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PubMed1990

Foodborne hepatitis A: evidence that microwaving reduces risk?

During July 1988, 68 persons in Chattanooga, Tennessee, developed serologically confirmed hepatitis A. Between 15 June and 3 July, 93% of case-patients ate at a specific restaurant compared with only 3% of the local community. An intravenous drug user who worked as a cook was identified as the source. A case-control study was done to identify the vehicle of transmission. Case-patients were more likely than controls to have eaten hamburger buns and pickles, the only foods routinely handled after cooking. Of the restaurant patrons included in the study, 12 microwaved their food before consumption; none developed clinical illness despite eating large amounts of food handled after cooking. Sandwiches that were not microwaved were significantly associated with illness (odds ratio = 9.6; P less than .02). This epidemiologic evidence suggests that microwaves inactivate hepatitis A virus in food.

Adolescent↗
PubMed2000

Monosodium glutamate and asthma.

Allen et al. (1987) conducted oral monosodium glutamate (MSG) challenges with 32 asthmatic volunteers and reported that 14 reacted to MSG. Another study by Moneret-Vautrin (1987) also reported MSG-induced asthma attacks in 2 of 30 asthmatic patients. Four additional studies have been conducted and none has confirmed the results of the above authors. These studies, by Schwartzstein et al. (1987), Germano (1991), Woods et al. (1998) and Woessner et al. (1999), challenged a total of 45 patients who gave a history of asthma attacks in oriental restaurants. None of these patients experienced asthmatic reactions after ingesting MSG (one-sided confidence interval of 0-0.066). Another 109 asthmatic patients, without a history of asthma in oriental restaurants, also did not react to ingestion of MSG (one-sided confidence interval of 0-0.027). With a confidence interval < 0.05 there is a >95% probability that MSG history-negative asthmatic patients are not sensitive to MSG. For the MSG history-positive asthmatics, 45 patients, in well-performed studies, underwent negative challenges to MSG, contrasting with two studies reporting positive challenges. Allen et al. (1987) and Moneret-Vautrin (1987), who reported positive MSG challenge results, performed studies with the following characteristics: 1) single blinded, conducted after discontinuing essential antiasthma medications; 2) used effort-dependent peak expiratory flow rate measurement of lung function; 3) added AM bronchodilators in some patients; 4) ignored wandering baselines on the placebo challenge days; and 5) conducted some challenges in the AM and some at night. In summary, the existence of MSG-induced asthma, even in history-positive patients, has not been established conclusively.

Asthma↗
PubMed1975

The Middleton outbreak: 125 cases of foodborne salmonellosis resulting from cross-contaminated food items served at a picnic and a smorgasbord.

One hundred and twenty-five of 173 people who ate at a picnic and/or a smorgasbord prepared by a bar-restaurant in a Midwestern town in September 1973 developed diarrhea, abdominal cramps, and other symptoms 23 hours (median time) later. Eleven were hospitalized. Stool cultures from 18 ill individuals grew Salmonella infantis, Salmonella agona, and Salmonella schwarzengrund. Stool cultures from 5 of 8 restaurant employees grew S. infantis or S. agona. Cultures of remaining foods and food-contact surfaces were negative. Food-specific attack rates, based on interviews with 121 eaters, implicated potato salad and chicken dressing as vehicles of transmission, both likely contaminated when prepared in pans that shortly before contained uncooked, chicken pieces suspected to have harbored salmonellae. Chickens were eventually traced to 3 farms where feed samples were found to contain Salmonella typhimurium and Salmonella cubana, raising the possibility that other feed samples may have contained the serotypes responsible for the outbreak. The main control measure was temporarily closing the food service, which was to have catered a large church picnic the next day. The outbreak had an economic impact estimated at $28,733.

Adult↗
PubMed1994

Protective effect of conventional cooking versus use of microwave ovens in an outbreak of salmonellosis.

