'High' risk? A systematic review of the acute outcomes of mixing alcohol with energy drinks

Alcohol mixed with energy drinks (AmED) is a relatively new consumption trend generating increasing concern regarding potential adverse effects. Despite the political and health imperative, there has been no systematic and independent synthesis of the literature to determine whether or not AmED offers additional harms relative to alcohol. The aim of this study was to review the evidence about whether co-consumption of energy drinks and alcohol, relative to alcohol alone, alters: (i) physiological, psychological, cognitive and psychomotor outcomes; (ii) hazardous drinking practices; and (iii) risk-taking behaviour.

Segurança das condições de aplicação de herbicidas com aerobarco em plantas daninhas aquáticas no lago da Hidrelétrica de Jupiá

Os objetivos deste trabalho foram quantificar as exposições dérmicas (EDs) e respiratórias (ERs) proporcionadas ao piloto e ao seu ajudante nas aplicações de herbicidas para o controle de plantas daninhas aquáticas com aerobarco; classificar essas condições de trabalho em seguras ou inseguras; e calcular a necessidade de controle das exposições (NCE) e o tempo de trabalho seguro (TTS). O aerobarco utilizado tinha casco de alumínio (4,85 x 2,42 m) e acionamento por hélice acoplada a motor a gasolina de 350 HP. O equipamento de pulverização era composto por bomba de diafragma com fluxo máximo de 49,69 L min-1, pressão máxima de 25 kg cm-2, acionada por motor a gasolina de 4 HP, e tanque de calda de 189 L. A barra de pulverização de alumínio era composta de duas seções laterais de 3 m, posicionadas na linha entre o encosto do banco do piloto e o início da estrutura protetora da hélice. Cada seção da barra tinha seis bicos com pontas de jato plano com indução de ar AI 100 03, espaçados de 0,5 m, e uma ponta OC 20 fixada em cada extremidade. O conjunto de pontas pulverizava faixas de 6 m de largura e aplicava o volume de calda de 200 L ha-1. O sistema tinha gerenciador de fluxo, controlado por central eletrônica acoplada a DGPS (com precisão submétrica), para corrigir automaticamente a vazão em função de alterações na velocidade real da embarcação. As EDs e ERs aos herbicidas foram calculadas com os dados substitutos das exposições às caldas, avaliadas com os traçadores cobre e manganês adicionados às caldas. As exposições foram extrapoladas para uma jornada de trabalho de seis horas. A segurança das condições de trabalho foi determinada com o cálculo da margem de segurança (MS), utilizando-se a fórmula MS = (NOEL x 70)/(QAE x 10), em que QAE = quantidade absorvível da exposição. As condições de trabalho foram classificadas em seguras, se MS>1, ou inseguras, se MS<1. As exposições proporcionadas pelas condições de trabalho foram de 10,65 mL de calda por dia para o piloto e de 16,80 mL por dia para o ajudante, que fica sentado em uma cadeira a 2,0 m à frente do piloto e da barra de pulverização. Classificaram-se como seguras as aplicações dos herbicidas glyphosate (Rodeo, 6 L ha-1), 2,4D (DMA 806 BR, 8 L ha-1) e fluridone (Sonar AQ, 0,4 L ha-1), para o piloto e o seu ajudante. Classificou-se como insegura a aplicação do herbicida diquat (Reward, 4,0 L ha-1) para as duas condições de trabalho, cujas necessidades de controle das exposições calculadas foram de 65% para o piloto e de 78% para o ajudante do piloto.

Avaliação de equipamentos de aplicação de herbicidas em operação de repasse em cana-de-açúcar e segurança para o trabalhador

