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Biomedical subjects

E Prescott

Publications and source records attributed to E Prescott.

At least 55 records · Page 3Linked to original sources
PubMed1998

Trends in smoking prevalence in Danish adults, 1964-1994. The influence of gender, age, and education.

BACKGROUND: Studies of time trends in smoking prevalence provide a better understanding of the determinants of smoking. The present study analyses changes over time in the prevalence of smoking and heavy smoking in relation to sex, age, and education. METHODS: Data on smoking behaviour were collected by questionnaire in random samples of the general population in the area of Copenhagen. The database used included 71,842 measurements of smoking behaviour for 32,156 subjects aged 30 years or more, who had been examined at intervals between 1964 and 1994. In bi- and multivariate analyses the effects of sex, age, education, time period, and study group on the prevalence of smoking and of heavy smoking were assessed. RESULTS: Smoking was least prevalent in women, in the oldest age group (more than 70 years), and among those with 8 years or more of school education. During the study period (from 1964/74 to 1990/94), the prevalence of smoking decreased from 72% to 54% in men and from 52% to 46% in women. In both men and women this decrease was smallest in the least educated (less than 8 years of school education). Heavy smoking was also least prevalent in women, in the oldest age group, and among the well educated. During the study period, the unadjusted prevalence of heavy smoking decreased from 52% to 38% in men, while it increased from 17% to 21% in women. The multivariate analysis showed that the time trend for heavy smoking only depended on sex, while educational attainment and age had no impact on the trend. CONCLUSION: During the last 30 years the prevalence of smoking has decreased in Denmark. The decrease has been smallest in women, and among the least educated, and the increasing trend in the prevalence of heavy smoking in women is a cause for concern.

Adult↗
PubMed1998

Genetic and acquired predisposing factors and treatment of osteoporosis in thalassaemia major.

We have previously shown a high incidence of osteopenia and osteoporosis in patients with thalassaemia major. These bone changes, were more severe in males than females, in those with diabetes mellitus and with hypogonadal-hypogonadism. Our recent studies concern the relationship of erythroid activity, assessed by serum transferrin receptors as an overall measure of anaemia, to osteoporosis. Serum transferrin receptor levels correlated with the mean pre-transfusion haemoglobin level, but there was no correlation with the incidence of osteopenia and osteoporosis. As osteoporosis has a strong genetic component we have also studied the COLIA1 and COLIA2 genes which code for the major protein of bone (type 1 collagen). Studies by others have shown in non-thalassaemic patients that a polymorphism G-->T or TT in a regulatory region of COLIA1 at the recognition site for transcription factor Sp1 is associated with the presence of osteoporosis. Our studies suggest that Sp1 polymorphism is not specific to any one ethnic group; the polymorphism occurs more commonly in females (female to male ratio 2:1). In male thalassaemia major patients the presence of the Sp1 mutation was associated with more severe osteoporosis of the spine and the hip compared with female patients. There is failure of improvement in spinal osteoporosis with bisphosphonate therapy (intravenous Pamidronate) in male patients with the Sp1 mutation.

Adolescent↗
PubMed1998

Gender and smoking-related risk of lung cancer. The Copenhagen Center for Prospective Population Studies.

Our aim was to compare risk of lung cancer associated with smoking by gender and histologic type. A total of 30,874 subjects, 44% women, from three prospective population-based studies with initial examinations between 1964 and 1992 were followed until 1994 through the National Cancer Registry. There were 867 cases of lung cancer, 203 among women and 664 among men. Rates among female and male never-smokers were similar, although confidence intervals around rates were wide. Rate ratios (RRs) increased with number of pack-years for both men and women to a maximum of approximately 20 in inhaling smokers with more than 60 pack-years of tobacco exposure. RRs did not differ much between men and women: adjusted for pack-years, age, and study population, the ratio between female and male smokers' RRs of developing lung cancer was 0.8 (95% confidence interval = 0.3-2.1). All histologic types were associated with smoking, with the largest RR seen for squamous cell carcinoma and anaplastic carcinoma. This prospective population-based study does not confirm previous reports from case-control studies of a higher relative risk in women than in men for lung cancer associated with smoking.