The authors conducted an investigation to determine the extent and source of an outbreak of Salmonella typhimurium gastroenteritis that occurred following a community picnic in Juneau, Alaska, in 1992, and to evaluate risk factors for illness. A case-control study among 54 picnic attendees and a retrospective cohort study among 60 members of 17 households who had taken home leftover food from the picnic were conducted. A case was defined as diarrhea with onset 12-72 hours after eating food that had been prepared for the picnic. The case-control study associated illness with eating roast pork from one of two pigs that had been flown in from a Seattle, Washington, restaurant. The roast pork was taken home by persons from at least the 17 households included in the cohort study. The cohort study identified 43 persons who ate roast pork, of whom 21 (49%) became ill. This compared with only one case of illness among 17 cohort members who had not eaten roast pork (relative risk = 8.3, 95% confidence interval 1.2-57.0). Of 30 persons who ate reheated meat, all 10 who used a microwave oven became ill, compared with none of 20 who used a conventional oven or skillet. The Seattle restaurant had prepared the roast pork by first thawing two frozen pigs for several hours at room temperature and then cooking them in a gas-fired flame broiler. One of the pigs was left unrefrigerated for 17-20 hours after cooking. Compared with conventional methods of reheating, microwave ovens had no protective effect in preventing illness. To prevent outbreaks such as this one, care must be taken to assure that food is both properly cooked and handled and properly reheated.

Adolescent↗
PubMed2004

Public attitudes toward smoking bans in a tobacco-producing county.

OBJECTIVES: Allen County, KY, is a rural county with a population of approximately 18,000. The county has a tobacco crop and is in a state in which tobacco interests are influential. The tobacco control program at the public health department developed a goal to reduce environmental tobacco smoke by restricting smoking in public places. To progress toward that goal, a public opinion poll was conducted to determine citizens' views regarding smoking restrictions in the county courthouse. METHODS: A telephone survey was conducted using the Allen County telephone directory as a sampling frame. The survey instrument included questions on support for smoking restrictions in the courthouse, restaurants, and workplaces as well as support for increasing Kentucky's cigarette tax. Interviews with 374 individuals--53.6% of the initial sample--were completed. RESULTS: Banning all smoking in the Allen County Courthouse was supported by 163 (43.4%) of the respondents. Designated smoking areas were supported by 168 (44.7%) of the respondents. Twenty-four (6.4%) of the respondents opposed any smoking restrictions at the courthouse. Women were more likely to support a ban on all smoking at the courthouse (45.4% compared with 40%). Males were more likely to support designated smoking areas (46.2% of males versus 43.8% of females). There was a small association between opposition to smoking restrictions at the courthouse and smoking by the respondent. An increase in Kentucky's cigarette tax was supported by 132 (35.1%) of the respondents and opposed by 184 (48.9%). There was no association between ownership of a tobacco-farming allotment and opinion regarding any of the tobacco control measures. CONCLUSIONS: Most Allen County residents support some form of restriction on smoking in public places (including the county courthouse and restaurants) and in workplaces. Only approximately one-third, however, supported an increase in the cigarette tax, perhaps reflecting a general antitax feeling. Ownership of tobacco allotments does not appear to be an important factor in determining attitudes on smoking control issues.

Agriculture↗
PubMedDate not supplied

Avoidance of smoky establishments: findings from Erie and Niagara Counties in New York.

The objective of this study was to determine the extent to which people avoid smoky restaurants, bars, bowling alleys, casinos, and bingo halls because of secondhand smoke. Data were collected with telephone interviews of a sample of 1,548 randomly selected adults in Erie and Niagara Counties between October 2002 and March 2003. Most nonsmokers (71%) reported that they are bothered by secondhand smoke. Thirty-four percent of nonsmokers and 10% of smokers responded that they had avoided patronizing a smoky establishment in the past 12 months. The places that were most often avoided were restaurants (17%), bars or taverns (13%), and bingo halls (9%).