Objetivou-se com este trabalho classificar em seguras ou inseguras as condições de trabalho de aplicação da formulação comercial de paraquat a 0,5% e de abastecimento dos tanques em operação de repasse em cultura de cana-de-açúcar com os pulverizadores costal manual, costal pressurizado e Pulmipur manual; determinar o efeito das variações na operação de repasse em quatro usinas de açúcar e álcool com o pulverizador costal pressurizado sobre as exposições dos trabalhadores ao paraquat; determinar a eficácia de equipamentos de proteção individual nessas condições de trabalho; e avaliar a intensidade da deriva e a eficácia de acessórios protetores de deriva. As exposições dérmicas e respiratórias dos trabalhadores foram avaliadas e utilizadas para calcular a margem de segurança (MS). Os valores de MS foram utilizados para classificar essas condições de trabalho em seguras (MS > 1) ou em inseguras (MS < 1). Para avaliar a deriva das aplicações na cultura e a eficácia dos protetores de deriva, foram estudados os tratamentos: formulação comercial de paraquat a 0,5% na calda, aplicada com o costal manual, sem e com o chapéu de proteção de deriva; com o costal pressurizado, sem e com a planilha de proteção de deriva; formulação comercial de paraquat pura com o Pulmipur; formulação comercial de glyphosate a 1% com o costal pressurizado e com a planilha, e puro com o Pulmipur; e testemunha sem aplicação. As duas atividades com o Pulmipur proporcionam as maiores exposições dérmicas, devido ao manuseio da formulação, e são inseguras sem o uso dos EPIs e seguras com estes. As atividades com o pulverizador costal manual ou pressurizado são seguras com ou sem os EPIs. As grandes diferenças nas EDs dos trabalhadores se devem às diferenças no tempo de trabalho diário e no número de trabalhadores nas equipes entre as usinas de açúcar e álcool. O protetor de deriva tipo chapéu é eficaz no controle da deriva na aplicação do paraquat, e a planilha, não.

Hematologia e ecotoxicidade do teflubenzuron no controle de Trichodina sp. em peixes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Fatigued driving : prevalence, risk factors and groups, and the law

Fatigue and sleepiness are major causes of road traffic accidents. However, precise data is often lacking because a validated and reliable device for detecting the level of sleepiness (cf. the breathalyzer for alcohol levels) does not exist, nor does criteria for the unambiguous detection of fatigue/sleepiness as a contributing factor in accident causation. Therefore, identification of risk factors and groups might not always be easy. Furthermore, it is extremely difficult to incorporate fatigue in operationalized terms into either traffic or criminal law. The main aims of this thesis were to estimate the prevalence of fatigue problems while driving among the Finnish driving population, to explore how VALT multidisciplinary investigation teams, Finnish police, and courts recognize (and prosecute) fatigue in traffic, to identify risk factors and groups, and finally to explore the application of the Finnish Road Traffic Act (RTA), which explicitly forbids driving while tired in Article 63. Several different sources of data were used: a computerized database and the original folders of multidisciplinary teams investigating fatal accidents (VALT), the driver records database (AKE), prosecutor and court decisions, a survey of young male military conscripts, and a survey of a representative sample of the Finnish active driving population. The results show that 8-15% of fatal accidents during 1991-2001 were fatigue related, that every fifth Finnish driver has fallen asleep while driving at some point during his/her driving career, and that the Finnish police and courts punish on average one driver per day on the basis of fatigued driving (based on the data from the years 2004-2005). The main finding regarding risk factors and risk groups is that during the summer months, especially in the afternoon, the risk of falling asleep while driving is increased. Furthermore, the results indicate that those with a higher risk of falling asleep while driving are men in general, but especially young male drivers including military conscripts and the elderly during the afternoon hours and the summer in particular; professional drivers breaking the rules about duty and rest hours; and drivers with a tendency to fall asleep easily. A time-of-day pattern of sleep-related incidents was repeatedly found. It was found that VALT teams can be considered relatively reliable when assessing the role of fatigue and sleepiness in accident causation; thus, similar experts might be valuable in the court process as expert witnesses when fatigue or sleepiness are suspected to have a role in an accident’s origins. However, the application of Article 63 of the RTA that forbids, among other things, fatigued driving will continue to be an issue that deserves further attention. This should be done in the context of a needed attitude change towards driving while in a state of extreme tiredness (e.g., after being awake for more than 24 hours), which produces performance deterioration comparable to illegal intoxication (BAC around 0.1%). Regarding the well-known interactive effect of increased sleepiness and even small alcohol levels, the relatively high proportion (up to 14.5%) of Finnish drivers owning and using a breathalyzer raises some concern. This concern exists because these drivers are obviously more focused on not breaking the “magic” line of 0.05% BAC than being concerned about driving impairment, which might be much worse than they realize because of the interactive effects of increased sleepiness and even low alcohol consumption. In conclusion, there is no doubt that fatigue and sleepiness problems while driving are common among the Finnish driving population. While we wait for the invention of reliable devices for fatigue/sleepiness detection, we should invest more effort in raising public awareness about the dangerousness of fatigued driving and educate drivers about how to recognize and deal with fatigue and sleepiness when they ultimately occur.

