Recovery of rare earths from waste cathode ray tube (CRT) phosphor powder with organic and inorganic ligands.

Cathode ray tubes (CRTs) have an appreciable amount of rare earth elements (REEs). In this document, the leaching and recovery of the REEs from CRTs, with different organic and inorganic ligands is presented. Among the complexing agents tested, the pyrophosphate ion was found to be the most advantageous for the extraction of REEs from CRTs, as an alternative to the traditional methods that use highly acidic solutions (pH < 1) and elevated temperatures. Thermodynamic analyses predict the formation of soluble REE-pyrophosphate complexes in a pH range of 2-8. Leaching solutions of 0.1 M Na4P2O7 at pH 6 and room temperature were employed. REE dissolution from the untreated CRT powder under these conditions was extremely low, due to the encapsulation by other components in the powders, such as ZnS (26%), and the high content of phosphates (6%), that severely limited the solubility of the REEs. To increase extraction, pretreatments were employed to alter and remove the passivating species: roasting at 800 °C or contact with concentrated solutions of sodium hydroxide at 95 °C. The combination of these pretreatments completely eliminated the Zn and 79% of the phosphate ion, as well as other base metals, resulting in an improved exposure of REEs for subsequent leaching. Extractions for Y, Eu, Sm, and Ce of 58, 90, 90 and 87%, respectively, were achieved with the pyrophosphate solution at ambient temperature. The REEs were later recovered as oxides by adjusting the solution pH to 11. Subsequently, once the pyrophosphate solution pH is reestablished, it may be reused for leaching.

Police accident report forms: safety device coding and enacted laws.

Safety device coding on state police accident report (PAR) forms was compared with provisions in state traffic safety laws. PAR forms were obtained from all 50 states and the District of Columbia (states/DC). For seat belts, 22 states/DC had a primary seat belt enforcement law vs 50 with a PAR code. For car seats, all 51 states/DC had a law and a PAR code. For booster seats, 39 states/DC had a law vs nine with a PAR code. For motorcycle helmets, 21 states/DC had an all-age rider helmet law and another 26 a partial-age law vs 50 with a PAR code. For bicycle helmets, 21 states/DC had a partial-age rider helmet law vs 48 with a PAR code. Therefore gaps in the ability of states to fully record accident data reflective of existing state traffic safety laws are revealed. Revising the PAR forms in all states to include complete variables for safety devices should be an important priority, independent of the laws.

Work-related injury among Connecticut minors.

Work-related injuries have recently been shown to be a significant cause of morbidity among adolescents. This study represents a population-based work-related injury profile for Connecticut minors. Review of 796 worker compensation reports for adolescents from 14 through 17 years of age submitted over 12 months revealed an overall age-specific injury rate of 15 per 1000 employed 16- and 17-year-olds; frequency of injury increased with age. Social and recreational workers had an injury rate of more than 20%, predominantly sprains and contusions. Among all other occupations and industries, cuts were the major type of injury (34%); more than one third of cutting injuries were associated with use of case cutters, another third with knives. There were no work-related deaths among minors in this study. Minors in the workplace are at high risk of injury compared with adults. This study suggests that identification of specific patterns of work-related injury could lead to targeted intervention strategies.

Population, income, and ecological correlates of child pedestrian injury.

Pedestrian injury is a significant health problem among urban children. This study is an analysis of the role of population, income, and ecological factors in the occurrence of child pedestrian collisions. One hundred and ninety-eight motor vehicle collisions occurring in Hartford, Connecticut involving pedestrians younger than 15 years old were reported to police during 1986 through 1987. Collision locations were abstracted from police reports and assigned a census tract. Census tracts were classified as "high frequency" (8+ collisions), "moderate frequency" (3 to 7 collisions), or "low frequency" (0 to 2 collisions). High-frequency census tracts had greater proportions of children and of nonwhite residents than moderate- or low-frequency tracts. They also were characterized by high proportions of households headed by females living below the poverty line. High-frequency tracts had a greater number of children per acre than moderate or low tracts. Children per acre had the strongest association with collision frequency (R = .72) and remained the most consistent when other variables were controlled. The number of children per acre is a potentially useful predictor of census tracts at risk for child pedestrian collisions. This may be useful in developing focused prevention strategies within an urban environment.

