ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

As part of a comprehensive study of residential magnetic field exposure in nine midwestern and mid-Atlantic states, we evaluated the use of appliances by 640 patients with acute lymphoblastic leukemia, 0–14 years of age, diagnosed between 1989 and 1993, and 640 matched control children. Mothers were interviewed regarding use of electrical appliances during their pregnancy with the subject and the child's postnatal use. The risk of acute lymphoblastic leukemia was elevated in children whose mothers reported use of an electric blanket or mattress pad during pregnancy [odds ratio (OR) = 1.59; 95% confidence interval (CI) = 1.11–2.29] but was reduced for use of sewing machines during pregnancy (OR = 0.76; 95% CI = 0.59–0.98). The risk of acute lymphoblastic leukemia was increased with children's use of electric blankets or mattress pads (OR = 2.75; 95% CI = 1.52–4.98) and three other electrical appliances (hair dryers, video machines in arcades, and video games connected to a television), but the patterns of risk for duration in years of use and frequency of use were inconsistent for most appliances used by children. Risks rose with increasing number of hours per day children spent watching television, but risks were similar regardless of the usual distance from the television. The inconsistency in the dose-response patterns for many appliances, reporting and selection bias, and the lack of an effect for measured 60 Hertz magnetic fields or wire codes in our companion study must be considered before ascribing these associations to exposures from magnetic fields. (Epidemiology 1998;9:234–245)

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

We examined the relation between Quetelet's body mass index (BMI) and age-adjusted mortality risk from specific diseases in a 26-year prospective cohort study of 12,576 non-Hispanic white women who had never smoked. To account for effects due to antecedent disease, we focused on women surviving 15–26 years after their report of body weight. High BMI (>27 kg per m2) decreased the risk of fatal respiratory disease (hazard ratios of 0.7 for ages 30–54 years and 0.6 for ages 55–74 years) but increased risk in all other disease categories. Low BMI (2) increased the risk of fatal respiratory disease (hazard ratios of 2.0 for ages 30–54 years and 1.4 for ages 55–74 years). Among middle-aged women (ages 30–54 years), we found that low BMI also increased the risk of certain fatal cardiovascular diseases (hazard ratios of 1.5 for cerebrovascular death and 2.5 for hypertensive and other cardiovascular deaths), but the increase in the risk of fatal cerebrovascular disease did not remain (hazard ratio of 0.4) after exclusion of subarachnoid and intraparenchymal hemorrhage deaths from the endpoint.Although the inverse relation between BMI and risk of fatal respiratory disease was also evident in the subset who reported body weight 17 years after baseline, further restriction of this subset to stable-weight women reporting no history of respiratory disease resulted in a U-shaped relation. Data from this subset also indicated that weight loss substantially increased the risk of fatal respiratory disease. These findings implicate high and low BMI as risk factors for fatal respiratory disease but suggest that the risk due to high BMI was obscured by weight loss that followed the onset of disease.The overall findings support an association between obesity and a higher risk of fatal disease but also raise the possibility that apparently healthy, never-smoking women can experience a higher long-term risk of fatal cardiovascular and respiratory diseases due to a lower body weight. (Epidemiology 1998;9:246–254)

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

We combined information on the temporal pattern of disease incidence for the 1993 cryptosporidiosis outbreak in Milwaukee with information on oocyst levels to obtain insight into the epidemic process. We constructed a dynamic process model of the epidemic with continuous population compartments using reasonable ranges for the possible distribution of the model parameters. We then explored which combinations of parameters were consistent with the observations. A poor fit of the March 1–22 portion of the time series suggested that a smaller outbreak occurred before the March 23 treatment failure, beginning sometime on or before March 1. This finding suggests that had surveillance systems detected the earlier outbreak, up to 85% of the cases might have been prevented. The same conclusion was obtained independent of the model by transforming the incidence time series data of Mac Kenzieet al.1This transformation is based on a background monthly incidence rate for watery diarrhea in the Milwaukee area of 0.5%.1Further analysis using the incidence data from the onset of the major outbreak, March 23, through the end of April, resulted in three inferred properties of the infection process: (1) the mean incubation period was likely to have been between 3 and 7 days; (2) there was a necessary concurrent increase inCryptosporidiumoocyst influent concentration and a decrease in treatment efficiency of the water; and (3) the variability of the dose-response function in the model did not appreciably affect the simulated outbreaks. (Epidemiology 1998;9:255–263)

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

The patterns of incidence and pathways of spread for cryptosporidiosis are poorly understood. In this study, we explored the possibility that drinking water caused significant water-borne cryptosporidiosis in Milwaukee well before the massive documented outbreak in April 1993. We generated time series of daily counts of emergency room visits and hospital admissions for gastroenteritis in Milwaukee using the billing records of the Medical College of Wisconsin for January 1, 1992, through May 3, 1993. The Milwaukee Water Works provided us with data on drinking water turbidity for the same period. The service area of the South Plant experienced a sharp rise in turbidity just before the outbreak. During the outbreak period, gastroenteritis events were most strongly associated with turbidity at a lag of 7 days in children and 8 days in adults. It is reasonable to conclude that these lag times reflect the incubation period ofCryptosporidium.During the 434 days before the outbreak, gastroenteritis events were most strongly associated with turbidity at a lag of 8 days among children and 9 days among adults in the service area of the North Plant, the plant that experienced the highest effluent turbidity during this period. These findings are consistent with the conclusion that waterborne cryptosporidiosis was occurring in Milwaukee for more than a year before the documented outbreak. (Epidemiology 1998;9:264–270)

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

In a cohort of women followed up for adolescent idiopathic scoliosis, we assessed the association between exposure to ionizing radiation from diagnostic radiography received in adolescence and subsequent adverse reproductive outcomes in adulthood. We estimated risk for unsuccessful attempts at pregnancy, spontaneous abortions, low birthweight (

ISSN:1044-3983    

出版商:OVID    

年代:1998

数据来源: OVID