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Biomedical subjects

J Rehm

Publications and source records attributed to J Rehm.

At least 91 records · Page 5Linked to original sources
PubMed1996

WHO working group on population levels of alcohol consumption: Oslo, 14-16 December 1994.

Target 17 of the Health Policy for Europe calls for the health-damaging consumption of dependence-producing substances such as alcohol, tobacco and psychoactive substances to be significantly reduced in all Member States between the year 1980 and the year 2000. With regard to alcohol, it is suggested that alcohol consumption be reduced by 25%, with particular attention to reducing harmful use. A question posed by a number of Member States is what is the level of per capita alcohol consumption of lowest risk to physical, psychological and social harm. A working group was convened to consider population levels of alcohol consumption with particular reference to the Member States of the European Region of WHO. A basis for understanding population problem experience can be established through the interaction between individual risk and distribution of consumption levels within the population. The working group concluded that public health policy within the European Region should continue to advise decreases of per capita consumption. Even when taking into account coronary heart disease, it can be concluded at the population level, across all ranges of alcohol consumption found in almost all countries of Europe, that a reduction in consumption is linked to better health. However, public health policy concerning alcohol should not be based solely on mortality. All outcomes of drinking, that is mortality, morbidity, social and criminal consequences, as well as quality of life, should be considered. The existing data relating alcohol consumption to health originates from countries primarily with a cultural experience of consuming alcohol. In those countries, where there is a cultural or religious tradition of not consuming alcohol, there can be no public health grounds for recommending alcohol consumption.

Adult↗
PubMed1996

Alcohol consumption in Switzerland 1987-93: adjusting for differential effect of assessment techniques on the analysis of trends.

Estimation of time trends in alcohol consumption for recent years in Switzerland is complicated by the fact that the assessment method was changed from personal interview to self-administered questionnaire. With a large-scale study which compared the two methods, it is possible in estimating time trends to allow for adjustment of the effects produced by this change of assessment method. Results indicate that alcohol consumption decreased by about 17% between 1987 and 1993. This decrease was observed uniformly for both genders and all age-groups, which supports the basic assumptions of Skog's revised theory of Ledermann (1985). Personal interviews resulted in considerably higher reported alcohol consumption (+22%) than written questionnaires.

Adolescent↗
PubMed1996

Prevalence of mental illness in Germany and the United States. Comparison of the Upper Bavarian Study and the Epidemiologic Catchment Area Program.

The objective of the present study was to compare data on the prevalence of mental illness in Germany and the United States. For this purpose, data from the Upper Bavarian Study (UBS) and the Epidemiologic Catchment Area (ECA) are presented and compared. In both studies, personal interviews were administered to a sample of community residents. The UBS sample consisted of 1,847 persons aged > or = 18 years, and the ECA study consisted of 24,371 household members aged > or = 18 years in five sites; 1,876 persons from the ECA sample lived in rural sites, and they were used for comparison with the (rural) UBS sample. The diagnostic classification (according to DSM-III) obtained by clinical interviewers in the UBS and by lay interviewers in the ECA was used. The total 6-month prevalence for any axis I Diagnostic Interview Schedule mental disorder (corrected for sample stratifications and adjusted for age) was 18.5% in the (rural) UBS, 18.0% in the total ECA sample (five sites), and 13.4% in the rural sites of the ECA. High morbidity rates for substance use disorders (UBS, 5.8%; ECA rural sites, 3.4%) and affective disorders (UBS, 6.8%; ECA rural sites, 4.1%) were observed in both studies. The 6-month prevalence rates for alcohol use disorders (3.1% considered marked or severe) were 5.1% in the UBS and 2.9% in the ECA rural sites. Concerning anxiety disorders (UBS, 1.6%; ECA rural sites, 6.7%) there was a substantial difference between the studies, which mainly resulted from a higher prevalence of phobia in the ECA program. There were higher rates of dysthymia (3.8% considered marked or severe) in the UBS (5.4%) than in the ECA rural sites (2.6%), whereas the rate of major depression was somewhat lower in UBS (1.4%) as compared with the ECA rural sites (2.4%). Alcohol use disorder was the most frequent category of mental disorder for men in both studies; for women, affective disorder and phobia (in the ECA) were the most frequent categories. Despite differences in methodology concerning sampling, instruments, and case identification the similarities between the results of the two studies were considerable.

