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T Kjellstrom

Publications and source records attributed to T Kjellstrom.

13 recordsLinked to original sources

Increased mesothelioma incidence in New Zealand: the asbestos-cancer epidemic has started.

AIMS: To examine the incidence and mortality patterns for malignant mesothelioma and pleural cancer in New Zealand between 1962-1996, and relate these to past use of asbestos. METHODS: Data concerning cases of mesothelioma 1962-1996, deaths from pleural and lung cancers 1974-1996, and data on imports of raw asbestos and asbestos products were obtained from government registers and publications. Time trends were analysed using different models. RESULTS: Mesothelioma incidence rates have increased progressively in New Zealand since the 1960s, and reached 25 per million for men in 1995. The increase follows an exponential model departing from a crude 'background rate' of 1-2 per million in 1984, and is particularly steep in males 50 to 60 years of age. The incidence is expected to double by 2010. CONCLUSION: New Zealand has entered an unrivalled period of occupational cancer deaths resulting from past workplace exposure to airborne asbestos fibres. The steep rise in mesothelioma incidence is likely to be accompanied by increases in other asbestos related diseases such as lung cancer. The unique causal association between mesothelioma and asbestos may be used to monitor changes in the public health impact of these exposures. The notification by medical practitioners of all potential asbestos related conditions/exposures to the Occupational Safety and Health (OSH) service is of great importance.

Adult↗

Daily mortality in relation to weather and air pollution in Christchurch, New Zealand.

OBJECTIVE: To investigate the relationship between the daily number of deaths, weather and ambient air pollution. METHOD: An ecological study. We assembled daily data for the city of Christchurch, New Zealand (population 300,000) from June 1988 to December 1993. We used Poisson regression models, controlling for season using a parametric method. RESULTS: Above the third quartile (20.5 degrees C) of maximum temperature, an increase of 1 degree C was associated with a 1% (95% CI: 0.4 to 2.1%) increase in all-cause mortality and a 3% (0.1 to 6.0%) increase in respiratory mortality. An increase in PM10 of 10 micrograms/m3 was associated (after a lag of one day) with a 1% (0.5 to 2.2%) increase in all-cause mortality and a 4% (1.5 to 5.9%) increase in respiratory mortality. We found no evidence of interaction between the effects of temperature and particulate air pollution. CONCLUSIONS: High temperatures and particulate air pollution are independently associated with increased daily mortality in Christchurch. The fact that these results are consistent with those of similar studies in other countries strengthens the argument that the associations are likely to be causal. IMPLICATIONS: These findings contribute to evidence of health consequences of fuel combustion, both in the short term (from local air pollution) and in the long term (from the global climatic effects of increased atmospheric CO2).

Adolescent↗

Health for all: analyzing health status and determinants.

An analysis of health status and determinants is presented as a basis for health for all renewal and in order to provide a model linking the health for all vision with strategy and action. Equity and gender, at the core of health for all, directly concern health status and the distribution of health determinants. The role of the various transitions (demographic, epidemiological, health risk and technological) is described, the need to strengthen the link between data and decision-making for health is explained, and the range of health determinants--macroeconomic, demographic/nutritional, environmental, tobacco and alcohol and their implications for policy--is outlined.

Epidemiologic Methods↗

Adult health: a legitimate concern for developing countries.

Adults, defined here as people between 15 and 59 years of age, in developing countries have a high risk of premature death and suffer from frequent morbidity and high rates of chronic impairment. Their ill health imposes a major burden on health services and large negative consequences on families, communities, and societies. This paper describes the level and impact of adult mortality and morbidity, and highlights some of its characteristics and causes, which in some cases contradict commonly held beliefs. It concludes that "adult health" is a legitimate public health concern for developing countries that is not being addressed. An agenda for remedial research and action is proposed.

Adolescent↗

The development and evaluation of Basic Epidemiology: Student's Text.

This paper describes the development and evaluation of a World Health Organization book Basic Epidemiology: Student's Text. This book was a response to a need identified by members of the WHO Global Environmental Epidemiology network. A draft was commented on by members of the Network and then at an editorial meeting. Two thousand copies of a pre-publication version were prepared and this version was formally evaluated by 13 teachers of introductory courses of epidemiology and less formally by members of the Epidemiology Network. A high response was received to the evaluation questionnaires; 45% of the students rated the test overall as 'very useful' and another 54% as 'useful'; many useful comments were received and were incorporated into the final version which will be published by WHO in 1993.

