Occupational asphyxiation by unknown compound(s): Environmental and toxicological approach

During a routine truck-tank washing operation, five healthy workers were found motionless inside an empty tanker. Four of them died inside the tanker while the fifth died the following day in hospital. Since the true nature of the fatal compound(s) were not known, a rigorous environmental and toxicological approach supported by autopsy findings was essential to clarify the cause of death.Environmental results indicated that H2S fumes arising from the liquid sulfur previously shipped were responsible for the serial deaths, also confirmed by a simulation performed on two similar truck-tanks.These environmental findings were supported by toxicological analyses through the measurement of thiosulfate, one of the main H2S metabolites. Abnormal thiosulfate concentrations from 1.1 to 186.2mg/kg were revealed in all post-mortem biological samples (blood, lung, liver, kidney, brain and fat). Finally, the cluster analysis performed on thiosulfate body distribution contributed to establishing the time of death according to the accident scene reconstruction.This report presents valuable findings in correctly identifying the cause of death in gas asphyxiation cases by unknown compound(s). © 2009 Elsevier Ireland Ltd

Reducing Unknown Risk:The Safety Engineers’ New Horizon

A significant gap exists between accident scenarios as foreseen by company safety management systems and actual scenarios observed in major accidents. The mere fact that this gap exists is pointing at flawed risk assessments, is leaving hazards unmitigated, threatening worker safety, putting the environment at risk and endangering company continuity. This scoping review gathers perspectives reported in scientific literature about how to address these problems. Safety managers and regulators, attempting to reduce and eventually close this gap, not only encounter the pitfalls of poor safety studies, but also the acceptance of ‘unknown risk’ as a phenomenon, companies being numbed by inadequate process safety indicators, unsettled debates between paradigms on improving process safety, and inflexible recording systems in a dynamic industrial environment. The immediacy of the stagnating long term downward major accident rate trend in the Netherlands underlines the need to address these pitfalls. A method to identify and systematically reduce unknown risks is proposed. The main conclusion is that safety management can never be ready with hazard identification and risk assessment.</p

Introduciendo factores externos de riesgo en el análisis de riesgo cuantitativo

El procedimiento convencional para la evaluación cuantitativa de riesgos de instalaciones industriales o áreas industriales, así como la planeación del uso de la tierra en relación a los principales peligros de accidentes deberían incluir escenarios de accidentes generados por factores externos de riesgos. En particular, el efecto dominó (también conocido como escalación  o  encadenados debido a i) lugares cercanos, ii) eventos naturales como terremotos o inundaciones, iii) maloperaciones internacionales que, principalmente, se da por  la interferencia de actos malintencionados. Una  perspectiva de estos problemas se mostrará a continuación y, a la vez, se discutirán los enfoques actuales y futuros disponibles para la evaluación cuantitativa  de estos factores externos de  riesgo en el marco de la evaluación cuantitativa de riesgos (QRA)

Environmental Toxicology: The legacy of Silent Spring

The transcript of a Witness Seminar held by the Wellcome Trust Centre for the History of Medicine at UCL, London, London, on 12 March 2002. First published by the Wellcome Trust Centre for the History of Medicine at UCL, 2004.©The Trustee of the Wellcome Trust, London, 2004.All volumes are freely available online at: www.history.qmul.ac.uk/research/modbiomed/wellcome_witnesses/Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.Annotated and edited transcript of a Witness Seminar held on 12 March 2002. Introduction by Dr John Clark, St Andrews.The period immediately following the Second World War brought great hopes of continuing benefits from widespread use of organo-chlorine and organophosphorus insecticides and other pesticides whilst the health risks of pre-war and other later practices were largely ignored. Rachel Carson’s Silent Spring (1962) coincided with the adoption of a more cautious approach to the use of pesticides, and the ensuing decades have been characterized by continued identification of both natural and man-made hazards and consequent efforts to minimize risk. ‘Environmental toxicology’ has no firm boundaries, encompassing as it does such diverse areas as the health risks of passive smoking, asbestos, lead, radon, air-borne particles, and accidental release of toxic chemicals (‘chemical incidents’), some of which still await resolution. Chaired by Professor Tony Dayan, this Witness Seminar brought together many of those who helped shape understanding in this area – 40 years after the publication of Silent Spring. Christie D A, Tansey E M. (eds) (2004) Environmental toxicology: The legacy of Silent Spring, Wellcome Witnesses to Twentieth Century Medicine, vol. 19. London: The Wellcome Trust Centre for the History of Medicine at UCL. ISBN 978 085484 0915The Wellcome Trust Centre for the History of Medicine at UCL is funded by the Wellcome Trust, which is a registered charity, no. 210183

