ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The early-life environment and its effect on growth and maturation of children and adolescents are associated with several adult chronic diseases, including Alzheimer’s disease. Because it is not feasible to collect information prospectively over the average life span, methods to reconstruct the early-life environment of the aged are necessary to evaluate these associations. In a community-based case-control study conducted in the United States, we collected U.S. census records and birth certificates to reconstruct the early-life socioeconomic environment of each elderly subject. Information was found on 82% of the available Alzheimer’s disease cases (239 of 292) and 87% of the available controls (245 of 282). We investigated risk of Alzheimer’s disease associated with father’s occupation, parental age, household size, sibship size, and birth order. Subjects whose fathers were unskilled manual workers or laborers were at higher risk for Alzheimer’s disease (odds ratio = 1.80, 95% confidence interval = 1.19–2.73). The risk of Alzheimer’s disease was increased with increasing number of people in the household. We also evaluated whether subjects with the apolipoprotein ϵ4 allele (APOE ϵ4), a strong genetic risk factor that is not a necessary cause or a sufficient cause by itself for the development of Alzheimer’s disease, were at higher risk than subjects who did not carry this allele. Among subjects with the APOE ϵ4 allele whose fathers held lower-socioeconomic level occupations, the odds of developing Alzheimer’s disease were higher (odds ratio = 2.35, 95% confidence interval = 1.07–5.16) compared with subjects without the allele (odds ratio = 1.40, 95% confidence interval = 0.78–2.52). Subjects carrying the APOE ϵ4 allele alone have a threefold increased risk of Alzheimer’s disease (odds ratio = 3.17, 95% confidence interval = 1.99–5.04). Compared with subjects with neither risk factor, subjects with both the genetic and the environmental risk factors (household size of seven or more and father’s occupation being manual) had a relatively high risk of Alzheimer’s disease (odds ratio = 14.8, 95% confidence interval = 4.9–46). The data suggest that APOE ϵ4 may modify the associations between father’s occupation, other early-life environmental factors, and development of Alzheimer’s disease in late life.

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Moderate alcohol consumption protects against coronary heart disease, but there is ongoing debate about whether the effects and the underlying mechanisms differ by type of alcoholic beverage. In our case-control study from Germany, we assessed and compared the effect of alcohol consumption from various sources on risk of coronary heart disease and its underlying mechanisms. The sample included 312 patients with clinically stable, angiographically confirmed coronary heart disease and 479 healthy controls. After control for potential confounding factors, the odds ratio for coronary heart disease was 0.55 (95% confidence interval = 0.37–0.83) for drinkers compared with nondrinkers. Risk reduction was particularly strong among the majority of study participants who reported drinking predominantly or exclusively beer. Alcohol consumption from various sources was consistently associated with a more favorable profile of lipids and hemostatic factors. Nevertheless, a strong inverse association persisted between beer drinking and coronary heart disease even after control for these “intermediate variables.” Our results support suggestions that the protective effect of moderate alcohol consumption against coronary heart disease is mediated in part by beneficial effects of ethanol on lipids and hemostatic factors. Additional mechanisms may account for the strong protective effect of moderate beer consumption.

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

In this study, we attempted to reduce existing uncertainty about the relative risk of lung cancer from residential radon exposure among never-smokers. Comprehensive measurements of domestic radon were performed for 258 never-smoking lung cancer cases and 487 never-smoking controls from five Swedish case-control studies. With additional never-smokers from a previous case-control study of lung cancer and residential radon exposure in Sweden, a total of 436 never-smoking lung cancer cases diagnosed in Sweden between 1980 and 1995 and 1,649 never-smoking controls were included. The relative risks (with 95% confidence intervals in parentheses) of lung cancer in relation to categories of time-weighted average domestic radon concentration during three decades, delimited by cutpoints at 50, 80, and 140 Bq m−3, were 1.08 (0.8–1.5), 1.18 (0.9–1.6), and 1.44 (1.0–2.1), respectively, with average radon concentrations below 50 Bq m−3used as reference category and with adjustment for other risk factors. The data suggested that among never-smokers residential radon exposure may be more harmful for those exposed to environmental tobacco smoke. Overall, an excess relative risk of 10% per 100 Bq m−3average radon concentration was estimated, which is similar to the summary effect estimate for all subjects in the main residential radon studies to date.

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Silica exposure has been associated with kidney disease and rheumatoid arthritis; an autoimmune mechanism has been proposed. Approximately 2 million people are occupationally exposed to silica in the United States, 100,000 at more than twice the National Institute for Occupational Safety and Health recommended exposure limit of 0.05 mg/m3. We examined renal disease morbidity and mortality, as well as arthritis mortality, in a cohort of 4,626 silica-exposed workers in the industrial sand industry (an industry previously unstudied). We compared the cohort with the U.S. population and also conducted internal exposure-response analyses using a job-exposure matrix based on more than 4,000 industrial hygiene samples. We found excess mortality from acute renal disease [standardized mortality ratio (SMR) = 2.61, 95% confidence intervals (95% CIs) = 1.49–4.24; 16 deaths], chronic renal disease (SMR = 1.61, 95% CI = 1.13–2.22; 36 deaths), and arthritis (SMR = 4.36, 95% CI = 2.76–6.54; 23 deaths) on the basis of multiple-cause mortality data, which considered any mention of disease on a death certificate. Linking the cohort with the U.S. registry of end-stage renal disease for the years 1977–1996, we found an excess of end-stage renal disease incidence (standardized incidence ratio = 1.97, 95% CI = 1.25–2.96; 23 cases), which was highest for glomerulonephritis (standardized incidence ratio = 3.85, 95% CI = 1.55–7.93; 7 cases). We found increasing end-stage renal disease incidence with increasing cumulative exposure; standardized rate ratios by quartile of cumulative exposure were 1.00, 3.09, 5.22, and 7.79. A positive exposure-response trend was also observed for rheumatoid arthritis on the basis of death certificate data. These data represent the largest number of kidney disease cases analyzed to date in a cohort with well-defined silica exposure and suggest a causal link between silica and kidney disease. Excess risk of end-stage renal disease due to a lifetime of occupational exposure at currently recommended limits is estimated to be 14%, above a background end-stage renal disease risk of 2%.

ISSN:1044-3983    

出版商:OVID    

年代:2001

数据来源: OVID