Category

Health

Lead influencing crime, Ice drug contaminating homes, and other highlights from CleanUp2017

700 scientists, engineers, regulators and other environmental professionals from more than 20 countries have been in Melbourne this week at the biennial CleanUp global forum.

CleanUp 2017, organised by the Cooperative Research Centre for Contamination Assessment and Remediation of the Environment (CRC CARE), ran in Melbourne from 11 to 13 September. Delegates discussed many of the most pressing environmental problems facing the world today, including chemical weapons, climate change, asbestos, and per-and poly-fluoroalkyl substances (PFAS).

For example, one paper that caught our eye described how children exposed to lead in soil are more likely to commit crime as young adults. Dr Mark Cave, from the British Geological Survey, compared lead levels in soil with socio-economic information about health, wealth, employment, housing and crime in England. He found a link between soil lead and criminal behaviour in Derby’s urban environment, and said results in Australia show a strong relationship between childhood lead exposure and subsequent rates of aggressive crime. You can hear more about his work in an Australian Science Media Centre online media briefing.

For more details on our involvement in the conference, see our post on LinkedIn here.

Learning from failure

As part of a major national project on innovation, Scientell has examined the contribution that learning from error and failure can make to innovation and progress. This is part of our work with the Australian Council of Learned Academies (ACOLA) to synthesise a wealth of information into a book on securing Australia’s future. The following is a sad example of failure.

On 29 March 2005, 37-year-old Elaine Bromiley entered a British hospital to undergo routine surgery to clear her sinuses. The mother of two was otherwise healthy.

Problems occurred immediately the anaesthetic was supplied. With no warning, Elaine’s oxygen levels plunged. Her airway was blocked – a most unusual event that happens in fewer than one in 50,000 routine cases of people being given an anaesthetic. The anaesthetist and the surgeon immediately tried to insert a tube into her airway. Additional medical staff quickly arrived to assist, including two recovery nurses, an ear, nose and throat surgeon and another consultant anaesthetist. For 20 minutes, the team desperately attempted to clear her airway.

Sadly, the emergency procedure failed. Elaine was transferred unconscious to the adjacent intensive care unit and died 13 days later.

Elaine’s husband Martin Bromiley was a commercial airline pilot. He knew how his industry would have responded to a similarly catastrophic event. One of the medical team told Martin that ‘maybe when this is investigated something can be learned. But we won’t investigate, not unless you sue or complain.’

‘For me as an airline pilot, that is where everything changed, because to me it is perfectly normal to investigate when something does not happen so you can learn from it, and here we had a situation where somebody was healthy, was going to be made more healthy, and was actually dead. I could not understand why you would not want to learn from it.’

It took some doing, but Martin managed to initiate an independent review of the case.

‘Arguably, it technically was a dream team to deal with this sort of emergency, but what we know happened, if you will excuse the phraseology, was that the situational awareness, the shared mental model of the three consultants, was different. They lost awareness of time; they lost awareness, perhaps more importantly, of the seriousness of the situation; they became fixated – which is not unusual under stress – on intubation to the exclusion of any other options, such as some form of surgical access.

From my background in aviation, I could see very quickly that these were in fact failings in what you refer to as “non-technical skills”: situation awareness, leadership, teamwork, prioritisation, communication, and assertiveness. These same human factors of failings in non-technical skills are the direct cause of 75% of aviation accidents.’

An incision into Elaine’s throat – a tracheotomy – may have saved her life. That it didn’t happen, was not the failings of any individual, but rather the failings of a flawed system.

Today, the findings from the inquest form the basis of training in Australia and elsewhere of healthcare clinicians, particularly those involved in advanced airway management.

The death of Elaine Bromiley was a tragic failure, but it was a failure that people learned from, and one that has improved the way in which emergency operating theatre procedures are conducted.

 

Is there a doctor on this flight?

Scientell is working with the Australian Council of Learned Academies (ACOLA) to synthesise a wealth of information into a book on securing Australia’s future. As part of this, we have examined the contribution that learning from error and failure can make to innovation and progress. This example demonstrates the way in which the medical profession is learning from the aviation industry’s approach to safety.

Safety is paramount for the aviation industry. Aircraft accidents are infrequent, but when they occur they involve massive losses of life. The exhaustive investigations that follow crashes have produced extensive literature into their causes, and new policies and regulations to improve safety. Research by the National Aeronautics and Space Administration (NASA) into aviation accidents has found that 70 per cent involve human error.

Writing in the British Medical Journal, Robert L Helmreich, professor of psychology at the University of Texas, states, ‘Error results from physiological and psychological limitations of humans. Causes of error include fatigue, workload, and fear as well as cognitive overload, poor interpersonal communications, imperfect information processing, and flawed decision making.’

‘In both aviation and medicine, teamwork is required, and team error can be defined as action or inaction leading to deviation from team or organisational intentions. Aviation increasingly uses error management strategies to improve safety. Error management is based on understanding the nature and extent of error, changing the conditions that induce error, determining behaviours that prevent or mitigate error, and training personnel in their use.’

Diagnosis should include data from confidential incident reporting systems and surveys, systematic observations of team performance, and details of adverse events and near misses.

It is now commonplace for medical doctors to learn from the approach to error and failure that has been refined and systematically adopted in aviation.

