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PubMed1978

Botulism type B: epidemiologic aspects of an extensive outbreak.

Between March 31 and April 6, 1977, 59 individuals developed type B botulism. All ill persons had eaten at the same Mexican restaurant and all had consumed a hot sauce made with improperly home-canned jalapeno peppers, either by adding it to their food, or by eating a nacho that had had hot sauce used in its preparation. There was a highly significant association between illness and consumption of hot sauce when a comparison was made between ill persons and well controls: 4% of all restaurant patrons eating at the restaurant during the outbreak period became ill with botulism; however, approximately two-thirds of those actually exposed to the toxic hot sauce became ill. Disease severity was statistically correlated with incubation periods. No differences in disease severity were found between persons of different age groups. The full clinical spectrum (mild symptomatology with neurologic findings through life-threatening ventilatory paralysis) of type B botulism was documented.

Adolescent↗
PubMed1994

Alcohol outlet density and motor vehicle crashes in Los Angeles County cities.

The extent to which the availability of alcohol encourages alcohol consumption resulting in alcohol-related problems remains controversial. In order to address this issue we used 1990 data from 72 cities within Los Angeles County to estimate the relation between densities of four types of alcohol outlets (restaurants, bars, liquor stores, mini-markets) and rates of two types of alcohol-related motor vehicle crashes reported by police (injury, property damage). After logarithmic transformation of variables, crash rates were regressed on outlet densities and possible demographic confounders. The demographic covariates accounted for 25% of the variance in injury crashes; adding the combined outlet density to the model yielded a significant elasticity estimate (beta +/- SE) (beta = 0.55 +/- 0.13). Separate models for types of outlets yielded significant elasticities for restaurants (beta = 0.22 +/- 0.07), liquor stores (beta = 0.46 +/- 0.17) and mini-markets (beta = 0.34 +/- 0.13), but not for bars (beta = 0.08 +/- 0.07). Alcohol-related crashes resulting in property damage also showed positive associations with outlet densities, but these associations were smaller and reached statistical significance for restaurants (beta = 0.19 +/- 0.11) and bars (beta = 0.21 +/- 0.10). Direction of influence cannot be inferred from these cross-sectional findings, but they do indicate that increased alcohol availability is geographically associated with increased alcohol-related motor vehicle crashes and that this association is independent of measured confounders.

Accidents, Traffic↗
PubMed2003

Migration of objects and inferences across episodes.

Participants viewed episodes in the form of a series of photographs portraying ordinary routines (e.g., eating at a restaurant) and later received a recognition test. In Experiment 1, it was shown that objects (e.g., a vase of flowers, a pewter lantern) that appeared in a single episode during the study phase migrated between memories of episodes described by the same abstract schema (e.g., from Restaurant Episode A at study to Restaurant Episode B at test), and not between episodes anchored by different schemas. In Experiment 2, it was demonstrated that backward causal inferences from one study episode influenced memories of other episodes described by the same schema, and that high-schema-relevant items viewed in one episode were sometimes remembered as having occurred in another episode of the same schematic type.

Humans↗
PubMed2002

Cross-contamination of lettuce with Escherichia coli O157:H7.

Contamination of produce by bacterial pathogens is an increasingly recognized problem. In March 1999, 72 patrons of a Nebraska restaurant were infected with enterohemorrhagic Escherichia coli (EHEC) O157:H7, and shredded iceberg lettuce was implicated as the food source. We simulated the restaurant's lettuce preparation procedure to determine the extent of possible EHEC cross-contamination and growth during handling. EHEC inoculation experiments were conducted to simulate the restaurant's cutting procedure and the subsequent storage of shredded lettuce in water in the refrigerator. All lettuce pieces were contaminated after 24 h of storage in inoculated water (2 x 10(9) CFU of EHEC per 3 liters of water) at room temperature or at 4 degrees C; EHEC levels associated with lettuce increased by > 1.5 logs on the second day of storage at 4 degrees C. All lettuce pieces were contaminated after 24 h of storage in water containing one inoculated lettuce piece (approximately 10(5) CFU of EHEC per lettuce piece) at both temperatures. The mixing of one inoculated dry lettuce piece with a large volume of dry lettuce, followed by storage at 4 degrees C or 25 degrees C for 20 h resulted in 100% contamination of the leaves tested. Microcolonies were observed on lettuce stored at 25 degrees C, while only single cells were seen on leaves stored at 4 degrees C, suggesting that bacterial growth had occurred at room temperature. Three water washes did not significantly decrease the number of contaminated leaves. Washing with 2,000 mg of calcium hypochlorite per liter significantly reduced the number of contaminated pieces but did not eliminate contamination on large numbers of leaves. Temperature abuse during storage at 25 degrees C for 20 h decreased the effectiveness of the calcium hypochlorite treatment, most likely because of bacterial growth during the storage period. These data indicate that storage of cut lettuce in water is not advisable and that strict attention must be paid to temperature control during the storage of cut lettuce.

