This Background Paper examines whether the agencies responsible for administering Federal environmental and health and safety laws have taken this concern for respiratory health to heart. This paper provides a partial response to the committees’ request for an assessment of noncancer health risks in the environment and follows OTA’s previous work on carcinogenic, neurotoxic, and immunotoxic substances.

This background paper, which describes the state-of the- art of identifying substances that can harm the immune system, represents one response to the committee’s request. Chapter 2 provides basic information about the principal components of the immune system and the general consequences that stem from perturbations to it. Chapter 3 describes methods for evaluating chemical immunotoxicity and reports on some known or suspected immunotoxicants. Chapter 4 summarizes Federal research and regulatory activities related to immunotoxicity.

Three major areas are covered in this Staff Paper: 1) a review of the studies of health effects related to passive smoking; 2) a review of current Federal, State and local, and private sector workplace smoking policies; and 3) a discussion of factors to consider in an analysis of the costs and benefits of implementing a workplace smoking policy.

The staff paper is part of a larger, ongoing OTA assessment of the ozone nonattainment issue, requested by the Senate Committee on Environment and Public Works and the House Committee on Energy and Commerce.

The purpose of this report is to examine two crucial questions: 1. What are we getting out of this investment? 2. How can we improve it?

This report on urban ozone was requested by the Senate Committee on Environment and Public Works, the House Committee on Energy and Commerce, and its Subcommittee on Health and the Environment in anticipation of the upcoming reauthorization of the Clean Air Act. Of the air pollutants that the Act covers, ozone has been the most difficult to bring under control; it may well be the most expensive.

This paper examines the health services and economics literature to learn what is known about the effects of patient cost-sharing (that is, annual deductibles, coinsurance, copayments, and out-of-pocket maximurns) on patients’ use of health care services, on plan expenditures, and on patients’ health outcomes.

This report discusses the Oregon legislature that passed the Oregon Basic Health Services Act in 1989, which established three mechanisms for increasing access to health insurance.

A technical memorandum by the Office of Technology Assessment (OTA) that "describes Federal activities that have taken place since 1979; reevaluates the 1979 cost-effectiveness analysis of vaccination against pneumococcal pneumonia, including new information on vaccine efficacy; and discusses policy implications" (p. iii).

This background paper presents the results of a study of physician and sperm bank practice of artificial insemination in the United States. It documents the number of women undergoing artificial insemination each year, the annual cost, medical and social screening criteria for women seeking artificial insemination and men who donate semen, the genealogical recordkeeping available to the resulting children, and physician attitudes toward possible changes in artificial insemination practice.

A technical memorandum by the Office of Technology Assessment that evaluates the results of Diagnosis Related Groups and "their implications for use in the Medicare program" (p. iii).

This report discusses biological rhythms: what they are, how they are controlled by the brain, and the role they play in regulating physiological and cognitive functions. The major focus of the report is the examination of the effects of nonstandard work hours on biological rhythms and how these effects can interact with other factors to affect the health, performance, and safety of workers.

This OTA’s report responds to the request of numerous Members of Congress to review the physical, emotional, and behavioral health status of contemporary American adolescents, including adolescents in groups who might be more likely to be in special need of health-related interventions: adolescents living in poverty, adolescents from racial and ethnic minority groups, Native American adolescents, and adolescents in rural areas. In addition, OTA was asked to: 1 ) identify risk and protective factors for adolescent health problems and integrate national data in order to understand the clustering of specific adolescent problems, 2) evaluate options in the organization of health services and technologies available to adolescents (including accessibility and financing), 3) assess options in the conduct of national health surveys to improve collection of adolescent health statistics, and 4) identify gaps in research on the health and behavior of adolescents.

This background paper reviews and evaluates the available literature linking health insurance coverage with the utilization and process of health care services and with individual health outcomes.

This background paper examines the epidemiologic evidence used by the CDC in deciding to revise the AIDS case definition and the impact the proposed definition will have on surveillance. The paper also explores the logistical consequences and other implications of the revised definition, including its impact on Social Security disability determinations.

This report identifies key technologies and shows how they are being used to communicate clinical information, simplify administration of health care delivery, assess the quality of health care, inform the decision-making of providers and administrators, and support delivery of health care at a distance.

This report begins with background discussion of China and its people. The report includes a special focus on country's strong religious and philosophic tradition. The report concludes with a discussion of possible benefits for the corresponding American experience.

This technical memorandum is about problems arising out of success. Recent advances in medical technology have permitted sick children who once would have died to survive with the assistance of sophisticated equipment and intensive nursing care. Often, the assistance is needed for just a short time, but sometimes the dependence on life-sustaining technology is permanent. As technology for helping keep children alive has improved, a new population of technology-dependent children has emerged.

This report is an assessment of health care for American Indians and Alaska Natives who are eligible for medical and health-related services from the Federal Government. The Federal agency that is responsible for providing these services is the Indian Health Service (IHS), a component of the Public Health Service (PHS) in the Department of Health and Human Services (DHHS).

This paper discusses the experiences of Australia, Canada, France, Germany, the Netherlands, Sweden, and the United Kingdom—technology assessment with six technologies (or sets of technologies) including evaluation and management efforts and how the technologies diffused— are presented and compared.

This report is a part of a larger study on International Differences in Health Care Technology and Spending. It discusses health care technology as a policy issue, healthcare technology in Australia, Canada, France, Germany, Netherlands, Sweden, United Kingdom and United States, as well as the lessons from the eight countries.

A case study requested by the Office of Technology Assessment (OTA) that presents "a brief overview of selected respiratory therapy modalities, including an assessment, drawn from the available medical and scientific literature, of what is known about the efficacy or effectiveness of various respiratory therapy procedures" (p. 3).

The purpose of this report is to: 1)update the estimated level of use of pneumococcal vaccine in the United States, 2)examine factors that influence its use, and 3) assess how, if at all, selected alternative payment methods might affect the use of this vaccine.

The report responds to the request of numerous Members of Congress to review the physical, emotional, and behavioral health status of contemporary American adolescents, including adolescents in groups who might be more likely to be in special need of health-related interventions: adolescents living in poverty, adolescents from racial and ethnic minority groups, Native American adolescents, and adolescents in rural areas.