Adolescent↗
PubMed1993

Drinking contexts and drinking problems among black and white women.

This study explored whether black and white women differ in how often they drink in particular types of social settings and if drinking in different contexts independently predicts alcohol-related problems. The analysis was based on the interview responses of 635 black and 663 white women drinkers who represent sub-samples from a nationwide survey of 5221 respondents conducted in 1984. The findings revealed that white women are more likely to attend restaurants, bars and parties away from home than black women and that a larger proportion of their alcohol consumption occurs in these settings than among black women. Factor analysis was used to develop scales on the the frequency of drinking in different social contexts. The results confirmed a three-dimensional factor structure that distinguished between drinking at home; drinking in social settings such as bars, restaurants and parties; and drinking in outdoor public areas like streetcorners and parks. A simultaneous equations path analysis was used to model the relationships among drinking contexts, the frequency of heavier drinking, drinking problems, race and other social characteristics. The major findings of the resulting models were that drinking contexts independently predict drinking problems and that race is not directly associated with drinking contexts or alcohol-related problems. However racial differences do exert significant indirect effects on social settings and drinking problems through differences in socio-economic status and normative attitudes. The conclusion emphasizes the complexity of the interrelationships of ethnic and social characteristics that underlie visible racial differences in the social patterns and situational contexts of alcohol use.

Adolescent↗
PubMed1999

The extent and nature of televised food advertising to New Zealand children and adolescents.

OBJECTIVE: There has been international concern over the balance of television advertising for healthy and less-healthy foods to which children and adolescents are exposed. This study examined the extent to which 9-17 year old New Zealanders were exposed to advertising for different food groups over a year and compared New Zealand rates of advertising with a 13-country study. METHOD: 'People meter' data collected over three months--May and September 1995 and February 1996--and food advertising from a sample week of television during hours when children were likely to be watching were also examined. Comparison was made with a similar 1989 South Australian study and an international study covering 13 countries. RESULTS: Both the exposure estimated for a year and the opportunities for exposure during the sample week were highest for sweet snacks, drinks, fast food/takeaways and breakfast cereals. There were very low levels for fruit, vegetables, and meat/fish/eggs. Water was not advertised in any sample month. Comparisons with the 13-country study showed New Zealand had the third-highest rate of food advertising, the highest rate of confectionery and drinks advertising, and the second-highest rate of restaurant advertising which included fast food restaurants. CONCLUSION: Current patterns of food advertising pose a conflict of interest between public health and commercial interests. Regulation of food advertising may be needed to address this in order to improve future health.

Adolescent↗
PubMed1995

The role of emotionality and typicality in speechreading.

Two experiments were carried out to investigate how emotionality and typicality could influence speechreading performance. Typical and atypical sentences for a certain script, and emotional sentences (happy and sad content, presented with happy, sad or neutral facial expression) were shown without sound on a TV-screen. Two different scripts (restaurant and doctor) were used. In Experiment 1, hearing-impaired subjects participated and in Experiment 2, normal-hearing subjects participated. Experiment 2 also evaluated the effects of tactile information. The results from both experiments showed that typical restaurant sentences were the easiest to speechread of all sentence-types, in line with script-theory (Abelson, 1981; Anderson, 1983; Bellezza & Bower, 1981; Nottenburg & Shoben, 1980; Yekovich & Walker, 1986). For the doctor script, sad sentences were better speechread than happy sentences, also according to script-theory. In addition, perception of emotional content was enhanced by tactile information. Generally, both the cognitive and emotional effects are script-dependent, suggesting important social constraints on speechreading accuracy.

Adult↗
PubMed2007

Deaths associated with choking in San Diego county.

