Showing papers in "American Journal of Epidemiology in 1975"

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: prevalence of coronary and hypertensive heart disease and associated risk factors

Abstract: A study of coronary heart disease (CHD) among Japanese migrants compared with Japanese living in Japan provided the opportunity to study factors possibly responsible for the high rates of CHD in America as compared with Japan. Comparable methods were employed in examining 11,900 men of Japanese ancestry aged 45--69 living in Japan, Hawaii and California. The age-adjusted prevalence rates for definite CHD as determined by ECG were: Japan 5.3, Hawaii 5.2 and California 10.8/1000. For definite plus possible CHD the rates were 25.4, 34.7 and 44.6. The prevalence of angina pectoris and pain of possible myocardial infarction, determined by questionnaire, showed a similar gradient. Elevated serum cholesterol showed a Japan-Hawaii-California gradient, but the prevalence of hypertension in Japan was intermediate between the prevalence in Hawaii and the higher prevalence in California. The three geographic locations were compared as to prevalence of CHD at comparable levels of blood pressure and cholesterol. At each blood pressure level and at each cholesterol level, the greater prevalence of CHD in California persisted. These facts, plus the near universality of smoking in Japan, suggest that conventional risk factors only partly explain the observed gradient in CHD.

Tucson epidemiologic study of obstructive lung diseases i: methodology and prevalence of disease

Abstract: Using a multistage stratified cluster sample of Anglo-white Tucson households (based on the 1970 Census block statistics), this longitudinal study enrolled 1655 households. The study sample of 3805 individuals thus selected representatively covered the household structures, including the age and sex subgroupings, of the Tucson Anglo-white population. The estimated prevalence rates had a very low standard error of estimate both overall and in the age- and sex-specific categories, indicating a good selection and sufficient numbers in all age-sex specific subgroups. As anticipated, prevalence rates of diagnosed respiratory and other chronic diseases were higher than those found nationally. Despite much higher rates of diagnosed pulmonary diseases within the age-sex populations over the age of 40, the results of this study are within the ranges of other surveys in terms of prevalence of many common chronic respiratory symptoms. Reasons for this apparent discrepancy are so far undertermined.

The Seattle virus watch. V. Epidemiologic observations of rhinovirus infections, 1965-1969, in families with young children.

Abstract: Rhinovirus (RV) infections in Seattle Virus Watch (VW) families (1965-1969) were monitored by screening respiratory specimens in WI-38 cell cultures and by homotypic neutralization tests on sera related to family episodes revealed by RV isolation. Temporally related illness in members not proven infected was also taken to indicate infection. RV isolates (including those from the New York VW, 1961-1965) were typed within the official 90-serotype frame. Typed isolates from New York (165 with 39 serotypes) and Seattle (456 with 59 serotypes) were compared with the Tecumseh Study to test the hypothesis that some serotypes are "common," persisting because of greater infectivity. Of 32 serotypes qualifying as "common" in at least 1 study, 4 were "common" in all 3 studies and 8 in 2 studies. The 23 "common" Seattle serotypes differed from the remaining 36 serotypes in being more infective and in their more frequent association with prolonged shedding. The New York and Seattle isolates together revealed an increase over time in the proportion not typable or of of higher numbered types, consistent with progressive shift in RV antigenic character. WI-38 isolates indicated spring peaks of RV all 4 years but a fall peak only in 1967. An even larger fall peak was seen when all specimens from September-November 1968 were re-examined in fetal tonsil diploid cells. Thus, both spring and fall peaks appear to describe RV seasonality. RV infections explained 16% of all reported respiratory illness (20% of upper respiratory), but RV-associated illness in young children, especially under 2 years, was more severe and almost twice as frequent as in adults. The age of introducers and the direct relation of family size to frequency of episodes indicate that community spread depends largely on preschool children, including infants. Within families, the secondary attack rate (SAR) was highest following paternal introduction and, for all introducers, the SAR varied inversely with age (mother excepted). RV shedding was observed most often (85% of specimens) from the day before to 6 days after illness onset but prolonged shedding was common (to 21 days in 20% and 28 days in 1.4% of infections). RV infectivity, reflected by SAR among nonimmunes, was highest for infants (78%) and, for all ages, was greater with ill than with well introducers (71% versus 27%). Immunogenicity of RV was poor (Seroresponse: 48% of shedders, 32% of nonshedding contacts) but varied greatly with serotype. Illness frequencies among non-immunes were 59% for all proven infections and 35% when infection was not shown..

