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At least 163 records · Page 9Linked to original sources
PubMed2002

Factors associated with pilot fatalities in work-related aircraft crashes--Alaska, 1990-1999.

Despite its large geographic area, Alaska has only 12,200 miles of public roads, and 90% of the state's communities are not connected to a highway system. Commuter and air-taxi flights are essential for transportation of passengers and delivery of goods, services, and mail to outlying communities (Figure 1). Because of the substantial progress in decreasing fatalities in the fishing and logging industries, aviation crashes are the leading cause of occupational death in Alaska. During 1990-1999, aircraft crashes in Alaska caused 107 deaths among workers classified as civilian pilots. This is equivalent to 410 fatalities per 100,000 pilots each year, approximately five times the death rate for all U.S. pilots and approximately 100 times the death rate for all U.S. workers. As part of a collaborative aviation safety initiative that CDC's National Institute for Occupational Safety and Health (NIOSH) is implementing with the Federal Aviation Administration (FAA), the National Transportation Safety Board (NTSB), and the National Weather Service, CDC analyzed data from NTSB crash reports to determine factors associated with pilot fatalities in work-related aviation crashes in Alaska. This report summarizes the result of this analysis, which found that the following factors were associated with pilot fatalities: crashes involving a post-crash fire, flights in darkness or weather conditions requiring instrument use, crashes occurring away from an airport, and crashes in which the pilot was not using a shoulder restraint. Additional pilot training, improved fuel systems that are less likely to ignite in crashes, and company policies that discourage flying in poor weather conditions might help decrease pilot fatalities. More detailed analyses of crash data, collaborations with aircraft operators to improve safety, and evaluation of new technologies are needed.

Accidents, Aviation↗
PubMed2003

Cancer mortality among American Indians and Alaska Natives--United States, 1994-1998.

In the United States, public health interventions to control infectious diseases, lower infant and maternal mortality, and improve basic sanitation have led to a substantial increase in life expectancy for American Indians and Alaska Natives (AI/ANs). During 1940-1995, average life expectancy among AI/ANs increased 39%, from 51 years in 1940 to 71 years in 1995; however, AI/ANs experienced a parallel increase in mortality rates for chronic diseases, including cancer, which is the second leading cause of death for AI/ANs nationally and the leading cause of death among Alaska Natives. A previous study examining cancer mortality rates during 1989-1993 documented lower cancer mortality rates for AI/ANs than for the overall U.S. population, with regional variation. To understand cancer mortality among AI/ANs subsequent to that period, the Indian Health Service (IHS) and CDC analyzed death certificate data provided by CDC's National Center for Health Statistics for deaths among AI/ANs in five U.S. geographic regions during 1994-1998. This report summarizes the results of that analysis, which indicate that cancer mortality rates among AI/ANs nationally were lower than cancer mortality rates for all U.S. racial/ethnic populations combined. Rates for AI/ANs varied by region, with the highest rates found in the Alaska and the Northern Plains regions. Plans or modifications for cancer prevention and treatment programs should account for regional variation, and programs to discourage smoking initiation, encourage tobacco cessation, and promote colorectal cancer screening among AI/ANs in the Alaska and the Northern Plains regions should be expanded.

Alaska↗
PubMed1991

A brief discussion of the development of Native owned health provider agencies in Alaska within the context of anticipated health and systems issues.

The Self-Determination Act brought about an explosive growth of tribally run programs in Alaska during the 1970s at the same time that the Alaska Native Claims Settlement Act was being implemented. Tribes demonstrated great creativity in blending IHS with other sources of funds to develop more effective and more acceptable delivery of services to their people. Further, the tribes in Alaska have demonstrated great aptitude in developing effective lobbying techniques with the United States Congress, such that they have actually been able to increase their funding base beyond what was assumed at the time of takeover from the IHS. However, several problems loom on the horizon. First, there is the problem of cost shifting within the IHS which contains the potential that tribes opting not to take advantage of the Self-Determination Act may be victimized by those who do. Second, there is the problem of too few resources to serve too many patients, which from time to time, propels the Indian Health Service toward an attempt to change the rules with respect to eligibility for services. Finally, the ability of the Indian Health Service (and by extension, its contract tribes) to provide an adequate level of services to American Indian and Alaska Native clients is being dramatically eroded by the same inflationary forces that are driving the larger system of health care in the United States toward the brink of disaster.

