In case-control studies, determination of alcohol consumption by cases immediately prior to the injury event is often conceptually straightforward. However, determination of consumption status by controls is difficult because they lack a reference point, especially when cases and controls are not individually matched. We describe a method of assigning alcohol consumption status to controls using a 24-hour drinking history, the distribution in time of case events, and the random assignment of a specific time period to each control subject. This methodology offers a practical approach for determining alcohol consumption status among control subjects immediately prior to a case event, when controls lack a reference point and have not been individually matched to cases. Published in 2001 by John Wiley & Sons, Ltd.

Adolescent↗

PubMedDate not supplied

A nonoccupational outbreak of inorganic mercury vapor poisoning.

An outbreak of inorganic mercury vapor poisoning involving 12 people occurred in a trailer park in Mississippi in 1973-74. For information concerning levels of mercury in hair and blood of humans with short-term exposures, these individuals were observed for as long as 10 months after the end of their exposures, and the amount of mercury in their blood and scalp hair was serially measured. Specimens were also obtained from nonexposed individuals in the trailer park. Inorganic mercury was measured in 1-cm segments of hair samples obtained both 6 and 9 months after termination of exposure. Over a 3-month period, the peak amount of inorganic mercury per gram of hair shifted in position from 7 cm to 13 cm from the scalp. The average mercury concentration in newly formed hair (the 4 cm of hair closest to the scalp) decreased fourfold over the same time period. Surface contamination of exposed hair by exogenous mercury also occurred. Levels of inorganic mercury in blood from exposed individuals ranged from 183 to 620 ng/ml and fell to levels similar to those of controls 4 to 6 months after ending exposure. The source of the outbreak was metallic mercury spilled on rugs. Attempts to remove the mercury failed and actually dispersed the metal over a larger surface area. Air mercury levels as high as 1.0 mg/m3 of air were found in one of the contaminated house trailers. Rugs or carpets contaminated with metallic mercury are a significant health risk.

Accidents, Home↗

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Community-based exercise intervention: Zuni Diabetes Project.

Non-insulin-dependent diabetes mellitus (NIDDM) is a serious health problem among the Zuni Indians of New Mexico. In July 1983, Indian Health Service personnel initiated a community-based exercise program designed to help control NIDDM in the community. To retrospectively evaluate the effects of the exercise program, the medical records of 30 participants with NIDDM were compared with the medical records of 56 nonparticipants with NIDDM matched by age, sex, health-care provider, and duration of NIDDM. From 1 July 1983 through 1 October 1985, participants had a mean weight loss of 4 kg, whereas nonparticipants had a mean weight loss of 0.9 kg (P less than .05). Participants' fasting blood glucose values dropped by a mean of 43 mg/dl, compared to a mean drop of 2 mg/dl among the nonparticipants (P less than .05). Participants were significantly more likely than nonparticipants to have stopped their hypoglycemic medication (relative risk 4.2) and to have decreased their medication dosage (relative risk 2.2). These results suggest that participation in a community-based exercise program can produce significant weight loss and improvement in glycemic control among a group of Native Americans with NIDDM.

Adolescent↗

PubMedDate not supplied

The Olympic Games: opportunities for health promotion.

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Exercise↗

PubMedDate not supplied

Distance between homes and exercise facilities related to frequency of exercise among San Diego residents.

Although personal determinants of exercise behavior have been studied extensively, few investigators have examined the influence of the physical environment on exercise habits. A random sample of 2,053 residents of San Diego, CA, were surveyed regarding exercise habits and other variables. A total of 385 exercise facilities in San Diego were classified into categories of either free or pay. After the addresses of respondents and facilities were located on a grid-map and coded, the density of exercise facilities around each respondent's home address was computed. Subjects who reported engaging in three or more exercise sessions per week reported a statistically greater density of pay facilities near their homes than did those who reported no exercise sessions, after controlling for age, education, and income. The finding suggests an association between proximity of exercise facilities and frequency of exercise.

Adult↗

PubMedDate not supplied

The status of the 1990 objectives for physical fitness and exercise.

During the past 5 years, considerable progress has been made in clarifying the relationship between physical activity and health and in collecting previously unavailable information about the activity levels of children and adults. Several of the objectives are likely to be achieved by 1990. Nevertheless, important questions remain to be answered, and data necessary to know the status of some objectives are not available. The established benefits of regular physical activity include a reduced risk of coronary heart disease, desirable weight control, and reduced symptoms of anxiety and mild-to-moderate depression. Other health effects appear likely, but are less firmly established. The salubrious effect of regular physical activity on reducing the risk of coronary heart disease appears to exist even at low levels of physical activity. More information is needed about the type and intensity of physical activity necessary to achieve the various health benefits ascribed to it. Although most people appear aware of the characteristics of activities likely to produce moderate to high levels of physical fitness, only 10-20 percent of the adult population participates in such activity. The number and effect of worksite physical fitness programs are too poorly documented to determine if the pertinent objectives can be achieved. Fewer than two-thirds of the number of children recommended in the objectives participate in daily physical education classes.

Adolescent↗

PubMedDate not supplied

The Behavioral Risk Factor Surveys: IV. The descriptive epidemiology of exercise.