Driving of motor vehicles as a risk factor for acute herniated lumbar intervertebral disc.

Abstract: In a case-control study of the epidemiology of acute herniated lumbar intervertebral disc in the New Haven, Connecticut, area, it was found that driving of motor vehicles was associated with an increased risk for developing this disease. It was estimated that men who spend half or more of their time on their job driving a motor vehicle are about three times as likely to develop an acute herniated lumbar disc as those who do not hold such jobs. Persons of either sex who said that they drove a car (either away from work or at work) were more likely to develop an acute herniated lumbar disc than those who did not drive at all. These associations between driving and acute herniated lumbar disc could not be attributed to any confounding variables considered in this study.

The tecumseh study of respiratory illness ix. occurrence of influenza in the community, 1966–1971

Abstract: The occurrence of types A and B influenza infections was determined by isolation and serology over six years among residents of Tecumseh, Michigan. By isolation, there was evidence of type A infection for a limited period during each year of the study; most rises in titer were detected during the periods of viral isolation, but some also occurred out of season. Outbreaks of type B infection were encountered three times during the six-year period and out of season infections were less frequently seen than with type A. Infection rates with type A were relatively flat over the age range, with high rates seen in infants and small children; in contrast, highest infection rates with type B were observed in the 5--14-year-olds. On examination of illness rates, it was found that some of the outbreaks wound have gone undetected if surveillance techniques for infection had not been in operation. Frequency of respiratory illness with activity restriction was taken as a guide to influenza virus activity during outbreaks; it was found that highest rates of such illnesses occurred among the 1--4-year-olds for type A outbreaks, and among the 5--9-year-olds during mixed or type B outbreaks.

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: mortality

Abstract: Stroke, coronary heart disease (CHD) and total mortality are evaluated from death certificates in enumerated cohorts of 45-64-year old Japanese men in Hiroshima and Nagasaki (1965-1970), in Homolulu (1966-1970), and in the San Francisco area (1968-1972). Total mortality is highest in Japan with no consistent differences between Japanese Americans in Homolulu and San Francisco. Age-specific CHD death rates are markedly lower in all three Japanese groups than in American whites. The CHD rates are consistently and significantly lower in Japan that in American Japanese. Stroke death rates for American Japanese men appear equivalent to figures for US white men of the same age, but are significantly lower than in the Japan cohort for the 60-64-year-old group. The number of stroke deaths below that age are too few as yet for analysis. Validation of mortality ascertainment and of the accuracy of death certification has been carried out in Japan and in Hawaii. The international differences in mortaltiy do not appear to be due to certification or other methodologic artifact.

Seroepidemiology of human papovaviruses discovery of virgin populations and some unusual patterns of antibody prevalence among remote peoples of the world

Abstract: A total of 1544 sera from 28 diverse and mainly isolated populations were examined for HI antibody to BK virus. A few extremely isolated populations were found with negligible or absent exposure to the virus, but in most populations, remote or cosmopolitan, antibody appeared in increasing prevalence during early childhood and remained stable throughout adult life. Antibody acquisition and prevalence rates in individual families reflected that of the general population. Examined for HI antibody to JC virus were 393 sera from 9 of the 28 populations. Age acquisition and prevalence rates of antibody were similar to those of BK virus, but experience with the 2 viruses was found to occur independently in several population groups, i.e., high exposure to BK with low exposure to JC, or vice-versa. Examined for neurtralizing antibody to SV40 were 151 sera with and without BK HI antibody in individuals from several primitive populations. SV40 antibody, mainly in low titer, occurred in 35% of the BK-positive group, but only 5% of the BK-negative group, suggesting that infection with BK or a closely related virus is responsible for antibody directed against SV40 in most humans unexposed to known vaccine or monkey sources of SV40 infection.

