Female victims of intimate partner physical domestic violence (IPP-DV), California 1998.

BACKGROUND: This study was conducted to identify factors associated with adult female victims of intimate partner physical domestic violence (IPP-DV) in California and to estimate statewide IPP-DV prevalence. METHODS: We analyzed data from the 1998 California Women's Health Survey, a random, computer-assisted telephone interview (CATI) survey of 4006 California women aged > or = 18, conducted by the California Department of Health Services. RESULTS: Data from the survey indicated that 6% of the women reported that in the previous 12 months, their intimate partners threw objects at them, or hit them with an object, or kicked, pushed, slapped, choked, beat up, or threatened them with a gun or a knife. Odds ratio (OR) analyses controlling for age and race/ethnicity suggest that a large number of factors are associated statistically with IPP-DV victims. These factors include feelings of ill physical and mental health; pregnancies at early age; smoking status; nutritional needs; low income; participation in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) program; having children aged < 18 in the household; and limited access to health care. Among the non-U.S.-born respondents, IPP-DV victims were significantly younger when they entered the United States than their nonvictim counterparts. A multiple logistic regression model identified the following factors as main correlates with IPP-DV: feelings of being overwhelmed in the past 30 days (OR = 3.4, 95% confidence interval [CI] = 2.5-4.6); aged 18 to 44 (OR = 2.8, 95% CI = 1.9-4.1); current smoking status (OR = 2.1, 95% CI = 1.5-2.9); participation in WIC in the previous 2 years (OR = 1.8, 95% CI = 1.2-2.6); and being out of work (OR = 1.4, 95% CI = 1.1-1.9). CONCLUSIONS: The above findings suggest that a variety of venues (e.g., schools, mental and physical health care providers, WIC, immigration programs, and social services) will be needed in order to identify/gain access to IPP-DV victims, provide referral resources, and implement any future prevention efforts.

Store tobacco policies: a survey of store managers, California, 1996-1997.

OBJECTIVE: To identify store tobacco policies and retailer perception and beliefs that may have contributed to changes in compliance with youth access laws in California. DESIGN: In the winter of 1996-7, a cross sectional, follow up telephone survey was conducted of California store managers whose stores were anonymously surveyed for illegal tobacco sales in the summer of 1996 (that is, 1996 Youth Tobacco Purchase Survey, YTPS). SETTING: A simple random sample of stores from a list of California stores likely to sell tobacco, used in the 1996 YTPS. PARTICIPANTS: 334 managers (77%) of the 434 stores surveyed in 1996 responded to the survey. After eliminating stores that stopped selling tobacco or were under new management or ownership, 320 responses of store managers were included in the analysis. The stores were analysed by type of ownership: chain, which included corporate managed (n = 61); franchise owned (n = 56); and independent (n = 203). MAIN OUTCOME MEASURES: Responses of store managers were linked with the 1996 YTPS outcomes. Manager responses were compared by chi2 tests. Logistic regression analyses were conducted to identify store factors associated with illegal tobacco sales. RESULTS: A lower likelihood of illegal sales rate was associated with the chain stores when compared with the independent stores (odds ratio (OR) = 0.4, 95% confidence interval (CI) 0.2 to 0.9). A lower likelihood of illegal tobacco sales was found in stores that implemented tobacco related activities in the previous year such as changing tobacco displays (OR = 0.5, 95% CI 0.2 to 0.9) or adding new warning signs (OR = 0.7, 95% CI 0.4 to 1.2). Store managers' beliefs that youth were sent to their stores to do compliance checks also resulted in a lower likelihood of illegal sales (OR = 0.7, 95% CI 0.4 to 1.1). CONCLUSIONS: Store tobacco youth access policies, and managers' beliefs about the extent of youth access enforcement in the community, are important in reducing illegal tobacco sales to minors.

Risk factors for systemic illnesses following agricultural exposures to restricted organophosphates in California, 1984-1988.

Organophosphate (OP)-related systemic illnesses reported to the Worker Health and Safety (WH&S) Branch, and restricted OP-related agricultural use data reported to the Information Services Branch at the California Department of Food and Agriculture (CDFA) (now CAL-EPA) during 1984-1988 were used to assess factors associated with OP-related systemic illnesses. Counts of OP-related systemic illnesses (numerator), relative to OP-related use data (denominator), such as pounds applied, number of applications, and acres treated (pounds applied/acres treated), were analyzed by crop treated, season of application, method of application, geographic region, and by specific OP applied. A Relative Illness/Use Ratio (RIUR) was calculated by Poisson regression. The highest risk of systemic illness was associated with OP applications to fleshy fruit (mainly fruit trees) compared to all other crops combined (RIUR = 2.9, 95%CI = 2.2-3.9) using pounds applied in the denominator, followed by vegetables and melons (RIUR = 1.9, 95%CI = 1.4-2.4). Air applications resulted in higher RIURs for systemic illness than did ground applications (RIUR = 2.1, 95%CI = 1.7-2.5). Specific OPs that showed significantly elevated RIURs for systemic illness when compared to other OPs were Mevinphos (RIUR = 5.8, 95%CI = 5.0-6.8), Demeton (RIUR = 4.3, 95%CI = 2.6-7.1), Oxydemeton-Methyl (RIUR = 3.8, 95%CI = 3.0-4.9), Methamidophos (RIUR = 1.6, 95%CI = 1.2-2.0) and Azinphos-Methyl (RIUR = 1.3, 95% CI = 1.1-1.6).

Risk factors for occupational illnesses associated with the use of paraquat (1,1'-dimethyl-4,4'-bipyridylium dichloride) in California.

