Validation of the English version of the KINDL<Superscript>®</Superscript> generic children’s health-related quality of life instrument for an Asian population – results from a pilot test

ObjectivesTo evaluate the psychometric properties of the KINDL questionnaire in an Asian population. Methods: Consecutive patients with diabetes mellitus (DM) and healthy subjects were recruited to complete the English KINDL questionnaire. The inclusion criteria for patients were age 8–16years, English-speaking, diagnosed with DM and absence of co-morbid conditions. Results:Thirty children with DM (mean age: 10.7±1.35years; 11M) and 39 healthy subjects (mean age: 10.6±1.23years, 17M) completed the child version whereas 31 adolescents with DM (mean age: 14.5±1.48years; 15M) and 32 healthy subjects (mean age: 14.3±0.87years, 16M) completed the adolescent version. Overall, children with DM reported better HRQoL than healthy children. Although this appeared counter-intuitive, several explanations are possible: (1) the development of resilience to the disease over time, (2) our subjects are well-managed, (3) response shift, (4) the provision of high quality medical care, (5) compared to normal children, diabetic subjects and their family pay greater attention to health issues. The reliability coefficients were (overall, scales): KINDL-Kid DM (0.79, 0.44–0.65), KINDL-Kid Healthy (0.71, 0.60–0.80), KINDL-Kiddo DM (0.77, 0.37–0.74) and KINDL-Kiddo Healthy (0.84, 0.21–0.79). Conclusions: The KINDL questionnaire appeared promising for use in Asian children. However, further validation in a sample more representative of the general population is required.     

An evaluation of psychometric properties of the client's questionnaire of the Wisconsin Quality of Life Index-Canadian version (CaW-QLI)

Psychometric properties of Client's questionnaire from the Canadian version of the Wisconsin Quality of Life-Index (CaW-QLI) were assessed with two groups, 89 English (E) and 94 French (F) individuals with schizophrenia or schizoaffective disorder. Sub-samples of 40E and 36F were re-interviewed within a 2-week period. Spearman correlations-SC between each domain and CaW-QLI global Score ranged from 0.39 to 0.76, while inter-domain correlations were low, confirming the multidimensional properties of the scale. Cronbach's (internal consistency) were 0.78(E) and 0.70(F) for the CaW-QLI global scores and, from 0.45 to 0.88 among seven of eight domains. Test–retest (Concordance Correlation Coefficient-CCC) ranged from 0.36 to 0.80 among the domains, and from 0.80(E) and 0.85(F) between CaW-QLI global scores. Regarding convergent validity, SC between CaW-QLI global score and Spitzer's QOL-Index were 0.72(E) and 0.58(F). As hypothesized, there were higher correlations between CaW-QLI global scores (E and F) and SF-36 scales related to mental health than those related to physical health. Minor changes in the scoring are proposed to enhance face and content validity.     

Accumulation of Selenium and Lack of Severe Effects on Productivity of American Dippers (Cinclus mexicanus) and Spotted Sandpipers (Actitis macularia)

Selenium has been found at elevated concentrations in water, sediments, and aquatic biota in the Elk River (British Columbia, Canada) and some of its tributaries downstream of several coal mines. Selenium water concentrations in those areas exceed Canadian and British Columbia guidelines and are above levels at which adverse effects to fish and waterfowl could occur. We compared selenium concentrations in the eggs of two riverine waterbirds, American dippers and spotted sandpipers, with measures of productivity: the number of eggs laid, egg hatchability, and nestling survival. In American dippers, the mean egg selenium concentration from the exposed areas, 1.10±SE 0.059 g/g wet weight, was indistinguishable from the reference areas, 0.96±SE 0.059 g/g wet weight. For spotted sandpipers, the mean egg selenium concentration in the exposed areas, 2.2±0.5 g/g wet weight, was significantly higher than in the reference areas, 1.2±0.14 g/g wet weight, but less than reported thresholds for waterfowl and other shorebirds. There were no significant differences in egg hatchability between dippers in reference and exposed areas, but reduced hatchability was apparent for sandpipers in exposed locations. Despite the slightly reduced hatchability in sandpipers, overall productivity was higher than regional norms for both species; thus, selenium did not affect the number of young recruited to local populations. We did not observe teratogenic effects in either species, although none was expected at these concentrations. Despite moderately high selenium concentrations in the water, mean egg selenium concentrations were less than predicted from uptake models. We hypothesise that the relatively low uptake of selenium into the eggs of the two waterbirds in this study is likely due to their lotic environments low biological transformation and uptake rates.     

