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No comprehensive data on sources or risk factors of cadmium exposure in Ukrainian children are available. In this we measured the blood levels of cadmium among 80 Ukrainian children and evaluated sources of exposure. A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted. We evaluated predictors of elevated blood cadmium using a multivariable logistic regression model. The model included socioeconomic data, parent occupation, environmental tobacco smoke, hygiene, body-mass index, and diet. Dietary habits were evaluated using the 1992 Block-NCI-HHHQ Dietary Food Frequency survey. Elevated cadmium was defined as blood levels in the upper quartile (0.25 microg/L). The mean age for all 80 children was 36.6 months. Geometric mean cadmium level was 0.21 microg/L (range = 0.11-0.42 microg/L; SD = 0.05). Blood cadmium levels were higher among children taking zinc supplements (0.25 vs 0.21 microg/L; P = 0.032), children who ate sausage more than once per week (0.23 vs 0.20; P = 0.007) and children whose fathers worked in a by-product coking industry (0.25 vs 0.21; P = 0.056). In the multivariable model, predictors of elevated blood cadmium levels included zinc supplementation (adjusted OR = 14.16; P < 0.01), father working in a by-product coking industry (adjusted OR = 8.50; P = 0.03), and low body mass index (<14.5; adjusted OR = 5.67; P = 0.03). This is the first study to indicate a strong association between elevated blood cadmium levels and zinc supplementation in young children. Whole-blood cadmium levels observed in this group of Ukrainian children appear to be similar to those reported in other Eastern European countries.

Objectives: Lead is common in the general population. However, data are lacking for the Ukraine and many other countries from the former Soviet Union (FSU). In this study we evaluate the level of blood lead among 212 Ukrainian children and determine predictors of elevated lead levels. We also describe the health effects associated with elevated blood lead., Methods: A nested case-control study from a prospective cohort of Ukrainian 3-year-old children was conducted in March 1998. Blood assays were analyzed for lead by labs at the Centers for Disease Control and using portable examination kits. We evaluated predictors of elevated blood lead (blood levels in the upper quartile >4.65 microg/dL) using a multivariable logistic regression model. The model included socioeconomic status, parent occupation, environmental tobacco smoke, hygiene, diet, and health status., Results: The geometric mean lead level was 3.15 microg/dL (range, 0.7--22.7). In our adjusted model, we observed a strong association between lead levels in the upper quartile and children whose fathers worked manual labor jobs in industries associated with lead exposures [adjusted odds ratio (OR)=2.25; P=0.025] and mothers who smoke indoors (adjusted OR=2.87; P=0.047). Daily hygiene and dietary habits were not associated with elevated lead levels. No increased risks of overall morbidity or lead-associated illness were observed (anemia, dental caries, renal disease, cardiovascular diseases, and musculoskeletal complaints)., Conclusion: This is the first study to describe lead levels and associated variables among Ukrainian children in the peer-reviewed literature. Elevated lead levels in these children were associated with paternal occupation and mothers smoking indoors. At age 3 no adverse health effects were observed. More data are needed to determine the level of heavy metal contamination in children from the Ukraine and many other former Soviet nation-states.

Anticardiolipin antibody, an immunoglobulin that binds negatively charged phospholipids, is considered to be an in vitro inhibitor of clot-based coagulation procedures. We adapted an enzyme immunoassay using stationary cardiolipin antigen to compare anticardiolipin antibody activity in the plasma of 44 cocaine abusers with its activity in the serum of 72 blood donors and a sample of 203 random specimens from healthy volunteers. Activity of 20 of the 44 abusers and 43 of 203 random specimens exceeded the donor control reference range. Patients using intravenous cocaine were more likely to have elevated activity than those who inhaled (P less than 0.05). Of 7 patients who had seizures or thromboembolic disorders, 5 were anticardiolipin antibody positive. Enzyme immunoassay may have predictive value for ischemic disease in cocaine abusers.

The University of Illinois Hospital (UIH) serves an inner-city urban population in one of the highest crime rate districts in Chicago. On May 20, 1986, the city's Level I Trauma ordinance took effect with the University of Illinois Hospital declining to participate. To measure the impact of the ordinance on a nonparticipating hospital, we undertook a retrospective analysis of our trauma patient utilization statistics. Consecutive monthly patient census data of 71 months was compiled with emphasis on patient presenting complaints and related subspecialty evaluation. We observed significant decreases of patients presenting with head injuries, fractures, and animal bites as well as with major trauma, minor trauma, and general surgery hospital admission. The final disposition of the patients arriving by ambulance was consistent with the observed decrease in major traumatic conditions and in minor traumatic conditions. However, the mean number of patient presentations per day (ppd) admitted to regular medical or surgical beds decreased from 2.70 ppd to 2.30 ppd while the mean number of ppd sent home increased from 2.64 ppd to 3.49 ppd. These data suggest that loss of trauma center status designation has a profound effect on utilization of emergency departments not participating in the trauma system. Nonparticipation appears to be associated with a significant decrease in utilization rates for major and minor trauma patients and a significant increase in the number of patients discharged who had arrived by the Chicago Fire Department Paramedic System (CFD). This effect on the emergency department extends to utilization of inpatient services.