Showing papers by "Manfred S. Green published in 1994"

Sex Differences in the Humoral Antibody Response to Live Measles Vaccine in Young Adults

Abstract: BACKGROUND Following vaccination of children using high-titre live measles vaccine, excess non-specific mortality was reported, particularly among females. Since vaccination with live measles virus results in a temporary depression of the immune response to other antigens, the female predominance in subsequent non-measles mortality may be due to sex differences in response to live measles vaccines. METHODS In this study, the immunogenicity of standard titre live Schwarz strain measles vaccine was examined 2 and 4 weeks post-vaccination in 223 males and 66 female aged 18-20 years in Israel in 1991. RESULTS Females had higher post-vaccination geometric mean titre (GMT) at all levels of pre-vaccination titres at both 2 and 4 weeks. Furthermore, after controlling for differences in pre-vaccination titres, overall the post-vaccination GMT for females was about 50% higher than for males (P < 0.001). CONCLUSIONS These findings indicate that females exhibit a stronger humoral immune response to measles vaccine. Possible sex differences in immunosuppression following measles vaccination should be explored.

Noise exposure, noise annoyance, use of hearing protection devices and distress among blue-collar workers

Abstract: OBJECTIVES--This study tested the hypotheses that, in high noise levels [> or = 85 dB(A)], hearing protection devices are used largely by workers sensitive to noise, as reflected by reports of noise annoyance, and that the usage would reduce distress symptoms. METHODS--Data collected from 1587 healthy male blue-collar workers included noise exposure level, noise annoyance, use of hearing protection devices, distress symptoms (somatic complaints and poststress irritability), and possible confounding by age, education and ethnic origin. RESULTS--Multiple logistic regression results indicated that the use of hearing protection devices was related to noise exposure level [odds ratio (OR) 2.94, 95% confidence interval (95% CI) 2.58--3.30], but more so to high noise annoyance (OR 3.03, 95% CI 2.77--3.29), even after control for age, education, and ethnic origin. No interaction was found between noise level and noise annoyance. These findings highlight the contribution of noise annoyance to the use of hearing protection devices. Of the 42.6% of workers using hearing protection devices in the presence of high ambient noise, 60% were highly annoyed. Noise-annoyed workers also tended to wear hearing protection devices even in low noise levels. The use of hearing protection devices was associated with lower distress symptoms among the low and moderately annoyed workers, but among the highly annoyed workers the reverse was true. CONCLUSIONS--Thus, for the highly annoyed workers, the use of hearing protection devices was perhaps an additional source of stress. One immediate implication of this study is that future intervention procedures should focus on unannoyed workers who tend to use hearing protection devices less.

Excess winter mortality from ischaemic heart disease and stroke during colder and warmer years in Israel: An evaluation and review of the role of environmental temperature

Abstract: Most data on winter excess mortality from cardiovascular disease have been reported from countries with large seasonal temperature variations. In this study, the contribution of environmental temperature to ischaemic heart disease (IHD) and stroke mortality was evaluated in a country with relatively small variations in seasonal temperature. The association between monthly temperature and cause-specific monthly proportion of annual mortality was studied in the population of Israel aged 45 years and over for the period 1976–85. Population size in this group averaged nearly 1 million people during the study period, and about 40% of all deaths were due to IHD or stroke. For men, IHD mortality was 51% higher and stroke mortality 48% higher in mid-winter than in mid-summer; for women the respective figures were 48% and 40%. In cosinor analysis for months above and below the median minimum temperature, it was shown that excess mortality in winter was greater in years below the median minimum temperature in almost all age-sex categories. In partial correlation analysis, most of the variation in IHD and stroke mortality was explained by variation in minimum monthly temperature. These findings strongly support the role of environmental temperature in excess winter mortality from cardiovascular disease over a wide age range, and efforts should be directed at identifying intervention measures which could significantly reduce the incidence of premature mortality.

Ethnic differences in indices of body mass and body fat distribution in Israel.