The current mortality rates of radiologists and other physician specialists: specific causes of death

Abstract: The cohort mortality experience of radiologists over a 50-year period has been compared to that of other specialists with low levels of radiation exposure. The 1920-1929 cohort of radiologists who joined the Radiological Society of North America had the highest mortality for several chronic diseases. After this early period, radiologists ranked highest only for cancer mortality. The excess risk of leukemia which was observed in the 1920-1929 and 1930-1939 cohorts has subsequently decreased. During the same period, lymphoma mortality, especially multiple myeloma, has been increasing with a significant excess of deaths appearing in radiologists who entered the specialty society between 1930-1939 and 1940-1949. A posible relationship between this finding and immunologic changes induced by radiation has been proposed.

Follow-up studies of world war ii and korean war prisoners ii. morbidity, disability and maladjustments

Abstract: US Army veterans taken prisoner (POW's) in World War II and in the Korean War are compared with controls as to hospital admissions from 1946 to 1965 (1954-1965 for Korean War POW's), and as to symptoms, disability, and maladjustments in 1966-1967. Sequelae of the POW experience are both somatic and psychiatric, and are of greatest extent and severity among Pacific World War II POW's. Among European World War II POW's only psychiatric sequelae are apparent. Somatic sequelae were most prevalent in the early years after liberation, but for Pacific World War II POW's they persist in the form of higher hospital admission rates for many specific causes in the most recent period. Nevertheless, persistent psychiatric sequelae (especially psychoneurosis but also schizophrenia) are the more notable and pervasive for both Pacific World War II POW's and Korean War POW's as seen not only in elevated hospital admission rates but also in VA disability awards and in symptoms reported on the cornell Medical Index Health Questionnaire. The excess morbidity appears to correlate well with retrospective accounts of weight-loss and nutritional deficiency diseases and symptoms during the POW period.

Thrombosis with low-estrogen oral contraceptives

Abstract: The relationship of oral contraception (OC) to thrombosis was studied retrospectively in 104 idiopathic cases 357 other thrombotic cases (exclusive of cerebrovascular thrombosis) and 1302 matched controls. The relative risk of idiopathic thromboembolism for OC users was estimated to be 7.2 times that for nonusers (p less than .0001); the relative risk for the whole series was 1.9 (p less than .0001). The low risk for nonidiopathic cases was considered to be due to selective prescription of contraception. The risk for the whole series was 1.9 (p less than .0001). The low risk for nonidiopathic cases was considered to be due to selective prescription of contraception. The risk for thos e taking 100 mcg or more of estrogen was higher than for those on lower doses though there is a definite risk of thrombosis even with the low-estrogen dosage. Results of another study indicating a 2-fold risk of biliary tract surgery among OC users was confirmed in this study.

Amyotrophic lateral sclerosis and parkinsonism-dementia on guam, 1945–1972 i. descriptive epidemiology

