Synopsis for March 5, 2004

The MMWR is embargoed until Thursday, 12 PM EST.

1. Homicide Trends and Characteristics ― Brazil, 1980-2002
2. Hypothermia-Related Deaths — United States, 2003
3. Alcohol Use Among Adolescents and Adults ― New Hampshire, 1991-2003
4. Exposure to Tear Gas from a Theft-Deterrent Device on a Safe ― Wisconsin, December 2003

Synopsis for March 5, 2004

Homicide Trends and Characteristics ― Brazil, 1980-2002

The public health burden of homicide increased dramatically between 1980 and 2002 in Brazil and one of its urban centers, Sao Paulo City, particularly among young males. These findings underscore the need for more prevention strategies that target young persons.

Brazil's overall homicide rate doubled between 1980 and 2002, making homicide the leading cause of death for Brazilians age 15 to 44. The homicide rate tripled in Sao Paulo City, one of Brazil's urban centers, with one in every 250 males 15 to 29-years of age a victim of a homicide in some districts of the city. Homicide is now a substantial public health problem among Brazilian adolescents and young adults, indicating a need for more homicide prevention strategies that target young people.

Hypothermia-Related Deaths — United States, 2003

Hypothermia deaths are preventable.

Hypothermia, a preventable disequilibrium of the body's temperature, causes approximately 700 deaths annually in the United States. Hypothermia is defined as a core body temperature < 95F (<35C). Signs of hypothermia include shivering, slurred speech, confusion, and impaired hand coordination. Excessive cold slows enzymatic activity throughout the body, leading to potentially fatal organ failure. Although advancements in rewarming and cardiopulmonary resuscitation have improved survival, the key to reducing mortality and morbidity is to protect the body from excessive cold exposure. Alcohol intake, activity level, and clothing characteristics are among the modifiable factors that can prevent hypothermia. In addition, vulnerable populations that may not be able to take care of themselves (the elderly, the homeless, the chronically ill, alcoholics, and drug users) need protection from hypothermia.

Alcohol Use Among Adolescents and Adults ― New Hampshire, 1991-2003

Interventions are needed to prevent adolescent drinking and to reduce excessive average and per occasion alcohol use among adults.

Alcohol abuse is the third leading preventable cause of death in the United States. Public health efforts have focused on reducing binge and heavy drinking, because these patterns of alcohol use increase the risk for cirrhosis, cancer, heart disease, stroke, injury, and depression. The New Hampshire Department of Health and Human Services analyzed data from the New Hampshire Behavioral Risk Factor Surveillance System (NHBRFSS), the New Hampshire Youth Risk Behavior Survey (NHYRBS), and New Hampshire Vital Records (NHVR) during 1991–2003. In New Hampshire, 15.8% of adults and 32.9% of adolescents report binge drinking and 6.3% of adults report heavy drinking. Among adults in the 2001 NHBRFSS, 15.8% reported binge drinking, compared with 18.6% in 1991. During 1991–2001, men were two to three times more likely than women to binge drink (Table 1). Women of childbearing age were more likely to report binge drinking than women aged >45 years (14.2% [95% confidence interval (CI) = 11.8%–16.6%] versus 2.3% [95% CI = 1.4%– 3.2%]). In 2001, a total of 6.3% of adults reported heavy drinking, compared with 6.8% in 1991 (Table 2).

Exposure to Tear Gas from a Theft-Deterrent Device on a Safe ― Wisconsin, December 2003

While these devices are no longer produced, persons who use or are around older safes and vaults (e.g., bankers, jewelers, locksmiths, and vault technicians) should be informed how to identify these devices and cautioned against tampering with them. If a device is identified, only trained persons (e.g., experienced locksmiths or HazMat personnel) should attempt to remove or neutralize the devices. In addition, appropriate personal protective equipment should be used when attempting to dismantle these devices. If the contents of a device are released, the area should be evacuated immediately. Persons who develop adverse health effects (e.g., eye, skin, or respiratory irritation) should seek medical attention immediately.

From the 1920s through 1950s, certain safes in the United States were fitted with theft-deterrent devices containing chemical vials of tearing agents (i.e., chloropicrin). The intent was that any malicious tampering with the safe door would crack the vial, releasing the substance, and would force the burglar to vacate. A device was recently discovered inadvertently in Wisconsin. Exposure to these tearing agents can cause irritation of the eyes, skin, and respiratory system; lacrimation; cough; and nausea and vomiting. The metal casing of these devices is approximately 3 inches wide and 6–8 inches tall and is usually fastened to the back of safe doors. The number of these devices sold or still in circulation is unknown.

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