Access to medicines, market failure and market intervention: a tale of two regimes

This study explores how an 'Intellectual Property Rights (IPR)/trade regime' has generated a particular set of problems regarding access to medicines despite patents on drugs being presented as economically necessary for reward and future drug innovation. These problems have also inspired and informed activities by so-called new actors in global health. This study argues that a parallel 'pro-access regime' has developed in order to correct some of the most high-profile issues associated with a dysfunctional global pharmaceutical market, especially problems regarding price and innovation that have been exacerbated by stringent global patent rights on new drugs. Therefore, the IPR/trade regime's basic role in global-health governance diverges from how it has been framed and understood, not least of all by its constituent agents and donors. The pro-access regime encompasses new actors in health such as Global Health Partnerships (e.g., GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria), major philanthropic foundations (e.g., the Gates and Clinton Foundations) and new access initiatives (e.g., UNITAID). The study problematises these actors' governance roles with respect to the overarching authority of the IPR/trade regime and makes a case that the two regimes should be understood as being closely connected with respect to the governance of access to medicines and the global political economy of pharmaceuticals

Lead and crime: an ecological study between lead contaminated topsoil and violent crime.

Lead is a known neurotoxicant. Human exposure to lead comes primarily through environmental exposures, including remnant lead paint, lead contaminated topsoil and lead contaminated water. Prenatal and early life lead exposure has been associated with numerous neurocognitive and neuropsychiatric disorders. This dissertation presents findings from an ecological study which evaluated the geospatial association between topsoil lead content and the incidence of FBI designated violent crime in Jefferson County, Kentucky. A total of 412 topsoil samples were collected along roadways (n=300) and from Louisville Metro Parks (n=112). Jefferson County crime data was obtained from the Louisville Metro Police Department – Crime Information Center. Shared areas of higher than expected rates of FBI designated violent crime was designated as the Study Area. Three Control Areaswere established based upon their low to expected rates of violent crime. The Control Areas were located northeast, southeast and southwest of the Study Area. Spatial Error Model was used to compare topsoil lead content between the Study Areaand the threeControl Areas. A Bayesian sparse spatial generalized linear mixed model (SGLMM) was used to evaluate the geospatial association between violent crime and topsoil lead content while controlling for eight pertinent census-tract-level covariates. Spatial Error Model results showed that the Study Areahad an approximate 8-fold increase in topsoil lead content compared to the referent Control Area. Unadjusted SGLMM, found that every 100-unit increase in topsoil lead content was associated with a 62 percent increased risk for violent crime events per census tract (RR=1.62, 95% CI:1.59, 1.64). The full SGLMM, which controlled for eight census-tract-level covariates, found that every 100-unit increase in topsoil lead content was associated with a 5 percent increased risk for violent crime events per census tract (RR=1.05, 95% CI: 1.03, 1.08). The results of this study are based upon an ecological study and should be interpreted with caution. However, these findings provide a rationale for the design of future studies aimed at exploring the relationship between lead poisoning and subsequent criminality

Knowledge Discovery Through Large-Scale Literature-Mining of Biological Text-Data

The aim of this study is to develop scalable and efficient literature-mining framework for knowledge discovery in the field of medical and biological sciences. Using this scalable framework, customized disease-disease interaction network can be constructed. Features of the proposed network that differentiate it from existing networks are its 1) flexibility in the level of abstraction, 2) broad coverage, and 3) domain specificity. Empirical results for two neurological diseases have shown the utility of the proposed framework. The second goal of this study is to design and implement a bottom-up information retrieval approach to facilitate literature-mining in the specialized field of medical genetics. Experimental results are being corroborated at the moment

Burn Injury Management, Pathophysiology and Its Future Prospectives

For intensive care physicians, burns are a frequent and challenging patient complication. Specialist facilities prioritise patient stabilisation, infection prevention, and functional rehabilitation to the greatest extent possible. Researchers have been focusing on burns for decades, and thanks to their efforts, the mortality rate for burn patients, especially young patients and those with moderate burns, has been steadily declining. However, the intensivist often faces challenges that make it hard to provide care and stabilise patients. There may be unique complications associated with burn wounds that necessitate either delayed treatment or prolonged rehabilitation. Improvements in patient stabilisation and treatment have resulted from advances made in burn wound care thanks to research. This article discusses recent advances in the treatment of burn patients, focusing on the pathophysiology of burns and the management of burn wounds