Toxic substances in blood: an analysis of current recommendations under a Bayesian (decision) approach

This article extends existing discussion in literature on probabilistic inference and decision making with respect to continuous hypotheses that are prevalent in forensic toxicology. As a main aim, this research investigates the properties of a widely followed approach for quantifying the level of toxic substances in blood samples, and to compare this procedure with a Bayesian probabilistic approach. As an example, attention is confined to the presence of toxic substances, such as THC, in blood from car drivers. In this context, the interpretation of results from laboratory analyses needs to take into account legal requirements for establishing the 'presence' of target substances in blood. In a first part, the performance of the proposed Bayesian model for the estimation of an unknown parameter (here, the amount of a toxic substance) is illustrated and compared with the currently used method. The model is then used in a second part to approach-in a rational way-the decision component of the problem, that is judicial questions of the kind 'Is the quantity of THC measured in the blood over the legal threshold of 1.5 μg/l?'. This is pointed out through a practical example.

2012 Emergency Response Guidebook: A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/ Hazardous Materials Transportation Incident,

A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Transportation Incident.

Hazardous Materials, December 31, 2013

Nearly all households use products that contain hazardous materials, and hazardous materials are transported on our roadways, railways and waterways daily. Although the risk of a chemical accident is slight, knowing how to handle these products and how to react during an emergency can reduce the risk of injury.

Le lambeau musculo-cutané du grand dorsal en V-Y dans la reconstruction de pertes de substances étendues de la paroi thoracique postérieure

Les pertes de substances étendues de la paroi thoracique postérieure sont régulièrement rencontrées en chirurgie reconstructive. Les causes les plus habituelles sont les escarres, l'extirpation de lésions néoplasiques et les déhiscences de plaie dans le cadre d'une chirurgie du rachis. L'exposition fréquente des côtes ou des vertèbres rend nécessaire l'emploi d'un lambeau afin de s'assurer de la pérennité de la couverture. Le lambeau musculo-cutané du trapèze est classiquement indiqué dans les plaies du rachis cervical et dorsal haut alors que le lambeau musculo-cutané du grand dorsal l'est dans les pertes de substances dorsales basses. Lorsque la taille du lambeau prélevé rend impossible la fermeture directe du site donneur, ce dernier doit être recouvert soit par une greffe de peau, soit par un autre lambeau, ce qui majore la morbidité dans les deux cas. En 2001, Micali a proposé un nouveau tracé de la palette cutanée du lambeau du grand dorsal en utilisant l'artifice du V-Y, permettant par conséquent la fermeture directe du site de prélèvement. Cette modification s'intéressait uniquement à la paroi thoracique antérieure. Nous avons étudié la faisabilité de cette technique appliquée au thorax postérieur. Trois patients ont bénéficié de la couverture d'une perte de substance thoracique postérieure par un lambeau musculo-cutané du grand dorsal en V-Y. Il s'agissait de 2 cas de déhiscence de plaie après chirurgie de stabilisation rachidienne et d'un cas d'exérèse d'un sarcome. La palette cutanée est orientée obliquement depuis la berge externe de la plaie, son bord médial étant cranial alors que son bord latéral est caudal et forme une pointe. Le muscle grand dorsal est levé selon la technique habituelle en conservant la palette cutanée attachée afin de préserver les vaisseaux perforants nourriciers. Le lambeau est avancé postérieurement afin d'oblitérer le défect sans tension. Le site donneur est ensuite suturé en première intention. Les trois lambeaux ont intégralement survécu et ont permis une couverture cutanéo- musculaire durable sans la survenue de complications. La modification de la technique de Micali que nous proposons permet d'obtenir de façon reproductible une couverture stable de pertes de substances étendues intéressant la paroi thoracique postérieure. Contrairement au dessin habituel de la palette cutanée, l'artifice du V-Y rend obsolète l'utilisation de greffes de peau puisque le site donneur peut être suturé sans tension. La chirurgie étant courte et la morbidité faible, cette technique peut également être appliquée aux patients fragiles pour lesquels une intervention longue de type lambeau libre est contre-indiquée.

Health consultation : Contamination of sump within residential property, Carroll County, Iowa (2007)

The Iowa Department of Natural Resources (IDNR) has been involved in an investigation surrounding the appearance of an unknown oil within the sump in the basement of a residence in Carroll, Iowa. The IDNR has requested the Iowa Department of Public Health (IDPH) to prepare a health consultation regarding their investigation. The IDPH, in cooperation with the Agency for Toxic Substances and Disease Registry (ATSDR), prepared this health consultation to review the current status of the IDNR investigation and to provide an evaluation of the public health implications of exposure to the unknown oil within the sump. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Health consultation : E.I. Du Pont de Nemours & Co., Inc. County Road X-23 site, Lee County, Iowa EPA facility ID: IAD980685804 (2007)

The U.S. Environmental Protection Agency (EPA) is completing a third five-year review of the E.I. du Pont de Nemours & Co., Inc., County Road X-23 Superfund site in Lee County, Iowa. The site is also known as the Baier and McCarl subsites. The EPA is inviting public comment on whether the current site remedy continues to be protective of public health and the environment. The Iowa Department of Public Health in cooperation with the Agency for Toxic Substances and Disease Registry (ATSDR) prepared this health consultation to review the current status of the Baier and McCarl subsites and to provide an evaluation of the public health status of these subsites. The information in this health consultation was current at the time of writing. Data that emerges later could alter this docum ent’s conclusions and recommendations.

Letter health consultation : Exposure to benzene from Equistar pyrolysis gasoline tank, Clinton, Iowa (2008)

The Iowa Department of Public Health (IDPH) has been asked by several citizens of Clinton, Iowa to evaluate potential health effects from exposure to benzene from an above ground tank located near a residential area. The above ground tank is managed by Equistar Chemicals, LP (Equistar) and is use to store pyrolysis gasoline prior to off-loading onto barges. The IDPH in cooperation with the Agency for Toxic Substances and Disease Registry (ATSDR) prepared this health consultation to review the air quality monitoring provided by Equistar and provide an evaluation of the health effects from exposure to benzene at the levels detected in ambient air near the tank. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Health consultation : Red Oak Landfill, Red Oak, Montgomery County, Iowa EPA facility ID: IAD980632509 (2005)

Landfill site from the National Priorities List (NPL). The EPA is inviting public comment on the proposed de-listing of the site from the NPL. The Iowa Department of Public Health in cooperation with the Agency for Toxic Substances and Disease Registry (ATSDR) prepared this health consultation to review the current status of the Red Oak Landfill site and to provide an evaluation of any public health consequences of de-listing the site. The information in this health consultation was current at the time of writing. Data that emerges later could alter this document’s conclusions and recommendations.

Recherches sur les substances nutritives que renferment les os, ou Mémoire sur les os provenant de la viande de boucherie, sur les moyens de les conserver, d'en extraire de la gélatine par la vapeur, etc. , par M. d'Arcet,... et Mémoire sur l'application spéciale de ce procédé à la nourriture des ouvriers... par M. A. de Puymaurin,...

Comprend : Mémoire sur l'application spéciale de ce procédé [extraction de la gélatine que renferment les os] à la nourriture des ouvriers de la Monnaie royale...