Death from choking is the fourth most common cause of unintentional-injury mortality, but little data are published on causes or locations of these episodes. These deaths typically are peaked at the extremes of age, with young children and the elderly having the greatest rate of fatal choking. Our objective was to characterize the causes of fatal airway obstruction in adults. The San Diego County Medical Examiner's database was searched for deaths attributed to choking in decedents 18 years and older during the 10-year period from 1994 to 2004. Data were abstracted regarding the underlying medical conditions, items choked on, location of the choking, and treatments involved in the individual cases. We found 133 victims who died from choking, with 14% having using alcohol or other sedatives and 55% having a documented neurological deficit or anatomic difficulty with swallowing. The most common specified food objects that victims choked on were meat products, and 45% occurred at home, followed by 26% at supervised facilities, and 14% at restaurants. Of the 19 choking episodes occurring in restaurants, only one employee was documented to attempt a resuscitative effort. Most victims who choked to death had an underlying neurological deficit, and occurred at home or supervised facilities appear to have an appropriate initial-response intervention.

Adult↗
PubMed2004

Rural-urban differences in the social climate surrounding environmental tobacco smoke: a report from the 2002 Social Climate Survey of Tobacco Control.

CONTEXT: Although previous research has found smoking rates to be higher among residents of rural areas, few studies have investigated rural-urban differences in exposure to environmental tobacco smoke (ETS). OBJECTIVE: This study contrasted the social climate surrounding ETS among Americans who resided in 5 levels of county urbanization. DESIGN: Data were collected via telephone interviews administered to a representative sample of 3,009 civilian, noninstitutionalized adults over age 18 in the United States. Households were selected using random digit dialing procedures. FINDINGS: Compared to residents of urban counties, rural residents reported fewer restrictions on smoking in the presence of children and lower incidences of smoking bans in households, family automobiles, work areas, convenience stores, fast-food restaurants, and restaurants. Interestingly, when rural-urban variations in knowledge and attitudes about ETS were examined, the magnitude of rural-urban differences was smaller or nonexistent for these indicators. Moreover, logistic regression models indicated that none of these rural-urban differences in knowledge and attitudes persisted after statistically controlling for region, smoking status, gender, race, age, and education factors. This suggests that the observed rural-urban differences in ETS bans could not be explained adequately by rural-urban differences in knowledge and attitudes about the dangers of ETS. CONCLUSIONS: The policy implications of this research point to a greater need in rural America for programs focusing on the restriction and elimination of ETS. They also suggest that programs focusing only on influencing the levels of ETS knowledge and attitudes among the general population may not be adequate in producing the desired change.

Adolescent↗
PubMed1997

[Isolation of enterohemorrhagic Escherichia coli (O157:H7) by an immunomagnetic separation method].

Three sporadic cases of enterohemorrhagic Escherichia coli (EHEC) O157 infection which occurred in Kanagawa in 1996 were investigated. In an attempt to determine sources of the infection, a novel method of immunomagnetic separation (IMS) was employed to isolate the bacterium from feces, foods, and other associated items. In the first case, strains of EHEC O157:H7 producing Vero toxin (VT) 2 were isolated from both feces of the patient and suspected food (cattle liver) kept at a restaurant, and the strains were found to be genotypically identical through an analysis of pulsed-field gel electrophoresis (PFGE). Subsequent investigation in the meat processing store, from which the above cattle liver had been retailed to the restaurants revealed that the store was contaminated with EHEC O157:H7 producing both VT1 and VT2. In the second case, a strain isolated from the patient was EHEC O157:H7 producing both VT1 and VT2 while strains isolated from the patient's family (without apparent symptom) and the suspected facility were O137:NM producing VT2. PFGE analysis indicated that the latter two strains were genotypically identical, suggesting that the facility thus contaminated with EHEC O157 caused the infection in question. In the third case, EHEC O157:NM producing VT2 was isolated from 4 out of 7 family members including the patient, and these strains were found to be genotypically identical by subsequent PFGE analysis. Source of the infection was, however, not determined due to lack of suspected food items. In this context, four slaughterhouses in Kanagawa Prefecture were investigated for presence of EHEC O157. As a result, strains of EHEC O157:H7 producing VT1 and VT2 were isolated from the contents of cattle's distal colon and surface of the skinned carcasses. Additional attempt was also made to determine a possibility of river water being contaminated with EHEC O157. The bacterium was, however, not isolated from water samples collected from 4 major rivers in the prefecture (at 10 collecting sites). Experiments were undertaken in order to evaluate the use of IMS in isolation of EHEC O157 from food items, with different pre-enrichment media and conditions. The results indicated that pre-enrichment by trypticase soy broth at 36 degrees C for 6 h followed by inoculating onto sorbitol MacConkey agar plate containing cefixime and tellurite was most appropriate to isolate EHEC O157 strains.

