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PubMed1992

Epidemiological data on US coal miners' pneumoconiosis, 1960 to 1988.

OBJECTIVES: Statistics on prevalence of pneumoconiosis among working underground coal miners based on epidemiologic data collected between 1960 and 1988 are presented. The main intent was to examine the time-related trend in prevalence, particularly after 1969, when substantially lower dust levels were mandated by federal act. METHODS: Data from studies undertaken between 1960 and 1968 were collected and compared. Information for the period 1969 to 1988 was extracted from a large ongoing national epidemiologic study. Tenure-specific prevalence rates and summary statistics derived from the latter data for four consecutive time intervals within the 19-year period were calculated and compared. RESULTS: The results indicate a reduction in pneumoconiosis over time. The trend is similar to that seen in a large radiologic surveillance program of underground miners operated concurrently. CONCLUSIONS: Although such factors as x-ray reader variation, changes in x-ray standards, and worker self-selection for examination may have influenced the findings to some extent, adjusted summary rates reveal a reduction in prevalence concurrent with reductions in coal mine dust levels mandated by federal act in 1969.

Adult↗
PubMed1993

Epidemiological data on Werdnig-Hoffmann disease in Germany (West-Thüringen).

This study contains the largest body of epidemiological data on Werdnig-Hoffmann disease (acute infantile spinal muscular atrophy; ASMA) in West-Thüringen in Germany. The incidence of ASMA was calculated to be 1 in 10,202 live births. The prevalence was 1 in 595,362 of the general population (as of 31 December 1987). The study gives an unexpectedly high incidence rate confirming the suggestion that ASMA in Central and Eastern Europe might be more frequent than in Western Europe. However, we consider that this high incidence rate in West-Thüringen is a result of the almost complete ascertainment made possible because of the well-organised and centralised health system existing in Thüringen over the last few decades.

Female↗
PubMed2001

Commentary: practical advantages of Bayesian analysis of epidemiologic data.

In the past decade, there have been enormous advances in the use of Bayesian methodology for analysis of epidemiologic data, and there are now many practical advantages to the Bayesian approach. Bayesian models can easily accommodate unobserved variables such as an individual's true disease status in the presence of diagnostic error. The use of prior probability distributions represents a powerful mechanism for incorporating information from previous studies and for controlling confounding. Posterior probabilities can be used as easily interpretable alternatives to p values. Recent developments in Markov chain Monte Carlo methodology facilitate the implementation of Bayesian analyses of complex data sets containing missing observations and multidimensional outcomes. Tools are now available that allow epidemiologists to take advantage of this powerful approach to assessment of exposure-disease relations.

Bayes Theorem↗
PubMed1989

Statistical analysis of epidemiologic data of pregnancy outcomes.

In this paper, a generalized logistic regression model for correlated observations is used to analyze epidemiologic data on the frequency of spontaneous abortion among a group of women office workers. The results are compared to those obtained from the use of the standard logistic regression model that assumes statistical independence among all the pregnancies contributed by one woman. In this example, the correlation among pregnancies from the same woman is fairly small and did not have a substantial impact on the magnitude of estimates of parameters of the model. This is due at least partly to the small average number of pregnancies contributed by each woman.

Abortion, Spontaneous↗
PubMed2002

Epidemiological data and ranking home and leisure accidents for priority-setting.

OBJECTIVE: To determine how to use the multitude of available epidemiological data to rank accidents for prioritisation of prevention. METHODS: A stepwise method to rank accidents for priority-setting at any time is proposed. The first step is to determine the overall objectives of injury prevention. Based on these objectives, the relevant epidemiological criteria are determined. These criteria need to be weighed by experts in such a way that these weights can be used for every new cycle of priority-setting. Thus, every time the method is applied: first, the relevant types of accidents are identified; second, the epidemiological criteria are determined per type of accident; and third, the types of accidents are ranked by means of standardised weights per criterion. The proposed indirect method is illustrated by an empirical example. The results were compared with a direct method, i.e. ranking by an expert panel. RESULTS: In the pilot, we ranked four age groups of victims of a home and leisure accident: 0-4, 4-19 and 20-54 years of age, and victims aged 55 years or older. The resulting rankings differ largely per application; number one are victims older than 55 years or those of 20-54 years. CONCLUSIONS: The proposed method enables a structured, transparent way to set priorities for home and leisure accidents. It is a promising method, although further development is clearly necessary, based on the actual application of the model.

