[No union on Database Research in the health sector [Editorial].].
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Journal Article↗
Biomedical subjects
V Rafnsson
Publications and source records attributed to V Rafnsson.
[How dangerous is indirect smoking? [Editorial].].
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Journal Article↗
Women's Health: Occupation, Cancer, and Reproduction. A conference overview.
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Female↗
Association between exposure to crystalline silica and risk of sarcoidosis.
OBJECTIVES: The possibility of an association between exposure to silica and autoimmune diseases has recently come under discussion. In the following case-referent study, a cohort exposed to diatomaceous earth and cristobalite provided an opportunity to evaluate such an exposure with reference to sarcoidosis. METHODS: The inhabitants of a district served by a single healthcare centre and a hospital formed the study base. A diatomaceous earth plant is located in this community and the medical institutions are responsible for primary and secondary health care of the population. Cases of sarcoidosis were identified from the hospital records according to certain clinical, radiological, and histological criteria. Referents were selected randomly from the population of the district. Information on exposure to crystalline silica, cristobalite, was obtained by record linkage of the cases and referents with a file which included all present and past workers at the diatomaceous earth plant and those who had worked at loading vessels with the product from the plant. RESULTS: Eight cases of sarcoidosis were found, six of which were in the exposed group. Of the 70 referents, 13 were exposed. The odds ratio (95% confidence interval) was 13.2 (2.0 to 140.9). CONCLUSION: The odds ratios were high and there were some indications of a dose-response relation which will hopefully encourage further studies. To our knowledge this is the first study to indicate a relation between sarcoidosis and exposure to the crystalline silica, cristobalite.
Adult↗
[Causes of death and incidence of cancer in physicians and lawyers in Iceland].
A retrospective study is accomplished in Iceland to study whether mortality and cancer incidence among male physicians (1,210) were lower than those among men of the general population and lawyers (1,032). Overall mortality among lawyers was similar to that of the general male population, however, mortality among the physicians was lower than that of the general population and the lawyers, due to lower mortality for all cancers (SMR 0.73), cerebrovascular diseases (SMR 0.53) and respiratory diseases (SMR 0.54). The physicians had higher mortality for suicide committed by drugs, solid or liquid substances. Cancer was not as frequent among the physicians as among the lawyers, particularly for lung cancer, the SIR was 0.45, but the rates were higher for cancer of the colon and brain among the physicians than among others.
Cause of Death↗
Risk of lung cancer among masons in Iceland.
OBJECTIVES: To estimate the risk of gastrointestinal cancer and lung cancer in a cohort of masons exposed to cement and hexavalent chromium by a follow up in the Icelandic Cancer Registry. METHODS: The cohort, 1172 men, was defined as those who had served their apprenticeship and were fully licensed as masons (cement finishers) in Iceland, were born after 1880 and were alive in 1955. The men were exposed to an aerosol of wet concrete, particularly when spraying. According to the analyses of urinary chromium the masons were exposed to hexavalent chromium. A computer file on masons was record linked to the Cancer Registry by making use of the personal identification numbers. Expected cancer incidence was calculated on the basis of number of person-years for each five-year age category during the individual calendar years of the study period and multiplied by the specific incidence for cause and calendar year for men in Iceland provided by the Cancer Registry. RESULTS: The standardised incidence ratio (SIR) for all cancers was 1.13 in the total cohort and 1.33 when allowance was made for 30 years to elapse before starting to count person years of risk. The risk for gastrointestinal cancers was not increased. The SIR for lung cancer was 1.69 in the total cohort and 1.77 when a lag of 30 years was included. The SIR for lung cancer among those born in 1920 or later was 1.86. Results from a postal questionnaire showed that fewer masons had never smoked and more masons had stopped smoking than the controls from the general population. CONCLUSION: The increased risk of lung cancer among the masons may be related to their work. The exposure information, although limited, supports the suggestion that hexavalent chromium in the cement may be the causal link, as information on the smoking habits indicate that the control for this important possible confounder is adequate.
Aged↗
Occupational Risk Factors for Breast Cancer among Nurses.