The Nottingham Health Profile: Score distribution, internal consistency and validity in asthma and COPD patients

This cross-sectional study among patients with asthma or Chronic Obstructive Pulmonary Disease (COPD) in general practice examined the psychometric properties of the Nottingham Health Profile (NHP). From 380 asthma patients and 170 COPD patients, data were obtained on the NHP, subjective measurements (i.e. sleep disturbances, problems in performing household activities, dyspnoea) and more objective measurements (peak expiratory flow rate, consultation rate, comorbidity). These data were used to compute score distributions, internal consistency (Cronbach's -coefficient) and construct validity. Score distributions were very skewed, with more than 50% of the patients achieving the best score. The internal consistency was moderate in the asthma group (mean =0.68) and acceptable in the COPD group (mean =0.74). Acceptable construct validity was found in both groups. Correlations between the NHP and the subjective measurements were, in general, statistically significant and higher than between the NHP and the more objective measurements. In conclusion, acceptable internal consistency and construct validity implies that the NHP can be used in cross-sectional studies concerning asthma and COPD patients in general practice, and in studies comparing these patients with other patient populations. Further research on the responsiveness of the NHP is needed to justify its use in longitudinal studies.     

Health-related quality of life in a rare disease: Hereditary hemorrhagic telangiectasia (HHT) or Rendu–Osler–Weber Disease

The levels of the health-related quality of life (HR-QoL) were analyzed in hereditary hemorrhagic telangiectasia (HHT) patients. The Short Form-36 Health Survey (SF-36) was administered to 50 HHT patients and scores were compared to a cohort of 2301 normal subjects. Clinical variables were patient age, illness duration, number of epistaxis episodes in the previous year and hemoglobin levels. Physical functioning, physical role limitations, bodily pain, social functioning, emotional role limitations and the physical component scores were lower among females. In multivariable analyses increasing age was related to lower physical functioning (P<0.04), physical role limitations (P<0.008), bodily pain (P<0.05) and emotional role limitations (P<0.01), while higher hemoglobin levels improved physical functioning(€P<0.03). The number of epistaxis episodes was negatively associated with physical role limitations (€P<0.009), vitality (P<0.002), social functioning (P<0.001), physical component summary (€P<0.001) and bodily pain (P<0.01). Illness duration was negatively related to the mental component summary (P<0.004). HHT patients had a lower HR-QoL with respect to normal controls in all domains except for bodily pain. Females had lower scores for several domains. Epistaxis was the most important clinical variable.     

Use of the SF-36 Health Status Survey with a Chronically Disabled Back Pain Population: Strengths and Limitations

