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D E Abbey

Publications and source records attributed to D E Abbey.

At least 19 recordsLinked to original sources

Long-term ambient ozone concentration and the incidence of asthma in nonsmoking adults: the AHSMOG Study.

We conducted a prospective study of a cohort of 3091 nonsmokers, ages 27 to 87 years, to evaluate the association between long-term ambient ozone exposure and development of adult-onset asthma. Over a 15-year period, 3.2% of males and 4.3% of females reported new doctor diagnoses of asthma. For males, we observed a significant relationship between report of doctor diagnosis of asthma and 20-year mean 8-h average ambient ozone concentration (relative risk (RR)=2.09 for a 27 ppb increase in ozone concentration, 95% CI=1.03 to 4.16). We observed no such relationship for females. Other variables significantly related to development of asthma were a history of ever-smoking for males (RR=2.37, 95% CI=1.13 to 4.81), and for females, number of years worked with a smoker (RR=1.21 for a 7-year increment, 95% CI=1.04 to 1.39), age (RR=0.61 for a 16-year increment, 95% CI=0.44 to 0.84), and a history of childhood pneumonia or bronchitis (RR=2.96, 95% CI=1.68 to 5.03). Addition of other pollutants (PM10, SO4, NO2, and SO2) to the models did not diminish the relationship between ozone and asthma for males. These data suggest that long-term exposure to ambient ozone is associated with development of asthma in adult males.

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Long-term inhalable particles and other air pollutants related to mortality in nonsmokers.

Long-term ambient concentrations of inhalable particles less than 10 microm in diameter (PM10) (1973- 1992) and other air pollutants-total suspended sulfates, sulfur dioxide, ozone (O3), and nitrogen dioxide-were related to 1977-1992 mortality in a cohort of 6,338 nonsmoking California Seventh-day Adventists. In both sexes, PM10 showed a strong association with mortality for any mention of nonmalignant respiratory disease on the death certificate, adjusting for a wide range of potentially confounding factors, including occupational and indoor sources of air pollutants. The adjusted relative risk (RR) for this cause of death as associated with an interquartile range (IQR) difference of 43 d/yr when PM10 exceeded 100 microg/m3 was 1.18 (95% confidence interval [CI]: 1.02, 1.36). In males, PM10 showed a strong association with lung cancer deaths-RR for an IQR was 2.38 (95% CI: 1.42, 3.97). Ozone showed an even stronger association with lung cancer mortality for males with an RR of 4.19 (95% CI: 1.81, 9.69) for the IQR difference of 551 h/yr when O3 exceeded 100 parts per billion. Sulfur dioxide showed strong associations with lung cancer mortality for both sexes. Other pollutants showed weak or no association with mortality.

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Respiratory symptoms and pulmonary function in an elderly nonsmoking population.

OBJECTIVE: To examine risk factors for chronic airway disease (CAD) in elderly nonsmokers, as determined by pulmonary function tests (PFTs), and to correlate reported respiratory symptoms with PFT measures. DESIGN: An observational survey. SETTING: Several communities in California. MEASUREMENTS: Exposures and respiratory history were assessed by standardized questionnaire. PFTs were performed and prediction equations derived. RESULTS: Significant risk factors for obstruction on PFTs in multiple logistic regression included reported environmental tobacco smoke (ETS) exposure (relative risk [RR]=1.44), parental CAD or hay fever (RR=1.47), history of childhood respiratory illness (RR=2.15), increasing age, and male sex. The number of years of past smoking was of borderline significance (RR=1.29 for 10 years of smoking; p=0.06). The prevalence of obstruction on PFTs was 24.9% in those with definite symptomatic CAD, compared with 7.5% in those with no symptoms of CAD. The prevalence of obstruction was 36.0% among those with asthma and 70.6% among those with emphysema. Also, symptomatic CAD correlated with reduction in lung function by analysis of covariance. The mean percent predicted FEV1 adjusted for covariates was 90.6% in persons with definite symptoms of CAD, compared with 97.8% in those without it (p < 0.001). CONCLUSIONS: Age, sex, parental history, childhood respiratory illness, and reported ETS exposures were significant risk factors for obstruction on PFTs. Self-reported respiratory symptoms also correlated significantly with PFTs.