A case-referent study nested in a cohort was used to evaluate occupational variables in the incidence of breast cancer among nurses. There were 59 cases and 118 randomly chosen referents. The participation rate was 97%. Odds ratios (ORs)and 95% confidence intervals (CIs)were calculated and the weights of potential confounding factors estimated by unconditional logistic regression. The odds ratio for breast cancer in a sister was 2.83 (95% CI 1.03-7.81). Specialization in pediatric, psychiatric, general (surgical and medical), geriatric, and primary care nursing, and "other kinds of nursing," gave an adjusted OR of 1.95 (95% CI 0.84-4.54). When working in different wards was accounted for, the highest adjusted ORs were found among nurses handling cytotoxic drugs, OR 1.65 (95% CI 0.53-5.17), and among pediatric nurses, OR 1.47 (95% CI 0.63-3.41); the lowest ORs were found among nurses in primary health care, OR 0.44 (95% CI 0.20-0.96). Analyses of the data stratified on age showed similar results. Occupational risks were not ascertained. Not only occupation but career-related life-styles should be taken into account in studies of health outcomes among working women.
Journal Article↗
Lung cancer incidence among an Icelandic cohort exposed to diatomaceous earth and cristobalite.
OBJECTIVES: The objective of this study was to determine the cancer incidence of a cohort exposed to diatomaceous earth and cristobalite with special focus on lung cancer. METHODS: The cohort was from a diatomaceous plant in northern Iceland and comprised 919 men and 423 women. Diatomite, when heated, is transformed from amorphous to crystalline silica with a high cristobalite content and traces of quartz. With the use of the identification number of all persons, a link was made with the Cancer Registry. The expected number of malignancies was calculated on the basis of person-years of observation for 5-year age categories during the respective calendar period of the study multiplied by the specific incidence of cancer site for men and women in Iceland. RESULTS: There was no increased overall incidence of cancer in the study population; 5 cases of lung cancer were observed versus 4.4 expected, the standardized incidence ratio (SIR) was 1.14 [95% confidence interval (95% CI) 0.37-2.65]. When the men in the cohort were divided according to their length of employment, there was an excess of lung cancer (3 observed versus 1.28 expected, SIR 2.34, 95% CI 0.48-6.85), nonmelanoma skin cancer (2 observed versus 0.19 expected, SIR 10.53, 95% CI 1.27-38.02), and brain cancer (3 observed versus 0.30 expected, SIR 10.00, 95% CI 2.06-29.23) for those who had worked 5 years or longer. A special investigation of smoking habits among the cohort revealed a smoking pattern similar to that of the general population. CONCLUSION: The results concerning lung cancer showed an excess risk for workers exposed to diatomaceous earth and cristobalite; the result was not, however, statistically significant. There was a trend towards a higher incidence of lung cancer with longer exposure to crystalline silica, and, in agreement with the results of a previous study from this industry, the findings indicate a causal relation.
Air Pollutants↗
Cancer incidence among Icelandic pesticide users.
BACKGROUND: This study was done to examine the cancer risk among pesticide users in Iceland. METHODS: We have followed a cohort of 2449 licensed pesticide users, students from a horticultural college, members of a pension fund for market gardeners, horticulturists and vegetable farmers up until the end of 1993 in the Icelandic Cancer Registry of cancer incidence. The observed number of cancers was compared with expected values calculated on the basis of cancer incidence for males and females in Iceland. RESULTS: The standardized incidence ratio (SIR) for all cancer sites was 0.80. Among females the increased incidence for cancer of lymphatic and haematopoietic tissue was significant (SIR = 5.56, 95% confidence interval (CI) 1.12-16.23). The incidence of rectal cancer was three times that expected (SIR = 2.94, 95% CI: 1.07-6.40), and this cancer was even more predominant among the licensed pesticides users (SIR = 4.63, 95% CI: 1.49-10.80). All cancers of the rectum were adenocarcinoma, however, one was adenocarcinoma in villous adenoma and one adenocarcinoma in tubulo-villous adenoma. CONCLUSION: The results provide some support for the suggestion that pesticide exposure may lead to cancer of the lymphatic and haematopoietic tissue in females. We suggest that some of the pesticides to which the licensed pesticide users were exposed may lead to rectal cancer.
Aged↗
Cancer incidence among seamen in Iceland.
