A practical guide for non-epidemiologists.
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Biomedical subjects
Publications and source records attributed to O Wong.
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A case-control analysis of breast cancer deaths among PVC fabricators is presented. This study is an extension of a cross-sectional mortality study of deaths occurring among 17 PVC fabricators during the years 1964 to 1973. Relative risk estimates were derived and tested using the Mantel-Haenszel procedure. Although no statistically significant relative risks were found, a least significant relative risk analysis indicated that the underlying relative risk would have to be on the order of three to one in order to be detected. There does seem to be reasonable assurance that very large increases in risk for breast cancer do not exist among these PVC fabricators.
Adult, normotensive subjects were divided into two groups on the basis of whether their first degree relatives were diagnosed as being hypertensive. Urine samples were collected over a 24-hr period for 3 days and analyzed for electrolyte excretion; the rate of electrolyte excretion was also measured separately during the overnight period. Significant correlations were shown between blood pressure and sodium and chloride excretion, both the 24-hr total and the overnight rate; Na/K ratio; weight; and body mass index for those subjects with a positive family history of hypertension. In subjects with no family history of hypertension there were no significant correlations between those parameters and blood pressure. The rate of urinary excretion of sodium overnight may provide a means for further studies on populations to determine the interrelationship between sodium excretion, other parameters, blood pressure, and family history of hypertension.
The General Health Questionnaire, a 30-item, self-response inventory, identified individuals who required significantly more pain medication after elective cholecystectomy. The questionnaire is well tolerated by surgical patients and is easy to score. It can identify those individuals prone to request excessive narcotic medication postoperatively.
An attempt has been made to examine retrospectively any antifertility influence of ethylene dibromide (EDB) by studying the reproductive performance of men exposed to EDB, exclusively on the basis of their reproductive histories in terms of live births to their wives, subsequent to their occupational exposure to EDB. The number of live, putatively legitimate, natural children born to the wives was compared to the expected number derived from national fertility tables published for successive birth cohorts of U.S. women by the National Center for Health Statistics. The indirect standardization method was used to adjust for the confounding effects of maternal age, parity, race and calendar year in deriving the expected births. The number of observed births was expressed as a percentage of the expected in assessing the workers' reproductive performance. One of the four plants studied showed a significant decrease in fertility.
An exploratory examination of the possibility of using multiple causes of death information from death certificates in mortality studies has been undertaken. The formation of a matrix of primary by contributory causes has been suggested. The matrix gives an overall picture of mortality patterns, serves as a scheme to identify disease combinations, and can be utilized as a data-editing device. From the matrix, several conventional, as well as several new statistics can be computed. The methodology has been illustrated with data from a cohort of steelworkers. The gain in information as a result of routinely recording multiple causes of death has also been discussed.
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In this paper, a new non-parametric competing-risk model is proposed. This model takes relative susceptibility into account, and is thus free from the usual assumption of independence between competing causes of death. Another feature of the model is the adjustments of survivors and deaths as a results of the elimination of one of the causes of death in the previous time interval. The computational procedure of the model is simple and can be incorporated into the regular life table procedures.
A cross-sectional mortality study of 4,341 deaths occurring among current and former employees of 17 PVC fabricators during 1964-1973 is presented. The objectives are: (1) to identify any angiosarcoma deaths among the employees of these fabricators, and (2) to examine the distribution of deaths by cause. No angiosarcoma deaths were found among the study group. Sex-race-cause-specific Proportionate mortality Ratios (PMR's) were computed, using the corresponding U.S. mortality as the standard. Among white employees, there appears to be an excess in total cancer mortality, particularly that of the digestive system. Observed deaths were found to exceed the expected in cancers of the breast and urinary organs among white females. Deficit mortality was observed in cirrhosis of liver among both male and female white employees.
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Next to tobacco, saccharin may be the substance that has been most studied epidemiologically. Over 5000 patients with bladder cancer have participated in case-control studies; over 27,000 diabetics have been observed for 234,000 person-years. The summary relative risk from combining all case-control studies is less than 0.98, the standardized mortality ratio for bladder cancer in diabetics is only 70. Analysis of these studies leads to the conclusion that saccharin is not related to human bladder cancer.
Certain Louisiana cancer rates are higher than the national averages. This review evaluates the existing epidemiologic literature pertaining to risk factors for cancer in Louisiana. Population-based case-control studies have identified smoking as the most important contributor to lung cancer in Louisiana. Nutritional factors have been found to impart a modest increase in lung, pancreas, and stomach cancer risk. Occupational epidemiologic studies have revealed exposure to asbestos in the cement, shipbuilding, and related industries as a significant risk factor for mesothelioma and lung cancer. Sugarcane farming has been found to increase the risk of lung cancer among sugarcane farmers who smoke, and the risk of mesothelioma among sugarcane farmers in general. Occupations with exposure to microwave and radio frequency electromagnetic radiation have been associated with an increased risk of brain cancer. An increased risk of laryngeal cancer has been observed among workers exposed to sulfuric acid at a Baton Rouge isopropyl alcohol plant. Except for the laryngeal cancer finding, data from occupational cohort studies of refinery/chemical workers revealed no significant excess in cancer of all sites, cancer of the lung, or any other cancer. Relevant epidemiologic data also revealed no increased cancer risk associated with potential exposures to industrial emissions among residents in communities adjacent to petrochemical facilities.