Neil D. McGlashan

Sudden infant deaths in Tasmania, 1980–1986: A seven year prospective study

This investigation was carried out by questionnaire to parents of SIDS cases and two controls for each case and aimed to follow up the fact that Tasmania has been shown to have an unusually high rate of this cause of death. Both chi 2 and relative risk calculations were employed. The high rate of SIDS of the 1970s has been confirmed in this series in the 1980s. Many of the epidemiological findings are closely in line with those found internationally. Of particular usefulness are new indications which lie within parental choice; cigarette smoking by parents leading to passive smoking by the baby carries a high relative risk (RR = 3.0, P less than 0.001) as does sleeping in the prone position (RR = 1.9, P less than 0.01) as against sleeping in a lateral position. Tenants of Housing Department homes are at raised risk of SIDS (RR = 2.6, P = 0.001). Density of persons within the home also raises the risks to babies (P less than 0.001) and a well ventilated bedroom lowers the risk (P less than 0.001).

South African asbestos: Production, exports, and destinations, 1959–1993

Production and export figures of South African asbestos were analyzed over 1959-1993. They show stable sales of chrysotile. Those of crocidolite and amosite reached their peaks in the mid-1970s, after which trade fell drastically, crocidolite to 5% of its earlier peak and amosite to nil. Factors responsible for these virtual collapses were health issues, stricter legislation in First World countries, and litigation. In 1992, 21 countries continued to import crocidolite, although in reduced quantities. In the early 1960s, Europe and North America were the major recipients of South African asbestos. By 1989-91, these regions were surpassed by the Far East, which took over 90% of chrysotile and 70% of amosite. For crocidolite at that time, the Middle East took nearly 40%, Europe 28%, and Africa 21%. This implies that the newly importing countries can confidently expect an increase in asbestos-related disease and death well into the twenty-first century, even if the trade ceased now.

Changes in the geographical and temporal patterns of cancer incidence among black gold miners working in South Africa, 1964–1996

We describe here the results of the final 8 years of geographical and temporal data of a 33-year study of the cancer experience of 12.8 million man-years of black miners working on the gold fields of South Africa over the period 1964–96. These workers were recruited from 15 territories, the major areas during the most recent period being Lesotho (26.8%), Transkei (21.5%) and Mozambique (15%). The earliest analyses, 1964–71 and 1972–79, showed hepatocellular and oesophageal cancers to be the most frequent cancers. The final analysis, for 1989–96, however, shows marked temporal changes in the relative position of four cancers or grouped malignancies: respiratory cancer up by 236%, hepatocellular carcinoma down to 32%, oesophageal holding steady, and lymphatic system cancers up by 420%, almost certainly because of association with HIV/AIDS infection. Significant geographical variations occurring between the home areas of the miners are important, as mining operations have little to do with the cancers that develop. The causes are essentially socio-environmental rather than occupational, and this means that the rates of the major cancers in the miners are surrogate measures of the same cancers in the home areas.

South Africa's export trade in asbestos: Demise of an industry

BACKGROUND South Africas export of each of its three types of asbestos, crocidolite, amosite, and chrysotile, and the total amounts to 84 countries in metric tonnes is examined over a 24-year period, 1980-2003. METHODS For convenience, the countries are divided into nine world regional groups, Europe, Eastern Europe, North America with the Caribbean, South America, Africa, Middle East, Far East, South Asia, and Oceania. RESULTS The three greatest importing countries of total asbestos in metric tonnes were all in the Far East region, ranging from Japan, South Korea to Thailand, and followed by USA and Italy. All exports to all countries diminished steadily as the South African trade came virtually to an end by 2003, due to ever increasing international pressure. CONCLUSION The export trade has changed significantly since 1960 from being dominantly to European countries to being directed in recent years to the Far East, with serious implications for asbestos-related ill-health in those countries.

