The main aim of this thesis is to investigate whether residence near hazardous waste landfill sites is associated with an increased risk of congenital anomaly. The thesis reports results of a multi-centre case-control study carried out in 10 regions in 6 European countries. Cases were live births, stillbirths, and induced abortions with major congenital anomalies resident at birth within a 7 km area around hazardous waste landfill sites. Controls, two per case, were non-malformed births resident in the same area. A total of 1089 cases of non-chromosomal anomaly, 270 cases of chromosomal anomaly, and 2508 controls were selected around 26 landfill sites. A 3 km zone around sites was defined as the zone of most likely exposure. An expert panel of four landfill specialists scored each landfill site according to their potential to cause exposure of nearby residents. A statistically significant 33% excess in risk of non-chromosomal anomalies was found for living within 3 km of a hazardous waste landfill site. The risk of non-chromosomal anomaly declined steadily with increasing distance from a site. Confounding factors or biases do not readily explain these findings. Risk of chromosomal anomalies was raised near sites but did not reach statistical significance. There was little evidence for relative risk of congenital anomaly (non-chromosomal or chromosomal) close to landfill sites to be associated with hazard potential of landfill sites, adding little support to a possible causal relationship. However, in the absence of a 'gold-standard' for the classification of hazard potential, misclassification of sites may have occurred. Lack of information on exposure of residents near the study sites or near landfill sites in general, limits interpretation of the results. Socio-economic status is a potential confounding factor in the current study but little is known in the literature about socio-economic status as a risk factor for congenital anomaly. This study finds a higher risk of non-chromosomal congenital anomaly and certain specific malformation groups in more deprived populations. These findings require follow-up in studies with larger geographical coverage.

Este trabalho apresenta uma contribuição para a avaliação da segurança de sistemas críticos, especialmente os de controle metro-ferroviários, através de uma nova metodologia com enfoque primordial para a questão da completeza das suas especificações. Esta metodologia tem como base de aplicação o modelo de transição de estados, sendo seus critérios de verificação denotados através de expressões WFF acrescidas de funções típicas ao modelo utilizado. Este método de avaliação é aplicado a um controle metro-ferroviário típico, obtendo-se resultados promissores como ferramenta de análise de segurança de sistemas críticos. / This works presents a contribution to the evaluation of safety critical systems especially the metro-railways controls, through a new methodology with primordial focus in the completeness of their specifications. This methodology uses a state transition model to specify an application, with is verifications criteria denoted through WFF expressions added by typical functions of the used model. This method of evaluation is applied to a typical metro-railway control, showing promising results as an safety analysis tool for critical systems.

Building fire safety is significantly influenced by building and fire safety regulations (often codes and standards). These regulations specify what fire safety measures should be included in a given building as a minimum requirement. Since fire engineers develop fire safety designs based on the regulations, they are often viewed as the primary agents in ensuring the fire safety of buildings. However, their mission often starts with given building design features, such as interior spatial layout, exterior shape, site plan, and so forth, which are mostly determined by architects (or architects). Although architects design buildings within the boundaries of the regulatory requirements, their focus is not generally on fire safety, but more on visual and spatial aesthetics of buildings. These objectives are linked to building form and functionality, which are not subject to the building and fire safety regulations. These objectives can sometimes compete with fire safety objectives in such a way that buildings can be unsafe in certain situations due to unintended effects of building design features on actual fire safety performance. To determine whether a building has design features which work against fire safety performance, evaluation of building fire safety performance must take into account the effects of building design features. If fire safety performance is significantly decreased by building design attributes, additional fire safety measures or modifications of the building design should be incorporated to provide an appropriate level of fire safety performance. While there have been various building fire safety evaluation tools developed over the last forty or so years, none of them comprehensively considers building design features and their associated effects as key performance parameters. In this context, the current study develops conceptual models for fire safety performance assessment in both qualitative and quantitative manners. After scrutinizing previous fire incidents and the building features which contributed to their outcomes, various fire safety performance attributes, including building design features, are identified and cause-effect relationships among the attributes are established. Then, the attributes are organized hierarchically like a tree diagram such that the performance of one upper level attribute is determined by the combined performance of multiple lower level attributes. In this way, the performance of bottom level attributes propagates upward to the upper level attributes. Two tree diagrams are established for the most common fire safety objectives, life safety and property protection. Each attribute in the tree diagrams has two quantified values: performance value and weighting factor. The current study uses three different performance values (0.01, 0.5, and 1) for bottom level attributes representing poor, average and good performance, respectively. In addition, as each attribute can have different contribution to upper level attributes, a weighting factor between 0 and 1 is assigned to each attribute which represent the relative importance. With these two values, the performance value of an upper level attribute is calculated using the weighted sum method (summation of multiplied values of performance value and weighting factor) which is commonly used in the Analytical Hierarchy Process. As the performance of an attributes is a function of specific designs, building uses, occupants, and site conditions, in the first instance, judgments of the fire engineers can be used to assign weights and performance values, but they can also be determined jointly among stakeholders. Generally speaking, the details of attributes for fire safety performance are not determined at once. Rather they are gradually determined as the building design progresses. This means that in early design building design phase, many of the attributes are unknown as well as fire safety performance. Once appropriate information can be provided to architects by fire engineers at each building design phase, it is likely to avoid possible conflicts between design details and fire safety performance. Using the fire safety evaluation model, weak attributes for fire safety performance can be identified and possible make-up strategy and building design approach can be developed in advance. This provides the potential for the collaboration between fire engineers and architects and at the end for increasing building fire safety performance of buildings.