The SF-36 is a widely used self-report health status survey. It has repeatedly demonstrated sound psychometric properties with regard to certain aspects of reliability and validity, and has proven effective as a means of tracking group outcomes. There were three major objectives of the present investigation: (1) to document group changes in a sample of chronically work disabled low back pain patients who underwent tertiary rehabilitation; (2) to evaluate the clinical utility of the SF-36 in measuring changes in patients as a result of treatment; and (3) to compare the SF-36 scores found for this sample to the United States norms for back pain/sciatica patients published elsewhere. All patients (n = 286) received an initial evaluation consisting of several assessment procedures, including the SF-36. First, the sample was broken down into a completer group (n = 188), a noncompleter group (n = 31), and a nonstarter group (n = 67). Next, the preprogram scores for the physical and mental component summary scales were compared to the norms for back pain/sciatica patients. Changes in the completer group's scores from preprogram to postprogram were then examined. To assess clinical utility, three additional self-report questionnaires were correlated to the eight scales and two summary scales of the SF-36. Results revealed no statistically significant differences with regard to demographics among the three groups. The preprogram scores for the physical and mental component summary scales were significantly lower when compared to the norms for back pain/sciatica patients. Further, patients who completed the program showed improvement on the SF-36 from preprogram to postprogram administration. When the correlations between SF-36 scales and other self-report questionnaires were examined, many of the highest correlations were found between the self-reported pain and disability measurements and the physical components of health on the SF-36. In terms of clinical usefulness, the SF-36 demonstrated limited clinical utility when attempts were made to use it on an individual patient basis. This is consistent with the psychometric limitations of the SF-36. Because of the brevity of each of the eight scales and the limited number of score levels, the reliability coefficients have been shown to be low in other studies (20), thereby increasing confidence intervals around an individual's scores on each of the scales.     

Cross-cultural development and validation of a patient self-administered questionnaire to assess quality of life in upper gastrointestinal disorders: The PAGI-QOL©

Summarize the Patient Assessment of Upper GastroIntestinal Disorders-Quality of Life (PAGI-QOL©) development and provide results on its reliability and validity from the international psychometric validation in dyspepsia, GastroEsophageal Reflux Disease (GERD), and gastroparesis. Methods: Subjects completed the pilot PAGI-QOL at baseline and 8weeks; and a subsample also at 2weeks. Other assessments were: Patient Assessment of Upper GastroIntestinal Disorders-Symptom Severity Index, SF-36, number of disability days. Results: 1736 patients completed the PAGI-QOL at baseline. The questionnaire was reduced, producing a 30-item final version covering five domains: Daily Activities, Clothing, Diet and Food Habits, Relationship (REL), and Psychological Well-Being and Distress. Internal consistency was excellent (Cronbachs range: 0.83–0.96). Test–retest reproducibility was good: intraclass correlations coefficients were over 0.70 except for the REL scale (0.61). Concurrent validity between the PAGI-QOL total score and all SF-36 subscale scores was good with moderate (0.52) to strong (0.72) correlations. PAGI-QOL scores showed excellent discriminant properties: patients who had spent some days in bed, had missed some days at work, and were kept from usual activities had much lower PAGI-QOL scores than those who did not (p<0.0001). Conclusion: The PAGI-QOL is a valid and reliable instrument assessing quality of life in patients with dyspepsia, GERD, or gastroparesis.     

Measurement of quality of life in women with breast cancer. Development of a Life Satisfaction Questionnaire (LSQ-32) and a comparison with the EORTC QLQ-C30

The purpose was to develop and validate a new instrument suitable for measuring perceived quality of life in women with breast cancer. The instrument is to be used within conventional cancer therapy as well as in complementary care, and is called the LSQ-32 (Life Satisfaction Questionnaire). The subjects were 362 women with breast cancer in all cancer stages. Cronbach's reliability coefficient of the LSQ was 0.89. The construct validity was estimated by a principal component analysis. Six orthogonal factors were identified: (1) Quality of family relation, (2) Physical symptoms, (3) Socioeconomic situation, (4) Quality of daily activities, (5) Sickness impact and (6) Quality of close friend relation. The criterion-related validity was estimated by comparing the LSQ-32 and the EORTC QLQ-C30. The scales/items of the EORTC QLQ-C30 were represented in the LSQ-32, but the factors Quality of family relation and Quality of close friend relation were not found in the EORTC QLQ-C30. It was concluded that the LSQ-32 as well as the EORTC QLQ-C30 are valuable tools in the measurement of quality of life in women with breast cancer. The LSQ-32, however, also contains an existential factor.The study was approved on 1992 04 08 by the Research Ethical Committee, Faculty of Health Sciences, University of Linköping.     