Alaska↗
PubMedDate not supplied

Surveillance of traumatic occupational fatalities in Alaska--implications for prevention.

Data on occupational injury fatalities in Alaska for the period 1980-85 were complied from workers' compensation claims and death certificates. These data yielded 422 unique cases for the 6-year period, for an average annual fatality rate of 36.3 per 100,000 workers. This rate is 5 times higher than the Bureau of Labor Statistics estimate of 7.6 per 100,000 for the United States during the same period. The four industries with the highest fatality rates were the same for Alaska as for the nation (agriculture-forestry-fishing, construction, mining, and transportation-communication-public utilities). The leading causes of occupational fatalities in Alaska, however, were considerably different than for the United States as a whole. Nationally, motor vehicles and industrial equipment accidents are the leading causes of death. In Alaska, the leading causes of occupational injury mortality are aircraft crashes and drowning. These findings highlight the benefit of local surveillance in planning prevention strategies.

Accidents, Aviation↗
PubMed2005

Flight safety in Alaska: comparing attitudes and practices of high- and low-risk air carriers.

INTRODUCTION: Aircraft operations are a vital component of the transportation system in Alaska. Between 1990-2002, a total of 481 people died in Alaska in aviation accidents. The purpose of this study was to examine the practices and attitudes of Alaska commuter and air taxi operators and their pilots as they relate to company fatal accident rates. METHODS: A case-control analysis based on accident statistics was performed, grouping operators and their pilots into cases and controls, based on operator fatal accident rates, during January 1990 to June 2001. Responses from two aviation safety surveys-one of air carrier operators and one of active commercial pilots-were compared between cases and controls. RESULTS: The average case pilot had less career flight experience than control pilots and worked 13 h x d(-1) and 81 h x wk(-10; that is, 1 h x d(-1) and 10 h wk-1 more than controls. Case operators were less likely to consider pilot fatigue a problem when scheduling flights (p = 0.05) and more likely to depend financially on timely delivery of bypass mail (p = 0.04). Case pilots were three times as likely as controls to fly daily into unknown weather conditions. Nearly 90% of case pilots reported that they never flew when so fatigued that they wanted to decline the flight, compared with 64% of control pilots (p = 0.01). CONCLUSIONS: Pilots of high-risk operators differed from those working for the other operators, both in experience and working conditions. The combination of pilot inexperience and longer work hours and workweeks may contribute to Alaska's high aviation crash rate.

Accidents, Aviation↗
PubMed1998

Drinking and drinking-related problems among Alaska natives.

Alcohol use has adversely affected many aspects of the Alaska Native community. To a large extent, overcoming the problem of alcohol abuse may require that Alaska Natives craft individual and community solutions to detrimental health, social, and economic conditions and instill new patterns of living that inhibit alcohol abuse. An example of this approach is the Alaska Federation of Natives' "sobriety movement," a grassroots campaign to promote sobriety that emphasizes traditional values and lifestyles. The use of "healing" or other traditional methods may help Alaska Natives both recover from the trauma of decades of cultural conflict and address alcohol problems in their communities.

Alaska↗
PubMedDate not supplied

WWAMI--Alaska's Medical School.

In 2005 Alaska's medical school is WWAMI, but the WWAMI program today is far different than it was in 1971 when it began with 5 Alaskans in a class of 9 at Fairbanks. WWAMI students may now complete nearly 3 years of the 4-year program in state. They can now complete postgraduate residency training at the Alaska Family Medicine Residency in Anchorage. Alaska also benefits from a host of other WWAMI initiatives, such as the MedCon medical consultation service. On the other hand, the Alaska WWAMI program still allows for only 10 medical school positions, as it has since its inception. In the face of a worsening physician shortage in the state, class expansion appears to be warranted. When comparing this option versus the costs of recruitment or the possibilities of increasing graduate medical education in the state, class size increase is well justified.