Calcium Compounds↗
PubMed2002

Incidence of enterotoxigenic staphylococci and their toxins in foods.

Of 504 food samples collected from cafeterias, 19 (3.8%) yielded strains of enterotoxigenic staphylococci, and 10 (52.6%), 4 (21.1%), 3 (15.8%), and 2 (10.5%) of these strains produced enterotoxins C (SEC), D (SED), B (SEB), and A (SEA), respectively. Moreover, SEA, SEB, and SEC were isolated from three hamburger samples. Of 181 food samples collected from four restaurants before the implementation of the hazard analysis and critical control point (HACCP) system, 7 (3.9%) were found to contain enterotoxigenic strains, and SED, SEC, and SEA were produced by 4 (57.1%), 2 (28.6%), and 1 (14.3%) of these strains, respectively. One meatball sample with SEC was detected in a restaurant. After the implementation of the HACCP system in four restaurants, neither enterotoxigenic staphylococci nor enterotoxins were detected in 196 studied samples.

Consumer Product Safety↗
PubMed2000

Public opinion and legislators' views on tobacco policy.

We explored the relationship between public opinion and Kentucky state legislators' views on increasing the cigarette excise tax to curb smoking, local option to pass stricter youth access to tobacco laws, and smoking restrictions in public places. The relationship of gender, education, political party affiliation, tobacco use, and tobacco allotment ownership to public and legislators' opinions was examined using logistic regression. Data from the random, statewide University of Kentucky Public Opinion Poll (n = 628 Kentucky adults) and a Delphi study of Kentucky legislators (n = 116 members of the Kentucky General Assembly) were used in this study. Controlling for the demographic differences in gender, age, ethnicity, education, and tobacco allotment ownership between the public opinion and legislator samples, legislators were far less likely than the public to support workplace or restaurant smoking restrictions. Participants with a college education were twice as likely to favor cigarette tax hikes and four to five times more likely to favor workplace and restaurant smoking restrictions than were those without a college degree. Tobacco allotment owners and tobacco users were less likely to support raising cigarette taxes and local option to curb teen tobacco use compared to nonowners and nonusers. Findings of this study suggest that Kentucky legislators are not keeping up with public opinion about tobacco control, particularly in regard to smoking restrictions in workplaces and restaurants. Health professional organizations can play a role by educating both their membership and lawmakers about public support for tobacco control policy.

Adult↗
PubMed1975

A large food-borne outbreak of hepatitis A. Possible transmission via oropharyngeal secretions.

In Minneapolis, 107 cases of hepatitis A were identified and traced primarily to consumption of cold sandwiches served for lunch in a department store's popular basement restaurant. A sandwich-maker in the restaurant was the index patient. The date of onset of her illness and the dates of food consumption and onset of illness of infrequent restaurant patrons were consistent with accepted periods of infectivity and incubation for hepatitis A. Because the sandwich-maker frequently touched her hands to her mouth when she worked, and because we could not find evidence for fecal, airborne, or other modes of transmission, we believe that she may have contaminated food with infectious oropharyngeal secretions. The secondary attack rate was much lower among household contacts who received immune serum globulin than among those who had not.