Telephone interview data from aggregated state surveys showed that about 21 percent of the U.S. adult population expends greater than or equal to 3 kcal/kg-day in vigorous leisure-time exercise. Three kilocalories per kilogram-day is equivalent to the amount commonly recommended to maximally reduce the incidence of coronary heart disease. Approximately 36 percent of the U.S. population reported no vigorous leisure-time exercise. Men, younger persons, and the more highly educated were most likely to expend greater than or equal to 3 kcal/kg-day, but for no subgroup did the rate exceed 30 percent. People who did not smoke, were not obese, and who did wear seat belts are also more likely to expend energy in vigorous leisure-time exercise. The prevalence of alcohol misuse is similar for all exercise categories. The proportion of people who expend greater than or equal to 3 kcal/kg-day is unrelated to self-reported occupational physical effort. Given the established and presumed benefits of physical activity, a substantial portion of the U.S. population would probably benefit from regular, vigorous, leisure-time exercise.

Adolescent↗

PubMedDate not supplied

Childhood participation in organized school sports and physical education as precursors of adult physical activity.

Increased levels of physical activity are associated with improved health. However, the determinants of an active lifestyle are unknown. Participation in school sports and physical education during childhood and adolescence are frequently mentioned as factors likely to promote more active lifestyles in adulthood. If this is true, public policy should more vigorously promote broad participation in school sports and physical education. However, review of the available literature reveals only six papers that address this issue directly, and all six have important methodological limitations. The study that provides the strongest support provides information only on sports participation during college, an age at which behavior patterns may already be firmly established. Therefore, more research in this area is needed. Future studies must consider definitions, confounding variables, recall bias, selection bias, content, and quality of school sports and physical education programs.

Adolescent↗

PubMedDate not supplied

Physical activity, behavioral epidemiology, and public health.

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Behavior↗

PubMedDate not supplied

Workshop on Epidemiologic and Public Health Aspects of Physical Activity and Exercise: a summary.

The Workshop on Epidemiologic and Public Health Aspects of Physical Activity and Exercise was conducted by the Centers for Disease Control on September 24-25, 1984. Fundamental topics were identified prior to the workshop, and experts were invited to participate. Ten papers were written, discussed at the workshop, revised, and are herewith published. The beneficial effects of physical activity on health are becoming progressively more apparent. A reduced risk of coronary heart disease, desirable weight control, and the reduction of symptoms of anxiety and mild to moderate depression are established. Beneficial effects on hypertension, type II diabetes, osteoporosis, and certain psychiatric and psychologic conditions appear likely but require additional study. Although the importance of physical activity to health is becoming better established, several important gaps in our knowledge remain. Physical activity is a complex behavior that is difficult to measure, and the accuracy of most measurement instruments is not known. Knowledge of the patterns of physical activity within our society and the determinants of those patterns is limited. Information on the rates of mechanical, metabolic, and psychologic risks of physical activity is largely absent. In addition, there is a need to know more about the dose-response effects of physical activity, the differential effects on various subgroups of the population, the specific dimensions of activity which effect different aspects of health, and the efficacy of various intervention and promotional strategies. Each paper stands as an independent contribution to the literature. As a group, the authors of these papers have provided the public health and scientific communities with a succinct yet comprehensive summary of the status of knowledge plus specific recommendations for future research in the areas of physical activity, public health, and epidemiology.

Epidemiology↗

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Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.

"Physical activity," "exercise," and "physical fitness" are terms that describe different concepts. However, they are often confused with one another, and the terms are sometimes used interchangeably. This paper proposes definitions to distinguish them. Physical activity is defined as any bodily movement produced by skeletal muscles that results in energy expenditure. The energy expenditure can be measured in kilocalories. Physical activity in daily life can be categorized into occupational, sports, conditioning, household, or other activities. Exercise is a subset of physical activity that is planned, structured, and repetitive and has as a final or an intermediate objective the improvement or maintenance of physical fitness. Physical fitness is a set of attributes that are either health- or skill-related. The degree to which people have these attributes can be measured with specific tests. These definitions are offered as an interpretational framework for comparing studies that relate physical activity, exercise, and physical fitness to health.

Energy Metabolism↗

PubMedDate not supplied

Relationships between exercise or physical activity and other health behaviors.

Physical activity may indirectly influence health behaviors such as overeating, smoking, substance abuse, stress management, risk taking, and others. Substantial evidence indicates that physical activity is positively associated with weight control and caloric intake. The data weakly support the hypothesis that physical activity and smoking are negatively associated. Few data are available to evaluate the association between activity and alcohol consumption, alcoholism, substance abuse, stress management, preventive health behaviors, and risk-taking behavior.

Alcohol Drinking↗

PubMedDate not supplied

Increase in Mycobacterium avium complex isolations among patients admitted to a general hospital.

In early 1979, an official of an Illinois hospital reported an increase in the number of patients from whom Mycobacterium avium complex recently had been recovered. Over the preceding 3 years specimens from a total of 51 patients were culture positive for M. avium complex: 7 in 1976, 8 in 1977, and 36 in 1978. Nine of 10 serotyped isolated were serotype 8. The increase was not attributable to an increase in the number of mycobacterial cultures performed. No other area hospitals had similar increases in rates of recovery of M. avium complex. Patients with M. avium complex were significantly more likely than patients with other mycobacteria to have been residents of the city where the hospital is located. The distribution of abnormalities in patients' chest films differed significantly between patients with M. avium complex in 1978 and patients with M. avium complex in 1976-77; in 1978, patients although equally likely to have infiltrates, nodules, or cavities, were more likely to have no abnormalities or abnormalities consistent with chronic obstructive pulmonary disease, and less likely to have other abnormalities. The data suggest that the increased rate of recovery of M. avium complex from patients could not be attributed to ascertainment bias or laboratory variation but may be due to an increase in the incidence of disease or colonization among persons living in the community where the hospital is located.

Adolescent↗