Abstract: An overview of the epidemiologic studies of amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) from 1945 through 1972 is presented. During this period 350 cases of ALS were documented. PD, which is apparently unique to the native Chamorro population, was not recognized during the early years of the study. A total of 213 PD patients have now been seen. The rates of both diseases have declined by approximately 50 per cent since 1965. In the early years incidence per 100,000 for ALS males approached 60; for females it was about 40. For PD males it was about 50; for females it was close to 20. The declines in both diseases have occurred in both sexes and at all age groups and no cohort phenomenon was observed. Marked geographic differences in the distribution of the diseases were observed with southern villages having the highest rates and western villages having the lowest rates; the remainder of the island was intermediate. Recent declines have been most marked in the southern high-rate villages. Chamorros living on the island of Rota have rates similar to those on Guam; those on Saipan have lower rates. A possible excess of ALS among Filipino residents ofGuam was noted; ALS has not been seen among other ethnic groups. Geographic mapping even in high incidence areas did not reveal true clusters or foci. Extensive case-control studies did not reveal any patterns of prior illness, life-style, or exposures distinguishing patients. A tendency for patients to be of somewhat lower socioeconomic level, have less education, eat more homegrown foods and raw meats, and more contact with animals was found. No Mendelian genetic patterns were observed; males were affected more frequently than female for both diseases. Cases did not occur before age 20, reached maximum frequency between ages 55 and 65 and there-after declined. Environmental factors associated with some aspects of the traditional way of life seem to be causally involved, but, since most aspects of the traditional life have changed in the past 50 years, the specific factors remain elusive.

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: introduction

Abstract: It has been observed that among men of Japanese ancestry, there is a gradient in CHD mortality increasing from Japan to Hawaii to California. A study of 11,900 Japanese men in Hiroshima and Nagasaki, Japan, Honolulu, Hawaii, and the San Francisco Bay Area of California has been conducted to investigate this disease difference. This paper describes the selection of the study populations and their age distributions, and outlines the study methods. This paper also introduces and briefly summarizes four papers that give the results for mortality comparisons, biochemical and blood pressure distributions and results for heart disease prevalence among the three cohorts.

Epidemiology of hepatitis B in hospital personnel.

Abstract: To identify occupational categories and work areas of possible risk for acquisition of nosocomial hepatitis B by hospital personnel, serologic sampling for hepatitis B surface antigen (HBSAg) and antibody (anti-HBS) by radioimmunoassay was carried out in 513 employees of a large metropolitan hospital serving predominantly indigent patients. HBSAg was detected in 0.7%, HBSAg and anti-HBS in 0.4%, and anti-HBS in 13.3% of the study population. No significant difference in seropositivity was noted between sexes. Furthermore, neither exposure to patients with hapatitis nor previous blood transfusion correlated with serologic evidence of hepatitis B infection. However, frequency and intensity of exposure to blood products was associated with serologic evidence of infection: 18.9% of those with frequent blood contact were positive for HBSAg or anti-HBS, compared with 11.4% of those without blood product exposure (p less than .05). Direct patient contact, apart from blood exposure, did not appear operative as a major factor in hepatitis B transmission in this population. Accordingly, occupational categories and work areas with highest risk for acquisition of nosocomial hepatitis B were those with greatest blood exposure.

Definition of rates: some remarks on their use and misuse

Abstract: In almost every scientific discipline there is a certain amount of lack of precision and ambiguity in terminology which often upsets and confuses beginners before they become accustomed to the situation and accept it (some never do). One reason for this might be that authorities in one field borrow terminology from another field in which they are not specialists. Another reason could be a matter of semantics; a particular language may have more than one meaning for the same word; or vice versa, people use two (or more) wordsas synonyms though, in fact, their meanings are distinct. The use of the word rate in epidemiology, demography, medicine and even in actuarial work suffers from these disadvantages; it is borrowed from physics and biochemistry and misinterpreted; it has more than one meaning in the English language; and the most common error—it is used interchangeably with the term proportion, because both are incorrectly assumed to be synonyms of ratio. Before you proceed to the next section, please, take a piece of paper and a pencil

Frost revisited: the modern epidemiology of tuberculosis.