Accident Prevention↗
PubMed1996

[Evaluation of acceptable exposure levels to industrial and environmental pollutants: problems raised because of the interpretation of epidemiological data].

In order to assess acceptable exposure levels to industrial and environmental pollutants, toxicological data must be collected which derive from two principal sources: in vivo and in vitro experimental studies and epidemiologic studies on exposed subjects. Whatever the extent of the toxicological results obtained on animals, epidemiologic data, when available, must take precedence over animal toxicity studies for setting up acceptable exposure levels. for several practical reasons (identification of exposed groups, adequate exposure gradient), the epidemiologic studies aiming at assessing the no-adverse effect levels of nongenotoxic chemicals are usually performed on occupationally exposed subjects and are cross-sectional. Even when the design of these studies probably exclude the interference of methodological biases, the interpretation of their results may still raise numerous difficulties. This article underlines three particular problems: 1) the adequate characterization of past and current exposure and hence the identification of the causal agent. 2) the health significance of the biomarkers which have been found to be related to exposure and 3) the extrapolation of the observations made on workers to the general population.

Animals↗
PubMedDate not supplied

[Maternal and obstetrical risk factors of placental vascular pathology (biologic and epidemiological data excluded)].

The purpose is to identify maternal and prenatal risks factors for placental vascular disorders. We excluded biologic and epidemiological data which are discussed in another chapter. Maternal risks factors are pre-existing vascular systemic diseases. Systemic lupus erythematosus (antiphospholipid antibodies are studied in another chapter) is a classical disease associated with unfavorable outcome, particularly when the disease is not quiescent and if the patient has a history of previous poor outcome. Obstetricians' awareness of the influence of inflammatory bowel diseases on pregnancy and fetal outcome is quite poor. These diseases, if they are not quiescent, can induce deleterious perinatal effects. Type 1 or even type 2 diabetes mellitus increases the risk of preeclampsia or hypertension in pregnancy, particularly when there is poor glycemic control early in pregnancy. The duration of type 1 diabetes affects the outcome of pregnancy more than type 2. Smoking during pregnancy is associated with many adverse events including spontaneous abortion, low birth weight and placental abruption. There are data about the dose-response relationship between the number of cigarettes smoked per day and the risk of abortion. Smoking during pregnancy is also protective against preeclampsia and this apparent paradox suggests the complexity of what is called vascular placental pathology. There is a significant relationship between pejorative perinatal vascular outcome and the non quiescence of renal disease. Mid-trimester uterine artery Doppler combining bilateral notches and increased uterine resistance index is the best criterion to predict the placental vascular risk of the pregnancy. Some promising studies suggest the feasibility of uterine Doppler ultrasound screening early in the pregnancy during the first trimester. Large studies are required to confirm this practice. Uterine artery Doppler in combination with other tests (elevated maternal serum hCG or ambulatory 24-hour blood pressure monitoring at 22 weeks gestation) could be a more efficient predictor of vascular complications. A large-scale evaluation is necessary before recommendations can be made. Multiple pregnancies increase the risk of preeclampsia 2- or 3-fold (RR 2.62; 95% CI: 2.03-3.38). A history of preeclampsia is the strongest predictor of unfavorable outcome for the second pregnancy.

Female↗
PubMed2004

Adiponectin gene polymorphisms and adiponectin levels are independently associated with the development of hyperglycemia during a 3-year period: the epidemiologic data on the insulin resistance syndrome prospective study.

The plasma concentration of the adipocyte-derived peptide adiponectin is decreased in patients with obesity and type 2 diabetes. The adiponectin gene is located on chromosome 3q27, where a diabetes susceptibility locus has been mapped. Adiponectin gene polymorphisms (single nucleotide polymorphisms [SNPs]) have been associated with BMI, insulin sensitivity, and type 2 diabetes in some cross-sectional studies. Our aim was to assess the contribution of these SNPs in the development of features of the insulin resistance syndrome in a 3-year prospective study in approximately 4,500 French Caucasian subjects from the Epidemiologic Data on the Insulin Resistance Syndrome (DESIR) cohort. For subjects who were normoglycemic at baseline, the 3-year risk of becoming hyperglycemic (diabetes or impaired fasting glucose) was affected by two SNPs: G-11391A and T45G. For G-11391A, the risk was increased in GA carriers (odds ratio [OR] adjusted for sex [versus GG] = 1.60 [95% CI 1.16-2.20]; P = 0.004). For T45G, it was increased in GG carriers (OR [versus TT] = 2.71 [1.31-5.60]; P = 0.007). After 3 years, GG subjects had a greater increase in BMI (P = 0.009) and waist-to-hip ratio (P = 0.007). Adiponectin levels at baseline were associated with the development of hyperglycemia (P = 0.005), but the predictive effects on the risk for hyperglycemia were independent of adiponectin genotypes. In conclusion, in the DESIR study, variations at the adiponectin locus affect body weight gain, body fat distribution, and onset of hyperglycemia, as well as adiponectin levels. Adiponectin gene SNPs may have several phenotypic effects that co-occur with the development of the metabolic syndrome.

