Introduction to disaster epidemiology for public health personnel

There has been a renewed interest in disaster epidemiology after the World Trade Center and Pentagon terrorist attacks of 2001, the devastation of Hurricane Katrina and the overwhelming loss of life that resulted from the tsunami that originated in the Indian Ocean and struck Indonesia and other adjacent countries on December 26, 2004. Institutions that have accepted the challenge of training the next generation of public health professionals as well as to continue the education of the dedicated professionals already serving in public health fields have a responsibility to train practitioners in the basic principles of disaster epidemiology as well as in practical applications of these principles. This culminating experience project involved developing an on-line course complete with the background information as well as relevant case studies that can be used as a curriculum for an introductory course in disaster epidemiology. ^

EXPOSURE OF PHARMACY PERSONNEL TO ANTINEOPLASTIC DRUGS

This dissertation consists of two parts: (1) Exposure of pharmacy personnel to antineoplastic drugs. The Salmonella reversion test was used to measure the mutagenic activities of urine concentrates from individuals preparing antineoplastic drugs for intravenous administration. Longitudinal studies were performed in which the total urine produced in 24-hour periods was collected, starting on a Sunday at 7 P.M. after a duty-free weekend and extending over an eight-day period. There was no detectable increase in mutagenic activity in the urine concentrates of three pharmacy administrators who had no contact with these drugs. All six individuals admixing drugs in open-faced, horizontal laminar flow hoods displayed a two-fold increase in mutagenesis by the fourth day with peak values of 2.7 to 24-fold occurring on days five and six, reduced values by day seven with a return to the spontaneous level by day eight. When four of the six positive individuals in the preceding experiment admixed comparable amounts of antineoplastic drugs in a closed-faced, vertical laminar flow hood, no increase in mutagenic activity was detected in their urine concentrates over the eight-day period. (2) Estimate of potential carcinogenic risks of antineoplastic drugs. Excision repair is the major repair system that is involved with the elimination of chemically induced DNA (deoxyribonucleic acid) lesions. This DNA excision repair capability increases in mammalian species with longer life span such as humans. In this study, the effect of functional DNA excision repair on the mutagenesis invoked by 17 antineoplastic drugs was determined by using a Salmonella/Microsome assay which was expanded to include some uvr('+) counterparts of the excisionless (uvrB) tester strains routinely employed. Although extrapolation cannot be made from bacteria to humans, one should be able to make a qualitative comparison as to which antineoplastic drugs are more potentially carcinogenic to humans based on the effects of excision repair on their mutagenesis in bacteria. The tested antineoplastic drugs were divided into three classes: those requiring excision repair for mutagenesis; those producing nonrepairable genetic damage; and those producing mostly repairable premutational DNA lesions. ^

(Table 1) Characteristics of South Pole personnel according to forced expiratory flow (FEF25-75) response to altitude

The impact of acute altitude exposure on pulmonary function is variable. A large inter-individual variability in the changes in forced expiratory flows (FEFs) is reported with acute exposure to altitude, which is suggested to represent an interaction between several factors influencing bronchial tone such as changes in gas density, catecholamine stimulation, and mild interstitial edema. This study examined the association between FEF variability, acute mountain sickness (AMS) and various blood markers affecting bronchial tone (endothelin-1, vascular endothelial growth factor (VEGF), catecholamines, angiotensin II) in 102 individuals rapidly transported to the South Pole (2835 m). The mean FEF between 25 and 75% (FEF25-75) and blood markers were recorded at sea level and after the second night at altitude. AMS was assessed using Lake Louise questionnaires. FEF25-75 increased by an average of 12% with changes ranging from -26 to +59% from sea level to altitude. On the second day, AMS incidence was 36% and was higher in individuals with increases in FEF25-75 (41 vs. 22%, P = 0.05). Ascent to altitude induced an increase in endothelin-1 levels, with greater levels observed in individuals with decreased FEF25-75. Epinephrine levels increased with ascent to altitude and the response was six times larger in individuals with decreased FEF25-75. Greater levels of endothelin-1 in individuals with decreased FEF25-75 suggest a response consistent with pulmonary hypertension and/or mild interstitial edema, while epinephrine may be upregulated in these individuals to clear lung fluid through stimulation of beta2-adrenergic receptors.

