Epidemiology of morbidity and mortality in US and Canadian recreational scuba diving.

OBJECTIVES: This study investigates morbidity and mortality suffered by divers in the USA and Canada. STUDY DESIGN: Prospectively recruited probability-weighted sample for estimating the national burden of injury and a weighted retrospective survey for estimating exposure. METHODS: The National Electronic Surveillance System and Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) were searched for scuba diving injuries. The Divers Alert Network diving fatality database was searched for deaths, and Sports and Fitness Industry Association estimates for diving were obtained from annual surveys. RESULTS: In the USA, there were an estimated 1394 emergency department (ED) presentations annually for scuba-related injuries. The majority (80%) were treated and/or released. There were an estimated 306 million dives made by the US residents 2006-2015 and concurrently 563 recreational diving deaths, a fatality rate of 0.18 per 105 dives and 1.8 per 105 diver-years. There were 658 diving deaths in the US 2006-2015 and 13,943 ED presentations for scuba injuries, giving a ratio of 47 diving deaths in the USA for every 1000 ED presentations. There were 98 cases of scuba-related injuries identified in the CHIRPP data. The prevalence of scuba-related injuries for patients aged 3-17 years was 1.5 per 105 cases, and the prevalence of scuba-related injuries to patients 18-62 years was 16.5 per 105 cases. DISCUSSION: In Canada and the USA, only one out of every 10,000 ED presentations is due to a scuba-related injury. That there are 47 deaths for every 1000 ED presentations for scuba injuries speaks to the relatively unforgiving environment in which scuba diving takes place. For 1.8 deaths per million recreational dives, mortality in scuba diving is nonetheless relatively low.

If it bleeds, it leads: the construction of workplace injury in Canadian newspapers, 2009-2014.

BACKGROUND: Public perceptions of workplace injuries are shaped by media reports, but the accuracy of such reports is unknown. OBJECTIVES: This study identifies differences between workers' compensation claims data and newspaper reports of workplace injuries in Canadian newspapers and media sources. METHODS: This study applies quantitative content analysis to 245 Canadian English-language newspaper articles from 2009 to 2014. Workers' compensation claims data is drawn from the Association of Workers' Compensation Boards of Canada. RESULTS: Newspapers dramatically overreport fatalities, injuries to men, injuries in the construction and mining/quarrying/oil industries, injuries stemming from contact with objects/equipment and fires/explosions, and acute physical injuries such as burns, fractures, intracranial injuries, and traumatic injuries. Newspaper reporters tend to rely upon government, police/firefighter, and employer accounts, rarely recounting the perspectives of workers. CONCLUSION: Newspapers overreported fatalities, injuries to men, and injuries in the construction and mining/quarrying/oil industries. This results in a misleading picture of occupational injuries in Canada.

Transgenic maize event TC1507: Global status of food, feed, and environmental safety.

Maize (Zea mays) is a widely cultivated cereal that has been safely consumed by humans and animals for centuries. Transgenic or genetically engineered insect-resistant and herbicide-tolerant maize, are commercially grown on a broad scale. Event TC1507 (OECD unique identifier: DAS-Ø15Ø7-1) or the Herculex®(#) I trait, an insect-resistant and herbicide-tolerant maize expressing Cry1F and PAT proteins, has been registered for commercial cultivation in the US since 2001. A science-based safety assessment was conducted on TC1507 prior to commercialization. The safety assessment addressed allergenicity; acute oral toxicity; subchronic toxicity; substantial equivalence with conventional comparators, as well as environmental impact. Results from biochemical, physicochemical, and in silico investigations supported the conclusion that Cry1F and PAT proteins are unlikely to be either allergenic or toxic to humans. Also, findings from toxicological and animal feeding studies supported that maize with TC1507 is as safe and nutritious as conventional maize. Maize with TC1507 is not expected to behave differently than conventional maize in terms of its potential for invasiveness, gene flow to wild and weedy relatives, or impact on non-target organisms. These safety conclusions regarding TC1507 were acknowledged by over 20 regulatory agencies including United States Environment Protection Agency (US EPA), US Department of Agriculture (USDA), Canadian Food Inspection Agency (CFIA), and European Food Safety Authority (EFSA) before authorizing cultivation and/or food and feed uses. A comprehensive review of the safety studies on TC1507, as well as some benefits, are presented here to serve as a reference for regulatory agencies and decision makers in other countries where authorization of TC1507 is or will be pursued.

Socio-economic correlates of municipal-level pollution emissions on Montreal Island.

BACKGROUND: Differential exposure to environmental hazards is one component of the social gradient in health. Few studies have investigated the association between socioeconomic characteristics and environmental hazards in a Canadian context. We assessed the relationships between pollution emissions and socio-economic characteristics for 27 municipalities on Montreal Island. METHODS: Pollution emissions were determined using Environment Canada's National Pollutant Release Inventory (NPRI) for the periods 1995-1996 and 2000-2001. Variables included the number of reporting industries, the average annual releases, and the average annual releases density. These data were cross-referenced with socio-economic data from the 1996 and 2001 Canadian Censuses, respectively. RESULTS: For both periods, pollution measures were inversely related to the average monthly amount of owners' major payments, the average income of households, the proportion of workers in the tertiary sector, and the proportion of individuals with a university education. Pollution measures were positively associated with the unemployment rate, the proportion of workers in the secondary sector, and the proportion of individuals with less than high school education. CONCLUSION: Socio-economic characteristics are associated with municipal-level pollution emissions on Montreal Island. Whether higher emissions are indicative of higher pollution exposure requires further investigation.