Adiponectin↗
PubMed1992

Improving dental epidemiologic data collection with computers.

A computerized dental data recording system (DDRS) was developed for the New England Elder Dental Study to improve data quality and increase field staff efficiency. The DDRS displays video screens similar to traditional paper forms to record data on coronal and root caries, dentate and denture status, subacute bacterial endocarditis screening, gingival bleeding, calculus, and periodontal attachment level. DDRS provides facilities for date and exam-component time tracking, on-line contextual comments, random record retrieval, editing, data backup, and data output in various data formats. This study compared the DDRS with a paper-form system for data entry accuracy. Dental caries and periodontal disease measurement data from 38 subjects were recorded on paper forms and independently entered using DDRS. The DDRS identified 150 illogical data errors, 39 inconsistent data errors, 7 invalid data and 34 miscellaneous data errors. Four technicians with field experience using both paper forms and DDRS reported time savings using DDRS in the field. DDRS has the potential for additional time savings by minimizing the time for data coding, cleaning, and management. Results demonstrate that DDRS could improve the quality of oral epidemiologic data by mandating strict adherence to protocols, preventing errors, and increasing field efficiency.

Computers↗
PubMed2001

The possibility of previous epidemiological data to serve as baseline for future national oral health surveys--a study in Vietnam.

AIM: The purpose of this paper is to review the most recent epidemiological data (1985-2000) on dental caries and periodontal diseases in Vietnam in an attempt to obtain a 'baseline' for future national oral health surveys. METHODS: Studies on periodontal diseases and caries were included when CPITN and WHO caries criteria had been applied and when the sample size was at least n = 200 for each age group. RESULTS: Almost all subjects had calculus. The median number of sextants with calculus in the 15-19-year- and in the 35-44-year-olds was 4.2 and 5.0, respectively. Only 2-7% of the 35-44-year-olds had one or more deep periodontal pockets. The estimated DMFT of the 12-, 15- and 35-44-year-olds was 1.8, 2.0 and 5.4, respectively, in the years around 1990. CONCLUSION: This review shows that (often neglected) epidemiological studies from the past on caries and periodontal diseases can contain comprehensive data sets that provide an estimate of the past oral health status which may serve as a baseline for future national surveys.

Adolescent↗
PubMed1994

Epidemiological data and costs of burn injuries in workers in Switzerland: an argument for immediate treatment in burn centres.

A complete statistical evaluation of epidemiological data and costs of burn injuries in 1984 with a follow-up for 5 years is presented, considering a collective of 1.77 million workers in Switzerland. The majority of burns are minor injuries; only about 5 per cent of the burn victims are admitted to a hospital, 0.2 per cent died. Burn injuries at work are rare, mainly owing to strict safety measures. Only one-fifth of the costs caused by burns are due to medical treatment. All other expenses result from continuation of payments of salaries and annuities. The treatment of the few severely burned patients in burn units produces effective costs which are higher than the tariff paid by the insurance. Even so, the predominant portion of the enormous costs is taken up by wages while off work and annuities. As our conclusion we stress the importance of primary care for all severe burns including all burns of the hands in a specialized centre. Any economic effort for primary burn treatment, however high it may be, is justified if the duration of rehabilitation and invalidity can be reduced.

Accidents, Occupational↗
PubMedDate not supplied

[Keratoconus. I. Various epidemiologic data].

Two hundred and fifty three patients with keratoconus (161 men and 92 women) have been observed in the period 1968-1988. Selected epidemiological data are presented; between others: the distribution in Poland, education of the patients, the time of onset and the time of diagnosis of the condition.

Adolescent↗
PubMed1993

Significance of some variables on interproximal alveolar bone height based on cross-sectional epidemiologic data.