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Spirometric reference equations for older adults.

The objective of this study was to develop spirometric reference equations for healthy, never-smoking, older adults. It was designed as a cross-sectional observational study consisting of 1510 Seventh Day Adventists, ages 43-79 years enrolled in a study of health effects of air pollutants. Individuals were excluded from the reference group (n = 565) for a history of current respiratory illness, smoking, or chronic respiratory disease, and for a number of 'non-respiratory' conditions which were observed in these data to be related to lower values of FEV1. Gender-specific reference equations were developed for the entire reference group and for a subset above 65 years of age (n = 312). Controlling for height and age, lung function was found to be positively related to the difference between armspan and height, and in males was found to be quadratically related to age. The predicted values for this population generally fell within the range of those of other population groups containing large numbers of adults over the age of 65 years. Individuals with lung function below the 5th percentile in this sample, however, could not be reliably identified by using the lower limits of normal predictions commonly used in North America and Europe.

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Long-term particulate and other air pollutants and lung function in nonsmokers.

The associations between lung function measures (spirometry and peak expiratory flow lability) and estimated 20-yr ambient concentrations of respirable particles, suspended sulfates, sulfur dioxide, ozone, and indoor particles were studied in a sample of 1,391 nonsmokers followed since 1977. Differences in air pollutants across the population were associated with decrements of lung function. An increase of 54 d/yr when particles < 10 micro(m) in diameter (PM10) exceeded 100 microg/m3 was associated with a 7.2% decrement in FEV1, as percent of predicted, in males whose parents had asthma, bronchitis, emphysema, or hay fever and with increased peak expiratory flow lability of 0.8% for all females and 0.6% for all males. An increase in mean SO4 concentration of 1.6 microg/m3 was associated with a 1.5% decrement in FEV1, as percent of predicted, in all males. An increase of 23 ppb of ozone as an 8-h average was associated with a 6.3% decrement in FEV1, as percent of predicted, in males whose parents had asthma, bronchitis, emphysema, or hay fever.

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Long-term concentrations of ambient air pollutants and incident lung cancer in California adults: results from the AHSMOG study.Adventist Health Study on Smog.

The purpose of this study was to evaluate the relationship of long-term concentrations of ambient air pollutants and risk of incident lung cancer in nonsmoking California adults. A cohort study of 6,338 nonsmoking, non-Hispanic, white Californian adults, ages 27-95, was followed from 1977 to 1992 for newly diagnosed cancers. Monthly ambient air pollution data were interpolated to zip code centroids according to home and work location histories, cumulated, and then averaged over time. The increased relative risk (RR) of incident lung cancer in males associated with an interquartile range (IQR) increase in 100 ppb ozone (O3) was 3.56 [95% confidence interval (CI), 1.35-9.42]. Incident lung cancer in males was also positively associated with IQR increases for mean concentrations of particulate matter <10 microm (PM10; RR = 5.21; CI, 1.94-13.99) and SO2 (RR = 2.66; CI, 1.62-4.39). For females, incident lung cancer was positively associated with IQR increases for SO2 (RR = 2.14; CI, 1.36-3.37) and IQR increases for PM10 exceedance frequencies of 50 microg/m3 (RR = 1.21; CI, 0.55-2.66) and 60 microg/m3 (RR = 1.25; CI, 0.57-2.71). Increased risks of incident lung cancer were associated with elevated long-term ambient concentrations of PM10 and SO2 in both genders and with O3 in males. The gender differences for the O3 and PM10 results appeared to be partially due to gender differences in exposure.

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Peak flow lability: association with asthma and spirometry in an older cohort.