Alaska↗
PubMedDate not supplied

Traumatic head and spinal cord injuries in Alaska (1991-1993).

Traumatic head and spinal cord injuries (SCI) are serious events, often leading to severe disability or death. Because these injuries are experienced most often by younger, more active people, they are associated with some of the most enduring physical, emotional, and financial costs. In order to describe several demographic and epidemiologic characteristics of traumatic head and spinal cord injuries in Alaska, a retrospective study was conducted using information collected from the Alaska Trauma Registry (ATR) for hospital trauma admissions in 1991 through 1993. Hospitalized traumatic head injury were identified in 2178 cases, for an average annual incidence rate of 129.5 per 100,000 population. For hospitalized traumatic SCI, 139 cases were identified, for an average annual incidence rate of 8.3 per 100,000 population. To analyze and assess the incidence of these injuries in Alaska, the following injury characteristics were explored through the Alaska Trauma Registry: demographics, mechanism of injury, work relatedness, use of safety equipment, involvement of alcohol, and discharge status.

Accidents↗
PubMedDate not supplied

A bibliometric analysis of cancer among American Indians & Alaska Natives, 1966-1993.

A bibliometric analysis was employed to objectively assess scientific studies published between 1966 and 1993 which have described cancer among American Indians and Alaska Natives. Searches of the MEDLINE (1966-1993) and CANCERLIT data bases (1983-1994) were used to identify relevant publications. In addition to examining publication sources and quantitative temporal trends, further bibliometric analyses were completed by considering a subset of papers published between 1982 and 1992. A total of 128 studies of cancer among American Indians and Alaska Natives were published between 1966 and 1993; 62 of these articles (48%) appeared between 1988 and 1993. Nine journals accounted for 53% of the total publications. The subset of 68 papers published between 1982 and 1992 were cited a total of 388 times in 136 different journals; the median number of citations was 2. Results demonstrate a limited number of published papers on cancer among American Indians and Alaska Natives. It is hoped that this paper will increase the awareness of cancer as an important health problem among American Indian and Alaska Natives and thereby serve to stimulate additional cancer-related research activities involving these groups.

Alaska↗
PubMedDate not supplied

Years of potential life lost and lost future productivity due to occupational fatalities--Alaska, 1990-1994.

INTRODUCTION: Alaska had the highest occupational fatality rate of any state for the 1980s. The impact of these events is estimated by the index of years of potential life lost before age 65 (YPLL), which was developed to measure the potentially preventable mortality occurring early in life. METHODS: Lost future productivity (wages) and YPLL were calculated from surveillance statistics for all workers killed on the job during this 5-year period. RESULTS: During 1990-1994, Alaska experienced 343 work-related deaths among civilians under age 65. YPLL was 9,690 years with an estimated lost future productivity of $367,000,000. DISCUSSION: Premature death due to occupational traumatic injury in Alaska for 1990-1994 was extremely costly to society. Premature death not only adversely affects the deceased workers' family, friends, and coworkers, but also society economically. Effective intervention strategies are needed to significantly reduce both the number and the cost of fatal occupational trauma in Alaska.

Accidents, Occupational↗
PubMed1996

Alaska Native cancer update: incidence rates 1989-1993.

Five-year average annual age-adjusted cancer incidence rates for Alaska Natives (Eskimos, Indians, and Aleuts) for the most recent period (1989-1993) are compared to rates of 20 years earlier. Rates for all cancers combined increased 28 and 25% in men and women, respectively, during the 25-year interval. Increases were seen in men in cancers of the lung, prostate, and colon and in women for cancers of the lung, breast, and corpus uteri. Rates are also compared to data from the the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) program for United States whites. Rates for all cancers combined in Alaska Native women are now similar to those of United States whites, whereas rates in Alaska Native men are lower than the United States, but only 10% lower. Significant site-specific differences previously reported between Alaska Natives and United States whites persist.

