Biomedical subjects

K M Bang

Publications and source records attributed to K M Bang.

At least 19 recordsLinked to original sources

PubMed1994

Surveillance for occupational asthma--Michigan and New Jersey, 1988-1992.

PROBLEM/CONDITION: A case of occupational asthma is a sentinel health event indicating a need for preventive intervention. REPORTING PERIOD COVERED: 1988-1992. DESCRIPTION OF SYSTEMS: As part of the Sentinel Event Notification System for Occupational Risks (SENSOR) Program, initiated by CDC's National Institute for Occupational Safety and Health in 1987, state-based surveillance and intervention programs for occupational asthma (OA) have been under development in Michigan and New Jersey. The initial 5-year projects in these states have been completed. RESULTS: From 1988 through 1992, the SENSOR programs in these states identified a total of 535 cases of occupational asthma and related conditions. Of these 535 cases, 328 cases met the SENSOR surveillance case definition for OA. In addition, 128 cases were classified as possible OA, 42 as reactive airways dysfunction syndrome, and 37 as occupationally aggravated asthma. In both Michigan and New Jersey, manufacturing was the industrial sector with the largest proportion of cases. In Michigan, > 40% of the case-patients worked in transportation equipment manufacturing. In New Jersey, 15% of case-patients worked in manufacturing of chemicals and allied products. Overall, isocyanates were the most frequently reported asthma-causing agents (19.4% of cases). Follow-up industrial hygiene sampling measured suspect agents at airborne concentrations generally below the permissible exposure limits established by the Occupational Safety and Health Administration. INTERPRETATION: In its first 5 years, the SENSOR system has led to the identification of previously unrecognized causes of occupational asthma. Overall findings indicate the need for more comprehensive control of such well-known occupational allergens as the isocyanates. In addition, SENSOR interventions have prompted improvements in protection for workers. ACTIONS TAKEN: Approaches to state-based surveillance and intervention for OA are being developed through newly funded 5-year SENSOR projects in four states (California, Massachusetts, Michigan, and New Jersey). The goal is to develop a model for effective state-based OA surveillance that can be applied by any state health department.

Asthma↗

PubMed1993

The effect of pulmonary impairment on all-cause mortality in a national cohort.

The association between pulmonary impairment and all-cause mortality was investigated among white subjects in a follow-up study of a large national cohort. Pulmonary function was measured during the National Health and Nutrition Examination Survey (NHANESI) (1971 to 1975); subsequent mortality information was obtained from the 1987 NHANES I Epidemiologic Follow-up Study (1982 to 1987). Of 4,764 white sample persons, ages 25 to 74 years examined during NHANES I, 658 (13.8 percent) were identified as having pulmonary impairment defined as a FEV1/FVC < or = 69 percent. A total of 743 (15.6 percent) sample persons died during the follow-up period. The association between pulmonary impairment and all-cause mortality was examined for male and female subjects separately using the Cox proportional hazards model controlling for age, smoking, educational level, body mass index, and respiratory diseases. The analysis suggests that reduced FEV1 percent predicted was a significant risk factor for mortality among both sexes, and the FEV1/FVC ratio was significantly associated with all-cause mortality among male subjects only.

Adult↗

PubMed1993

Prevalence of chronic obstructive pulmonary disease in blacks.

Chronic obstructive pulmonary disease (COPD) is a significant cause of morbidity and mortality in blacks. The prevalence of COPD among blacks was estimated from the spirometry data obtained from the first National Health and Nutrition Examination Survey (NHANES), 1971-1975. Of 873 subjects, 585 (67%) had acceptable spirometry trials. Chronic obstructive pulmonary disease was defined as a forced expiratory volume in one second (FEV1) less than 65% of the predicted value. The mean FEV1 percentage predicted was 96.7%. The overall prevalence of COPD was 5.4%; 3.7% for males and 6.7% for females. The prevalence was significantly higher with age for both males and females. The multiple logistic regression analyses showed that age and sex were associated with COPD but respiratory symptoms did not attain statistical significance.

Adult↗

PubMed1991

Acceptability and reproducibility criteria of the American Thoracic Society as observed in a sample of the general population.