Johne's disease in Canada part II: disease impacts, risk factors, and control programs for dairy producers.

Part I of this 2-part review examined the clinical stages, pathophysiology, diagnosis, and epidemiology of Johne's disease, providing information relevant to Canada, where available. In Part II, a critical review of the economic impacts of the disease, risk factors, and important control measures are presented to enable Canadian bovine practitioners to successfully implement control strategies and participate in control programs. In cattle positive by enzyme-linked immunosorbant assay, there is a 2.4 times increase in the risk of their being culled, and their lactational 305-day milk production is decreased by at least 370 kg. Reduced slaughter value and premature culling account for losses of CDN dollars 1330 per year per infected 50-cow herd. Research has failed to show a consistent association between Mycobacterium avium subsp. paratuberculosis test status and reduced fertility or risk of clinical or subclinical mastitis. Host level factors include age and level of exposure, along with source of exposure, such as manure, colostrum, or milk. Agent factors involve the dose of infectious agent and strains of bacteria. Environmental management factors influence the persistence of the bacteria and the level of contamination in the environment. Emphasizing a risk factor approach, various control strategies are reviewed, including a number of national control programs currently in place throughout the world, specifically Australia, The Netherlands, and the United States. By reviewing the scientific literature about Johne's disease, control of the disease could be pursued through informed implementation of rational biosecurity efforts and the strategic use of testing and culling.

Exposing the "myth" of ABC, "anything but chrysotile": a critique of the Canadian asbestos mining industry and McGill University chrysotile studies.

BACKGROUND: Beginning in the 1930s, the Canadian asbestos industry created and advanced the idea that chrysotile asbestos is safer than asbestos of other fiber types. METHODS: We critically evaluate published and unpublished studies funded by the Quebec Asbestos Mining Association (QAMA) and performed by researchers at McGill University. RESULTS: QAMA-funded researchers put forth several myths purporting that Quebec-mined chrysotile was harmless, and contended that the contamination of chrysotile with oils, tremolite, or crocidolite was the source of occupational health risk. In addition, QAMA-funded researchers manipulated data and used unsound sampling and analysis techniques to back up their contention that chrysotile was "essentially innocuous." CONCLUSIONS: These studies were used to promote the marketing and sales of asbestos, and have had a substantial effect on policy and occupational health litigation. Asbestos manufacturing companies and the Canadian government continue to use them to promote the use of asbestos in Europe and in developing countries. Am. J. Ind. Med. 44:540-557, 2003.

AAPS/RAPS/CAPRA collaborative program: exploring the challenges of drug regulation in a global environment: clinical concerns.

Globalization of the pharmaceutical industry has led to a need to harmonize the regulatory requirements governing the marketing of medicinal products. To minimize the barriers impeding global drug product registration, the International Conference on the Harmonization of Technical Requirements of Pharmaceuticals for Human Use (ICH) was established in 1990. The ICH has developed a series of guidelines that reflect agreements reached by participating nations on aspects of the chemistry and clinical technical sections that will fulfill the regulatory requirements of these various jurisdications. Nevertheless, there continue to be points of divergent perspectives and barriers that can impede the use of foreign clinical data. Given the importance of these issues, the Regulatory Science (RS) section of the American Association of Pharmaceutical Scientists (AAPS), in conjunction with the Regulatory Affairs Professional Society (RAPS) and the Canadian Association of Professional Regulatory Affairs (CAPRA) cosponsored a public forum on this topic. This manuscript provides a summary of the speaker presentations and audience discussions regarding the design of clinical trials and the extrapolation of results from these trials to support international drug registration.

Medical care reform: lessons from around the world.

Once again the United States is in a ferment of health policy reform. Proposals abound but sage observers remark that national health insurance has been "just around the corner" more than once in the last forty years. This time may be different, however. Proposals from all across the ideological spectrum are converging on the notion of "managed care" which is perhaps best known in its guise as a health maintenance organization (HMO). Other forms of managed care exist but they have neither the history nor the incentives found in traditional HMOs. The discussion on national health insurance (NHI) proposals has focused on financing issues to the virtual exclusion of public health concerns. In this article, the author addresses rural health and public hospitals in the United States; two problems that have been with us for a long time. Then articles examining the Canadian and English medical care systems are reviewed, illustrating some of the weaknesses of these approaches to national medical care. Research studies relating to Europe and the developing nations are next. Once again, these are intended to highlight public health problems found in differing medical care systems. Finally, the author examines utopian views of the United States medical care system of the future: the reform proposal offered by the National Association for Public Health Policy, the experimental policy in Washington State, and a vision of a planned system. The review is intended to draw together the lessons offered by public health policy research in other countries and the United States and apply them to the issue at hand: reforming the United States medical care system.

Funding medical and health-related research in the public interest.

Public funding for medical and health-related research in Canada is declining. At the same time, the pharmaceutical industry is directing increasing amounts of money to publicly funded agencies such as universities and the Medical Research Council of Canada. However, the kinds of research most valuable to commercial firms may not be those most valuable to the Canadian public. There is a danger that research priorities and activities in public institutions may become skewed as a result of increased drug-industry funding. Mechanisms need to be found to ensure an appropriate balance between the research that is most valuable to the public interest and to the long-term advancement of knowledge, and the research that is likely to lead to marketable products. One such mechanism is the direction of a proportion of the money from drug companies to a "no-strings-attached" fund specifically to support types of research that are in the public interest but not likely to lead to marketable products.