Biomedical subjects

H I Hall

Publications and source records attributed to H I Hall.

16 recordsLinked to original sources

PubMed2001

Factors associated with sunburn in white children aged 6 months to 11 years.

OBJECTIVE: To determine the sunburn experience and factors associated with sunburn among white children aged 6 months to 11 years. METHODS: Telephone interviews were conducted with parents and primary caretakers of children, selected by random, stratified sampling, in the contiguous United States in the summer of 1998. Information was gathered on demographic characteristics of parents and children, and children's sunburn experience during the past year, protection from sun exposure, and hours per week spent outdoors. The proportion of children experiencing sunburn in the past year was calculated. Multivariate logistic regression analyses were conducted to determine factors associated with sunburn. Information for 1052 white children was available for the analyses. RESULTS: An estimated 42.6% of U.S. white children experienced one or more sunburns within the past year (95% CI 38.2-47.0). Sunburn was less common among children who ever wore hats (adjusted OR 0.59, 95% CI 0.40-0.87) and more common among children who did not always wear sunscreen (OR for using sunscreen sometimes compared with always, 2.25; 95% CI 1.31-3. 86). Sunburn was also more common among children with sun-sensitive skin and older children. CONCLUSIONS: A large proportion of U.S. white children experience sunburns. Parents and children may benefit from education about protection from sun exposure.

Age Distribution↗

PubMed2000

Breast and cervical carcinoma mortality among women in the Appalachian region of the U.S., 1976-1996.

BACKGROUND: Previous studies have shown high cervical carcinoma mortality and increasing breast carcinoma mortality in the Appalachian region of the U.S. (which includes parts of 12 states and all of West Virginia). In the current study the authors report trends in breast and cervical carcinoma death rates among women in Appalachia for 1976-1996. METHODS: Death rates were calculated from information provided on death certificates and reported to the National Center for Health Statistics for Appalachian women and for women living elsewhere in the U.S. ("other U.S. women"). Trends were examined with joinpoint regression techniques overall and by age and race. Average annual mortality rates were calculated by state for 1992-1996 for each state's Appalachian and non-Appalachian areas. RESULTS: Overall breast carcinoma mortality was lower among Appalachian women than among other U.S. women throughout the study period; however, after rates decreased among both groups in the 1990s, the difference appears to have narrowed. No such decline was observed for women age >/= 70 years. Overall cervical carcinoma mortality was higher among Appalachian women than among other U.S. women but decreased during the study period to rates closer to those for other U.S. women. No significant decrease was observed among women age < 50 years. Overall, for both black and white women, breast carcinoma mortality was lower and cervical carcinoma mortality higher among women in Appalachia compared with their counterparts elsewhere in the U.S. For both breast and cervical carcinoma, the average annual death rates (1992-1996) varied by geographic areas within the Appalachian states, but most differences were not significant. CONCLUSIONS: Analysis of mortality trends in breast and cervical carcinoma may provide guidance for prevention and control activities to reduce premature mortality from these diseases.

Adult↗

PubMed2000

Preventable risk factors for nasal cancer.

PURPOSE: To determine preventable risk factors for cancers of the nasal cavity and paranasal sinuses in the United States, we analyzed data from the population-based, case-control Selected Cancers Study. METHODS: Cases were men born between 1929 and 1953 who were diagnosed with primary nasal cancer between 1984 and 1988 and identified from population-based cancer registries; we narrowed the cohort to 70 subjects whose diagnosis of nasal cancer was confirmed by pathology review. All living controls interviewed for the Selected Cancers Study were included as the comparison group (n = 1910); they were recruited by random-digit dial telephone and were frequency-matched to the lymphoma cases of the Selected Cancers Study by geographic area and age. Both cases and controls were interviewed by telephone. RESULTS: Logistic regression analyses showed that cases were 2.5 times more likely than controls to have smoked cigarettes [95% confidence interval (CI) = 1.1-5.3], and 2.2 times more likely to have worked in selected occupations, including lawn care, forestry, and maintenance of highway right-of-way areas (CI = 1.2-3.7). These occupations may cause workers to be exposed to pesticides or herbicides. The population attributable risk (PAR) was 53% for having ever smoked cigarettes. CONCLUSIONS: The study results suggest that among U.S. men, some nasal cancer may be preventable by avoiding cigarette smoking.