The error management approach that Helmreich advocates includes:

  • Dealing with latent factors that have been detected, changing the organisational and professional cultures, providing clear performance standards, and adopting a non-punitive approach to error (but not to violations of safety procedures);
  • Providing formal training in teamwork, the nature of error, and in limitations of human performance;
  • Providing feedback and reinforcement on both interpersonal and technical performance; and
  • Making error management an ongoing organisational commitment through recurrent training and data collection.

As physician Dr Lucian Leape, a physician and professor at Harvard School of Public Health, states:

‘The most fundamental change that will be needed if hospitals are to make meaningful progress in error reduction is a cultural one. Physicians and nurses need to accept the notion that error is an inevitable condition, even among the conscientious professionals with high standards. Errors must be accepted as evidence of system flaws not character flaws.’ [1]

 

[1] Lucian L Leape, Error in medicine. JAMA, 272:23, 1851-1857, (1994)

Eternity: could we ever become immortal?

People now live longer than ever before. A girl born in Australia today can expect to live for about 84 years, but a girl born in the late 1800s was expected to live for just 54 years.

We owe this improvement to better food, advances in medicine and having more money. Fewer babies and young children die, and our work and lives are far safer than they used to be.

What can be done to extend your life? Let’s start with the things you can control yourself.

First: watch your diet and weight. The Mediterranean area of Europe is home to lots of people who are more than 100 years old. Most people there eat healthy diets that are high in fruits, vegetables, nuts and healthy fats such as olive oil. Also, don’t smoke or drink too much alcohol when you are older.

Next: study. Educated people live longer. They are more likely to have better jobs and make healthier lifestyle choices. Be friendly. Strong social networks help support us; helping other people may help us better look after ourselves.

Exercise is good. Light physical activity every day leads to less disability in old age and a longer, healthier life. Stand instead of sitting. Sitting for long periods when studying, working and watching television is unhealthy, so try to spend some time doing these things on your feet.

For more on this and 41 other inventions of the future, check out our book, Imagining the Future: Invisibility, Immortality and 40 Other Incredible Ideas, by Simon Torok and Paul Holper (CSIRO Publishing), http://www.publish.csiro.au/pid/7344.htm

The 60-second guide to world water

The ocean covers 71 per cent of the Earth’s surface and contains almost 97 per cent of the planet’s water. But only 2.5 per cent of Earth’s water is freshwater, and just a fraction (1.2 per cent) of that freshwater is surface water available for our needs.

For a recent project, Scientell assessed the state of current and future global water resources and described some existing and potential technologies for creating potable water on small and large scales.

Here we distil some of the interesting information to quench your thirst for water knowledge.

Water blog graphic

 

There are 780 million people who don’t have access to uncontaminated drinking water.

Climate change is affecting water supplies. In many places, changing precipitation or melting snow and ice are altering hydrological systems, affecting the quantity and quality of water resources. Glaciers continue to shrink almost worldwide, affecting runoff and water resources downstream. Climate change is poised to intensify floods and drought.

Some countries, including Australia, have installed desalination plants to ensure continuity of water supply in the face of rainfall declines partly due to climate change. Ironically, the energy the plants consume produces carbon dioxide that adds to climate change, unless their energy source is renewable.

There are more than 17,000 desalination plants worldwide. Reverse osmosis is a common desalination process. The technique entails pumping salty water through a membrane that lets water through but blocks salt.

Extracting pure water from wastewater uses just a fraction of the energy needed to convert seawater. However, communities may object to drinking water converted from sewage. In 2006, for example, more than 61 per cent of the residents of drought-stricken Toowoomba in Queensland voted against such a scheme.

The race is on to create cheap, low energy water purification methods.

CSIRO is developing small, portable water purification devices ‘the size of a teapot’ that would be rechargeable, inexpensive and more effective than many existing purifiers. The active component is a membrane, treated with plasma to boost the water absorption rate through carbon nanotubes. These tubes, just 10,000th the width of a human hair, remove contaminants and salt from dirty water.

In 2013, the Indian Institute of Technology Madras announced a nanoparticle water filtration system. The filter relies on silver nanoparticles embedded in a cage made of aluminium and chitosan, a carbohydrate derived from the chitin in crustacean shells. Other nanoparticles can target contaminants such as mercury.

Researchers from the National University of Singapore have engineered a biomimetic membrane that can purify water at low pressure, thus reducing energy costs. Biomimetic methods mimic natural biochemical processes – in this case the layers of cells on the roots of mangrove trees, which purify water.

Improving global access to clean water would be an incredibly powerful and valuable scientific breakthrough.

 

Resources

9 Great Water Filter Technology Advancements (You Need To Know About Today)
Available at http://all-about-water-filters.com/great-water-filter-technology-advancements-you-need-to-know-about-today/

The new water technologies that could save the planet.
Available at http://www.theguardian.com/sustainable-business/new-water-technologies-save-planet

Six water purifying designs for the developing world
Available at http://inhabitat.com/6-water-purifying-devices-for-clean-drinking-water-in-the-developing-world/

How Stuff Works: 10 Innovations in Water Purification
Available at http://science.howstuffworks.com/
environmental/green-tech/sustainable/10-innovations-water-purification.htm#page=0

Recycled drinking water: what Australians need to know
Available at https://theconversation.com/recycled-drinking-water-what-australians-need-to-know-7216