An analysis of spirograms of 6,486 subjects from the general population, ages 8 to 90, was conducted to determine their ability to satisfy the American Thoracic Society's (ATS) acceptability and reproducibility criteria. The results indicate that both older and younger subjects had more difficulty satisfying the ATS acceptability and reproducibility criteria. The difficulty in satisfying the ATS reproducibility criterion, particularly in younger subjects, was in part associated with their smaller heights and lung volumes. A relatively uniform within-subject variability of FVC and FEV1 in terms of the mean differences between the largest and second largest FVC and FEV1, for all heights, was observed. In addition, unlike the ATS reproducibility criterion, when a constant 200-ml reproducibility criterion for FVC and FEV1 was used, there was no longer a significant difference between the number of reproducibility criterion failures for the 14 different height groups used. These results suggest that the ATS reproducibility criterion, based on a percentage of the FVC and FEV1, may inappropriately classify a higher percentage of subjects with smaller heights and lung volumes as having a nonreproducible test. In contrast, subjects with larger heights and lung volumes are much less likely to fail the ATS reproducibility requirement. These results emphasize the importance of following the ATS recommendation of using the reproducibility criterion only as a goal during data collection, not to classify a subject as having an invalid test.

Adolescent↗

PubMed1990

The impact of pulmonary infections on the survival of lung cancer patients.

To determine the impact of pulmonary infections on survival in patients with lung cancer, a retrospective review of the records of 121 such patients treated at Howard University Hospital in Washington, DC, was done. There were 77 men and 44 women; 118 were black. The mean age was 63.5 years. Forty-three patients had squamous cell carcinoma, 31 had adenocarcinoma, 18 had large cell carcinoma, 19 had small cell carcinoma, and ten were unclassified. The stages were as follows: two patients in Stage 0, 15 in Stage I, seven in Stage II, 45 in Stage III, and 44 in Stage IV. Eight patients could not be staged at diagnosis. Eighty-five patients (70%) had documented infections; 37 had single episodes; and 48 had more than one. The five most common organisms recovered were alpha/gamma streptococci, Staphylococcus aureus, Klebsiella pneumoniae, Enterobacter aerogenes, and Pseudomonas aeruginosa. The median survival of all infected patients was 4.2 months which was significantly shorter than that of uninfected patients who had a median survival of 12.9 months (P less than 0.05). When Stage III patients were analyzed separately, infected patients lived a median of 5.8 months and uninfected patients, 13.4 months (P less than 0.05). This study indicated that pulmonary infections frequently occur in patients with lung cancer and suggested that they may adversely affect survival.

Bacterial Infections↗

PubMed1990

Prevalence of chronic bronchitis among US Hispanics from the Hispanic Health and Nutrition Examination Survey, 1982-84.

In the Hispanic Health and Nutrition Examination Survey (HHANES), Puerto Ricans had a higher age-adjusted prevalence of self-reported chronic bronchitis (2.9 percent, 95% CI = 2.2, 3.6) than Mexican Americans (1.7 percent, 95% CI = 1.3, 2.1) or Cubans (1.7 percent, 95% CI = 0.9, 2.5). The prevalence of chronic bronchitis was at least 2 times higher in smokers as compared to nonsmokers among Puerto Ricans and Cubans, but not for Mexican Americans.

Adolescent↗

PubMed1988

Evaluation of recent trends in cancer mortality and incidence among blacks.

Recent trends in the cancer incidence, mortality, and 5-year survival rate for the black population were evaluated using the available national data up to 1981. Blacks have the highest overall age-adjusted cancer rates in both incidence and mortality of any US population group. The overall cancer incidence rates for blacks rose 17%, while for whites it increased 13% from 1969 to 1981. The rate in black men has increased 22.9%, while the rate in black women has increased 13.1%. The overall increase is the result of increases in cancers of the lung, prostate, colon-rectum, and esophagus. The age-specific incidence of lung cancer reflects the decrease of its incidence in those between 20 and 40 years of age because of the change in smoking habits after the Surgeon General's report on smoking. The overall cancer mortality rates for blacks increased 39% during the period. Lung cancer had the highest mortality rate, having increased more than 77.8% since 1969. This trend greatly reflects the recent increase in lung cancer incidence among black women. The overall 5-year cancer survival pattern for blacks was almost unchanged from 1973 to 1981, while whites had slightly higher survival rates during this period. However, blacks had substantial increases in survival rates for cancers of the esophagus and bladder during the period.

Black or African American↗

PubMed1988

Skin cancer in blacks in the United States.

Skin cancer is rare in blacks compared with whites in the United States. The most common form is squamous-cell carcinoma, not basal-cell carcinoma, as it is in whites. Sunlight does not appear to be an important etiologic factor in skin cancer in blacks, as most lesions occur on covered areas. Malignant melanoma is low in frequency but commonly affects acral areas and has a poor prognosis. Mycosis fungoides and dermatofibrosarcoma protuberans appear to have a high frequency among skin cancers. Squamous-cell carcinoma, malignant melanoma, and mycosis fungoides have a relatively high mortality rate in blacks. Bowen's disease and Kaposi's sarcoma occur in blacks but are rare. As there is a high frequency of squamous-cell carcinoma of the skin in blacks, prevention and early detection should benefit the patient. Considering the difficulties encountered in applying epidemiologic methods to skin cancer on a national scale, etiologic studies should be conducted in carefully selected areas. Future investigations of skin cancer in blacks should include an examination of risk factors such as burns, trauma, and diet and familial and immunologic aspects as well.