OBJECTIVE: To determine the success rate and correlates of ambulatory peak expiratory flow (PEF) monitoring in an epidemiologic study. DESIGN: An observational survey. SETTING: Several communities in California. PARTICIPANTS: We studied 1,223 nonsmoking men and women (mean age, 66 years) from an established cohort. OUTCOME MEASURES: A standard respiratory symptoms and diagnoses questionnaire, spirometry before and after bronchodilator, and a diary of PEF recorded four times per day for 7 days at home. RESULTS: A physician diagnosis of asthma was reported in 8.6% of the women and 9.4% of the men. Of those who agreed to complete PEF diaries at home, 87% successfully provided a valid measure of PEF lability. The mean PEF lability from those with asthma was significantly higher than the others (12.0% vs 8.9% in women and 10.2% vs 8.1% in men). Independent correlates of higher PEF lability included asthma, wheezing symptoms, airways obstruction by spirometry, older age, and male gender. CONCLUSIONS: Middle-aged and elderly persons are largely successful at providing a measure of PEF lability at home. In nonsmoking adults living in California, increased PEF lability is correlated with asthma, wheezing, airways obstruction, and older age, validating its use in epidemiology studies as an index of airways hyperreactivity.

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Validity of selected physical activity questions in white Seventh-day Adventists and non-Adventists.

The validity and reliability of selected physical activity questions were assessed in both Seventh-day Adventist (N = 131) and non-Adventist (N = 101) study groups. Vigorous activity questions similar to those used by others and new questions that measured moderate and light activities were included. Validation was external, comparing questionnaire data with treadmill exercise time, resting heart rate, and body mass index (kg.m-2), and internal, comparing data with other similar questions. Both Adventist and non-Adventist males showed significant age-adjusted correlations between treadmill time and a "Run-Walk-Jog Index" (R = 0.28, R = 0.48, respectively). These correlations increased substantially when restricting analysis to exercise speeds exceeding 3 mph (R = 0.39, R = 0.71, respectively). Frequency of sweating and a vigorous physical activity index also correlated significantly with treadmill time in males. Correlations were generally weaker in females. Moderate- and light-intensity questions were not correlated with physical fitness. Internal correlations R = 0.50-0.78) between the above three vigorous activity questions were significant in all groups, and correlations (R = 0.14-0.60) for light and moderate activity questions were also documented. Test-retest reliability coefficients were high for vigorous activity questions (R = 0.48-0.85) and for one set of moderate activity questions (R = 0.43-0.75). No important differences in validity and reliability were found between Adventist and non-Adventists, but the validity of vigorous activity measures was generally weaker in females.

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Passive smoking and chronic respiratory disease symptoms in non-smoking adults.

A prospective study was conducted to investigate the possible effects of environmental tobacco smoke (ETS) on the development of definite symptoms of airway obstructive disease (AOD) in a non-smoking adult population. In all 3914 subjects completed a standardized respiratory symptoms questionnaire in 1977 and 1987 and a computerized algorithm was used to identify new cases of definite symptoms of AOD during the follow-up period. In multivariate logistic regression models which adjusted for age, gender, income, educational level, years smoked in the past, and concentrations of ambient air pollutants, ETS exposure during childhood only was associated with a relative risk (RR) of 1.09 (95% confidence interval [CI]: 0.69-1.79), during adulthood only with an RR of 1.28 (95% CI: 0.90-1.79), and during both childhood and adult life with an RR of 1.72 (95% CI: 1.31-2.23). Results were not significantly changed when only lifetime never-smokers were used in analyses, and no interaction between ETS exposure and concentrations of ambient air pollutants was observed.

Air Pollution↗

Asthma related to occupational and ambient air pollutants in nonsmokers.

We attempted to determine the association between occupational and air pollutant exposure with the development of adult asthma through the analysis of a standardized respiratory questionnaire administered to a cohort of 3914 nonsmoking adults in 1977 and again in 1987. Ambient air pollution concentrations were estimated over a 20-year period using monthly interpolations from fixed-site monitoring stations applied to zip code locations by month of residence and work site. Second-hand smoke exposure was significantly associated with the development of asthma (related risk [RR] = 1.45, confidence interval [CI] = 1.21 to 1.75). Airways obstructive disease before age 16 was related to a marked increased risk (RR = 4.24, CI = 4.03 to 4.45). An increased risk of asthma was significantly associated with increased ambient concentrations of ozone exposure in men (RR = 3.12, CI = 1.61 to 5.85).

