Defining obesity by body mass index in the Thai population: an epidemiologic study

The objective of this study was to develop cut-off values and evaluate the accuracy of body mass index (BMI) in the definition of obesity in the Thai population. A cross-sectional, epidemiologic study in 340 men and 507 women aged 50 +/- 16 yr (mean +/- SD; range: 20-84 yr), were sampled by stratified clustering sampling method. Body composition, including percentage body fat (%BF), was measured by dual energy X-ray absorptiometry (GE Lunar Corp, Madison, WI). BMI was obtained by dividing weight (in kg) by height (in m2). The "golden standard "for defining obesity was %BF > or =25% in men and %BF > or =35% in women. The %BF-based prevalence of obesity in men and women was 18.8% and 39.5%, respectively. However, using the BMI cut-off of > or =30, only 2.9% of men and 8.9% of women were classified as obese. In the cubic regression model, BMI was a significant predictor of %BF, such that in men a BMI of 27 kg/m2 would predict a %BF of 25%, and in women a BMI of 25 kg/m2 would correspond to a %BF of 35%. The area under the receiver operating characteristic curve for BMI was approximately 0.87 (95% CI: 0.82-0.92) and 0.86 (95% CI: 0.83-0.90) in men and women, respectively. In conclusion, for the Thai population, BMI is a reasonably useful indicator of obesity; however, the cut-off values of BMI for diagnosing obesity should be lowered to 27 kg/m2 in men and 25 kg/m2 in women.     

An epidemiologic study of the carpal tunnel syndrome in an adult female population

The relationships between certain reproductive, demographic, and medical variables and the carpal tunnel syndrome were examined using data from a hospital-based case-control study of women ages 45 to 74 years in the New Haven and Hartford, Connecticut, areas from 1977 to 1979. Characteristics of 40 carpal tunnel syndrome cases and 1,043 controls from hospital surgical services were compared. A history of diabetes was associated with an increased frequency of occurrence of the carpal tunnel syndrome, a finding consistent with clinical observation. Recent weight gain and use of estrogen replacement therapy were identified as possible risk factors; this provides some support for the theory that fluid retention in the soft tissues of the carpal tunnel is etiologically involved, although these results are preliminary and further research must be carried out to refute or support these findings. The negative association of the carpal tunnel syndrome with height and a history of varicose veins and the positive association with age at menopause cannot be explained and need verification.     

Tobacco use among American Indians in Oklahoma: an epidemiologic view

OBJECTIVES: With the exception of national surveys that sample the entire U.S. population, little information exists on tobacco habits among American Indians. This study is a comparison of tobacco use findings in the 1990s among American Indians in Oklahoma, a state with a large and diverse American Indian population (39 tribes). METHODS: Data on current tobacco use are presented from two statewide surveys, the Oklahoma Youth Tobacco Survey and the Native American Behavioral Risk Factor Survey, as well as two large epidemiologic studies of chronic disease among American Indians-the Cherokee Diabetes Study and the Strong Heart Study. Three of these four sources of data involve research/surveys exclusively about American Indians. RESULTS: Nontraditional use of tobacco by American Indians occurs frequently, according to each instrument. Initiation to this habit begins in middle school and increases dramatically during high school. After age 50, reporting by individuals that they currently smoke declines steadily. CONCLUSIONS: Despite sampling different individuals for the surveys and different tribes for the epidemiologic research, results were comparable in age groups that overlapped. These findings support national data indicating that American Indians have higher prevalence rates of smoking than other racial/ethnic groups. American Indians report smoking on average about a half a pack of cigarettes per day. Individuals reporting using tobacco solely for ceremonial purposes were far fewer than habitual users. Buying tobacco products in American Indian smoke shops helps tribal economies; this fact needs to be considered for prevention programs to succeed.     

