Cost of injury - United States: a report to Congress, 1989

Article Abstract:

The Congress directed the National Highway and Traffic Safety Administration and the Centers for Disease Control to evaluate the economic effect of injuries within the United States. This report is a summary of the findings which document the lifetime economic cost of all such injuries by age, sex and cause. The lifetime economic cost was used because it is a direct measure of medical expenditures, rehabilitation costs and the indirect costs of loss of work due to injury or premature death. In the base year of 1985, 57 million individuals were injured in the United States with a lifetime cost of $157.6 billion. The largest proportion of this group were adults aged 25-44 years of age (42 percent). Injuries to individuals aged 15-24 made up 25 percent of the total. The causes of injuries in order of importance were: motor vehicles ($48.7 billion), falls ($37.3 billion), firearms ($14.4 billion), poisonings ($8.5 billion), burns ($3.8 billion) and drownings or near-drownings ($2.5 billion). All other factors not included in the above break-down were responsible for an additional $42.4 billion in lifetime costs. These injuries resulted in 155,665 deaths in 1985. Individuals hospitalized for their injuries numbered 2.3 million, and 54.4 million received treatment as outpatients or were disabled sufficiently to require reduced physical activity for at least one day. This represented a total direct medical cost of $44.8 billion, which included $24.5 billion in hospital, professional and rehabilitation costs. Private funds including health insurance, workers' compensation, etc. paid approximately 72 percent of these costs for individuals under 65 years of age. For those individuals older than 65, Medicare and other public funds paid approximately 72 of the direct medical costs.

Finance, Statistics, Accidents, Medical emergencies

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A report of fluorosis in the United States secondary to drinking well water

Article Abstract:

Although federal and state regulations require monitoring of municipal water supplies, there are no regulations governing private wells. In some states in the Midwest and Southwest high concentrations of fluoride are found in the ground water, far exceeding the recommended levels for prevention of tooth cavities. In this case study, a 54-year-old woman hospitalized for depression was found to have an abnormal increase in the density of bone tissue (osteosclerosis) in the spine, ribs, and pelvis, and abnormal curvature of the spine. She also had stiffness in her hips and knees. The fluoride concentration in her residential well water was exceedingly high, pointing to a diagnosis of fluorosis. She had lived alone at her residence for seven years, fewer than the 10 to 20 years usually considered the amount of time necessary to develop fluorosis. With very high doses, and among children, the amount of time required to develop fluorosis is known to be shorter. The families in the area were informed about the fluoride problem. Reports from areas such as Punjab State, India, where excessive fluoride is endemic, have documented the progression of the malady from vague complaints of muscle and joint pain, to spinal and other skeletal deformities resulting in reduced mobility and contractures, to neurological complications involving the spine. Improvement usually follows removal of the fluoride exposure, probably because fluoride continues to be excreted in the urine. In regions where there is a probability of high levels of fluoride in the ground water it would be advisable for fluoride concentrations to be measured when new wells are dug. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Standards, Case studies, Testing, Causes of, Drinking water, Fluorosis, Fluorine

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Effect of exogenous surfactant (calfactant) in pediatric acute lung injury

Article Abstract:

An attempt is made to determine if endotrachael instillation of calfactant in infants, children, and adolescents with acute lung injury (ALI) would shorten the course of respiratory failure. Results reveal that calfactant acutely improved oxygenation and significantly decreased mortality in infants, children, and adolescents with ALI although no significant decrease in the course of respiratory failure measured by duration of ventilator therapy, intensive care unit was observed.

Risk factors, Influence, Acute respiratory distress syndrome, Adult respiratory distress syndrome, Trachea, Tracheal diseases

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