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16 September 2002
| Bright lights, big city | |
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Arch Dis Child 2002; 87: 111-113 |
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| A harsh mistress | |
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A recent analysis of UK mortality statistics confirms that fishermen and seafarers have the most dangerous jobs of all. Between 1976 and 1995, seafarers were 26.2 times and fishermen 52.4 times more likely than all other occupations combined to have fatal accidents at work (rates of 51.6 and 103.1 deaths/100 000 worker-years, respectively). Drowning was the most common cause of death, followed by injuries and asphyxiation. According to the researchers this is not just a British phenomenon. Fishermen in Demark, Australia and Alaska enjoy fatal accident rates of 145, 143 and 116/100 000 worker-years, respectively. Lancet 2002; 360: 543-544 |
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| Wheezy genes | |
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Recent work on the ADAM 33 gene provides insight into the pathogenesis of asthma, and possibilities for management. Researchers scanned the entire genomes of 460 Caucasian sibling pairs and found a locus on chromosome 20 which was linked
to both asthma and bronchial hyperresponsiveness. They surveyed 135 polymorphisms of 23 genes, identifying an allele of the ADAM
(A Disintegrin And Metalloprotease) gene, ADAM33, as being significantly associated with asthma. The gene codes for membrane proteins and is expressed in bronchial smooth muscle and lung fibroblasts, suggesting that its role in asthma susceptibility may involve airway function rather than immunological factors.
Nature 2002; 418: 426-430
In the United States, women who obtain Civil Protection Orders against violent partners can take heart that such orders seem to afford protection in the long run, but the early benefits are much less certain. In Seattle, Washington, between August 1998 and January 2000, 2691 women reported episodes of Intimate Partner Violence (IPV) to the police: 225 obtained temporary protection orders (TPOs) for two weeks, and 185 went on to obtain permanent protection orders (PPOs) for a year or more.
In the 12 months following the index incident the overall rates of police-reported IPV were 13.5 and 12.3/100 person-years for physical and psychological abuse, respectively. Women with TPOs reported slightly higher levels of physical abuse than those without orders, but were almost five times more likely to report psychological abuse. Women with PPOs reported similar rates of psychological abuse as women without orders, but were five times less likely to report physical abuse.
It is estimated that police records capture about 50% of IPV incidents.
JAMA 2002; 288: 589-594
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| Litigation and conversation | |
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As if they didn’t have enough to worry about with the current medical indemnity crisis, surgeons are now advised that the tone of voice they use with patients might lead to litigation! Consultations of 57 US surgeons (36 of whom had had at least two malpractice claims filed against them) with 114 patients were recorded. Four 10-second sound clips were extracted from each consultation: two retained content and two were filtered using an audio technique which retains the expressive features of speech without recognisable content. The clips were rated by 12 Harvard University undergraduates. Controlling for content, a dominant tone was associated with a history of litigation (OR, 2.74), while a concerned or anxious tone was not (OR, 0.46). Surgery 2002; 132: 5-9 |
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©The Medical Journal of Australia 2002 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377
According to a study conducted in Delhi, India, one of the most polluted cities in the world, atmospheric pollution is leaving children vulnerable to rickets. Researchers compared biochemical indicators of vitamin D status in 26 children aged 9–24 months living in a heavily polluted area of the inner city (Mori Gate) and 31 age-matched children from a less-polluted area on the outskirts (Gurgaon). Pollution levels were confirmed using a haze sensor, which detects UVB radiation to produce a haze score (lower scores indicating higher levels of atmospheric pollution). All the families were Hindu vegetarians and lived in one-room dwellings with some communal outdoor space. Haze scores confirmed that UVB was less available in Mori Gate than in Gurgaon (mean scores, 2.1 v 2.7). Mean total serum 25(OH)D concentration was significantly lower in the Mori Gate children than in the Gurgaon children (12.4 ng/mL v 27.1 ng/mL) and these children’s mean alkaline phosphatase and parathyroid hormone levels were correspondingly higher. Twelve Mori Gate children had severe 25(OH)D deficiency (levels <12 ng/mL), three having levels usually associated with rickets (<5 ng/mL).