Hearing deterioration in professional divers: an epidemiologic study

Hearing acuity was measured in 116 professional divers. After approximately 6 yr they were retested. At most frequencies, the divers had higher hearing thresholds than otologically normal subjects at the same age, both at the first and at the final examination. The divers' hearing deteriorated faster than that of the otologically normal subjects. The young divers' hearing thresholds were lower than in unscreened nondivers at comparable age, but the gap closed gradually with increasing age. Accordingly, the divers' hearing deteriorated faster than that of unscreened nondivers. Some of the divers had suffered permanent hearing loss from acute barotrauma. Considering the regular noise exposure during commercial diving, this must have contributed significantly to the observed hearing deterioration.     

An epidemiologic study of maladaptive eating attitudes in a Canadian school age population

Although cases of anorexia nervosa and bulimia are being seen increasingly by health care professionals, little data is available on the prevalence of these disorders in the general population of school age children. Using a validated eating attitude test (EAT), a total of 5150 students, aged 12–20, from public schools and one university in the Province of Manitoba were surveyed. Overall, 5% of males and 22% of females scored 30 or above on the scale, suggesting significant concerns and attitudes regarding eating. These concerns were somewhat higher in urban versus rural settings and seemed to increase between the ages of 12 and 13 and remain high thereafter. Many of the students who scored high on the EAT were overweight, suggesting that these attitudes or concerns are not specific to anorexia nervosa and/or bulimia.     

Where cancer patients die: an epidemiologic study

In a sample of deaths among cancer patients, the relationship of place of death to age, sex, length of time between diagnosis and death, cancer site, and patients' socioeconomic status was investigated. The Rochester (N.Y.) Regional Tumor Registry provided these data for all cancer patients who died in Monroe County, N.Y., during 1976, 1977, and 1978. Patients who had not been residents of the county were excluded from the sample, as were patients under 15 years of age at death and those whose cancers had been diagnosed only at autopsy. Analysis with a logit model was used to estimate odds ratios that compared the probabilities of death in an acute care hospital and in a chronic care facility with the probability of death at home. Patients whose cancers had been diagnosed less than 1 month before their deaths were significantly more likely to die in a hospital than were patients whose cancers had been diagnosed earlier. Cancer sites, too, were significantly related to place of death: persons with leukemia or lymphoma were most likely to die in a hospital, followed by patients with lung, breast, and upper gastrointestinal tract cancers; persons with colorectal, genitourinary, and miscellaneous cancers were most likely to die at home. The patients whose deaths were studied were classified by socioeconomic area (SEA) ranking. Patients who had resided in higher level SEAs were more likely to die at home than those from lower level SEAs; however, this trend was reversed among patients from the lowest level SEAs, who had a relatively high rate of death at home and a low rate of death in chronic care facilities.     

Driving-related behavior: an epidemiologic study of undergraduate students

The purpose of this article was to describe self-reported driving-related behavior and compare the frequency of risk-taking among drivers with and without a history of traffic accidents (TA). A cross-sectional study was designed, and 2,116 undergraduate students from a public university in Brazil ranging in age from 18 to 25 were interviewed. Association between independent variables and history of TA was described using frequency, chi2, p, odds ratio, and 95% confidence intervals. Male data were analyzed through logistic regression. Men showed a higher risk than women of having been involved in TA. Drivers with more frequent risk-taking had a greater risk of history of TA. Behaviors observed to be associated with TA in men were: "history of fines", "driving on the shoulder", and "drinking and driving". Open-ended questions demonstrated that students show low awareness of their own responsibility in TA. Interventions among students are necessary and must prioritize males and mainly those from upper socioeconomic groups.     

水族老年人高血压流行病学研究

目的 了解水族老年人高血压患病情况.方法 采用整群随机抽样方法对都匀水族老年人群进行高血压流行病学调查.结果 都匀水族老年人高血压患病、知晓率、治疗率、控制率分别为32.15％、26.67％、12.97％、0.00％.男女高血压患病率分别为42.14％和21.71％,差异有统计学意义(P＜0.01).吸烟、饮酒、摄盐量、文化程度低、BMI均与都匀水族老年人高血压有关.结论 都匀水族老年人高血压患病率较高,改善其生活习惯,加强其高血压健康教育刻不容缓.     

