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Murray M Finkelstein

Publications and source records attributed to Murray M Finkelstein.

7 recordsLinked to original sources
PubMed2003

Relation between income, air pollution and mortality: a cohort study.

BACKGROUND: Community levels of air pollution have been associated with variability in mortality rates, but previous studies have inferred exposure to pollutants on a citywide basis. We investigated mortality in relation to neighbourhood levels of income and air pollution in an urban area. METHODS: We identified 5228 people in the Hamilton-Burlington area of southern Ontario who had been referred for pulmonary function testing between 1985 and 1999. Nonaccidental deaths that occurred in this group between 1992 and 1999 were ascertained from the Ontario Mortality Registry. Mean household income was estimated by linking the subjects' postal codes with the 1996 census. Mean neighbourhood levels of total suspended particulates and sulfur dioxide were estimated by interpolation from data from a network of sampling stations. We used proportional hazards regression models to compute mortality risk in relation to income and pollutant levels, while adjusting for pulmonary function, body mass index and diagnoses of chronic disease. Household incomes and pollutant levels were each divided into 2 risk categories (low and high) at the median. RESULTS: Mean pollutant levels tended to be higher in lower-income neighbourhoods. Both income and pollutant levels were associated with mortality differences. Compared with people in the most favourable category (higher incomes and lower particulate levels), those with all other income-particulate combinations had a higher risk of death from nonaccidental causes (lower incomes and higher particulate levels: relative risk [RR] 2.62, 95% confidence interval [CI] 1.67-4.13; lower incomes and lower particulate levels: RR 1.82, 95% CI 1.30-2.55; higher incomes and higher particulate levels: RR 1.33, 95% CI 1.12-1.57). Similar results were observed for sulfur dioxide. The relative risk was lower at older ages. INTERPRETATION: Mortality rates varied by neighbourhood of residence in this cohort of people whose lung function was tested. Two of the broader determinants of health--income and air pollution levels--were important correlates of mortality in this population.

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PubMed2003

Diesel exhaust exposure in the Canadian railroad work environment.

An investigation of occupational exposure to diesel exhaust, in terms of elemental carbon, was conducted as part of a feasibility study in the Canadian railroad industry. Both personal and area samples were collected from three major operating divisions of the railways: mechanical service, transportation, and engineering. A total of 255 elemental carbon samples have been described. The results show that all but six elemental carbon concentrations, expressed as size-selective respirable air samples taken using a 10 mm nylon cyclone, are well below the 2001 proposed American Conference of Governmental Industrial Hygienists' (ACGIH) threshold limit value (TLV) of 20 microg/m3. The concentration of diesel exhaust, expressed as elemental carbon, in the railroad industry is much lower than that in some other major industries such as mining and forklift truck operations. If the TLV is to be applicable to a broad range of workplace settings such as railroad, construction, and mining, the use of a TLV that is based on an elemental carbon measurement of size selective respirable samples, as recommended in the 2001 ACGIH proposal, would appear to be the most valid strategy for control of exposure to diesel exhaust.

Canada↗
PubMed2002

Medical conditions, medications, and urinary incontinence. Analysis of a population-based survey.

OBJECTIVE: To assess associations between various medical conditions and drug treatments and reports of urinary incontinence. DESIGN: Secondary analysis of responses to the second wave of the National Population Health Survey (NPHS). Odds ratios were calculated using survey-weighted multiple logistic regression; confidence intervals were calculated using bootstrap methods. SETTING: Canadian households in all 10 provinces, as assessed by Statistics Canada's NPHS. PARTICIPANTS: From among respondents to the NPHS, the 54,920 people aged 30 years or older. MAIN OUTCOME MEASURES: Responses to the question "Do you have urinary incontinence diagnosed by a health professional?" and analysis of variables related to medical conditions and medications. RESULTS: Urinary incontinence was associated with strokes, arthritis, and back problems in both sexes. Odds ratios for incontinence were elevated among men and women who reported having asthma. Narcotics and diuretics were strongly associated with incontinence in both sexes. Psychoactive medications were associated with incontinence in women; antidepressants were associated with incontinence in men. CONCLUSION: Physicians should consider the possibility that patients with common conditions, such as arthritis, back problems, or respiratory conditions associated with coughing, might also have urinary incontinence. Physicians should also be aware that urinary incontinence might be a side effect of therapies and make relevant inquiries. Medications associated with incontinence could be changed.

Adult↗
PubMed2002

Preventive screening. What factors influence testing?

OBJECTIVE: To determine factors associated with having preventive screening tests in a population-based sample of Ontario women. DESIGN: Secondary analysis of data from Statistics Canada's National Population Health Survey linked to data from the Ontario Health Insurance Plan to ascertain whether women aged 20 or older had Pap smears, mammography, bone densitometry, or cholesterol testing. Factors associated with having testing were subjected to logistic regression analysis. SETTING: Ontario. PARTICIPANTS: Women aged 20 or older; from 19,600 Canadian households, 2232 Ontario women gave consent to linkage of administrative databases. MAIN OUTCOME MEASURES: Age-specific population screening rates. Odds ratios and probabilities of having screening in relation to socioeconomic, geographic, and physician-associated factors. RESULTS: Having screening was associated with age, income, education, and place of residence. Women with regular physicians were more likely to have Pap smears (odds ratio [OR] 4.4, range 1.7 to 12), densitometry (OR 22, range 3.6 to 140), and cholesterol testing (OR 8.0, range 2.3 to 29). Women who had periodic health examinations were more likely to have Pap smears (OR 6.7, range 4.6 to 9.8), mammograms (OR 3.7, range 2.3 to 5.9), densitometry (OR 3.7, range 1.3 to 10.5), and cholesterol testing (OR 3.0, range 2.0 to 4.5). The probability of having testing increased with number of visits a year to a doctor, but ceased to increase after three visits. CONCLUSION: Having screening tests was associated with socioeconomic factors including income, education, and place of residence. Patients who went to doctors for episodic care only were less likely to have preventive screening than patients who went for periodic health examinations.

Adult↗
PubMed2002

Incontinence Quality of Life Instrument in a survey of primary care physicians.

OBJECTIVE: To assess the performance of the Incontinence Quality of Life (I-QOL) Instrument in measuring the impact of urinary incontinence on the quality of life of family medicine patients. STUDY DESIGN: Postal survey. Multiple imputations of missing answers. Linear regression analysis of I-QOL predictors. Comparison by receiver operating characteristic of the I-QOL and the Short Form 12 (SF-12). POPULATION: Women 45 years or older attending either of 2 family medicine clinics. Response rate was 605 (61%) of 992. OUTCOMES MEASURED: Prevalence of stress, urge, and mixed incontinence. Scores on the I-QOL and SF-12 instruments. RESULTS: Of the 605 respondents, 310 (51%) reported urinary incontinence in the month before the survey. One or more items were missing on 19% of the I-QOL scales and scores were imputed. The relation between I-QOL and the number of leakage episodes was nonlinear. I-QOL scores decreased with the number of episodes, the amount of leakage, and poorer general health. There was no association between the I-QOL and age, education, or type of incontinence. The I-QOL was more sensitive than the SF-12 to the statement, "urinary incontinence is a problem." CONCLUSIONS: The I-QOL is a useful instrument for the investigation of incontinence-related quality of life in the community setting.

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