Adult↗
PubMed1997

Has risk associated with smoking increased? Results from the Copenhagen Center for Prospective Population Studies.

BACKGROUND: Two recent much cited publications have raised the concern that risk associated with cigarette smoking has so far been underestimated. In this study we wish to determine whether excess all-cause mortality associated with smoking has increased during the last 20-30 years in a study population representative of the general Danish population and whether any such changes relate to changes in smoking behaviour. METHODS: Pooled data from three prospective population studies conducted in Copenhagen with detailed information on smoking habits. A total of 31,194 subjects, 17,669 males and 13,525 females, initially examined between 1964 and 1992 with examinations repeated at intervals from 1-10 years, were followed until 1995 for all-cause mortality. Relative mortality risk in smokers versus never-smokers was calculated within periods of five calendar years and compared throughout the study period. RESULTS: Male smokers' exposure did not change during the study period whereas female smokers' exposure to tobacco increased in terms of age at smoking onset, quantity smoked and depth of inhalation. During follow-up 5744 males and 2900 females died. In males, death rate ratios (comparing continuous smokers with never-smokers) did not change in the study period. In females, ratios increased from 1964-1978 to 1979-1994 by a factor of 1.3 (95% confidence interval 1.0-1.8). CONCLUSIONS: In agreement with the observed changes in smoking habits, excess mortality in male smokers did not increase whereas excess mortality in female smokers increased slightly.

Adolescent↗
PubMed1997

Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma: a prospective study based on a sample of the general population. Copenhagen City Heart Study Group.

BACKGROUND: Women are more often admitted to hospital for asthma than men. A study was undertaken to determine whether this is caused by gender differences in the prevalence or severity of the disease. METHODS: Admissions to hospital for asthma in 13,540 subjects were followed from 1977 to 1993. RESULTS: At baseline 315 subjects (2.3%) reported asthma, 2.2% of women and 2.5% of men. During follow up 160 subjects were admitted to hospital for asthma. After controlling for self-reported asthma and smoking, women had a higher risk of being admitted to hospital than men (relative risk 1.7, 95% confidence interval 1.2 to 2.4). This increased risk was not due to misclassification of chronic obstructive pulmonary disease (COPD) as asthma. CONCLUSIONS: These findings indicate gender-related differences in either the severity, perception, or management of asthma.

Adult↗
PubMed1997

Trends in stroke incidence. The Copenhagen City Heart Study.

BACKGROUND AND PURPOSE: Stroke incidence has increased in some countries and decreased in others. After 20 years of intensive antihypertensive treatment the latter could be expected, and we have evaluated the sex-specific temporal trends in stroke incidence using 17 years of follow-up in the Copenhagen City Heart Study. SUBJECTS AND METHODS: Our cohort comprised 19,698 subjects living in Copenhagen, Denmark. They were invited for health examinations in the following time periods: 1976 through 1978, 1981 through 1983, and 1992 through 1994. Trends are presented for all persons who attended at least one of the two first examinations as well as the total cohort including nonresponders. Subjects between 45 and 84 years of age were followed from March 1, 1976 until March 1, 1993. Changes in age-specific stroke incidence were calculated by means of Poisson regression analysis. RESULTS: For subjects aged 45 to 64 years, no significant trends were observed, with an annual incidence rate ratio of 1.00 (95% confidence interval [CI], 0.97 to 1.03) and 1.04 (95% CI, 0.99 to 1.08) for men and women, respectively. In subjects aged 65 to 84 years a significant decrease in stroke incidence was found in men, whose annual rate ratio was 0.97 (95% CI, 0.95 to 0.99), but not in women, whose annual rate ratio was 0.98 (95% CI, 0.95 to 1.00). Throughout four observed periods the stroke incidence among men remained significantly higher than that for women. CONCLUSIONS: During the period from 1976 to 1993 there has been a decline in incidence of stroke in men and women aged 65 to 84 years that was significant only in men, whereas no changes were found for persons aged 45 to 64 years.

