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PubMedDate not supplied

Unintentional carbon monoxide deaths in California from residential and other nonvehicular sources.

To investigate risk factors of unintentional carbon monoxide deaths in California from nonvehicular sources, we identified 270 deaths resulting from nonvehicular sources of carbon monoxide poisoning from death certificates and coroners' investigation reports. Data recorded between 1979 and 1988 in the state of California on risk factors and carbon monoxide sources were abstracted from investigation reports. We also used census and state statistics to calculate rates and relative risks. The highest rates, which occurred in winter, were found among males, African Americans, and the elderly. Relative risks (in parentheses) were higher among individuals who (a) lived in multiunit dwellings (2.1), (b) dwelled in mobile/trailer homes (4.7), and (c) resided in temporary shelters (30.0) than among individuals who lived in single-family houses (1.0). Unvented combustion heating appliances and charcoal fuel were associated significantly with the risks of fatal unintentional carbon monoxide poisoning.

Accidents↗
PubMedDate not supplied

Illness and absenteeism among California highway patrol officers responding to hazardous material spills.

Highway patrol officers are the primary responders to hazardous material spills in California, yet little is known regarding the health effects resulting from this exposure. A historical cohort study of 993 California highway patrol officers who responded to hazardous material spills in 1984 was conducted. The records of officers who were exposed to acutely toxic chemicals were followed for the subsequent week to determine if they demonstrated more absenteeism or illness compared to officers who were not exposed to toxic chemicals. No significant differences in the frequency of absenteeism or illness was found between the two groups during the week following exposure. No indication was found that exposure to hazardous materials during a highway patrol spill response results in increased absenteeism.

Absenteeism↗
PubMedDate not supplied

Ambient air pollution and cancer in California Seventh-day Adventists.

Cancer incidence and mortality in a cohort of 6,000 Seventh-day Adventist nonsmokers who were residents of California were monitored for a 6-y period, and relationships with long-term ambient concentrations of total suspended particulates (TSPs) and ozone (O3) were studied. Ambient concentrations were expressed as mean concentrations and exceedance frequencies, which are the number of hours during which concentrations exceeded specified cutoffs (e.g., federal and California air quality standards). Risk of malignant neoplasms in females increased concurrently with exceedance frequencies for all TSP cutoffs, except the lowest, and these increased risks were highly statistically significant. An increased risk of respiratory cancers was associated with only one cutoff of O3, and this result was of borderline significance. These results are presented in the context of setting standards for these two air pollutants.

Aged↗
PubMedDate not supplied

Acute health effects from community exposure to N-propyl mercaptan from an ethoprop (Mocap)-treated potato field in Siskiyou County, California.

A 145-acre potato field adjacent to Dorris, California, was treated with ethoprop (Mocap) to control nematodes. Ethoprop releases n-propyl mercaptan, a highly odorous and volatile gas, as a degradation product of the pesticide. An epidemiological investigation was undertaken by the California Department of Health Services because community residents sought medical attention for odor-related illness. Elevated health effects were found among those who reported smelling a strong odor (n-propyl mercaptan has a characteristic onion-like odor). In a logistic regression analysis, the most highly elevated 6-wk health effect incidence risks, expressed as odds ratios (ORs) adjusted for age, sex, and current cigarette smoking status, were for headache (OR = 5.08), diarrhea (OR = 3.80), runny nose (OR = 5.31), sore throat (OR = 3.58), burning/itching eyes (OR = 5.64), fever (OR = 3.59), hay fever attacks (OR = 3.50), and asthma attacks (OR = 6.0). Based upon these elevated health effects, it is recommended that human exposures to n-propyl mercaptan be minimized to the extent practicable.

Adult↗
PubMedDate not supplied

Risk factors for occupational illnesses associated with the use of paraquat (1,1'-dimethyl-4,4'-bipyridylium dichloride) in California.

This study was conducted to identify risk factors for paraquat-related occupational illnesses. Pesticide-related illness is a reportable disease in California. A total of 231 skin (26.0%), eye (32.0%), local respiratory (3.5%), and systemic (38.5%) paraquat-related cases were reported to the Worker Health and Safety Branch, California Department of Food and Agriculture, during 1971 through 1985. Following paraquat exposure, we found no cases of pulmonary fibrosis. Annual numbers of cases ranged between 1 and 33 (median = 14 cases/y). Information on illnesses reported during 1981 through 1985 (n = 62) was merged with detailed information on paraquat use in agricultural settings (111,716 applications) for the same years. We found that crop treated, method of application, and season of application all contributed independently to the risk of reported illness. Hand application was associated with a higher risk of illness, compared with air application (RR = 99.1, 95% CI = 22.16-443.47); summer application was associated with a higher risk of illness than was winter application (RR = 4.1, 95% CI = 1.91-8.61); and fruit trees were associated with higher risk of illness than were other crops (mainly cotton) (RR = 3.6, 95% CI = 1.18-11.21).