The objective of the study was to analyze the significance of some variables on interproximal alveolar bone height, based on cross-sectional epidemiologic data from a Swedish survey conducted in 1983-1984, in the northern medical care district of Alvsborg county. 723 dentate individuals (92% of the randomly selected dentate individuals) with complete anamnestic, clinical and radiographic documentation were included in the statistical analyses. The computerized method used to measure interproximal alveolar bone height as a % of root length (B/R) provided data at each measurable interproximal surface of the individual teeth. On the population basis, a multivariate linear regression analysis showed that: (i) mean B/R values did not differ significantly between men and women, (ii) B/R value decreased with increasing age at a linear rate of 0.26% (0.04 mm) per year of age, (iii) the higher the calculus index value, the lower the mean B/R value, (iv) the higher the plaque index value, the higher the mean B/R value, (v) level of education, dentist attendance frequency and prevalence of defective margins of dental restorations did not show any statistically significant association with B/R, (vi) individuals attending the dental hygienist less than once every 2 years had higher mean B/R value than individuals attending the dental hygienist at least once every two years, and (vii) current smokers exhibited significantly lower mean B/R value than former and non-smokers. Individuals smoking more than 5 g of tobacco per day had lower mean B/R values than individuals smoking between 1 and 5 g of tobacco per day. There was no statistically significant relationship between snuffing and B/R.

Adult↗
PubMed2001

Lognormal model for determining dose-response curves from epidemiological data and for health risk assessment.

A practical method is proposed for determining human dose-response curves based on reasonable assumptions and simplifications. The epidemiological data needed are the fractions of the population suffering an adverse response from exposures to two or more patterns of fluctuating concentrations of a pollutant, and the statistical parameters of each pattern. The method calculates the two parameters of the threshold type dose-response curve of the pollutant, represented by a cumulative lognormal distribution. This distribution was derived from a reasonable statistical model. The calculation does not require any arbitrary safety factors and yields central values. The dose-response parameters then may be used to calculate the health risk rate of exposure to any other fluctuating concentration pattern. Another method is proposed to select appropriate threshold limit values (TLVs) using calculations involving these parameters. Examples are given to illustrate the calculations. Results with hypothetical data gave apparently reasonable results. They showed the importance not only of the geometric mean concentration but also of the geometric standard deviations of both the concentrations and of the dose-response curve, that greatly influence the results. It is believed that results of useful accuracy should be obtained. Health risk rates are readily understood. They are useful for cost-benefit calculations. Relative rates can be used to compare the hazards of different operations and different plants. The method may make possible the development of standards specifying maximum allowable risk rates.

Cost-Benefit Analysis↗
PubMed1992

Epidemiologic data linking diet to hyperlipidemia and arteriosclerosis.

There is little debate that an elevated plasma cholesterol level, specifically an elevated plasma LDL cholesterol level, increases cardiovascular disease risk. Data from inter- and intrapopulation studies have clearly demonstrated that as total and LDL cholesterol levels increase, cardiovascular disease risk increases. Although this relationship is generally accepted, the specifies of the relationship generate debate. Relevant questions pertain to the actual level of plasma cholesterol at which cardiovascular disease risk is increased, whether the relationship holds true across all age groups and both sexes, and what contributions plasma HDL levels and the plasma LDL/HDL ratio make to cardiovascular disease risk independent of plasma LDL levels. Irrespective of these uncertainties, the evidence that elevated plasma LDL cholesterol levels constitute an independent risk factor for cardiovascular disease has been a major component in studying the genetic and environmental factors involved in hypercholesterolemia. Epidemiologic data reveal relationships between a number of dietary elements and elevated plasma cholesterol levels with the strongest relationships between dietary fatty acids, plasma cholesterol levels, and cardiovascular disease incidence. The data from a variety of epidemiologic investigations, both cross-cultural and cross-sectional, indicate that plasma total cholesterol levels are increased by saturated fat intake and obesity. HDL cholesterol levels are decreased by intakes of low-fat, high-carbohydrate diets, a high BMI, and lack of activity and increased by intake of dietary fat, alcohol, and physical activity. Controlled clinical trials have provided verification of these epidemiologic observations in practically every case.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2003

[Metabolic syndrome or insulin resistance syndrome. Recent epidemiological data].

Three definitions are currently proposed to define metabolic syndrome or insulinresistance syndrome (WHO, EGIR, NCEP-ATP III). These definitions are described and recent epidemiological data assessing the frequency of this syndrome in different populations according to these three definitions are presented. Observational studies indicates an increased cardiovascular morbidity and mortality risk in subjects with metabolic/insulin resistance syndrome. These findings imply to identify these at risk subjects and to define the optimal preventive management strategy.

Adult↗