Search PubMed⌕ Search

Biomedical subjects

R Bhopal

Publications and source records attributed to R Bhopal.

At least 37 records · Page 2Linked to original sources
PubMed2000

What is the risk of coronary heart disease in South Asians? A review of UK research.

OBJECTIVE: The aim of this study was to systematically review the evidence that coronary heart disease risk is higher in South Asians than in comparative 'white' populations, particularly seeking studies of incidence. METHODS: A systematic literature review was carried out using a personal research literature collection, MEDLINE 1966-1998 and citations from references. RESULTS: Of 19 studies, none reported disease incidence. Most studies reported prevalence, mortality rates or health care utilization data. Most studies were on people born on the Indian subcontinent, thus omitting the British-born. Several did not report on women. The strongest evidence of an excess of CHD in South Asians came from mortality data comparing those born in the Indian subcontinent with the whole population of England and Wales. In South Asians coronary heart disease is common and important, but neither the actual disease rates nor the excess risk in relation to the 'white' population are known. Both prevalence and mortality data suggested that the frequency of coronary heart disease in Indians, Pakistanis and Bangladeshis differed. CONCLUSION: Estimates of South Asians' excess risk of coronary heart disease are imprecise and may be too high (if there are data errors) or too low (for comparison with the general population blunts ethnic variations). South Asians are a heterogeneous group yet most studies of CHD report on Bangladeshis, Indians and Pakistanis combined. Indians probably have less CHD than Bangladeshis and Pakistanis. Cohort studies on CHD in South Asians are needed and these should be designed so that data can be combined for future systematic reviews.

Adult↗
PubMed2000

An exploration of awareness bias in two environmental epidemiology studies.

Awareness bias in environmental health research is the tendency to report more illness because of concerns arising from proximity to a hazard in the absence of a measurable biological effect. Such bias complicates the interpretation of self-reported symptoms in communities exposed to emissions from heavy industry. We used data from two epidemiologic studies in Northeast England where community concerns existed about health risks from industry. An association between proximity to industry and self-reported respiratory and nonrespiratory illnesses and symptoms had been found in one study but not in the other. An indicator of concern about industrial pollution was constructed from responses to a 17-item questionnaire about issues that had caused stress or anxiety. Univariate and multivariate analyses of health outcome variables in both studies showed that individuals with "industry-related worries" reported more illness, irrespective of proximity to industry. We conclude that self-reported illness was influenced by both worry and proximity to industry, but that worry about the hazard had the greatest effect on self-reported illness. We suggest that because absolute certainty about the role and extent of awareness bias in environmental epidemiology studies is unlikely to be achieved, self-reported data should be supplemented with other observations.

Adult↗
PubMed2000

Is it feasible to construct a community profile of exposure to industrial air pollution?

OBJECTIVE: An epidemiological investigation to assess the validity of residential proximity to industry as a measure of community exposure. METHODS: 19 Housing estates in Teesside (population 1991: 77 330) in north east England were grouped into zones: A=near; B=intermediate; C=further from industry. With residential proximity of socioeconomically matched populations as a starting point a historical land use survey, historical air quality reports, air quality monitoring, dispersion modelling data, and questionnaire data, were examined. RESULTS: The populations in zones A, B, and C were similar for socioeconomic indicators and smoking history. Areas currently closest to industry had also been closest for most of the 20th century. Historical reports highlighted the influence of industrial emissions to local air quality, but it was difficult to follow spatial pollution patterns over time. Whereas contemporary NO(x) and benzene concentrations showed no geographical variation, dispersion modelling of emissions (116 industrial stacks, traffic, and domestic sources) showed a gradient associated with industry. The presumed exposure gradient of areas by proximity to industry (A>B>C) was evident for all of zone A and most of zones B and C. CONCLUSIONS: It was feasible to assemble a picture of community exposure by integration of measurements from different sources. Proximity of residence was a reasonable surrogate for complex community exposure.

Air Pollutants↗
PubMed1999

Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study.