Abstract: At the outset, I would like to express my pleasure and gratitude at the very great honor bestowed upon me by the Epidemiology Section of the American Public Health Association. And then, I wish to enter a quick disclaimer, for, to use a hackneyed phrase, no man is an island. During virtually all of my professional life, I have been blessed by challenging assignments, by reliable, capable assistants, and by colleagues and supervisors who were both tolerant and stimulating. One of the few unfortunate aspects of this occasion is the absence from this podium of the large team of diverse individuals to whom I am indebted. Not the least of my good fortunes was the opportunity to work,for and with Dr. Carroll E. Palmer, who was a student and colleague of both Reed and Frost. One of Carroll's stories about Frost that has come to mind more than once during recent

The seattle virus watch vi. observations of infections with and illness due to parainfluenza, mumps and respiratory syncytial viruses and mycoplasma pneumoniae

Abstract: Seattle Virus Watch families were observed, 1965-1969, for infections with paramyxoviruses and M. pneumoniae by agent isolation and antibody assay of serial sera. Infection rates, based on serology, exceeded those in Tecumseh where families contained fewer young children. Rates per 100 person-years were 44.4 for parainfluenzavirus, 21.6 for respiratory syncytial (RS) virus and 12.3 for M. pneumoniae. Preschool children experienced the highest rates for RS and parainfluenza-viruses but, for the latter, rates were also high among older children and adults. Within invaded families infection rates generally varied inversely with age, although for M. pneumoniae the rates for adults and 6-9 year old children nearly equalled the infant rate. The introducers' identity and/or the age-specific infection rates in invaded families support the role of young schoolchildren in community spread of M. pneumoniae and, together with older children and adults, of RS virus. Young schoolchildren were less important than infants, preschoolers, and adults in spreading parainfluenza-viruses and less important than preschoolers and infants for mumps. The frequent infection of exposed older children and adults suggests that reinfection with all the agents studied is common. All agents spread significantly within families and secondary attack rates for the mostly non-immune infants indicated high infectivity of parainfluenza and mumps viruses. The basic high pathogenicity of these agents and of RS virus is indicated by the high frequency of illness among virus shedders (80-90%) and among seroconverting infants (greater than or equal 68%). The less frequent illness of older persons with serologically proven infection is consistent with diminished clinical response to reinfection. Parainfluenza-associated illnesses were relatively severe and contributed up to 9.3% to total respiratory illnesses. RS virus-related illnesses also were severe but contributed less (4-5%) to total respiratory disease. Mumps-associated illness was largely respiratory, 65% overall, 77% in infected infants and 75% above age 9. Thus, mumps virus emerges as another respiratory pathogen which is spread largely by 2-5-year old children rather than by schoolchildren with "typical" parotitis.

The relationship of reported parental history to the incidence of coronary heart disease in the western collaborative group study

Abstract: The relationship of a reported parental history of coronary heart disease (CHD) to the incidence of CHD was determined in this prospective study of CHD in an intake population of 39-59-year old men. Reported parental history of CHD was found to be associated with level of schooling, the type A behavior pattern, serum cholesterol and beta/alpha lipoprotein ratio. Men with reported parental history had an increased incidence of angina pectoris in both age defined by symptomatic myocardial infarction and sudden coronary death. Adjustment then was made simultaneously for the confounding effects of the risk factors found to be associated with the prevalence of parental history of CHD. After such adjustment a reported parental history of CHD was still found to have a significant association (p = 0.01) with the combined incidence of symptomatic myocardial infarction and angina pectoris in subjects under 50 years of age.

Spontaneous abortion as a screening device. The effect of fetal survival on the incidence of birth defects.

Abstract: To make sound inferences about the distribution, causes and risks of congenital anomalies requires an understanding of selective survival among fetuses. Studies of spontaneous abortions are therefore advocated. A simple model is proposed of the distribution, among spontaneous abortions and births, of conceptuses with and without anomalies. The resulting equation accomodates both maternal and fetal factors. Interaction between maternal and fetal factors is hypothesized, in the form of a maternal device for screening out anomalous conceptuses. A number of the known facts about congenital anomalies are shown to be plausibly interpreted in terms of the proposed model. Finally, some clinical and epidemiologic implications of the model for the study of spontaneous abortions are pointed out.

