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PubMed1987

Summary of illnesses and injuries reported in California by physicians in 1986 as potentially related to pesticides.

As a result of legislation in the early 1970's, physicians are required to report all cases of illness or injury which may have been a result of exposure to pesticides. The California Department of Food and Agriculture receives these reports through a variety of reporting mechanisms and compiles them into an annual data base. In 1986, 2099 illness/injury reports were received by the Worker Health and Safety Branch of the California Department of Food and Agriculture. After investigation by the County Agricultural Commissioners' staff, 1065 (51%) were determined to be confirmed cases of occupational illness/injury related to pesticide exposure. In addition, there were also 146 (7%) cases of non-occupational pesticide-related illness/injury, 424 (20%) cases determined to be unrelated to pesticide exposure, and 464 (22%) cases for which there was insufficient information to determine a cause and effect relationship. The number of confirmed cases of pesticide-related illness/injury decreased by nearly 30% from the corresponding 1985 figures. This apparent decrease is an artifact of the classification scheme employed for 1986. The change is primarily a result of a reduction in the number of field worker cases determined to be confirmed pesticide-related exposures. In previous years most investigations of pesticide application history for grape vineyard worker dermatitis cases were confined to a history from the last field worked prior to visiting a physician. This method assumes no latency period between exposure and onset of symptoms and/or that the worker immediately visited a physician at the onset of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Agricultural Workers' Diseases↗
PubMed1985

Antibodies to bovine leukemia virus and presence of malignant lymphoma in slaughtered California dairy cattle.

Rates of malignant lymphoma (ML) in California dairy cattle and relationships between ML and presence of antibodies to bovine leukemia virus (BLV) were investigated. An excessively high rate of lymphoma was found in the population studied and a previously unknown relationship between ML and p-24 antibodies to BLV was identified. Sera from slaughtered California holstein dairy cows were tested by agar gel immunodiffusion for presence of antibodies to the gp-51 and p-24 antigens of BLV. Of the 7,760 cows slaughtered, 32% and 10% had gp-51 and p-24 antibodies, respectively, and 52 cows (0.67%) were condemned for ML. Lymphoma was diagnosed histopathologically in 37 (86%) of 43 cows sampled from those 52 condemned. Highly elevated prevalence rates of ML in gp-51 and p-24 antibody-positive cows were 172.6 and 511.5 per 10,000 cows, respectively. A prevalence rate of lymphoma not associated with presence of BLV antibodies was estimated for the first time to be 1.55 per 10,000 cows. A highly significant (P less than .00001) and strong (odds ratio = 26.0) association was found between presence of p-24 antibodies and presence of ML for cows with gp-51 antibodies. When results of serologic tests were compared in regard to diagnosis of ML, the highest sensitivity was with use of gp-51 serology alone (97.3%) and highest specificity was with use of p-24 serology alone (90.4%). False-negative and false-positive rates of diagnosis of ML for gp-51-positive, p-24-negative and gp-51-positive, p-24-positive cows were 0.21 and 94.8%, respectively.

Animals↗
PubMed1988

Prevalence of udder infections and mastitis in 50 California dairy herds.

The California mastitis test (CMT) and bacteriologic culture were performed on samples of bulk-tank milk and cow-composite milk (n = 23,138 cows) from 50 California dairies, 19 of the 50 with known mastitis problems. Thirty-eight (76.0%) bulk-tank milk samples and 12,334 (53.3%) cows were positive by results of the CMT. Potential mastitis agents were isolated from 5,085 (22%) cows. Staphylococcus aureus was isolated from all 50 herds, Streptococcus agalactiae was isolated from 47 herds, and Mycoplasma sp was isolated from 24 herds. For cow-composite milk samples, the prevalences were 9.3% for Str agalactiae, 9.1% for S aureus, 0.9% for Mycoplasma sp, 1.2% for coliform bacteria, 0.9% for other streptococci, 0.8% for coagulase-negative staphylococci, and 1.3% for other organisms. The relative sensitivity and the relative specificity of the CMT performed on cow-composite milk samples were 83.4% and 55.2%, respectively, and the predictive value of positive CMT results was 34.2%.

Animals↗
PubMed1988

Hospital behavior under competition and cost-containment policies. The California experience, 1980 to 1985.

