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At least 1,729 records · Page 96Linked to original sources
PubMed1995

Recreational use of inhalant drugs by adolescents: a challenge for family physicians.

BACKGROUND AND OBJECTIVES: This paper assesses the incidence and prevalence of inhalant use in an adolescent population. The purpose was to document patterns of incidence and prevalence. METHODS: A survey study was conducted, in which self-reported measures of inhalant use were assessed during 3 consecutive years. All surveys were completed as part of a school-based study. The responses of 10,198 middle school and high school students were analyzed. The primary measures included self-reported use of substances that were inhaled to create a state of euphoria. RESULTS: Of the responding students, overall rates of 12.8% for lifetime use and 4.6% for past-month use were observed. Cross-sectional analysis revealed increasing inhalant use among students in grades 6-8 that leveled off in grade 9 and decreased in grades 10-12. Incidence of inhalant use was found to be increasing in younger adolescents. CONCLUSIONS: Inhalant use may be an early marker of substance abuse and should be the focus of increased prevention and early diagnosis and treatment. Family physicians may be among the first to suspect inhalant use in casual users and should be alert to inhalant use among adolescent patients.

Administration, Inhalation↗
PubMedDate not supplied

Hazards associated with the recreational drug 'ecstasy'.

The amphetamine analogue 'ecstasy' is a popular 'designer' drug and is perceived by its users to be relatively harmless. However, it has been associated with several fatalities through a disorder of thermoregulation, and severe reactions have been reported across many disciplines. This article emphasises the hazardous nature of the drug and highlights the urgency and nature of treatment in the acutely toxic state.

Adolescent↗
PubMed1993

Recreational injuries and deaths in northern Wisconsin: analysis of injuries and fatalities from snowmobiles over 3 years.

Snowmobiles represent the second most common cause of trauma related to motorized vehicles in northern Wisconsin. The epidemiology of these injuries is evaluated. Specific comparisons between snowmobiles and other vehicles are made. We conclude that snowmobiles represent a controllable etiology for injuries and death. Our data suggest some interventions to prevent injuries and improve treatment.

Adult↗
PubMed1993

Fatality due to recreational use of chlorodifluoromethane and chloropentafluoroethane.

Reports on fatalities of chlorofluorocarbons usually involve chlorotrifluoroethane, trichlorofluoromethane, dichlorodifluoromethane or chlorodifluoromethane, where analysis was done using packed column gas chromatography. In this case a death was caused by an azeotropic mixture of chlorodifluoromethane and chloropentafluoroethane, a combination that has not previously been reported in the forensic literature. This report details the analysis using mass selective detection employing capillary gas chromatography columns currently used in many toxicology laboratories. Postmortem toxicology revealed blood concentrations of chlorodifluoromethane and chloropentafluoroethane of 71 mg/L and 0.30 mg/L, respectively. Brain, liver, and lung concentrations of chlorodifluoromethane were (mg/kg) 2.8, 4.4, and 1.6, respectively. Brain, liver, and lung concentrations of chloropentafluoroethane were (mg/kg) 0.80, 0.80, and 0.11, respectively. The victim's blood contained 5.5 mg/L caffeine. Lidocaine, used in resuscitation attempts, was also present in the victim's blood. No other alkali-extractable drugs or volatile alcohols were detected in the victim's blood. The cause of death was acute respiratory arrest due to chlorofluorocarbon inhalation.

Adult↗
PubMed1997

Leptospirosis on Oahu: an outbreak among military personnel associated with recreational exposure.

In December 1992, a common-source waterborne outbreak of leptospirosis occurred on the island of Oahu in the state of Hawaii. Two male service persons were hospitalized with culture-confirmed leptospirosis. Eighteen others had similar histories of exposure to the same freshwater swimming site. Although six men developed signs and symptoms comparable to those of the two confirmed cases, none manifested culture or serologic evidence of leptospirosis. The increased incidence of leptospirosis in Hawaii coupled with an increased risk in young males characterize the military population in Hawaii as a high-risk population with respect to leptospirosis.