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: distribution of biochemical risk factors

Abstract: Distributions of serum cholesterol, glucose, uric acid and triglycerides are examined among Japanese men living in Japan, Hawaii and California. Laboratory methods are described in detail and efforts to assure comparability of these methods. In every age group studied, the mean, median and percentile for each of the biochemical variables are lower for men in Japan than in Hawaii and California.

Epidemiologic studies of coronary heart disease and stroke in japanese men living in japan, hawaii and california: blood pressure distribution

Abstract: Blood pressure measurements were made on three Japanese populations residing in Japan, Honolulu, and Northern California. A common protocol was utilized in an effort to standardize inter-observer variability. Zero terminal digit preference varied among the three areas and there was differential clustering of diastolic values at 80 mm Hg and 90 mm Hg in Hawaii and California, respectively. Diastolic blood pressure did not rise with age in any of the three populations while systolic blood pressure rose in each. Blood pressure levels in Japanese in Japan were intermediate to those in Hawaiian and Northern California Japanese, California having the higher blood pressure levels. Since the relative weights of the Japanese migrants to Hawaii and California were substantially higher than the relative weights of the non-migrant populations in Japan, the blood pressures were adjusted for these differences. When this was done, most of the differences among the various study subgroups were explained. The findings indicate that the blood pressure distributions of the Japanese populations residing in Japan, Hawaii, and Northern California cannot of themselves account for the observed differences in coronary heart disease and stroke occurrence among these populations in which there is a gradient from high stroke rates in Japan to low rates in California and a reverse trend for coronary heart disease.

Acute respiratory disease of university students with special reference to the etiologic role of Herpesvirus hominis.

Abstract: Infections with Herpesvirus hominis type 1 were associated with 11.5% of acute respiratory illnesses of university students who were admitted to the student infirmary over a 6-year period. Over three-quarters of these infections were detected in students with pharyngitis or tonsillitis; 42% had ulcerated lesions on tonsils or posterior pharynx but only 11% had lesions in the anterior portion of the mouth or lips. Almost all of the H. hominis infections were accompanied by significant rises in neutralizing antibodies and few students had detectable antibodies in the initial serum collected during the acute phase of illness. Special studies revealed herpes-specific IgM antibodies in the early convalescent sera of some of these patients. The data demonstrate that 80% of the infections detected were primary infections with H. hominis. Only 30% of university students possessed neutralizing antibodies to H. hominis and about 10% of those without antibodies acquired antibodies each year. These data suggest that the majority of persons from middle income families reach young adulthood without acquiring infections of H. hominis and the spread of the virus requires close and intimate contact.

Epidemic venezuelan equine encephalitis in north america in 1971: vector studies

Abstract: A major epidemic of Venezuelan equine encephalitis occurred in south Texas in the summer of 1971. More than 1500 equines died of VEE in Texas, and 110 human cases with no deaths were reported. Vector studies in south Texas and northern Tamaulipas revealed that the overall mosquito infection rates during the peak of the epidemic were about 1:100, one of the highest rates observed for a major epidemic. Mosquito infection rates of this magnitude could easily explain the intensity of VEE outbreaks in both equines and man. A total of 943 VEE virus isolations were made from mosquitoes. Eight of the 12 mosquito species found infected were implicated in the epidemic cycle of VEE for the first time. Sufficient laboratory and field evidence is available to prove that Psorophora confinnis was one of the primary vectors of VEE. The lack of laboratory evidence necessitates the use of the term "probable" primary vectors for other species apparently equally as involved on the basis of field infections; these include Aedes sollicitans, Aedes thelcter and Psorophora discolor. Eight other species from which less than 10 VEE virus isolations were made were considered auxiliary vectors. Mosquitoes of some species were tested individually; such tests showed 2-4% of the probable primary vectors to be infected. The first isolation of VEE virus of the epidemic was made from P. confinnis on June 28, 1971. Highest mosquito infection rates occurred during the week of July 5. Mosquito infection rates declined precipitously in the last 3 weeks of July 1971, signaling the end of the epidemic in the study area. One explanation for the decline was that equines, the principal epidemic hosts, were eliminated as a source of virus by death or by acquisition of natural or induced immunity. Mosquito control appeared to be effective in reducing the infected mosquito population while the immunization of equines with TC 83 VEE vaccine was accomplished. Quarantines appeared to be effective in restricting the VEE virus activity to south Texas. Undoubtedly all of the control measures contributed to stopping the epidemic. Continued VEE surveillance by various government and other agencies failed to reveal any further epidemic VEE activity in the US in 1972. Other arboviruses isolated during the VEE studies in south Texas included St. Louis encephalitis virus, and San Angelo subtype of the California Group. A virus of the Bunyamwera Group was also isolated from Palo Blanco, Tamaulipas.

