An evaluation of technologies for the heavy metal remediation of dredged sediments.

Sediments dewatering is frequently necessary after dredging to remediate and treat contaminants. Methods include draining of the water in lagoons with or without coagulants and flocculants, or using presses or centrifuges. Treatment methods are similar to those used for soil and include pretreatment, physical separation, thermal processes, biological decontamination, stabilization/solidification and washing. However, compared to soil treatment, few remediation techniques have been commercially used for sediments. In this paper, a review of the methods that have been used and an evaluation of developed and developing technologies is made. Sequential extraction technique can be a useful tool for determining metal speciation before and after washing. Solidification/stabilization techniques are successful but significant monitoring is required, since the solidification process can be reversible. In addition, the presence of organics can reduce treatment efficiency. Vitrification is applicable for sediments but expensive. Only if a useful glass product can be sold will this process be economically viable. Thermal processes are only applicable for removal of volatile metals, such as mercury and costs are high. Biological processes are under development and have the potential to be low cost. Since few low cost metal treatment processes for sediments are available, there exists significant demand for further development. Pretreatment may be one of the methods that can reduce costs by reducing the volumes of sediments that need to be treated.

Styrene toxicity: an ecotoxicological assessment.

Although other aromatic compounds (e.g., benzene, toluene, polycyclic aromatic hydrocarbons (PAH), etc.) have been thoroughly studied over the years, styrene has been given little attention probably due to its lower rate of industrial use. In addition, it is less toxic than benzene and PAH, proven carcinogens. However, it is classified as a mutagen and thus potentially carcinogenic. Its main use is in the production of the polymer polystyrene and in the production of plastics, rubber, resins, and insulators. Entry into the environment is mainly through industrial and municipal discharges. In this review, the toxicological effects of styrene on humans, animals, and plants are discussed. Its mode of entry and methods of monitoring its presence are examined. Although its effects on humans and aquatic life have been studied, the data on short- or long-term exposures to plants, birds, and land animals are insufficient to be conclusive. Since exposure to workers can result in memory loss, difficulties in concentration and learning, brain and liver damage, and cancer, development of accurate methods to monitor its exposure is essential. In addition, the review outlines the present state of styrene in the environment and suggests ways to deal with its presence. It might appear that the quantities are not sufficient to harm humans, but more data are necessary to evaluate its effect, especially on workers who are regularly exposed to it.

Cost-effective carotid endarterectomy in community practice.

The purpose of this study was to compare hospital charges for carotid endarterectomy on a surgeon-specific basis. The cost of carotid endarterectomy is influenced by preoperative evaluation, operating time, use of the intensive care unit, length of hospital stay, and surgical results. Length of stay and average hospital charges for 18 doctors performing 344 carotid endarterectomies at three hospitals were analyzed. Outcome data were also reviewed. The results demonstrated a wide variation in hospital charges among surgeons. Surgeons using the most cost-effective measures achieved comparable or superior outcomes. In an era of managed care, severe cost constraints mandate that surgeons perform similar studies in their own communities so that cost-effective clinical pathways can be developed. With the use of appropriate guidelines, carotid endarterectomy can be performed at relatively low cost without sacrificing quality.

Carotid endarterectomy in community practice: surgeon-specific versus institutional results.

The efficacy of carotid endarterectomy in preventing stroke is clearly related to appropriate patient selection and low surgical morbidity and mortality. It has been suggested that since results at some centers are better than nationwide statistics, perhaps the operation should be limited to those institutions. In this paper we present an experience with carotid endarterectomy over the past twelve years. These 566 consecutive cases were performed by two vascular surgeons in a large metropolitan area using thirteen different hospitals ranging from 150 to 500 beds. Our mortality of 0.5% and permanent stroke incidence of 1.6% did not vary significantly from hospital to hospital. Where the results of surgical audits were available from the individual hospitals, the overall complication rates were significantly higher. We conclude that individual surgeons, not institutions, determine the efficacy of carotid endarterectomy in community practice.