September 2007 AJPH Highlights: Safety and Security

Article ID: 531831

Released: 24-Jul-2007 3:55 PM EDT

Source Newsroom: American Public Health Association (APHA)

Newswise — The articles below will be published online July 31, 2007, at 4 p.m. (ET) by the American Journal of Public Health under "First Look" at http://www.ajph.org/first_look.shtml. All studies, excluding that authored by Michael Rabinoff, DO, PhD, will appear in the September 2007 print issue of the Journal. "First Look" articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, http://www.apha.org , and is available at http://www.ajph.org.

(1) CIGARETTE ADDITIVES COULD BE MAKING IT TOUGHER FOR SMOKERS TO QUITAt least 100 of the 599 documented cigarette additives have "pharmacological" actions, many of which enhance or maintain the delivery of nicotine, which could increase the addictiveness of cigarettes.

Researchers investigated tobacco industry documents and other sources for evidence of possible pharmacological and chemical effects of tobacco additives. They found that 100 of the 599 documented cigarette additives had pharmacological actions that camouflage environmental tobacco smoke emitted from cigarettes, enhance or maintain nicotine delivery, mask symptoms and illnesses associated with smoking behaviors and therefore could increase the addictiveness of cigarettes. As lawmakers debate whether to allow federal regulation of tobacco products, the study's findings point to a need for regulation of cigarette additives as well. [From: "Pharmacological and Chemical Effects of Cigarette Additives." ] NOTE: This study will appear in a future print issue but will be published online along with the September issue.

(2) CONTRACT WORKERS NOT SUBJECT TO SAME SAFETY OVERSIGHT AS DOE STAFFIncreasing reliance on contractors and subcontractors is a serious occupational health and safety challenge, especially when it comes to the removal of hazardous nuclear and chemical wastes.

Researchers examined the U.S. Department of Energy's (DOE) extensive occupational health and safety program, including the part designed for contractors and subcontractors. While the program is "an excellent safety culture on paper," an analytic essay concludes that hiring practices and contract language deliver mixed messages, including some safety disincentives to contractors. For example, the agency requires contractors to make sure lower-tier subcontractors have adequate safety procedures in place, yet in practice that goal is "often not realized," according to the analysis. That holds true for all businesses that use contractors. "Cost considerations come first; many small subcontractors do not have the expertise to provide complex worker health and safety programs" and few have enough training to enforce safety. Also, the department's rule allows for a variance if a contractor cannot meet all health and safety requirements.

"Subcontractors should have safety procedures and personnel training appropriate to the hazards they face, but training alone is not adequate without oversight and enforcement," according to the analysis, which also recommends a national system of recording and reporting workplace injuries by contractor and subcontractor level. "Safety must be viewed as an asset, not just as a cost." [From: "Protecting Contract Workers: Case Study of the U.S. Department of Energy's Nuclear and Chemical Waste Management." ] (3) ALREADY HIGH MURDER RATE INCREASED IN NEW ORLEANS AFTER KATRINAWhile the overall population of New Orleans dropped considerably following Hurricane Katrina's devastation of the city, murder rates there climbed in the following two years.

A Tulane University researcher used estimated repopulation trajectories after Hurricane Katrina from the City of New Orleans Emergency Operations Center, the Louisiana Recovery Authority, Rand Corporation and an analysis of postal service change-of-address requests to estimate murder rates for 2005 and 2006. He found that murder rates jumped by 14 percent between 2004 and 2005 and by a staggering 69 percent between 2004 and 2006. The huge increase in 2006 began during the second quarter of that year and continued unabated through the rest of the year.

"Compared with rates in cities of comparable size, murder rates in New Orleans have been substantially higher since at least 2004, and the disparity has been worsening since then," the study's author said. The comparable national murder rate in 2004 was 13.2 per 100,000 people, compared with 57.1 in New Orleans. Two years later, the calculated murder rate in New Orleans was 96.6 per 100,000 people - more than eight times higher than a projected comparable national average of approximately 11.9. [From: "Murder Rates in New Orleans, 2004 to 2006." ]

(4) PRIMARY SEATBELT ENFORCEMENT LAWS INCREASE SEATBELT USEStates with laws that allow law enforcement officers to pull over a vehicle if someone isn't buckled up have higher seatbelt use rates than states without such laws. Primary seatbelt enforcement also seems to increase seatbelt use among those least likely to wear them.

Researchers examined 2002 Behavioral Risk Factor Surveillance System data from 50 states and the District of Columbia and found that in states with primary safety belt laws, safety belt use was 85 percent, compared with 74 percent in states with secondary enforcement laws. Such secondary laws allow drivers to be ticketed for seatbelt violations only after being stopped for a different violation. The study found that primary enforcement laws may have the greatest impact on those who traditionally have lower rates of seatbelt use, including men, young adults, people with less education, the obese and those who drive after drinking.

Motor vehicle crashes kill more than 40,000 people each year, and the study's authors said their findings suggest primary safety belt laws could substantially drive down that number if adopted nationwide. [From: "Associations Between Sociodemographics and Safety Belt Use in States With and Without Primary Enforcement Laws." ] (5) PROVIDING SAFE PLAY SPACES HELPS INNER-CITY KIDS BE MORE ACTIVEGiving inner-city children a safe place to play could dramatically increase their level of physical activity and even cut down on the time they spend watching television and playing video games.

Researchers opened a schoolyard and provided attendants to ensure children's safety. Over the next two years researchers observed the number and physical activity levels of children in the schoolyard and surrounding neighborhood and a comparison neighborhood. They found that after the schoolyard opened, the number of children who were outdoors and physically active was 84 percent higher in the intervention neighborhood than the comparison neighborhood. Surveys also showed that children in the intervention school spent less time watching television or movies or playing video games on weekdays than children in the comparison school.

"Overall, the results provide additional evidence that perceived lack of neighborhood safety may be an important determinant of physical activity in children and suggest that physical activity levels of low-income urban children may be increased through simple environmental interventions that provide safety," the study's authors said. [From: "A Pilot Study of an Environmental Intervention to Increase Physical Activity in Inner-City Children." ]

(6) FEWER KIDS ARE DYING, BUT GAP BETWEEN RICH AND POOR WIDENSAmerica's poorest children are much more likely to die from birth defects, unintentional injury, murder and all causes than the middle class or the wealthy, despite tremendous gains in reducing overall child death over the past three decades.

A study looked at U.S. child mortality rates from 1969-2000 for children ages 1-14 and found that although overall rates declined dramatically for children at the lowest socioeconomic level, gaps in mortality widened. In 1969-1971, children in the most deprived quintile had, respectively, 52 percent, 13 percent, 69 percent, and 76 percent higher risks of all-cause, birth defects, unintentional injury, and homicide mortality than children in the least deprived quintile. The corresponding relative risks increased to 86 percent, 44 percent, 177 percent and 159 percent in 1998-2000.

"Such large and growing disparities in childhood mortality run counter to the Healthy People 2010 goals and have important implications for the magnitude of current overall health inequalities as well as for the future course of inequalities in adult health," the study's authors said. [From: "Widening Socioeconomic Disparities in U.S. Childhood Mortality, 1969-2000." ]

The American Journal of Public Health is the monthly journal of the American Public Health Association (APHA), the oldest organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at www.apha.org.


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