A population-based study of severe firearm injury among children and youth.

BACKGROUND: Firearm injuries are a major cause of pediatric mortality and morbidity in the United States. To date, population-based studies describe the epidemiology of firearm-related deaths; however, the patterns of severe, nonfatal pediatric firearm-related injuries are not as well defined. OBJECTIVES: To determine the epidemiology of severe firearm-related deaths and injuries among a statewide population of children and youth ages birth to 19 years. METHODS: Demographic, geographic, and cost data were analyzed from Connecticut death certificates for 1988 through 1992 and hospital discharge data for 1986 through 1990 for firearm-related unintentional, self-inflicted, and assaultive injury among children and youth ages birth to 19 years. RESULTS: There were 219 firearm deaths: 68% homicides, 25% suicides, 6% unintentional, and 1% of undetermined intent, resulting in an annual age-specific death rate of 6.6 per 100,000 persons. There were 533 hospitalizations for gunshot wounds (16 per 100,000); 41% were assaults, 1% suicide attempts, 39% unintentional gunshot wounds, 1% legal interventions, and 18% of undetermined intent. More than 80% of deaths from gunshot wounds and hospitalizations occurred among 15- to 19-year-old males, most occurring in Connecticut's five largest cities. Most firearm homicides occurred among urban residents; most firearm suicides occurred among nonurban residents; and unintentional shootings were evenly distributed between urban and nonurban residents. The total cost of firearm-related hospitalizations averaged $864,000 per year. CONCLUSIONS: Firearms are a major cause of mortality and morbidity of Connecticut children and youth, exceeded only by motor vehicles as a cause of death among those 1 to 19 years of age. Handguns were responsible for a disproportionate amount of trauma compared with other firearm types. The epidemiology of pediatric gunshot injuries requires a range of strategies for prevention. Physicians caring for families with children must include firearm injury prevention counseling as a routine part of anticipatory guidance.

Evaluation of the effectiveness of a pavement stencil in promoting safe behavior among elementary school children boarding school buses.

OBJECTIVE: The majority of school bus-related fatalities among children attending elementary school in the United States occur as children board or alight from buses. Injuries occur during boarding when children enter the street and are struck by buses or other vehicles. This study evaluated the effectiveness of a stencil in the shape of a school bus applied to the pavement at a bus stop in improving safe behaviors at bus stops. Specifically, we assessed the frequency of children running toward the bus as it approached or entered the street. METHODS: Elementary school bus stops with similar roadways, traffic profiles, and numbers of children boarding participated in the study. Stops were randomly assigned to an intervention group, in which children were instructed to remain within a safe area during boarding that was demarcated by a pavement stencil, or an education-only group, in which the safe area was demarcated by some existing environmental feature. Both groups received education about safe boarding procedures. Observers rated behavior at each stop daily for 5 consecutive weeks. Data were analyzed as bivariate odds of any unsafe behavior in the education-only group. RESULTS: One hundred forty-five observations from seven bus stops with stencils and 174 daily observations from six education-only stops were completed. Observations of children in the education-only group were twice as likely to show unsafe behavior while waiting (odds ratio [OR], 2.1; 95% confidence interval [CI], 1.3-3.6) and during boarding (OR, 2.1; 95% CI, 1.2-3.9). ORs were significantly higher in the education-only group for boys, girls, and children in grades 4 through 6. When no adult was present, there was a greater likelihood of unsafe behavior among all children in the education-only group while waiting (OR, 16.1; 95% CI, 3.9-72.4) and during boarding (OR, 15.0; 95% CI, 3.2-81.4). The presence of an adult at the stop did not have an independent effect on behavior. Children at education-only stops located on roadways with high traffic volume were more likely to engage in unsafe behavior while waiting (OR, 8.0; 95% CI, 3.8-17.3) and during boarding (OR, 4.9; 95% CI, 2.2-11.0). No differences were observed during boarding between stencil and education-only groups when 10 or more children were at the stops. CONCLUSION: The pavement stencil, when accompanied by education about safe boarding, may represent a cost-effective approach to reducing unsafe behavior at bus stops by children of elementary school age.

Injury prevention training in pediatric residency programs.