Black People↗

PubMed1988

Comprehensive family practice clerkship in a minority institution.

A comprehensive family practice clerkship program at Howard University College of Medicine has been conducted since 1970. This institution is one of three predominantly black institutions offering a family practice program. The senior clerkship is mandatory and at least 20 to 25 percent of each class elect to participate in a four-to six- week family practice preceptorship. As a result of the clerkship's success, over 50 percent of the program's graduates actively practice in primary medical manpower shortage or medically underserved areas.

Black or African American↗

PubMed1988

Current epidemiologic status on aging in U.S. blacks: update on hypertension and diabetes.

The total number of American blacks aged 65 years and over is estimated to be approximately 2.3 million, and the black elderly population will continue to increase faster than the white elderly population throughout the remainder of this century. During the period 1985 to 2025, the elderly population in the United States will increase to 105 percent.The prevalence of hypertension and diabetes for the elderly population (65 years and over) is much higher in blacks than in whites. During the period 1976 to 1980, 76.5 percent of black women aged 65 to 74 years had definite hypertension, compared with 53.4 percent of white women.Many factors are associated with the development of hypertension and diabetes in blacks. Specfic epidemiologic studies are necessary to identify black-white differences in risk factors, including biomedical risk, socioeconomic status, psychosocial risk, nutritional status, lifestyle, and genetic factors.

Aged↗

PubMed1987

Age and prevalence of sickle-cell trait in a large ambulatory population.

We performed hemoglobin electrophoresis in 30,400 apparently healthy black individuals in the Washington D.C. Metropolitan area, who were participating in a community based sickle-cell screening program during the period 1978-1985. The overall prevalence of sickle-cell trait was 6.7%. The frequency of sickle-cell trait in various age groups, which included young children, adults, and individuals over 65 years of age, ranged from 6.4 to 7.4%. There were no statistically significant differences in the prevalence of sickle-cell trait among the various age groups, nor did we detect a significant trend for increasing or decreasing sickle cell frequency with advancing age (P = 0.418). Thus, in this population sickle-cell trait appears to have no effect on longevity. If the various complications of sickle-cell trait reported in the literature are not fortuitous, their frequency and/or severity must be too low to affect prevalence figures.

Adolescent↗

PubMed1987

Increased cancer risks in blacks: a look at the factors.

Incidence and mortality rates of cancer in blacks have been increasing at a faster rate than in whites. In particular, recent incidence rates of lung cancer in black men have increased, while the rates in white men decreased for the first time since 1982 to 1983. This leveling off in incidence for whites may suggest the beginning of a downturn in lung cancer because the smoking prevalence has decreased substantially since 1965.There is considerable evidence that cancer risks in blacks are higher than in whites. The major risk factors to cancer include cigarette smoking, diet, alcohol, and occupational exposure to industrial carcinogens. Other factors, including immunogenetic and unknown risks, might be associated partially with an increased incidence of cancer in blacks. Analytic epidemiologic studies addressing the relationship between genetic factors, or biomarkers, and cancer along with epidemiologic methods are warranted. Key factors that contribute to the prevention of cancer mortality should be identified and promulgated through primary or secondary cancer prevention programs.

Adult↗

PubMed1987

Skin cancer in black Americans: a review of 126 cases.

Primary cancer of the skin is rare in blacks. The records of 126 black patients with skin cancer were reviewed. Histopathologic findings included squamous cell carcinomas (43) basal cell carcinomas (39) malignant melanomas (8) dermatofibrosarcomas (16) Bowen's disease (6) mycosis fungoides (14) and sebaceous cell carcinoma (1).There is a higher percentage of skin cancer involving covered areas in blacks than among whites. Squamous cell carcinoma was the most common skin cancer in blacks. The distribution of basal cell carcinoma in blacks was 30 percent in this series, as compared with 80 percent in whites in the 1977 to 1978 survey. The majority of patients with squamous cell carcinoma had associated predisposing conditions and lesions on non-sun-exposed skin. Sunlight and occupational chemical exposure did not appear to be associated with skin cancer in blacks in this series.

Adult↗

PubMed1986

Lymphocytopenia in high cancer risk population: evidence in automobile pattern makers.

