Health risk score

Using the industrial air pollution reports (toxic chemical air releases) of industries, EPA calculates a health risk score for each square kilometer of the United States. The health risk or probability that exposure to that particular air mass will induce illness is defined as the hazard multiplied by the exposure. 13 ... 

In calculating the hazards, EPA relies upon animal experiments and human studies for information to establish the probability of illness as a function of different exposure levels. The exposures used in the equation are derived from smokestack monitors strategically placed or from mathematical models that take meteorological factors into consideration. The paths taken by the pollution and numbers of males and females of different ages who reside in each area are taken into consideration in calculating health risk scores. 

The health risk scores are not intended to measure the risks of being stricken by the exposures or the actual exposures to toxicants. Rather, they are meant to help screen for polluted areas that may need additional study. The health risk scores are also not definitive for the following three reasons ... 

The health risk scores do not take other conditions and activities into consideration. The use of toxic chemicals for other purposes in an area is ignored. Following are examples of these ... 

USEPA. Health risk scores. EPA publication no. 450/3-90-022, March 1991. 

Sklan, E.H., Lowenthal, A., Komer, M., Ritov, Y., Landers, D.M., Rankinen, T., Bouchard, C., Leon, A.S., Rice, T., Rao, D.C., Wilmore, J.H., Skinner, J.S., Soreq, H. (2004). Acetylcholin-esterase/paraoxonase genotype and expression predict anxiety scores in health, risk factors, exercise training, and genetics study. Proc. Natl Acad. Set USA 101 5512-17. 

CHRONIC HEALTH RISKS weight loss weakness anemia neurological symptoms blood pressure effects affects hearing threshold and growth in children interference with vitamin D metabolism severe depression of sperm counts decrease function of the prostate impaired mental development decease IQ scores in children spontaneous abortion low birth weight. 

Wiiraorc, J. H., Skintwr, J. S and Soreq. H. (2004). Acctylcholinestcrasc/paraoxonase genotype and expres.sion predict anxiety scores in Health, Risk Factors, Exercise Training, and Genetics study. Pnx Natl. Acad. Sci. U S A 101, 5512-5517,... 

PAA is an acrylate polymer formed from the monomer acrylamide, which is a neurotoxin that causes peripheral neuropathy. Non-polymerised remnants of acrylamide in PAA pose some potential risks. It is claimed that, people unintentionally absorb around 25 pg of acrylamide daily from the environment, which may account for a significant number of cancer cases. Although there is no solid proof so far for a connection between acrylamide intake and cancer, it remains under investigation, and acrylamide can still be considered as a probable human carcinogen. On a health hazard spectrum, acrylamide registers 2 (3 = a very high hazard to health 2 = a medium hazard, and 1 = harmful to health arsenic scores highly at 2.3, while one of the lowest scores is ammonia at 1.0) [37]. 

The World Health Organization (2004) has suggested, as an example, a simple risk scoring matrix, as shown in Figure 6.1 ... 

The primary outcome of NINDS part I was early clinical improvement by 24 hours, dehned as complete resolution of the stroke symptoms or an improvement in the National Instimte of Health Stroke Scale (NIHSS) score by 4 or more points. There was no difference in early clinical improvement in the rt-PA group compared to the placebo group (relative risk 1.2, 95% Cl 0.9-1.6, p = 0.21). 

The category risks to personnel and plant consists of two parts environmental abuse potential and occupational health/safety hazards and, here again, points are subtracted from a basic score for environmental/safety hazards. 

Patients at greatest risk for mortality from acute pancreatitis are those who have multi-organ failure (e.g., hypotension, respiratory failure, or renal failure), pancreatic necrosis, obesity, volume depletion, greater than 70 years of age, and an elevated APACHE II score.3,4 The Acute Physiology, Age, and Chronic Health Evaluation (APACHE) II score is a rating scale of disease severity in critically ill patients. 

Activated protein C in patients with severe sepsis and high risk of death (Acute Physiology, Age, and Chronic Health Evaluation II [APACHE II] score greater than 25). 

There are various severity of illness scoring systems for sepsis and trauma (R11). Severity scoring can be used, in conjunction with other risk factors, to anticipate and evaluate outcomes, such as hospital mortality rate. The most widely used system is the Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) classification system (K12). The APACHE III was developed to more accurately predict hospital mortality for critically ill hospitalized adults (K13). It provides objective probability estimates for critically ill hospitalized patients treated in intensive care units (ICUs). For critically ill posttrauma patients with sepsis or SIRS, another system for physiologic quantitative classification and severity stratification of the host defense response was described recently (R11). However, this Physiologic State Severity Classification (PSSC) has yet not been applied routinely in ICU setting. 

B. Indications and use Xigrix is indicated for the reduction of mortahty in adult patients with severe sepsis (sepsis associated with acute organ dysfunction) who have a high risk of death [as determined by the acute physiology and chronic health evaluation (APACHE) score, the most widely used method of assessing the severity of illness in acutely ill patients in intensive care units]. 

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