Previous studies of hospital competition have found that greater competition leads to higher hospital costs. We describe herein the change in behavior of California's hospitals since the introduction of competitive and cost-containment programs. To examine the impact of California's pro-competition policies on hospital performance, we grouped the state's short-term hospitals according to the level of competition within their markets. From 1983 through 1985, total inpatient costs (inflation adjusted) increased by less than 1% in hospitals in low-competition markets compared with a decrease of 11.29% in hospitals located in highly competitive markets. After controlling for the effects of the Medicare prospective payment system program, the rate of increase in cost per discharge in hospitals in highly competitive markets was 3.53% lower than the rate of increase in hospitals in low-competition markets during the period from 1983 through 1985. We conclude that these pro-competition policies are having dramatic and potentially far-reaching effects on the nature of hospital competition, leading to increased competition based on price.

California↗
PubMed1988

Dispersal of Culex quinquefasciatus from a dairy in southern California.

The dispersal of Culex quinquefasciatus was studied near Norco, California in a periurban situation of southern California. Concurrent studies indicated that host-seeking females were most active up to one hour after sunset. A mark-release-recapture technique was used to document a mean distance traveled of 0.91 km in 12 hr (the first flight period) and a cumulative distance of 1.27 km after 36 hr (following the second flight period). Nearly 0.32% of 47,750 marked females were recaptured. A majority of the population moved with the prevailing wind. Unmarked females were captured at all trapping locations in the study.

Animals↗
PubMed1987

Chemical contamination of California drinking water.

Drinking water contamination by toxic chemicals has become widely recognized as a public health concern since the discovery of 1,2-dibromo-3-chloropropane in California's Central Valley in 1979. Increased monitoring since then has shown that other pesticides and industrial chemicals are present in drinking water. Contaminants of drinking water also include naturally occurring substances such as asbestos and even the by-products of water chlorination. Public water systems, commercially bottled and vended water and mineral water are regulated, and California is also taking measures to prevent water pollution by chemicals through various new laws and programs.

California↗
PubMed1987

Case-control studies of prostate cancer in blacks and whites in southern California.

To identify risk factors for prostate cancer and to try to explain the high risk of blacks relative to whites, case-control interview studies of prostate cancer were conducted in both populations in southern California. Both studies included 142 pairs of cases and population controls matched on age. Cases in blacks were identified by the population-based tumor registry of Los Angeles County and cases in whites were identified by a population-based tumor registry of a southern California retirement community. A past history of venereal disease was associated with a high risk of prostate cancer in both populations [relative risk (RR) = 2.3 in whites; RR = 1.7 in blacks]. The result in blacks was statistically significant (P = .03). Black cases tended to have more frequent sexual intercourse than black controls at all ages; the difference became statistically significant for intercourse late in life. Data from controls suggested that, overall, blacks have earlier and more frequent sexual activity than whites, but the two populations were dissimilar in social class characteristics. Fat intake was a risk factor for prostate cancer in both populations, but vitamin A consumption and protein intake were inconsistently related or unrelated to prostate cancer risk. While beta-carotene was not consistently related to risk, there was some indication that in persons with low fat intake, low beta-carotene intake may be associated with high risk. Circumcision was negatively associated with risk in both populations (RR = 0.5 in whites; RR = 0.6 in blacks). These results are discussed in the context of major etiologic hypotheses for prostate cancer.

Black People↗
PubMed1986

Capitation in California--an analysis of at-risk financing of Medicaid services.

Recent legislative changes have fostered the growth of a highly competitive health care market in California. In addition to selective hospital contracting for Medicaid (Medi-Cal) services, the California Medical Assistance Commission is attempting to initiate pilot projects to capitate Medi-Cal beneficiaries in selected geographic areas throughout the state. Selective contracting with county capitated organized health systems is also underway in Santa Barbara County, with plans for other counties on the drawing boards. This paper describes these capitated programs as well as addressing problems that may arise in this transition from a fee-for-service to a capitated Medi-Cal system. Specifically considered are issues related to underutilization, quality of care, implementation, eligibility and effects on existing patterns of care.

California↗
PubMed1986

Pediatrician participation in Medicaid--findings of a five-year-follow-up study in California and elsewhere.

