Biomedical subjects

D Rothenbacher

Publications and source records attributed to D Rothenbacher.

64 records · Page 4Linked to original sources

PubMed1997

Body weight, pre-existing disease, and all-cause mortality in a cohort of male employees in the German construction industry.

The impact of body weight on all-cause mortality is subject to ongoing debate. We assessed the relation between body mass index (BMI) and all-cause mortality in a cohort of 8043 male employees in the German construction industry who underwent detailed occupational health examinations at ages 25-64 and who were followed for all cause mortality over an average period of 4.5 years. Overall, there was a negative, graded relation between BMI and all-cause mortality, which persisted after controlling for multiple covariates including age and cigarette smoking, and after excluding the initial two years of follow-up. There was a strong positive cross-sectional relationship between BMI and a medical diagnosis of diabetes, hypertension, and ischemic heart disease at the baseline examination. While BMI showed a strong negative relation with all-cause mortality among men with such diseases, the association was much weaker and non-monotonic for mean free of these diseases. Our results underline the importance of preexisting diseases for the prognostic value of body weight.

Adult↗

PubMed1997

Treatment decisions in palliative cancer care: patients' preferences for involvement and doctors' knowledge about it.

The aim of this study was to evaluate the extent to which hospitalised patients with advanced cancer and a palliative treatment goal wanted to be involved in the process of making treatment decisions and how well their physicians actually knew their preferences for participation. 59 hospitalised patients with non-curable cancer, 86 hospitalised patients with chronic non-neoplastic disease, and 115 non-hospitalised persons were surveyed with a standardised questionnaire. In addition, the physicians of the hospitalised patients were asked to complete a similar questionnaire. The majority of patients with advanced cancer wanted to decide either by themselves/mainly by themselves (9%) or to collaborate and decide together with their physician (73%), compared with 17% and 49%, respectively, of patients with chronic non-neoplastic disease, and 40% and 56%, respectively, of the non-hospitalised persons (difference between groups: P = 0.001). Younger age, higher education, employment and higher Karnofsky index were significantly associated with active involvement. The agreement of patients' preference with their physicians' assessment did not exceed chance. In conclusion, most patients wanted to participate in a decision regarding their treatment, although physicians were unaware of their patients' preferences.

Adult↗

PubMed1997

Helicobacter pylori in out-patients of a general practitioner: prevalence and determinants of current infection.

Data on prevalence and determinants of Helicobacter pylori infection in well-defined populations are scarce. We investigated the prevalence and determinants of active H. pylori infection in a population of out-patients attending a general practitioner in Southern Germany. Infection status was determined by [13C]urea breath test. In addition, information on potential risk factors and medical history was collected. Five hundred and one of the 531 eligible patients participated in the study (response rate of 94.4%). In total, 117 of the 501 patients had a positive [13C]urea breath test (23.4%). Prevalence of H. pylori infection increased with age from 10.8% (95% CI 5.7-18.1%) in the age group 15-29 years to 30.8% (95% CI 22.1-40.6%) in the age group 60-79 years and was 20.3%, 30.4% and 28.2% for the age groups 30-39, 40-49 and 50-59 years, respectively. Education and childhood living conditions, especially the number of siblings, were identified as additional independent determinants of infection.

Adolescent↗

PubMed1997

The association between alcohol consumption and all-cause mortality in a cohort of male employees in the German construction industry.

BACKGROUND: Many epidemiological studies have shown a J- or U-shaped association between alcohol consumption and total mortality. It has been argued that the higher mortality among abstainers than among moderate drinkers might result from misreporting of alcohol consumption, confounding or inclusion of a high proportion of ex-drinkers or individuals with pre-existing diseases among abstainers. METHODS: These concerns were addressed in a cohort study among 8043 construction workers aged 25-64 years who underwent occupational health examinations at six centres in South West Germany during 1986 to 1988. Abstainers were compared with alcohol users with respect to biological markers of alcohol consumption, prevalence of pre-existing diseases and other covariates. Study participants were followed for all-cause mortality until 1994. RESULTS: There was a clear monotonic dose-response relationship of biological markers with self-reported alcohol consumption. Prevalence of pre-existing diseases was highest among heavy drinkers, while no major differences were observed between abstainers and men who consumed 1-49 g of alcohol per day. Overall, 172 men died during the follow-up period. There was a strong U-shaped relationship between alcohol consumption and total mortality. Mortality was 2.8 times higher (95% confidence interval [CI]: 1.5-5.4) among non-drinkers than among men who consumed 1-49 g of alcohol per day after control for potential confounders in multivariable analyses. Strongly increased mortality was also found among heavy drinkers. Exclusion of non-drinkers with pre-existing diseases did not change the U-shaped association. CONCLUSIONS: We found a strong U-shaped association between alcohol consumption and all-cause mortality which is unlikely to be explained by misreporting, confounding or pre-existing disease.