Adolescent↗
PubMed2002

Food-borne outbreak of gastroenteritis associated with genogroup I calicivirus.

An outbreak of gastroenteritis affecting 158 of 219 (72%) guests and employees at a hotel is described. Food served at the hotel restaurant is believed to have been the source of the outbreak and to have been contaminated by sick employees working in the restaurant. A secondary attack rate of 22% was seen involving 43 persons in all. In stool specimens from seven of eight patients, Norwalk-like viruses (NLVs) were detected by electron microscopy. While NLV-specific PCR using primers JV12 and JV13 were negative, all specimens examined with primers NVp69 and NVp110 were positive. The failure of primers JV12 and JV13 was attributed to several mismatches in the JV12 primer. Genotyping and sequence analysis revealed that all samples had identical sequences and clustered with genogroup I, and the most closely related well-characterized genotype is Desert Shield. This is the first described food-borne outbreak associated with genogroup I virus in Sweden.

Adolescent↗
PubMed1997

Campylobacteriosis in New Zealand: results of a case-control study.

STUDY OBJECTIVE: To identify and assess the contributions of major risk factors for campylobacteriosis in New Zealand. DESIGN: Case-control study. Home interviews were conducted over nine months using a standardised questionnaire to assess recent food consumption and other exposures. SETTING: Four centres in New Zealand with high notification rates of campylobacter infections--Auckland, Hamilton, Wellington, and Christchurch. PARTICIPANTS: Case patients were 621 people notified between 1 June 1994 and 28 February 1995 as having campylobacter infection. Control subjects were selected randomly from telephone directories, and were matched 1:1 with case patients in relation to sex, age group, and home telephone prefix. RESULTS: Risk of campylobacteriosis was strongly associated with recent consumption of raw or undercooked chicken (matched odds ratio 4.52, 95% confidence interval 2.88, 7.10). There was also an increased risk with chicken eaten in restaurants (matched odds ratio 3.85; 2.52, 5.88). Recent consumption of baked or roasted chicken seemed to be protective. Campylobacteriosis was also associated with recent overseas travel, rainwater as a source of water at home, consumption of raw dairy products, and contact with puppies and cattle, particularly calves. CONCLUSIONS: Improperly cooked chicken seems to be associated with a large proportion of campylobacteriosis in New Zealand. Thorough cooking of chicken in homes and restaurants could reduce considerably the incidence of this disease.

Campylobacter Infections↗
PubMed1986

Respiratory cancer in Danish bakers: a 10 year cohort study.

A national cohort based on the census at 9 November 1970 and the death registration files from 1970 to 1980 was analysed to see if skilled Danish bakers had an excess of respiratory cancer. The group of skilled bakers was divided into occupational subgroups to try to narrow down the possible causes of cancer. Significant excess mortality was found among skilled bakers in retail bakeries, skilled bakers in hotels and restaurants, and independent bakers. To adjust for confounding factors, the SMR was calculated with control groups of equal social status and smoking habits. With all skilled workers as the reference group, skilled bakers in retail bakeries still had an excess, but now insignificant, risk but skilled bakers in hotels and restaurants had a significant excess risk. Compared with all self employed people in urban occupations in which an average of six or fewer workers were employed as a referent group, independent bakers had an insignificant excess risk. Suspected carcinogens in bakeries include polycyclic aromatic hydrocarbons (PAH), reaction products of PAH, free radicals, n-nitrosodimethylamine, aflatoxin, sterigmatocystin, and zeralenone.