Medi-Cal-California's Medicaid program-underwent significant changes during the period 1978 through 1983. Most notable were the imposition of new copayments, reductions in physician reimbursement and selective contracting for hospital services. The state-funded medically indigent program was transferred to the counties and the state began to experiment with bulk purchasing of drugs and supplies, a lock-in for overutilizers and primary care case management. How have these changes affected primary care providers' participation in Medi-Cal? Surveys of California pediatricians in 1978 and 1983 suggest that while most continue to participate, the level of limited participation in Medi-Cal increased from 23% to 51%. Most pediatricians express discontent with the level of Medicaid payments and there is a growing sentiment that Medicaid regulations interfere with the provision of high quality medical care. Future Medi-Cal policy developments, such as contracting for physician services, should be structured in ways that maximize participation of primary care providers in the program.

Attitude of Health Personnel↗
PubMed1987

Equine ehrlichiosis in northern California: 49 cases (1968-1981).

Case records of horses with equine ehrlichiosis (Ehrlichia equi) at the University of California Veterinary Medical Teaching Hospital and Ackerman Creek Large Animal Clinic were analyzed for evaluation of clinical signs, time of onset, hematologic values, response to treatment, and recovery. Equine ehrlichiosis was found to be seasonal in horses in the foothills of northern California, with higher incidence than reported previously. The horses developed fever, anorexia, depression, limb edema, icterus, and ataxia. Hematologic changes were leukopenia, thrombocytopenia, icterus, anemia, and inclusion bodies in the neutrophils and eosinophils. Diagnosis was made by observing the characteristic inclusion bodies, using a standard Wright's stain. Mortality was low, although complications of opportunistic secondary infection and injury due to ataxia did develop. Treatment with tetracycline resulted in prompt clinical improvement within 24 hours. Chronic cases were not detected. Equine ehrlichiosis should be differentiated from diseases with similar clinical signs including encephalitis, liver disease, purpura hemorrhagica, equine infectious anemia, and equine viral arteritis.

Animals↗
PubMed1987

The epidemiology of firearm deaths among residents of California.

Firearms are a leading cause of death in the United States, yet the effort to understand their aggregate impact on the public's health has only just begun. There were 26,442 firearm deaths among California residents during the years 1977 through 1983. During this period firearms were the eighth leading cause of death for California as a whole, sixth for male Californians and first for black males aged 15 to 34 years and black females aged 15 to 24 years. A plurality of firearm deaths were suicides; unintentional deaths contributed only 3% of the total. Black men aged 25 to 34 years had the single highest firearm mortality rate; 80% of firearm deaths in that group were homicides. Men 75 years old and older had the highest firearm mortality rate when all races were considered together, however, and 93% of firearm deaths in that group were suicides. The discussion focuses on our current understanding of firearms as a medical and public health problem and suggests directions for future research and intervention.

Adolescent↗
PubMed1987

The distribution of services to the underserved. A comparison of minority and majority medical graduates in California.

We assessed the belief that minority physicians are more likely to serve traditionally underserved minority populations by examining the medical practice profiles of minority and majority physicians who graduated from seven California medical schools in 1974 and 1975. The results indicate that minority graduates are more likely to locate their practices in areas with health care personnel shortages (53%) than are majority graduates (26%). Minority physicians had a higher proportion of Medicaid or Medi-Cal patients, and they saw a greater percentage of minority patients (60%) than did majority physicians (21%). We conclude that minority graduates of US medical schools, at least those from California, serve traditionally underserved populations to a greater degree than do their majority graduate colleagues. These findings lend strong support to the contention that aggressive affirmative action programs by medical school admission committees serve the important utility function of improving the distribution of medical services.

California↗
PubMedDate not supplied

New trends in drug use among youth in California.

New trends in drug use in the United States of America have usually started in populations of young users in California. The use of hallucinogenic drugs (psychedelics), phencyclidine (PCP) and the smoking of cocaine free base were all first detected in populations of young Californian users. Five patterns of youthful drug use are described: experimental, social-recreational, circumstantial-situational, intensified and compulsive. These patterns are supported by several myths whereby users tend to trust the appearance and folklore surrounding specific drugs. New trends in drug use detected in a sample population of young users in California include increased use of cocaine, psilocybin mushrooms, psycho-active phenylisophropylamines, PCP, fentanyl, and codeine combined with glutethimide. Other evidence suggests that future trends are likely to include increased use of cathinone, yohimbine, fentanyl analogues and ephedrine.

