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[Air pollution in Switzerland--sources and extent].

The immediate source of air pollution is the fuel consumption that goes on in domestic heating (about 50%), in motor vehicles (about 25%), and in industry (about 25%). Immissions in towns and agglomerations do not only depend on the number and size of these issuing sources but also on the location and meteorological conditions. The average sulphur dioxide content in various towns amounts to 0.03-0.06 ppm in winter and in summer to 0.01-0.03 ppm. In weather conditions with little exchangeability, as is often the case in Zurich, particulate matter and sulphur dioxide concentrations frequently lie above threshold limits applied abroad. In the area of heavy traffic for instance, daily averages of carbon monoxide of up to 20 ppm, and maximum hourly averages of up to 50 ppm are measured--concentrations which lie also considerably above threshold limits. For nitrogen oxides, hydrocarbons and lead too, concentrations such as are measured in large foreign cities occur. In the future, coordinated time measurements will have to be carried out more frequently in Switzerland--especially in places with strong emitting sources and unfavorable meteorological conditions.

Air Pollution↗
PubMed1998

[General hepatitis B vaccination in Switzerland: what is the attitude of vaccinating physicians?].

The purpose of this study is to assess Swiss physicians' knowledge on hepatitis B, their perception of parental information concerning this infection, their attitude towards planned universal vaccination, and their agreement with different universal immunisation scenarios. Vaccination scenarios were assessed in the following groups: infants, children at school entry, children aged 11 to 13, and children aged 14 to 16. Furthermore, scenarios involving the immunisation of school-aged children included the administration of the vaccine doses by the child's private physician or by the school health officer. Questionnaires were mailed to members of the Swiss Society of Pediatrics (n = 994), to a random sample of family physicians (n = 1000), to internists practicing general medicine (n = 500), and to chief medical officers of school health services in nine major Swiss cities. Physicians reported that they were sufficiently well informed on the serious potential sequelae of hepatitis B and the efficacy of vaccine prevention, but insufficiently informed on its epidemiology. They do not fundamentally disagree with the introduction of universal immunisation and think that parents are not aware of the potential long term dangers associated with this infection. Pediatricians and general practitioners believe that vaccinating infants at the cost of three extra injections would not be accepted by their peers and parents, and that immunising older children in their office would be feasible though difficult. School health officers believe that the immunisation of children aged 14 to 16 within the school health setting would be feasible. Universal vaccination of older children and adolescents is the scenario that best fits Switzerland's needs, perceptions and present circumstances.

Adolescent↗
PubMed1998

[Economic evaluation of various hepatitis B vaccination Strategies in Switzerland].

The aim of this study was to assess and compare the costs and epidemiological impact of different vaccination strategies against hepatitis B in Switzerland. A birth cohort of 85,000 individuals was followed over its lifetime using a decision tree analysis. Published data were used to simulate the risk of hepatitis B virus (HBV) infection in the cohort, the consecutive clinical outcomes and the associated costs. Five vaccination scenarios were assessed and compared to the baseline, defined as the high-risk group strategy without prenatal screening. These were: 1. systematic prenatal screening and vaccination of newborns at risk; 2. universal vaccination of infants; 3. universal vaccination of schoolchildren; 4. universal vaccination of infants and schoolchildren; 5. universal vaccination of infants, schoolchildren and adolescents. Results are presented using a 3% annual discounting rate. Systematic prenatal screening reduced the number of chronic infections by 11% and prevented 6 deaths per year. The cost per year of life saved was estimated to be 23,350 CHF. The four universal vaccination scenarios had a much larger impact on the number of chronic infections and deaths prevented (reduction of 68-78%). Costs per year of life saved for universal vaccination ranged from 8820 CHF (infant strategy) to 12,380 CHF (schoolchildren strategy). However, the vaccination of schoolchildren would be as cost-effective as the vaccination of infants using alternative assumptions (a lower compliance for infants compared to schoolchildren or the need for a booster later in the life for infants). The benefit-cost ratio ranged from 1.2 (systematic prenatal screening and vaccination of newborns at risk) to 2.9 (vaccination of infants). Universal vaccination against hepatitis B is more cost-effective than the current selective vaccination strategy of newborns.

