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Showing papers by "Frank E. Speizer published in 1981"


Journal ArticleDOI
TL;DR: The hypothesis that premature cessation of ovarian function increases the risk of nonfatal myocardial infarction is supported.

317 citations


Journal ArticleDOI
TL;DR: This study assessed the relationship between air pollution levels and numbers of emergency room visits in an industrial town by analyzing the deviations of daily visit numbers from the expected values based on day of week, season, and year.
Abstract: This study assessed the relationship between air pollution levels and numbers of emergency room visits in an industrial town. Records of emergency room visits to the major hospital during March, April, October, and November of 1974–1977 were abstracted. Air pollution and temperature data were collected from instruments located centrally, near the hospital. For the analyses, the morbidity indices were the deviations of daily visit numbers from the expected values based on day of week, season, and year. The diagnostic categories were collapsed to “all respiratory diseases,” “all diseases but trauma,” and “all diseases.” The mean deviations for each category were first grouped by pollutant quartile and by maximum temperature. These deviations did not vary in a fashion consistent with a pollutant effect for SO2, TSP, NO2, CO, or O3—either unlagged or lagged by 24 hours. A linear regression model showed small but statistically significant effects of unlagged TSP and of unlagged SO2 on the respiratory disease i...

128 citations


Journal ArticleDOI
TL;DR: Data imply that, at present, a decision to prescribe postmenopausal hormones should be based primarily on weighing possible benefits from the relief of menopausal symptoms against known or suspected risks of other diseases, particularly uterine cancer in women with an intact uterus.
Abstract: Information was collected by mail survey about myocardial infarction (MI), use of female hormones after menopause, and coronary risk factors 121,964 registered nurses ages 30-55 years. One hundred twenty-three women with a known type of prior menopause reported hospitalization for MI. Overall, use of female hormones by these women was very similar to that of control women matched for age and type of menopause. Compared with nonusers, the relative risk (RR) for women who had ever taken female hormones was 0.9 (95% confidence limits 0.6-1.2), and for current users the RR was 0.7 (0.5-1.1). For women with bilateral oophorectomy, the RR for current users was 0.4 (0.2-0.8). These data imply that, at present, a decision to prescribe postmenopausal hormones should be based primarily on weighing possible benefits from the relief of menopausal symptoms against unknown or suspected risks of other diseases, particularly uterine cancer in women with an intact uterus.

118 citations


Journal ArticleDOI
TL;DR: The currently available epidemiologic evidence from population studies of the health effects of atmospheric sulfur oxides and particulate matter is examined to approximate the exposure-response relationship linking pollutant concentrations with mortality and morbidity levels.
Abstract: Steadily rising energy costs have increased the need for reliable information on the health effects of atmospheric sulfur oxides and particulate matter. Because ethical and practical considerations limit studies of this question under controlled conditions, observational studies provide an important part of the relevant information. This paper examines the currently available epidemiologic evidence from population studies of the health effects of these pollutants. Nonexperimental studies also have important limitations, including the inability to measure accurately the exposure burden of free living individuals, and the potential for serious confounding by other factors affecting health. We begin with a discussion of some of these methodologic issues. The evidence is then reviewed, first in association with fluctuations in 24 hr mean concentration of sulfur oxides and particulate matter, and then in association with differences in mean annual concentration. In the last section, this evidence is summarized and used to approximate the exposure-response relationship linking pollutant concentrations with mortality and morbidity levels.

110 citations


Journal ArticleDOI
01 Oct 1981-Cancer
TL;DR: The data provide reassurance that OC use is not likely to be associated with any major increase in risk of ovarian cancer, but suggest that future studies of this relationship need to consider the possible confounding effect of infertility.
Abstract: This study examines the relationship between oral contraceptive (OC) use ovarian cancer and parity using data collected from a large group of married registered nurses (n=172413) aged 30-55 in 1976 who received questionnaires by mail. A final sample of 47 cases of confirmed ovarian cancer of epithelial origin was identified. 10 controls randomly chosen from other respondents free from ovarian cancer were matched for each case by year of birth (total controls=470). Relative risk (RR) or the association between variables estimated as the exposure-odds ratio were summarized across categories of other variables using the Mantel-Haenszel procedure. The 95% confidence intervals were computed using a test-based procedure. OC use was identified in 14 (28%) of 47 cases and in 152 (33%) of 464 controls giving an overall RR for OC use of 0.8 (95% confidence limits 0.4-1.5). This inverse relationship may be due to a statistically significant effect in the small number of women less than 35 years of age. An RR of 0.2 (0.1-1.0) was observed in 2 of 9 (22%) cases and in 54 of 109 (50%) controls who were under 35 years of age. RR for current use versus never use was 0.8 (0.3-2.1) as derived from an analysis restricted to individuals who were premenopausal (and thus potential users of OC) before diagnosis. Mean duration of use among OC users was 44 months in cases and 41 months in controls. 11 of 47 cases (23%) and 57 of 470 controls (12%) had never had a pregnancy lasting more than 6 months giving an RR associated with nulliparity of 2.2 (1.1-4.5). Ovarian cancer risk was not significantly associated with age at onsent of menses and age at first pregnancy. The study did not establish an overall increase in risk of ovarian cancer associated with OC use. Nulliparity however was associated with increased risk of ovarian cancer a finding consistent with other studies of ovarian cancer. Further studies of ovarian cancer and OC use should include measurement of potential for becoming pregnant.