Adenocarcinoma↗

PubMed1999

Stage of breast cancer in relation to body mass index and bra cup size.

Most studies on women with breast cancer indicate that obesity is positively associated with late-stage disease. Some results have shown a similar relationship between breast size and stage. A recent study found that the association between body mass index (BMI) and stage was limited to cancers that were self-detected, suggesting that the BMI-stage relation may be due to delayed symptom recognition. We examined the relationships between stage and both BMI and breast (bra cup) size, stratified by method of detection, using data from a population-based case-control study of 1,361 women (ages 20-44 years) diagnosed with breast cancer during 1990-1992. Height and weight measurements and information on bra cup size, method of cancer detection and other factors predictive of stage at diagnosis were collected during in-person interviews. A case-case comparison was conducted using logistic regression to estimate odds of regional or distant stage rather than local stage in relation to BMI and bra size. Odds of late-stage disease were increased with higher BMI [adjusted odds ratio (OR) for highest to lowest tertile = 1.46, 95% confidence interval (CI) 1.10-1.93] and larger bra cup size (OR for cup D vs. cup A = 1.61, 95% CI 1.04-2.48). These relationships were not modified by the method of detection. Differences in etiologic effects, rather than differences in detection methods, may explain the relations observed between stage and both BMI and breast size.

Adult↗

PubMed1999

Update on the incidence and mortality from melanoma in the United States.

BACKGROUND: Increases in the incidence of malignant melanoma have been among the largest of all cancers in the United States. OBJECTIVE: We report updated trends in melanoma rates among the US white population. METHODS: Incidence and mortality rates were calculated for 1973 to 1994. Trends were examined with stratification by state, age, and sex, and by anatomic site, stage, and melanoma thickness at diagnosis. RESULTS: Melanoma incidence and mortality rates increased dramatically from 1973 to 1994, rising 120.5% and 38.9%, respectively. In recent years, however, rates for most age-sex groups appeared to stabilize or even decline. Male patients continued to have higher incidence and mortality rates than female patients, but for both male and female patients the largest increases by site were for the trunk. A large proportion of melanomas were detected in the local stage and with a thickness less than 0.75 mm. CONCLUSION: Prevention of sun exposure is recommended to reverse the high incidence rates of melanoma.

Adult↗

PubMed1999

Risk of breast cancer in young women in relation to body size and weight gain in adolescence and early adulthood.

Findings have been inconsistent on effects of adolescent body size and adult weight gain on risk of breast cancer in young women. These relations were examined in a population-based case control study of 1590 women less than 45 years of age newly diagnosed with breast cancer during 1990-1992 in three areas of the US and an age-matched control group of 1390 women. Height and weight were measured at interview and participants asked to recall information about earlier body size. Logistic regression was used to estimate the relative risk of breast cancer adjusted for other risk factors. Women who were either much heavier or lighter than average in adolescence or at age 20 were at reduced risk. Weight gain after age 20 resulted in reduced risk, but the effect was confined to early-stage and, more specifically, lower grade breast cancer. Neither the risk reduction nor the variation by breast cancer stage or grade was explained by the method of cancer detection or by prior mammography history. These findings suggest that relations between breast cancer risk in young women and body weight at different ages is complex and that the risk reduction with adult weight gain is confined to less aggressive cancers.

Adolescent↗

PubMed1999

Sources of health insurance in the U.S.: analysis of state-level data and implications for public health programs.

Lack of health insurance coverage is associated with lack of accessibility to preventive health care services such as mammography screening, clinical breast examination, Papanicolaou smear test, digital rectal examination, proctoscopy examination, and cholesterol screening. State and federal public health agencies must have an understanding of insurance coverage of the population to plan intervention programs aimed at early detection of medical conditions. Using data from the March Supplement of the Current Population Survey for the years 1994, 1995, and 1996, this study examines the sources of health insurance coverage in the U.S. The implications of the findings for public health programs are discussed.

Adult↗

PubMed1999

Sun protection behaviors among African Americans.

