ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Several epidemiologic studies indicate that some paternal occupations are associated with an increased risk of birth defects in offspring. We evaluated this relation using data from a population-based case-control study. Cases are infants with a major birth defect registered with the Metropolitan Atlanta Congenital Detects Program between 1968 and 1980. We selected controls from livebirths in the Atlanta area using frequency matching for race, year, and hospital of birth. Case and control parents were interviewed to solicit information on several factors, including occupation. We classified paternal occupation according to the job held during the time from 6 months before until 1 month after the estimated date of conception. We compared fathers in one occupational category with fathers in all other categories combined. We identified a number of associations including: firemen with cleft lip [odds ratio (OR) = 13.3; 95% confidence interval (CI) = 4.0–44.4]; painters with atrial septal defect (OR = 2.7; 95% CI = 1.0–7.4); and farmers with cleft lip and palate (OR = 3.3; 95% CI = 0.9–11.9). This study, however, did not corroborate several associations found in previous studies, such as painters and neural tube defects. We identified several additional occupations as potential risk factors for some defects, including printers, electronic equipment operators, and vehicle manufacturers.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

State and local health departments investigate an increasing number of cluster allegations, for which the selection of appropriate statistical methods is an important problem. Many of the methods for the spatial analysis of health data assume, either implicitly or explicitly, some model of disease occurrence, and comparisons of methods can be difficult when their underlying disease models differ. We review some of the issues involved in the statistical analysis of spatial disease patterns and describe several methods recently proposed to detect areas of increased disease rates. The disease models upon which the methods are based are explicitly described, and they provide a useful basis for comparing alternative clustering methods.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Heavy maternal alcohol consumption during pregnancy has been associated with fetal growth retardation, but whether more moderate consumption also is associated remains a controversial issue. We examined moderate consumption in 1233 women with singleton livebirths, by calculating a weighted average of weekly consumption in the first 20 weeks from questions that asked about alcohol consumption before pregnancy, as well as any changes during the first half of pregnancy. The adjusted odds ratio for (“moderate”) consumption of three or more drinks per week for low birthweight was 2.6 [95% confidence limits (CL) = 1.2, 5.7], and that for intrauterine growth retardation was 2.3 (95% CL = 1.2, 4.6). Examining the joint effect of smoking with alcohol consumption revealed associations that differed by outcome; we found a synergistic effect for low birthweight, but not for intrauterine growth retardation. Moderate alcohol consumers had an average birth-weight decrement of 143 gm, which varied by smoking. There was little association of alcohol consumption with preterm delivery (< 37 weeks). Paternal alcohol consumption was not associated with any of the fetal growth measures after adjustment for other variables.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Amyloidosis is associated with the deposition of amyloid substance in various tissues of the body. In several forms of familial amyloid polyneuropathy, mutated transthyretin is the main fibril component. The disease is inherited as an autosomal dominant trait with onset in adult life, but few carriers develop symptoms. The aim of the present investigation was to screen for additional factors that might be necessary for the development of familial amyloid polyneuropathy. We conducted a case-control study involving 51 male and 30 female cases of clinically overt familial amyloid polyneuropathy and 306 male and 317 female population controls. We considered occupational exposures, disease histories, and medical treatments as potential determinants of risk for clinically overt disease. We found an odds ratio of 5.4 for dressmakers. Low and high levels of exposure to organic solvents resulted in an odds ratio of 2.1 and 11.8, respectively. A history of prostatic hyperplasia, cholecystic disease, or appendectomy was also a risk factor, possibly as a consequence of anesthesia.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Physical activity has repeatedly been shown to protect against colorectal cancer. Since adenomas are precursors to most colorectal cancers, we examined the relation of physical activity to the risk for colorectal adenomas in a colonoscopy-based study of 200 adenoma cases and 384 adenoma-free controls. Physical activity was assessed by telephone using a modification of a validated questionnaire comprising 17 items concerning three activity dimensions: leisure, work, and sport. Dietary information was obtained with a validated semiquantitative food frequency questionnaire. We created indices for each dimension of physical activity, which we categorized by quartile. Using logistic regression analysis, we found that leisure activity protected women against colorectal adenomas. Women in the second through fourth quartiles were considerably less likely than those in the first quartile to develop adenomas [crude odds ratio = 0.48; 95% confidence interval (CI) = 0.28–0.81]. There was no protective effect of work activity among either men or women. Men who participated in no sport were at increased risk for adenomas (odds ratio = 1.68; 95% CI = 0.93–3.02). Physical activity appears to protect against both colorectal cancer and colorectal adenomas.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Macrosomia (birthweight ≥4,500 gm) is associated with increased perinatal morbidity and mortality. Although past studies have evaluated risk factors for macrosomia, little is known about the effect of a prior macrosomic birth on the risk for a macrosomic infant in a subsequent birth. To assess the risk for delivery of a macrosomic infant subsequent to a previous macrosomic infant, we performed a population-based cohort study utilizing the Washington State linked infant birth file for 1984–1990. We identified 1,793 infants with birthweight ≥4,500 gm who were linked to a subsequent birth and 3,596 randomly selected infants with birthweight of < 4,500 gm also linked to a subsequent livebirth. We then compared the risks for subsequent macrosomic births between the two groups. Infants with birthweights ≥4,500 gm were 7.0 times more likely (95% confidence interval = 5.4–9.1) to have a subsequent macrosomic sibling than were infants with smaller birth-weights, after controlling for pregnancy smoking status, parity, and gestational age. Race, maternal age or marital status, and diabetes mellitus did not materially affect this relation. The overall prevalence of macrosomic infants subsequent to a previous macrosomic birth was 22%, a proportion that did not vary notably with parity, or when paternity changed between successive births. Mothers with one macrosomic infant are at markedly increased risk for repeat macrosomic births.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