78 citations


Journal ArticleDOI
TL;DR: Use of specific vitamin preparations was found to increase with age and was highest in California, and women who used specific preparations of vitamins A, C, and E generally consumed them in quantities many times greater than the RDA.

57 citations


Journal ArticleDOI
TL;DR: Smokers experienced a three-fold increase in risk of MI relative to individuals who never smoked, which was not explained by history of hypertension, diabetes, high cholesterol or familial MI.
Abstract: The relationship between smoking and the risk of hospitalization for acute myocardial infarction (MI) was evaluated among 121,964 nurses and aged 30-55 years who resided in 11 of the larger US states and who responded to a mail questionnaire. Among 249 women who experienced an MI, 159 (64%) were smokers at the time of hospitalization. Of 4977 controls matched to the cases on the basis of age, 1850 (37%) were smoking at the corresponding time. Smokers experienced a three-fold increase in risk of MI relative to individuals who never smoked, which was not explained by history of hypertension, diabetes, high cholesterol or familial MI. Women who had stopped smoking experienced a risk of MI no greater than women who had never smoked.

40 citations


Journal ArticleDOI
TL;DR: The presence of this relationship using non-hospitalized controls of similar social status to cases supports the reality of this association, which has recently been challenged as an artifact due to inappropriate choice of hospitalized controls.
Abstract: The relationship between age at birth of a first child and breast cancer was evaluated for 1159 affected women and 11,590 women without cancer in data collected in 1976 among married female registered nurses residing in 11 states in the United States. A positive trend of increasing risk of breast cancer with later ages at first birth was found (chi 2(1) for trend in proportions = 30.9, p less than 0.01). Adjustment for potential confounding variables by multiple logistic regression did not affect this trend. The presence of this relationship using non-hospitalized controls of similar social status to cases supports the reality of this association, which has recently been challenged as an artifact due to inappropriate choice of hospitalized controls.

35 citations


Journal ArticleDOI
TL;DR: Exposure to zinc chloride aerosol as a result of detonation of a smoke bomb in an airport disaster drill resulted in participants experiencing upper respiratory tract symptoms which corresponded in frequency of occurrence and intensity with proximity to the site and duration of exposure.

25 citations


Journal ArticleDOI
TL;DR: Smokers experienced a three-fold increase in risk of MI relative to individuals who never smoked, which was not explained by history of hypertension, diabetes, high cholesterol or familial MI.
Abstract: The relationship between smoking and the risk of hospitalization for acute myocardial infarction (MI) was evaluated among 121,964 nurses and aged 30-55 years who resided in 11 of the larger US states and who responded to a mail questionnaire. Among 249 women who experienced an MI, 159 (64%) were smokers at the time of hospitalization. Of 4977 controls matched to the cases on the basis of age, 1850 (37%) were smoking at the corresponding time. Smokers experienced a three-fold increase in risk of MI relative to individuals who never smoked, which was not explained by history of hypertension, diabetes, high cholesterol or familial MI. Women who had stopped smoking experienced a risk of MI no greater than women who had never smoked.

18 citations


01 May 1981
TL;DR: In this article, a very extensive air pollution monitoring system that is operating in the Chestnut Ridge region of Western Pennsylvania is described, and several distinct epidemiological approaches are used to test hypotheses about relations of air pollution exposures to morbidity and mortality rates in this region.
Abstract: This project involves several tasks designed to take advantage of: (1) a very extensive air pollution monitoring system that is operating in the Chestnut Ridge region of Western Pennsylvania; and (2) the very well developed analytic dispersion models that have been previously fine-tuned to this particular area. The major task is to establish, through several distinct epidemiological approaches, health data to be used to test hypotheses about relations of air pollution exposures to morbidity and mortality rates in this region. The closely spaced network of monitors, plus the dispersion modeling capabilities allow for the investigation of health impacts of various pollutant gradients in neighboring geographic areas, thus minimizing the confounding effects of social, ethnic, and economic factors. The pollutants that are monitored include total gaseous sulfur, sulfates, total suspended particulates NO/sub x/, NO, ozone/oxidants, and coefficient of haze. There are some properties of this air pollution data that require the restructuring of the standard epidemiological procedures. A revised format for a more complete characterization of exposure to air pollution is suggested and steps toward a totally revised epidemiological procedure are presented. The apparent result that several common epidemiological assumptions are inappropriate raises some questions about the value of previous research.more » Thus another important goal of this project is to collect and test the many available models for associating health effects with air pollution, to determine their predictive validity and their usefulness in the choice and siting of future energy facilities.« less



Journal ArticleDOI
TL;DR: This book is the result of a symposium on the health effects of nitrogen oxides held at the Joint American Chemical Society and the Chemical Society of Japan Chemical Congress in 1979 and provides a very nice review of the measurement techniques for ambient NO/sub x/ and also of the EPA's methods for evaluating and selecting a reference method.