Airborne cow allergen, ammonia and particulate matter at homes vary with distance to industrial scale dairy operations: an exposure assessment

<p>Abstract</p> <p>Background</p> <p>Community exposures to environmental contaminants from industrial scale dairy operations are poorly understood. The purpose of this study was to evaluate the impact of dairy operations on nearby communities by assessing airborne contaminants (particulate matter, ammonia, and cow allergen, Bos d 2) associated with dairy operations inside and outside homes.</p> <p>Methods</p> <p>The study was conducted in 40 homes in the Yakima Valley, Washington State where over 61 dairies operate.</p> <p>Results</p> <p>A concentration gradient was observed showing that airborne contaminants are significantly greater at homes within one-quarter mile (0.4 km) of dairy facilities, outdoor Bos d 2, ammonia, and TD were 60, eight, and two times higher as compared to homes greater than three miles (4.8 km) away. In addition median indoor airborne Bos d 2 and ammonia concentrations were approximately 10 and two times higher in homes within one-quarter mile (0.4 km) compared to homes greater than three miles (4.8 km) away.</p> <p>Conclusions</p> <p>These findings demonstrate that dairy operations increase community exposures to agents with known human health effects. This study also provides evidence that airborne biological contaminants (i.e. cow allergen) associated with airborne particulate matter are statistically elevated at distances up to three miles (4.8 km) from dairy operations.</p

Construct dimensionality and properties of the categories in the ICF Core Set for low back pain

Objective: The aim of this study was to explore by Rasch analysis whether the Comprehensive International Classification of Functioning, Disability and Health (ICF) Core Set might represent a future clinical tool for measuring functioning of patients with low back pain. Material and methods: The Comprehensive ICF Core Set for low back pain was scored by health professionals for 118 patients with low back pain. Qualifier levels, invariance, construct validity and ordering of the categories in the components of Body function, Body structure, Activities and participation and Environmental factors were explored by Rasch analysis. Results: The number of qualifier levels had to be reduced. Categories within Body functions and within Environmental factors reflected a single underlying construct. The categories within the component of Activities and Participation did not meet the requirements of a single underlying construct in the present population. Few categories covered the problems reported by patients with a relatively high level of function.Conclusion: Rasch analysis indicated that the Comprehensive ICF Core Set for low back pain may be used with some modification of categories as a common tool for assessing problems within the components Body functions, and Activity and Participation. However, detecting ICF categories that reflect the higher functional levels in patients with low back pain, and revision of the qualifier levels may be necessary

Health and environmental consequences of the world trade center disaster.

The attack on the World Trade Center (WTC) created an acute environmental disaster of enormous magnitude. This study characterizes the environmental exposures resulting from destruction of the WTC and assesses their effects on health. Methods include ambient air sampling; analyses of outdoor and indoor settled dust; high-altitude imaging and modeling of the atmospheric plume; inhalation studies of WTC dust in mice; and clinical examinations, community surveys, and prospective epidemiologic studies of exposed populations. WTC dust was found to consist predominantly (95%) of coarse particles and contained pulverized cement, glass fibers, asbestos, lead, polycyclic aromatic hydrocarbons (PAHs), polychlorinated biphenyls (PCBs), and polychlorinated furans and dioxins. Airborne particulate levels were highest immediately after the attack and declined thereafter. Particulate levels decreased sharply with distance from the WTC. Dust pH was highly alkaline (pH 9.0-11.0). Mice exposed to WTC dust showed only moderate pulmonary inflammation but marked bronchial hyperreactivity. Evaluation of 10,116 firefighters showed exposure-related increases in cough and bronchial hyperreactivity. Evaluation of 183 cleanup workers showed new-onset cough (33%), wheeze (18%), and phlegm production (24%). Increased frequency of new-onset cough, wheeze, and shortness of breath were also observed in community residents. Follow-up of 182 pregnant women who were either inside or near the WTC on 11 September showed a 2-fold increase in small-for-gestational-age (SGA) infants. In summary, environmental exposures after the WTC disaster were associated with significant adverse effects on health. The high alkalinity of WTC dust produced bronchial hyperreactivity, persistent cough, and increased risk of asthma. Plausible causes of the observed increase in SGA infants include maternal exposures to PAH and particulates. Future risk of mesothelioma may be increased, particularly among workers and volunteers exposed occupationally to asbestos. Continuing follow-up of all exposed populations is required to document the long-term consequences of the disaster

Health problems and disability in long-term sickness absence: ICF coding of medical certificates

<p>Abstract</p> <p>Background</p> <p>The purpose of this study was to test the feasibility of International Classification of Functioning, Disability and Health (ICF) and to explore the distribution, including gender differences, of health problems and disabilities as reflected in long-term sickness absence certificates.</p> <p>Methods</p> <p>A total of 433 patients with long sick-listing periods, 267 women and 166 men, were included in the study. All certificates exceeding 28 days of sick-listing sent to the local office of the Swedish Social Insurance Administration of a municipality in the Stockholm area were collected during four weeks in 2004-2005. ICD-10 medical diagnosis codes in the certificates were retrieved and free text information on disabilities in body function, body structure or activity and participation were coded according to ICF short version.</p> <p>Results</p> <p>In 89.8% of the certificates there were descriptions of disabilities that readily could be classified according to ICF. In a reliability test 123/131 (94%) items of randomly chosen free text information were identically classified by two of the authors. On average 2.4 disability categories (range 0-9) were found per patient; the most frequent were 'Sensation of pain' (35.1% of the patients), 'Emotional functions' (34.1%), 'Energy and drive functions' (22.4%), and 'Sleep functions' (16.9%). The dominating ICD-10 diagnostic groups were 'Mental and behavioural disorders' (34.4%) and 'Diseases of the musculoskeletal system and connective tissue' (32.8%). 'Reaction to severe stress and adjustment disorders' (14.7%), and 'Depressive episode' (11.5%) were the most frequent diagnostic codes. Disabilities in mental functions and activity/participation were more commonly described among women, while disabilities related to the musculoskeletal system were more frequent among men.</p> <p>Conclusions</p> <p>Both ICD-10 diagnoses and ICF categories were dominated by mental and musculoskeletal health problems, but there seems to be gender differences, and ICF classification as a complement to ICD-10 could provide a better understanding of the consequences of diseases and how individual patients can cope with their health problems. ICF is feasible for secondary classifying of free text descriptions of disabilities stated in sick-leave certificates and seems to be useful as a complement to ICD-10 for sick-listing management and research.</p

Tracing the city - parkour training, play and the practice of collaborative learning

The article examines how parkour training is constructed and transmitted amongst localised peer groups known as ‘traceurs’. It concentrates on training practices that develop as a result of peer interaction in open, public spaces rather than formal training sessions that take place within a gym or as part of a regulated coaching programme. Drawing on extended interview material from a range of parkour practitioners with varying levels of experience and expertise, the article investigates the traceur's perspective on group training and how this relates to cognition and processes of learning. Using traceurs' own reflections the research will identify how physical obstacles, mental challenges, fear and risk are handled through repeated actions that then result in deeply embedded somatic responses to the built environment. The repertoire of moves that is shared between traceurs offers a patterned way of learning that, in turn, provides a route to embodied knowing. The research demonstrates how group training sessions in parkour can be conceived as collaborative learning and how that relates to theories of social learning (Bandura 1977, Lave 2009, Wenger 1998). The article argues that the efficacy of play as an approach to training provides a vehicle for active learning that chimes with the utilitarian aspect of parkour practice where to know and overcome obstacles represents the knowing and attainment of freedom