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AJPH NEWS Release

EMBARGOED UNTIL April 29, 2004, 4:00 PM (ET)
CONTACT: For copies of articles, contact Natalie Raynor, (202) 777-2511, natalie.raynor{at}apha.org

All articles are online at www.ajph.org after the embargo.
To view the preliminary table of contents, visit www.ajph.org/future/94.5.shtml

American Journal of Public Health: May 2004 Highlights

• Silicosis a significant risk for highway workers
• Majority of pregnant women receive no dental care
• Improved mental health services can keep kids out of the juvenile justice system
• San Francisco vs. Amsterdam: decriminalizing marijuana does not increase drug abuse
• Some Medicare HMOs have succeeded in breaking down health barriers for older men

The articles highlighted below appear in the May 2004 issue of the American Journal of Public Health, the Journal of the American Public Health Association.

____________________

Silicosis a significant risk for highway workers
The United States' massive effort to repair the nation's highway system is putting a large population of highway construction workers at risk of developing silicosis. Silicosis is a disabling, non-reversible and sometimes fatal lung disease caused by inhaling dust containing extremely fine particles of crystalline silica. According to a study looking at highway construction trends, silicosis surveillance case data and environmental exposure data, highway repair workers are at increased risk for silicosis the longer they work on roads. Using a jackhammer puts workers at the greatest risk, but other tasks that stir up dangerous amounts of silica dust include milling asphalt and sawing and cleaning up concrete. Road materials such as concrete, asphalt and masonry products contain silica sand and other types of crystalline silica.
   "To reduce worker exposure, future activities addressing the silica exposure hazard must focus on prevention," the study's authors wrote. Successful prevention can be as simple as using water to reduce dust levels on the job. The study's authors also said highway workers should be required to wear high efficiency-filtering masks as part of a "comprehensive respiratory protection program" until effective dust controls are put in place.
[From: "Highway Repair: A New Silicosis Threat." Contact: David J. Valiante, MS, CIH, New Jersey Department of Health and Senior Services, Occupational Health Surveillance Program, david.valiante{at}doh.state.nj.us.]

Majority of pregnant women receive no dental care
The majority of pregnant women do not see a dentist even if they have oral health problems, and being obese or a smoker increases the chances that a pregnant woman will not receive dental care.
   A study of almost 2,000 Washington women who had recently given birth found that 58 percent had received no dental care during their pregnancy. And 26 percent of those who suffered an oral health problem such as a toothache or bleeding gums did not see a dentist during their pregnancy. Pregnant women who were obese or smoked cigarettes were even less likely to receive dental care, and the poorest women surveyed also had increased risk of never seeing a dentist.
   Earlier studies have pointed to a greater need to provide oral health services to pregnant women, but this is the first study to look into some of the other factors that keep pregnant women away from dentists' offices.
   "...[T]here is a need for enhanced education and training of physicians, midwives, and other practitioners concerned oral health during pregnancy," the study's authors wrote. "Since women who do not receive dental care during their pregnancy are more likely to be obese or to smoke, lack of dental care may be a marker for poor health."
[From: "Dental Care Use and Self-Reported Dental Problems in Relation to Pregnancy." Contact: Mona T. Lydon-Rochelle, PhD, MPH, CNM, University of Washington, Seattle, minot{at}u.washington.edu.]

Improved mental health services can keep kids out of the juvenile justice system
Providing troubled youth with better access to mental health services can keep them out of the juvenile justice system, according to a study of two Ohio mental health and juvenile justice systems currently undergoing federal review, researchers found that by reaching out to troubled youth with such services as individual and group counseling and medication monitoring, those youth were much less likely to end up behind bars or otherwise involved in the juvenile justice system. While the study's authors press for more research in other communities, they say their results show that by integrating the public mental health system with the juvenile justice system, troubled youth have a better chance of staying out of a life of crime.
    "Our results were derived from only two communities and are subject to other limitations, but they suggest that community-based care coordinated across child-serving agencies can reduce or delay entry into the juvenile justice system as well as recidivism among those who have been involved in the system."
[From: "Can Better Mental Health Services Reduce the Risk of Juvenile Justice System Involvement?" Contact: E. Michael Foster, PhD, Department of Health Policy and Administration, Pennsylvania State University, emfoster{at}psu.edu.]

San Francisco vs. Amsterdam: decriminalizing marijuana does not increase drug abuse
The decriminalization of cannabis had not led to increased drug use, calling U.S. drug policy in question when it comes to marijuana, according to a study that compared experience cannabis users in San Francisco and Amsterdam.
   Researchers questioned hundreds of cannabis users about their age at onset of use, frequency and quantity of use duration and intensity of intoxication as well as their use of other illicit drugs. They found little statistical difference between users in Amsterdam, where cannabis use is allowed under certain conditions, and San Francisco, where cannabis use is outlawed. This is the first comparative study examining whether criminalization constrains drug use or decriminalization increases it.
   "Proponents of criminalization attribute to their preferred drug-control regime a special power to affect user behavior," the study's authors wrote. "Our findings cast doubt on such attributions."
   The researchers recommend more study into the issue using more cities and larger sample sizes to explore whether decriminalizing leads to different outcomes under different conditions.
   "Dutch decriminalization does not appear to be associated with greater use of other illicit drugs relative to drug use in San Francisco, nor does criminialization in San Francisco appear to be associated with less use of other illicit drugs relative to their use in Amsterdam," they said. "Indeed, to judge from the lifetime prevalence of other illicit drug use, the reverse may be the case."
[From: "The Limited Relevance of Drug Policy: Cannabis in Amsterdam and in San Francisco." Contact: Craig Reinarman, Department of Sociology, University of California, craigo{at}ucsc.edu.]

Some Medicare HMOs have succeeded in breaking down health barriers for older men
In the continuing battle to eliminate racial and ethnic disparities in health, some Medicare managed care plans are succeeding when it comes to older men.
    A study of how socioeconomic and demographic factors affected men's access to such preventive health services as prostate cancer screenings and flu vaccination found enrollees in some Medicare health maintenance organizations were able to reduce racial and socioeconomic barriers to those services. Data came from a review of administrative files and a survey of 1,915 male enrollees in Medicare HMOs. Men were more likely to receive preventive services if they were married, had higher household incomes and were enrolled in a Medicare HMO.
[From: "Use of Preventive Services by Men Enrolled in Medicare+ Choice Plans." Contact: Leo Morales, MD, PhD, Santa Monica, Calif., morales{at}rand.org.]

The American Journal of Public Health is the monthly journal of the American Public Health Association, the oldest and largest organization of public health professionals in the world. APHA is a leading publisher of public health-related books and periodicals promoting high scientific standards, action programs and policy for good health. More information is available at www.apha.org.

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