Adolescent↗
PubMed1998

[Information strategy for physicians and public health regarding introduction of general hepatitis B vaccination in Switzerland].

Information is extremely important for immunisation programmes. The information should be clear, transparent, easily accessible and adapted to the different target populations. Parents consider the information presently available to be insufficient. This constitutes an obstacle to the introduction of universal vaccination against Hepatitis B in Switzerland. The population groups targeted by the information have to be the public health authorities, physicians, adolescents, parents and teachers. Various documents are now available or in preparation and should allow an effective discussion between these different partners.

Adolescent↗
PubMed1981

[Non-occupational accidents in Switzerland].

Of the over 3000 people killed in Switzerland through accidents, some 1300 die on the roads, 600 to 700 lose their lives as a result of accidents in the home, and a further number are killed in sporting accidents. these nonindustrial accidents are described in terms of their epidemiology and causes. In addition measures are discussed for preventing accidents in these three areas. At the center of the problems of traffic accidents are those caused by alcohol, the readiness of young people to take risks, and the orientation problems of children and the elderly. In sport, skiing accidents are very common, also falls in the home.

Accident Prevention↗
PubMed1984

[Analysis of recent trends in cardiovascular mortality in Switzerland].

During the last decade (1970-1980), the cardiovascular mortality rate, based on the mention of a cardiovascular disease as the primary cause of death, has decreased in all age groups in Switzerland. This decrease is greater in the female population. However, the mortality rate of ischemic heart diseases continues to increase in the 60 plus age group. If all deaths where a cardiovascular disease is reported, as either the primary or immediate cause, are considered, the decrease is less marked. The reason seems to be an increase in the number of deaths due to cancer, where a cardiopathy is reported as the immediate cause.

Adult↗
PubMed1981

[National research program on the economy and efficacy of the health system in Switzerland: scientific objective and practical aspects].

Scientific and policy targets of the National Research Program on Health Care Efficiency. Following a brief review of the general background, the specific goals of the program are presented: the realization of a solid scientific and interdisciplinary basis in the field of systematic health-system-research in Switzerland. After a review of the criteria which were employed to select out of one hundred offers some twenty research projects, a summary of these projects permits to illustrate the architecture of the whole program.

Cost-Benefit Analysis↗
PubMed1980

[The professional and familial status of female physicians in Switzerland].

A questionnaire on professional and family life was sent to all women doctors in Switzerland (N=2570). 70% were returned, 80% of the respondents are exercising their profession, though only 50% in full time jobs. The most important reason for not working is the presence of small children, mainly in doctors aged 30-40.

Adult↗
PubMed1986

[Health personnel in Switzerland: concept, sources and results].

Data concerning health manpower are recorded, in Switzerland, at different levels and in connection with various applications: at the national level, on the occasion of the Federal Census of Population; at the cantonal level, from the cantonal health authorities, which are recording data in connection with professional licences. Both of these main surveys are complementary, because the Federal Census is decennial, whereas cantonal data are continuously recorded. The present article makes by the way of examples some suggestions about how to use the professional data, describes a method for an interpretation of cantonal data and comments results at the national level. Health manpower constitutes a most important part of healths statistics. For instance many questions about controlling health costs and health planning cannot be treated without extensive knowledge of the structure and the development of the medical and paramedical professions.

Data Collection↗
PubMed1984

[Statistics of obligatory accident insurance--a contribution to health statistics in Switzerland].

After our compulsory accident insurance was reorganized, all employees and workers of Switzerland have been insured against accidents and occupational diseases since the beginning of 1984. The federal law on accident insurance prescribes also homogeneous statistics and SUVA has to run this task. The data thus gained are important for the Swiss health statistics and make it possible to set forth on a broader basis the work begun by SUVA under the previous law. The essay reviews object, organization and use of the data as well as the various aspects of data protection.

Accidents, Occupational↗
PubMed1988

[Reproductive mortality in Switzerland between 1952 and 1982].