Adolescent↗
PubMed1996

On the emerging paradigm of drinking patterns and their social and health consequences.

Recent epidemiological and social studies have increasingly pointed to the importance of drinking patterns in explaining consequences of alcohol consumption. This paper presents recommendations for research in the area based on the presentations and discussions of the first "International Conference on Social and Health Effects of Different Drinking Patterns" held in Toronto in November 1995. In particular, the social dimension in pattern research, and the relationship between patterns of drinking and casualties as well as social harm, are stressed. The paper also argues for better theories, incorporating knowledge from related basic disciplines. In addition, we emphasize the need for improved methodologies and standardized methods for assessing drinking patterns. Finally, implications of research on drinking patterns for policy and programme development are discussed.

Alcohol Drinking↗
PubMed1995

Mortality risk and mental disorders: longitudinal results from the Upper Bavarian Study.

The object of the study was the assessment of the mortality risk for persons with a mental disorder in an unselected representative community sample assessed longitudinally. Subjects from a rural area in Upper Bavaria (Germany) participated in semi-structured interviews conducted by research physicians in the 1970s (first assessment) and death-certificate diagnoses were obtained after an interval up to 13 years later. The sample consisted of 1668 community residents aged 15 years and over. Cox regression estimates resulted in an odds ratio of 1.35 (confidence interval 1.01 to 1.81) for persons with a mental disorder classified as marked to very severe. The odds ratio increased with increasing severity of mental illness from 1.04 from mild disorders, 1.30 for marked disorders, to 1.64 for severe or very severe disorders. The relative risk (odds ratio) for persons with a mental disorder only and no somatic disorder was 1.22, for persons with only a somatic disorder 2.00, and for those with both a mental and somatic disorder 2.13. The presence of somatic illness was responsible for most of the excess mortality. Somatic disorders associated with excess mortality in mental disorders were diseases of the nervous system or sensory organs, diseases of the circulatory system, diseases of the gastrointestinal tract, and diseases of the skeleton, muscles and connective tissue (ICD-8). Thus, while mental illness alone had a limited effect on excess mortality, comorbidity with certain somatic disorders had a significant effect.

Adolescent↗
PubMed1995

Young teenagers and access to alcohol in a Swiss canton: evidence from observational testing and from a telephone survey.

In the first part of the study, the readiness of bartenders and waiters to serve alcoholic beverages to young teenagers was studied. The fieldwork was conducted in a random sample of bars and restaurants in Lausanne and in villages of the canton of Vaud, where 13-year-old and 15-year-old boys ordered either beer or pastis (an aniseed-flavoured aperitif). Results showed that alcoholic beverages were very accessible to 13-year-old and 15-year-old youths although the minimum legal age for purchasing and consuming beer is 16 years and for pastis is 18 years: 81% of the test orders were served. An analysis of interaction of patterns between servers and clients suggested that time necessary to refuse orders may play an important role in explaining this result. In the second part of the study, knowledge and attitudes of owners and managers of bars, restaurants and different kinds of commercial outlet were studied in a telephone interview survey about the minimum legal age for purchasing and consuming alcoholic beverages. Only 17% of the respondents knew the correct minimum legal ages for purchasing and consuming alcoholic beverages.

Adolescent↗
PubMed1995

Alcohol consumption and all-cause mortality.

