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: Objective: To explore injury deaths in international and domestic interstate travellers, together with those newly arrived to Australia. Methods: A population‐based cohort study of all injury‐related deaths between 1January 2006 and 31 December 2017 registered with Births Death and Marriages in Australia was conducted using Australian Bureau of Statistics’ (ABS) Cause of Death information. Population data on travellers were obtained from Tourism Research Australia. Results: There were 4,503 injury‐related traveller deaths (domestic interstate:3,055; international:934; new arrivals:514). The average annual age‐standardised mortality rates in domestic interstate travellers was 0.75 per 100,000, compared with 2.22 per 100,000 in international travellers. Leading causes of injury‐related death were land transport incidents (n=1495, 33.2%), self‐harm (n=786, 17.5%) and falls (n=513, 11.4%), with differences in mechanism by state/territory, traveller type and age group. Intentional self‐harm was common amongst all visitor types, however, it was the primary cause of death in new arrivals Conclusion: Age‐standardised mortality rates were almost three‐fold higher in international than domestic travellers. New arrivals, international and domestic travellers have different injury profiles, and each require specific prevention strategies. Implications for public health: While COVID has restricted travel to and within Australia, this has provided an opportunity for exploration, reflection, and consideration of risk factors for travellers, and to develop targeted injury prevention strategies for visitor types, so travel experience can be optimised and the magnitude of harm can be reduced., Injuries are a leading cause of travel‐related mortality and morbidity globally.[sup.1,2] While Australia is not typically considered a dangerous country for visitors, injuries and deaths occur.[sup.2,3] In 2019, there were [...]

: Objective: This study aimed to describe the epidemiology and risk factors contributing to drowning among migrants in Australia. Methods: A total population retrospective epidemiological study of unintentional drowning deaths in Australia between 1 July 2009 and 30 June 2019 of people born outside Australia (migrants). Cases were extracted from the National Coronial Information System. Descriptive statistics, chi‐square and relative risk were calculated. Crude drowning rates were based on country of birth and population in Australia. Results: There were 572 migrant deaths over the study period, 28.9% of total drowning deaths, 82.9% were male. Twenty‐one per cent were aged 25–34 years and 40.8% had lived in Australia for 20+ years. Migrants at highest risk of drowning were from: South Korea (2.63/100,000 95%CI: 0.85–8.25), Taiwan (2.29/100,000 95%CI: 0.27–13.44), and Nepal (2.15/100,000 95%CI: 0.23–11.55). Migrants were more likely to drown when around rocks (p Conclusions: Migrants are not over‐represented in drowning statistics. However, unique trends were found for drowning among migrants based on country of birth and length of time in Australia. Implications for public health: Holistic drowning prevention strategies and policies are required to effectively lower drowning risk among migrant communities., Globally, 90% of drowning mortality occurs in low‐ and middle‐income countries, with more than half of the drowning burden experienced by China, India, Pakistan and Bangladesh.[sup.1,2] The latest Global Burden [...]

Improvements in life expectancy and changes in lifestyle have contributed to a 'disease transition' from communicable to noncommunicable diseases (NCDs). Damage to public health infrastructure (PHI), such as sanitation and water, places people with NCDs at risk of disease exacerbation or even death. We propose the interdisciplinary characteristics of environmental health (EH) and the indirect, but vital, role in maximizing treatment and care for people with NCDs demonstrates the profession is an essential resource for addressing this problem. To explore this proposal, five focus groups were conducted with 55 EH professionals in Queensland, Australia. Relationships were identified between NCD exacerbation and PHI, such as power, sanitation, services, supplies, and water. Preparedness and response activities should focus on this priority PHI, which will require EH professionals to be part of interdisciplinary solutions. Recognizing this role will help protect the health of people with NCDs during and after a disaster., Introduction The frequency, intensity, and severity of natural disasters across the globe have increased in recent decades (Aitsi-Selmi et al., 2015; Burkle, 2010; Hogan & Burstein, 2007; Intergovernmental Panel on [...]