OBJECTIVES: To quantify the content and setting of injury prevention training provided to pediatric residents and to identify aspects of residency programs associated with this training. DESIGN: Mail survey. SETTING: US pediatric residency programs. PARTICIPANTS: Residency program directors. MAIN OUTCOME MEASURES: Number of programs stating that they train residents in various injury prevention topics, and the setting of this training. RESULTS: More than 80% of programs addressed 92% of topics surveyed dealing with disease prevention, but only 59% of topics dealing with injury prevention. Injury prevention topics covered less frequently included smoke detector use and swimming pool, sports, and firearm safety. Programs used continuity clinics most often to teach injury prevention. No specific program characteristic was associated with the content or setting of injury prevention training. Residency programs located in states in which house fires, drowning, or firearm injuries are the leading causes of death were not more likely to offer prevention training on these topics. CONCLUSIONS: Injury prevention is less frequently taught than disease prevention in pediatric residency training. Injury prevention is most often taught in continuity clinics, the setting most consistent with ongoing primary patient care. A gap exists between the leading causes of injury death and injury prevention topics taught to pediatric residents. Residency programs must better recognize and adapt to the epidemiology of trauma in their communities, better enabling new pediatricians to meet their patient's needs.

Accuracy of fatal motorcycle-injury reporting on death certificates.

This study identifies differences in motorcycle injury fatality statistics gathered from different sources. Police Accidents Reports (PARs), identifying fatal motorcycle injuries occurring in Connecticut during 1987 were matched with state death certificates. Matched death certificates were analyzed in three major areas: content, coding, and motorcycle fatality reporting. Death certificates underreported motorcycle fatalities by 38% compared to PARs. Forty percent of death certificates were missing some or all of the required information: 7 did not include the word motorcycle, 18 did not contain acceptable ICD-9 terminology for a motorcyclist, and 17 did not describe how the injury occurred. Forty-one percent of death certificates contained external cause of injury code (E-code) errors. Incomplete information on death certificates was responsible for 52% of inaccurate reporting and E-code errors for 48%. The accuracy of fatal motorcycle injury cause of death reporting on death certificates could be improved by better physician training and rapid implementation of both the computerized death certificate coding systems and upcoming ICD-10 classification system.

Childhood injuries in Hartford, Connecticut.

Vital statistics and hospital discharge data were analyzed to provide a detailed epidemiologic profile of injury among Hartford residents 0 to 19 years of age. During 1980-86, 76 death certificates identified injury as the cause of death, resulting in an annual age-specific death rate of 2.3 per 10,000 persons. Injuries caused more deaths among one to 19 year olds (58%) than all other diseases combined. During 1982-86 injury was listed as the principal diagnosis leading to hospitalization for 2,220 Hartford residents 0 to 19 years. The hospitalization rate was 95 per 10,000 persons. Injuries accounted for 16% of all hospital discharges. For ages 0 to 19, homicide was the leading injury-related cause of death accounting for 43% of fatalities. Falls were the leading cause of injury-related hospitalizations accounting for 22% if all discharges. Clay-Arsenal (23%) and the Northeast (17%) neighborhoods accounted for the largest proportion of injury deaths. Actual inpatient hospital charges for 1986 were reviewed. The total cost for 420 injury discharges utilizing 2,208 hospital days exceeded $1.4 million dollars. Fifty-one percent of the injury discharges listed Medicaid as the primary expected payment source for acute care injury-related discharges. The statistical patterns identified in this report will help public health professionals establish goals for injury control efforts such as a reduction in morbidity, mortality, severity, and/or medical costs.

Bicycle injury in Connecticut.

We reviewed vital statistics (1987-92) and hospital discharge data (1987-91) for Connecticut residents to describe the epidemiology of bicycle-related injuries in the state. Each year there are approximately eight deaths (rate = 0.25/100,000) and 289 hospitalizations (rate = 8.8/100,000) due to bicycle related injury. Nonfatal bicycle injuries resulted in 1,500 hospital days at a cost of $1.7 million dollars. Death and hospitalization rates are highest among male children and adolescents five to 19 years of age. Most of the mortality and serious morbidity from bicycle-related trauma is due to head injuries. Both fatal and nonfatal bicycle head injury rates are highest in towns with a population less than 50,000 residents. Bicycle-related head injury is an important cause of mortality and morbidity of Connecticut children and youth and is largely preventable through the use of bicycle helmets. The data presented here allow for the development, implementation, and evaluation of community-based bicycle safety and helmet programs.

