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Biomedical subjects

K J Rothman

Publications and source records attributed to K J Rothman.

At least 91 records · Page 5Linked to original sources
PubMed1989

Bias arising in case-control studies from selection of controls from overlapping groups.

Three examples are used to demonstrate that the selection of controls from categories that overlap can lead to bias. Case-control studies that use friend controls and the practice of age-matching controls to cases within a specified number of years (caliper matching) are examples of the selection bias described in the paper. The bias resulting from the use of friend controls can be large and, since the use of friend controls is common, this source of bias is of considerable practical consequence. The use of friend controls or the selection of controls according to other variables with categories that overlap should be avoided.

Age Factors↗
PubMed1989

Carcinogenicity of dark liquor.

To investigate whether the non-alcohol content of distilled alcoholic beverages affects the carcinogenicity of the beverage, we conducted an epidemiologic study of laryngeal and hypopharyngeal cancer. We interviewed 384 cases (or spouses, for deceased cases), and compared their responses with those of 876 controls. We classed distilled liquors as dark or light, a rough division according to content of potentially carcinogenic compounds in the beverages. The relative effect on hypopharyngeal cancer risk was much stronger for those who reported high consumption of dark liquor (relative risk = 4.4, 90% confidence interval = 2.9, 6.8) than for those reporting comparable consumption of light liquor (relative risk = 1.3, 90% CI = 0.8, 2.1). For laryngeal cancer, consumption of dark liquor had a smaller effect, and there was little distinction between the effects of dark and light liquor. The data appear consistent with the theory that the non-alcoholic content of distilled alcoholic beverages is a determinant of cancer risk, and that alcoholic beverages act topically rather than systemically in their carcinogenic action.

Alcoholic Beverages↗
PubMed1988

Chemical quality of maternal drinking water and congenital heart disease.

We undertook a case-control study to investigate the association between chemicals in maternal drinking water consumed during pregnancy and congenital heart disease in the offspring. Two hundred and seventy affected children and 665 healthy children were enrolled in the study. Information on contaminant levels in maternal drinking water was available from records of routine water analysis of samples taken from public taps in the communities where the mothers resided during pregnancy. Mothers provided information during a telephone interview on their health, pregnancy management, and demographic characteristics. Nine inorganic metals were analysed for detection of an association with congenital heart disease. The chemical exposures of particular interest were arsenic, lead, mercury and selenium. None of the chemicals was associated materially with an increase in the frequency of congenital heart disease overall. Arsenic exposure at any detectable level was associated with a threefold increase in occurrence of coarctation of the aorta (prevalence odds ratio = 3.4, 95% confidence interval = 1.3-8.9). Detectable traces of selenium in drinking water were associated with a lower frequency of any congenital heart disease than was observed among children exposed to drinking water not containing detectable levels of selenium (prevalence odds ratio = 0.62, 95% confidence limits = 0.40-0.97). A dose-response effect was observed over four levels of selenium exposure. Non-differential errors in the measurement and classification of exposure to contaminants routinely monitored in drinking water could account for lack of positive findings. In addition, most of the contaminant levels were below the maximum levels set by the Environmental Protection Agency, so that lack of evidence of effect may have been due to the low exposure levels in this population.

Arsenic↗
PubMed1988

A strengthening programme for weak associations.

The strength of a causal association depends on the relative prevalence of other component causes for the same disease. Weak associations may sometimes be strengthened by restricting attention to people at low risk. This technique may lead to fewer subjects to study, but nevertheless may provide more information by which to evaluate a causal relation. A second method for strengthening associations is to reduce non-differential misclassification, which tends to dilute associations. Increasing the specificity of measurement for exposure, disease, and the timing between causal action and disease onset should produce stronger associations that are easier to interpret and more descriptive of the underlying causal mechanism.

Epidemiologic Methods↗
PubMed1986

Tobacco habits.

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Humans↗
PubMed1985

Congenital heart disease in relation to maternal use of Bendectin and other drugs in early pregnancy.

