The Second Fatality

Things got back to normal for a while, and we made some safety progress until the second fatality, exactly one week later. 

I was on site immediately after a young man had his head crushed between a moving gantry crane and three of the concrete building support columns. The collisions had left pools of blood at the base of each of three pillars as the crane had traversed the length of the building. It was obviously an accident that could have been prevented, and to top it off, the man s father was one of the company division managers at a site a few miles away. 

During the investigation it was discovered that a similar accident had happened a year previously on the same crane and in the same manner as this one. That accident had resulted in the injured person fracturing his jaw when it was trapped between the crane handrail and one of the support columns. The accident investigation report was 

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The second fatal circumstance was that the operators were working, on that night in April 1986, in a condition of frantic hurry for various reasons. 

Acutely hazardous wastes are the second most common type of listed waste. U. S. EPA designates a waste as acutely hazardous if it contains the appendix constituents that scientific studies have shown to be fatal to humans or animals in low doses. In a few cases, acutely hazardous wastes contain no appendix constituents, but are extremely dangerous for another reason. An example is a listed waste that designates unused discarded formulations of nitroglycerine as acutely hazardous. Although nitroglycerine is not an appendix hazardous constituent, wastes containing unused... 

The second decision was the near-fatal one that sent Haefliger to Austria the year before the Anschluss. He was to go to Vienna, said the committee, to set up "a closer relationship" to the munitions industries there. 

Recognizing that the chemical industry is safe, why is there so much concern about chemical plant safety The concern has to do with the industry s potential for many deaths, as, for example, in the Bhopal, India, tragedy. Accident statistics do not include information on the total number of deaths from a single incident. Accident statistics can be somewhat misleading in this respect. For example, consider two separate chemical plants. Both plants have a probability of explosion and complete devastation once every 1000 years. The first plant employs a single operator. When the plant explodes, the operator is the sole fatality. The second plant employs 10 operators. When this plant explodes all 10 operators succumb. In both cases the FAR and OSHA incidence rate are the same the second accident kills more people, but there are a correspondingly larger number of exposed hours. In both cases the risk taken by an individual operator is the same.4... 

The second parasitic disease we want to consider is sleeping sickness, or African trypanosomiasis, as it is also known. Sleeping sickness results from an infection by protozoa called trypanosomes that are closely related to Leishmania, and, like leishmaniasis, sleeping sickness is spread by flies. On a more general level, however, the two diseases seem quite distinct. Leishmaniasis takes several forms, only one of which is fatal, but untreated sleeping sickness invariably leads to death. Leishmaniasis is a menace in much of the... 

The lethal oral dose in humans is probably around 100, but doses as low as 16 mg have reportedly been fatal whereas doses of 2 000 mg have been survived. After ingestion, effects usually occur within 10-30 minutes and include stiffness of the face and neck muscles and increased reflex excitability. Strychnine acts by altering nerve impulses in the spinal cord, resulting in a decreased threshold for stimulation, and, hence, a hyperexcitable state. Any sensory stimulus may produce a violent motor response that, in the early stages of intoxication, tends to be a coordinated extensor thrust and, in later stages, may be a tetanic convulsion with opisthotonos anoxia and cyanosis develop rapidly. Between convulsions, muscular relaxation is complete, breathing is resumed, and cyanosis lessens. Because sensation is unaffected, the convulsions are painful and lead to overwhelming fear. As many as 10 convulsions separated by intervals of 10-15 minutes may be experienced, but death often occurs after the second to fifth convulsion, and even the first convulsion may be fatal if sustained death is commonly due to asphyxia.If recovery occurs, it is remarkably prompt and complete despite the violence of the illness muscle soreness may persist for a number of days. ... 

Asthma is best thought of as a disease in two time domains. In the present domain, it is important for the distress it causes—cough, nocturnal awakenings, and shortness of breath that interferes with the ability to exercise or to pursue desired activities. For mild asthma, occasional inhalation of a bronchodilator may be all that is needed. For more severe asthma, treatment with a long-term controller, like an inhaled corticosteroid, is necessary to prevent symptoms and restore function. The second domain of asthma is the risk it presents of future events, such as exacerbations, or of progressive loss of pulmonary function. A patient s satisfaction with his or her ability to control symptoms and maintain function by frequent use of an inhaled 32 agonist does not mean that the risk of future events is also controlled. In fact, use of two or more canisters of an inhaled 3 agonist per month is a marker of increased risk of asthma fatality. 

Human African trypanosomiasis (African sleeping sickness) around 60 million people at risk In sub-Saharan Africa, resulting annually in around 500,000 cases and 50,000 deaths. Fatal if not treated. Most drugs are old and difficult to administer. Until recently the only treatment available for the second-stage of the disease was Melarsoprol, an arsenic-based drug that kills 5 per cent of patients. 

This is a widely used antiepileptic drug, which occasionally causes liver dysfunction. There are two types of dysfunction, the first type is a mild transient elevation of the transaminases (ALT, AST), which resolves the second type is of a more severe hepa to toxicity, manifested as fatty liver with jaundice and necrosis, which may lead to fatal liver failure. 

Kwashiorkor usually occurs in the second or third year in the life of a child. Edema is the principal symptom. The condition arises from a combination of circumstances, but the primary cause appears to be a weaning diet that is both inadequate and indigestible and, notably, is lacking of protein. The principal calories are supplied by carbohydrate. The condition is accelerated by repeated infections of a bacterial, parasitic, or vital nature. Without treatment, the disease is fatal in most cases. 

Fatalities. In the second option, the common measure of stochastic response from exposure to radionuclides and hazardous chemicals would be fatalities, without any modifications to account for such factors as differences in lethality fractions for responses in different organs or tissues or expected years of life lost per fatality. This option is particularly advantageous for radionuclides, because fatalities is the measure of response provided by the most scientifically defensible database on stochastic radiation effects in humans. Fatalities is the measure of response normally emphasized in radiation risk assessments. 

This is what happens in our blood—the bicarbonate concentration is ten times that of the carbonic acid and this keeps our blood at a pH of 7.4. Any large change in the pH of our blood may be fatal (acidosis or alkalosis). Other buffer systems work the same way. For example, the second buffer system in our blood is... 

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