Some proposed "comparability areas" for U. S. statistics on cause of death.
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Biomedical subjects
Publications and source records attributed to D Hewitt.
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The Agency for Toxic Substances and Disease Registry (ATSDR) conducted biological testing to assess dioxin exposure in residents of a community who lived in an area with heavy chemical industry. Dioxin concentrations were measured in blood serum samples from 28 adult residents of the community. Fourteen of those tested had blood dioxin concentrations that exceeded the 95th percentile prediction level of an age-matched comparison population. Specific congener analyses indicated that the elevated dioxin concentrations were primarily due to high concentrations of 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD), 1,2,3,7,8 pentachlorodibenzo-p-dioxin (PeCDD), and hexachlorodibenzo-p-dioxins (HxCDs). Principal components analysis (PCA) indicated that the profiles of dioxin congeners were different in people with elevated blood dioxin concentrations compared to those with background concentrations. Elevated blood dioxin concentrations were detected only in older members of the population, which suggests that dioxin exposures were higher in the past. The sources of the dioxin exposure have not been identified.
Blood lead (PbB) was measured in a sample of 245 lead smelter employees and their wives in Trail, B.C. and 144 controls in Nelson, B.C. Smelter workers were divided into three groups according to lead exposure: (1) directly-exposed, (2) indirectly-exposed, and (3) office workers. The average PbB values found (41, 33, and 16 micrograms/dl, respectively) reflected exposure level. In the highest exposure group, male smokers had significantly higher PbB concentrations than nonsmokers (44 vs. 37 micrograms/dl). For exposed males, average number of "days off work ill" increased with increasing PbB range and significant correlations were found between PbB values and five biologically plausible health symptoms. None of those symptoms planted to detect response bias correlated. Because of a 4-month strike, PbB values were measured in a sub-sample from each exposure group before and 1, 2, and 4 months after smelter operation resumed. Exposed workers' PbB levels stabilized after 1 month's operation.
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As part of a population survey and a follow-up study of plasma lipid profiles by high temperature gas-liquid chromatography, we have determined the quantities and relative proportions of all major chemical classes and molecular species of lipids of plasma from 1200 subjects at Visit 2 of the Toronto-McMaster Lipid Research Clinic Prevalence Study. We have compared these values between our 24 subjects with ischemic vascular disease and 73 control subjects matched for age, sex, and plasma total cholesterol and triacylglycerols. The phosphatidylcholine/free cholesterol ratio showed the highest association with ischemic vascular disease of any of over 10 other lipid parameters and all the common risk indicators except high density lipoprotein cholesterol. The phosphatidylcholine/free cholesterol ratio had a relative risk ratio of 20/4 (95% confidence limits, 15/9, 23/1) and high density lipoprotein cholesterol, a risk ratio of 23/1 (95% confidence limits, 24/0, 19/5) for ischemic vascular disease. The average ratio of phosphatidylcholine/free cholesterol for the ischemic vascular disease group was 1.36 and for the controls 1.51, the population average being 1.50. Plasma high density lipoprotein cholesterol had a significant correlation (R = 0.15) with the phosphatidylcholine/free cholesterol ratio in the total population sample. The increased risk for ischemic vascular disease from a lower phosphatidylcholine/free cholesterol ratio may possibly be explained on the basis of decreased fluidity and stability of the lipoproteins due to a relative oversaturation with free cholesterol.
The introduction of the European Convention on Human Rights into UK law will have a direct effect on practice in mental health care. The authors discuss developments associated with the Convention, examine different articles and suggest the changes they could bring. They suggest that, rather than reacting to the development of convention rights, healthcare professionals should take the opportunity to influence new standards for psychiatric care.
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