Bioaerosol emissions from a suburban yard waste composting facility.

The purpose of this study was to assess worker and community exposure to bioaerosols emitted from a suburban yard waste composting facility in northern Illinois, USA. Characterization of on- and off-site viable bioaerosols was undertaken through a total of 288 on- and off-site Andersen samples conducted over 10 sampling days. A total of 46 dust samples and 38 Kramer-Collins spore samples were also collected in this period. Evaluation of the impact of the facility on community bioaerosol concentrations was undertaken by comparing on- and off-site measurements by sampling locations, wind direction, and site activity. On-site concentrations of total spores, Aspergillus/Penicillium spores, total bacteria, Gram-positive bacteria, Gram-negative bacteria, actinomycetes, total particulates, endotoxin, and beta-1,3 glucans were higher than off-site concentrations. Total fungal spores averaged 13,451 spores/m3 (range 5,223-26,067) on-site and 8,772 spores/m3 (range 243-18,276) off-site. Viable bacterial airborne concentrations (in cfu/m3) averaged 11,879 on-site (range 480-78,880) and 3,204 off-site (range 160-17,600). Mean levels of endotoxins (in ng/m3) were 1.94 on-site (range 0.12-6.06) and 0.14 off-site (range 0.01-0.41). Mean levels of beta-1,3 glucans (in ng/m3) were 2.17 on-site (range 0.12-14.45) and 0.24 off-site (range 0.01-0.78). Mean total viable fungi, on the other hand, were higher off-site than on-site (8,651 vs 3,068 cfu/m3). On-site concentrations of total bacteria, Gram-positive bacteria, Gram-negative bacteria, and actinomycetes demonstrated a statistically significant pattern of decreasing concentration with distance from pile and higher downwind vs upwind concentrations. Mean on-site concentrations of viable bacteria, viable fungi, and endotoxins were significantly higher during periods of activity compared to periods of no activity. Off-site concentrations of bacteria were also significantly higher during periods of activity compared to no activity. The highest concentrations of total particulates, endotoxin, and beta-1,3-glucans were observed in the personal samplers worn by workers at the facility. One personal sampler measured an Asp f1 exposure of 22.17 ng/m3 during turning activity. Peak exposures to several bioaerosol constituents were sufficiently high to warrant use of respirators by workers during periods of pile activity that lead to dust generation.

Medical outcome of cocaine bodystuffers.

To describe the clinical course of cocaine "bodystuffers" presenting to regional emergency departments, a descriptive retrospective analysis was performed on all cases of cocaine bodystuffers received by a metropolitan poison control center and associated toxicology service from January 1993 to May 1994. We identified 46 cases of patients classified as bodystuffers. Of these, 34 patients (74%) remained asymptomatic. Eight patients (18%) had mild symptoms including hypertension and tachycardia that resolved with no treatment beyond decontamination or benzodiazepines (one patient). Two patients (4%) had moderate symptoms including agitation and fever that resolved with no treatment beyond decontamination or benzodiazepines (one patient). Two patients (4%) had severe symptoms including seizure and cardiac dysrhythmia. Both died. Radiographs of the abdomen were negative for foreign body in all 23 examinations performed. Mild cocaine intoxication is common in cocaine bodystuffers. Severe intoxication can occur, resulting in death. Abdominal radiographs are not of value for stuffers ingesting cellophane-wrapped packets. More experience is needed to determine the length of intensive care monitoring that these patients require.

Late increase in acetaminophen concentration after overdose of Tylenol Extended Relief.

We report a case demonstrating a late increase in acetaminophen concentration after ingestion of Tylenol Extended Relief (extended-release acetaminophen; McNeil Consumer Products) along with drugs known to slow gastrointestinal motility. Coingestants that slow gastrointestinal motility are known to affect the interpretation of serum drug concentrations. However, this case illustrates potentially significant differences between extended-release and immediate-release acetaminophen and demonstrates an exception to the current manufacturer recommendation for the use of the Rumack-Matthew nomogram in this setting.

Toxicology screening in urban trauma patients: drug prevalence and its relationship to trauma severity and management.

Although toxicology screening is often used when treating trauma patients, its utility and significance remain controversial. Data from 623 toxicology screens performed in urban trauma center patients with mental status alterations are reported. The study patients were predominantly black and male, with a mean age of 32 (+/- 22) years. Overall, 86% of screens were positive. Substances of abuse, including ethanol, were noted in 525 (84%) of urine toxicology screens. Ethanol, cannabinoids, and cocaine were the drugs most commonly found in urine, with positivity noted in 53%, 37%, and 34% of screens. Serum analysis was 44% positive, with ethanol noted in 41% of patients. In blacks, the odds ratio of illicit drug use before trauma ranged from 1.9 to 4.2 (p less than 0.005), and in those aged 17 to 40 years, the odds ratio for illicit urine drugs ranged from 4.7 to 16.8 (p less than 0.001). In patients older than 40 years, the odds of a positive serum ethanol level were 1.7 times greater than in younger patients, and a level above 300 mg% was 3.8 times more likely in this age group (p less than 0.001). When serum ethanol was detected, the odds ratio of a head injury was 1.4 relative to patients without serum ethanol (p less than 0.06), and the odds ratio for abdominal injury was 1.6 for patients with serum ethanol (p less than 0.03). The odds of a TS less than 12 were 1.8 (p less than 0.05), and the odds of a GCS less than 12 were 3.3 (p less than 0.001) with ethanol levels greater than 100 mg%.(ABSTRACT TRUNCATED AT 250 WORDS)