The cancer incidence was investigated among 27,884 fishermen and sailors from the merchant fleet who had been members of a pension fund for seamen during 1958-1986 in Iceland. The cancer incidence was followed through 1966-1988. Expected values were based on rates for the general male population in Iceland. In the whole cohort, 758 malignant neoplasms had occurred as compared to 688.43 expected, standardized incidence ratio (SIR) = 1.10, 95% confidence limit (CI) 1.03-1.18. There was an excess for cancer of the stomach, rectum, larynx, and lung and nonmelanoma skin cancer; the SIRs were 1.29, 1.44, 1.77, 1.61, and 1.51, respectively. When analyzing the cancer incidence according to length of employment, the SIRs for many of the cancer sites were high for those with a short employment and many SIRs decreased with increasing length of employment. The SIRs for lung cancer were high in all subgroups. Only for stomach cancer and leukemia was there a substantial increase in SIR with increasing length of employment. The SIR was 1.55 for stomach cancer (CI 1.01-2.27) in the group with longer than 10 years of employment, and 1.97 for leukemia (CI 0.85-3.87) in the same group. It is concluded that the risk of both stomach and lung cancer seems to be associated with the occupation of seamen.
Cohort Studies↗
Cancer incidence among female manual workers.
We investigated cancer incidence during the period 1970-1992 among unskilled Icelandic female workers who contributed to two pension funds for manual workers. We found an increase in the standardized rate ratios (SRRs) for all cancer with increasing time before the follow-up period began. We found no clear relation between cancer incidence and length of employment. The SRRs were higher for those who became members of the funds in 1977 or later than for those who started earlier: among these women, we found SRRs for all cancers, 1.36; cancer of the stomach, 1.49; cancer of the lung, 1.48; cancer of the cervix, 3.19; and cancer of the bladder, 6.00.
Adult↗
Cancer incidence among Icelandic nurses.
This study investigated cancer incidence among Icelandic nurses, with a special focus on breast cancer. Cancer incidence in the study group was compared with that of the general female population. Elevated standardized incidence ratios (SIRs) were seen for some cancer sites, including breast cancer. For all cancers, breast cancer, and selected cancer sites, SIR increased with increasing length of time intervals allowed to elapse before the study period began. The nurses with a shorter employment time had a higher incidence of cancer than those with a longer one. Known confounding factors--parity and age at first birth--do not appear to be a convincing explanation of the excess of breast cancer. The possibility cannot be excluded that the nursing occupation constitutes an independent risk factor for breast cancer.
Adult↗
Mortality among Icelandic nurses.
OBJECTIVE: The goal of the study was to investigate the mortality pattern of female nurses in a retrospective cohort study with special focus on suicide. METHODS: The mortality of nurses was compared with that of the general female population. The main outcome measure was the standardized mortality ratio (SMR). The participants were 2159 female nurses (ie, all registered nurses in Iceland between 1920-1979). RESULTS: A long-lasting healthy worker effect was found in the cohort. A moderate excess of suicide was observed. A deficit was found for stomach cancer, ischemic heart disease, and respiratory disease. When the cohort was divided according to employment time, there was an excess of brain cancer among those with an employment time of less than 20 years, and all the suicides occurred in that group. The deficit of ischemic heart disease and respiratory disease was more pronounced in the group employed more than 20 years. CONCLUSIONS: It was concluded that nurses, primarily those with a long employment time, enjoy the benefits of their initial good health, but the moderate excess of suicide could be associated with stress and frustration, which the nurses relate to their work situation.
Adult↗
Mortality among Icelandic seamen.
BACKGROUND: The aim of this cohort study was to evaluate the mortality of Icelandic seamen with particular reference to cancer deaths. SUBJECTS: In all 27,884 seamen, both fishermen and sailors of the merchant fleet, who had been members of a pension fund between 1958 and 1986 were followed-up. RESULTS: Most standardized mortality ratios (SMR) were greater than 1:1.26 for all causes, 1.13 for all malignant neoplasms, 1.80 for liver cancer, 1.19 for stomach cancer, 1.56 for lung cancer, and 1.21 for kidney cancer. The highest SMR was found for unknown causes, 3.16. There was no 'healthy worker effect'. For most causes of death latency time and mortality were strongly correlated. When analysing the relation between duration of employment and mortality a correlation was found for all-causes and for stomach cancer; however, this was not statistically significant. CONCLUSION: Seamen have an unusual mortality pattern and the excess for unknown causes is a rare finding indicating a peculiar situation for this group. The excess of stomach and lung cancer was high but it was not convincingly related to duration of employment and thus a relationship to occupation cannot be confirmed.
Adult↗
Risk of fatal accidents occurring other than at sea among Icelandic seamen.