Objective: To describe illnesses of returned travellers presenting at GeoSentinel sites in New Zealand. Methods: Record data for all patients presenting for travel-related illnesses seen at two GeoSentinel sites, operating as commercial travel clinics, in Auckland and Hamilton, NZ, were extracted for the period November 1997 to December 2001. Results: 205 patients were identified with 262 diagnoses. Just over half were females (54.21%) and nearly half were in the 25-35 years age group (47.3%). About two-fifths of patients reported a pre-travel health consultation (41.0%). The commonest diseases diagnosed were diarrhoeal illnesses (23%), dermatological diagnoses (16%, excluding animal bites), animal bites (10%), and non-specific viral illnesses (8%), many of which manifest as respiratory infections. Tropical diseases, such as schistosomiasis (4%) malaria (2%) and dengue fever (0.5%), were not common. Conclusions: Information on travel-related illnesses, when reported through a global reporting system, can be useful for the travel health adviser in identifying issues of current concern. Although the frequency of tropical disease is low, it remains important to prevent these potentially fatal diseases. Implications: GeoSentinel makes a global contribution to the surveillance of emerging and re-emerging infectious diseases through a network of individual sites in various countries including New Zealand. This information can be used to help provide preventive advice for travellers as well as help in assessing illness in post-travel patients and potentially assist in preventing the secondary spread of some diseases acquired abroad following return.

Issue Addressed: Cycling participation rates in Australia and Queensland remain low. Rural residents typically do not have distinct cycling infrastructure available for use. Investigating current cycling participation and barriers to cycling engagement will inform future work to promote cycling engagement.Methods: Data were collected through the inclusion of cycling-related questions in the 2012 Queensland Social Survey.Results: The majority of the sample had not cycled in the previous 12 months (66%; n = 831). Significantly more rural residents reported not cycling due to environmental concerns (P < 0.05) and preferring other modes of transport or exercise (P < 0.01). Rural cyclists (31.4%; n = 113) had higher levels of cycling engagement in the previous week (41.6% to 32.6% urban; χ2  = 7.83; n = 420; P < 0.05) but lower cycling durations than urban cyclists (41.6% rural residents cycling for 30+ minutes vs 57.4% urban residents; χ2  = 8.25; n = 418; P < 0.01). Rural cycling engagement was independently associated with being male (OR = 2.34; 95% CI = 1.40-3.91); sufficient physical activity engagement (OR = 1.86; 95% CI = 1.10-3.15); and having children at place of residence (1-2 children: OR = 3.21; 95% CI = 1.88-5.49; 3+ children: OR = 3.01; 95% CI = 1.17-7.75).Conclusions: One-third of all adults cycled in the previous 12 months irrespective of location; however reasons for not cycling varied by urban/rural location. Results indicate that environmental factors appear to be inhibiting cycling participation in rural areas. Advocating for government commitment for infrastructure development to support safe cycling across Queensland including outside of metropolitan areas is required. SO WHAT?: This research explores self-reported cycling engagement amongst a sample of urban and rural dwelling Queenslanders. Differences in cycling exposure and reasons for lack of engagement offer insights into what may encourage greater cycling participation. [ABSTRACT FROM AUTHOR]

Introduction Drowning is a leading cause of unintentional death. Rivers are a common location for drowning. Unlike other location-specific prevention efforts (home swimming pools and beaches), little is known about prevention targeting river drowning deaths. Methods A systematic literature review was undertaken using English language papers published between 1980 and 2014, exploring gaps in the literature, with a focus on epidemiology, risk factors and prevention strategies for river drowning. Results Twenty-nine papers were deemed relevant to the study design including 21 (72.4%) on epidemiology, 18 (62.1%) on risk factors and 10 (34.5%) that proposed strategies for prevention. Risk factors identified included age, falls into water, swimming, using watercraft, sex and alcohol. Discussion Gaps were identified in the published literature. These included a lack of an agreed definition for rivers, rates for fatal river drowning (however, crude rates were calculated for 12 papers, ranging from 0.20 to 1.89 per 100 000 people per annum), and consensus around risk factors, especially age. There was only one paper that explored a prevention programme; the remaining nine outlined proposed prevention activities. There is a need for studies into exposure patterns for rivers and an agreed definition (with consistent coding). Conclusions This systematic review has identified that river drowning deaths are an issue in many regions and countries around the world. Further work to address gaps in the published research to date would benefit prevention efforts. [ABSTRACT FROM AUTHOR]