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Chronic respiratory disease associated with long-term ambient concentrations of sulfates and other air pollutants.

Seventh-day Adventist (SDA) non-smokers who had resided since 1966 within five miles of their 1977 residence (n = 3914) completed a standardized respiratory symptoms questionnaire in 1977 and again in 1987. For each participant, cumulative ambient concentrations from 1977 to 1987 of suspended sulfates (SO4) in excess of several cutoffs as well as mean concentrations were estimated by interpolating monthly ambient concentration statistics from state air monitoring stations to the individual's residential and workplace zip codes. There were significant associations between ambient concentrations of suspended sulfates and development of new cases of asthma, but not new cases of overall airway obstructive disease (AOD) or chronic bronchitis. Comparison of previous analyses, in this population, of respiratory disease symptoms and total suspended particulates (TSP), ozone, and sulfur dioxide (SO2), and multipollutant analyses of these pollutants with SO4, indicated these results were not due to a surrogate relationship with other air pollutants. Development of definite symptoms of AOD and chronic bronchitis was most strongly related to TSP.

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A prospective study of risk for peptic ulcer disease in Seventh-Day Adventists.

Cross-sectional and prospective data were collected and analyzed to identify risk factors for the development of peptic ulcer disease in a population of 34,198 white, non-Hispanic Seventh-Day Adventists. On a life-style questionnaire administered in 1976, 3853 subjects reported ever having had a physician-diagnosed peptic ulcer for a lifetime prevalence of 13.5% for men and 11.0% for women. Odds ratios of greater than 2.0 (P less than 0.0001) were observed for use of "stronger pain relievers," current cigarette smoking, and history of rheumatism or other arthritis and coronary disease. For both sexes, lower but statistically significant odds ratios (P less than 0.05) were found for eating white bread, "snacking," ever having smoked cigarettes, low church involvement, poor dietary adherence, high blood pressure, rheumatoid arthritis, aspirin use, job frustration and dissatisfaction, having a "blue collar household," and having less education. During 3 years of follow-up, 154 incident cases of ulcer were identified. The average annual incidence was 1.7 per 1000. Multivariate adjusted relative risks were statistically significant for using stronger pain relievers (P less than 0.001), having rheumatic conditions (P = 0.006), and using aspirin (P = 0.013). These findings suggest that rheumatic disease and use of aspirin and stronger pain relievers are more important risk factors for development of peptic ulcer disease in certain populations than diet, life-style, or psychological or socioeconomic characteristics.

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Long-term ambient concentrations of total suspended particulates and oxidants as related to incidence of chronic disease in California Seventh-Day Adventists.

Cancer incidence and mortality in a cohort of 6000 nonsmoking California Seventh-Day Adventists were monitored for a 6-year period, and relationships with long-term cumulative ambient air pollution were observed. Total suspended particulates (TSP) and ozone were measured in terms of numbers of hours in excess of several threshold levels corresponding to national standards as well as mean concentration. For all malignant neoplasms among females, risk increased with increasing exceedance frequencies of all thresholds of TSP except the lowest one, and those increased risks were highly statistically significant. For respiratory cancers, increased risk was associated with only one threshold of ozone, and this result was of borderline significance. Respiratory disease symptoms were assessed in 1977 and again in 1987 using the National Heart, Lung and Blood Institute respiratory symptoms questionnaire on a subcohort of 3914 individuals. Multivariate analyses which adjusted for past and passive smoking and occupational exposures indicated statistically significantly (p less than 0.05) elevated relative risks ranging up to 1.7 for incidence of asthma, definite symptoms of airway obstructive disease, and chronic bronchitis with TSP in excess of all thresholds except the lowest one but not for any thresholds of ozone. A trend association (p = 0.056) was noted between the threshold of 10 pphm ozone and incidence of asthma. These results are presented within the context of standards setting for these constituents of air pollution.

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The effect of chronic aspirin use on duodenal and gastric ulcer hospitalizations.