Childhood injury in Connecticut.

We reviewed vital statistics (1988-95) and hospital discharge data (1990-94) for Connecticut children and youth to describe the epidemiology of childhood injuries. There are approximately 175 deaths (rate = 21/100,000) and 4,230 hospitalizations (rate = 468/100,000) annually due to injury. Nonfatal injuries resulted in over 94,000 hospital days at a cost of nearly $155 million dollars. Death and hospitalization rates are highest among male children and adolescents 15 to 19 years of age. Geographic analysis of injury revealed significantly higher injury death and hospitalization rates in towns greater than 100,000 population. In addition, a majority of the homicides occurred in large urban areas, and most of the motor vehicle occupant deaths and suicides occurred in suburban and rural areas. Injury is an important cause of mortality and morbidity in youth and is largely preventable. The data presented here allow for the development, implementation, and evaluation of community based injury prevention programs.

Firearm-related fatality surveillance in Hartford County, Connecticut.

OBJECTIVES: To evaluate the feasibility of implementing a firearm fatality surveillance system in Hartford County, Connecticut. METHODS: Medical examiner, police, and crime lab data were collected for firearm deaths occurring in Hartford County during 1997. Data included characteristics of victims, suspects, and firearms. We used standard criteria for evaluating an epidemiological surveillance system. RESULTS: The surveillance system detected 52 firearm-related fatalities; 31 were suicides and 21 were homicides. Handguns accounted for 50% of the suicides and 72% of the homicides. Sensitivity was 96%, specificity was 100%, representativeness adequate, simplicity enhanced by a common case identifier, flexibility constrained by the use of existing data, timeliness varied by data source, and system acceptable to all data sources. Estimated statewide cost is $200 per case, or $52,000 per year. CONCLUSION: Firearm injury surveillance in Hartford County is feasible and expansion to statewide coverage possible. The surveillance yielded considerable data at reasonable costs.

Burn injuries among children in an urban emergency department.

To determine the profile of burn injury among an ambulatory population, we conducted a retrospective chart review over a one-year period of all first visits by patients under age 18 receiving burn care in our emergency department. Of the 109 visits, contact burns were most numerous (43.1%) followed by scalds (33.9%), flame/explosion (11.0%), cigarettes (5.5%) and electrical (2.8%). For children under 11 years of age, contact burns caused over half of all burns. Irons accounted for 44.7% of contact burns and 19.1% of all burns. The next most frequent causative agents were beverages (14.7%), food (nonbeverage) (7.3%), tap water/bath (7.3%), and cooking-related (6.4%). Contact burns were more likely to be smaller and more localized when compared with other burns. The cause and causative agents of burns differ in frequency and relative importance depending on the patient population studied and the level of medical care being provided. Specific burn prevention strategies should be directed toward particular patterns of injury within defined patient groups.

The Safe Teen Work Project: a study to reduce cutting injuries among young and inexperienced workers.

A tool used to cut cardboard containers, known as a case cutter, frequently causes lacerations among adolescent grocery store workers. We evaluated a safety program using a less hazardous case cutter combined with worker education. Nine supermarket stores were divided into three groups. In Group A stores, employees received new safety case cutters with education; in Group B stores, employees received education using old cutters; Group C stores were the control. Case cutting lacerations were tracked 3 years before, and 1 year after, the intervention. There were 199 cutting injuries. Cutting injury rates decreased 3.5/100,000 man-hours in Group A stores, compared to 1.5 in Group B stores and 1.6/100,000 man-hours in control stores, with a marked reduction of compensation-related injuries in A stores. Estimated cost savings for A stores were $245/year/store and $29,413/year for the chain. An intervention to decrease case cutting injuries among adolescent grocery store workers can be protective and cost-effective.

Misclassification of childhood homicide on death certificates.

Suspect classification of homicide deaths of Connecticut residents under 20 years of age was noted for 29 percent of cases examined. Misclassification was attributed to incomplete or erroneous information recorded on the death certificates, rather than errors in the designation of ICD-9 homicide codes. The results have important implications in the interpretation of vital statistics when homicide is listed as the cause of death and underscore the value of record linkage systems.

Injury reporting in Connecticut newspapers.