Summary: The 19th Commonwealth Games, conducted once in every four years since 1930, will be held in New Delhi from the 3rd through until the 14th of October, 2010. There will be approximately 17 sports on display and there will also be 15 para-sporting events. This paper focuses on health and safety issues for travellers to India in general, although it provides specific references to advice for visiting Commonwealth Games athletes and team staff, who will be travelling to the games. Whilst it needs be remembered that travel health advice can change, travellers are advised to seek up-to-date travel health advice for India, from their professional providers, closer to their departure. [Copyright &y& Elsevier]

Summary: Background: Calls for disaster medical assistance teams (DMATs) are likely to continue in response to international disasters. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to pre- and post-deployment health care. Methods: Data was collected via an anonymous mailed survey distributed via State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the 2004 South East Asian Tsunami disaster. Results: The response rate for this survey was estimated to be around 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45–55 years age group (31/59). Seventy-six percent of the respondents were male (44/58). Only 42% (25/59) received a medical check prior to departure and only 15% (9/59) received a psychological assessment prior to deployment. Most respondents indicated that both medical and psychological screening of personnel would be desirable. Most DMAT personnel received some vaccinations (83%, 49/59) before departure and most felt that they were adequately immunised. While nearly all DMAT members participated in formal debriefing post-deployment (93%, 55/59), far less received psychological debriefing (44%, 26/59), or a medical examination upon return (10%, 6/59). Three respondents reported experiencing physical ill health resulting in time off work following their return. While only one reportedly experienced any adjustment problems post-deployment that needed time off work, 32% (19/59) found it somewhat difficult to return to work. There were multiple agencies involved in the post-deployment debriefing (formal and psychological) and medical examination process including Emergency Management Australia (EMA), Australian Government, State/Territory Health Departments, District Health services and others. Conclusions: This study of Australian DMAT members suggests that more emphasis should be placed on health of personnel prior to deployment with pre-deployment medical examinations and psychological assessment. Following the return home, and in addition to mission and psychological debriefing, there should be a post-deployment medical examination and ongoing support and follow-up of DMAT members. More research is needed to examine deployment health support issues. [Copyright &y& Elsevier]

Summary: Background: Disaster medical assistance teams (DMATs) have responded to numerous international disasters in recent years. As part of a national survey, the present study was designed to evaluate Australian DMAT experience in relation to health and safety aspects of actual deployment. Methods: Data were collected via an anonymous mailed survey distributed by State and Territory representatives on the Australian Health Protection Committee, who identified team members associated with Australian DMAT deployments from the time of the 2004 South East Asian tsunami disaster. Results: The response rate for this survey was 50% (59/118). Most of the personnel had deployed to the tsunami affected areas. The DMAT members were quite experienced with 53% of personnel in the 45–55 years age group (31/59) and a mean level of clinical experience of 21 years. 76% of the respondents were male (44/58). Once deployed, most felt that their basic health needs were adequately met. Almost all stated there were adequate shelter (95%, 56/59), adequate food (93%, 55/59) and adequate water (97%, 57/59). A clear majority, felt there were adequate toilet facilities (80%, 47/59), adequate shower facilities (64%, 37/59); adequate hand washing facilities (68%, 40/59) and adequate personal protective equipment (69%, 41/59). While most felt that there were adequate security briefings (73%, 43/59), fewer felt that security itself was adequate (64%, 38/59). 30% (18/59) felt that team members could not be easily identified. The optimum shift period was identified as 12h (66%, 39/59) or possibly 8h (22%, 13/59) with the optimum period of overseas deployment as 14–21 days (46%, 27/59). Missing essential items were just as likely to be related to personal comfort (28%) as clinical care (36%) or logistic support (36%). The most frequently nominated personal items recommended were: suitable clothes (49%, 29/59); toiletries (36%, 22/59); mobile phone (24%, 14/59); insect repellent (17%, 10/59) and a camera (14%, 8/59). The most common personal hardship reported during their deployment was being away from home/problems at home (24%, 14/59); however, most felt that their family was adequately informed of their whereabouts and health status (73%, 43/59). Conclusions: This study of Australian DMAT members suggests that, in the field, attention should be given to basics, such as adequate food, water, shelter and personal hygiene as well as appropriate clothing, sunscreen and vector protection. The inclusion of appropriate personal items can be assisted by provision of a minimum suggested personal equipment list, with local conditions and the nature of the deployment being taken into account. A personal survival kit should also be recommended. There should be medical and psychological support for team members themselves, including the provision of a dedicated team member medical cache. Concern for their own health and ability to communicate with family members at home are major issues for deployed team members and need to be addressed in mission planning. This should also recognise security issues, including briefings, evacuation plans and exit strategies. The team members concerns about adequate security and the risk profile of humanitarian intervention in natural disasters compared with complex humanitarian emergencies may help determine future deployment of civilian or defence based teams. [Copyright &y& Elsevier]

