Arsenic speciation in the urine and hair of individuals exposed to airborne arsenic through coal-burning in Guizhou, PR China

The extent of exposure of residents of Changqing (Guizhou, PR China) to arsenic through coal-burning was investigated. Despite the low coal-arsenic content (56.3 +/- 42.5 mg As kg(-1)) when compared with coals collected at different location and times from the same province, more than 30% of the study subjects have shown symptoms of arsenicosis. Coal, urine, hair, and water samples were collected in mid-September 2001 and analysed for arsenic. The average urinary and hair-arsenic concentrations in the exposed subjects were 71.4 +/- 37.1 mug As g(-1) creatinine (control 41.6 +/- 12.1) and 7.99 +/- 8.16 mg kg(-1), respectively. A positive correlation between the hair and urinary-arsenic concentration (R-2 = 0.601) was found. There was no significant difference between females and males for both urinary and hair-arsenic concentrations. Females were found to have a higher dimethylarsinic acid but lower percentages of inorganic arsenic and monomethylarsonic acid in their urine than males. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved.

A Review of the Environmental and Health Effects of Termiticides under Australian Conditions

There exists a major cost issue as regards termite damage to wooden structures. A factor in this cost has been the increasing trend towards slab-on-ground construction. Current literature has been reviewed in relation to concerns about the possible public/environmental health consequences of the repeated use of termiticides in large quantities. The previous, current and projected future use patterns of termiticides are reviewed in the context of techniques appropriate for termite control and treatment priorities. The phasing out of organochlorine termiticides in Australia was undertaken to minimise impact of these substances on the environment and to a lesser extent on public health. These persistent chemicals were replaced by substances with high activity but relatively low persistence in the soil. There has also been an increase in the use of alternative methods (e.g. physical barriers) for the control of termites. The transition away from organochlorine termiticides has led to a realisation that significant information gaps exist with regard to replacement chemicals and other technologies. Although relatively persistent, the organochlorine chemicals have a limited lifespan in soils. Their concentrations are gradually attenuated by processes such as transport away from the point of application and biodegradation. Wooden structures originally treated with these substances will, with the passing of time, be at risk of termite infestation. The only available option is re-treatment with chemicals currently registered for termite control. Thus, there are likely to be substantial future increases associated with the cost of re-treatment and repairs of older slab-on-ground dwellings. More information is required on Australian termite biology, taxonomy and ecology. The risks of termite infestation need to be evaluated, both locally and nationally so that susceptible or high risk areas, structures and building types can be identified and preventive measures taken in terms of design and construction. Building regulations and designs need to be able to reduce or eliminate high-risk housing; and eliminate or reduce conditions that are attractive to termites and/or facilitate termite infestation.

Why Scotland needs more than just a new migration policy

The Scottish Executive has adopted a policy to combat Scotland's declining population by encouraging inward migration. Using a multi-state population model this paper presents nine long-term population scenarios for Scotland using three net international migration levels and three fertility paths. The results show inward migration can slow population decline but makes little difference to population ageing. Without a higher fertility rate Scotland's population will become demographically unsustainable. Our simulations show that a higher fertility rate substantially reduces the future ageing.

Telemedicine - the way ahead for medicine in the developing world

An e-mail link with the facility to send high-resolution digital images is a cheap and uncomplicated telemedicine method. The Swinfen Charitable Trust helped establish such a link in Patan Hospital Kathmandu, Nepal in March 2000. Over 12 months using this link 42 telemedicine referrals were sent to specialists throughout the world. Referrals were: 36% respiratory medicine; 21% neurology, 21% dermatology; 14% cardiology; 5% nephrology; and 3% radiology - 28 had digital pictures attached, of which 96% were of high enough quality on which specialists were able to comment. Thirty-nine replies were received. The average time for a specialist reply was 2 days, and 45% were answered within 24 hours. All replies were judged by independent assessors to be helpful or very helpful for diagnosis, management and education. The assessors decided that in 50% of cases the advice if acted upon would have shortened hospital stay. This pilot study has shown that a low-cost telemedicine link is technically feasible and can be of significant benefit for diagnosis, management and education in a developing world setting.