Age Distribution↗
PubMed1997

Gender difference in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study.

Recent findings suggest that females may be more susceptible than males to the deleterious influence of tobacco smoking in developing chronic obstructive pulmonary disease (COPD). This paper studies the interaction of gender and smoking on development of COPD as assessed by lung function and hospital admission. A total of 13,897 subjects, born after 1920, from two population studies, 9,083 from the Copenhagen City Heart Study (CCHS) and 4,814 from the Glostrup Population Studies (GPS), were followed for 7-16 yrs. Data were linked with information on hospital admissions caused by COPD. Based on cross-sectional data, in the CCHS the estimated excess loss of forced expiratory volume in one second (FEV1) per pack-year of smoking was 7.4 mL in female smokers who inhaled and 6.3 mL in male smokers who inhaled. In the GPS, the corresponding excess loss of FEV1 was 10.5 and 8.4 mL in females and males, respectively. Two hundred and eighteen subjects in the CCHS and 23 in the GPS were hospitalized during follow-up. Risk associated with pack-years was higher in females than in males (relative risks (RRs) for 1-20, 20-40 and >40 pack-years were 7.0 (3.5-14.1), 9.8 (4.9-19.6) and 23.3 (10.7-50.9) in females, and 3.2 (1.1-9.1), 5.7 (2.2-14.3) and 8.4 (3.3-21.6) in males) but the interaction term gender x pack-years did not reach significance (p=0.08). Results were similar in the GPS. After adjusting for smoking in more detail, females in both cohorts had an increased risk of hospitalization for COPD compared to males with a RR of 1.5 (1.2-2.1) in the CCHS and 3.6 (1.4-9.0) in the GPS. This was not likely to be caused by a generally increased rate of hospital admission for females. Results were similar when including deaths from COPD as endpoint. In two independent population samples, smoking had greater impact on the lung function of females than males, and after adjusting for smoking females subsequently suffered a higher risk of being admitted to hospital for COPD. Results suggest that adverse effects of smoking on lung function may be greater in females than in males.

Adult↗
PubMed1996

Association of chronic mucus hypersecretion with FEV1 decline and chronic obstructive pulmonary disease morbidity. Copenhagen City Heart Study Group.

The aim of this study was to examine the association between chronic mucus hypersecretion, and FEV1 decline, and subsequent hospitalization from chronic obstructive pulmonary disease (COPD). We used data from The Copenhagen City Heart Study on 5,354 women and 4,081 men 30 to 79 yr of age with assessment of smoking habits, respiratory symptoms, and spirometry at two surveys 5 yr apart. Information on COPD hospitalization during 8 to 10 yr of subsequent follow-up was obtained from a nationwide register. Chronic mucus hypersecretion was significantly associated with FEV1 decline; the effect was most prominent among men, where chronic mucus hypersecretion at both surveys was associated with an excess FEV1 decline of 22.8 ml/yr (95% confidence interval, 8.2 to 37.4) compared with men without mucus hypersecretion, after adjusting for age, height, weight change, and smoking; in women, the excess decline was 12.6 ml/yr (0.7-24.6). Chronic mucus hypersecretion was associated with subsequent hospitalization due to COPD after adjusting for age and smoking; relative risk was 5.3 (2.9 to 9.6) among men and 5.1 (2.5 to 10.3) among women. After further adjusting for FEV1 at the second survey, the relative risk was reduced to 2.4 (1.3 to 4.5) for men and 2.6 (1.2 to 5.3) for women. Chronic mucus hypersecretion was significantly and consistently associated with both an excess FEV1 decline and an increased risk of subsequent hospitalization because of COPD.

Adult↗
PubMed1995

Chronic mucus hypersecretion in COPD and death from pulmonary infection.

