ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

In 1976, an accident in a plant near Seveso, Italy, exposed the local population to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD). Persons residing in three zones of decreasing TCDD contamination (A, B, and R) and a reference population were followed up for cancer occurrence in 1977–1986. The most exposed subgroup (A) was small, and only 14 cancer cases were observed. In zone B, hepatobiliary cancer was elevated, especially for those living in the area for >5 years [relative risk (RR) = 2.8; 95% confidence interval (CI) = 1.2–6.31. Men exhibited an increase in hematologic neoplasms, most notably lymphoreticulosarcoma (RR = 5.7; 95% CI = 1.7–19.0). Women experienced an increased incidence of multiple myeloma (RR = 5.3; 95% CI = 1.2–22.6) and myeloid leukemia (RR = 3.7; 95% CI = 0.9–15.7). In zone R, the incidence of soft tissue tumors and non-Hodgkin's lymphomas was elevated, particularly among persons living in the area for >5 years (RR = 3.5; 95% CI = 1.2–10.4 for sarcomas, and RR = 2.0; 95% CI = 1.2–3.6 for non-Hodgkin's lymphomas). Breast cancer among females was below expectations in the most contaminated zones, and a clear deficit for endometrial cancer was observed in zones B and R. (Epidemiology 1993;4:398–406)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We examined the relation of stressful life events to the risk of colorectal cancer in a population-based case-control study conducted in Stockholm from 1986 to 1988. Completed questionnaires were available for 569 incident cases ascertained through hospital records and the regional cancer registry. Controls were randomly selected from a population register and were frequency matched to the age and sex distribution of the cases; 510 controls completed the study questionnaire. A history of serious work-related problems in the prior 10 years was strongly associated with the occurrence of colorectal cancer. Compared with those with no such problems, the age- and sex-adjusted odds ratio (OR) was 5.5 [95% confidence interval (CI) = 2.3–23.5]. Change of residence was also associated with increased risk: relative to those who had not moved, the OR was 2.8 (95% CI = 1.17.1). Similar analyses revealed gist increased odds of cal-orectal cancer were associated with death of a spouse: OR = 1.5 (95% CI = 1.0–2.3). After multivariate adjustment for dietary risk factors and physical activity, these ORs were not substantially altered. Because most of the events were relatively uncommon in this population, the estimates of effect were not precise. (Epidemiology 1993;4:407–414)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We investigated the effects of occasional alcohol binges on birth outcomes in a cohort of live singletons born to 709 moderate drinkers recruited from a Seattle, WA, health maintenance organization before their sixth month of pregnancy. We compared infants of women with one or more binges in the month-before pregnancy or in the first two trimesters with those whose mothers reported no binges in either period. Mean values of birthweight, length, head circumference, gestational age, intrauterine growth, andApgar scoresdid not differ notably between the two groups. The risk of having an adverse neonatal discharge diagnosis initially appeared lower in infants of binging mothers, but this difference vanished after recategorization of the variable and control for confounding. Our results indicate that occasional binges, during a broad window of exposure and among otherwise moderate drinkers, do not adversely affect the birth outcomes examined here. (Epidemiology 1993;4:415–420)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

An indirect method for estimating the prevalence rates of chronic diseases that are treated by specific drugs was proposed in 1988 to European countries in the framework of a European Community concerted action on diabetes epidemiology. Data on consumption of antidiabetic drugs were collected at the national level niine-countries and at a regional level in two. Using official drug sales data and recent demographic data, we estimated the diabetes prevalence rates in each country or region. The estimated diabetes prevalence in Europe varied from 1.6% in Northern Ireland to 4.7% in Malta. In four countries that already had diabetes prevalence data, the estimation through drug consumption provided figures 3–20% lower than those from field surveys. This study showed a large variety of prescribing habits for diabetic patients in Europe (for example, the proportion of insulin-treated patients varies from 13% to 36%) and underscores the need for a consensus on antidiabetic treatments based on valid clinical research. The proposed approach does not replace field surveys but provides an inexpensive and practical marker of disease frequency and therapeutic attitudes over space and time. (Epidemiology 1993;4:421–427)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

We extended a previous cohort study of workers at a metal components manufacturing facility, which found elevated rates of lung cancer and unspecified nonmalignant respiratory diseases, by evaluating mortality rates from 1950 to 1987 for 3,630 workers categorized according to potential exposures to metal dusts, cutting oils/fluids, metal fumes, and solvents. Lung cancer rates were elevated for workers with exposure to metal dusts and cutting oils/fluids [standardized mortality ratio (SMR) = 1.8; 95% confidence interval (CI) = 1.2–2.6]. We found that elevated mortality was restricted to those workers first exposed during 1950–1959 (SMR = 2.5; 95% CI = 1.6–3.7) and that mortality rates were similar for workers with exposure durations of

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

The accurate and timely detection of unusual patterns in data from public health surveillance systems presents an important challenge to health workers interested in early identification of epidemics or clues to important risk factors. We apply the Kalman filter, a Bayesian method, to public health surveillance data collected in the United States to—illustfate-a-methodology-used to detect sudden, sustained changes in reported disease occurrence, changes in the rate of change of health event occurrence, as well as unusual reports or outliers. The method allows use of information external to reported data in forecasting expected numbers, information such as expert judgment, changes in case definition or reporting practices, or changes in the health event process. Results show good agreement with epidemiologically established patterns beginning early in the data series and demonstrated usefulness on a relatively short series. Because the method is unfamiliar to most practicing epidemiologists in public health, it should be compared with—other techniques and made more “user-friendly” before general application. (Epidemiology 1993;4:435–443)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID

摘要:

It has been assumed that a younger age at initiation of cigarette smoking is associated with an increased risk of lung cancer, but previous studies have not adjusted for two strong risk factors, the amount smoked and duration smoked. We used data from a population-based case-control study with 282 histologically confirmed lung cancer cases matched to 3,282 random controls to determine whether age at initiation of smoking plays an independent role in the occurrence of lung cancer. After controlling for age, sex, and amount of tobacco exposure, men who began to smoke before age 20 had a substantially higher risk of developing lung cancer [odds ratio (OR) = 12.7; 95% confidence interval (CI) = 6.39–25.2] compared with men who began smoking at age 20 or older (OR = 6.03; 95% CI = 2.82–12.9). For women, the heavy increase in risk continued until age 25 (OR = 9.97; 95% CI = 4.68–21.2) compared with women who began smoking at age 26 or older (OR = 2.58; 95% CI = 0.5312.4). There was no predisposition toward a specific histologic type of lung cancer. In this study, up to 52.4% of lung cancer cases in men and up to 73.0% of lung cancer cases in women could be attributed to this effect of early age of first smoking. (Epidemiology 1993; 4:444–448)

ISSN:1044-3983    

出版商:OVID    

年代:1993

数据来源: OVID