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Biomedical subjects

Hajo Zeeb

Publications and source records attributed to Hajo Zeeb.

11 recordsLinked to original sources
PubMed2006

Albinism in Africa as a public health issue.

BACKGROUND: Oculocutaneous albinism (OCA) is a genetically inherited autosomal recessive condition and OCA2, tyrosine-positive albinism, is the most prevalent type found throughout Africa. Due to the lack of melanin, people with albinism are more susceptible to the harmful effects of ultraviolet radiation exposure. This population must deal with issues such as photophobia, decreased visual acuity, extreme sun sensitivity and skin cancer. People with albinism also face social discrimination as a result of their difference in appearance. The World Health Organization is currently investigating the issues concerning this vulnerable population. METHODS: Systematic electronic search of articles in PubMed concerning albinism in Africa. Furthermore, a World Health Organization (WHO) pilot survey of albinism was drafted in English, French and Portuguese, and distributed to African countries through WHO African Regional Offices (AFRO) in an attempt to gather further information on albinism. RESULTS: Epidemiologic data on albinism, such as prevalence, were available for South Africa, Zimbabwe, Tanzania and Nigeria. Prevalences as high as 1 in 1,000 were reported for selected populations in Zimbabwe and other specific ethnic groups in Southern Africa. An overall estimate of albinism prevalences ranges from 1/5,000-1/15,000. In addition, both the literature review and the survey underscored the medical and social issues facing people with albinism. CONCLUSION: The estimated prevalence of albinism suggests the existence of tens of thousands of people living with albinism in Africa. This finding reiterates the need for increased awareness of and public health interventions for albinism in order to better address the medical, psychological and social needs of this vulnerable population.

Africa↗
PubMed2006

Causes of death in obesity: relevant increase in cardiovascular but not in all-cancer mortality.

BACKGROUND AND OBJECTIVE: To assess the relation between body mass index (BMI) and the risk of death from various causes in a prospective cohort study. METHODS: In 6,192 obese patients (BMI > or =25 kg/m(2)) with mean BMI 36.6 kg/m(2) (SD 6.1) and mean age 40.4 years (SD 12.9) who had been referred to the obesity clinic of the Heinrich-Heine-University Düsseldorf, Germany, between 1961 and 1994, there were 1,058 deaths from all causes during a median follow-up time of 14.8 years. We calculated standardized mortality ratios (SMRs) with 95% confidence intervals (CIs) for death from predefined groups of diseases by using Germany as reference population. RESULTS: In both sexes, risk of death from cardiovascular diseases (men: SMR = 2.2, CI 1.9-2.5; women: SMR = 1.6, CI 1.5-1.8), from diabetes (men: SMR = 5.4, CI 3.2-8.7; women: SMR = 3.5, CI 2.6-4.8), and in men from digestive diseases (SMR = 1.6, CI 1.01-2.3) was significantly increased. In contrast to other studies, an association between obesity and all-cancer mortality could not be found. Only in morbidly obese women (BMI > or =40 kg/m(2)), all-cancer mortality was significantly increased (SMR = 1.5, CI 1.1-1.9). CONCLUSION: Obesity is associated with increased risk of death from cardiovascular diseases and diabetes in both sexes, and from diseases of the digestive system in men.

Adolescent↗
PubMed2006

Medical exposure of the population from diagnostic use of ionizing radiation in luxembourg between 1994 and 2002.

A national evaluation on radiation doses from diagnostic procedures (x rays and nuclear medicine) was conducted in Luxembourg for the period 1994-2002 aiming at the estimation of the annual collective dose. The calculations were based on a survey of frequencies of more than 250 types of radiological examinations and included more than 425,000 patients. This evaluation ensured the practical implementation of Article 12 of the European Directive 97/43/EURATOM, which obliges the Member States to determinate the population dose from medical exposure. The results show an increase of the annual effective dose per capita from 1.59 mSv in 1994 to 1.98 mSv in 2002. The impact of computed tomography to dose received from medical use of radiation has dramatically increased in this time period. Luxembourg has one of the highest computed tomography examination rates compared to other health care level I countries. The following measures to minimize medical exposures were proposed in the study: medical physicists should have a more central role to play in patient dosimetry in interventional and diagnostic radiology, especially concerning computed tomography. Also, the implementation of an electronic "X-ray patient card" for all irradiated patients--except dental--and the use of the European referral criteria that give guidance and recommend investigations in various clinical settings can both help to decrease medical radiation exposures.

Adolescent↗
PubMed2005

Travel and health status: a survey follow-up study.