The anatomic distribution of some skin cancers suggests that sun exposure may be an etiologic factor for skin cancer among African Americans. Yet little is known about sun protection behaviors among African Americans. We analyzed data from the 1992 National Health Interview Survey (N = 1,583) to determine the prevalence of sun protection behaviors and sun sensitivity. About 6% of African Americans reported being extremely sensitive to the sun and severe sunburning, and 9% reported mild burns. Overall, 53% of respondents (47% of men and 57% of women) reported that they were very likely to wear protective clothing, seek shade, or use sunscreen lotion. Women were more likely than men to report seeking shade and using sunscreen. Sun protection behaviors were more frequently reported by those who sunburn more easily and were positively associated with age. Use of sunscreen was positively associated with income and education. Education about sun protection and early detection may help reduce the morbidity and mortality of skin cancer among African Americans.

Adolescent↗

PubMed1996

Risk factors for hazardous substance releases that result in injuries and evacuations: data from 9 states.

This study was undertaken to determine risk factors associated with hazardous substance releases (at fixed facilities or during transport) that have public health consequences. Data from nine states with surveillance systems for such releases and their consequences were analyzed. Risk factors were determined for releases resulting in (1) injuries or (2) evacuations. Both outcomes were more likely to occur as a result of facility releases (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.44, 2.47, for injuries; OR = 3.29, 95% CI = 2.28, 4.74, for evacuations). Releases of ammonia, chlorine, and acids resulted in injuries and evacuations more frequently than releases of other substances.

Disaster Planning↗

PubMed1995

Health effects related to releases of hazardous substances on the Superfund priority list.

The Agency for Toxic Substances and Disease Registry maintains an active, state-based surveillance system to record the public health consequences of hazardous substance releases. During 1992, the 9 participating states reported 1,876 events; 80% of the events occurred at fixed facilities, and 20% were transportation related. The most frequently released substances were volatile organic compounds, acids, herbicides, and ammonia. In 263 events, 600 people were injured and 4 died. Employees were injured more frequently (71%) than first responders or the general public. The most frequently reported injuries were respiratory and eye irritation. Evacuations occurred in 13% of the events. These results provide information for preparedness planning and training of first responders and employees.

Accidents↗

PubMed1994

Surveillance for emergency events involving hazardous substances--United States, 1990-1992.

PROBLEM/CONDITION: A review of existing reporting systems indicated that not enough information was being collected to determine the public health consequences of emergency events involving hazardous substances. REPORTING PERIOD COVERED: January 1990 through December 1992. DESCRIPTION OF SYSTEM: State health departments in selected states collect and each quarter transmit information about the events, substances released, and the public health consequences of hazardous substance releases (i.e., morbidity, mortality, and evacuations) to the Agency for Toxic Substances and Disease Registry (ATSDR). Five state health departments (Colorado, Iowa, Michigan, New Hampshire, and Wisconsin) began data collection on January 1, 1990. On January 1, 1992, the reporting state health departments included those from Colorado, Iowa, New Hampshire, New York, North Carolina, Oregon, Rhode Island, Washington, and Wisconsin. RESULTS AND INTERPRETATION: During 1990-1992, 3,125 events were reported from participating states to ATSDR's Hazardous Substances Emergency Events Surveillance (HSEES) system. Of these events, 2,391 (77%) were fixed-facility events (i.e., occurred at stationary facilities), and 723 (23%) were transportation related. In 88% of events, a single chemical was released. The most frequently released hazardous substances were volatile organic compounds (18% of the total 4,034 substances released), herbicides (15%), acids (14%), and ammonias (11%). In 467 events (15% of all events), 1,446 persons were injured; 11 persons died as a result of these injuries. Respiratory irritation (37%) and eye irritation (23%) were the most frequently reported health effects. A total of 457 (15%) events resulted in evacuations; of these, 400 (88%) were ordered by an official (e.g., a police officer or firefighter).(ABSTRACT TRUNCATED AT 250 WORDS)

Emergencies↗

PubMed1994

Recall bias in disease status associated with perceived exposure to hazardous substances.

Recall bias was assessed in a study of cancers reported by persons living in a community with a hazardous waste treatment facility (A) and a control community (B). The self-reported cancers were verified against medical records and pathology reports. Of the 56 cancer cases reported, 43 were in community A and 13 were in community B. The difference in incorrect reporting of neoplasms between community A and community B was 12% for neoplasms and 23% for malignancies. Before verification, there was a borderline significant association (P = 0.049) between living in community A and all self-reported cancers [odds ratio (OR) 1.88, 95% confidence interval 0.99-3.57]. The verified data showed that ORs decreased with the increasing precision of diagnosis. The effect of misclassification on the OR was an inflation by 15% for neoplasms and by 31% for malignancies. The results demonstrate the importance of verifying reported cases of disease, even a disease as well defined as cancer.

