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Biomedical subjects

P Decoufle

Publications and source records attributed to P Decoufle.

17 recordsLinked to original sources

Legal blindness among 10-year-old children in Metropolitan Atlanta: prevalence, 1985 to 1987.

The prevalence of legal blindness in 10-year-olds in metropolitan Atlanta was 6.8 per 10,000 during 1985 to 1987. The prevalence was 8.8 per 10,000 in Black boys, 8.6 per 10,000 in White boys, 6.7 per 10,000 in White girls, and 1.8 per 10,000 in Black girls. Retinopathy of prematurity was the most common known cause (1.0 per 10,000). Of the 61 cases, 40 had other disabilities, including 14 with mental retardation, cerebral palsy, and epilepsy. The low prevalence among Black girls and the frequent occurrence of blindness with other disabilities are noteworthy.

Black or African American

Use of the Mantel-Haenszel chi 2 overestimates precision in studies with sparse data.

Probability values or "test-based" confidence limits computed on the basis of the Mantel-Haenszel chi 2 statistic may be invalid if minimum cell-size requirements are not met. In 30 studies of occupational proportionate mortality published from 1985 through 1987, the Mantel-Haenszel chi 2 was used in potential violation of cell-size requirements in 21 studies. Sixteen (76%) studies included at least one value that, when compared with testing with the Poisson distribution, was erroneously reported as statistically significant at the 0.05 level. We conclude that by using the Mantel-Haenszel chi 2 with sparse data, some epidemiologists overestimate precision.

Bias

Estimating the number of suicides among Vietnam veterans.

Unconfirmed reports that 50,000 or more Vietnam veterans have committed suicide give the impression that these veterans are at exceedingly high risk of suicide compared with other veterans and nonveterans of the same age. On the basis of projections from two population-based mortality studies, the authors estimate that fewer than 9,000 suicides occurred among all Vietnam veterans from the time of discharge through the early 1980s. The sixfold or greater relative risk of suicide implied by the unsubstantiated suicide death tolls is also demonstrated to be incompatible with the findings of epidemiologic studies of mortality risk among Vietnam veterans.

Adult

Are racial differences in the prevalence of diabetes in adults explained by differences in obesity?

To determine whether the higher prevalence of diabetes found among blacks in the United States is explained by racial differences in obesity, we examined the prevalence of diabetes adjusted for adiposity, education, and income in a cohort of US Army veterans from the Vietnam era. Among 12,558 white men and 1677 black men, aged 30 to 47 years, blacks were more likely than whites to have diagnosed diabetes (adjusted prevalence ratio, 1.9; 95% confidence interval, 1.3 to 2.7). Within every age, adiposity, and socioeconomic stratum, blacks had a higher prevalence of diagnosed diabetes than whites. In a subgroup of veterans for whom fasting serum glucose values were measured, blacks were more likely than whites to have fasting hyperglycemia (fasting serum glucose value greater than or equal to 7.8 mmol/L) (adjusted prevalence ratio, 5.7; 95% confidence interval, 2.7 to 12.0). These data provide evidence that the higher prevalence of diabetes found among blacks is not explained by differences in obesity.

Adult

Mortality patterns among workers in a gray iron foundry.

The long-term mortality experience of 2861 men employed for at least one month in the period 1938 to 1967 in a gray iron foundry was examined to determine if they experienced unusual death rates for specific causes indicative of exposure to hazardous materials in the work environment. Both white and non-white workers experienced favorable mortality for most major disease categories compared to general population rates, even men employed five or more years. No deaths from pneumoconiosis were observed nor were deaths from other chronic respiratory diseases in excess. Analysis of detailed cancer sites showed no significant departures from expectation overall. However, in the subgroup of men who achieved five or more years employment prior to 1938, a twofold increase in mortality from digestive cancer (14 observed deaths vs. 7.4 expected) and respiratory cancer (8 observed deaths vs. 4.0 expected) was seen. Absence of information on specific foundry jobs held by the subjects and associated exposures limits full interpretation of the findings. However, the excess observed for respiratory cancer among long-term employees followed for 30 years is consistent with previous reports.