Translation,cultural adaptation,and initial reliability and multitrait testing of the Kidney Disease Quality of Life instrument for use in Japan

Background: The Kidney Disease Quality of Life instrument (KDQOL) consists of 79 items: 36 asking about health-related quality of life (HRQOL) in general (the Medical Outcomes Study SF-36) and 43 asking about QOL as it is affected by kidney disease and by dialysis. Aim: Translation, cultural adaptation and initial reliability and multitrait testing of the KDQOL for use in Japan. Methods: Translation and cultural adaptation began with two translations into Japanese, two backtranslations into English, and discussions among the translators, the project coordinators in Japan, and the developers of the original (US-English) version. Focus-group discussions and field testing were followed by analyses of test–retest reliability, internal consistency, and convergent and discriminant construct validity. Results: All eight of the SF-36 scales met the criterion for internal consistency (Cronbach's ranged from 0.73 to 0.92) and were reproducible (intraclass correlations between test and retest scores ranged from 0.60 to 0.82). Of the 10 kidney-disease-targeted scales, only two had coefficients of less than 0.70: sleep (0.61) and quality of social interaction (0.35). One item on the quality of social interaction scale had a very weak correlation with the remainder of that scale (r = 0.10). Eliminating that item from scoring increased the coefficient of the scale from 0.35 to 0.64. All three items on the quality of social interaction scale had very strong correlations with other scales. Conclusions: First, in Japanese patients receiving dialysis the SF-36 scales are internally consistent and their scores are reproducible. Second, with the possible exception of the quality of social interaction scale, the Japanese version of the KDQOL,can provide psychometrically sound kidney-disease-targeted data on quality of life in such patients.     

Measuring change over time: a comparison of results from a global single item of health status and the multi-dimensional SF-36 health status survey questionnaire in patients presenting with menorrhagia

This paper compares the sensitivity to change of a multi-item, multi-dimensional health status measure with a single global health status question, in the assessment of treatment for menorrhagia. A cohort study of patients recruited by general practitioners, was carried out, with a follow up at eighteen months. Questionnaires were administered postally at baseline and follow up. General practices in Berkshire, Buckinghamshire, Northamptonshire and Oxford-shire supplied three hundred and nine women who reported heavy menstrual bleeding, and received either drug treatment alone or both drug and surgical treatment (endometrial resection or hysterectomy) during the eighteen months between the two admini-strations of the questionnaires. A single global question was given to patients asking them to rate their overall health status as excellent, very good, good, fair or poor. The eight dimensions of the SF-36 health survey questionnaire were also given to patients to complete. The dimensions of the SF-36 indicated only small levels of improvement for patients who received drug treatment. However, on many dimensions of the SF-36, a moderate to large improvement was detected for the surgical group. However, small changes were reported in overall health status, as indicated by the single global question, for both groups. Single item measures of health status may not provide a sufficiently accurate indication of health status to be appropriate for use in longitudinal studies.     

The determinants of CABG patients' outcomes

This study examined the selfreported health status of 90 patients who had undergone Coronary Artery Bypass Grafting (CABG). Data were collected by the Short Form36 (SF36) instrument, administered twice at preoperative and postoperative periods. The reliability of the SF36 ranged from 0.68 to 0.93 in the analysis of preoperative and postoperative measures of health status. The CABG patients reported markedly lower health status on all eight SF36 dimensions at the preoperative period and considerable improvements on all dimensions at the postoperative period. The assessment of CABG patients' outcomes showed that perceived usefulness of the procedure contributed positively to their perceived health status when the effect of preoperative health status was controlled. Patients who perceived the CABG procedure as useful appeared to have more improved postoperative health status after the procedure.     