Alaska↗
PubMed1996

Detection of alpha-fetoprotein and hepatitis-B surface antigen in blood spotted on filter paper: use as a screen for hepatocellular carcinoma in Alaska Natives.

A program of twice yearly testing of Alaska Native carriers of hepatitis-B surface antigen (HBsAg), for alpha-fetoprotein elevations as an indicator of early hepatocellular carcinoma has been established in Alaska. Because many HBsAg carriers live in remote regions of Alaska, logistical and cost considerations complicate the efficiency of this program. We evaluated the feasibility of using blood spotted onto mail-in cards as a system of blood collection and commercial assays for alpha-fetoprotein and HBsAg testing. We compared alpha-fetoprotein levels and the detection of HBsAg in both plasma and blood spots from HBsAg-positive carriers, normal volunteers, and pregnant females. There was good correlation between serum and blood spot AFP levels (r = 0.94, p < 0.001) over a wide range of serum alpha-fetoprotein levels. alpha-fetoprotein and HBsAg remained detectable in blood spots stored at room temperature for more than 8 weeks. The sensitivity of detection of HBsAg in blood spots was not as great in blood spots when compared to plasma levels. This system has been incorporated into the hepatocellular carcinoma screening program in Alaska. It should also prove feasible and economical for such screening to be undertaken in developed countries and possibly make alpha-fetoprotein screening affordable in those developing countries where the prevalence of hepatitis-B virus infection is high.

Alaska↗
PubMedDate not supplied

Smoking attributable mortality and economic costs in Alaska 1992-94.

Tobacco is one of the leading preventable cause of death in the United States and Alaska. Alaska has one of the highest smoking prevalences. The Smoking-Attributable Mortality, Morbidity and Economic Cost software developed by the Centers for Disease Control and Prevention was used to estimate the deaths and economic impact due to smoking in Alaska. In Alaska during the three year period 1992-94, 1416 deaths were estimated to be attributable to smoking, accounting for 19.8% of the 7159 deaths during that time. Direct medical care costs in 1993 due to smoking related illnesses were estimated at $96.5 million. Additional smoking related costs include an indirect mortality cost of $81.61 million and indirect morbidity cost of $15.94 million. The total economic cost attributable to smoking related illness for 1993 is estimated at $194 million [corrected]. In summary, for the time period 1992-94, smoking was estimated to result in 470 deaths per year and in economic costs of almost $300 million per year.

Adolescent↗
PubMedDate not supplied

Nutritional rickets among breast-fed black and Alaska Native children.

Although nutritional rickets remains a problem primarily in developing countries, children in northern climates in developed countries may also be at risk. We reviewed the case histories of five children diagnosed in Alaska during 1993-96. Three of the children were black and two Alaska Native. Their ages ranged from 11 to 20 months and they presented during January, April, and September. All of the children were breast-fed but only two received their milk intake exclusively from breast milk. The presenting complaint included abnormal gait in two children and seizures, bowed legs, and growth delay in one child each. All five children demonstrated a decrease in their height-for-age percentile. The most common physical finding was a rachitic rosary which was present in four children. In Alaska, all black and Alaska Native children (and other more pigmented children) less than two years of age who receive all or part of their milk intake from breast milk should receive vitamin D supplementation regardless of the time of year.

Black or African American↗
PubMed1997

The psychological repercussions of the sociocultural oppression of Alaska Native peoples.

Issues of the mental health of arctic and subarctic Alaska Natives are explored. Their sociopolitical history is described to familiarize psychologists with the special circumstances of several groups of peoples in Alaska that have been ignored in psychological literature. This history demonstrates how intervention by European Americans in Alaska has prompted a self-alienation of Native peoples that has contributed to exorbitant suicide rates, increasing levels of addiction, high rates of interpersonal violence, and high teenage pregnancy. These developments are contrasted with traditional lifestyles. Recommendations are made about the role of psychology in the facilitation of the recovery process of Alaska Native peoples.

