Decline in smoking-related mortality among Rhode Island physicians.
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Biomedical subjects
Publications and source records attributed to H D Scott.
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An epidemiologic investigation of an acupuncturist's practice in Rhode Island identified 35 patients who were infected with hepatitis B virus during 1984. Of 366 patients seen by the acupuncturist during 1984, 316 (86%) completed questionnaires and submitted serum for hepatitis B serology. Use of tests for immunoglobulin M antibody to hepatitis B core antigen (IgM anti-HBc) identified 17 case-patients who otherwise may have gone undetected. Thirty-four of the 35 case-patients were treated in only one of the two clinics run by the acupuncturist. Patients who received a greater number of acupuncture needles during their treatment course were more likely to have been infected; the attack rate for patients who received less than 150 needles was 9%, compared with 33% for patients who received greater than or equal to 450 needles (p less than 0.001). Attack rates were higher during a one-month period when the index case-patient was more likely to have been viremic than during any other period in 1984 (relative risk = 4.1, 95% confidence interval = 2.3-7.3). While observing the acupuncturist's technique, the investigators noted several potential mechanisms for needle contamination. This study highlights the potential for transmission of hepatitis B in situations of repeated needle use.
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A survey of practicing physicians in Rhode Island revealed a cigarette smoking rate of only 8.3 per cent in 1983. This represents a continuation of the consistent decrease seen in the percentage of physician smokers in each such survey since 1963. Under age 30, the rate was only 4.5 per cent. An exponential model suggests that the overall rate for Rhode Island physicians will be below 3 per cent by the year 2000.
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