Disease Outbreaks↗
PubMed1997

[Changes in cardiac function during recreational diving].

Underwater diving is a widely practised leisure activity. As cardiac patients may wish to participate, cardiologists should be aware of potential changes of cardiac function during diving. Multiple factors may affect haemodynamics. Firstly, changes in pressure, secondary to ventilation of a high density gas mixture which increases afterload. Hyperoxia is the principal factor which slows the heart rate, a commonly observed phenomenon. Excitability and conduction speed may be modified by the increase in hydrostatic pressure. During decompression, gaseous pulmonary embolism may increase right heart pressures and cause a paradoxical embolism may increase right heart pressures and cause a paradoxical embolism in patients with a right-to-left shunt. Immersion increases the preload. Exposure to cold also plays a role increasing afterload and slowing the heart rate. These factors may disturb cardiac function and expose cardiac patients to accidents during underwater diving.

Animals↗
PubMed1997

Mixed genogroup SRSV infections among a party of canoeists exposed to contaminated recreational water.

Samples of faeces collected from a party of canoeists involved in a gastroenteritis outbreak were examined by electron microscopy and RT-PCR for evidence of infection with SRSVs. A broadly reactive primer pair was used to detect SRSVs followed by application of genogroup-specific primers to SRSV-positive specimens. Exposure data were collected by means of a questionnaire. SRSVs were detected in 1/4 specimens examined by EM and 3/4 by RT-PCR. Genogrouping, and sequencing of PCR products revealed two distinct strains: a genogroup I strain, related to the Desert Shield virus, and a genogroup II strain, related to the Lordsdale virus to be associated with the outbreak. Exposure data indicated that capsising and eating food before getting changed were associated with an increased risk of gastroenteritis and was consistent with infection following the consumption of contaminated water. This study confirms the greater sensitivity of RT-PCR for the diagnosis of SRSV infections and its utility, when incorporating genogroup-specific primers, in establishing more complex epidemiological data.

Adolescent↗
PubMed2002

Surveillance for waterborne-disease outbreaks--United States, 1999-2000.