The association of chronic mucus hypersecretion and mortality is a matter of debate. We wished to determine whether the relationship between chronic mucus hypersecretion and chronic obstructive pulmonary disease (COPD)-related mortality could be explained by proneness to pulmonary infection. We followed 14,223 subjects of both sexes for 10-12 yrs. Cases where COPD was an underlying or contributory cause of death (n = 214) were included, and hospital records were obtained when possible (n = 101). From the presence of increased mucus, purulent mucus, fever, leucocytosis and infiltration on chest radiography, death was classified as either due to pulmonary infection (n = 38), other causes (n = 51), or unclassifiable (n = 12). Of subjects reporting chronic mucus hypersecretion at the initial examination, pulmonary infection was implicated in 54% of deaths, whereas this only occurred in 28% of subjects without chronic mucus hypersecretion. Controlling for covariates, in particular smoking habits, a Cox analysis showed a strong inverse relationship between ventilatory function and COPD-related mortality. Chronic mucus hypersecretion was found to be a significant predictor of COPD-related death with pulmonary infection implicated (relative risk (RR) 3.5) but not of death without pulmonary infection (RR 0.9). We consider that subjects with COPD and chronic mucus hypersecretion are more likely to die from pulmonary infections than subjects without chronic mucus hypersecretion. This may explain the excess mortality in subjects with COPD and chronic mucus hypersecretion found in previous studies.

Cause of Death↗
PubMed1993

A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome.

The primary objectives of this study were to examine to what extent fibromyalgia patients later on developed presumpted causative somatic diseases and to examine symptoms and muscle strength some years after the diagnosis of fibromyalgia was established. A secondary objective was to describe the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow-up visit. 60 out of 83 reported increased pain, 8 reported improvement of pain. The 83 subjects showed no significant fall in muscle strength during the follow-up period. The majority reported severe fatigue but only one fifth fulfilled the proposed chronic fatigue syndrome criteria.

Adult↗
PubMed1993

Fibromyalgia in the adult Danish population: I. A prevalence study.

Epidemiologic studies of fibromyalgia have so far been based on rheumatologic and general practice settings, which are poor proxies for the underlying population. The study is based on a national health interview survey carried out by the Danish Institute for Clinical Epidemiology in 1990/91 on approx. 6000 randomly selected Danish citizens. For this study 1219 subjects from the eastern part of Denmark aged 18 to 79 years were asked about widespread muscle pain. One-hundred-and-twenty-three persons fulfilled the screening criteria. Clinical examination could be performed on 65 persons (53%). Eight subjects, all female, met the 1990 American College of Rheumatism criteria for fibromyalgia. Dropouts were regarded as not having fibromyalgia. The prevalence of fibromyalgia in the Danish population between 18 and 79 years of age was found to be a minimum estimate of 0.66% (95% confidence limits 0.28%-1.29%).

Adolescent↗
PubMed1993

Fibromyalgia in the adult Danish population: II. A study of clinical features.

Clinical characteristics of fibromyalgia have so far been based mainly on patients identified in rheumatologic settings. This paper offers the clinical findings in fibromyalgia based on a national health interview survey, in which 123 persons fulfilled preset criteria for widespread pain. Clinical examination could be performed on 65 subjects (53%) and included physical examination, tender point palpation by two blinded trained physicians, blood sample analysis, measurement of dynamic muscular strength and a detailed self-administered questionnaire. Significantly more subjective swelling, fatigue, headache, difficulty in stair-climbing, and poorer self-evaluated health with more tender points was found. Contrary to that which was expected, fibromyalgia subjects did not suffer from sleep disturbances, irritable bowels or morning stiffness. Our findings indicate that clinical characteristics of fibromyalgia in the general population may differ from those found in rheumatological settings.

Adult↗
PubMed1992

[Methylmethacrylate and organic dementia. A dose-response analysis among dental technicians and opticians].