BACKGROUND: To date there is little sound knowledge on the relationship between travel and health status as perceived by the traveller. Our aim was to investigate the frequency and risk factors of travel-associated illnesses and injuries and identify potential protective factors. METHODS: All adults enrolled in a health insurance scheme who planned to travel in 2002 were eligible for participation in a baseline survey. Pre-travel written questionnaires and post-travel telephone interviews were conducted with responders. We analysed travel-associated health problems using descriptive methods and multivariate logistic regression. RESULTS: From 8316 persons who returned a pre-travel questionnaire, a sample of 2384 were chosen, of whom 1471 completed post-travel interviews. 10.1% of all travellers reported travel-associated illnesses, and 1.8% suffered from injuries during travel. Among travellers to European destinations, 6.0% reported an illness as opposed to 16.2% of travellers to overseas destinations. Predictors for travel-associated illness were age <30 years (OR 1.48), duration of travel >4 weeks (OR 3.35) and travel destination. Perceived health status as scored by the travellers improved after travel. The frequency of medical consultations and personal health-related expenses decreased significantly shortly after travel. CONCLUSIONS: In this study, travel had a positive effect on the perceived health status of the traveller. The positive effects of travel seemed to outweigh the impact of health problems. Travel did not lead to increased health-related costs, neither in individual health expenses nor indirectly through increased medical consultation rates.

Adult↗
PubMed2005

Overweight and obesity at school entry among migrant and German children: a cross-sectional study.

BACKGROUND: Overweight and obesity have become a global epidemic and are increasing rapidly in both childhood and adolescence. Obesity is linked both to socioeconomic status and to ethnicity among adults. It is unclear whether similar associations exist in childhood. The aim of the present study was to assess differences in overweight and obesity in migrant and German children at school entry. METHODS: The body mass index (BMI) was calculated for 525 children attending the 2002 compulsory pre-school medical examinations in 12 schools in Bielefeld, Germany. We applied international BMI cut off points for overweight and obesity by sex and age. The migration status of children was based on sociodemographic data obtained from parents who were interviewed separately. RESULTS: The overall prevalence of overweight in children aged 6-7 was 11.9% (overweight incl. obesity), the obesity prevalence was 2.5%. The prevalence of overweight and obesity was higher for migrant children (14.7% and 3.1%) than for German children (9.1% and 1.9%). When stratified by parental social status, migrant children had a significantly higher prevalence of overweight than German children in the highest social class. (27.6% vs. 10.0%, p = 0.032) Regression models including country/region and socioeconomic status as independent variables indicated similar results. The patterns of overweight among migrant children differed only slightly depending on duration of stay of their family in Germany. CONCLUSION: Our data indicate that children from ethnic minorities in Germany are more frequently overweight or obese than German children. Social class as well as family duration of stay after immigration influence the pattern of overweight and obesity in children at school entry.

Child↗
PubMed2005

Tutorial: using confidence curves in medical research.

Confidence intervals represent a routinely used standard method to document the uncertainty of estimated effects. In most cases, for the calculation of confidence intervals the conventional fixed 95% confidence level is used. Confidence curves represent a graphical illustration of confidence intervals for confidence levels varying between 0 and 100%. Although such graphs have been repeatedly proposed under different names during the last 40 years, confidence curves are rarely used in medical research. In this paper, we introduce confidence curves and present a short historical review. We draw attention to the different interpretation of one- and two-sided statistical inference. It is shown that these two options also have influence on the plotting of appropriate confidence curves. We illustrate the use of one- and two-sided confidence curves and explain their correct interpretation. In medical research more emphasis on the choice between the one- and two-sided approaches should be given. One- and two-sided confidence curves are useful complements to the conventional methods of presenting study results.

Animals↗
PubMed2003

Mortality from cancer and other causes among male airline cockpit crew in Europe.

Airline pilots and flight engineers are exposed to ionizing radiation of cosmic origin and other occupational and life-style factors that may influence their health status and mortality. In a cohort study in 9 European countries we studied the mortality of this occupational group. Cockpit crew cohorts were identified and followed-up in Denmark, Finland, Germany, Great Britain, Greece, Iceland, Italy, Norway and Sweden, including a total of 28,000 persons. Observed and expected deaths for the period 1960-97 were compared based on national mortality rates. The influence of period and duration of employment was analyzed in stratified and Poisson regression analyses. The study comprised 547,564 person-years at risk, and 2,244 deaths were recorded in male cockpit crew (standardized mortality ratio [SMR] = 0.64, 95% confidence interval [CI] = 0.61-0.67). Overall cancer mortality was decreased (SMR = 0.68; 95% CI = 0.63-0.74). We found an increased mortality from malignant melanoma (SMR = 1.78, 95% CI = 1.15-2.67) and a reduced mortality from lung cancer (SMR = 0.53, 95% CI = 0.44-0.62). No consistent association between employment period or duration and cancer mortality was observed. A low cardiovascular mortality and an increased mortality caused by aviation accidents were noted. Our study shows that cockpit crew have a low overall mortality. The results are consistent with previous reports of an increased risk of malignant melanoma in airline pilots. Occupational risk factors apart from aircraft accidents seem to be of limited influence with regard to the mortality of cockpit crew in Europe.