Attitude of Health Personnel↗

A comparison of hospital admissions data and official government statistics of serious traffic accident injuries.

Two sources of New Zealand statistics on serious traffic accident injuries were compared for the period 1973-82. The official statistics based on Ministry of Transport reports showed consistently lower figures than the supposedly comparable hospital admission statistics from the Department of Health. The reporting ratio in the official statistics had decreased from 66% of the first admissions to hospital in 1973 to 43% in 1982. The highest reporting ratios were observed for drivers and passengers (66% in 1982). For pedestrians it was 48%, for motor cyclists 45% and for bicyclists 15%. A detailed analysis of reporting ratios for specific types of accidents among children showed that for certain accidents almost none of the injured children were recorded in the Ministry of Transport statistics. It is concluded that these statistics present a distorted picture of the nonfatal road toll and that a new statistical reporting system combining information from several sources is needed.

Accidents, Traffic↗

2,4,5-T and cancer.

Explore the source record for details and available documents.

2,4,5-Trichlorophenoxyacetic Acid↗

Ongoing research in occupational health and environmental epidemiology in developing countries.

Research in occupational health and environmental epidemiology can play an important role in furthering our understanding of occupational and environmental health problems. Research guides us in the recognition, management, and prevention of health problems. However, in developing countries, where rates of occupational and environmental illnesses and injuries are higher and where these problems are often more severe than in developed countries, research capabilities are less developed. In mid-1990, a project was undertaken to (a) document ongoing research in occupational health and environmental epidemiology in developing countries, (b) facilitate the exchange of information among researchers in this field, (c) stimulate research, and (d) avoid unnecessary duplication among researchers in this field. A questionnaire was mailed, the purpose of which was to learn the current status of research in developing countries and to develop a directory of such ongoing research. The questionnaire was sent to 1,528 individuals. Of the 500 research projects identified, 77% were investigating chemical hazards; 26%, physical hazards; 10%, biological hazards; and 10%, psychosocial hazards (some projects addressed multiple hazards). The chemical hazards studied most frequently were dusts, pesticides, and lead. The greatest number of research projects were identified in China, India, Brazil, Korea, and Thailand. Most projects were descriptive or cross-sectional epidemiologic studies or industrial hygiene or exposure-assessment studies. The World Health Organization has published a directory of the specific research projects that were identified in this survey.

Developing Countries↗

Analysis of submicrogramme levels of cadmium in whole blood, urine and hair by graphite furnace atomic absorption spectroscopy.

Toxicological studies require the analysis of heavy metals in many widely differing samples. In this paper, a simple and accurate method is described for the determination of cadmium in whole blood, urine, and hair. The blood and urine samples were digested in nitric acid at 70 degrees C, and the hair was digested in a 1:1 mixture of nitric and sulphuric acid. Although a low temperature necessitated longer digestion, the operation was conveniently carried out overnight. The digestion and any subsequent extraction or dilution was carried out in the same tube. The methods used optimised digestion efficiency and minimised sample contamination. The method was also found to be precise and highly reproducible with relative standard deviation (RSD) values within 5%.

Cadmium↗

Housing and health transition in Thailand.

Over the past half-century, Thailand's health profile has been undergoing an epidemiologic transition in association with various fundamental societal changes, shifting from one with a predominant burden of communicable disease to one in which noncommunicable diseases and accidents now predominate. The primary question is why have the disease rates in the Thai population changed? Answering this question requires an examination of the underlying transitions in social and contextual factors. This paper explores, using published data, how housing conditions, as one set of environmental health risks, have undergone transition in recent years and how this change maps on the health-transition process. A combination of economic development, urbanization, modernization, and increased health literacy resulted in a range of health-protecting changes in housing design and materials. Pre-eminent among such changes are improvements in household sanitation and in equipment, ventilation, and fuel pertaining to indoor cooking and heating. In tropical countries like Thailand, gains have been made in mosquito-proofing houses and in minimizing open pools of water to combat the risks of malaria, dengue fever, and other mosquito-borne infections. Meanwhile, the growth in shantytown and slum housing around the urban fringe, often in precarious environmental settings, introduced a negative dimension to the evolving profile of housing-related health risks, whereas the urban sprawl of modern residences creates health risks that are due to traffic crashes and the lack of walking in daily transport.

Accidents↗