Hospitals large

Population density and variation in population along the route Ability to shelter-in-place effectively (sealed buildings vs. open-air housing) Presence of sensitive receptors (e.g., schools, hospitals, large gathering places)... 

Hotels - Small industry - Hospitals - Large industry - Electrolysis... 

The great quantity of very fine fibers in a meltblown web creates several unique properties such as large surface areas and small (<1 fiva) pore sizes. These have been used in creating new stmctures for hospital gowns, sterile wrap, incontinence devices, oil spill absorbers, battery separators, and special requirement filters. It is expected that much innovation will continue in the design of composite stmctures containing meltblown webs. 

Medical Programs. Large chemical plants have at least one hill-time physician who is at the plant five days a week and on call at all other times. Smaller plants either have part-time physicians or take injured employees to a nearby hospital or clinic by arrangement with the company compensation-insurance carrier. When part-time physicians or outside medical services are used, there is Httle opportunity for medical personnel to become familiar with plant operations or to assist in improving the health aspects of plant work. Therefore, it is essential that chemical-ha2ards manuals and procedures, which highlight symptoms and methods of treatment, be developed. A hill-time industrial physician should devote a substantial amount of time to becoming familiar with the plant, its processes, and the materials employed. Such education enables the physician to be better prepared to treat injuries and illnesses and to advise on preventive measures. 

Alkylphenol ethoxylates are chemically stable and highly versatile surfactants that find appHcation in a large variety of industrial products including acid and alkaline metal cleaning formulations, hospital cleaners, herbicides (qv) and insecticides, oil-weU drilling fluids, synthetic latices, and many others (see Disinfectants AND antiseptics Elastop rs, synthetic Insect control technology Metal surface treati nts Pesticides Petroleum, drilling fluids). 

If the chemical has been confined to the mouth, give large quantities of water as a mouthwash ensure that the mouthwash is not swallowed If the chemical has been swallowed, small amounts of water may be administered, more if the chemical is corrosive administer a specific antidote if one exists Do not induce vomiting Arrange transport to hospital Information to accompany the casualty ... 

Phenol was the first commercial antiseptic its introduction into hospitals in the 1870s led to a dramatic decrease in deaths from postoperative infections. Its use for this purpose has long since been abandoned because phenol burns exposed tissue, but many modern antiseptics are phenol derivatives. Toluene has largely replaced benzene as a solvent because it is much less toxic. Oxidation of toluene in the body gives benzoic acid, which is readily eliminated and has none of the toxic properties of the oxidation products of benzene. Indeed, benzoic acid or its sodium salt (Na+, C6H5COO ions) is widely used as a preservative in foods and beverages, including fruit juices and soft drinks. 

Flori and le Vaillant (2004) studied the temporal relationship between the uptake of the more aggressive antiretroviral therapy and the use and cost of hospital treatment for HIV-infected patients in France from 1995 to 2000 from a hospital perspective. The authors found that during this period the proportion of patients on ARV treatment increased from 69.5% to 97%, with a large rise in the use of polytherapy. This increase was most notable for patients with CD4 cell counts above 500. ART expenditures per patient increased between the study years by 220%, reaching US 1,886 in 2000. Unlike that, inpatient hospitalization fell by 60% and average length of stay declined. Thus hospital costs (excluding ART) decreased to US 2,137 in 2000. 

It would be diflBcult to estimate the quantity of TGDD which enters the environment each year. In addition to the common pesticides listed in Table I, other chlorophenols nd their derivatives are used widely. For example, large amounts of the disinfectant, hexachlorophene (2,2 -methylenebis(3,4,6-trichlorophenol)), are used in homes, hospitals, and industry, and the Dowcides 2 and B (2,4,5-trichlorophenol and its sodium salt) are industrial microbiocides. More than 50,000,000 lbs of trichloro-phenol are made in the United States each year (24), and much of it eventually must be dispersed in the environment. The dioxin content seems to be variable but is generally below 0.5 ppm (25). 

Uncontrolled mirror-image studies (Table 2.4) largely support these findings. Of seven published studies, five suggested that the use of risperidone reduced hospital bed-stay and some calculated savings in health-care expenditure resulting from this. Conversely, Viale et al (1997) calculated that in-patient savings were offset by increases in community services costs, and Hammond et al (1999) estimated a substantial overall cost increase for community patients switched to risperidone for at least 3 months. 

There is little evidence relating to the pharmacoeconomic aspects of the use of quetiapine. In the UK, a retrospective audit of 20 patients (Lee et al, 1998), published only as a conference abstract, tentatively suggested decreased costs for those patients, largely through a reduction in hospital stay and resource use. Quetiapine may also improve quality of life (Hellewell et al, 1999). A large, randomized, controlled pharmacoeconomic evaluation is apparently under way (Drummond et al, 1998) and results are awaited. 

---