Adolescent↗

PubMedDate not supplied

Cluster: a software system for epidemiologic cluster analysis.

A software package for cluster analysis was developed that incorporates 12 methods to analyse residence and time data, and morbidity or mortality rates. The Knox, Barton, Chen and Ohno methods of the software are illustrated with data for 123 cancer cases reported by a citizen requesting a cluster investigation. Longitude and latitude for each address were assigned by a geographic information system for analyses with the Barton (p > 0.05) and Knox methods (p > 0.05). The data were also analysed for time of the event with the Chen method, comparing the observed incidence to expected county disease rates (p = 0.61), and for temporal patterns within the geographically defined population with the Ohno method (p >0.05). It was concluded that no statistically significant disease cluster existed.

Adolescent↗

PubMedDate not supplied

Sun protection behaviors of the U.S. white population.

BACKGROUND: Sun protection behaviors are recommended to prevent skin cancer, which has increased in incidence. This study measured the prevalence of sun protection behaviors and determined personal characteristics associated with them. METHODS: Data from 10,048 white respondents to the 1992 National Health Interview Survey Cancer Control Supplement were analyzed. Multiple logistic regression models were constructed to relate personal characteristics to specific behaviors. RESULTS: Fifty-three percent of respondents reported they were "very likely" to use sunscreen, wear protective clothing, or seek shade if they were outside on a sunny day for more than 1 hr. Proportions for the individual behaviors were 32, 28, and 30%, respectively. Compared with people who do not burn, those reporting severe sunburn after 1 hr of sun exposure reported more use of sunscreens (odds ratio [OR] = 2.4, 95% confidence interval [CI] 2.0, 2.9), shade (OR = 1.8, 95% CI 1.5, 2.1), and protective clothing (OR = 2.2, 95% CI 1.9, 2.7). Other factors associated with practicing protection behaviors included a personal history of skin cancer, older age, and female sex. CONCLUSIONS: A large percentage of white U.S. adults did not protect themselves from sun exposure. Additional education of the general public and persons at higher risk for skin cancer is needed.

Adolescent↗

PubMedDate not supplied

Surveillance of hazardous substance releases and related health effects.

The public health consequences of hazardous substance releases have not been characterized adequately. In response, therefore, the Agency for Toxic Substances and Disease Registry implemented an active, state-based surveillance system. Information is collected with respect to the events, chemicals, victims, injuries, and evacuations. Five states reported 1,249 events during 1990 and 1991. Seventy-two percent of the events occurred at fixed facilities, and 28% of the events were transportation related. In 80% of the events, one chemical was released. The most frequently released chemicals were herbicides, acids, volatile organic compounds, and ammonias. In 204 events, 846 persons were injured and 7 died. Employees were injured more frequently than first responders or the general public. The most frequently reported injuries were respiratory irritation and eye irritation. Evacuations occurred in 14% of the events. These results provide information for preparedness planning and training of first responders and employees.

Adult↗

PubMedDate not supplied

Public health consequences of hazardous substance releases.

Information collected on events and public health consequences can indicate trends in temporal and spatial distribution, chemical releases, and morbidity and mortality of emergency events. This knowledge will be useful in training first responders, planning preparedness for such events, and formulation of guidelines and policies. The impact of such training or policies should reduce both the number of events (primary prevention) and the morbidity and mortality associated with these events (secondary prevention). HSEES is the first comprehensive, state-based surveillance system of hazardous substance releases and public health consequences. Successful implementation of the system requires an active, state-based approach that uses multiple data sources and collects information in a consistent format. Good working relationships between agencies are of paramount importance for obtaining notification about events and information for the lengthy data-collection form. The system is more sensitive in recording hazardous substance releases than any existing single national database, as shown through quality-control evaluations in which HSEES data are compared with events reported to other databases. Consistency in data reporting is further evaluated by case studies sent to states on a regular basis. The five states that participated during the first 2 years of surveillance were not randomly selected. However, with additional states participating in HSEES, the representativeness of surveillance data will improve for making national estimates.

Cohort Studies↗