This study was conducted to identify risk factors for paraquat-related occupational illnesses. Pesticide-related illness is a reportable disease in California. A total of 231 skin (26.0%), eye (32.0%), local respiratory (3.5%), and systemic (38.5%) paraquat-related cases were reported to the Worker Health and Safety Branch, California Department of Food and Agriculture, during 1971 through 1985. Following paraquat exposure, we found no cases of pulmonary fibrosis. Annual numbers of cases ranged between 1 and 33 (median = 14 cases/y). Information on illnesses reported during 1981 through 1985 (n = 62) was merged with detailed information on paraquat use in agricultural settings (111,716 applications) for the same years. We found that crop treated, method of application, and season of application all contributed independently to the risk of reported illness. Hand application was associated with a higher risk of illness, compared with air application (RR = 99.1, 95% CI = 22.16-443.47); summer application was associated with a higher risk of illness than was winter application (RR = 4.1, 95% CI = 1.91-8.61); and fruit trees were associated with higher risk of illness than were other crops (mainly cotton) (RR = 3.6, 95% CI = 1.18-11.21).

Determinants of disability in illnesses related to agricultural use of organophosphates (OPs) in California.

Organophosphate (OP)-related illness data reported to the Worker Health and Safety Branch (WH&S) at the California Department of Food and Agriculture (CDFA, now Cal-EPA) in the years 1984-1988 were examined. Eight hundred and seventy-eight cases with systemic illness and 199 cases of skin disease or eye injury were identified. Systemic cases were divided into two outcome groups: (1) "severe," disability and/or hospitalization days (n = 361), and (2) "mild," no disability or hospitalization days (n = 372). For the remainder (n = 145) or 16.5% of the cases, illness severity could not be determined. Using multiple logistic regression, independent predictors of "severe" illness were identified among the systemic cases. Workers coming in contact with OP residue on commodities or in the field ("exposed to residue" or ER) (OR = 4.6, 95% CI = 3.03-7.07) and mixer/loaders/applicators (MLA) (OR = 4.1, 95% CI = 2.72-6.07) were at significantly increased risk of severe illness when compared with cases exposed to OP application drift. Cases with a Spanish surname were also at increased risk of severe illness (OR = 1.8, 95% CI = 1.25-2.73). Increased numbers of OPs per exposure were also associated with severe illness (p < 0.001). Among cases who were exposed to only one OP, severe systemic cases were more likely than mild systemic cases to be associated with exposure to diethyl than dimethyl compounds (OR = 1.6, 95% CI = 1.09-2.38). Severe systemic cases were also more likely than severe skin/eye cases to be associated with exposure to OPs with high toxicity (OR = 5.5, 95% CI = 2.42-12.60) and with exposure to diethyl groups (OR = 4.8, 95% CI = 1.90-12.00). These findings suggest that reducing exposure to OP residues, to OPs with diethyl groups, and to multiple OPs, and exposure during mixer/loader/applicator activities would reduce the risk of OP-related illness.

Clustering of Parkinson's disease points to environmental etiology.

On three adjacent kibbutzim in the Negev (southern region) of Israel, 13 cases of Parkinson's disease were found in a population of 592 persons who were at least 40 yr of age. There were no clinical (or other) findings that distinguished these Parkinson's disease cases. Long-term residence is characteristic of this population. During the past 40 yr, water has been supplied to these persons via wells from a common aquifer. On the basis of local age-specific incidence data, no difference in age distribution was found between clustered and nonclustered cases. The incidence of Parkinson's disease is about five times greater in each of the three kibbutzim than in the remainder of the region. The three kibbutzim in the cluster use similar agricultural chemicals, as do other kibbutzim. Although associations with rural residence and well water use have been reported elsewhere, clusters of this sort have not been reported. Clusters strongly suggest that common environmental factors exist. Drinking water and agricultural chemicals are the most likely common environmental factors.

Clustering of Parkinson's disease in southern Israel.

On three adjacent kibbutzim (collective rural communities) in the Negev (Southern Israel) 13 parkinsonian patients were found among a population of 592 persons 40 years or older. The clinical picture was not different from that of patients from other areas with idiopathic parkinsonism. Long term residence in the kibbutzim is characteristic of this population. In the past most of the drinking water has been supplied by wells from a common aquifer. From other patients with Parkinson's disease in the Negev, we estimated the age-specific incidence for the region. The incidence is about five times greater in each of these kibbutzim than in the remainder of the Negev. Although associations with rural residence and well water use have been reported elsewhere, clusters of this sort have not been reported. They strongly suggest that a common environmental factor exists.

Assessing dermatitis in epidemiologic studies: occupational skin disease among California grape and tomato harvesters.

We conducted a cross-sectional investigation to determine whether table grape harvesters, who have significant cutaneous contact with crop-associated materials that may cause skin disease, are more likely to develop dermatitis than are a control group of tomato workers performing mechanical harvesting with minimal cutaneous contact with crop-associated substances. A secondary aim was to develop methods for studying skin disease in farm workers, including a standard questionnaire and physical examination. California table grape workers (n = 183) and tomato workers (n = 43) completed an interviewer-administered questionnaire and waist-up physical examination at their work site during harvest operations. On physical examination, pustular eruptions such as acne and folliculitis were present in 30% of subjects, and eczematous rashes were noted in 10% of subjects. Irritant or allergic contact dermatitis was diagnosed in 2% of subjects. No significant differences in prevalence for these skin conditions were observed between the two groups of workers. In contrast to the physical examination results, grape workers were more likely than tomato workers to report a rash occurring in the previous 3 months (52% vs. 19%, p less than 0.001). Explanations for this discrepancy are discussed. The sensitivity of the questionnaire for current skin conditions was 31%, and the specificity was 94%. Improved sensitivity was seen for eczematous skin conditions (55%). We conclude that questionnaires provide an efficient means of assessing subject characteristics, but may have limited sensitivity for some dermatologic outcomes.