For nearly 100 years the design of highways has incorporated safety through the application of criteria to each individual design element. Design elements are items like the horizontal curve, vertical curves, the cross-section, clear zone and roadside slopes. As a result, safety is only indirectly addressed since the design elements are developed in isolation without a good understanding on the impact of one element on another. To make matters worse, design elements communicate messages to the driver about the appropriate speed for the highway. Long straight tangent sections encourage drivers to drive faster whereas curved highway segments communicate a lower operating speed. This can lead to inconsistent message to the driver when design elements are not coordinated with each other. A new method is proposed that accounts for the interaction between design elements in such a way that the designer can estimate the frequency and societal cost of motor vehicle crashes. With this estimate of cost, the designer can base design decisions on what would minimize the societal cost of both the infrastructure improvement and safety. This method will allow designers to formulate highway designs that achieve a specific level of safety and communicate consistent information to drivers. This research provides a valuable planning and design tool for practitioners and policy makers alike. It represents an important shift in the highway design paradigm.

Digitized by Kansas Correctional Industries

Today, ever changing and advancing techniques of construction are constantly pushing the envelope of structural possibilities in the built environment. Although not new, the concept of Double-Skin Façades (DSF) finds increasing implementation with the advent of sustainable construction, aiming to reduce energy consumption to condition buildings whilst improving indoor air quality. As is the case with the traditional concept of the compartment fire, methodologies and assumptions on which our general understanding of the fire problem is based, did fundamentally not change. Inherently bound to this, is the concept of compartmentalisation, prescribing measures to avoid horizontal and vertical fire spread in buildings. A DSF, most commonly featuring a ventilated cavity between curtain wall and the secondary glass façade at an offset, is prone to drastically alter fire and smoke behaviour once able to enter. Unlike curtain walls, the chimney-like aspect ratio of such façades is able to trap fire and combustion gases within the cavity, potentially compromising the integrity of the building perimeter above the fire. The current approach to this issue tends to focus on using non-combustible construction materials and the installation of sprinkler systems to avoid breakage of window panes in the first place. Another topic of interest is the weak connection between floor slab and curtain wall which can allow vertical fire spread to adjacent floors. Research has also been discussing the use of mullions to deflect the fire plume away from the façade. Even if useful in DSF’s, aesthetics and problems with functionality will most likely prevent mullions from being introduced into the DSF. However, very little relevant research actually investigated the fire-induced flow structure under these conditions so that properly informed design decisions can be made. The project at hand aims to understand hazards to the floors above and below the fire floor by experimentally investigating the governing processes by means of large-scale fire testing and small-scale salt-water modelling (SWM). The gathered data shall serve as a basis to discuss current spandrel and cavity design decisions. Results have been compared in terms of dimensionless numbers and demonstrate complex interactions between DSF cavity width and spandrel height, encouraging a discussion about the need of further research of this topic.