Gender stereotypes and drinking cognitions as indicators of moderate and high risk drinking among young women and men

The study examined differences in gender stereotypes, restrained drinking and self-efficacy for alcohol refusal between moderate and high risk drinkers among a university sample of 301 women and 118 men. Both female and male high risk drinkers displayed a response conflict, typified by high scores on restrained drinking but low scores on self-efficacy. This pattern of response conflict was more pronounced for high risk drinking women, who also identified poorly with feminine traits (e.g. ‘nurturing’, ‘love children’, ‘appreciative’). The findings are discussed in relation to society's double standard that accepts intoxication in men but condemns it in women.

It blasted me into space : intoxication and an ethics of pleasure

O'Malley and Valverde point out that in the 21st century, pleasure is a warrantable motive for drug and alcohol use only when it is attached to the idea of moderation. This presents a problem for those researchers who wish to theorise about those individuals who use drugs deliberately to induce intoxication. This paper uses unconventional means to come to an understanding of intoxication, it uses the stories of interviewed former heroin addicts, published autobiographies, biographies and even some fictional accounts to come to an understanding of the. difficulties of dealing with intoxication and the drug-using subject, it also uses the accounts that Michel Foucault gave about his own use of drugs and its relationship to an ethics of pleasure and resistance. The article uses theories of risk and edgework to understand the underlying meanings of intoxication to many drug users.

Patron offending and intoxication in night time entertainment districts (POINTED) : a study protocol

Risky alcohol consumption is the subject of considerable community concern in Australia and internationally, particularly the risky drinking practices of young people consuming alcohol in the night-time economy. This study will determine some of the factors and correlates associated with alcohol-related risk-taking, offending and harm in and around licensed venues and night-time entertainment precincts across five Australian cities (three metropolitan and two regional). The primary aim of the study is to measure levels of pre-drinking, drinking in venues, intoxication, illicit drug use and potentially harmful drinking practices (such as mixing with energy drinks) of patrons in entertainment areas, and relating this to offending, risky behaviour and harms experienced. The study will also investigate the effects of license type, trading hours, duration of drinking episodes and geographical location on intoxication, offending, risk-taking and experience of harm. Data collection involves patron interviews (incorporating breathalysing and drug testing) with 7500 people attending licensed venues. Intensive venue observations (n=112) will also be undertaken in a range of venues, including pubs, bars and nightclubs. The information gathered through this study will inform prevention and enforcement approaches of policy makers, police and venue staff.

Reducing intoxication among bar patrons: some lessons from prevention of drinking and driving

Intoxication in and around licensed premises continues to be common, despite widespread training in the responsible service of alcohol and laws prohibiting service to intoxicated individuals. However, research suggests that training and the existence of laws are unlikely to have an impact on intoxication without enforcement, and evidence from a number of countries indicates that laws prohibiting service to intoxicated individuals are rarely enforced. Enforcement is currently hampered by the lack of a standardized validated measure for defining intoxication clearly, a systematic approach to enforcement and the political will to address intoxication. We argue that adoption of key principles from successful interventions to prevent driving while intoxicated could be used to develop a model of consistent and sustainable enforcement. These principles include: applying validated and widely accepted criteria for defining when a person is ‘intoxicated’; adopting a structure of enforceable consequences for violations; implementing procedures of unbiased enforcement; using publicity to ensure that there is a perceived high risk of being caught and punished; and developing the political will to support ongoing enforcement. Research can play a critical role in this process by: developing and validating criteria for defining intoxication based on observable behaviour; documenting the harms arising from intoxication, including risk curves associated with different levels of intoxication; estimating the policing, medical and social costs from intoxicated bar patrons; and conducting studies of the cost-effectiveness of different interventions to reduce intoxication.

'Wide-awake drunkenness'? Investigating the association between alcohol intoxication and stimulant use in the night-time economy

Aims: We tested whether patrons of the night-time economy who had co-consumed energy drinks or illicit stimulants with alcohol had higher blood alcohol concentration (BAC) levels than patrons who had consumed only alcohol. Design: Street intercept surveys (n=4227) were undertaken between 9 p.m. and 5 a.m. over a period of 7 months. Setting: Interviews were undertaken with patrons walking through entertainment precincts, queuing to enter venues or exiting venues in five Australian cities. Participants: The response rate was 92.1%; more than half the study sample was male (60.2%) and the median age was 23 years (range 18-72). Measurements: Data were collected on demographics, length of drinking session, venue types visited, types and quantity of alcohol consumed and other substance use. A BAC reading was recorded and a subsample of participants was tested for other drug use. Findings: Compared with the total sample (0.068%), illicit stimulant consumers (0.080%; P=0.004) and energy drink consumers (0.074%; P<0.001) had a significantly higher median BAC reading, and were more likely to engage in pre-drinking (65.6, 82.1 and 77.6%, respectively, P<0.001) and longer drinking sessions (4, 5 and 4.5 hours, respectively, P<0.001). However, stimulant use was not associated independently with higher BAC in the final multivariable model (illicit stimulants P=0.198; energy drinks P=0.112). Interaction analyses showed that stimulant users had a higher BAC in the initial stages of the drinking session, but not after 4-6 hours. Conclusions: While stimulant use does not predict BAC in and of itself, stimulants users are more likely to engage in prolonged sessions of heavy alcohol consumption and a range of risk-taking behaviours on a night out, which may explain higher levels of BAC among stimulants users, at least in the initial stages of the drinking session.