Disease Outbreaks↗
PubMed2002

Exposure to environmental tobacco smoke in Finland in 2000.

OBJECTIVES: Exposure to environmental tobacco smoke at workplaces, homes and other places was assessed. METHODS: Exposure to environmental tobacco smoke was defined as occurring when a person reported inhaling, at least occasionally, tobacco smoke from other people's smoke. Some of the exposed were also smokers themselves. Questionnaire-based survey data and industrial hygiene measurements on environmental tobacco smoke were used to estimate the numbers of exposed persons by exposure level in Finland in January 2000. RESULTS: About 340,000 workers (16% of the employed population) were exposed to environmental tobacco smoke at work, of them 30,000 were exposed almost continuously (1.4% of the employed population). The mean level of exposure was 1 microg/m2 as measured by nicotine in workroom air. The nicotine concentration ranged from < 1 to > 100 microg/m3. Nearly 600,000 Finns (1% of the population) were exposed to environmental tobacco smoke at home. According measurements abroad, their mean nicotine exposure corresponded to about 4 microg/m3 at work. In addition, over 1 million Finns were exposed during leisure time to an unknown mean level of environmental tobacco smoke. Annual exposure of the Finnish population in January 2000 was estimated to originate mainly from smoking at home (48%) and leisure time in smoky restaurants (45%). Smoking was restricted at workplaces in 1995 and occupational exposure constituted 7% of the total population exposure in January 2000. New restrictions on smoking in restaurants should decrease the exposure of restaurant workers and customers even further. CONCLUSIONS: In spite of regulations, environmental tobacco smoke still remains the most common occupational exposure to chemical carcinogens in Finland.

Adolescent↗
PubMed2000

[Epidemiological investigation on an outbreak of angiostrongyliasis cantonensis in Wenzhou].

OBJECTIVE: To find out the cause and transmission factors of an outbreak of eosinophilic meningoradiculitis in Wenzhou City during October to November in 1997. METHODS: In addition to a retrospective cohort study on 182 persons who had dined at a same restaurant of the city, etiological and immunoserological investigations were conducted. RESULTS: Among 105 cases who had eaten the undercooked Ampullaria gigas in that restaurant, 47 cases were infected, the incidence rate was 44.8%; whereas none of the persons who did not eat the under-cooked Ampullaria gigas in that restaurant got the infection, the difference between the two groups being significant(P < 0.001). The incidence rate of the cases who had eaten 4 and more pieces of the undercooked Ampullaria gigas was 86.2%(25/29), while that of those who had eaten less than 4 pieces was 28.9%(22/76), the difference between the two being very significant (chi 2 = 27.83, P < 0.001, RR = 2.98). The third stage larvae of the Angiostrongylus cantonensis were found out from Ampullaria gigas living in the same locality, and the adult worms of Angiostrongylus contonensis were found out from the rats living in the locality else. The positive rate of serum anti-Angiostrongylus cantonensis antibody in the patients was 84.0%. CONCLUSION: On the basis of the clinical, epidemiological, immunoserological and etiological investigations, an outbreak of the angiostrongyliasis cantonensis caused by eating undercooked Ampullaria gigas was confirmed.

Adolescent↗
PubMed2006

Secondhand smoke and indoor public spaces in Paducah, Kentucky.