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PubMed1997

Chronic respiratory disease morbidity in construction workers: patterns and prognostic significance for permanent disability and overall mortality.

The aim of this study was to determine chronic respiratory disease morbidity in construction workers, and to assess the prognostic value of various morbidity measures on permanent disability and on all-cause mortality. Subjects in this analysis were male employees in the German construction industry, aged 40-64 yrs, who were examined by the occupational health service between August 1986 and December 1988. Prevalence of respiratory disorders as characterized by: 1) pathological findings on lung auscultation; 2) reduced forced expiratory volume in one second (FEV1); and 3) a medical diagnosis of chronic respiratory disease (International Classification of Diseases 9th revision (ICD-9) 490496) was assessed among occupational groups of construction workers, and compared with prevalence among white-collar employees. Active follow-up was conducted between October 1992 and July 1994 to ascertain working and life status (completeness: 92 and 96%, respectively). The prognostic value of the morbidity measures on permanent disability and on all-cause mortality was assessed using the Cox proportional hazards model. In the entire cohort, crude prevalence was 7.6% for pathological findings on lung auscultation, 8.8% for a reduced FEV1 (<70% of predicted value), and 6.1% for a recorded diagnosis of chronic respiratory disease. There was strong variation of prevalence with age, smoking status and, less clearly, occupation. The relative risk for permanent disability varied between 1.9 and 3.2, and for mortality between 2.0 and 2.9, respectively, when men with the various measures of bronchopulmonary disorders were compared with other men. The morbidity measures utilized allow the identification of employees at higher risk of disability and death, and this may facilitate targeting of specific prevention and rehabilitation measures.

Adult↗

PubMed1997

Use of commonly prescribed antibiotics is not associated with prevalence of Helicobacter pylori infection in adults.

BACKGROUND: The aim of the study was to investigate the association of the use of commonly prescribed antibiotics with prevalence of Helicobacter pylori infection in a population of adult outpatients. METHODS: All patients aged 15-79 years who visited the practice of a general practitioner (GP) between June and September 1996 in a suburban community near Ulm, a city in southern Germany, were asked to participate in the study. Infection status was determined with a 13C-urea breath test. In addition, the patients were asked to fill out a self-administered questionnaire. RESULTS: Overall, 475 outpatients were included in the study (response, 94.1%). A total of 266 patients (56.0%) reported a history of antibiotic treatment within the past 5 years, whereas 147 patients (30.9%) did not (62 patients (13.1%) did not know). Prevalence of infection in patients with a history of antibiotic medication during the past 5 years was 23.3%, whereas the prevalence of infection was 20.4% in subjects without antibiotic treatment (P = 0.283 after stratification for age). Control for other potential confounders by multivariable analysis did not materially alter the results. CONCLUSION: Coincidental antibiotic treatment is not associated with H. pylori prevalence in adults.

Adolescent↗

PubMed1996

Smoking patterns and mortality attributable to smoking in a cohort of 3528 construction workers.

This study describes the smoking patterns of 3528 construction workers as reported at occupational health examinations, in four occupational health centres located in the South of Germany, conducted between August 1986 and December 1988. Subjects were aged 20 to 59 years and were working as plumbers, carpenters, painters or varnishers, plasterers, bricklayers, unskilled workers or white collar employees. Overall smoking prevalence was 53.5%. It was considerably higher than in a representative population sample of the same age groups. Active follow up was carried out to ascertain vital status between October 1992 and July 1994. The effect of smoking on all cause mortality was assessed using the cox proportional hazard model. The relative risk of current smoking was 2.5 (95% CI 1.4-4.4) after adjustment for age, profession, self reported alcohol consumption, body mass index, nationality, and company size. 60% of the deaths among smokers and 34% of deaths in the whole cohort were attributable to smoking. These findings underline the need for comprehensive efforts to reduce smoking and its negative consequences in the occupational group.

Adult↗

PubMed1996

Older workers in the construction industry: results of a routine health examination and a five year follow up.

