Age and gender patterns in motor vehicle crash injuries: importance of type of crash and occupant role.

To evaluate the interaction of gender, age, type of crash, and occupant role in motor vehicle crash injuries leading to hospitalization, we analyzed 1997 Wisconsin hospital discharge data for patients with primary E-code diagnoses of motor vehicle injuries. The overall ratio of males to females (M/F ratio) hospitalized for motor vehicle crash injuries was 1.33 (95% confidence interval (CI): 1.26-1.41). The M/F ratio varied by type of crash and differed for passengers and drivers. For injuries sustained in collisions between vehicles, the M/F ratio was 0.96 (95% CI: 0.87-1.05); in loss of control accidents the M/F ratio was 1.95 (95% CI: 1.76-2.17). Within each type of crash, the M/F ratio for drivers was similar to that for the entire type; the M/F ratio for passengers was about half of the type total. Expressed as rates of hospitalization per 100,000 people in the general population, hospitalizations of drivers in collisions with another motor vehicle increased steeply in males, but not in females, beginning at about age 70. For drivers in loss of control crashes, male rates exceeded female rates in all age groups, with peaks in the groups 15-24 and 85-89. For passengers, injury rates from collisions with other motor vehicles were greater for females, especially in the elderly, and injury rates from loss of control crashes were similar for both genders, with peaks at 15-24 and 85-94. The higher fatality of men in loss of control motor vehicle crashes, compared to women, suggests an important area for further investigation.

Evaluation of a local cooperative project to improve postoperative pain management in Wisconsin hospitals.

The effectiveness of a local collaborative quality improvement project in improving the management of postoperative pain for Wisconsin Medicare patients was assessed. Six quality indicators were evaluated on the basis of baseline data from 714 subjects at 15 collaborating hospitals and follow-up data from 406 subjects from the same 15 hospitals. After efforts to improve postoperative pain management, there was statistically significant improvement in all six quality indicators.

Hospitalizations for vehicle associated injuries in Wisconsin.

Computerized data from the Wisconsin Office of Health Care Information (OHCI) was utilized to evaluate the epidemiology of vehicle associated injuries treated in acute care Wisconsin hospitals in 1997. There were 6043 vehicle associated injuries which required hospitalization in Wisconsin in 1997, a rate of 141 per 100,000 males and 91 per 100,000 females. Seventy-eight percent of these were motor vehicle traffic related (8% of which involved collisions with pedestrians), 9% were motor vehicle non-traffic related and 6% were pedal cycle related. This study demonstrates how the risk of these various types of vehicle related injuries varied with age, gender, and county of residence, and describes the distribution of morbidity associated with each type. The information described in this paper may be useful in developing hypotheses regarding the causes of vehicle related injuries in Wisconsin, and ultimately lead to the development of interventions which will decrease morbidity, mortality, and costs due to vehicle related injuries.

Age- and gender-adjusted comparison of Wisconsin native mortality with general Wisconsin population, for diabetes and diabetes-related causes of death--1986-1995.

UNLABELLED: To compare mortality for diabetes and diabetes-related causes in Native American (NA) with total mortality for Wisconsin population by age, and gender. METHODS: Adjusting for age and sex, standardized mortality ratios (SMRs) were calculated for Wisconsin Native Americans for 1986-1995, using the 1990 total Wisconsin population as a reference and death certificate data to count and categorize deaths. RESULTS: Statistically significant high NA SMRs were found for total deaths (SMR = 1.28, p < .005), diabetes (SMR = 2.87, p < .005), heart disease (SMR = 1.16, p < .005), and kidney disease (SMR = 2.72, p < .005). There was substantial concordance in SMRs between men and women. NA SMRs were above 1 for all five year age groups below 75. Comparisons are provided with national data. CONCLUSION: Mortality due to diabetes mellitus, heart disease and kidney disease are higher among Native Americans in Wisconsin for all age groups below 75 and in both genders.

Concentrations of blood and hair mercury and serum PCBs in an Ojibwa population that consumes Great Lakes region fish.