Viral hepatitis in Tasmania

Abstract A planar graph of the island has been constructed in which nodes are weighted for total municipal population size and links represent road access between the nodes. The graph is repeated for 163 weekly periods and the notified viral hepatitis cases are shaded upon each. Even utilizing incomplete notifications, the system of spread breaks down into 3 discrete sub-systems, each centered upon a port of potential disease entry. Wide differences of municipal hepatitis incidence rates are shown, and disease diffusion through space exhibits a strong tendency to follow analogous patterns repetitively through time. In a second, more localized study, patient movement records were collected to identify some high risks within the social environment of the Hobart metropolitan area. Lack of public awareness of disease hazards was highlighted.

Book reviews : Pyle, G.F. 1985: The diffusion of influenza: patterns and paradigms. New Jersey: Rowman and Littlefield. 218 pp. US

advantages of stifling epidemic outbreaks and reducing losses by morbidity. Pyle’s mode of approach to this humanistic goal is twofold: he defines influenza experience and he employs that as background upon which to search for an effective model of viral spread. An effective model is thus seen as one which allows some form of protective or preventive scenario to be operationalized. This approach involves real difficulty in the first place concerned with source material. Specific ’hard’ public health data for large areas that is across national borders are almost impossible to find in comparable format for any considerable period of time even today. Rather the analyst has to fall back either on lay reporting and anecdotal evidence or on short spells of firmly based data collection from certain localities. The former is the mode Pyle (1969) used in his classic study of cholera spread patterns in the US in the nineteenth century and is, in fact, really all one could employ in reconstructions of unrecorded past events. As a method, it interestingly contrasts with Curson’s (1985) immensely painstaking and accurate analysis (over the

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Abstract Against a background of a potential oversupply of medical practitioners, this study develops a method of quantifying the hinterland and population served by each practice centre. Allowance is made for varying age and sex demands for medical service and demonstrates a seven-fold variation in workload per doctor in rural Tasmania. The need for means to correct the inertia inherent in this geographic maldistribution is emphasised.

A geographic approach to general practice workloads: The example of rural Tasmania

Abstract Spatial variations of separate causes of alcohol-related mortality for Tasmania are analysed at local government area (LGA) scale. Areas of especial significance are discovered. Alcohol purchases by LGA and selected census-based demographic indices are described and then correlated with deaths to test the null hypothesis that alcohol-related death is unrelated to local demographic structure. Oesophageal cancer is strongly related to country of birth and alcoholism and cirrhosis to population masculinity and marital status. Fatal road accidents ascribed to alcohol-abuse are related to masculinity at a young age at community scale. These associations offer implications for prevention programmes.

The social correlates of alcohol-related mortality in Tasmania, 1971–1978

There are many revolutionary elements in, the Giorgione and it would be a perversion of the point of a brilliant picture, full of innovation, to see it in terms of prospect and refuge; as well analyse it in terms of how much pigment of a particular colour was used. It diminishes the subject and the artist. One could most usefully take a series of such paintings in this period and note how over time the outside played a more significant part in the composition and the meaning of the paintings, but this would draw attention to changing approaches to landscape, not to the universalism of response to it. So one is unhappy with the way in which the author has dipped eclectically into the rich treasure house of pre-eighteenth century paintings to support his central proposition. Another point of criticism is that the theory is not applied to non-representational painting. If there truly is a biological response ought it not to guide us in our approach to abstract painting? The fact that we would find such an idea difficult to accept is itself significant. We would not expect it to apply. But in fact all painting is artifice, it involves selection and cultural and perceptual filters of all kinds; nothing is what it seems. Appleton almost implies that art which is not abstract is representational and that all representational art may be subject to the same analytical procedures. Nothing is said about Islamic art or about Oriental art, for example, yet it should be possible to apply a universal theory, based on biological imprints, across cultural frontiers. If the critical framework is heavily culture-dependent then we deny its universality. If it is universal neither in time nor space then one may ask what use it is.