Geographic origin and risk for congenital infection in a Canadian inner city: findings and implications for policy

This study examines associations between geographic origin and risk for congenital infections, through a chart review of women from the St. James Town area of Toronto delivering at Wellesley Hospital in 1996. Foreign-born women (n = 203) were significantly less likely than Canadian-born women (n = 53) to be HBsAg negative (187/193 vs. 48/48; RR = 0.97, 95% CI 0.94-0.99). There was no significant difference in rubella seronegativity, but rubella immunity was unacceptably low in both groups (less than 90%). A number of rubella non-immune women had delivered previously in Canada. Procedures must be implemented to ensure completion of hepatitis B immunization series in affected newborns, and rubella immunization in seronegative women prior to discharge. As well, updating immunization status most become a routine part of the immigration medical examination.

Smoking: attitudes of Costa Rican physicians and opportunities for intervention

The aim of this study was to obtain information, using a written questionnaire, on the knowledge, smoking behaviour, and attitudes of Costa Rican physicians about smoking as a health issue. A random sample of 650 physicians was chosen from a list of active physicians; 287 of them were covered by survey between August 1993 and October 1994, and 217 (76%) responded with data for the study. While 40% of the physicians who participated were ex-smokers, 19% were current smokers; 67% of these two groups combined reported smoking in the workplace. Only 49% believed that physicians could be a nonsmoking role model; the majority (87%) had asked patients about their smoking status. The only cessation technique consistently used (90%) was counselling about the dangers of smoking. Measures such as setting a date to quit smoking and nicotine replacement were rarely recommended (< or = 2%). Nearly all the physicians (99%) considered smoking to be a major health issue. These results showed a high prevalence of smoking among Costa Rican physicians, with little recognition of the need for them to set an example as a role model. While they were knowledgeable about the health risks of smoking, they did not recommend any of the proven techniques to help their patients to quit smoking. A clear consensus for more strict tobacco regulation exists, but to date little has been done to act on this.