A total of 1454 automobile pattern makers were studied to determine the degree of lymphocyte reduction. These occupational workers have been known to be at high risk for colorectal cancer. As a group, pattern makers had significantly lower lymphocyte counts than the comparison group. The proportion of lymphocytopenia (less than 1500/mm3) in pattern makers was 26.2% as compared with 5.6% in the comparison group. Continuous monitoring of lymphocyte reduction in pattern makers may be worthwhile to evaluate whether these workers face a high risk for deficiency in lymphocytes in association with their risk for high rates of colorectal cancer.

Automobiles↗

PubMed1986

Screening for colorectal cancer and polyps among pattern makers.

In response to a union request, a cancer screening program was conducted for the Pattern Makers' League of North America. Ten colon cancer cases were detected among the 1,465 white men screened with a flexible sigmoidoscope. The difficulties in obtaining appropriate "expected" numbers were that prevalent detectable preclinical colon cancer is not equivalent to incident disease, and the flexible sigmoidoscope yields results not directly comparable to those of the rigid sigmoidoscope used previously. The "expected" number of cancers was obtained by using an independent estimate of 5 years for the mean duration of the detectable preclinical phase. This implied that the expected number of colon cancer cases should be based on the age-specific incident rates among white men in the next-older 5-year age group and that the annual expected number should be multiplied by five. Therefore, the ten observed cases of colon malignancies represented an approximately threefold increase. For invasive cancer only, there was a slightly less than twofold cancer increase. Fifteen percent of the men had one or more colorectal polyps.

Adult↗

PubMed1986

Sensitivity of fecal hemoccult testing and flexible sigmoidoscopy for colorectal cancer screening.

Fecal Hemoccult testing and flexible sigmoidoscopy have been proposed as means of screening for colorectal cancer in the general population, as well as in identified high-risk groups. A colorectal cancer screening program was conducted for the Pattern Makers' League of North America. A total of 1,473 white males were screened with fecal Hemoccult testing and flexible sigmoidoscopy during the period 1981 to 1983. The fecal Hemoccult test after diet restriction was positive in 38 workers (2.6%). Among 12 colorectal cancers, including in situ cases, only three were positive by this test. The sensitivity of this test for picking up cancer is only 25%. The positive predictive value was 7.9%. It is concluded that the Hemoccult test for the detection of colorectal cancer and polyps is not a valuable tool because of low sensitivity, whereas flexible sigmoidoscopy has a significant role in colorectal cancer screening of an asymptomatic population at risk.

Colonic Neoplasms↗

PubMed1986

Longitudinal evaluation of pulmonary function in copper smelter workers exposed to sulfur dioxide.

From 1973 to 1974, a longitudinal study of pulmonary function in 113 Utah copper smelter workers reported significant declines in FVC and FEV1 related to sulfur dioxide exposure. In 1980, we performed a 7-yr follow-up study, finding significant increases in FVC and FEV1. The 66 follow-up participants were similar to those 47 lost to follow-up with regard to age and initial pulmonary function. Subgroups of smelter workers with initial higher exposures to sulfur dioxide and FEV1 less than 90% predicted did not show an accelerated rate of decline. To reconcile these differences between the 2 studies, we reevaluated the spirometry curves from 1973 and 1974. All had short expiratory times, with none 6 s or longer, whereas all of the curves from the spirograms obtained in 1980 exceeded 6 s. In addition, from 1980 to 1983, we performed a longitudinal study of 48 of the original workers, finding small annual mean declines for FVC of 6 ml and FEV1 of 5 ml. Personal exposures to sulfur dioxide were not significantly different in 1982 than in 1976; thus, we were unable to corroborate the findings of the initial longitudinal study.

Copper↗

PubMed1984

Pneumoconiosis and exposures of dental laboratory technicians.

One hundred and seventy-eight dental laboratory technicians and 69 non-exposed controls participated in an epidemiological respiratory study. Eight technicians who had a mean of 28 years' grinding nonprecious metal alloys were diagnosed as having a simple pneumoconiosis by chest radiograph. Mean values for per cent predicted FVC and FEV1 were reduced among male nonsmoker technicians compared to male nonsmoker controls; after controlling for age, there was also a reduction in spirometry with increasing work-years. An industrial hygiene survey was conducted in 13 laboratories randomly selected from 42 laboratories stratified by size and type of operation in the Salt Lake City, Utah metropolitan area. Personal exposures to beryllium and cobalt exceeded the Threshold Limit Values (TLVs) in one laboratory. Occupational exposures in dental laboratories need to be controlled to prevent beryllium-related lung disorders as well as simple pneumoconiosis.

Adult↗