Safe handling of agricultural pesticides in Minnesota: results of a county-wide educational intervention.

Safe pesticide handling in a group of Minnesota farmers, aged 40 years and older, was influenced through the use of a multifaceted, countywide educational intervention. Two intervention counties and two control counties were involved in this effort. The intervention consisted of mailed pesticide information to farm households, educational programs on pesticides for county physicians, elementary school training modules on pesticides and the use of safe pesticide handling displays in key business areas by agricultural extension agents. Five hundred eight farmers were identified as pesticide users (186 in the intervention counties and 322 in the control counties). The use of gloves and other protective clothing while handling pesticides increased in the intervention group. Improvement was greater in those who had used protective equipment the least before the intervention. From these results, it appears that a broad-based educational intervention might have a modest impact in how farmers protect themselves when using pesticides.

Mammogram utilization among farm women.

Utilization of preventive health care services is lower in rural populations than in urban populations, possibly as a result of barriers to preventive health care that are characteristic of rural settings. This study was conducted to identify factors associated with mammogram utilization among farm women. Mammogram utilization among farm women from six southern Minnesota counties was examined as part of a larger community-based cancer intervention study. Farm women aged 40 and older were randomly selected from a list of farm households and interviewed by telephone to determine mammogram utilization and factors related to utilization. Of the 606 respondents, 78 percent reported ever having a mammogram and 49 percent reported a mammogram within the past year. Physician recommendation for a screening mammogram and family history of breast cancer were found to be associated with ever having a mammogram. Correct knowledge of mammogram screening guidelines was associated with a mammogram within the past 12 months. Overall, physician recommendation was the most influential determinant of utilization. As more emphasis is placed on prevention, patient education by physicians can have the greatest impact on mammogram utilization.

Factors associated with safe use of agricultural pesticides in Minnesota.

How farmers protect themselves against pesticide exposure has important public health consequences. To obtain insights into pesticide self-protection, this study obtained data on chemically resistant glove and other protective equipment use as they relate to the type of farming practice, demographic characteristics of farmers and their farming operations, farmers' preventive health beliefs and behaviors, and factors related to their health care. Data were obtained by telephone interviews conducted in six rural Minnesota counties. Survey respondents totaled 1, 327 (87% response rate), with 502 reporting pesticide use. Ninety-five percent of the latter respondents believed in the effectiveness of protective equipment and 88 percent believed that pesticide exposures are harmful. Fifty-six percent of the subjects wore chemically resistant gloves and 22 percent wore other protective clothing 75 percent of the time or more when using pesticides. Glove use and certification to use restricted pesticides was less frequent for women. The use of protective equipment in this group of Minnesota farmers was weakly related to being certified to apply restricted pesticides, believing in the effectiveness of protective clothing, believing that smoking causes serious health problems, using crop insecticides, and distance to a health care facility.

Benchmarking of the CAP-88 and GENII computer codes using 1990 and 1991 monitored atmospheric releases from the Idaho National Engineering Laboratory.

The CAP-88 environmental radiological assessment computer code was benchmark tested to establish confidence in its results. The results from CAP-88 were compared to the results from the GENII computer code, which has undergone rigorous testing. The codes were benchmarked using 1990 and 1991 monitored atmospheric releases from Idaho National Engineering Laboratory facilities and the results (the effective dose equivalent to the maximally exposed offsite individual) were quantitatively compared using a metric based on the uncertainty in the Gaussian plume model and terrestrial transport models. The results of the benchmark tests were within the 95% acceptance region specified in the test protocol. CAP-88 was found to overpredict effective dose equivalent relative to GENII for elevated releases, largely because CAP-88 calculates a larger atmospheric dispersion factor (chi/Q) than does GENII using the same meteorological data. However, CAP-88 consistently underpredicted effective dose equivalent relative to GENII for ground-level releases. This was because CAP-88 accounts for the processes of plume depletion by dry and wet deposition while GENII does not account for these processes. The effect of depletion was tested and found to be most important for a ground-level release of a highly depositing species such as radioiodine which implies that acceptable benchmark results would be difficult to obtain for a highly dopositing species.

Analysis of management in thirty-three closed head injury patients who "talked and deteriorated".

Of 215 patients with severe head injuries, 33 (15%) closed head injury patients who talked before their conditions deteriorated to a Glasgow coma scale score of 8 or less were identified. Of this select group, 15 died (45%), but none of the remaining were left in a vegetative state and 14 patients had a "favorable" outcome (42%). Twenty-five patients (76%) underwent surgical decompression. In these 25 patients, 14 subdural hematomas, 4 epidural hematomas, and 7 intracerebral contusions and hematomas were the initial surgical lesions. Twenty of the 25 patients were operated on within 4 hours (16 within 2 hours) of their neurological deterioration. Eleven of the 25 surgically treated died, for a mortality rate of 44%. All 15 deaths were studied further. Autopsies with examination of the brain were performed in 13 patients. Five patients died with severe brain injuries not complicated by iatrogenic factors, and 4 patients died of severe associated injuries. Iatrogenic factors significantly complicated the deaths of 6 patients (40%). It is concluded that most patients who "talk and deteriorate" have sustained very serious life-threatening injuries. Intracranial hematomas are the most frequent cause of this situation, and rapid diagnosis and decompression is the most important factor in salvaging these patients.