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H Dolk

Publications and source records attributed to H Dolk.

58 records · Page 4Linked to original sources
PubMed1988

[Epidemiologic surveillance of congenital abnormalities using the EUROCAT Register].

The EUROCAT programme is a concerted action of the European Economic Community for the epidemiologic surveillance of congenital anomalies. Surveillance is based on a network of regional registries coordinated by a central registry. The programme started in 1979 and by 1987, 23 centres were participating, covering together more than 300,000 births per year. The surveillance process implies the selection of the anomalies possibly associated with environmental teratogens or mutagens, the definition of abnormal variations in the rate of these anomalies (the alarms), the establishment of base-line rate and the continuous monitoring of rate. The programme is evaluated by reference to four criteria: the sensitivity of the system in detecting teratogens or mutagens, the specificity of alarms, the rapidity in warning of alarm and in investigating their causes, and the programme efficiency expressed as its cost-utility ratio.

Congenital Abnormalities↗
PubMedDate not supplied

Perinatal and infant mortality and low birth weight among residents near cokeworks in Great Britain.

With growing evidence of the adverse health effects of air pollution--especially fine particulates--investigators must concentrate on the fetus, neonate, and infant as potentially vulnerable groups. Cokeworks are a major source of smoke and sulfur dioxide. In the current study, the authors investigated whether populations residing near cokeworks had a higher risk of adverse perinatal and infant outcomes. Zones of 7.5-km radius around 22 cokeworks in Great Britain were studied, within which the authors assumed that exposure declined from highest levels within 2 km to background levels. Routinely recorded birth and death data for Great Britain during the period 1981-1992 were analyzed. Each individual record had a postcode that referred to a small geographical area of typically 15-17 addresses. The authors calculated expected numbers on the basis of regional rates, stratified by year, sex, and a small-area socioeconomic deprivation score. For all cokeworks combined, the observed/expected ratio (95% confidence intervals within parentheses) within 2 km of cokeworks was 1.00 (0.95, 1.06) for low-birth-weight (i.e., < 2,500 g) infants; 0.94 (0.78, 1.12) for still births; 0.95 (0.83, 1.09) for infant mortality; 0.86 (0.72, 1.03) for neonatal mortality; 1.10 (0.90, 1.33) for postneonatal mortality; 0.79 (0.30, 1.46) for respiratory postneonatal mortality; and 1.07 (0.77, 1.43) for postneonatal Sudden Infant Death Syndrome. Respiratory postneonatal mortality was low throughout the entire 0-7.5-km study area (observed/expected = 0.74 [0.61, 0.88]). There was no statistically significant decline in risk with distance from cokeworks for any of the outcomes studied. The authors concluded that there was no evidence of an increased risk of low birth weight, stillbirths, and/or neonatal mortality near cokeworks, and there was no strong evidence for any association between residence near cokeworks and postneonatal mortality. One must remember, however, the limited statistical power of the study to detect small risks.

Air Pollutants↗
PubMedDate not supplied

Local research ethics committees' approval in a national population study.

BACKGROUND: Epidemiological research using patient records faces considerable uncertainty regarding requirements for local ethical review, confidentiality of data and patient permission. SETTING AND DESIGN: We report the experiences of the national study of clustering and geographical variation in anophthalmos and microphthalmos, which, from 1994, has been compiling a register of affected children born in England since 1988. The information is obtained from clinicians and local health authority records without any direct contact with patients or their families. RESULTS: Of 110 district health authorities, 47 required ethical approval. Only one committee accepted the approval of any other committee. Procedures and application forms varied widely. Fewer than one-fifth of the forms completed asked about compliance with the Data Protection Act, yet confidentiality safeguards must be the foremost ethical issue faced by the study. Two committees required that the study inform GPs and two committees required that the study obtain parental permission. DISCUSSION: While new mechanisms including regional committees are being established, there is an urgent need for a standard application form to save time and resources for research. Continuing lack of consistency about the need for subject (parental) permission impedes the proper design and costing of research.

Anophthalmos↗