Aspirin is commonly accepted as a risk factor for gastric ulcer; however, there is little published evidence linking aspirin consumption to duodenal ulcer. The effect of 1 g of aspirin per day on site-specific ulcer hospitalizations was examined using data from a 3-year randomized, double-blind, placebo-controlled trial of 4,524 subjects (Aspirin Myocardial Infarction Study). There were 23 duodenal ulcer and 14 gastric ulcer hospitalizations during the follow-up period. All but two were verified by endoscopy, radiogram, or biopsy/surgery. For males, a Cox-model survival analysis showed that the age- and smoking-adjusted relative risk for duodenal ulcer hospitalization was 10.7 times higher for the aspirin group than for the placebo group (95% confidence interval, 2.5 to 45.5; p less than 0.0001). The adjusted relative risk for gastric ulcer was 9.1 (95% confidence interval, 1.2 to 71.4; p = 0.04). Due to the small number of females in the study, the relationship between site-specific ulcer and aspirin consumption for females was not analyzed. However, for males and females combined, the age-, smoking-, and sex-adjusted relative risk for peptic ulcer hospitalization was 7.7 (95% confidence interval, 2.7 to 21.7; p less than 0.0001). We conclude that chronic aspirin use is a risk factor for hospitalization for both duodenal and gastric ulcer in males, and for peptic ulcer in males and females.

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Applications of a method for setting air quality standards based on epidemiological data.

A method for setting air quality standards for long-term cumulative exposures of a population based on epidemiological studies has been developed. It uses exposure estimates interpolated from monitoring stations to zip code centroids, each month applied to zip code by month residence histories of the population. Two alternative cumulative exposure indices are used--hours in excess of a threshold, and the sum of concentrations above a threshold. The indices are then used with multiple logistic regression models for the health outcome data to form dose response curves for relative risk, adjusting for covariates. These curves are useful for determination of at what exposure amounts and threshold levels, effects which have both statistical and public health significance begin to occur. The method is applied to a ten year follow-up of a sub cohort of 7,343 members of the National Cancer Institute-funded Adventist Health Study. Up to 20 years of residence history was available. Analysis for prevalence of symptoms was conducted for four air pollutants--total oxidants, sulfur dioxide, nitrogen dioxide, and total suspended particulates. For each pollutant, cumulated exposures were calculated above each of five different thresholds. Statistically significant effects were noted for total suspended particulates, total oxidants, sulfur dioxide, past and passive smoking.

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Dietary habits and past medical history as related to fatal pancreas cancer risk among Adventists.

Epidemiologic studies of diet and pancreas cancer are few, and include ecologic comparisons and a limited number of prospective and case-control studies. Foods and/or nutrients that have been suggested to be associated with increased risk of this cancer include total fat intake, eggs, animal protein, sugar, meat, coffee and butter. Consumption of raw fruits and vegetables has been consistently associated with decreased risk. Dietary habits and medical history variables were evaluated in a prospective study of fatal pancreas cancer among 34,000 California Seventh-day Adventists between 1976 and 1983. Forty deaths from pancreas cancer occurred during the follow-up period. Compared to all US whites, Adventists experienced decreased risk from pancreas cancer death (standardized mortality ratio [SMR] = 72 for men; 90 for women), which was not statistically significant. Although there was a suggestive relationship between increasing meat, egg, and coffee consumption and increased pancreatic cancer risk, these variables were not significantly related to risk after controlling for cigarette smoking. However, increasing consumption of vegetarian protein products, beans, lentils, and peas as well as dried fruit was associated with highly significant protective relationships to pancreas cancer risk. A prior history of diabetes was associated with increased risk of subsequent fatal pancreas cancer, as was a history of surgery for peptic or duodenal ulcer. A history of tonsillectomy was associated with a slight, nonsignificant protective relationship as was history of various allergic reactions. These findings suggest that the protective relationships associated with frequent consumption of vegetables and fruits high in protease-inhibitor content are more important than any increase in pancreas cancer risk attendant on frequent consumption of meat or other animal products. Furthermore, the previously reported positive associations between diabetes and abdominal surgery and pancreas cancer risk are supported in these data.

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