Abstract: Ethnic differences in cardiovascular disease have been demonstrated in the Jewish population in Israel. Different measures of body fat have been shown to be directly and indirectly associated with increased risk of cardiovascular disease. It is not known to what extent lifestyle and genetic factors contribute to the distribution of body fat. The aim of this study was to examine ethnic differences in the distribution of body fat among Israelis. Between 1985 and 1989, a sample of 2154 males and 1395 females employed in Israeli industry were screened for selected risk factors for cardiovascular disease, in the framework of the Israel CORDIS study. Anthropometric measurements included height, weight, three circumferences (waist, hip, chest) and two skinfolds (subscapular and triceps skinfolds). In univariate analysis of six anthropometric variables, highly significant differences (P < 0.001) between ethnic groups were found in both sexes. The subjects of European origin had the highest amount of fat in the upper part of the body (WHR) for both sexes. After adjustment for factors such as cigarette smoking, education and sporting activity, the discrimination between ethnic groups remained statistically significant (P < 0.001) for all anthropometric indices except the triceps skinfold. Body mass index was not the best discriminating variable. Chest-to-waist ratio was the most powerful discriminator in males, but the subscapular-to-triceps ratio was the most powerful in females. These findings suggest that differences in body fat distribution are derived from both genetic and lifestyle factors.

Long-term persistence of anti-diphtheria toxin antibodies among adults in Israel Implications for vaccine policy

Abstract: Vaccination against diphtheria has essentially led to the disappearance of the disease in Israel. However, in other countries with high immunization coverage, isolated cases and small outbreaks have occurred in adults. Immunity following vaccination or natural exposure to toxigenic strains ofC. diphtheriae is conferred by serum antibodies to diphtheria toxin. Since booster doses of diphtheria toxoid are recommended every ten years in adults, this raises the question of persistence of protective levels Of anti-diphtheria toxin antibodies. In this study we assessed a possible age-related decline in anti-diphtheria toxin antibodies among adults in Israel. The study population comprised random samples in three age groups: 263 male recruits aged 18–19 years, 116 male reserve soldiers aged 25–35 years and 153 aged 41–51 years. Anti-diphtheria toxin antibody levels were measured by means of ELISA. Results indicate that 64.3% (95% CI=58.5–70.1%) of those aged 18–19 had anti-diphtheria toxin levels in excess of 0.1 IU ml−1, whereas the corresponding figures for ages 25–35 and 41–51 were 32.8% (95% CI=24.2–41.3%) and 15% (95% CI=9.4–20.7%). However, even in the oldest age group, 95.4% (95% CI=90.8–98.1%) had antibodies above the presumed protective level of 0.01 IU ml−1. Although these results indicate a significant age-related decline in anti-diphtheria toxin antibodies in vaccinated subjects, most had apparently protective levels. The absence of cases suggests that vaccine-induced immunity is long-lasting. However the immune status of the population should be carefully monitored.

Serum Lipids and Haematological Factors Associated with Resting Heart Rate: The Cordis Study

Abstract: OBJECTIVE We set out to examine the association between resting heart rate and haematological factors and blood lipids, all believed to be associated with coronary heart disease. METHODS In a cross-sectional study, 6016 industrial employees in Israel were screened between 1985 and 1987 for cardiovascular disease risk factors [the CORDIS Study (Cardiovascular Occupational Risk Factors Detection in Israeli Industries)]. Repeated measures of resting heart rates were obtained. Complete data were available for 5393 participants. The lowest mean measure was used to examine the association with individual factors. RESULTS For men, of the blood lipids, only triglycerides were independently positively associated with resting heart rate after controlling for all the possible confounding factors (P 150 mg/dl). Platelet count and haemoglobin were independently positively associated with heart rate (P < 0.0001 in both groups). For women, low-density lipoprotein cholesterol and leucocyte count were independently positively associated with resting heart rate (P < 0.05 and P = 0.006, respectively). CONCLUSION These associations suggest that the role of resting heart rate as a predictor of coronary heart disease may be partly explained by its association with triglycerides, haemoglobin, platelet count and leucocyte count, which may be confounding factors or intervening variables.

Epidemiologic features of urolithiasis among industrial employees. The Israeli CORDIS Study.