Levels of organochlorine pesticides and polychlorinated biphenyls (PCBs) in mothers' milk collected in Osaka prefecture from 1969 to 1976

Long-term investigations of polychlorinated hydrocarbon levels in mothers' milk were made from 1969 to 1976. The levels ofp,p-DDE, p,p DDT, dieldrin and PCB in mothers' milk were within the range reported by others. However, -BHC(Hexachlorocyclohexane) levels in the milk were 10 times that found in non-Japanese. A gradual decrease in the -BHC level in the milk was observed during this period. In contrast, the levelsof p,p-DDE,p,p-DDT, dieldrin and PCB were consistent for the 7-year period. A significant correlation between the levels of PCB andp,p-DDE in mothers' milk and blood was observed in the 1974–1976 samples. However, after prohibition of the use of chlorinated hydrocarbons, this relationship was less apparent in the 1972–1973 samples.     

Association study of proposed candidate genes/regions in a population of Spanish asthmatics

A number of genes/regions have recently been reported to be linked to asthma or its related phenotypes (i.e. atopy and bronchial hyperresponsiveness), by genetic linkage and allele-sharing methods. We have performed a case–control study comparing the allelic distribution of nine microsatellite markers and two genetic variants in a group of patients attended at emergency room departments because of an acute attack of asthma with respect to an external healthy population of controls. A total of 146 asthmatic subjects and 50 population controls from Barcelona, Spain, were genotyped for nine microsatellite markers from some asthma/atopy candidate genes/regions: the -subunit of the high-affinity IgE receptor (FcRI-) located on chromosome 11; the 5q31–32 candidate region; the T-cell receptor genes, TCR- on chromosome 14 and TCR- on chromosome 7. Two genetic variants of the -subunit of the high-affinity IgE receptor (FcRI-) gene were also analyzed. None of the asthmatic or control individuals carried the Ile181Leu variant. There were no significant differences between asthmatic and control subjects neither for the polymorphic markers nor for the other variant of the -subunit of the high-affinity IgE receptor (FcRI-) gene. No association could be observed in this sample of Spanish asthmatics with the genes/regions studied.     

Quality of life of caregivers in Parkinson’s disease

Objective: To assess the impact of PD on informal caregivers of patients and identify the main factors related to caregiver strain. Patients and methods: Pairs of PD patients and their caregivers. Evaluation by neurologists included the Hoehn and Yahr, Schwab and England, UPDRS (parts 1–3), ISAPD, and Pfeiffers SPMSQ rating scales. Patients completed the Euro-QoL 5D, PDQ-8, and Hospital Anxiety and Depression Scale. The SQLC was used to assess caregivers quality of life (QoL), with caregivers, in turn, applying the Euro-QoL and PDQ-8 to assess patients health-related quality of life (HRQoL). Multiple linear regression models were fitted to ascertain factors linked to the SQLC. Results: Significant correlations were in evidence between the following scores: SQLC and clinical rating scales and SQLC and patients HRQoL. Based on multiple regression analysis, patients functional state (ADL) proved to be the main predictor of caregivers QoL. Self- and caregiver-assessed patients HRQoL also proved to be a relevant factor. Conclusions: (1) Patients functional state was significantly related to caregivers psychosocial burden; (2) patients HRQoL proved to be an additional factor linked to caregiver QoL; (3) improvement of patient disability and HRQoL might alleviate caregiver strain.     

Muscle Learning Therapy—Efficacy of a Biofeedback Based Protocol in Treating Work-Related Upper Extremity Disorders

Work-related upper extremity disorders (WRUEDs) continue to present significant treatment and financial challenges to providers, employers, and insurers. This retrospective study reviews outcomes for 309 subjects who, between 1995 and 1999, were referred through the workers' compensation system for treatment of computer keyboard- and mouse-related WRUED injuries. The mean length of time from the recorded date of injury to the date of intake was 12.9 months. Subjects were offered a 12-visit course in muscle learning therapy (MLT). MLT is an operant conditioning program which uses surface electromyography (sEMG) to train injured workers to control their muscles during work activities. Patient response to therapy was obtained by a therapist-administered questionnaire during Visit 8 of 12. A group of 309 subjects, who had failed to respond to a previous course of therapy (typically physical therapy), reported significant improvements of pain in the neck, thorax, and upper extremities. Ninety six percent reported that they felt more in control, 86% reported feeling better overall, and 81% reported either working the same and feeling better or working and accomplishing more. This study provides preliminary support for this approach and provides justification for controlled clinical trials in the future.     