Introdução: O aumento no consumo mundial de imunoglobulina humana tem desafiado os sistemas de saúde no estabelecimento de padrões de utilização adequados a esta terapia. O conhecimento das políticas públicas pelos profissionais de saúde, aderidos a uma conscientização ao uso racional e estudos baseados em evidências científicas é fundamental para assegurar o acesso adequado e uma maior segurança e efetividade de tratamento. Objetivo: Avaliar a utilização de imunoglobulina humana em hospital universitário de alta complexidade do sul do país e suas indicações relacionando as mesmas aos protocolos clínicos estabelecidos. Métodos: Trata-se de um estudo transversal, retrospectivo, baseado na busca de informações através do prontuário eletrônico dos pacientes do Hospital de Clínicas de Porto Alegre no período de janeiro à dezembro de 2015 Resultados: Foram identificadas 191 prescrições de imunoglobulina humana endovenosa, totalizando 116 pacientes. Desses pacientes, 23% apresentaram síndrome de Guillain Barré, púrpura trombocitopênica idiopática, miastenia gravis, transplante renal, imunodeficiência com aumento de IgM e outras anemias hemolíticas autoimunes. Todas essas situações clínicas tem indicação de uso de acordo com os protocolos estabelecidos pelo Ministério da Saúde. Os demais casos identificados (77%) não constam nas indicações previstas nos protocolos do Ministério da Saúde. Conclusão: Foi possível identificar a utilização de imunoglobulina humana endovenosa em hospital de alta complexidade e quantificar os casos clínicos que fazem uso desse medicamento e que apresentam protocolos nacionais orientando os profissionais de saúde quanto a correta administração desse medicamento. Observou-se que a maioria dos casos identificados no estudo não apresentam regulamentos oficiais que autorizem a sua administração. / Introduction: The increase in the world consumption of human immunoglobulin has challenged the health systems in establishing appropriate standards of use for this therapy. Knowledge of public policies by health professionals adhering to rational use awareness and evidence-based studies is critical to ensure adequate access and greater safety and effectiveness of treatment. Objective: To evaluate the use of human immunoglobulin in a university hospital of high complexity in the South of the country and its indications relating them to the established clinical protocols. Methods: This is a cross-sectional, retrospective study based on the search of information through the electronic medical records of patients from the Hospital de Clínicas of Porto Alegre from January to December 2015 Results: 191 prescriptions of intravenous human immunoglobulin were identified, totaling 116 patients. Of these patients, 23% had Guillain Barré syndrome, idiopathic thrombocytopenic purpura, myasthenia gravis, renal transplantation, immunodeficiency with increased IgM and other autoimmune hemolytic anemias. All of these clinical situations are indicated for use according to protocols established by the Ministry of Health. The other cases identified (77%) are not included in the indications provided for in the protocols of the Ministry of Health. Conclusion: It was possible to identify the use of intravenous human immunoglobulin in hospital of high complexity and to quantify the clinical cases that use this medicine and that present national protocols guiding healthcare professionals about the correct administration of this medicine. It was observed that the majority of the cases identified in the study do not present official regulations that authorize its administration.

This dissertation explores empirically how external factors can influence the organizational structure of firms and how the structure a firm chooses can affect worker outcomes. The first chapter examines how a policy reform affected the organizational choices of firms. The MINER Act of 2006 resulted in increased scrutiny and penalties for underground coal mining operations relative to surface operations. In turn, this changed the incentives for coal preparation facilities to own these mines. Particularly, markets most affected by the reform saw an increase in ownership along an extensive margin and markets already integrated saw a decrease along an intensive margin. I argue these results reflect the competing incentives created by the policy. The increased riskiness of shut downs and flows in production resulted in preparation plants integrating with at least one mine to assure a basic level of supply. The increased regulatory liability of ownership induced by the new regulatory structure resulted in a countervailing force, reducing the intensity of integration in markets that were integrated prior to the reform. The second chapter (with David Weil) studies the prevalence of contractor utilization in the mining industry. Outsourcing of tasks has increased significantly in the underground coal mining industry over the last two decades. We hypothesize that the market and organizational incentives facing contractors increase the likelihood of injuries and fatalities to their workforce. Our results suggest increased risk exposure for mines with high contractor utilization. These findings have important implications for enforcement and public policies and extend the evidence of the adverse impact of forms of subcontracting on health and safety to the mining sector. Finally, the third chapter provides a case study of two major actors in the industry, Alpha Natural Resources and Massey Energy Company. It looks at the ownership choices the two companies have made in the past decade. Looking at these different decisions allows for the identification of contract operations that are of concern from a regulatory standpoint in this industry. This paper provides a blueprint for future research in determining the prevalence of these particular contracting arrangements in US coal mining.

