Source Of Public Health Concern Research Articles

The impact of declining smoking on radon-related lung cancer in the United States.

We examined the effect of current patterns of smoking rates on future radon-related lung cancer. We combined the model developed by the National Academy of Science's Committee on Health Risks of Exposure to Radon (the BEIR VI committee) for radon risk assessment with a forecasting model of US adult smoking prevalence to estimate proportional decline in radon-related deaths during the present century with and without mitigation of high-radon houses. By 2025, the reduction in radon mortality from smoking reduction (15 percentage points) will surpass the maximum expected reduction from remediation (12 percentage points). Although still a genuine source of public health concern, radon-induced lung cancer is likely to decline substantially, driven by reductions in smoking rates. Smoking decline will reduce radon deaths more that remediation of high-radon houses, a fact that policymakers should consider as they contemplate the future of cancer control.

Transitions to regular smoking and to nicotine dependence in women using cannabis

Background While there is substantial support in the literature for an increased prevalence of cannabis use in cigarette smokers, emerging studies allude to the possibility that cannabis users may, in turn, be at significantly elevated risk for rapid transitions in their cigarette smoking trajectories. If there is evidence in its favor, the increased rates of cigarette smoking in cannabis users may prove to be the most significant public health problem associated with cannabis use. Methods In a sample of 3787 female twins (age range 18–29 years), we examined, using discrete-time survival analyses, whether women who reported cannabis use were at increased risk for regular cigarette smoking and progression to nicotine dependence. Results After controlling for a large number of potential covariates, we found that women who used cannabis were at 4.4 and 2.8 increased hazards for transitioning from initiation to regular smoking and from regular smoking to nicotine dependence, respectively. Conclusions Cannabis use is associated with transitions to more involved stages of cigarette smoking in women. This is a source of public health concern, first due to the high mortality associated with cigarette smoking and second, due to the high prevalence of cannabis use in the general population.

Content and ratings of teen-rated video games.

Children's exposure to violence, blood, sexual themes, profanity, substances, and gambling in the media remains a source of public health concern. However, content in video games played by older children and adolescents has not been quantified or compared with the rating information provided to consumers by the Entertainment Software Rating Board (ESRB). To quantify and characterize the content in video games rated T (for "Teen") and to measure the agreement between the content observed in game play and the ESRB-assigned content descriptors displayed on the game box. We created a database of all 396 T-rated video game titles released on the major video game consoles in the United States by April 1, 2001, to identify the distribution of games by genre and to characterize the distribution of ESRB-assigned content descriptors. We randomly sampled 80 video game titles (which included 81 games because 1 title included 2 separate games), played each game for at least 1 hour, quantitatively assessed the content, and compared the content we observed with the content descriptors assigned by the ESRB. Depictions of violence, blood, sexual themes, gambling, and alcohol, tobacco, or other drugs; whether injuring or killing characters is rewarded or is required to advance in the game; characterization of gender associated with sexual themes; and use of profanity in dialogue, lyrics, or gestures. Analysis of all content descriptors assigned to the 396 T-rated video game titles showed 373 (94%) received content descriptors for violence, 102 (26%) for blood, 60 (15%) for sexual themes, 57 (14%) for profanity, 26 (7%) for comic mischief, 6 (2%) for substances, and none for gambling. In the random sample of 81 games we played, we found that 79 (98%) involved intentional violence for an average of 36% of game play, 73 (90%) rewarded or required the player to injure characters, 56 (69%) rewarded or required the player to kill, 34 (42%) depicted blood, 22 (27%) depicted sexual themes, 22 (27%) contained profanity, 12 (15%) depicted substances, and 1 (1%) involved gambling. Our observations of 81 games match the ESRB content descriptors for violence in 77 games (95%), for blood in 22 (27%), for sexual themes in 16 (20%), for profanity in 14 (17%), and for substances in 1 (1%). Games were significantly more likely to depict females partially nude or engaged in sexual behaviors than males. Overall, we identified 51 observations of content that could warrant a content descriptor in 39 games (48%) in which the ESRB had not assigned a content descriptor. We found that the ESRB assigned 7 content descriptors for 7 games (9%) in which we did not observe the content indicated within 1 hour of game play. Content analysis suggests a significant amount of content in T-rated video games that might surprise adolescent players and their parents given the presence of this content in games without ESRB content descriptors. Physicians and parents should be aware that popular T-rated video games may be a source of exposure to a wide range of unexpected content.

Enteric virions and microbial biofilms - a secondary source of public health concern?