OBJECTIVES: To describe how newspapers report injury events and how often they contain information about injury prevention measures. METHODS: A commercial service provided all newspaper clippings reporting unintentional injury events between July and September 1995 from 17 daily and 55 weekly newspapers published in Connecticut, USA. Each clipping was reviewed to determine the presence or absence of 35 content variables. RESULTS: There were 962 articles and excluding 35 editorials, 927 reported injury events and 17% pertained to persons under 21 years. Of the 60% that described motor vehicle collisions only 3% mentioned driver alcohol use, 9% seat belt use, and fewer than 1% airbag use. In the 17 motorcycle and 44 bicycle stories, 29% and 20% respectively, mentioned helmet use. In the 16 articles about house fires only 13% mentioned smoke detector use. There were no significant differences in injury reporting by circulation size. CONCLUSIONS: Newspapers are an important source of public information but are woefully deficient in providing information on injury prevention.

Evaluating the impact of a street barrier on urban crime.

OBJECTIVES: Violence is a major urban public health problem in the United States. The impact of a physical barrier placed across a street in a public housing project to prevent street violence and drug activity was evaluated. METHODS: Hartford Police Department data on violent and drug related crime incidence within the housing project containing the barrier were analyzed by use of a computerized geographic information system. RESULTS: Violent crime decreased 33% on the intervention street during the 15 month period after erection of the barrier, compared with the 15 month period before erection of the barrier, but there was no change in drug related crime. On adjoining streets and surrounding blocks, violent crime decreased 30%-50% but drug related crimes roughly doubled. A non-adjacent area of the housing project and the entire city experienced 26% and 15% decreases in violent crimes, and 414% and 25% increases in drug crimes, respectively. CONCLUSIONS: The barrier decreased violent crime but displaced drug crimes to surrounding areas of the housing project. These results have important implications for other cities that have erected or are considering erecting similar barriers.

Child pedestrian injury: a population-based collision and injury severity profile.

Linked multiple data sources were analyzed to provide a population-based collision and injury severity profile among pedestrians under 20 years of age struck by a motor vehicle during 1986-1987 in Hartford, Connecticut. Data sources included police accident reports, medical examiner records, and hospital charts. There were 234 motor vehicle-pedestrian collisions reported to the police in the study period. Of these, 213 were Hartford residents resulting in an annual age-specific pedestrian collision rate of 22.8 per 10,000 persons. A spot map of collision location reveals several well-defined geographic areas, which includes nearly half (45%) of the motor vehicle-pedestrian collisions. We reviewed 143 of 192 medical charts (75%) and 6 medical examiner records. The case fatality rate was 4.2% and the mean Injury Severity Score was 4.4. These findings will be useful for designing, implementing, and evaluating a targeted child pedestrian safety program.

A population-based study of motorcycle injury and costs.

STUDY OBJECTIVE: To provide a population-based injury and cost profile for motorcycle injury in Connecticut. DESIGN: Population-based retrospective epidemiologic review of Connecticut death certificates, hospital discharge data, and police accident reports. RESULTS: Connecticut death certificates identified 112 deaths from motorcycle injuries for an annual death rate of 1.2 per 100,000 persons. Death rates were highest among 20- to 24-year-old men. Nonhelmeted motorcyclists were 3.4-fold more likely to die than were helmeted riders (P less than .05). An estimated 2,361 motorcycle-related hospital discharges resulted in an annual hospitalization rate of 24.7 per 100,000 persons. Head, neck, and spinal injuries accounted for 22% of all injuries. Total costs exceeded $29 million; 29% of hospitalized patients were uninsured, and 42% of the cost was not reimbursed to the hospitals. CONCLUSION: Motorcycle injuries contribute significantly to Connecticut's mortality, morbidity, and medical costs. Our study suggests that a uniform helmet law would save an estimated ten lives and prevent more than 90 nonfatal injuries in Connecticut each year at a cost savings to the state of $5.1 million. These data are crucial in advocating re-enactment of motorcycle helmet laws.

Pediatric injury prevention.

Pediatric injuries are the leading cause of childhood death and disability and are responsible for more childhood deaths than all other diseases combined. The panel summarized the principles of pediatric injury prevention and reviewed the incidence, epidemiology, and prevention of six common pediatric injuries.