Adolescent↗
PubMed2006

The proportion of self-reported asthma associated with work in three States: California, Massachusetts, and Michigan, 2001.

OBJECTIVES: To assess the proportion of adult asthma at the state level that may be related to work. DESIGN: Work-related asthma questions were added to the 2001 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire in California, Massachusetts, and Michigan. RESULTS: Findings indicate 7.4-9.7% of those with current asthma reported that their asthma may be work related. These results estimate that approximately 137,000 adults in California, 39,000 in Massachusetts, and 63,000 in Michigan have asthma that may be work related. CONCLUSIONS: These findings are unique in providing population-based estimates at the state level that illustrate that a substantial portion of adult asthma morbidity is due to exposures in the work environment.

Adolescent↗
PubMedDate not supplied

The California Physicians Diversion Program's experience with recovering anesthesiologists.

This article examines the effectiveness of the rehabilitation of anesthesiologists who are addicted to alcohol or other drugs. There has been some concern and discussion about allowing anesthesiologists who are addicted to alcohol or other drugs to continue practicing in their specialty. This article analyzes success rates, relapse rates, and failure rates among the anesthesiologists and residents of anesthesiology in the California Physicians Diversion Program for chemically dependent doctors. Of the 255 physicians who have successfully completed the program during the ten years prior to March 1990, 35 were practicing anesthesiologists, including six resident anesthesiologists. Although doctors in this specialty are more at risk for manifesting addiction to alcohol and other drugs, California's experience demonstrates that they have an equal chance of recovery and contradicts the pessimism about recovery in anesthesiologists.

Alcoholism↗
PubMedDate not supplied

California's approach to perinatal substance abuse: toward a model of comprehensive care.

In the late 1980s and early 1990s there was a growing awareness of the many health, social, psychological, treatment, and recovery needs of pregnant and parenting women and their drug-exposed children. This awareness sensitized policymakers and service providers to the necessity for women-centered programs. Many points of intervention, from primary prevention to treatment of drug dependence, are required to adequately respond to the various needs of this heterogeneous population; a comprehensive women-centered model of care is required that includes health, social, and personal support services. In addition, programs are needed that are aimed at the prevention and treatment of use, abuse, and addiction to alcohol and tobacco, which are dangerous to women's health and birth outcomes and responsible for more costs to society than are associated with use of illicit drugs. The existing system of social services and health care has been fragmented and uncoordinated in responding to substance-abusing women generally, and especially to those who are pregnant and/or parenting. A panel of experts and policymakers in California delineated the appropriate components of a model of service delivery for pregnant and parenting women. This article assesses the implementation of California programs that were informed by the model.

Adult↗
PubMedDate not supplied

California Collaborative Center for Substance Abuse Policy Research: a history and update.

The California Collaborative Center for Substance Abuse Policy Research is engaged in policy research, training, and information dissemination on substance abuse policy in and for the state of California. As such it is a cosponsor of the recent Therapeutic Jurisprudence conference with Haight Ashbury Free Clinics. The following recoups a presentation made by Richard B. Seymour on behalf of Center codirector Carroll Estes at that conference on the nature, history, and future priorities of the Center.

California↗
PubMedDate not supplied

Epidemiology and public health Consequences of methamphetamine use in California's Central Valley.

Methamphetamine use is an increasingly serious public health problem in California and other parts of the country. Despite sensationalistic media attention, however, very little is known about users of this clandestinely consumed drug. Employing methods known as Rapid Assessment and Response, the authors describe the epidemiology and public health implications of methamphetamine use in California's Central Valley, with a focus on Sacramento, which many social indicators suggest has been more severely affected by methamphetamine than any city in the nation. Data sources for this report include interviews with drug users, statistical reports, epidemiologic studies, and local informed expert opinion. In their social demography, methamphetamine users in the Central Valley are in marked contrast to those of coastal cities such as Seattle and San Francisco, being largely heterosexual, and of mixed racial/ethnic heritage. Three-quarters or more initiate their use of the drug while still in their teens, with more than a quarter beginning use before the age of 15. Many of these rapidly gravitate to regular use, and continue using well into their thirties. Methamphetamine users are at much higher risk of infection with HIV than opiate users, particularly if they inject. Partly because methamphetamine enhances libido, users of the drug typically also have many more sexual partners. Not surprisingly, data indicate that methamphetamine users are more likely than heroin users to be HIV-infected. Methamphetamine appears to be less of a street drug than heroin, complicating efforts at street outreach. However, because it is typically used in social settings, a social or diffusion approach to HIV prevention might be particularly promising.