Cooking↗
PubMed2002

Tobacco industry manipulation of the hospitality industry to maintain smoking in public places.

OBJECTIVE: To describe how the tobacco industry used the "accommodation" message to mount an aggressive and effective worldwide campaign to recruit hospitality associations, such as restaurant associations, to serve as the tobacco industry's surrogate in fighting against smoke-free environments. METHODS: We analysed tobacco industry documents publicly available on the internet as a result of litigation in the USA. Documents were accessed between January and November 2001. RESULTS: The tobacco industry, led by Philip Morris, made financial contributions to existing hospitality associations or, when it did not find an association willing to work for tobacco interests, created its own "association" in order to prevent the growth of smoke-free environments. The industry also used hospitality associations as a vehicle for programmes promoting "accommodation" of smokers and non-smokers, which ignore the health risks of second hand smoke for employees and patrons of hospitality venues. CONCLUSION: Through the myth of lost profits, the tobacco industry has fooled the hospitality industry into embracing expensive ventilation equipment, while in reality 100% smoke-free laws have been shown to have no effect on business revenues, or even to improve them. The tobacco industry has effectively turned the hospitality industry into its de facto lobbying arm on clean indoor air. Public health advocates need to understand that, with rare exceptions, when they talk to organised restaurant associations they are effectively talking to the tobacco industry and must act accordingly.

Civil Rights↗
PubMed1992

Urinary fluoride excretion in children using potassium fluoride containing salt or sodium fluoride supplements.

With the introduction of fluoridated domestic salt in France in 1986, questions have arisen with respect to its efficacy in caries prevention. It has been of interest to compare the urinary excretion of fluoride in children who consume fluoridated salt to that in children who take fluoride tablets. Ninety-three schoolchildren, 10-14 years of age, participated in the study and were divided into four groups: group I consumed fluoridated salt with every meal; group II ate at a school restaurant once a day and consequently consumed fluoridated salt at only their evening meal, as fluoridated salt is not authorized for use in collective restaurants; group III consisted of children taking fluoride tablets (1.0 mg F/day) exclusively, and group IV did not receive any systemic administration of fluoride for prevention and constituted a low-fluoride control group. Total 24-hour urine samples were collected from all subjects. The average daily urinary flow rates varied from 0.51 to 0.68 ml/min, but showed no statistically significant differences among the groups. The average urinary fluoride concentrations were 0.60, 0.30, 0.99, and 0.28 mg/l, respectively, for groups I-IV. The mean 24-hour urinary fluoride concentrations and excretion rates for children who consumed fluoridated salt at all meals (group I) were not statistically different from those using tables (group III). There were also no statistically significant differences between groups II and IV. The differences between urinary fluoride concentrations and excretion rates of groups I and III, as compared with group IV, were statistically significant.

Administration, Oral↗
PubMed2003

Monitoring antitobacco sentiment among community leaders.

Two public health objectives, one methodological and the other substantive, are realized in the present study. First, average survey ratings are replaced by negated mean cumulative logits (MCLs), which have the advantage of interitem commensuration. Second, these negated MCLs improve the analysis of two Florida tobacco control surveys of community leaders. Because of their common logit metric, negated MCLs for different item types are compared on their expressed antitobacco sentiment. They are also averaged to construct a precise indicator of overall sentiment. These results show that in 1998 and 1999, community leaders were most averse to selling to minors, kids buying cigarettes, and restaurant and workplace smoking. The latter aversion anticipated voters' overwhelming support of the 2002 Florida constitutional amendment prohibiting smoking in restaurants and workplaces. The authors hope that this analysis for antitobacco programs will improve other substance-abuse monitoring with surveys whose items are yet unwritten.

Attitude to Health↗