We examined the association between self-rated risk of stroke or myocardial infarction and actual morbidity and mortality by gender among participants of the Pawtucket Heart Health Program Health Survey in a nested case-control study. We defined cases (N = 191) as survey participants who later had a cardiac event registered in the Pawtucket Heart Health Program cardiovascular disease morbidity and mortality surveillance system. We matched controls (N = 573) on age, sex, date of survey, and city of residence. Women reporting a high perceived risk of stroke or myocardial infarction were four times as likely as women who indicated low perceived risk tc have a future cardiovascular event [adjusted odds ratio = 4.0; 95% confidence interval (CI) = 1.5–10.3]. Men who perceived their risk as average were twice as likely as those who rated their risk as low to have a future myocardial infarction 01 stroke (adjusted odds ratio = 1.9; 95% CI = 1.0–3.6), whereas those who perceived their risk as high were at only slightly higher risk of morbid or mortal events (adjusted odds ratio = 1.8; 95% CI = 0.9–3.9).

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The relation between exposure to crystalline silica and lung cancer has been a controversial topic, and findings have appeared inconsistent. In this paper, we focus on lung cancer risks in epidemiologic studies of Silicotics. We abstracted data from 29 studies for quantitative evaluation. We identified several studies that suffered from biases due to competing risks of different causes of death—in particular, death due to silicosis itself. After adjustment for competing risks, all 29 studies demonstrated lung cancer relative risk (RR) estimates greater than one. The pooled RR estimate for the 23 studies that could be combined was 2.2, with a 95% confidence interval (CI) of 2.1–2.4. The pooled estimates by study design were 2.0 (95% CI = 1.8–2.3) for cohort studies and 2.5 (95% CI = 1.8–3.3) for case-control studies. The proportional mortality studies combined gave a summary RR of 2.0 (95% CI = 1.7–2.4), whereas the studies of cancer incidence gave a summary RR of 2.7 (95% CI = 2.3–3.2). Although statistical tests demonstrated heterogeneity between studies, and the confidence intervals given above may therefore be a little too narrow, the overall findings could not be attributed to chance, confounding by smoking, or other sources of bias. We conclude that the association between silicosis and lung cancer is causal, either due to silicosis itself, or due to a direct effect of the underlying exposure to silica.

ISSN:1044-3983    

出版商:OVID    

年代:1995

数据来源: OVID