Summary: The 29th modern Olympic Summer Games, conducted once every 4 years since 1896, will be held in Beijing, China, from 8 to 24 August 2008. There will be approximately 28 major and 302 minor events in 37 venues in the prominent cities of Beijing, Hong Kong and Shanghai, and also in Qingdao (a coastal town in Shandong Province), Qinhuangdao (northeast of Beijing), Shanghai, Shenyang (an industrial city in Liaoning Province) and in Tianjin (on the coast near Beijing). Following the Olympic Games, the Paralympic Games will be conducted from 6 to 17 September 2008 in Beijing and 20 Paralympic Sports will be represented. This paper focuses on health and safety issues for travellers to China in general, although it makes specific references to advice for visiting Olympic and Paralympic athletes and team staff, who will be travelling to the games. It must be remembered that travel health advice can change, and that travellers should be advised to seek up-to-date travel health advice for China closer to their departure. [Copyright &y& Elsevier]

Presents a study that investigated the illnesses and injuries suffered by travelers that joined the Blake Expedition in 2001 to the Amazon regions of Brazil and Venezuela. Methods; Results; Discussion.

Aircrew fitness-to-fly is among the elements that make aviation the safest form of long-distance transport. The health of cabin crew is a crucial determinant in carrying out safety-related duties. 'Fitness-to-fly' is associated with defined workplace conditions, for which airlines have a legal duty to ensure fitness for employment. We explored the literature on fitness-to-fly to obtain a pragmatic assessment of the challenges for aeromedical examinations. Regulations promulgated by aviation regulatory authorities and airline-internal policies have similar status and meaning, yet there is no harmonised approach internationally, and an inability to conform periodic medical assessments to actual operational fitness. The COVID-19 pandemic has highlighted the need to better understand fitness-to-fly criteria. Fitness-to-fly measures are mainly based on self-reported data and there is a need for a 'safety' factor for self-reports. Aeromedical evaluations should evolve from meeting medical standards to include pandemics as an element of the overall risk of aircraft operations. Re-evaluating criteria for fitness-to-fly assessment will further the goal of linking research to the actual needs of public health decisionmakers. If airlines are to resume operations at pre-pandemic levels, they must demonstrate to the public and public health agencies that fitness-to-fly assessment is appropriate and effective. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented that describes the results of a survey into occupational health issues at a dental school in Queensland, Australia.

Presents several letters to the editor related to health and diseases. Trends in antimalarial drugs prescribed in New Zealand from 1993 to 1998; Interaction between mefloquine and coumarin anticoagulants; Case study of gnathostomiasis without eosinophilia in a 37-year-old Caucasian woman.

Abstract: The development of occupational health services in Australia was influenced by numerous historical events. Australia was first established as a British penal colony in 1788 and slowly developed with free settlement during the 1800s. Gold was discovered in 1851, which led to an explosion in the amateur and largely unregulated mining industry. By the early 1900s, industrial development had begun on a wide scale. Early occupational health services appeared, largely in response to the unacceptable working conditions which employees were facing at the time. Occupational health research also emerged, as physicians and scientists explored the origins of workplace hazards and disease. Social forces played a major role in the late 20th century, as quality of life, including work life, became an increasingly important issue in the wider Australian community. Although great strides have been made in occupational health services during the past 200 years, a continuous decline in funding for worker''s health research poses probably the most serious challenge in contemporary Australia and one that continues into the new millennium. [Copyright &y& Elsevier]

Comments on two articles which appeared in the 2000 issue of 'Journal of Travel Medicine.' Health and safety problems faced by backpackers in north Queensland; Efficacy of combined vaccine against typhoid fever and hepatitis A.