Chemical incident management: gaseous emissions from a stockpile of coal.

Spontaneous combustion of coal releases a wide range of airborne pollutants which, in high concentrations, may be hazardous to health. Little is known about how the effects on health change in relation to the release of multiple substances. This article reports an incident in which a stockpile of coal released potentially harmful gases into the environment. Although the resultant health effects reported were few, the co-ordinated response by local authorities and health authorities highlighted the advantage of a multidisciplinary approach. Public health departments need to be aware of major chemical hazards within their district. Prompt environmental monitoring and exposure measurement needs to be arranged as this is crucial to making an appropriate response. Updated registers are needed from private companies and public bodies; who can provide timely measurements of chemical hazards. Health districts with more than one local authority may benefit from pooling resources and knowledge in order to prepare for such an incident.

Analysis of a petrol plume over England: 18-19 January 1997.

OBJECTIVES: About 7000 tonnes of unleaded petrol were discharged into the English Channel after a tanker collision off Ostend on Saturday 18 January 1997. The petrol evaporated and the vapour plume was carried across the central part of England to Wales, resulting in reports of unidentified odours, and irritation of the eyes, skin, and upper respiratory tract. This work uses this incident to show how marine and atmospheric dispersion modelling together with routine air quality monitoring can assist in identifying hazards to the population at risk from chemical incidents. METHODS: Public health surveillance and results from environmental sampling were compared with the behaviour of the plume as predicted by computer modelling. RESULTS: The predicted plume path and dispersion were shown to correlate well with the results from surveillance and environmental analysis. CONCLUSIONS: There is a need for public health professionals to interact with medical toxicologists, atmospheric and marine scientists and engineers, and other environmental experts in managing events of this nature.

Galactosemia: clinical features, diagnosis and management. A case report.

The case report and discussion presented here were prepared in response to legislation in Louisiana which requires that the Dept of Health and Hospitals establish a program to inform physicians and hospitals of the current medical standards for the diagnosis, clinical management, and recognition of galactosemia. Classical galactosemia is an inborn error of galactose metabolism caused by a deficiency of galactose-1-phosphate uridryl transferase. It is inherited as an autosomal recessive trait and its estimated occurrence is 1/60,000. The presenting symptoms which include vomiting, diarrhea, jaundice, and failure to thrive result from the ingestion of foods containing galactose--breast milk and formulas containing cow's milk. Although some states routinely screen all newborns for galactosemia, the results of the newborn screening are often not available before the infant presents with symptoms. Early recognition and immediate withdrawal of galactose from the diet can prevent serious morbidity and mortality. There is significant clinical variability and not all infants present with typical acute manifestations of the disease.

Recognizing genetic hemochromatosis.

This article reviews the disease process hemochromatosis, which is now recognized as one of the most common genetic disorders. Hemochromatosis is transmitted as autosomal recessive, and occurs in 3% of persons of Anglo-Saxon descent. It is caused by an inappropriate increase in intestinal iron absorption resulting in deposition of excess iron in tissues. Hemochromatosis usually presents in males in their 40s, and females much later. The most frequent initial symptoms are weakness, lassitude, weight loss, and symptoms related to the onset of diabetes mellitus. The classical triad of cirrhosis, diabetes mellitus, and skin pigmentation occurs late in the disease. There is debate over the value of mass screening for the disorder; however, it is recommended that once a case has been identified family members at risk should be screened. Therapy is directed at removing excess iron by phlebotomy. By instituting early therapy, many of the long-term complications, including cirrhosis and hepatoma, can be prevented. It is imperative that physicians learn to recognize early signs and symptoms of hemochromatosis so that treated patients can expect a normal life span with minimal medical intervention.

Relationship between preferences for part-time work and characteristics of unemployed youths.

Using data from the March 1979 Current Population Survey, the relationship was examined between preferences for part-time work and the personal characteristics of 2,087 unemployed 16- through 24-year olds in the civilian, noninstitutional population of the United States. Age and school enrollment were found to be the strongest correlates of desire for part-time work. Gender, race, veteran status, marital status, and educational attainment were related only slightly to part-time job preferences. These data support the notion that most unemployed youths searching for part-time work are 16 to 19 years old and enrolled in school; on the other hand, knowing merely this does not indicate that youth unemployment has little economic significance, as some analysts have suggested. Additional research on the consequences of teenage labor market problems on subsequent adult well-being is needed to determine the significance of youth unemployment.

Erythropoietic uroporphyria of Gunther first presenting at 58 years with positive family studies.

Erythropoietic uroporphyria of Gunther was seen in a 58-year-old man who presented with photosensitivity, haemolytic anaemia, and classical laboratory findings. Family studies showed five asymptomatic relatives with erythrocyte uroporphyrin concentrations in the probable latent heterozygote range.