No abstract

Since September 11, 2001, and the consequent restructuring of the US preparedness and response activities, public health workers are increasingly called on to activate a temporary round-the-clock staffing schedule. These workers may have to make key decisions that could significantly impact the health and safety of the public. The unique physiological demands of rotational shift work and night shift work have the potential to negatively impact decisionmaking ability. A responsible, evidence-based approach to scheduling applies the principles of circadian physiology, as well as unique individual physiologies and preferences. Optimal scheduling would use a clockwise (morning-afternoon-night) rotational schedule: limiting night shifts to blocks of 3, limiting shift duration to 8 hours, and allowing 3 days of recuperation after night shifts.

Arsenic, cadmium, lead, and mercury present potential health risks to children who are exposed through inhalation or ingestion. Emerging Market countries experience rapid industrial development that may coincide with the increased release of these metals into the environment. A literature review was conducted for English language articles from the 21st century on pediatric exposures to arsenic, cadmium, lead, and mercury in the International Monetary Fund's (IMF) top 10 Emerging Market countries: Brazil, China, India, Indonesia, Mexico, Poland, Russia, South Korea, Taiwan, and Turkey. Seventy-six peer-reviewed, published studies on pediatric exposure to metals met the inclusion criteria. The reported concentrations of metals in blood and urine from these studies were generally higher than US reference values, and many studies identified adverse health effects associated with metals exposure. Evidence of exposure to metals in the pediatric population of these Emerging Market countries demonstrates a need for interventions to reduce exposure and efforts to establish country-specific reference values through surveillance or biomonitoring. The findings from review of these 10 countries also suggest the need for country-specific public health policies and clinician education in Emerging Markets.