OBJECTIVE: To study mortality among seamen, particularly from fatal accidents that occurred other than at sea. DESIGN: Cohort study. SETTING: Iceland. SUBJECTS: 27,884 seamen, both fishermen and sailors from the merchant fleet, who had been members of a pension fund from 1958 to 1986. MAIN OUTCOME MEASURES: Cause of death (ICD seventh revision), standardised mortality ratio. RESULTS: Most standardised mortality ratios were greater than 1, being 1.26 for all causes and 1.83 for all external causes. There was no healthy worker effect. The excess of deaths from all external causes included all subcategories of death from accidents, poisonings, and violence and not just accidents at sea (water transport accidents, ICD codes E850-E858). A significant trend was found for length of employment and mortality from all accidents at sea, drowning at sea, accidental poisoning, other accidents, and accidental drowning; correlation coefficients for all causes, all accidents, suicide, and injuries undetermined whether accidentally or purposely inflicted were 0.7-0.8. Compared with seamen who started work during 1968-77, those who started work in 1978 or later had higher mortality from all causes, road traffic accidents, poisoning, other accidents, homicide, and injuries unknown whether accidentally or purposely inflicted, but not from all accidents at sea and accidental drowning. CONCLUSION: Seamen seem to be a special group with a high risk of fatal accidents occurring not only at sea. The association between fatal accidents other than at sea and length of employment as seamen indicates that seamen are modified by their occupation towards hazardous behaviour or a risky lifestyle.
Accident Proneness↗
Mortality among female manual workers.
STUDY OBJECTIVE: The aim was to determine whether female manual workers have higher mortality than other women. DESIGN: This was a retrospective cohort study in which mortality was compared with that of the general female population. Main outcome measures were standardised mortality ratio (SMR) and 95% confidence intervals (CI). SETTING: Reykjavík region. PARTICIPANTS: Participants were 18,878 women, the cumulated members of a pension fund for manual workers between 1970 and 1986. MAIN RESULTS: A healthy worker effect was observed in the total cohort. The study was then restricted to those who had contributed to the pension fund any time after reaching 20 years of age, and a 10 year latency period was instituted. When analysing subcohorts by duration of employment the standardised mortality ratios for all causes of death and all cancers increased with longer employment time up to 10 years. However, the ratios were low in the group with over 10 years of employment. Those who began contributing to the fund in 1977 or later had higher mortality than those who began earlier. There was an excess of lung and bladder cancer in the total cohort and in all the subcohorts except in the group with over 10 years' employment. Mortality from accidents and suicides was in excess in all the groups. CONCLUSIONS: Mortality is high among some groups of female manual workers. A deficit was found among those with the longest employment. Differences in mortality have widened in recent years. An excess of suicides shows that women in this group have, for some reason, less will to live than other women.
Adult↗
Fatal accidents among Icelandic seamen: 1966-86.
OBJECTIVE: To investigate whether fatal accidents, including drownings, have decreased among Icelandic fishermen and seamen. DESIGN: Historical prospective study. The study population was record linked with the National Register and the Register of Deceased to get information on water transport accidents (ICD-7, E850-E858) during the period 1966-86. The number of persons in each calendar year and the number of days at sea registered at the pension fund were both used as denominator to find annual mortalities. SETTING: Iceland. SUBJECTS: 27,884 seamen who were members of the Seamen's Pension Fund. The cohort included both fishermen and seamen from the merchant fleet. MAIN OUTCOME MEASURES: Changes in mortality from all accidents and drownings from 1966-86. RESULTS: The mortality for all fatal accidents was 89.4 per 10(5) person-years and did not change appreciably during the study period. The mortality for drowning was unchanged at 73.2 per 10(5) person-years. The greatest number of drownings were among those 20-24 years of age but the mortality for drowning was highest among those 45-54 years of age. CONCLUSION: Mortality because of fatal accidents and drownings among these seamen was high and did not conclusively decrease during the study period. Further preventive measures are needed.
Accidents, Occupational↗
Mortality from ischemic heart disease in Iceland, 1951-1985.
The objective of this study was to evaluate mortality rates from ischemic heart disease among Icelanders during the period of 1951 to 1985. In some developed countries, the number of deaths from ischemic heart disease declined markedly in this time period, and it is interesting to study whether the same has occurred in Iceland. The study was based on information obtained from the Statistical Bureau of Iceland, which keeps records of deaths based on death certificates as well as other population records. Nonparametric tests were used to correlate death rates and calendar years. Rates per 100,000 were calculated and plotted. The results indicated that the mortality rates from ischemic heart disease among Icelanders have not yet peaked.
Adult↗