Reproductive mortality includes mortality attributable to pregnancy and childbirth and its sequelae, termination of pregnancy and contraception. The latter is mainly due to an increase of cardiovascular diseases in oral contraceptive users. An estimate of reproductive mortality in Switzerland is based on available figures on cardiovascular mortality, smoking and use of oral contraceptives. The reproductive mortality has been steadily declining since 1952 in the age group of 15-34, a stagnation of this risk can be observed for women over 35 since 1962. Theoretically this stagnation might be due to the use of oral contraceptives and an increase in smoking.

Abortion, Illegal↗
PubMed1982

[Epidemiology of drug use in Switzerland].

A description of the consumption patterns of medicaments is given on the base of a survey taken of 1081 randomly selected persons between the ages of 15 and 74, originating from all three parts of Switzerland. On the whole, the data show a high inclination among the population to manipulate one's own condition by the intake of medicaments. Particularly among the younger age groups, the inclination to self-medication is high.

Adolescent↗
PubMed1979

[An overview of health education in Switzerland].

The present research is an attempt to give an overall view of health education programmes in Switzerland. Three phases are planned: 1. Inventory of health education programmes, 2. evaluation of these programmes, 3. recommendations for the improvement of the present situation. The present paper gives the underlying concepts of the project. These concepts are: - personal responsibility and active participation, - coordination of existing structures. The inventory is meant to give an exhaustive view of the fields covered, the target groups, the channels of informations, and the organization.

Health Education↗
PubMed1981

[Practical industrial medicine in Switzerland].

The actual state of the industrial medicine in Switzerland, which has not reached yet a satisfying level, is brought in connection with the development of the corresponding legislation as well as the traditionally rather negative attitude of the social partners towards the introduction of an efficient industrial medicine. The revised law of accident prevention might promote the completion of the necessary infrastructure. To our own behoof, we should take advantage of the experiences made in our neighbour states. The independent and competent activity of an industrial physicians is considered as the essential condition of an efficient protection of the worker to the advantage of themselves as well as the employers. The lack of postgraduate instruction and the deficient image of this specialty of medicine in our country are responsible for the difficulties in providing our industry with a considerable number of doctors of industrial medicine. The paper concludes with an information on the tasks of the Service of Occupational Medicine of the Federal Office for Industry and Labour and on examples of its work during the past years.

Government Agencies↗
PubMed1979

[Suicide in Switzerland 1876-1977].

To make statements about the evolution of suicide frequency, one has to analyse long periods. The Federal Bureau of Statistics disposes of data since 1876. When treating the statistics material of such as long period, changes in the "dark-numbers" have to be considered for they can simulate (false) tendencies. There are various reasons to assume that the dark-numbers today are smaller than at the end of the last and at the beginning of this century. A separated analysis according to age-groups brings more specific results for the size of the dark-number as well as its changes varies from age-group to age-group. In Switzerland the suicide rate of males above 30 years of age is low presently than at the begining of this century, whereas the suicide rate of males below 30 years (without regard to fluctuations) is practically the same. Since the Second World War, the suicide rate of females oscillates within a range of near-constancy. Prospective statements cannot be made. The calculated suicide rates since 1971 are only provisonal, for the basic population sizes are estimated.

Adolescent↗
PubMed1986

[Mortality differences according to socioeconomic group in Switzerland 1980: 15 to 74-year-old males].

In this paper, SMRs by socio-economic group are given for Swiss men, aged 15 to 74. One of the classifications given is similar to the English Social Classes, the other is based on distinction of self-employed and white/blue collar wage earners by economic sector (agriculture, industry or services; Table 1). The resulting differentials are similar in size to those observed between men and women, and are present with both classification schemes. Some methodological issues are discussed: SMR's have been adjusted using a random sample of 3058 death certificates from 1981 linked to their census records. Quality of occupational information does not deteriorate much up to age 74. These results are of interest as Switzerland has enjoyed an unprecedented spell of full employment and rising wages between 1950 and 1980. Implications for social security are mentioned.

Adolescent↗
PubMed1986

[Variations in perinatal mortality according to the hour of birth in Switzerland].

In Switzerland like in most developed countries, the number of births is strongly related to the hour of the day and the day of the week: this pattern is very probably related to the current practice in obstetrics. Less expected is the fact that the perinatal mortality shows a striking circadian rhythm according to the hour of birth. The paper presents this pattern and comments some related issues.

Circadian Rhythm↗