Helium-3 in different carriers from pelagic clays of DSDP Hole 91-596B and Core LR-44-GPC-3

To better understand the composition, characteristics of helium diffusion, and size distribution of interplanetary dust particles (IDPs) responsible for the long-term retention of extraterrestrial 3He, we carried out leaching, stepped heating, and sieving experiments on pelagic clays that varied in age from 0.5 Ma to ~90 Myr. The leaching experiments suggest that the host phase(s) of 3He in geologically old sediments are neither organic matter nor refractory phases, such as diamond, graphite, Al2O3, and SiC, but are consistent with extraterrestrial silicates, Fe-Ni sulfides, and possibly magnetite. Stepped heating experiments demonstrate that the 3He release profiles from the magnetic and non-magnetic components of the pelagic clays are remarkably similar. Because helium diffusion is likely to be controlled by mineral chemistry and structure, the stepped heating results suggest a single carrier that may be magnetite, or more probably a phase associated with magnetite. Furthermore, the stepped outgassing experiments indicate that about 20% of the 3He will be lost through diffusion at seafloor temperatures after 50 Myrs, while sedimentary rocks exposed on the Earth's surface for the same amount of time would lose up to 60%. The absolute magnitude of the 3He loss is, however, likely to depend upon the 3He concentration profile within the IDPs, which is not well known. Contrary to previous suggestions that micrometeorites in the size range of 50-100 µm in diameter are responsible for the extraterrestrial 3He in geologically old sediments [Stuart, F.M., Harrop, P.J., Knott, S., Turner, G., 1999. Laser extraction of helium isotopes from Antarctic micrometeorites: source of He and implications for the flux of extraterrestrial 3He flux to earth. Geochimica et Cosmochimica Acta, 63, 2653-2665, doi:10.1016/S0016-7037(99)00161-1], our sieving experiment demonstrates that at most 20% of the 3He is carried by particles greater than 50 µm in diameter. The size-distribution of the 3He-bearing particles implies that extraterrestrial 3He in sediments record the IDP flux rather than the micrometeorite flux.

Securing Medical Personnel: Case Studies of Two Source Countries and Two Destination Countries

A shortage of medical personnel has become a critical problem for developing countries attempting to expand the provision of medical services for the poor. In order to highlight the driving forces determining the international allocation of medical personnel, the cases of four countries, namely the Philippines and South Africa as source countries and Saudi Arabia and the United Kingdom as destination countries, are examined. The paper concludes that changes in demand generated in major destination countries determine the international allocation of medical personnel at least in the short run. Major destination countries often alter their policies on how many medical staff they can accept, and from where, while source countries are required to make appropriate responses to the changes in demand.

Energy consumption and carbon dioxide emissions in rail and road freight transport in Spain: a case study of car carriers and bulk petrochemicals

This article provides a new methodology for estimating fuel consumption and emissions by enabling a correct comparison between freight transportation modes. The approach is developed and integrated as a part of an intelligent transportation system dealing with goods movement. A key issue is related to energy consumption ratios and consequent CO2 emissions. Energy consumption ratios are often used based on transport demand. However, including other ratios based on transport supply can be useful. Furthermore, it is important to indicate which factors are associated with variations in energy consumption and emissions; especially of interest are parameters that have a higher incidence and order of magnitude, in order to fairly compare and understand the difference between transport modes and sub-modes. The study finds that the use of an energy consumption equation can improve the quality of the estimates. The study proposes that coefficients that define the energy consumption equation should be tested to determine market niches and sources of improvement in energy consumption according to the category of vehicles, fuel types used, and classes of products transported.

Preliminary temperature accelerated life test (ALT) on lattice mismatched triple-junction concentrator solar cells-on-carriers

A temperature accelerated life test on concentrator lattice mismatched Ga0.37In0.63P/Ga0.83In0.17As/Ge triple-junction solar cells-on-carrier is being carried out. The solar cells have been tested at three different temperatures: 125, 145 and 165°C and the nominal photo-current condition (500X) is emulated by injecting current in darkness. The final objective of these tests is to evaluate the reliability, warranty period, and failure mechanism of these solar cells in a moderate period of time. Up to now only the test at 165°C has finished. Therefore, we cannot provide complete reliability information, but we have carried out preliminary data and failure analysis with the current results.

Case-control study of risk of cerebral sinus thrombosis in oral contraceptive users who are carriers of hereditary prothrombotic conditions

Objective: To investigate whether users of oral contraceptives who are carriers of a hereditary prothrombotic condition (factor V Leiden mutation, protein C, S, or antithrombin deficiency) have an increased risk of cerebral sinus thrombosis.