Adult

Causes of death among laundry and dry cleaning workers.

To make a preliminary determination as to whether a potential health hazard exists for workers exposed to dry cleaning solvents (carbon tetrachloride, trichloroethylene, and tetrachloroethylene), we analyzed the causes of death of 330 deceased laundry and dry cleaning workers by the proportionate mortality method. The increased risk for malignant neoplasms resulted primarily from an excess of lung and cervical cancer and slight excesses of leukemia and liver cancer. Although the number of deaths was small, the increased risk of cancer noted in this investigation underscores the need for additional epidemiologic studies of this occupational group.

Adult

Mortality among workers employed in the pharmaceutical industry: a preliminary investigation.

The cause-specific mortality experience of 826 plant employees and 249 sales representatives employed by a large U.S. pharmaceutical firm was examined to determine if there were unusual patterns of fatal disease that might relate to factors in the work environment. Deaths that occurred between 1954 and 1976 among actively employed or retired workers were identified through company records and a proportionate mortality analysis was carried out using the total U.S. as a standard. PMRs were computed for male and for female workers and for several broad occupational categories. A significant difference between observed and expected mortality from suicide was present in both males and females and there was an indication that drug overdoses were over-represented. PMRs for several cancer sites were elevated, but excesses were not always confined to particular occupational categories. Excesses of respiratory cancer were present in male maintenance workers and in female production workers. Increased relative frequencies of melanoma among males and of leukemia among females were confined to the production worker category. Some of the findings may provide leads for further investigations of the pharmaceutical industry.

Adult

Causes of death among construction machinery operators.

Causes of death among 2,190 deceased operating engineers identified from the 1967 International Union of Operating Engineers death benefit listing were analyzed to determine if there were conditions occurring with unusual frequency that might be indicative of hazardous conditions in the work environment. The most striking finding was a three-fold excess of fatal accidents occurring at places other than the home or resident institution. The increased risk was evident in each of four regions of the country and at all ages under 65. Significant excesses in deaths from lung cancer and intestinal cancer were seen also. Comparative mortality from lung cancer was directly related to age, with the greatest increase (two-fold) occurring after age 75. There was no evidence of a greater than expected frequency of deaths from non-malignant respiratory disease among operating engineers.

Accidents

Mortality by cause among stationary engineers and stationary firemen.

Causes of death among 1,113 stationary engineers and firemen identified from union death benefit listings were analyzed to determine if there were conditions occurring with unusual frequency suggestive of exposure to hazards in the work environment. The relative frequencies of specific disease conditions in the study group were compared to the experience of the general population by the method of proportionate mortality. Deaths from cancer of the buccal cavity and pharynx and cancer of the rectum occurred twice as often as expected, each result being statistically significant at the 5% level. Lung cancer deaths were 20% higher than expected overall, and consistently excessive in each of four geographic subdivisions of the United States. Mortality from coronary heart disease was elevated in each region, particularly at ages under 55. No increase in the relative frequency of deaths from nonmalignant respiratory disease was found nor were fatal accidents more frequent than expected. Some of the findings may be important in view of potential exposure to carbon monoxide and several carcinogenic materials for these occupational groups.

Adult

Cancer risks associated with employment in the leather and leather products industry.

A recent study of relationships between occupation and cancer at Roswell Memorial Institute, Buffalo, New York, identified significantly high risks of bladder among men and women with a history of employment in plants manufacturing leather and leather products. Among males, the relative risk increased with duration of employment and remained elevated after adjustment for smoking habits. Among male leatherworkers, significantly increased risks were seen for cancers of the buccal cavity and pharynx and larynx that could not be explained by differences in smoking habits. Malignant lymphomas were also associated with elevated risks among men and women who had worked in the leather industry. Review of processes and agents found in leather manufacture reveals several areas with exposure to potentially carcinogenic materials, including azo and other synthetic dyes that have induced cancer in laboratory animals. Further studies of person employed in the leathermaking and fabrication industries seem advisable to characterize the nature of exposure-response relationships.

Female