Demographic risk factors for alcohol-related aggression in and around licensed venues

AIMS: Few studies have examined the role of gender and both area-level and individual socio-economic status (SES) as independent predictors of alcohol-related aggression (ARA) in and around licensed venues. METHODS: The aim of the present study was to investigate the relationship between gender, area-level SES and individual SES (operationalised as occupational category) and ARA in and around licensed venues. The sample comprised 697 men and 649 women aged 16-47, who completed a patron intercept survey as part of a larger study assessing trends in harm and stakeholders' views surrounding local community level interventions in dealing with alcohol-related problems in the night-time economy. RESULTS: Binary logistic regression analyses showed that age, gender, occupational category, area-level SES and level of intoxication at time of interview were all significant predictors of involvement in ARA. Being male doubled the odds of involvement in ARA, while age was a protective factor. Blue collar workers had more than double the odds of ARA involvement of professionals, while those living in the most socio-economically disadvantaged areas were over twice as likely to report experiencing ARA compared to those living in the most advantaged areas. However, assessment of the predictive model by gender revealed that effects of age, occupational category and area-level SES were restricted to male participants, with greater intoxication no longer predictive. CONCLUSIONS: ARA among patrons was significantly more likely to occur among men, those in blue collar occupations, and individuals living in low SES areas, suggesting both individual and area-level disadvantage may play a role in ARA.

ACUTE TOXICITY and ENVIRONMENTAL RISK of OXYTETRACYLINE and FLORFENICOL ANTIBIOTICS TO PACU (Piaractus mesopotamicus)

The oxytetracyline (OTC) and florfenicol (FLO) are the most used antibiotics for bacterial disease control in fish. The aims are: estimating the lethal concentration 50% initial (LC(I) 50;48h) of OTC (Terramicina (R)) and FLO (Aquaflor (R)) for pacu (Piaractus mesopotamicus); classifying OTC and FLO according to the acute toxicity and the risk of environmental intoxication; and assessing OTC and FLO dilution effect in water quality variables. Fish were acclimatized for 10 days in a bioassay room at 27 +/- 2 degrees C. Then nine animals (three each concentration) were exposed to 7.0; 7.5; 8.0 or 8.5 mg L(-1) of OTC or to 600.0; 700.0; 800.0; 900.0 and 1000.0 mg L(-1) of FLO and a control treatment. The water quality variables recorded daily were: pH, temperature, electric conductivity, and dissolved oxygen. OTC and FLO were classified according to acute toxicity and environmental risk. The estimated OTC LC(I) 50;48h for pacu is 7.6 mg L(-1) and the estimated FLO is > 1000 mg L(-1). OTC reduced the dissolved oxygen concentration, and it was considered moderately toxic, causing risk of environmental intoxication to pacu. FLO is not toxic; it does not cause risk of environmental intoxication to pacu and does not change water quality variables.

Association between cannabis use and sexual risk behavior among young heterosexual adults

To study the association between cannabis use and frequent sexual risk behavior, we tested the hypothesis of a situational influence of cannabis use in sexual encounters using a combination of global association study and event-level analysis and examined possible mediator variables, including the personality trait of hedonism/risk preference, psychosocial stress, and HIV-related beliefs, using mediation models. The results of a computer-assisted telephone interview of a random sample of 2790 heterosexual men and women aged 16-24 years showed that risky sexual behavior was more frequent in cannabis-using men and women than in non-using persons. The results did not support a situational effect of cannabis intoxication on sexual risk behavior. The more frequent sexual risk behavior among cannabis users was mediated by decreased intentions to use HIV protection, by lower HIV-self-efficacy, and higher risk preference/hedonism. Only among women psychosocial stress was a partial mediator. The findings show that HIV prevention programs for cannabis-using young adults should emphasize the role of person variables instead of situation variables.

Understanding youthful risk taking and driving.

National Highway Traffic Safety Administration, Washington, D.C.