Amphetamine-Related Disorders↗
PubMed2004

Pilot-testing a statewide outcome monitoring system: overview of the California Treatment Outcome Project (CALTOP).

Timely information provided by an effective outcome monitoring system (OMS) is key to making improvements in treatment program effectiveness, service provision, and client outcomes. The California Treatment Outcome Project (CalTOP) developed and pilot-tested an automated outcome monitoring system for California's alcohol and other drug (AOD) system of care. CalTOP was designed to track client movement through treatment programs, measure standardized assessment of client service needs, record service utilization, assess treatment outcomes and client satisfaction, and determine the extent to which treatment produces cost-offsets in other health and social service systems. Information collected by CalTOP revealed that client problem severity at admission was high, services needed were diverse, and treatment services were generally not well matched to the level of problem severity or needs of clients. Also, client retention and length of stay in treatment were generally insufficient to maximize the potential benefits associated with treatment. This article presents the type of information on client demographics and treatment retention that was provided by CalTOP and outlines recommendations for implementing an AOD outcome monitoring system statewide.

Adult↗
PubMed1989

Condom sales at public universities in California: implications for campus AIDS prevention.

Public health officials have called for increased use of condoms to protect Americans from sexually acquiring human immunodeficiency virus (HIV) infection. To investigate the availability of condoms for sale on college campuses, we asked student union directors and bookstore managers from all 28 public universities in California, with a combined enrollment of half a million students, to complete a detailed questionnaire in August and September 1987. Two thirds of the campuses reported having condoms for sale in either their bookstores or convenience stores; one third said condoms were available in the men's and women's restrooms in their student unions. On most campuses, sales were instituted in the past year in response to the AIDS (acquired immune deficiency syndrome) epidemic. However, very few campuses provided AIDS education at the point of sale, and condoms were not easily available outside of store hours. Respondents felt that the most important obstacles to increasing the distribution of condoms on campus included concern about presenting a negative image of the university and the low priority assigned to this issue by the university administration and others on campus. This study suggests that although condom availability has improved in the past year, the opportunity exists at most California public universities to increase the distribution of condoms and improve associated AIDS-related health education efforts.

Acquired Immunodeficiency Syndrome↗
PubMed1997

Health risk behaviors among California college students.

Health risk behaviors among students attending 4-year colleges in California were examined. The Youth Risk Behavior Survey for College Students was administered in a two-stage (29 universities, 5,652 students) random sample. All campuses and 3,810 (69%) students participated in the survey. In the 30 days preceding the survey, 36.7% of the students had binged at least once while drinking; 25.3% had driven after consuming alcohol; 32% had ridden in a car with someone who had been drinking; 17.6% had used marijuana; and 6% had carried a knife, gun, or club. More than half of the students who were sexually active and not married or living with a primary partner had not used a condom the last time they had sexual intercourse. Only 5% of regular bicycle riders always wore a helmet. Fewer than half (44%) reported aerobic physical activity on 3 or more of the preceding 7 days. The results of this study indicate a substantial amount of serious, risky health behaviors among California college students.

Adolescent↗
PubMed1997

Principles for assuring the health of college students: a California perspective.

Given the rapidity of change in both higher education and health care, re-examining the values and precepts that undergird the profession of college health is an ongoing need. Reported in this article are the results of a structured process in which a group of college health professionals from California, along with others interested in the health of college students, examined several trends affecting higher education and health; considered possible scenarios for these sectors; created a shared vision for the future of college health; and developed strategies useful in attaining that vision. The results of these deliberations are presented as a set of principles that, if followed, should increase the likelihood that college health centers will be responsive to user needs. Although the article is based on a California-based conference, the principles discussed are almost certainly valuable for all in college health.

Adolescent↗
PubMed1999

Feast or famine? Supplemental food programs and their impacts on two American Indian communities in California.

