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Biomedical subjects

R Doll

Publications and source records attributed to R Doll.

At least 235 records · Page 13Linked to original sources
PubMed1977

Use of medicines in general practice.

The prescriptions issued by general practitioners to a population of about 40 000 people were studied. During one year 53-8% of all males and 65-7% of all females had at least one drug dispensed. The proportion receiving medicines increased with age and was higher among females at all ages. Psychotropic drugs were prescribed more often than any other group and accounted for almost one-fifth of all prescriptions. Altogether 9-7% of the males in the population and 21-0% of the females received at least one psychotropic drug during the year. Among women aged 45-59 33-0% received a psychotropic drug, and 11-2% were given an antidepressant. Althoug antimicrobial drugs were prescribed less often than psychotropic drugs, they were given to more people.

Adolescent↗
PubMed1977

Mortality among doctors in different occupations.

A total of 20540 male doctors who replied to a questionnaire on their smoking habits that was sent to them on 1 November 1951, and who were aged 35 years and over, were classified according to their occupation as listed in the Medical Directory for 1952 and followed up until 1 November 1971. Examination of the mortality rates in 11 occupational groups showed gross heterogeneity for smoking-related diseases but not for all other diseases grouped together. On average, general practitioners smoked 37% more cigarettes than did hospital physicians and surgeons and the overall death rates among general practitioners were about 23% higher than among physicians and surgeons of similar ages. This excess death rate was chiefly accounted for by a 38% excess mortality from smoking-related diseases such as lung cancer, chronic bronchitis, and ischaemic and pulmonary heart disease. The few other statistically significant associations between occupation and disease were thought to be due either to chance or to the effect of the disease on the choice of specialty.

Aged↗
PubMed1977

Cancers of the lung and nasal sinuses in nickel workers: a reassessment of the period of risk.

Nine hundred and sixty-seven men who were employed in a nickel refinery in South Wales on at least two occasions five or more years apart before 1945 have been followed up, and the mortality rates from different causes related to the date of their first employment. Previous reports suggested that the occupational risks of lung and nasal sinus cancer had been eliminated by 1925. It is now shown that the risk persisted until 1930, which accords better with the temporal changes in the process.

Dust↗
PubMed1977

A mortality study among workers in an English asbestos factory.

The previous report on this cohort study of workers in an asbestos textile factory (Knox et al., 1968) showed little evidence of increased mortality among workers who had entered the factory after the implementation in 1932 of the first Asbestos Industry Regulation (1931) but observed that no firm conclusions could be drawn, as little carcinogenic effect would be expected for 20 years after first exposure. A further 8 1/2 years of follow-up has revealed some asbestos-related disease in this latter group, although very much less than for employees first exposed before 1933. Among the 963 workers first exposed in 1933 or later, mortality was increased for carcinoma of the bronchus (31 deaths; 19-3 expected for all lung cancers) and non-malignant respiratory disease (35 deaths, 25-0 expected), and a further 5 deaths were attributed to pleural mesothelioma.

Adult↗
PubMed1976

Mortality in relation to smoking: 20 years' observations on male British doctors.

In 1951 the British Medical Association forwarded to all British doctors a questionnaire about their smoking habits, and 34440 men replied. With few exceptions, all men who replied in 1951 have been followed for 20 years. The certified causes of all 10 072 deaths and subsequent changes in smoking habits were recorded. The ratio of the death rate among cigarette smokers to that among lifelong non-smokers of comparable age was, for men under 70 years, about 2:1, while for men over 70 years it was about 1-5:1. These ratios suggest that between a half and a third of all cigarette smokers will die because of their smoking, if the excess death rates are actually caused by smoking. To investigate whether this is the case, the relation of many different causes of death to age and tobacco consumption were examined, as were the effects of giving up smoking. Smoking caused death chiefly by heart disease among middle-aged men (and, with a less extreme relative risk, among old men,) lung cancer, chronic obstructive lung disease, and various vascular diseases. The distinctive features of this study were the completeness of follow-up, the accuracy of death certification, and the fact that the study population as a whole reduced its cigarette consumption substantially during the period of observation. As a result lung cancer grew relatively less common as the study progressed, but other cancers did not, thus illustrating in an unusual way the causal nature of the association between smoking and lung cancer.