The Illness Intrusiveness Rating Scale: A measure of severity in individuals with hyperhidrosis

Objective: We estimated the reliability and validity of the Illness Intrusiveness Ratings Scale (IIRS) in hyperhidrosis, using an electronic mail form of administration. Methods: Recent contributors to an electronic mail discussion group on hyperhidrosis responded to the IIRS, questions about surgical history, items designed to assess severity, and demographic questions, on two occasions four weeks apart. A variety of hypotheses regarding the relationships between these variables were constructed a priori. Results: Sixty-eight people replied on two occasions. Internal consistency was high (Cronbach's 0.88), as was test–retest reliability ( 0.89). The total IIRS score correlated with a global severity question (0.61; p<0.001). Total IIRS score was lower in participants who had previously had surgery for hyperhidrosis, compared with those who had not (47 vs. 36; p=0.02), and changed dramatically in the direction of diminished severity in four patients who underwent surgery during the course of the study (54 vs. 17; p=0.01). Weak-to-moderate correlations were observed between total score and use of topical preparations, use of medications, number of clothing changes during a day, and limitations in choice of wardrobe. Conclusions: The IIRS is both reliable and valid in the assessment of patients with hyperhidrosis. A novel form of administration does not appear to affect its properties.     

Health-related quality of life of mothers of children with leukemia in Japan

Objective: The study compared the health-related quality of life (HRQOL) of Japanese mothers of children with leukemia to that of mothers of children without leukemia. Method: We used the Medical Outcomes Study 36-item Short-Form (SF-36) to measure the HRQOL of 97 mothers of children (average age 6.2, range 0–14) with leukemia diagnosed between 1999 and 2000, and compared their scores to those of 240 mothers of children without leukemia matched to the children with leukemia. Main results: Of the eight unadjusted domain scores of the SF-36, five were significantly low among mothers of children with leukemia compared to mothers of children without leukemia: role-physical functioning (RP), general health perception (GH), vitality (VT), social functioning (SF) and mental health (MH). Their SF-36 domain scores, when adjusted for demographic and clinical factors were also significantly low in RP, GH, VT, SF, RE and MH. The MH and SF scores in mothers of children with leukemia requiring hospital care were, respectively, approximately 20 points (1 standard deviation (SD), p < 0.0001) and 30 points (1.5 SD, p < 0.0001) lower than that of mothers of children without leukemia. Conclusion: Mothers of children with leukemia requiring hospital care have poor HRQOL, particularly with regard to mental health and social functioning, and are at a greater risk for depression. These results suggest that the current system for treating leukemic diseases of children in Japan should also include close monitoring of mothers mental health, and provision of appropriate treatment and psycho-social support.     

Heterosexual copulatory patterns in stumptail macaques (Macaca arctoides) and in other macaque species