Environmental fiber-induced pleuro-pulmonary diseases in an Anatolian village: an epidemiologic study

This study was designed to determine the prevalence of pleural mesothelioma and other malignancies in the Anatolian village of Tuzk?y, where neither asbestos nor any environmental carcinogen has been detected. Another village (Kizilk?y) located 12 km from Tuzk?y was selected as a control. Three hundred twelve subjects from Tuzk?y who were at least 25 yr of age and 95 subjects from Kizilk?y were studied. Analysis of X-rays of the Tuzk?y group revealed that subjects had calcified pleural plaques (17%), pleural thickening (10.5%), obscured costophrenic angles (15%), and diffuse interstitial pulmonary fibrosis (12.1%). Sixty-seven deaths were records in Tuzk?y during the previous 3 yr, 41 of which resulted from malignant diseases. There were no X-ray abnormalities or deaths resulting from malignancies in the control group. Because of the high incidence of mesothelioma and lung cancer which usually results from asbestos exposure, the presence of asbestos in Tuzk?y was investigated, but none was detected in spite to Tuzk?y's volcanic location. Nevertheless, zeolite, an asbestiform mineral, was detected in the stones of buildings and in the village soil, as well as in the lung and pleura of the patients during biopsy. Thus, this mineral was considered to be responsible for the fiber-induced pleuro-pulmonary diseases in Tuzk?y. No zeolite was found in the soil and stones of the control village.     

Postprandial lipemia: reliability in an epidemiologic field study.

Ten subjects from the Forsyth County, North Carolina, and Washington County, Maryland, field centers in the Atherosclerosis Risk in Communities Study had two fat tolerance tests within a 10-day period from September 1988 to February 1989 to determine the reproducibility of markers for postprandial lipemia. No significant differences between visits were found in fasting mean plasma lipids, lipoproteins, and apolipoproteins. Postprandial triglycerides and retinyl palmitate were measured at 3.5 and 9.0 hours after the test meal in whole plasma. There were no significant differences in the mean levels of these analytes between visits. The correlation of triglycerides between repeat visits at 9.0 hours (r = 0.87) was stronger than in fasting samples (r = 0.67) or at 3.5 hours (r = 0.69). The mean plasma retinyl palmitate level at 3.5 hours was 15% higher than at the 9.0-hour level. The correlation of repeat measures of retinyl palmitate at 9.0 hours (r = 0.94) was much stronger than at 3.5 hours (r = 0.79). In conclusion, estimates of reliability in postprandial measurements of 9.0-hour triglycerides and retinyl palmitate levels were as strong as fasting lipid measurements of total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, and high density lipoprotein cholesterol, and both postprandial triglyceride measurements exceeded that of fasting triglyceride (r = 0.67).     

Relations among standard epidemiologic measures in a population

Recent developments in population mathematics apply to measurement issues in epidemiology. In particular, they demonstrate explicitly the relations that prevail among incidence, prevalence, case-fatality, mortality, and duration of illness in a population at a moment in time, rather than in a cohort of persons followed through time (or in a population artificially assumed to be stationary). They indicate explicitly how certain common indicators such as the ratio of deaths to new cases should be interpreted. They also suggest possible new strategies for estimating certain measures, but these would require some reorientation of current approaches to measurement.     

流行病学研究中的病因与病因推断

因果(causality)与因果推断(causal-inference)是科学研究的核心问题,例如爱因斯坦认为:“西方科学是建立在以因果律为基础的形式逻辑之上”。虽然不同学科之间因果定义的内涵基本一致,但是他们的外延却大相径庭,其因果推断的理论与方法更是各具特色。其中,区别最大的是自然科学与     

Subacute sclerosing panencephalitis: an epidemiologic study in Israel.