INTRODUCTION: Secondhand smoke (SHS) is the third leading cause of preventable death in the United States. It is responsible for an estimated 3,000 lung cancer deaths annually in never-smokers in the US. It also accounts for over 35,000 deaths annually from coronary heart disease in never-smokers. It increases the number and severity of asthmatic attacks in over 300,000 asthmatic children each year, and is associated with Sudden Infant Death Syndrome and middle ear infections, in addition to other illnesses in children. The purpose of this study was to examine indoor air quality in a sample of hospitality venues in Paducah, Kentucky. The relation between indoor air pollution and the presence of on premises smoking was assessed. METHODS: A Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles in the air. The SidePak uses a built-in sampling pump that draws air through the device and the particulate matter in the air scatters the light from a laser. Based on this light scattering, the device determines to assess the real-time concentration of particles smaller than 2.5 microm in micrograms per cubic meter, or PM2.5. RESULTS: The average PM2.5 concentration in the eleven locations sampled in Paducah, Kentucky, was 177 microg/m3. The average fine particle pollution level in the non-smoking sections tested was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. The average PM2.5 level across all nine smoking-permitted hospitality locations sampled in Paducah was 200 microg/m3. For a full-time employee in the venues sampled in this study, the average annual PM2.5 exposure would be 46 microg/m3 (assuming exposure to 200 microg/m3 on the job, exposure to zero particles off the job, and a 40-hour work week). The EPA average annual PM2.5 limit is exceeded by 3.1 times due solely to occupational exposure. Of the ten locations visited that permit indoor smoking, the air monitoring was done in the non-smoking section of six of them. These locations included five restaurants and one public government office. The average fine particle pollution level in these non-smoking sections was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. It is also interesting to note that the average fine particle pollution level in the smoking section of one restaurant was actually less than the average fine particle pollution level in the "no smoking" section of two other restaurants. CONCLUSIONS: The effects of secondhand smoke are substantial and rapid, explaining the relatively large health risks associated with secondhand smoke exposure that have been reported in epidemiological studies. This study shows that physically separating smokers and non-smokers is not an effective way to protect non-smoking patrons from tobacco smoke pollution. "No smoking" sections provided protection to nonsmokers that can be characterized as trivial at best. In fact, patrons in Paducah cannot be certain that their exposure will not be higher in the "no smoking" sections of certain venues when compared to the smoking sections of other venues. It is imperative that physicians and other healthcare providers actively and aggressively lobby local policymakers to pass regulatory and/or public health ordinances, which have been demonstrated to be effective in controlling exposure to secondhand smoke.

Air Pollutants↗
PubMedDate not supplied

[Fissure sealants--5 years of use].

This study assesses the caries prevalence, retention and cost-effectiveness of a pit and fissure sealant in a children population with 622 cases, 5 years after a single application of an auto-polymerized sealant to permanent molars. The status of the sealant and the presence of caries or restaurations on the sealed teeth was assessed. In a self-controlled group of children, the prevalence of disease (caries and restaurations) was also assessed in non-sealed teeth, for comparison. The sealant application was compared with Class I-restauration with amalgam for cost-effectiveness analysis.

Adolescent↗
PubMed1977

Carboxyhaemoglobin saturation in relation to smoking and various occupational conditions.

The effects of smoking and occupational conditions on COHb saturation were studied among employees on traffic duty, in restaurants, in iron foundries, and in an office. The subjects were 139 smokers and 152 nonsmokers working in the same environments. Changes in COHb saturation were observed in samples of blood obtained before and after the working period. Samples of air were collected during the working hours in restaurants, in foundries and in office, 190 samples in all, for the determination of content of CO. Among the nonsmokers there was no change in COHb saturation in restaurants and in office work. On traffic duty and in iron foundries the increase was significant, but the values after work were less than half the permitted occupational threshold limit value (TLV) level of 6 per cent units. In the smoking group the mean values of COHb saturation before work were about twice the mean COHb saturation in the nonsmokers after work. In office work and in foundries the mean COHb saturations after the work exceeded the permitted TLV.

Adolescent↗
PubMed1993

[Investigation on the incidence of genital herpes in different professional groups in Qingdao].

Genital herpes is one of 8 legally reportable sexually transmitted diseases (STD) in China. Using a HSV antigen ELISA kit we detected and typed HSV antigen in 1,148 clinical specimens collected from the genital organs (penis, cervix, vagina and vulva) of 446 men and 702 women in Qindao and divided into 11 different professional and 2 special groups (patients with cervical cancer and pregnant women). The highest positive rate of HSV antigen was found among long-distance transport drivers (48.0%). The second and third high positive rates were among waiters and waitresses in private, restaurants (39.2%) and patients with cervical cancer (38.2%). The positive rates among self-employed retailers and employees in private inns and restaurants were notably higher than those among employees in state-run shops, restaurants and hotels. And, the positive rate among workers was higher than that among peasants. There was no notable difference between the positive rate of HSV antigen among men (24.2%) and that among women (21.5%). But the incidence of HSV-2 infection was much higher than that of HSV-1 infection. The results indicate that some special professional groups have high rates of genital HSV infection. More attention needs to be paid to these special groups in order to control sexually transmitted herpes diseases.