To clarify the association of Bendectin and other drugs used in early pregnancy with the occurrence of congenital heart disease, we interviewed 298 mothers of children with congenital heart disease and 738 mothers of healthy controls. Differential recall of drug use by mothers of affected children and mothers of controls was evaluated by comparison of information collected by interview with that recorded in the prenatal record. Data derived from maternal interviews were generally consistent with the record data. Reported Bendectin use was minimally associated with congenital heart disease (prevalence odds ratio, 1.1; 90 per cent confidence interval, 0.8 to 1.5). The data from this study were consistent with previously reported associations of other drugs with congenital heart disease. In particular, aspirin use in early pregnancy was associated with about a twofold increase in the frequency of defects in septation of the truncus arteriosus (prevalence odds ratio, 2.1; 90 per cent confidence interval, 1.1 to 3.9).

Acetaminophen↗
PubMed1985

Epidemiology of squamous cell cancer of the head and neck.

Epidemiologic investigations have been instrumental in identifying numerous factors associated with the development of cancer. Tobacco and alcohol are unquestionably the major risk factors for squamous cell carcinoma of the head and neck region. Diet appears to play a role in the development of these cancers, as nutritional deficiencies have been found to increase risk. Clinical observation and epidemiologic studies have also identified ionizing radiation as an unequivocal risk factor, although of lesser importance from the public health point of view. Overall, epidemiologic evidence shows that occupational exposures play a minor, though definite, role in the development of head and neck cancer. For sinonasal cancer, however, studies corroborate that occupational exposures are the major determinants of disease.

Ascorbic Acid↗
PubMed1984

Work-related risk factors for laryngeal cancer.

The authors conducted a case-control study to identify employment-related risk factors for laryngeal cancer. Richmond County, Georgia, and the contiguous counties were chosen as the study area because the 1950-1969 laryngeal cancer mortality rate for white males in Richmond County was almost double the corresponding rate for the entire United States, and because a large proportion of the working population was employed in industries for which excess risk among workers had been reported. All persons with newly diagnosed squamous cell carcinoma of the larynx treated in the area hospitals were identified. Potential controls were selected from patients admitted to these hospitals during the same time period as the cases, excluding those patients admitted for cancer, lung disease, or employment-related disease. Eighty-five control subjects were individually matched to 42 cases for sex, age, area of residence, and smoking and alcohol-drinking history. From lifetime employment histories, laryngeal cancer rate ratios were estimated comparing the incidence rate among subjects who had ever worked in an occupation with the incidence rate among subjects who had never worked in that occupation. Among the 10 occupations in which at least 15 subjects had worked, the authors found rate ratio estimates above 3.0 for farmers, textile processors who separated, filtered or dried textile fibers, and for all laborers and maintenance personnel.

Adult↗
PubMed1984

Pyloric stenosis and maternal Bendectin exposure.

As part of a long-term follow-up of structural disorders present at birth or shortly thereafter in infants born at Group Health Cooperative of Puget Sound, all infants with a diagnosis of pyloric stenosis born between July 1, 1977 and June 30, 1982, were identified. Automated pharmacy profiles were examined to determine whether an association between maternal Bendectin use in the first trimester and infantile hypertrophic pyloric stenosis existed. Among the 3,835 women exposed to Bendectin while pregnant, in this group of 13,346 births, 13 had infants who developed pyloric stenosis, and among the 9,511 women not exposed, 13 had infants who developed pyloric stenosis, resulting in a risk ratio estimate of 2.5 (95% confidence interval (CI) 1.2-5.2). When mothers were divided according to the number of prescriptions for Bendectin filled, the relative risk estimate increased from 1.2 (95% CI 0.4-4.4) in women who filled only one prescription to 7.6 (95% CI 4.9-11.6) in women who filled five or more prescriptions for Bendectin during their pregnancy.

Adult↗
PubMed1983

Projections of asbestos-related disease 1980-2009.

Approximately 19,000 cases of mesothelioma and 55,000 cases of lung cancer will arise in U.S. men with histories of nontrivial occupational exposure to asbestos. There are approximately 65,000 U.S. men now alive with clinically diagnosable asbestosis. These estimates are based, in the case of the cancer, on estimates of the effective number of asbestos-exposed workers required to produce the current national incidence of mesothelioma. The asbestosis estimates are based on a number of rough measures relating the prevalence of asbestosis to the incidence of mesothelioma, the incidence of compensable asbestosis in other countries, the prevalence of and mortality from pneumoconioses generally, and the number of workers heavily exposed to asbestos.

Asbestos↗