[The development of home nursing services. A study of the development of home nursing services in the Municipality of Odense from 1976 to 1980].
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Biomedical subjects
Publications and source records attributed to J Olsen.
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This study is based on a representative sample of 709 Danish women aged between 25 and 45 who were interviewed in 1979. The purpose was to estimate the proportion of women with reduced fecundity who seek medical care and to identify sociodemographic variables associated with presentation to the medical care system. The study showed that the majority of women with reduced fecundity did not seek medical care. The propensity to seek care was not significantly associated with a woman's age or education, nor with family income or the employment status of the head of the household. Women living in rural areas or in homes with two or more rooms per family member had a greater tendency to seek medical care for secondary reduced fecundity compared with women living in cities or in more crowded homes. The implications of these findings for epidemiological studies of the association of reduced fecundity and occupation are discussed.
The sources of error encountered in occupational health epidemiology present unique and difficult problems. Knowledge of these possible sources of error is essential for the proper design of studies interpretation of study results. This article describes important sources of bias in occupational health research including healthy worker selection, information bias and the differential distribution of workplace health services. The paper emphasizes that reference groups must be chosen with extreme care in order to avoid potential problems of healthy worker selection. In addition, knowledge of the process by which diseases are diagnosed is important in planning appropriate study designs.
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The present study examines secular changes in the rate of twinning in Denmark during the period of 1931-77. Total twinning (i.e., mono- and dizygotic twinning combined) declined from a crude rate of 15.0 twin births per 100 deliveries in 1931 to 9.6 twin births per 100 deliveries at the end of the period. After direct adjustment for maternal age and parity (between the years 1935 and 1965), a 22% decline in total twinning rates was noted. Estimates of the rates of dizygotic twinning over the same period, again adjusted for maternal age and parity, show a decline of 20%. Thus there is evidence of a real decline in twinning, independent of the effects of changing patterns of maternal age and parity. These findings are consistent with reports of a general decline in twinning rates from a number of other countries. The interpretation of such secular changes is a matter for speculation.
The objectives of this study were to estimate the incidence of receiving an early retirement pension among a group of skilled workers and to examine the pattern of the major categories of diagnoses for which pensions were awarded. During the period April 1, 1971 to March 31, 1976, 589 union members were awarded disability pensions and 361 were awarded early old-age pensions. The incidence density of disability pensions is very low among young union members but is observed to increase with age. The Standard Disability Ratio also increases with age, indicating that the age-specific disability pensioning rate increases more rapidly among union members than among the standard population of all men in Denmark. The low rate of pensioning observed among young union members is probably due to healthy worker selection. Low Standard Disability Ratios are found for early old-age pensioners when a standard population of all men in Denmark is used. An examination was made of the diagnoses for which disability pensions were awarded in the two largest occupational sub-groups of the union, cabinet makers and carpenters. Carpenters were found to have high Standard Proportional Ratio for the category "accidents" while cabinet makers have high ratio for the category "diseases of the nervous system".
A case-reference study was conducted to estimate the association between neuropsychiatric diseases leading to early retirement pensioning and exposure to organic solvents in the Danish wood industry. Cases were defined as all members of the Carpenter/Cabinet Makers' Trade Union who were diagnosed with a neuropsychiatric disease and received disability or early old-age pensions during the period January 1, 1971 to December 31, 1975. The case group comprised 171 disability pensioners and 35 early old-age pensioners. A reference group of equal size was selected among union members with other diseases who were pensioned over the same time-period. Controls were matched to cases according to age and type of pension. Among a total of 412 eligible study subjects, 342 (i.e., 287 disability pensioners and 55 early old-age pensioners) could be located in 1978. Of these, 9.8% of the disability pensioners and 12.7% of the early old-age pensioners did not respond to the questionnaire. Information regarding occupational exposure and vocational training was obtained both directly from study subjects and from the files of the trade union. Medical diagnoses were obtained through registry linkage and by manual search of hospital records. Former employees with high levels of exposure to organic solvents were more likely to receive disability pensions for neuropsychiatric reasons compared to more modestly-exposed individuals. Cabinet-makers and especially cabinet-makers with high exposure to lacquers and glues had a higher risk of receiving a disability pension for a neuropsychiatric disease than carpenters. Possible sources of bias are discussed in the article.
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Survival of early old-age and disability pensioners from unskilled and semiskilled labourers was compared with the employed workers from the same local trade union. All members receiving early old-age or disability pensions during the period October 1, 1969 to September 30, 1973 were assigned to the index group provided they were still alive September 30, 1973. 2 active workers were selected as controls for each pensioner according to the closest age match. The pensioners had about 7 times higher mortality risk than their active fellow workers in the follow-up period from September 30, 1973 to January 1, 1979. It is emphasized that proper comparison is needed if excess mortality associated with early retirement is to be estimated.
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