A comparison of the mating behavior patterns of several macaque species reveals that the mating behavior of Macaca arctoidesexhibits several unique features. The laboratory groups of stumptail monkeys observed had exceptionally long single-mount copulations characterized by a large number of pelvic thrusts, a slow thrusting rate, and an unusually salient male orgasmic pattern (characterized by body rigidity followed by body spasms and a typical facial expression and vocalization). The frequency with which the copulation culminates in ejaculation is unusually high, and copulating stumptails generally manifest tieing in a genital lock after ejaculation. This research was supported in part by the Interdisciplinary Training Program, Langley Porter Neuropsychiatric Institute, University of California, San Francisco; by United States Public Health Service Training Grant No. 5-T1-MH-7082 from the National Institute of Public Health; and by Grant No. GS-31943X from the National Science Foundation to Dr. S. L. Washburn of the University of California at Berkeley, given for Primate Studies and Human Evolution.This paper was given as one part of the presentation prepared for the symposium Male and Female Sexual Behavior in Primate Societies, Fourth International Congress of Primatology, Portland, Oregon, August 1972. The first part was published as Male-Female, Female-Female, and Male-Male Sexual Behavior in the Stumptail Monkey, with Special Attention to the Female Orgasm,Archives of Sexual Behavior 3: 95–116, 1974.     

The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30): Validation of English version in Singapore

Objective: This study aimed to validate the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30, English version 3.0) in Singaporean cancer patients. Methods: In a cross-sectional study, a heterogeneous sample of cancer patients (n = 57) self-administered a questionnaire containing the QLQ-C30, the Short Form 36 Health Survey (SF-36) and assessing health and sociodemographic status. Construct validity was assessed by testing a priori hypotheses that QLQ-C30 scales would be moderately or strongly correlated with SF-36 scales measuring similar dimensions of health-related quality of life (HRQoL) and that subjects reporting mild symptoms would have better HRQoL scores than those reporting severe symptoms. Internal consistency reliability was assessed using Cronbachs . Results: Strength of Spearmans correlations between the QLQ-C30 and SF-36 scales assessing similar dimensions of HRQoL ranged from 0.35 to 0.67. Subjects with mild symptoms had better scores than those with severe symptoms for all six QLQ-C30 HRQoL scales (p < 0.05 for five scales, Mann–Whitney U tests). Cronbachs ranged from 0.19 for the cognitive functioning scale to 0.91 for the global QoL scale. Conclusion: This study provides preliminary evidence for the validity and reliability of the EORTC QLQ-C30 in English-speaking Singaporean cancer patients.     

Critical evaluation of polychlorinated biphenyl toxicity in terrestrial and marine mammals: Increasing impact of non-ortho and mono-ortho coplanar polychlorinated biphenyls from land to ocean

Residues of potentially toxic non-ortho chlorine substituted coplanar 3,3,4,4-tetra-,3,3,4,4,5-penta-, 3,3,4,4,5,5-hexachlorobiphenyl and their mono- and di-ortho analogs (2,3,4,4,5-penta-, 2,3,3,4,4-penta-, 2,3,3,4,4,5-hexa-and 2,2,3,3,4,4-hexa-, 2,2,3,4,4,5-hexa-chlorobiphenyl) were determined in humans, dogs, cats (terrestrial), a finless porpoise (Neophocoena phocoenoides-coastal), Dall's porpoises (Phocoenoides dalli,dalli), Baird's beaked whales (Berardius bairdii) and killer whales (Orcinus orca-open ocean). Among the coplanar polychlorinated biphenyl (PCB) congeners, the concentration of the di-ortho congeners was the highest and the non-ortho congeners was the lowest. However, all three coplanar PCBs occurred at significantly higher levels than toxic polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs). The relative bioconcentration and metabolic capacity of terrestrial and marine mammals to these chemicals, suggest that the toxic threat of coplanar PCBs increases from land to ocean, but the reverse is true for PCDDs and PCDFs. The toxic threat of coplanar PCBs to higher aquatic predators such as cetaceans was principally assessed by 2,3,7,8-T₄CDD Toxic Equivalent Analysis which is based on the induction of arylhydrocarbon hydroxylase (AHH) and ethoxyresorufinO-deethylase (EROD). Analysis indicates, in particular, that the bioaccumulation of toxic 3,3,4,4,5-penta- and 2,3,3,4,4-pentachlorobiphenyls in carnivorous marine mammals is a cause for considerable concern.