Estimates of global and regional potential health gains from reducing multiple major risk factors

Background Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors. Methods We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks. Results Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa. Interpretation Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions, The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial.

Hemochromatosis and alcoholic liver disease

The close association of excessive alcohol consumption and clinical expression of hemochromatosis has been of widespread interest for many years. In most populations of northern European extraction, more than 90% of patients with overt hemochromatosis are homozygous for the C282Y mutation in the HFE gene. Nevertheless, the strong association of heavy alcohol intake with the clinical expression of hemochromatosis remains. We (individually or in association with colleagues from our laboratories) have performed three relevant studies in which this association was explored. In the first, performed in 1975 before the cloning of the HFE gene, the frequency of clinical symptoms and signs was compared in patients with classical hemochromatosis who consumed 100 g or more of alcohol per day versus in nondrinkers or moderate drinkers who consumed less than 100 g of alcohol per day. The results showed no difference between the two groups except for features of complications of alcoholism in the first group, especially jaundice, peripheral neuritis, and hepatic failure. Twenty-five percent of those with heavy alcohol consumption showed histologic features of alcoholic liver disease (including cirrhosis) together with heavy iron overload. It was concluded that these patients had the genetic disease complicated by alcoholic liver disease. In the second study (2002), 206 subjects with classical HFE-associated hemochromatosis in whom liver biopsy had been performed were evaluated to quantify the contribution of excess alcohol consumption to the development of cirrhosis in hemochromatosis. Cirrhosis was approximately nine times more likely to develop in subjects with hemochromatosis who consumed more than 60 g of alcohol per day than in those who drank less than this amount. In the third study (2002), 371 C282Y-homozygous relatives of patients with HFE-associated hemochromatosis were assessed. Eleven subjects had cirrhosis on liver biopsy and four of these drank 60 g or more of alcohol per day. The reason why heavy alcohol consumption accentuates the clinical expression of hemochromatosis is unclear. Increased dietary iron or increased iron absorption is unlikely. The most likely explanation would seem to be the added co-factor effect of iron and alcohol, both of which cause oxidative stress, hepatic stellate cell activation, and hepatic fibrogenesis. In addition, the cumulative effects of other forms of liver injury may result when iron and alcohol are present concurrently. Clearly, the addition of dietary iron in subjects homozygous for hemochromatosis would be unwise. (C) 2003 Elsevier Inc. All rights reserved.

Listening to young people's voices: Youth sports leaders' advice on facilitating participation in sport

This article reports on a study that accepts the proposal that we listento the voices of young people in relation to sport and physical recreation.The study sought the advice of young sports leaders on what can be done to facilitate young people’s involvement in sport. The study used group interviews (Nominal Group Technique) with over 600 14–18-year-olds toelicit responses to a single question, ‘What can be done to help young people participate in sport?’ This article focuses on young people’s views on issues to do with climate and conditions. We argue that, while their advice offers support for some current initiatives in youth sport, it also provides new insights and challenges and suggests a reordering of existing priorities for youth sport and leisure provision.

Social positioning and the construction of a youth sports club

This article uses the concept of social positioning to explore the construction of a youth sports club by young people, their parents and coaches. The year-long ethnography of Forest Athletics Club (FAC) identified two athlete positions of Samplers and Beginning Specializers. Four parents’ positions were identified, those of Non-Attenders, Spectators, Helpers and Committed Members. One coach position was the Committed Volunteer. Each of these positions was interdependent. Particular expectations, practices and values were attached to these positions. It is argued that the club operates according to multiple agendas and that FAC is a complex and dynamic social phenomenon that is practised differently by the three groups of key players.