Outbreak of lymphocytic choriomeningitis virus infections in medical center personnel

Abstract: An outbreak of lymphocytic choriomeningitis (LCM) virus infections occurred in Medical Center personnel at the University of Rochester in 1972-1973. A total of 48 infections was discovered, 31 in staff of the radiation therapy area, 12 in the staff of the Vivarium facility, and 5 in other individuals who worked in the Medical Center. Twenty-one of the infections were associated with recent febrile illness with myalgia. Epidemiologic and virologic studies indicated that the source of the infection was Syrian hamsters which were used in tumor research; the tumor cell lines themselves were shown to be contaminated with LCM virus and probably represented the original source of contamination of the Rochester facility. Infection occurred not only through direct contact with infected animals but also from mere presence in the room where the animals were held. This outbreak emphasizes the need for restricting access to animal quarters and for surveillance of hamsters and tumor cell lines and indicate the necessity of separating animal facilities from patient-care facilities.

Characteristics of menopausal women: a survey of king and pierce counties in washington, 1973–1974

Abstract: Age-specific menopause rates, frequency and duration of menopausal estrogen use, and characteristics of users and non-users of menopausal estrogen therapy are presented for the population of King and Pierce counties in the state of Washington from 1973-1974 survey data. Age-specific menopause rates do not differ substantially from rates derived from data from the 1960-1962 US Health Examination Survey, although women over 50 years of age were more likely to report operative menopause in the present study than in the Health Examination Survey. The estimated frequency of menopausal estrogen use of over 3 months' duration in the population was 51%; this is in contrast to an estimated 26% rate of severe menopausal symptoms. Median use of menopausal estrogen therapy was over 10 years. Estrogen users were younger than non-users and reported more formal education. More users had had difficulty with severe menopausal symptoms and more had had a hysterectomy.

Some epidemiologic features of motorcycle collision injuries. I. Introduction, methods and factors associated with incidence.

Abstract: Using official police reports and hospital admission and emergency room medical records. 1273 persons with a confirmed medically treated motorcycle injury were identified in Sacramento County, California, during 1970. Less than 39% of all injured motor-cyclists were identified in this study using only official police reports. The annual incidence rate was highest for 18-year-old male drivers. In addition to age of the driver, risk of injury was associated with drivers of short stature (less than 173 cm) operating an intermediate or larger size motorcycle. Risk of injury was higher for drivers with training than for those without training or those who operated their motorcycles frequently regardless of type of use. Risk of injury was not related to make of motorcycle but was related to engine size. Two-thirds of the injury-producing collisions involved a motorcycle and a second motor vehicle. Motorcycle collisions occurred most frequently during the afternoon and early evening hours and during the summer months, but peaks in incidence of collisions occurred during weeks which included a holiday.

Lung cancer and air pollution in southcentral los angeles county

Abstract: An increased rate of lung cancer has been consistently observed from 1968-1972 among males in southcentral Los Angeles. This excess risk occurs across several social classes and occupational categories. No differential excess of oral cavity, pancreatic, laryngeal and bladder cancer was observed in the same area, lessening the possibility that regional variations in smoking habits accounted for the excess lung cancer. Air sampling has indicated an excess of certain polynuclear aromatic hydrocarbons (PAH) in southcentral Los Angeles. There was a correlation between the geographic distribution of lung cancer cases and the general location of industries which have emitted these PAH. A case-controlled study of smoking, occupational and residential history in the southcentral area is underway.