This article examines the use of supplemental food programs by two Native American populations and assesses some of the health and cultural impacts of these programs. A cross-sectional survey of 80 American Indian families, 40 families residing on the Round Valley Indian Reservation and 40 in Sacramento, California was conducted to determine access, use and appropriateness of supplemental feeding programs. Respondents at both the rural and urban geographic location showed considerable familiarity with available supplemental feeding programs. USDA Food Commodities were utilized most at Round Valley, raising the concern that provided staples which were highly processed and contained significant amounts of sodium, sucrose, and fat, could contribute to the problems of obesity and diabetes. Native Americans in Sacramento used food banks and food closets as their primary source of supplemental foods, and some expressed concern that the foods provided were highly sweetened and high in fat. While some nutrition advising was available at both geographical localities, access was inadequate. The study found that the foods provided by the supplemental food programs varied considerably in their nutritional quality and healthier foods such as fresh fruits, vegetables, and meats were either completely lacking or in short supply. In addition, culturally sensitive nutritional counseling and the development of education modules to instruct program recipients in the preparation of healthy meals and how to manage obesity and diabetes were needed and requested within the California Native American communities surveyed.

Adult↗
PubMed1994

Use of probabilistic methods to understand the conservatism in California's approach to assessing health risks posed by air contaminants.

Many state and federal agencies have prepared risk assessment guidelines, which describe methods for quantifying health risks associated with exposure to vapors and particulates emitted from point and area sources (e.g., California Air Pollution Control Officers Association [CAPCOA] under the Air Toxics "Hot Spots" Act [Assembly Bill 2588] and the U.S. Environmental Protection Agency [EPA] under the Clean Air Act). In general, these guidelines recommend or require the use of upperbound "point" estimates for numerous exposure parameters. This methodology yields a single risk estimate, which is intended not to underestimate the true risk and may significantly overstate it. This paper describes a risk assessment of a facility's airborne emissions using a probabilistic approach, which presents a range and distribution of risk estimates rather than a single point estimate. The health risks to residents living near a food processing facility, as estimated using techniques recommended by California AB2588, are compared to the results of a probabilistic analysis. Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) were identified as the emitted chemicals of concern. The point estimate method recommended by CAPCOA resulted in estimates that were greater than the 99.99th percentile risk predicted by the probabilistic analysis. As shown in other assessments of persistent airborne chemicals, secondary or indirect exposure pathways (i.e., ingestion of beef, ingestion of cow's milk, and ingestion of mother's milk) rather than inhalation, were the greatest contributors to risk. In this analysis, the probability distributions for the cancer potency factor and ingestion of cow's milk had the largest impact on the results of the 33 exposure factors considered.

Air Pollutants↗
PubMed1997

Ambient air concentrations of fine (PM2.5) manganese in U.S. national parks and in California and Canadian cities: the possible impact of adding MMT to unleaded gasoline.

The October 1995 court decision allowing Ethyl Corporation to offer methylcyclopentadienyl manganese tricarbonyl (MMT) for sale to refiners for introduction into unleaded gasoline as an octane enhancer is likely to result in increased fine (PM2.5) manganese (Mn) concentrations in ambient air. Concern exists regarding possible health effects. In this paper, recent fine Mn concentrations in three monitoring networks and one U.S. Environmental Protection Agency (EPA) study of personal exposure are analyzed. One network consists mainly of rural sites in national parks in the United States, a second consists mainly of urban sites in California, and the third consists mainly of urban sites in Canada where MMT has been used for a number of years. During the late 1980s and early 1990s, mean ambient concentrations ranged from 1 ng/m3 in the mostly rural network to 3 ng/m3 in the mostly urban California network to 12 ng/m3 in the MMT-impacted Canadian network. Several lines of evidence suggested that some of the fine Mn observed in the United States during the 1986-1992 period was contributed by automobiles using leaded gasoline, for which MMT was a registered fuel additive. However, the near-disappearance of leaded gasoline has resulted in a very small portion of fine Mn being attributed to automobiles in the years since 1992. A source apportionment analysis suggested that crustal contributions to ambient fine Mn are on the order of 1-2 ng/m3 in both the United States and Canada.

Air Pollutants↗
PubMed2001

Observations and model simulations of carbon monoxide emission factors from a California highway.

A series of twelve intensively monitored 1-hr CO dispersion studies were conducted near Davis, CA, in winter 1996. The experimental equipment included twelve CO sampling ports at elevations up to 50 m, three sonic anemometers, a tethersonde station, aircraft measurements of wind and temperature profile aloft, and a variety of conventional meteorological equipment. The study was designed to explore the role of vehicular exhaust buoyancy during worst-case meteorological conditions, such as low winds oriented in near-parallel alignment with the road during a surface-based nocturnal inversion. From the study, field estimates of the CO emission factor (EF) from a California vehicle fleet were computed using two different methods. The analysis suggests that the CT-EMFAC/EMFAC (EMission FACtor) models currently used to conduct federal conformity modeling significantly overpredict CO emissions for high-speed, free-flowing traffic on California highways.

Air Pollutants↗