Acculturation↗
PubMed1998

Epidemiology of work-related aviation fatalities in Alaska, 1990-94.

Alaska, with less than one-half of 1% of the United States workforce, accounts for 9% of all occupational aviation fatalities nationally; 30% of all occupational fatalities in Alaska are related to aviation. To understand this high mortality, we investigated occupational aviation crashes to identify risk factors. Occupational aviation fatalities in Alaska during 1990-94 were examined using National Transportation Safety Board reports and merged with records from the Alaska Occupational Injury Surveillance System. There were 876 aircraft crashes; 407 (46%) were work-related. Occupational crashes were 2.2 times (CI: 1.5, 3.2) more likely to result in fatalities than non-occupational crashes. Risk factors identified included poor weather conditions defined as Instrument Meteorological Conditions (IMC). A crash during IMC was 5.3 times (CI: 3.5, 7.9) more likely to result in fatalities than crashes in other conditions. Of aircraft involved in fatal occupational incidents, 33% were not completely destroyed, allowing the potential for survivors. An estimated 30% reduction in fatalities could have occurred if current technology in occupant protection had been used.

Accidents, Aviation↗
PubMed2002

Rapid wastage of Alaska glaciers and their contribution to rising sea level.

We have used airborne laser altimetry to estimate volume changes of 67 glaciers in Alaska from the mid-1950s to the mid-1990s. The average rate of thickness change of these glaciers was -0.52 m/year. Extrapolation to all glaciers in Alaska yields an estimated total annual volume change of -52 +/- 15 km3/year (water equivalent), equivalent to a rise in sea level (SLE) of 0.14 +/- 0.04 mm/year. Repeat measurements of 28 glaciers from the mid-1990s to 2000-2001 suggest an increased average rate of thinning, -1.8 m/year. This leads to an extrapolated annual volume loss from Alaska glaciers equal to -96 +/- 35 km3/year, or 0.27 +/- 0.10 mm/year SLE, during the past decade. These recent losses are nearly double the estimated annual loss from the entire Greenland Ice Sheet during the same time period and are much higher than previously published loss estimates for Alaska glaciers. They form the largest glaciological contribution to rising sea level yet measured.

Journal Article↗
PubMedDate not supplied

Low national breast and cervical cancer-screening rates in American Indian and Alaska Native women with diabetes.

BACKGROUND: The cervical cancer mortality rate for American Indian and Alaska Native women is twice that of all races in the United States. To date the only published national breast and cervical cancer-screening rates for American Indian and Alaska Native women are based on self-reported data. When the Indian Health Service (IHS) conducts an annual audit on patients with diabetes, it includes cancer screening. This observational study presents national breast and cervical cancer-screening rates for American Indian and Alaska Native women with diabetes. METHODS: Cancer-screening rates were extracted from the 1995 diabetic audit for the 12 IHS areas. These rates were compared with rates for women without diabetes of the same age, 50 to 69 years, by chart review, at four IHS hospitals in the Aberdeen IHS area. RESULTS: Screening rates for women with diabetes in the 12 areas varied: mammogram (ever) 35% to 78%; clinical breast examination (last year) 28% to 70%, and Papanicolaou smear (last year) 26% to 69%. The Aberdeen IHS area women with diabetes had 51% more clinic visits per year than women without diabetes, but the groups had similar screening rates. CONCLUSION: Cancer-screening rates for American Indian and Alaska Native women vary by region. In the Aberdeen IHS area, women with diabetes had more visits (missed opportunities) but similar screening rates as women without diabetes. The diabetic audit could be used to monitor national IHS cancer-screening trends for women with diabetes and in the Aberdeen IHS area for all women aged 50 to 69 years.

Aged↗