Adolescent↗
PubMed1985

Control of snow pool mosquitoes with Bacillus thuringiensis serotype H-14 in mountain environments in California and Oregon.

Studies were conducted in mountainous areas of California and Oregon to test the effectiveness of Bacillus thuringiensis serotype H-14 in controlling larvae of snow pool Aedes mosquitoes, and also the effect of such larval control on the density of adult mosquitoes. California and Oregon studies showed that a wettable powder formulation of B.t.i. was effective in controlling mosquito larvae. In Oregon, treatment was effective even at water temperatures as low as 5 degrees C. Sampling of adult mosquitoes at campgrounds where intensive larval control was done failed to demonstrate a lowering of adult mosquito density in comparison with untreated control areas. Flight range studies showed that snow pool Aedes species can fly distances of up to 2 km, suggesting that infiltration from outside the treated area was one cause of failure. Inadequate seasonal timing appeared to be an additional factor. Using a simple computer model, we estimated that larval mosquito control with B.t.i. could be done for about $5,000 per season for a 500 ha area similar to our test area, a cost of $10 per ha ($4 per acre).

Aedes↗
PubMed1985

Practice patterns, attitudes, and activities of University of California Pharm.D. graduates.

Graduates of the University of California at San Francisco (UCSF) Doctor of Pharmacy program from 1970 to 1981 were surveyed to determine their practice patterns, professional activities, and attitudes toward the profession of pharmacy. Of 1061 surveys mailed in September 1982, 752 (72%) were returned. A majority of respondents indicated that they would choose pharmacy as a profession again if starting over and that they would advise a friend to enter the profession. The private hospital setting was the practice site cited most frequently by respondents. Over one third of practicing pharmacists were actively enrolled in or had completed advanced pharmacy training. California was the practice location for 84% of respondents; only one third indicated that salary was very important or somewhat important in their decision to practice at their current location. A large percentage of respondents were involved in teaching, community service activities, and professional associations. Most entry-level UCSF Pharm.D. graduates are satisfied with their professional status and find opportunities for advancement.

Attitude of Health Personnel↗
PubMed1972

Importation of Shiga bacillus dysentery into California. Clinical and public health significance.

Concurrent with the regional epidemic of classic Shiga dysentery in Central America during 1969 and 1970, a pronounced increase in the isolation of Shigella dysenteriae type 1 was noted in California. A retrospective study of 20 cases diagnosed in California in 1969 and 1970 revealed that 18 of the patients had traveled to Central America or Mexico during or immediately before the onset of symptoms. Sixteen were known to have been admitted to hospital; there was one death. Despite the concern that such importations might result in epidemics in this country among groups living in crowded, unsanitary settings, no definite secondary transmission was identified in this study. The problems of differential diagnosis, laboratory isolation of the agent, chemotherapy, and epidemic control are discussed.

Adult↗
PubMed1972

Hydatid disease is endemic in California.

Hydatid disease, a parasitic infection of global importance and a condition for which there is no known medical treatment, is established endemically in the Central Valley of California. Only further study will reveal whether or not the infection is now spreading or intensifying or is remaining fairly stable at a relatively low level of endemicity. California physicians should be aware of its presence and the fact that in most sheep-raising areas of the world it constitutes a problem of major medical and public health importance. Although a number of national or regional programs for hydatid disease control have been undertaken, clear progress has been evident only in Iceland, in New Zealand and in the Australian state of Tasmania.(2,4,5)

Adult↗
PubMed1973

Epidemiology of viral hepatitis in California, 1950-1970.

Epidemiologic patterns of type A (infectious) and type B (serum) hepatitis in California from 1950 to 1970 are presented. During this period hepatitis incidence increased greatly among teenagers and young adults but no significant increase occurred in other age groups. Much of this age-specific increase is related to the increasing drug abuse problem during the last decade. Other factors which possibly contribute to the current pattern of hepatitis in California are the overcrowding and inadequate sanitary facilities among a portion of young people between the ages of 15 and 30. Until these factors change or effective vaccines are developed, viral hepatitis will continue to be a significant public health problem.

Adolescent↗