also account for a significant percentage of long-
term recovery and permanent disability due to
injury. Prevention efforts focus on increasing pub-
lic awareness and reducing exposure to risks.
See also ANGER AND ANGER MANAGEMENT; BLUNT
TRAUMA; GUNSHOT WOUNDS; MULTIPLE TRAUMA; OCCU-
PATIONAL HEALTH AND SAFETY.
tuberculosis prevention Until researcher Selman
Waksman (1888–1973) discovered the powerful
antibiotic streptomycin in 1944, TUBERCULOSIS
(called “consumption” because its sufferers literally
wasted away as the INFECTIONconsumed lung and
other tissue) killed more people than any other dis-
ease. Antibiotic regimens developed in the ensuing
decade significantly reduced tuberculosis infections
in the United States by the mid-1960s. By the mid-
1980s, however, strains of tuberculosis began
appearing that were resistant to the conventional
antibiotic therapy (now called multidrug-resistant
tuberculosis or MDR-TB). Concurrently HIV/AIDS
proliferated, making those who became infected
highly susceptible to other infections such as tuber-
culosis. People who have DIABETES, kidney disease,
LEUKEMIA, or LYMPHOMAor who receive IMMUNOSUP-
PRESSIVE THERAPYsuch as following ORGAN TRANSPLAN-
TATION are also more susceptible to tuberculosis
infection. Tuberculosis tends to develop more fre-
quently among confined populations such as in
prisons and crowded living conditions.
Doctors diagnose about 15,000 people with
tuberculosis in the United States each year, about
half of whom are immigrants who likely became
infected in their native countries. Tuberculosis
spreads by BREATHING droplets a person already
infected with the disease breathes or coughs out
into the air. Most people who have healthy
immune systems can fight off infection, though
the causative microorganism (Mycobacterium tuber-
culosis) may remain inactive in their bodies (called
latent tuberculosis). Only people who have active
tuberculosis can spread the infection to others. A
SKINtest can detect the presence of M. tuberculosis.
Public health policy in the United States requires
skin testing, called a tuberculin skin test, in
numerous occupations including public safety
(police, fire, and emergency aid response), teach-
ing, food handling and preparation, and health
care. The typical course of treatment for diagnosed
active tuberculosis is a regimen of two or more
ANTIBIOTIC MEDICATIONStaken for 6 to 10 months.
Prevention efforts focus on screening susceptible
populations for early diagnosis and treatment, and
on encouraging people who show symptoms of
tuberculosis to receive medical treatment. Anyone
who has had close contact with a person diagnosed
with tuberculosis, as well as those who have
HIV/AIDS and a marginal tuberculin skin test result
should receive more frequent screening tests and
discuss prophylactic antibiotic therapy with their
doctors. Research continues the quest for a tuber-
culosis VACCINE. The BCG vaccine currently avail-
able provides very limited protection. Doctors
administer it primarily to young children exposed
to non-lung forms of tuberculosis infection.KEY MEASURES FOR PREVENTING TUBERCULOSIS- Receive periodic tuberculin SKINtests to screen for the pres-
ence of M. tuberculosis. - Receive prophylactic antibiotic therapy when at high risk for
INFECTION. - Take protective measures such as wearing a surgical mask
when in close contact with someone diagnosed with tuber-
culosis. - If being treated for tuberculosis, take the full course of
antibiotic therapy as prescribed.
See also KIDNEYS; LUNGS; OCCUPATIONAL HEALTH
AND SAFETY.water safety More than 4,000 people drown in
the United States each year, and as many as
12,000 experience near-drowning (also called sub-
mersion injury). The HYPOXIA(lack of oxygen) that
occurs with submersion results in residual compli-
cations in about 40 percent of people who are
revived, ranging from mild memory impairment
and disturbances of cognitive function to PERSIST-
ENT VEGETATIVE STATE. Virtually all water accidents
are preventable.
The common scenarios for water-related
injuries correlate with age:- Children under age 1 year are most likely to
drown in toilets, bathtubs, and buckets or other
containers of water.
water safety 49