The substance methylmethacrylate (MMA) is an organic solvent which is employed inter alii for prostheses which is suspected of being neurotoxic. With the object of illustrating whether there is a connection between exposure to MMA and symptoms of organic dementia, a cross-sectional investigation was carried out on a population consisting of occupationally active dental technicians and opticians (n = 528) and a group of dental technicians who were no longer occupationally active (n = 173). No noteworthy difference in the background variables, apart from age, was observed. Age was taken into consideration in the analysis. The results show a statistically significant increase in the prevalence of the chronic symptoms on increasing exposure. Where the acute symptoms are concerned, the connection is not statistically significant, but a tendency is observed. A chronic symptom index constructed on the basis of 13 questions concerning chronic symptoms is compared with the life exposure and the age. A statistically significant increase in the index was found with exposure to MMA, although not for the oldest age group. The pattern symptoms, presence of bias and other forms of exposure are discussed. It is concluded that this investigation confirms the hypothesis that symptoms of organic dementia have a connection the exposure to MMA. The results support the presumption that MMA causes acute and chronic damage to the central nervous system even with exposure below the safety limits. It is recommended that the occupational environment of dental technicians, including the present safety limits, should be revised.

Cross-Sectional Studies↗
PubMed1992

Effect of occupational exposure to cobalt blue dyes on the thyroid volume and function of female plate painters.

It has previously been shown that long-term oral exposure to cobalt can cause goiter and myxedema. The effect of industrial cobalt exposure on thyroid volume and function was determined for 61 female plate painters exposed to cobalt blue dyes in two Danish porcelain factories and 48 unexposed referents. Thyroid volume was determined by ultrasonography. The cobalt blue dyes were used in one of two forms, cobalt aluminate (insoluble) and cobalt-zinc silicate (semisoluble). Only the subjects exposed to semisoluble cobalt had a significantly increased urinary cobalt content (1.17 micrograms.mmol-1 versus 0.13 micrograms.mmol-1, P less than 0.0001). These subjects also had increased levels of serum thyroxine (T4) and free thyroxine (FT4I) (P = 0.0001 and 0.0029, respectively), unaltered serum thyroid stimulating hormone (TSH), and marginally reduced 3,5,3'-triiodothyronine (T3), whereas thyroid volume tended to be lower (P = 0.14). The group exposed to insoluble cobalt did not differ significantly in any thyroid-related parameters. No correlation between urinary cobalt and FT4I or thyroid volume was found. The study demonstrates an effect of cobalt on thyroid hormone metabolism.

Air Pollutants, Occupational↗
PubMed1989

[Organic dementia among dental technicians. A cross-sectional study of dental technicians with opticians as the control group].

The preparation methyl metacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a cross-sectional questionnaire investigation was undertaken in a population consisting of 256 dental technicians and 160 opticians, all of whom were professionally active. The percentage replies for the two groups were 88 and 85 respectively. The two groups do not differ from one another as regards background variables with the exception of age and adjustments are made for this in the analysis. The results demonstrate that there is a statistically higher prevalence of the majority of acute and also chronic symptoms among dental technicians than among opticians. The symptom pattern and the presence of information and selection bias are discussed and it is concluded that this investigation confirms the hypothesis that symptoms compatible with organic dementia are commoner among dental technicians. The results raise the suspicion that MMA may cause acute and chronic damage to the central nervous system, even after very slight exposure. Revision of the occupational environment of dental technicians, including the current hygienic limits for MMA, is recommended.

Adult↗
PubMed1989

[Organic dementia among dental technicians: a cross-sectional investigation of dental technicians using opticians as control].

The preparation methylmethacrylate (MMA) an organic solvent which is employed inter alii in the production of prostheses, is regarded as neurotoxic. With the object of illustrating to what extent dental technicians have symptoms compatible with organic dementia as compared with a control group, a cross-sectional questionnaire investigation was undertaken in a population consisting of 256 dental technicians and 160 opticians, all of whom were professionally active. The percentage replies for the two group were 88 and 85 respectively. The two groups do not differ from one another as regards background variables with the exception of age and adjustments are made for this in the analysis. The results demonstrate that there is a statistically higher prevalence of the majority of acute and also chronic symptoms among dental technicians than among opticians. The symptom pattern and the presence of information and selection bias are discussed and it is concluded that this investigation confirms the hypothesis that symptoms compatible with organic dementia are commoner among dental technicians. The results raise the suspicion that MMA may cause acute and chronic damage to the central nervous system, even after very slight exposure. Revision of the occupational environment of dental technicians, including the current hygienic limits for MMA, is recommended.

Cross-Sectional Studies↗