The Broken Hill Centre for Remote Health Research is involved in a number of research projects relevant to population health and the delivery of health services in rural and remote settings.
Factors affecting attendance at Broken Hill blood lead screening clinic
Silver, lead and zinc have been mined in Broken Hill for more than 100 years. In the early 1990’s, lead was identified as a significant public health issue for young children living in the city, and a major government funded program was initiated to deal with the problem. Children’s blood lead levels have since decreased by more than half. The rate of participation in blood lead screening has, however, decreased in recent years, to about 50% in 2005, raising concern that children with high blood lead levels may not be attending the clinic and so may be missing out on appropriate treatment and advice.
To begin to understand what factors contribute to clinic attendance, this project is comparing information from data routinely collected by the lead testing clinic with that colleced in 2001. The information will be used to develop strategies that aim to increase the number of young children who attend for annual blood lead testing.
The research is being led by Frances Boreland. Final results will be available from August 2006. For further information about the study contact Frances Boreland on +61 8 8080 1279.
Effect of home remediation on children’s blood lead levels
As mentioned, a major government funded program was initiated in the early 1990's to deal with the lead problem in Broken Hill. As part of the lead program evaluation, the effectiveness of home remediation for reducing children’s blood lead levels was explored using a randomized controlled trial. The results showed the benefits to be modest.
The study is currently being prepared for publication.
For further information contact Professor David Lyle on +61 8 8080 1236.
The effect of low blood lead levels on children’s IQ
While the effects of severe lead poisoning have been known for centuries, the effects of low-level lead exposure remain highly controversial. Recently concern has been raised that blood lead levels below the current National Health and Medical Research Council guidelines (10 µg/dL) may not be safe. The aim of this study is to examine the relationship between low level lead exposure (around 10 µg/dL and less) and childhood development problems.
The study is being undertaken jointly by the University of Adelaide, the Adelaide Women’s and Children’s Hospital, and the Broken Hill University Department of Rural Health, and will involve recruiting children from two communities long involved with the lead industry, Port Pirie and Broken Hill. Children’s blood lead level and IQ will be measured, along with other potential confounders such as parental IQ.
The research is being led in Broken Hill by Professor David Lyle. For further information about the study contact David Lyle on +61 8 8080 1236.
Short term costs of alcohol misuse to agencies in Broken Hill
In Broken Hill alcohol misuse is dealt with initially by police and the hospital emergency department (ED). This study used routinely collected data to determine the short-term economic cost of dealing with alcohol misuse. Both the police and ED participated simultaneously in the project over two one-week periods, first during Broken Hill's cooler season, and later during the warmer seasons.
For ED, calculations were based on the NSW Health Costs of Care Standards, while police based their calcuations on staff hourly rates and costs for vehicle maintenance etc, where appropriate. To complete the picture, basic demography of those affected by alcohol was collected.
The research was led by Dr Margaret Lesjak with co-investigators Loi Zanette (Broken Hill Base Hospital ED), Dr David Garne (UDRH) and Sgt Greg McMahon (Broken Hill Police, Barrier LAC responsible for police data).
For further information contact Margaret Lesjak on +61 8 8080 1287
Abdominal Aortic Aneurysm Screening Project
An abdominal aortic aneurysm (AAA) is an abnormal dilatation, or bulging, of the abdominal aorta. The condition has a prevalence of 5-10% in men over the age of 50 years.
The consequences of an undiagnosed AAA may be rupture of the aneurysm, giving rise to a surgical emergency. 80% of individuals with a ruptured AAA die before reaching hospital, while 50% of those undergoing emergency repair upon reaching a hospital with vascular surgical services may also die.
The majority of AAAs are asymptomatic and when symptoms are present they are usually non-specific. Diagnosis is difficult. Less than 50% of AAAs are detected on normal physical examination: more commonly diagnosis occurs as an incidental finding when a patient is undergoing investigation for another reason. AAA is, however, detectable on directed unltrasound of the abdomen. This procedure is easy to carry out and is highly specific and sensitive for the detection of AAA.
A screening programme for detection of abdominal aortic aneurysm in men aged 65 and over living in the Broken Hill area was conducted over two periods in 2007 and 2008, with assistance from community representatives, Westmead Vascular Laboratory, the Greater Western Area Health Service and Toshiba Australia.
One aim of the programme was to permit surgical intervention as an elective procedure rather than emergency surgery, which has a much higher mortality, and requires evacuation of the patient to Adelaide.
In addition to coordinating the programme, the Centre's role was to assess the effectiveness, acceptability and feasibility of the programme in Broken Hill, and to determine its transferability for wider application. The Institute of Rural Clinical Services and Teaching provided funding for the evaluation.
For further information about the study contact Dr Margaret Lesjak on +61 8 8080 1287.
Evaluation of the Mental Health Emergency Care - Rural Access Project
The Mental Health Emergency Care - Rural Access Project (MHEC - RAP) is designed to improve the quality and responsiveness of metal health emergency services in the Greater Western Area Health Service (GWAHS). It is intended to improve access to services and safety in the assessment and treatment of clients and to improve coordination of services provided by health, police and ambulance.
An action research evaluation is taking place that will inform on development of the project and examine the extent to which their objectives are met.
Specifically, the evaluation will address the following questions:
1. What is the MHEC-RAP model and how does it develop to meet mental health emergency care needs, so as to address and improve access, safety, and service coordination in rural and remote locations?
2. Do the activities of the MHEC-RAP team lead to changes in (either or both) the patient journey and provider decisions about care? The patient journey describes the identification, assessment, transport and care for particular/ typical mental health patients.
3. What impact have the activities of the MHEC-RAP team had on the agencies and patients associated with mental health emergency care in rural and remote health?
Research is being led by Emily Saurman. For further information about the study, contact Associate Professor David Perkins on +61 8 8080 1282 or Emily Saurman on +61 8 8080 1203.