OBJECTIVE: To describe the health status of older construction workers and the occurrence of early retirement due to disability or of mortality within a five year follow up. METHODS: Firstly, a cross sectional study was performed among 4958 employees in the German construction industry, aged 40-64 years, who underwent standardised routine occupational health examinations in 1986-8. The study population included plumbers, carpenters, painters/varnishers, plasterers, unskilled workers, and white collar workers (control group). Job specific prevalence and age adjusted relative prevalence were calculated for hearing loss, abnormal findings at lung auscultation, reduced forced expiratory volume, increased diastolic blood pressure, abnormalities in the electrocardiogram, increased body mass index, hypercholesterolaemia, increased liver enzymes, abnormal findings in an examination of the musculoskeletal system, and abnormalities of the skin. Secondly, follow up for disability and all cause mortality was ascertained between 1992 and 1994 (mean follow up period = 4.5 y). Job specific crude rates were calculated for the occurrence of early retirement due to disability and for all cause mortality. With Cox's proportional hazards model, job specific relative risks, adjusted for age, nationality, and smoking were obtained. RESULTS: Compared with the white collar workers, a higher prevalence of hearing deficiencies, signs of obstructive lung diseases, increased body mass index, and musculoskeletal abnormalities were found among the construction workers at the baseline exam. During the follow up period, 141 men died and 341 men left the labour market due to disability. Compared with white collar workers, the construction workers showed a 3.5 to 8.4-fold increased rate of disability (P < 0.05 for all occupational groups) and a 1.2 to 2.1-fold increased all cause mortality (NS). CONCLUSIONS: This study shows the need and possibilities for further health promotion in workers employed in the construction industry, targeting both work related conditions and personal lifestyle factors. Rehabilitation measures should be enforced to limit the rate of disability among construction workers.

Adult↗

PubMedDate not supplied

Distribution, determinants, and prognostic value of gamma-glutamyltransferase for all-cause mortality in a cohort of construction workers from southern Germany.

BACKGROUND: Serum gamma-glutamyltransferase (GGT) is commonly measured as a marker of hepatobiliary disorders in clinical practice, but little is known about its distribution and prognostic value for all-cause mortality. METHODS: Distribution and determinants of serum GGT levels were assessed among 8,043 construction workers ages 25-64 who underwent occupational health examinations in six centers in Southern Germany from 1986 to 1988. Study participants were followed for all-cause mortality until 1994. RESULTS: Serum GGT levels were considerably higher in this cohort than among male employees examined in a national survey conducted during the same period. The factors most strongly related to serum GGT were self-reported alcohol consumption, body mass index, diabetes, and hypertension, but relations of GGT levels were also found with nationality, occupation, and smoking. There was a strong dose-response relation between serum GGT levels and all-cause mortality (P value for trend < 0.001). Compared with men with GGT levels below 15 U/liter (measured at 25 degrees C), relative risks (95% CI) were 1.46 (0.86-2.49), 1.78 (1.08-2.94), 2.09 (1.26-3.45), and 3.44 (2.20-5.38) for men with GGT levels of 15-19, 20-29, 30-49, and > or = 50 U/liter, respectively. This relation was reduced but not eliminated by control for body mass index, diabetes, hypertension, alcohol consumption, and other covariates in multivariable analysis. CONCLUSION: Serum GGT is a strong risk indicator of all-cause mortality.

Adult↗

PubMedDate not supplied

Do waste incinerators induce adverse respiratory effects? An air quality and epidemiological study of six communities.

The purpose of the study presented here was to simultaneously measure air quality and respiratory function and symptoms in populations living in the neighborhood of waste incinerators and to estimate the contribution of incinerator emissions to the particulate air mass in these neighborhoods. We studied the residents of three communities having, respectively, a biomedical and a municipal incinerator, and a liquid hazardous waste-burning industrial furnace. We compared results with three matched-comparison communities. We did not detect differences in concentrations of particulate matter among any of the three pairs of study communities. Average fine particulate (PM2.5) concentrations measured for 35 days varied across study communities from 16 to 32 micrograms/m3. Within the same community, daily concentrations of fine particulates varied by as much as eightfold, from 10 to 80 micrograms/m3, and were nearly identical within each pair of communities. Direct measurements of air quality and estimates based on a chemical mass balance receptor model showed that incinerator emissions did not have a major or even a modest impact on routinely monitored air pollutants. A onetime baseline descriptive survey (n = 6963) did not reveal consistent community differences in the prevalence of chronic or acute respiratory symptoms between incinerator and comparison communities, nor did we see a difference in baseline lung function tests or in the average peak expiratory flow rate measured over a period of 35 days. Based on this analysis of the first year of our study, we conclude that we have no evidence to reject the null hypothesis of no acute or chronic respiratory effects associated with residence in any of the three incinerator communities.

Adolescent↗