OBJECTIVE: This paper describes an exposure assessment of an American Indian population using blood and hair samples as indicators of mercury and polychlorinated biphenyl exposure from the consumption of fish taken from the Great Lakes region. METHODS: Questionnaires regarding fish consumption were completed by 89 Ojibwa tribal members. Mercury concentrations were determined in human hair and blood samples, and polychlorinated biphenyl concentrations were determined in serum. RESULTS: Fish were consumed at the highest rates in April, May, June, and July. Lake trout, whitefish, and walleye were the preferred fish consumed by 91.4% of the respondents. Concentrations of blood mercury were all below 55 micrograms/L (ppb), while concentrations of mercury in hair were all less than 3 mg/L (ppm). Hair mercury concentrations were correlated with the previous year's fish consumption (p = .05). Dental amalgams and blood mercury concentrations were also significantly correlated (p < .002). Serum polychlorinated biphenyl concentrations, determined as the sum of 89 congeners, were all below 9.6 ppb total polychlorinated biphenyls. Subject age and total serum polychlorinated biphenyls were correlated (p < .001). CONCLUSIONS: The concentrations of mercury and polychlorinated biphenyls in this Ojibwa population were relatively low, but several individuals were identified as having elevated concentrations and additional testing may be warranted. Since the accumulation of contaminants was related to fish consumption and age, a long-term monitoring program that assesses chronic exposure to fish diets would be beneficial.

Salmonella enteritidis outbreak in a restaurant chain: the continuing challenges of prevention.

In 1990, a Salmonella enteritidis (SE) outbreak occurred in a restaurant chain in Pennsylvania. To determine its cause(s), we conducted a case-control study and a cohort study at one restaurant, and a survey of restaurants. Egg dishes were associated with illness (P = 0.03). Guests from one hotel eating at the restaurant had a diarrhoeal attack rate of 14%, 4.7-fold higher than among those not eating there (P = 0.04). There were no differences in egg handling between affected and unaffected restaurants. Eggs supplied to affected restaurants were medium grade AA eggs from a single farm, and were reportedly refrigerated during distribution. Human and hen SE isolates were phage type 8 and had similar plasmid profiles and antibiograms. We estimate the prevalence of infected eggs during the outbreak to be as high as 1 in 12. Typical restaurant egg-handling practices and refrigeration during distribution appear to be insufficient by themselves to prevent similar outbreaks.

Two successive outbreaks of Clostridium perfringens at a state correctional institution.

An outbreak of acute gastrointestinal illness of short duration involving 100 inmates at a correctional institution followed a similar outbreak among the same population by eight days. Clostridium perfringens was the specific etiology in both outbreaks; the vehicle was roast beef in the first outbreak, ham in the second. Direct observation of food handling practices revealed that the meats were not cooled quickly enough following cooking; not reheated adequately prior to serving, and; held at improper temperatures prior to serving.

Outbreak of illness due to volatilized asphalt coming from a malfunctioning fluorescent lighting fixture.

We investigated an outbreak of headache, eye irritation, sore throat, nasal congestion, and nausea in an office complex, ongoing for three months and regularly resolved upon leaving the building. Investigation suggested that the etiology of the illness was malfunctioning fluorescent light ballasts , which overheated and resulted in melting and volatilization of contained asphalt . Correction of the problem resulted in almost complete disappearance of symptoms within two weeks.

Effect of maternal weight gain on fetal, infant, and childhood death and on cognitive development.

The effect of maternal weight gain during pregnancy on fetal, infant, and childhood death and on cognitive development was analyzed by examining the conception products of 2590 women who participated in the Child Health and Development Studies of the School of Public Health, University of California, Berkeley. Although there was a strong inverse association between maternal weight gain and fetal and neonatal death, the implications of this are uncertain and are herein discussed. When the analysis was confined to pregnancies with gestational periods greater than 35 weeks, there was no effect of maternal weight gain on fetal, neonatal, infant, or childhood death. Children whose mothers gained between 5 and 29 lb during their pregnancy scored higher on the Raven Coloured Progressive Matrices test at age 5 than did those whose mothers gained less than 5 or more than 29 lb. Within the 5- to 29-lb group there were no significant differences in test scores among the different categories of maternal weight gain.