Based on a large US representative cohort with detailed baseline interview and examination data, the relationship between alcohol consumption and all-cause mortality is examined over a period of 15 years follow-up. Results show a significant linear relationship for females and males under 60 years of age at baseline, and a non-significant U-shape for the older ones. Both results remain stable for different kinds of adjustment including adjustment for nutritional variables and smoking. Excluding people with heart disease history at baseline leads to an even more pronounced linear relationship for both males and females under 60 years of age. Furthermore, it is shown that the curvilinear relationship for men found in previous research is partly due to the age groups examined.

Adult↗
PubMed1994

Drinking patterns, risk taking and road accidents of young drivers: results of a Swiss case-control study.

A case-control study was conducted to test hypotheses about involvement in alcohol-related road accidents. Cases were defined as all male drivers between 18 and 25 years of age who were involved in a police-registered alcohol-related road accident in the Swiss cantons of Vaud and Ticino or the city of Zurich in 1990 and who had a BAC level of 0.8% and more (N = 306). Accident-free controls were drawn from registers of all persons with a driver's licence, matched for sex, age, and place of residence (N = 612). The main research instrument was a questionnaire distributed to cases and controls. Since response rates were relatively low in both groups (ca. 35%), specific analyses were undertaken to exclude the possibility of a selection bias. Results demonstrated that drinking pattern and risk behaviour were important contributing factors to the accidents. Especially, male persons with a permanent heavy-drinking style, males with a risky-driving style plus a regular or periodically heavy-drinking style, and persons who enjoy taking risks and drink to cope, increase their risk of being involved in an alcohol-related traffic accident more than sixfold. A tendency to engage generally in risky behaviour did not increase the risk of involvement in an alcohol accident.

Accidents, Traffic↗
PubMed1993

The relationship between coffee consumption and serum cholesterol under consideration of smoking history.

A large German population sample of 6820 men and 7258 women was used to investigate the relationship between coffee consumption, total serum cholesterol and HDL cholesterol. Analyses were conducted on men and women separately. Differences in age, body mass index, diastolic blood pressure, smoking habits, alcohol, fish, milk and tea consumption, physical activity and medication use were controlled for in the analyses. Interactions between coffee consumption and smoking habits in their relationship with serum cholesterol were part of the analyses. For men, a positive relationship between coffee consumption and total serum cholesterol was found among smokers and life-long abstainers but not in the group of ex-smokers. In women a relationship between coffee consumption and total serum cholesterol was also present, but very weak (only statistical significant in covariance analyses). Levels of HDL cholesterol did not correlate with coffee consumption in either men and women. Hypotheses concerning the peculiarities of the group of ex-smokers are developed, and supporting empirical evidence is given. It is suggested that the group of ex-smokers should always be analysed separately.

Adult↗
PubMed1993

Methodological approaches and problems in research into alcohol-related accidents and injuries.

A classification system for methodologies and problems in research on alcohol-related accidents and injuries is introduced. On the basis of this system, possible designs and statistical methods are presented, and their possible contributions to research on alcohol-related accidents/injuries are evaluated. Special consideration is given to potential biases in secondary data sources, and to methods of overcoming these biases. Finally, the need for more theory-driven research is established.

Accidents↗
PubMed1993

Effects on mortality of alcohol consumption, smoking, physical activity, and close personal relationships.

The study analyses the risks of mortality associated with alcohol consumption and smoking, as well as possible counteracting effects of physical activity and social support through close personal relationships. Data are based on the Upper Bavarian Study, a longitudinal epidemiological study of a representative community sample (n = 1668) in a rural area. Extensive semistructured psychiatric interviews by research physicians were conducted between 1975 and 1977 (n = 1536). Thirteen years after psychiatric assessment, information was obtained from the community register concerning death in the interval, data of death and cause of death according to ICD 9. This information could be ascertained for 93.1% (n = 1430) of those who had been interviewed, thus providing a good basis for generalizing the findings. Results indicate that alcohol intake and cigarette smoking increased mortality while physical activity and the availability of a steady partner had protective effects. There were no interactive effects between the four variables studied, except for a dramatically increased risk for women drinking more than 20 ml of pure alcohol a day and reporting no physical exercise at wave one assessment. The relative risks of alcohol intake and smoking, and the counteracting effects of physical activity and partnership, are exemplified in the cases of a 40-year-old female and a 40-year-old male. Specific analyses of the relationship between alcohol consumption, smoking, physical exercise and personal relationships, on the one hand, and, on the other, different causes of death, are presented.