Accidents, Aviation↗
PubMed2003

Mortality from cancer and other causes among airline cabin attendants in Europe: a collaborative cohort study in eight countries.

There is concern about the health effects of exposure to cosmic radiation during air travel. To study the potential health effects of this and occupational exposures, the authors investigated mortality patterns among more than 44,000 airline cabin crew members in Europe. A cohort study was performed in eight European countries, yielding approximately 655,000 person-years of follow-up. Observed numbers of deaths were compared with expected numbers based on national mortality rates. Among female cabin crew, overall mortality (standardized mortality ratio (SMR) = 0.80, 95% confidence interval (CI): 0.73, 0.88) and all-cancer mortality (SMR = 0.78, 95% CI: 0.66, 0.95) were slightly reduced, while breast cancer mortality was slightly but nonsignificantly increased (SMR = 1.11, 95% CI: 0.82, 1.48). In contrast, overall mortality (SMR = 1.09, 95% CI: 1.00, 1.18) and mortality from skin cancer (for malignant melanoma, SMR = 1.93, 95% CI: 0.70, 4.44) among male cabin crew were somewhat increased. The authors noted excess mortality from aircraft accidents and from acquired immunodeficiency syndrome in males. Among airline cabin crew in Europe, there was no increase in mortality that could be attributed to cosmic radiation or other occupational exposures to any substantial extent. The risk of skin cancer among male crew members requires further attention.

Adult↗
PubMed2002

Mortality from cancer and other causes among airline cabin attendants in Germany, 1960-1997.

Airline cabin attendants are exposed to several potential occupational hazards, including cosmic radiation. Little is known about the mortality pattern and cancer risk of these persons. The authors conducted a historical cohort study among cabin attendants who had been employed by two German airlines in 1953 or later. Mortality follow-up was completed through December 31, 1997. The authors computed standardized mortality ratios (SMRs) for specific causes of death using German population rates. The effect of duration of employment was evaluated with Poisson regression. The cohort included 16,014 women and 4,537 men (approximately 250,000 person-years of follow-up). Among women, the total number of deaths (n = 141) was lower than expected (SMR = 0.79, 95% confidence interval (CI): 0.67, 0.94). The SMR for all cancers (n = 44) was 0.79 (95% CI: 0.54, 1.17), and the SMR for breast cancer (n = 19) was 1.28 (95% CI: 0.72, 2.20). The SMR did not increase with duration of employment. Among men, 170 deaths were observed (SMR = 1.10, 95% CI: 0.94, 1.28). The SMR for all cancers (n = 21) was 0.71 (95% CI: 0.41, 1.18). The authors found a high number of deaths from acquired immunodeficiency syndrome (SMR = 40; 95% CI: 28.9, 55.8) and from aircraft accidents among the men. In this cohort, ionizing radiation probably contributed less to the small excess in breast cancer mortality than reproductive risk factors. Occupational causes seem not to contribute strongly to the mortality of airline cabin attendants.

Accidents, Aviation↗
PubMed2002

Cohort mortality study of German cockpit crew, 1960-1997.

BACKGROUND: Cockpit crew in civil aviation are exposed to several potential health hazards, among them cosmic ionizing radiation. To assess the influence of occupational and other factors on mortality we conducted a cohort study among cockpit crew. METHODS: All pilots and other cockpit personnel of two German airlines were traced through registries and other sources for the period 1960-1997. Standardized mortality ratios, with German population rates as the reference, were calculated. We estimated the individual radiation dose based on individual job histories and assessed dose-response trends in stratified and regression analyses. RESULTS: We compiled a cohort of 6061 male cockpit personnel, yielding 105,037 person-years of observation. The maximum estimated individual radiation dose was 80.5 mSv. Among 255 deaths overall (standardized mortality ratio [SMR] = 0.48; 95% confidence interval [CI] = 0.42-0.54) there were 76 cancer deaths (SMR = 0.56; CI = 0.43 - 0.74). Most cancer and cardiovascular SMRs were reduced. A slight increase was seen for brain cancer (SMR = 1.68; CI = 0.66-3.62). Employment duration was associated with the all-cancer mortality in Poisson regression analyses. No other dose-response relation was found. CONCLUSIONS: German cockpit crew have a low overall and cancer mortality. The role of occupational causes, and particularly cosmic radiation, appears limited.

Aerospace Medicine↗