Suicide by poisoning in New Zealand--a toxicological analysis.

AIM: Determine major substances and risk factors for suicide by chemical overdose in New Zealand between 2001 and 2005. METHOD: All intentional deaths between 2001 and 2005 were reviewed. Primary substances causing death were verified from toxicology reports. RESULTS: The chemical suicide rate was higher among older Europeans, women and those in paid work than other groups. Carbon monoxide and tricyclic antidepressants (TCAs) continue to be the most common chemicals used, in spite of market changes. Anaesthetics and cyanide deaths among workers were noted. CONCLUSION: Restricted access to work-related chemicals and stricter prescription/dispensing controls for TCAs may reduce self-poisoning in New Zealand.

Quantitative estimate of the risks and benefits of possible alternative blood donor deferral strategies for men who have had sex with men.

BACKGROUND: Implementation of sensitive screening methods for human immunodeficiency virus (HIV) and hepatitis viruses prompts the question of what quantitative risks may result from altered deferral strategies for donation of blood by men who have had sex with men (MSM). STUDY DESIGN AND METHODS: Quantitative probabilistic models were developed to assess changes in the residual risk of transfusion-transmitted HIV and hepatitis B virus (HBV) associated with blood testing and quarantine release errors (QREs) in the initial year of two hypothetical policy scenarios that would allow donations from donors who have abstained from MSM behavior for at least 5 years (MSM5) or at least 1 year (MSM1). RESULTS: The MSM5 and MSM1 models, respectively, predicted annual increases in units of HIV-infected blood of 0.5% (0.03 mean additional units; 95% confidence interval [CI], 0-1) and 3.0% (0.18 mean additional units; 95% CI, 0-1) over current estimated HIV residual risk using recent, nationwide biologic product deviation reports to estimate QRE rates. These estimates are approximately 10-fold lower than estimates based on New York State QRE data from the previous decade. The models predicted smaller increases in infectious HBV donations. CONCLUSIONS: QREs remain the most significant preventable source of risk. More accurate inputs, including the percentage of MSM in the population, the percentage of MSM who have abstained from MSM activity for 1 or 5 years, the prevalence of HIV and HBV in MSM who have abstained from MSM activity for 1 or 5 years, the rate of self-deferral, and QRE rates, are required before making more precise predictions.

Suicide and occupation in New Zealand, 2001-2005.

Emerging evidence for the role of occupation in suicide risk prompted this analysis. All suicide records in New Zealand between 2001 and 2005 were reviewed. Age- and sex-adjusted suicide rates were calculated for nine major occupational groups. Rates for those not in paid work were adjusted for sex only. A total of 2,024 suicide cases were reviewed. People engaged in paid work had one-fourth of the suicide rate of the non-waged (p < 0.005). Those working in farming, fisheries, or forestry and trades had higher suicide rates than people in other occupations. Homemakers and people with office jobs had the lowest suicide rates. Occupation influenced suicide rates. The continuing disparity in suicide rates between non-waged and waged workers is of particular concern and needs to be addressed. Farmers and trades workers should be monitored more closely.

Building social capital in first-time parents through a group-parenting program: a questionnaire survey.

BACKGROUND: Parents who are connected into strong family and community networks are said to have high social capital enabling them to provide a positive context where their children's social, emotional and educational needs are met. OBJECTIVES: To identify parent satisfaction with, strengths and weaknesses of, opportunities to build social capital, and the impact of a two-course pilot health and relationship focused Parenting Education Program-PEPE, designed for first-time parents, on the core work of the well-child nurse/health visitor. DESIGN: Retrospective descriptive survey using postal questionnaires. SETTING: Twelve pilot parenting courses facilitated across five regions of New Zealand. PARTICIPANTS: All parents (n = 105) and clinical nursing staff (n = 12) involved in the pilot parenting courses were invited to participate. Overall response rate was 82%. METHODS: Questionnaires developed by investigators were mailed to the eligible population. Numerical data was analysed using PC-SAS. Narrative data was subjected to thematic content analysis. RESULTS: Attendance at both parenting courses positively correlated with an increase in measures of social capital: development of strong social networks (82% Your New Baby course respondents: 95% CI, 75-89, and 98% Your Growing Baby course respondents: 95% CI, 96-100), and positive relationships with others (93% Your New Baby course respondents: 95% CI, 88-98, and 86% Your Growing Baby course respondents: 95% CI, 83-89). Increased confidence in respondent's parenting ability was also identified (96% Your New Baby course respondents: 95% CI, 92-100; 96% Your Growing Baby course respondents: 95% CI 93-99). CONCLUSIONS: The PEPE programme was well accepted by first-time parents leading to significant improvements in development of social capital and parenting confidence. Well-child health nurses are in a prime position to foster social capital and help rebuild communities within which they work to enhance parenting outcomes.

Occupational respiratory health of New Zealand horse trainers.

OBJECTIVES: To confirm that working with horses is an occupational respiratory hazard and observed associations are not attributable to confounding. METHODS: A postal survey of the respiratory health of 659 horse trainers and a comparison group of 506 vegetable growers was conducted. Data were analysed using logistic regression. RESULTS: Relative to vegetable growers, horse trainers reported higher rates of chronic bronchitis [odds ratio (OR) = 6.8, 95% confidence interval (CI): 2.2-21.4] and organic dust toxic syndrome/farmers' lung (ODTS/FL) (OR = 3.5, 95% CI: 1.8-6.8). Grinding oats, spreading hay, and using powdered feed supplements were associated with increased respiratory symptoms among trainers. Associations between symptoms and working with horses increased for full-time workers. CONCLUSIONS: This study found evidence that working with horses is a risk factor for ODTS/FL and bronchitis. The associations did not appear to be explained by bias, including confounding. However, the possibility of confounding cannot be entirely ruled out, and confirmatory studies are needed. Future studies should consider inorganic dust exposures.

"It's your whole way of life really": negotiating work, health and gender.

Recent discussions in contemporary geographies of health have highlighted the need to understand the social contexts in which people experience health and illness. Qualitative and mixed method studies have been shown to be invaluable to such research, especially where investigations seek to understand the circumstances and responses surrounding particular conditions. In this paper, we move beyond biomedical approaches to combine methods in health research and gain insights into the complex contexts and relations affecting men's and women's respiratory health. Drawing on three literatures and past work on respiratory disease in selected primary industries, we report on qualitative research conducted with men and women horse trainers and vegetable growers working in southern New Zealand. We note the gendered work differences that could be affecting contrasting disease rates and focus on notions of 'metaphor' and 'place' to analyse the narratives trainers and growers construct about their health. We report that men and women negotiate a "whole way of life" that involves both specific workplaces and social relations that shape their work and health experiences.