvent recycling in Hong Kong is difficult to estimate. About 87.4% of all the waste organic solvents disposed of at the licensed facilities are potentially recyclable although whether they can be recycled in practice depends on many factors. Examples of existing waste organic solvent management and recycling practices from selected industries in Hong Kong are presented. The economic feasibility of current and future potential recycling systems is evaluated for a few selected cases. An integrated waste organic solvent management strategy is proposed to minimize adverse impacts of organic solvents to the environment and human health.