Through their many sorption sites, microbial biofilms can accumulate both organic and inorganic particulate and colloidal material from bulk water environments. An application of such first principles to the ecology of "biocolloidal" enteric virions would suggest that they too may be concentrated by biofilms in a similar way. Though previous studies have isolated human gastrointestinal (enteric) virions from microbial biofilms, the exact human health significance of this has been neither fully investigated nor completely understood. Through an assessment of the location, accumulation and persistence of model enteric virion (phiX174, MS2 and B40-8 bacteriophages as well as 20 nm fluorescent latex microspheres) within biofilms, the aim of the current study was to investigate whether the interaction of enteric virions with distribution pipe biofilms could provide a secondary source of public health concern to consumers. Model enteric virions were found to be incorporated into biofilms at concentrations representing 1% of those present in the adjacent bulk water environment. A sub-population (0.01%) of these persisted throughout an experimental period of 30 days, inferring their potential to accumulate over time. Furthermore, model enteric virions were partitioned into bacterial microcolonies, environments where biofilm bacteria can persist and re-grow, even in the presence of "acceptable" levels of disinfection. A risk model for enteric virion accumulation and release from distribution pipe biofilms suggested that associated risks may exceed USEPA benchmark values. These findings could have wide-reaching implications in water treatment and distribution strategies, and necessitate a re-appraisal of current water guideline values.

Violence in E-rated video games.

Children's exposure to violence, alcohol, tobacco and other substances, and sexual messages in the media are a source of public health concern; however, content in video games commonly played by children has not been quantified. To quantify and characterize the depiction of violence, alcohol, tobacco and other substances, and sex in video games rated E (for "Everyone"), analogous to the G rating of films, which suggests suitability for all audiences. We created a database of all existing E-rated video games available for rent or sale in the United States by April 1, 2001, to identify the distribution of games by genre and to characterize the distribution of content descriptors associated with these games. We played and assessed the content of a convenience sample of 55 E-rated video games released for major home video game consoles between 1985 and 2000. Game genre; duration of violence; number of fatalities; types of weapons used; whether injuring characters or destroying objects is rewarded or is required to advance in the game; depiction of alcohol, tobacco and other substances; and sexual content. Based on analysis of the 672 current E-rated video games played on home consoles, 77% were in sports, racing, or action genres and 57% did not receive any content descriptors. We found that 35 of the 55 games we played (64%) involved intentional violence for an average of 30.7% of game play (range, 1.5%-91.2%), and we noted significant differences in the amount of violence among game genres. Injuring characters was rewarded or required for advancement in 33 games (60%). The presence of any content descriptor for violence (n = 23 games) was significantly correlated with the presence of intentional violence in the game (at a 5% significance level based on a 2-sided Wilcoxon rank-sum test, t(53) = 2.59). Notably, 14 of 32 games (44%) that did not receive a content descriptor for violence contained acts of violence. Action and shooting games led to the largest numbers of deaths from violent acts, and we found a significant correlation between the proportion of violent game play and the number of deaths per minute of play. We noted potentially objectionable sexual content in 2 games and the presence of alcohol in 1 game. Content analysis suggests a significant amount of violence in some E-rated video games. The content descriptors provide some information to parents and should be used along with the rating, but the game's genre also appears to play a role in the amount of violent play. Physicians and parents should understand that popular E-rated video games may be a source of exposure to violence and other unexpected content for children and that games may reward the players for violent actions.

Violence in G-rated animated films.

Children's exposure to violence in the media is a possible source of public health concern; however, violence in children's animated films has not been quantified. To quantify and characterize violence in G-rated animated feature films. Violence content was reviewed for all 74 G-rated animated feature films released in theaters between 1937 and 1999, recorded in English, and available for review on videocassette in the United States before September 1999. Duration of violent scenes, type of characters participating in violent acts (good, neutral, or bad), number of injuries/fatalities, and types of weapons used for each film. All 74 films reviewed contained at least 1 act of violence (mean duration, 9.5 minutes per film; range, 6 seconds-24 minutes). Analysis of time trends showed a statistically significant increase in the duration of violence in the films with time (P=.001). The study found a total of 125 injuries (including 62 fatal injuries) in 46 (62%) of the films. Characters portrayed as "bad" were much more likely to die of an injury than other characters (odds ratio, 23.2; 95% confidence interval, 8.5-63.4). A majority of the violence (55%) was associated with good or neutral characters dueling with bad characters (ie, using violence as a means of reaching resolution of conflict), and characters used a wide range of weapons in violent acts. Our content analysis suggests that a significant amount of violence exists in animated G-rated feature films. Physicians and parents should not overlook videocassettes as a source of exposure to violence for children. JAMA. 2000;283:2716-2720.