Adolescent↗
PubMed1996

Epidemiology of diarrhea among expatriate residents living in a highly endemic environment.

OBJECTIVE: To determine the etiology of diarrhea among expatriate residents living in a developing country and identify risk factors for travelers' diarrhea that are difficult to evaluate in tourist populations. DESIGN: Clinic based case-control study. SETTING: Primary care travel medicine clinic in Kathmandu, Nepal. PARTICIPANTS: A total of 69 expatriate residents with diarrhea, compared with 120 tourists with diarrhea, and 112 asymptomatic resident and tourist controls, selected systematically during a 1-year period. MAIN OUTCOME MEASURES: Risk factors for diarrhea assessed by questionnaire and pathogen prevalence assessed by microbiologic analysis of stool specimens. RESULTS: The dominant risk factors for diarrhea among expatriate residents included younger age (P = .003), shorter duration of stay in Nepal (P < .001), and eating out in restaurants (P = .01). Eating raw vegetables, salads, fresh fruit, or ice served in restaurants was not significantly associated with diarrhea. Longer duration of residence was linearly correlated with protection. Enteric pathogens were identified in 44 (64%) of 69 residents with diarrhea compared with 100 (83%) of 120 tourists with diarrhea, with enterotoxigenic Escherichia coli, Campylobacter, and Shigella predominant for both groups. Pathogens were also found in stools from 32 (37%) of 87 asymptomatic resident controls and 13 (52%) of 25 tourist controls. The attack rate of diarrhea among expatriates was estimated to be 49% (95% confidence interval, 37% to 61%) per month during the first 2 years of residence. The highest-risk months were April through July. CONCLUSIONS: Diarrhea among expatriates in a highly endemic environment is a persistent risk. The extremely high prevalence of enteric pathogens among asymptomatic persons reflects widespread exposure. The most important risk factors for travellers' diarrhea are difficult to modify, including younger age, duration of stay, eating in restaurants, and seasonality. Preventive dietary recommendations may not be fully protective, suggesting that pretravel advice should emphasize empiric treatment in addition to strategies to avoid exposure.

Adult↗
PubMedDate not supplied

Patterns and trends in food portion sizes, 1977-1998.

CONTEXT: While general consensus holds that food portion sizes are increasing, no empirical data have documented actual increases. OBJECTIVE: To determine trends in food portion sizes consumed in the United States, by eating location and food source. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative data from the Nationwide Food Consumption Survey (1977-1978) and the Continuing Survey of Food Intake by Individuals (1989-1991, 1994-1996, and 1998). The sample consists of 63 380 individuals aged 2 years and older. MAIN OUTCOME MEASURE: For each survey year, average portion size consumed from specific food items (salty snacks, desserts, soft drinks, fruit drinks, french fries, hamburgers, cheeseburgers, pizza, and Mexican food) by eating location (home, restaurant, or fast food). RESULTS: Portion sizes vary by food source, with the largest portions consumed at fast food establishments and the smallest at other restaurants. Between 1977 and 1996, food portion sizes increased both inside and outside the home for all categories except pizza. The energy intake and portion size of salty snacks increased by 93 kcal (from 1.0 to 1.6 oz [28.4 to 45.4 g]), soft drinks by 49 kcal (13.1 to 19.9 fl oz [387.4 to 588.4 mL]), hamburgers by 97 kcal (5.7 to 7.0 oz [161.6 to 198.4 g]), french fries by 68 kcal (3.1 to 3.6 oz [87.9 to 102.1 g]), and Mexican food by 133 kcal (6.3 to 8.0 oz [178.6 to 226.8 g]). CONCLUSION: Portion sizes and energy intake for specific food types have increased markedly with greatest increases for food consumed at fast food establishments and in the home.