OBJECTIVE: To compare coronary risk factors and disease prevalence among Indians, Pakistanis, and Bangladeshis, and in all South Asians (these three groups together) with Europeans. DESIGN: Cross sectional survey. SETTING: Newcastle upon Tyne. PARTICIPANTS: 259 Indian, 305 Pakistani, 120 Bangladeshi, and 825 European men and women aged 25-74 years. MAIN OUTCOME MEASURES: Social and economic circumstances, lifestyle, self reported symptoms and diseases, blood pressure, electrocardiogram, and anthropometric, haematological, and biochemical measurements. RESULTS: There were differences in social and economic circumstances, lifestyles, anthropometric measures and disease both between Indians, Pakistanis, and Bangladeshis and between all South Asians and Europeans. Bangladeshis and Pakistanis were the poorest groups. For most risk factors, the Bangladeshis (particularly men) fared the worst: smoking was most common (57%) in that group, and Bangladeshis had the highest concentrations of triglycerides (2.04 mmol/l) and fasting blood glucose (6.6 mmol/l) and the lowest concentration of high density lipoprotein cholesterol (0.97 mmol/l). Blood pressure, however, was lowest in Bangladeshis. Bangladeshis were the shortest (men 164 cm tall v 170 cm for Indians and 174 cm for Europeans). A higher proportion of Pakistani and Bangladeshi men had diabetes (22.4% and 26.6% respectively) than Indians (15.2%). Comparisons of all South Asians with Europeans hid some important differences, but South Asians were still disadvantaged in a wide range of risk factors. Findings in women were similar. CONCLUSION: Risk of coronary heart disease is not uniform among South Asians, and there are important differences between Indians, Pakistanis, and Bangladeshis for many coronary risk factors. The belief that, except for insulin resistance, South Asians have lower levels of coronary risk factors than Europeans is incorrect, and may have arisen from combining ethnic subgroups and examining a narrow range of factors.

Adult↗
PubMed1999

Concepts and terminology in ethnicity, race and health: be aware of the ongoing debate.

Although the expansion of the scientific literature in the field of ethnicity, race and health is welcome, it has been weakened by the diverse and inconsistent terms used to describe a group or individual's ethnicity. Further, a clear definition of what is meant by the terms ethnicity and race in publications is often lacking, making it difficult to compare studies. This problem is leading to much debate in the USA and the UK. Journal editors and researchers need to be aware of these debates, and actively involved in resolving problems and raising standards.

Ethnicity↗
PubMed1999

Primary biliary cirrhosis once rare, now common in the United Kingdom?

There is a widespread impression that the number of patients with the autoimmune liver disease primary biliary cirrhosis (PBC) is increasing, although its incidence and prevalence vary widely. Using thorough case-finding methods and rigorous definitions to assess changes in incidence and prevalence with time and to explore the symptomatology and mortality of the disease in a large group of unselected patients, we performed a descriptive epidemiological study of PBC in a well defined population over a fixed period of time using established diagnostic criteria and with clinical follow-up of all cases. In a population of 2.05 million in northern England 770 definite or probable PBC cases were identified. Prevalence rose from 201.9 per 10(6) in the adult population and 541. 4 per 10(6) women over 40 in 1987 to 334.6 per 10(6) adults and 939. 8 per 10(6) women over 40 in 1994. Incidence was 23 per 10(6) in 1987 and 32.2 per 10(6) in 1994. Three hundred patients died in median follow-up of 6.27 years (141 liver deaths); the standardized mortality ratio was 2.85. At presumed diagnosis, 60.9% had no symptoms of liver disease. By June 1994 62% of prevalent patients had liver symptoms. PBC is apparently increasing. It is still unclear whether this is because of a true increase, case finding, or increased disease awareness. The study draws attention to (1) high mortality from liver disease and non-liver-related causes even in patients initially with no liver symptoms and (2) apparently poor diagnostic awareness of the disease.

Adult↗
PubMed1999

A comparison of proxy measures of abdominal obesity in Chinese, European and South Asian adults.

AIMS: To assess whether four proxy measures of abdominal obesity (waist circumference; waist-to-hip ratio (WHR); waist-to-height ratio and C index, a measure of body shape) were uniformly associated with features of the metabolic syndrome (triglycerides, high density lipoprotein (HDL) cholesterol, 2-h glucose) in three ethnic groups. METHODS: Anthropometric and biochemical data were collected in 629 Europeans (320 men, 309 women), 380 Chinese (183 men, 197 women) and 597 South Asians (275 men, 322 women) aged 25-64 years in Newcastle upon Tyne, UK. Linear regression models were used to determine whether relationships differed between ethnic groups. RESULTS: Linear regression analysis showed that most proxy measures of abdominal obesity were associated with features of the metabolic syndrome. There were significant interactions between WHR and ethnicity and C index and ethnicity in the relationship with log triglycerides when comparing European and Chinese women. Interactions existed between all proxy measures and ethnicity in the relationship with log triglycerides and HDL cholesterol when comparing European and South Asian women. In men, interactions between ethnicity and waist circumference, WHR and C index when comparing Europeans and South Asians, and between ethnicity and WHR and C index when comparing South Asian and Chinese for log 2-h glucose were significant (P < 0.001). All interactions remained significant when differences in smoking, alcohol and physical activity were taken into account. CONCLUSIONS: Not all the proxy measures of abdominal obesity were consistently related to features of the metabolic syndrome across the ethnic groups studied. However, waist circumference and waist to height ratio were the most consistent and WHR the least when comparing across the ethnic groups.

Abdomen↗