Abstract: We examined the prevalence of urolithiasis in 5574 men and women employees in 21 industrial plants in Israel who were screened for cardiovascular risk factors between 1985 and 1987 (the CORDIS Study) Among the data gathered were previous physician diagnosis of urolithiasis and ergonomic and demographic data Urolithiasis was much more frequent in men than in women (age-adjusted prevalence of 45% in men and 12% in women, P < 0001) Older subjects had higher prevalence than young subjects There were ethnic differences, and the highest prevalence was in subjects of European origin Of the occupational factors, only industrial sector was related to prevalence of urolithiasis Urolithiasis was more frequent among employees in wood industries than in other sectors (P < 05) We concluded that there is an effect of industrial sector on the prevalence of urolithiasis To determine the cause and magnitude of the association of wood industries with increased prevalence of urolithiasis, ergonomic and chemical factors should be investigated

A trial of the reactogenicity and immunogenicity of an inactivated hepatitis A vaccine.

Abstract: Purified, formaldehyde-inactivated and alum-adjuvanted hepatitis A virus (HAV) vaccines have recently become available for clinical trials. The vaccine is administered intramuscularly in a schedule of 0, 1, and 6 months. The aim of the study was to evaluate the reactogenicity and immunogenicity of an inactivated hepatitis A (HA) vaccine. Three groups of volunteers comprised the study population: 28 volunteers without antibody to HAV were given HA vaccine and, for comparison, 43 subjects received hepatitis B vaccine for possible adverse reactions to the HA vaccine; 12 other subjects received immunoglobulin alone. Each 1 ml dose of HA vaccine contained 720 enzyme units or about 100 ng of antigen. Anti-HAV was determined by means of a commercial assay (Abbott Laboratories: HAV-EIA), and by a more sensitive ELISA. No significant adverse reactions were reported. In the group that received HA vaccine, 4 weeks following the first dose all had detectable antibodies (> or = 20 mIU/ml) by the sensitive ELISA. By commercial HAV-EIA, at 20 weeks following the second dose 75.0% had detectable antibodies, and after the third vaccine all had detectable antibodies. This new inactivated HA vaccine is highly immunogenic and had no significant side effects.

[AIDS-related knowledge, behavior and attitudes of workers in Israel].

Abstract: Control of the AIDS pandemic depends largely on the success of educational programs designed to persuade the population at risk to use currently recommended methods of prevention. In Israel there are no regular national surveys on the health-related behavior of the population. The consequent lack of reliable data makes it difficult both to develop and to evaluate AIDS-related educational programs. A survey was therefore conducted among 536 employees of 3 workplaces in Dec. 1992, using anonymous questionnaires. The level of general knowledge of the disease was good, although in selected areas there were deficiencies: more than 20% of the men and 40% of the women believed that AIDS can be contracted through the use of public toilets. More than 50% of the subjects indicated that they would like more information on the disease, and believe that insufficient education is given youth regarding the use of the condom. Women tended to be more worried than men about the possibility of contracting AIDS, and were more likely to adopt preventive behavior and educate their children in this regard. These findings indicate the need to design separate educational programs for men and women. Further on-going surveys in representative samples of the general population are urgently needed to monitor trends in AIDS-related knowledge, attitudes and behavior.

Clinical, serological and molecular characteristics of 471 hepatitis B virus carriers.

Abstract: A total of 471 Israel Defense Forces (IDF) blood donors identified as hepatitis B virus (HBV) carriers were examined a few months after blood donation. When compared to the general population of IDF blood donors the HBV carriers were older, belonged to certain ethnic groups and were predominantly males. Physical examination revealed minimal findings: 1 (0.3%) had splenomegaly and 5 (1.6%) had hepatomegaly. Fifty-two individuals (11.1%) had elevated liver enzymes. E antigen was present in 3.2% of HBV carriers, 94% had anti-e antibodies and 1.9% had anti-delta antibodies. Of 258 carriers tested for HBV DNA, 29 (11.2%) were positive. Abnormal liver enzymes were significantly associated with the presence of e antigen as well as with the presence of HBV DNA.