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Occupational electrocutions in Jefferson County, Alabama.

Few studies have presented the general epidemiology of electrocution deaths using local medical examiner data. Data were obtained from coroner/medical examiner's files for electrocution deaths occurring between 1981 and 1998. All 27 occupational electrocutions were among men; 92.6% were white and 7.4% were black, with a mean age of 33.1 years. The rates of high- and low-voltage electrocution were similar. Low-voltage deaths showed a seasonal pattern, with the largest numbers in July, August and October. Deaths occurred most frequently among electricians and electrical helpers. The level of detail available from medical examiner records permits more complete evaluation of injury patterns than is possible using death certificate data; however, even more detailed studies, exploring worker activity at the time of injury, education, experience and training, are needed.

Accidents, Occupational↗

A 15-year review of railway-related deaths in Jefferson County, Alabama.

A retrospective computer search of the records of the Jefferson County Coroner/Medical Examiner Office covering the 15-year period from 1981 to 1995 revealed 86 cases in which either a train caused death or in which a body was found dead by the tracks. The average age of the decedents was 39 years (range, 3 weeks-87 years). Men accounted for 88% of the deaths. The manners of death were as follows: three natural, 64 accident, seven suicide, six homicide, and six undetermined. Six decedents were found dead by the tracks, but death was not caused by a train. Six decedents were railroad employees who died on the job. In 47 cases, the decedents were trespassing on railroad property. Five trespassers were riding the rails, and 42 were pedestrians struck by a train. Motor vehicle collisions with trains claimed 27 lives--19 drivers and eight passengers. All together, 45% of the decedents were intoxicated. Intoxication was greatest by far in individuals witnessed to have been lying on the tracks before being hit by a train. The nature of individuals riding the rails has changed in the past few decades. Freight trains today are being used by illegal immigrants as transportation within the United States. The majority of traffic fatalities occurred because the driver intentionally tried to beat the train to the crossing. These drivers were seldom intoxicated, and only two were teenagers. Lives of such impatient drivers might be spared by the installation of a crossing guard-rail that cannot be circumvented.

Accidents↗

A review of methadone deaths in Jefferson County, Alabama.

Interpretation of the concentration of a drug is more difficult when a combination of drugs is present in a decedent's blood. An increase in deaths resulting from co-intoxication with methadone and a benzodiazepine led the authors to perform a retrospective study of cases examined at the Jefferson County Coroner/Medical Examiner Office. They found 101 deaths wherein methadone was detected in the blood. Based on the drugs detected in the blood, these 101 cases were grouped into four categories: (1) pure methadone intoxication, (2) intoxication with methadone and benzodiazepine, (3) intoxication with methadone and other drugs excluding benzodiazepine, and (4) intoxication with methadone, benzodiazepines, and other drugs. Methadone was the sole intoxicant in 15 cases, with a mean concentration of 0.27 mg/L. Benzodiazepines were the most frequently detected co-intoxicant (60 of 101 cases). Benzodiazepine was the only co-intoxicant in 30 cases, and the mean methadone concentration in those 30 cases was 0.599 mg/L. Higher levels of methadone may occur in acute intoxication with methadone and benzodiazepine because benzodiazepines compete with methadone for methadone receptors. Higher levels of methadone may occur with chronic abuse of methadone and benzodiazepines because over time, benzodiazepines inhibit the hepatic enzymes that metabolize methadone.

Adolescent↗

Training community health workers to reduce health disparities in Alabama's Black Belt: the Pine Apple Heart Disease and Stroke Project.

African American women have significantly higher mortality rates from heart disease and stroke than White women despite advances in treatment and the management of risk factors. Community health workers (CHWs) serve important roles in culturally relevant programs to prevent disease and promote health. This article describes the Pine Apple Heart and Stroke Project's activities to (1) revise the Women's Wellness Sourcebook Module III: Heart and Stroke to be consistent with national guidelines on heart disease and stroke and to meet the needs of African American women living in rural southern communities; (2) train CHWs using the revised curriculum; and (3) evaluate the training program. Revisions of the curriculum were based on recommendations by an expert advisory panel, the staff of a rural health clinic, and feedback from CHWs during training. Questionnaires after training revealed positive changes in CHWs' knowledge, attitudes, self-efficacy, and self-reported risk reduction behaviors related to heart disease, stroke, cancer, and patient-provider communication. This study provides a CHW training curriculum that may be useful to others in establishing heart disease and stroke programs in rural underserved communities.

Black or African American↗

Summertime elevation of 222Rn levels in Huntsville, Alabama.

Indoor Rn concentrations and Rn in adjacent karst terrains were studied at four houses with crawlspaces in Huntsville, AL. In warm summertime weather, Rn-rich air may vent through limestone solution cavities exposed as holes at the surface of the properties. A probable interrelated-finding is that the indoor levels of 222Rn are distinctly higher in the summer than winter. The karst underlying the homes is structurally faulted and, in all probability, facilitates Rn transport from the solution cavities to the crawlspaces. Abrupt day-to-day changes in indoor Rn concentrations were recorded in addition to large seasonal changes. If the owners or residents of these particular homes had attempted to make, and interpret, short-term screening measurements for Rn during the fall season, problems, including false negatives, could have arisen because of order-of-magnitude changes in Rn concentration occurring over a few days. The best time of year to make screening measurements would be during the summer when indoor Rn concentrations are more likely to reach their maximum values.

Air Pollutants, Radioactive↗