Data Collection↗
PubMed2005

Exposure to and annoyance with second-hand smoke in Switzerland: results of the Tobacco Monitoring survey.

OBJECTIVES: To present selected results on exposure to second-hand smoke and experienced annoyance with second-hand smoke in the Swiss population, particularly in restaurants and in the workplace. METHODS: The data were collected as part of the Swiss Survey of Tobacco Use ("Tobacco Monitoring") commissioned by the Swiss Federal Office of Public Health. It is a representative, continuous survey of tobacco consumption among 14- to 65-year-olds in Switzerland. Since January 2001, four times a year a new sample of 2,500 persons has been taken (i.e. 10000 participants annually). The survey was conducted using standardized telephone interviews in German, French and Italian. RESULTS: Approximately half of the working population in Switzerland is exposed to second-hand smoke in the workplace. In restaurants, cafes and bars, nearly 9 out of 10 people are exposed to environmental tobacco smoke. Non-smokers in particular report annoyance with second-hand smoke. CONCLUSIONS: The Swiss population has a high level of exposure to second-hand smoke. There is a need for public health educational programs and legislation aiming at banning smoking in public areas and in the workplace.

Adolescent↗
PubMedDate not supplied

"What did you say?" Using review of tape-recorded interactions to increase social acknowledgments by trainees in a community-based vocational program.

Dana and Rick, two adults with developmental disabilities enrolled in a restaurant training program, had poor prospects for long-term employment because of inappropriate social behavior. They often made no response, mumbled inaudibly, or made a negative remark when spoken to by their supervisors or other employees. Each trainee's Individual Vocational Plan (IVP) included goals of prompt and polite acknowledgement of coworker initiations. Previous efforts to improve Dana and Rick's acknowledging behavior had been unsuccessful. Throughout the study, each trainee's responses to 20 verbal initiations by coworkers (i.e., requests, questions, corrective feedback, praise, and social comments) were recorded during each of two observation periods per workshift. Throughout one of the observation periods during the intervention phases, the trainees carried in their work aprons a small, audio cassette recorder that recorded their interactions with coworkers. The primary intervention consisted of a preworkshift meeting in which the trainee and experimenter reviewed five randomly selected interactions recorded during the previous day's shift. The review included self-evaluation, praise, corrective feedback, and role-play. A multiple baseline across subjects design showed each trainee acknowledged a greater number of coworker initiations as a function of the intervention. Each trainee also acknowledged more coworker initiations during the second observation period when the tape recorder was never worn. In a subsequent intervention phase, Dana reviewed her tape-recorded interactions prior to randomly selected shifts. Rick's acknowledgments increased to a socially valid level when the review procedure was supplemented with graphic feedback. Both trainees continued to acknowledge their coworkers' initiations at levels equal to nondisabled restaurant employees when they no longer wore the tape recorder during a final phase and during follow-up observations 4 to 8 weeks later.

Adult↗
PubMed2005

The environment influences whether high-fat foods are associated with palatable or with unhealthy.

This study investigated whether relatively automatic evaluations of food differ between situations and between obese people and lean controls. These evaluations were assessed in the affective priming paradigm (APP) -- a response latency based measure for associations. In Experiment 1, we either focused participants (33 obese and 26 lean controls) on the palatability (restaurant condition) or on the healthiness (health condition) of food, prior to the APP. Independent of weight-status, relatively automatic evaluations of food were based on palatability in the restaurant condition, and on health in the health condition. So, the current focus of attention can shape the way foods are evaluated relatively automatically. In Experiment 2, craving was induced in participants (27 obese and 29 lean controls). Unexpectedly, the craving induction did not achieve its goal of focusing on the palatability of food in general, but just for low-fat foods, possibly because of the health-emphasizing environment -- a hospital. Interestingly, obese people showed a stronger palatability priming effect with increasing levels of initial craving. For normal weight controls the effect was in the same direction, but missed significance. In our environment, palatability of food may be too salient, and health may not be salient enough, influencing automatic food-evaluations.

Adult↗