Reye's syndrome: epidemiologic and viral studies, 1963–1974

Abstract: Fifty-eight children with Reye's syndrome (RS) confirmed by liver biopsy were treated at the University of Cincinnati between 1963 and 1974. Cases were clustered in the winter and spring with the peak in February and March. These coincided with the occurrence of influenza and, numerically, were associated more closely with influenza B than with influenza A. Six of the 58 cases were associated with chickenpox. Twenty-six children with RS were seen from 1963 to 1971, before the beginning of a systematic epidemiologic and virologic study. Viral infection was documented in either the patient or a contact in only 19% of those studied. Between 1971 and 1973, after the study was initiated, 16 cases of RS were diagnosed and viral infection was confirmed in 56% of these. In 1974, an epidemic of RS occurred during an influenza B epidemic and viral infection was found in either the patient or a contact in 81% of 16 cases. This study demonstrates that an association with viral infection can be proven in the majority of cases of RS when an intensive investigation is undertaken. During this study no significant environmental toxic exposures could be idenified. Most children had taken aspirin and other medications, and seven children had a history of excessive aspirin ingestion.

Epidemiologic characteristics of patients with prostatic neoplasms

Abstract: A case-control study was conducted between 1957 and 1965 on 128 patients with benign prostatic hyperplasia (BPH), 256 age-matched controls, 290 prostate cancer patients and 290 age-matched controls for the prostate cancer patients, all of whom had completed the Roswell Park Memorial Institute epidemiology questionnaire and were interviewed on admission to the Institute. Compared to the control groups a higher proportion of both case groups were Protestants and residents of smaller towns. The major finding in this case-control study was a significantly higher risk for prostate cancer in fertile males compared to both married and non-married, but infertile males. This finding was confirmed when fertility was used as a variable for the classification of study groups in an earlier prospective study reporting the follow-up of patients with BPH and non-neoplastic controls. In this study, patients with children were found to have a relative risk of 2.69 for prostate cancer compared to the married patients with no children. Fertility may be a manifestation of constitutional-hormonal factors that increase the risk of prostate cancer.

Amyotrophic lateral sclerosis and parkinsonism-dementia on Guam, 1945-1972. II. Familial and genetic studies.

Abstract: The extraordinarily high rate of amyotrophic lateral sclerosis (ALS) and parkinsonism-dementia (PD) in the Chamorro linguistic group on Guam suggested a genetic etiology for these diseases. Results of three studies are described. Two involved comparisons of the rates of disease in relatives and spouses of index patients and controls. In the third we examined offspring of doubly affected parents, 10 spouse pairs with ALS, 3 spouse pairs with PD and 13 spouse pairs in which 1 spouse had ALS and the other PD. Within the limitations of numbers and age of offspring, we found a tendency among siblings and offspring of ALS cases to have a higher risk than control relatives. Numbers were small and in no instance were significant differences encountered. Spouses of patients had at least as high risk of developing ALS or PD as any of the groups of blood relatives. A slightly higher age-specific rate of ALS and PD occurred in the offspring of doubly affected parents. The only group large enough for present analysis are 60 offspring of doubly affected ALS parents over the age of 20. Thus far only 3 have developed ALS. Within our entire patient population of 350 ALS cases and 219 PD cases there were 12 instances in which one parent of the patient was not Chamorro. In addition there is a consistent two- to threefold excess of affected males which could not be accounted for by competitive risks of death from other causes among females. While a familial tendency does exist these findings and observations are not compatible with any simple Mendelian form of inheritance. It is possible that genetic influences affect the occurrence of these diseases but our studies suggest that environmental factors play at least as important a role.