Subacute sclerosing panencephalitis (SSPE), a disease related to measles (rubeola) infection, was more common in Arabs and Sephardi Jews than in Ashkenazi Jews in Israel. There were no familial aggregates and it is unlikely that genetic differences account for this selectivity. Among several non-genetic factors which might explain the selectivity, family size emerged as a possible risk factor. Family size has not previously been suspected as influencing the risk of SSPE. Preponderance of SSPE in rural areas and among the poor would also be compatible with this idea as family size tends to be larger in rural and lower socioeconomic groups. In large families, there may be a greater change that older siblings will transmit measles to very young siblings. In small families, measles may be acquired from peers at about school age when risk of SSPE may be lower.     

A population based study comparing changes in rotavirus burden on the Island of Ireland between a highly vaccinated population and an unvaccinated population

BackgroundRotavirus infection is a leading cause of gastroenteritis in infants and children globally. Reductions in rotavirus activity have been observed following introduction of rotavirus vaccination programmes, however a reductions have also been reported in some unvaccinated countries.The Island of Ireland incorporates the two jurisdictions Northern Ireland (NI) and the Republic of Ireland (IE). Both have similarities in climate, demography, morbidity and mortality but distinct health administrations and vaccination policies. Rotarix was added to the childhood immunisation programme in NI on the 1 July 2013. IE have not introduced routine rotavirus vaccination to date.The aim of this population based ecological study was to evaluate the impact of the rotavirus vaccine on burden of rotavirus disease in NI, and to compare with IE as an unvaccinated control population. This will help determine if the changes seen were due to the rotavirus vaccine, or due to confounding factors.MethodsA number of population based measures of disease burden were compared in both jurisdictions pre-vaccine (six years; 2007/08–2012/13) and post-vaccine (two years; 2013/14–2014/15). The data sources included national rotavirus surveillance data based on laboratory reports/notifications; hospital admission data; and notifications of gastroenteritis in under 2 year olds.ResultsIn the post-vaccination period, rotavirus incidence in NI dropped by 54% while in IE it increased by 19% compared to the pre-vaccine period. Notifications of gastroenteritis in under 2 s in NI declined by 53% and hospital admissions in under 5 year olds in NI declined by 40% in the post vaccine period.ConclusionsThis natural experiment demonstrated a significant reduction in rotavirus disease activity post-vaccine introduction in NI with associated reductions in healthcare utilisation, with a concurrent increase in rotavirus disease activity in the non-vaccinated population in IE. These findings support rotavirus vaccination as an effective measure to reduce childhood morbidity.     

The Air Force health study: an epidemiologic retrospective

In 1979, the U.S. Air Force announced that an epidemiologic study would be undertaken to determine whether the Air Force personnel involved in Operation Ranch Hand-the program responsible for herbicide spraying in Vietnam-had experienced adverse health effects as a result of that service. In January 1982 the Air Force Health Study (AFHS) protocol was approved and the 20 year matched cohort study consisting of independent mortality, morbidity and reproductive health components was initiated. This controversial study has been criticized regarding the study's potential scientific limitations as well as some of the administrative aspects of its conduct. Now, almost 30 years since the implementation of the AFHS and nearly a decade since the final follow up examinations, an appraisal of the study indicates that the results of the AFHS do not provide evidence of disease in the Ranch Hand veterans caused by their elevated levels of exposure to Agent Orange.     

Chronic pulmonary effects of volcanic ash: an epidemiologic study

The chronic pulmonary effects of exposure to volcanic ash were investigated by conducting a cross-sectional epidemiological study of 2,006 women between 30 and 59 yr of age who lived in three areas subjected to different levels of airborne ash. In the three areas prevalences of chronic bronchitis and other respiratory symptoms were so low that volcanic ash did not seem to be a major cause of respiratory disease. In the highly exposed area, however, 9.9% of the women experienced symptoms of one or more respiratory diseases, while 6.4% of the women in the medium- and 5.4% of the women in the low-exposure area had these symptoms. Prevalences of each disease and symptom increased as total suspended particulate level increased, suggestive of an association of mild respiratory symptoms with volcanic ash.