Cheryl Brunton

Height and surfacing as risk factors for injury in falls from playground equipment: a case-control study.

OBJECTIVES: Despite the widespread promotion of safety standards no epidemiological studies have adequately evaluated their effectiveness in preventing injury in falls from playground equipment. This study evaluated the effectiveness of the height and surfacing requirements of the New Zealand standard for playgrounds and playground equipment. SETTING: Early childhood education centres and schools in two major cities in the South Island of New Zealand. METHODS: Data were collected on 300 children aged 14 years or less who had fallen from playground equipment. Of these, 110 (cases) had sustained injury and received medical attention, while 190 (controls) had not sustained injury requiring medical attention. RESULTS: Logistic regression models fitted to the data indicated that the risk of injury being sustained in a fall was increased if the equipment failed to comply with the maximum fall height (odds ratio (OR) = 3.0; 95% confidence interval (CI) 0.7 to 13.1), surfacing (OR = 2.3; 95% CI 1.0 to 5.0), or safe fall height (OR = 2.1; 95% CI 1.1 to 4.0) requirements. Falls from heights in excess of 1.5 metres increased the risk of injury 4.1 times that of falls from 1.5 metres or less and it was estimated that a 45% reduction in children attending emergency departments could be achieved if the maximum fall height was lowered to 1.5 metres. CONCLUSIONS: Although the height and surfacing requirements of the New Zealand standard are effective in preventing injury in falls from playground equipment, consideration should be given to lowering the maximum permissible fall height to 1.5 metres.

Young people's use of condoms and their perceived vulnerability to sexually transmitted infections

Objective: Although sexually transmitted infections (STIs) are most prevalent among young people, they do not use condoms consistently to prevent infection. This study examined young peoples perceptions of vulnerability to STIs and pregnancy.

The Impact of Decriminalisation on the Number of Sex Workers in New Zealand

In 2003, New Zealand decriminalised sex work through the enactment of the Prostitution Reform Act. Many opponents to this legislation predicted that there would be increasing numbers of people entering sex work, especially in the street-based sector. The debates within the New Zealand media following the legislation were predominantly moralistic and there were calls for the recriminalisation of the street-based sector. This study estimated the number of sex workers post-decriminalisation in five locations in New Zealand: the three main cities in which sex work takes place as well as two smaller cities. These estimations were compared to existing estimations prior to and at the time of decriminalisation. The research suggests that the Prostitution Reform Act has had little impact on the number of people working in the sex industry.

Screening for Influenza Infection in International Airline Travelers

We sought the collaboration of an international airline and border control agencies to study the feasibility of entry screening to identify airline travelers at increased risk of influenza infection. Although extensive and lengthy negotiations were required, we successfully developed a multisector collaboration and demonstrated the logistical feasibility of our screening protocol. We also determined the staffing levels required for a larger study to estimate the prevalence of influenza in international airline travelers.

Chronic liver disease mortality attributable to hepatitis B and C in New Zealand.

Abstract Background: This research aimed to estimate the prevalence and population attributable risk percent (PAR%) of hepatitis B (HBV) and C (HCV) infection among chronic liver disease (CLD) deaths in New Zealand. The PAR% is the percentage of CLD cases attributable to either HBV or HCV. Within New Zealand, there are large differences in HBV prevalence by ethnic group, so prevalence and PAR% estimates were made separately for the three major ethnic groups.

Hand sanitisers for reducing illness absences in primary school children in New Zealand: a cluster randomised controlled trial study protocol

BackgroundNew Zealand has relatively high rates of morbidity and mortality from infectious disease compared with other OECD countries, with infectious disease being more prevalent in children compared with others in the population. Consequences of infectious disease in children may have significant economic and social impact beyond the direct effects of the disease on the health of the child; including absence from school, transmission of infectious disease to other pupils, staff, and family members, and time off work for parents/guardians. Reduction of the transmission of infectious disease between children at schools could be an effective way of reducing the community incidence of infectious disease. Alcohol based no-rinse hand sanitisers provide an alternative hand cleaning technology, for which there is some evidence that they may be effective in achieving this. However, very few studies have investigated the effectiveness of hand sanitisers, and importantly, the potential wider economic implications of this intervention have not been established.AimsThe primary objective of this trial is to establish if the provision of hand sanitisers in primary schools in the South Island of New Zealand, in addition to an education session on hand hygiene, reduces the incidence rate of absence episodes due to illness in children. In addition, the trial will establish the cost-effectiveness and conduct a cost-benefit analysis of the intervention in this setting.Methods/DesignA cluster randomised controlled trial will be undertaken to establish the effectiveness and cost-effectiveness of hand sanitisers. Sixty-eight primary schools will be recruited from three regions in the South Island of New Zealand. The schools will be randomised, within region, to receive hand sanitisers and an education session on hand hygiene, or an education session on hand hygiene alone. Fifty pupils from each school in years 1 to 6 (generally aged from 5 to 11 years) will be randomly selected for detailed follow-up about their illness absences, providing a total of 3400 pupils. In addition, absence information will be collected on all children from the school rolls. Investigators not involved in the running of the trial, outcome assessors, and the statistician will be blinded to the group allocation until the analysis is completed.Trial registrationACTRN12609000478213

A waterborne outbreak of campylobacteriosis in the South Island of New Zealand due to a failure to implement a multi-barrier approach

Outbreaks of waterborne gastroenteritis continue to occur in developed countries. Darfield, a rural town in the South Island of New Zealand experienced an outbreak of campylobacteriosis following a transgression of Escherichia coli on 16 August 2012. A descriptive outbreak investigation was performed. As a result, 29 cases had a laboratory-confirmed diagnosis of campylobacteriosis and 138 were identified as probable cases. Heavy rains, contamination of water with animal effluent from nearby paddocks and failures in the treatment of drinking water led to pathogens being distributed through the towns water supply. A multi-barrier approach is advocated to ensure the quality of water and many countries have legislation or programmes to address this. Although legislation for water safety plans based on a multi-barrier approach is in place in New Zealand, at the time of the outbreak it was not a requirement for the Darfield water supply. In addition, despite the awareness of the importance of a multi-barrier approach, competing interests, including those from the agricultural industry and financial restraints on water suppliers, can prevent it from being implemented. Governments need to be more willing to enforce legislation and standards to protect the public from waterborne disease.

The public health response to microbiological hazards after the canterbury earthquakes

The city of Christchurch and the wider Canterbury region recently experienced two major destructive earthquakes, the first in September 2010 and the second in February 2011, both followed by thousands of aftershocks. Christchurch has an untreated artesian water supply and the earthquakes resulted in major disruption to its wells, reservoirs and water distribution networks. The major wastewater treatment plant was also badly damaged, as were sewerage networks with extensive raw sewage discharges into rivers and the ocean. Ground liquefaction was extensive and created additional hazards with contaminated silt being almost ubiquitous. Despite these hazards and the extent and duration of the disruption to vital public health infrastructure, no outbreaks of gastro-intestinal or respiratory infection occurred in the aftermath of the earthquakes. This presentation will discuss the microbiological hazards encountered in the immediate post-disaster period and the initial public health response measures taken to reduce disease risk including water testing and chlorination. It will also describe the enhanced surveillance measures instituted to monitor gastrointestinal and respiratory disease and some of the recent research findings about liquefaction. Finally, the presentation will review progress on post-disaster recovery with respect to water and waste services.