Adolescent↗
PubMed1993

Measurement error in alcohol consumption: the Swiss Health Survey.

It is planned to include in the Swiss Health Survey (SHS) the questions on the consumption of alcohol that have been part of the Trend Surveys of the Swiss Institute for the Prevention of Alcohol and Drug Problems (SIPA). Since both surveys use different questioning methods (SHS: telephone interview/self-administered questionnaire; SIPA Trend Surveys: personal interviews) a comparative study was carried out to test possible effects of the methods used on responses about alcohol consumption. A split-sample design was used, whereby 1097 persons were asked about their alcohol intake by personal interview, and 1154 persons completed a self-administered questionnaire with the same questions. Considerable differences were found: on an average, consumption reported by personal interview was 38.5% higher among males (including abstainers: 35.9%) and 18.0% higher among females (including abstainers: 17.4%) than that reported by self-administered questionnaire. Consumption figures as assessed by personal interview correspond better to the per capita consumption figures as estimated by sales. Preliminary conclusions concerning the design of future surveys of alcohol consumption in Switzerland are presented.

Adolescent↗
PubMed1992

Pet birds as an independent risk factor for lung cancer: case-control study.

OBJECTIVE: To test the hypothesis that exposure to pet birds increases risk of developing lung cancer. DESIGN: Case-control study. Computerised interviews were used to assess previous exposure to pets and other risk factors for lung cancer. SETTING: Three major hospitals treating respiratory disease in former West Berlin. SUBJECTS: All people newly diagnosed as having primary malignant neoplasm of the trachea, bronchi, or lung who were 65 or younger and control subjects matched for age and sex from the general population of former West Berlin. 279 cases and 635 controls qualified for the study; 239 cases and 429 controls participated. MAIN OUTCOME MEASURES: Odds ratio of developing lung cancer according to whether or not pet birds were kept and the duration of keeping pet birds. RESULTS: In addition to the risk of lung cancer imposed by smoking, passive smoking, and occupational exposure to carcinogens, an increased relative risk of 2.14 (95% confidence interval 1.35 to 3.40) was found among people exposed to pet birds. The adjusted odds ratio for exposures longer than 10 years was 3.19 (1.48 to 8.21). CONCLUSIONS: Avian exposure seems to carry a risk of lung cancer. Until the pathogenesis is understood, long term exposure to pet birds in living areas should be avoided, especially among people at high risk of developing lung cancer.

Animals↗
PubMed1992

Using follow-up data to avoid omitted variable bias: an application to cardiovascular epidemiology.

Omitted variable bias is discussed in the context of linear models. It is shown that the effect of omitted variables can be controlled in linear models for metric dependent variables by using data from follow-up studies. Two different models for analysing such data are proposed. In the first model the omitted variables are assumed to be uncorrelated with the explanatory variables in the model and to be constant over time. These assumptions lead to a special structure of the covariance matrix of the errors over time. Efficient estimation of the parameters in the linear model has to take this special covariance matrix of the errors into account by using appropriate generalized least squares or maximum likelihood methods. In the second model the omitted variables are assumed to be time constant. Additionally, they are allowed to be correlated with the explanatory variables, that is these variables are omitted confounders in the usual epidemiological sense. It is shown that even in this case the parameters of the linear model can be estimated consistently with ordinary least squares if a follow-up study is available. The differences between the parameter estimates under the first and the second model may be used to construct a Hausman test for misspecification. The models, the estimation methods and the Hausman test are illustrated by the example that explores the determinants of serum cholesterol in German adoloscents of both sexes.

Adolescent↗