PROBLEM/CONDITION: Since 1971, CDC, the U.S. Environmental Protection Agency (EPA), and the Council of State and Territorial Epidemiologists (CSTE) have maintained a collaborative surveillance system for the occurrences and causes of waterborne-disease outbreaks (WBDOs).This surveillance system is the primary source of data concerning the scope and effects of waterborne diseases on persons in the United States. REPORTING PERIOD COVERED: This summary includes data regarding outbreaks occurring during January 1999-December 2000 and previously unreported outbreaks occurring in 1995 and 1997. DESCRIPTION OF THE SYSTEM: The surveillance system includes data for outbreaks associated with drinking water and recreational water. State, territorial, and local public health departments are primarily responsible for detecting and investigating WBDOs and voluntarily reporting them to CDC on a standard form. The unit of analysis for the WBDO surveillance system is an outbreak, not an individual case of a waterborne disease. Two criteria must be met for an event to be defined as a WBDO. First, > or = 2 persons must have experienced a similar illness after either ingestion of drinking water or exposure to water encountered in recreational or occupational settings. This criterion is waived for single cases of laboratory-confirmed primary amebic meningoencephalitis and for single cases of chemical poisoning if water-quality data indicate contamination by the chemical. Second, epidemiologic evidence must implicate water as the probable source of the illness. RESULTS: During 1999-2000, a total of 39 outbreaks associated with drinking water was reported by 25 states. Included among these 39 outbreaks was one outbreak that spanned 10 states. These 39 outbreaks caused illness among an estimated 2,068 persons and were linked to two deaths. The microbe or chemical that caused the outbreak was identified for 22 (56.4%) of the 39 outbreaks; 20 of the 22 identified outbreaks were associated with pathogens, and two were associated with chemical poisoning. Of the 17 outbreaks involving acute gastroenteritis of unknown etiology, one was a suspected chemical poisoning, and the remaining 16 were suspected as having an infectious cause. Twenty-eight (71.8%) of 39 outbreaks were linked to groundwater sources; 18 (64.3%) of these 28 groundwater outbreaks were associated with private or noncommunity wells that were not regulated by EPA. Fifty-nine outbreaks from 23 states were attributed to recreational water exposure and affected an estimated 2,093 persons. Thirty-six (61.0%) of the 59 were outbreaks involving gastroenteritis. The etiologic agent was identified in 30 (83.3%) of 36 outbreaks involving gastroenteritis. Twenty-two (61.1%) of 36 gastroenteritis-related outbreaks were associated with pools or interactive fountains. Four (6.8%) of the 59 recreational water outbreaks were attributed to single cases of primary amebic meningoencephalitis (PAM) caused by Naegleria fowleri. All four cases were fatal. Fifteen (25.4%) of the 59 outbreaks were associated with dermatitis; 12 (80.0%) of 15 were associated with hot tubs or pools. In addition, recreational water outbreaks of leptospirosis, Pontiac fever, and chemical keratitis, as well as two outbreaks of leptospirosis and Pontiac fever associated with occupational exposure were also reported to CDC. INTERPRETATION: The proportion of drinking water outbreaks associated with surface water increased from 11.8% during 1997-1998 to 17.9% in 1999-2000. The proportion of outbreaks (28) associated with groundwater sources increased 87% from the previous reporting period (15 outbreaks), and these outbreaks were primarily associated (60.7%) with consumption of untreated groundwater. Recreational water outbreaks involving gastroenteritis doubled (36 outbreaks) from the number of outbreaks reported in the previous reporting period (18 outbreaks). These outbreaks were most frequently associated with Cryptosporidium parvum (68.2%) in treated water venues (e.g., swimming pools or interactive fountains) and by Escherichia coli O157:H7 (21.4%) in freshwater venues. The increase in the number of outbreaks probably reflects improved surveillance and reporting at the local and state level as well as a true increase in the number of WBDOs. PUBLIC HEALTH ACTION: CDC and others have used surveillance data to identify the types of water systems, their deficiencies, and the etiologic agents associated with outbreaks and evaluated current technologies for providing safe drinking water and safe recreational water. Surveillance data are used also to establish research priorities, which can lead to improved water-quality regulations. Only the groundwater systems under the influence of surface water are required to disinfect their water supplies, but EPA is developing a groundwater rule that specifies when corrective action (including disinfection) is required. CDC and EPA are conducting epidemiologic studies to assess the level of waterborne illness attributable to municipal drinking water in nonoutbreak conditions. Rules under development by EPA--the Ground Water Rule (GWR), the Long Term 2 Enhanced Surface Water Treatment Rule (LT2ESWTR), and Stage 2 Disinfection Byproduct Rules (DBPR)--are expected to further protect the public from contaminants and disinfection byproducts in drinking water. Efforts by EPA under the Beaches Environmental Assessment, Closure, and Health (BEACH) program are aimed at reducing the risks for infection attributed to ambient recreational water by strengthening beach standards and testing; providing faster laboratory test methods; predicting pollution; investing in health and methods research; and improving public access to information regarding both the quality of the water at beaches and information concerning health risks associated with swimming in polluted water. EPA's Beach Watch (available at http://www.epa.gov/waterscience/beaches) provides online information regarding water quality at U.S. beaches, local protection programs, and other beach-related programs. CDC partnered with a consortium of local and national pool associations to develop a series of health communication materials for the general public who attend treated recreational water venues and to staff who work at those venues. CDC has also developed a recreational water outbreak investigation toolkit that can be used by public health professionals. All of the CDC materials are accessible at the CDC Healthy Swimming website (http://www.cdc.gov/healthyswimming).

Communicable Diseases↗