<p> The purpose of this study was to identify ideas about how occupational safety and health (OSH) professionals influence decision-makers on matters impacting occupational health and safety management systems. A modified nominal group technique was used that involved 67 participants in ten nominal groups and identified the most important ideas about how OSH professionals can influence workplace safety and health decision making. The research produced themes of communication, scientific, professionalism, leadership, adaptability, and business acumen that resulted in six domains of occupational safety and health professional influence.</p><p>

Parcela expressiva do transporte de cargas e de passageiros é realizada atualmente no Brasil pelo modo rodoviário, sendo que mais de 90% da malha viária federal é composta por rodovias bidirecionais com duas faixas de tráfego. A necessidade de manobras de ultrapassagem neste tipo de rodovia é bastante comum e a falta de oportunidades para que elas se realizem pode comprometer a eficiência operacional e condições gerais e específicas de segurança ao longo da via. O principal parâmetro de projeto relacionado às manobras de ultrapassagem é a Distância de Visibilidade de Ultrapassagem (DVU). Hoje há critérios distintos para a fixação dos valores mínimos de projeto para este parâmetro: a DVU dimensionada pelo critério geométrico é aplicada no desenvolvimento do projeto de geometria da rodovia e a DVU dimensionada pelo critério de sinalização é utilizada no projeto de sinalização da via. Os valores mínimos de DVU recomendados diferem bastante de um critério para outro, assim como as considerações pertinentes ao dimensionamento dos mesmos. No Brasil as referências para os valores estabelecidos são o Manual de Projeto Geométrico de Rodovias Rurais e o Manual de Sinalização Rodoviária, ambos publicados em 1999 pelo extinto DNER (atual DNIT). Quando se considera, por um lado, que as metodologias para estabelecimento dos mencionados valores mínimos são fundamentadas em estudos e pesquisas de campo realizados nos Estados Unidos na primeira metade do século passado e, por outro lado, o avanço das características técnicas das rodovias e dos veículos em circulação bem como as alterações ocorridas no comportamento dos motoristas ao longo das últimas décadas, torna-se evidente a necessidade de revisão de tais metodologias. Considerando sua aplicação às rodovias brasileiras, julga-se conveniente o desenvolvimento de pesquisas sobre a realização de manobras de ultrapassagens na malha viária nacional, com o objetivo de verificar se os valores da DVU atualmente em uso são adequados. Neste sentido, este trabalho apresenta uma análise crítica dos principais modelos e critérios hoje adotados no país e no Exterior, com base em ampla pesquisa bibliográfica e no levantamento de dados relacionados a manobras de ultrapassagem observadas em três rodovias do Estado de São Paulo, assim como a proposição de modelos alternativos para a definição de valores mínimos para a DVU segundo o critério geométrico e o critério de sinalização. / Today, most of the transportation in Brazil – of both people and goods - uses the country’s highway system. Two-lane highways represent over 90% of the federal highway network. Passing maneuvers are often required on such highways and the lack of opportunities may compromise operational efficiency and safety conditions. Passing Sight Distance (PSD) is the key project parameter related to passing maneuvers. Today, there are two different methods to establish minimum PSD design values: the geometric criteria, which are used highway on geometric design, and the signaling criteria, used to mark pavement surface. Minimum PSD values recommended by geometric criteria and signaling criteria are often very different, as well as the assumptions on which these models are based. In Brazil the references adopted are the Highway Design Manual for Rural Highways (Manual de Projeto Geométrico de Rodovias Rurais) and the Highway Signaling Manual (Manual de Sinalização Rodoviária), both published in 1999 by DNER (today called DNIT). Considering that the recommended values are based on field studies carried out in the United States in the first half of the 20th century, it is clear that these criteria must be reviewed, specially taking into account the technical advances of highways and vehicles, as well as the changes occurred in driving behavior over the last decades. Considering the application to Brazilian highways, it is important to research passing maneuvers through national roads in order to verify the adequacy of PSD values adopted. Therefore, this work presents a critical analysis of major models used today in Brazil and abroad, based on extensive bibliographical research and on field studies related to passing maneuvers in three highways in São Paulo State. New models to determine minimum PSD values are also proposed for both geometric and signaling criteria.