Adult↗
PubMed1976

Rauwolfia derivatives and breast cancer in hypertensive women.

Three groups of women were selected from a sample of death certificates that had been coded by the Office of Population Censuses and Surveys for all conditions mentioned on them: (1) all women with reference to both breast cancer and hypertension; (2) all women with reference to hypertension and other cancers; (3) a group of women with reference to hypertension without cancer, selected to match the breast-cancer patients with respect to five features. When the women with breast cancer were compared with both the women with other cancers and the women without cancer, there was a positive association between breast cancer and the use of rauwolfia derivatives, although neither the differences in the frequency nor duration observed were statistically significant. The association appeared to be strongest for use near the time of diagnosis of the cancer. This agrees with nearly all other data and would be expected if rauwolfia derivatives promoted the development of breast cancer from previously initiated cells.

Breast Neoplasms↗
PubMed1976

A retrospective study of renal cancer with special reference to coffee and animal protein consumption.

Interviews were obtained with 106 patients with adenocarcinoma of the renal parenchyma, 33 patients with carcinoma of the renal pelvis and 139 individually matched control patients. Comparison of the cancer patients with the control patients showed no evidence of a positive association between either type of renal cancer and coffee or animal protein consumption. Carcinoma of the renal pelvis was associated positively with cigareete consumption (relative risk estimate 1-8) and the daily consumption of analgesic tablets was more frequent in patients with cancer of the renal parenchyma than in their matched controls (14-2% compared with 1-9%,P less than 0.005). It appeared likely that the latter relationship was non-causal.

Adenocarcinoma↗
PubMed1976

Risk factors for myocardial infarction in young women.

Seventy-seven women discharged from hospital with a diagnosis of myocardial infarction and 207 control patients were investigated. All were under 45 years of age at the time of admission. Heavy cigarette smoking, reported treatment for pre-eclamptic toxaemia, and type II hyperlipoproteinaemia were found to be independent risk factors for myocardial infarction. Reported treatment for hypertension and diabetes are probably also independently associated with subsequent development of the condition, but the associations between myocardial infarction and reported treatment for obesity and psychiatric illness appear to be secondary. Previous publications have suggested that use of oral contraceptives is an independent risk factor. Examination of the effect of several factors combined, suggests that they act synergistically, the presence of three or more factors increasing the risk 128-fold.

Adult↗
PubMed1976

Late effects of x irradiation in patients treated for metropathia haemorrhagica.

We have previously reported on the causes of death among 2,068 patients treated with X irradiation for metropathia haemorrhagica at three Scottish radiotherapy centres between 1940 and 1960 (Doll and Smith, 1968). This cohort of women has now been followed up for a further seven years. 500 (24 per cent) women have now died, 78 (3-8 per cent) have emigrated and 25 (1-2 per cent) could not be traced. The numbers of deaths from different causes have been compared with the numbers expected in a population of similar age and sex exposed to the Scottish national mortality rates over the same period. An excess of deaths from leukaemia (seven observed, 2-3 expected) and of cancers of the heavily irradiated sites (59 observed, 40-1 expected) continues to be observed five or more years after treatment. There is no indication of any change in the excess death rate, due to cancers of sites in the radiation field, with time since treatment up to at least 20 years after the radiation exposure. Over the same period the number of deaths from cancer of the breast was below expectation (ten observed, 22-3 expected) and no increased mortality from coronary disease was seen (102 observed, 100-9 expected). The mean dose of radiation to the bone marrow has been determined for each woman ant it is estimated that the excess rate of leukaemia in the first 20 years after treatment is about 1-1 per million women per year per rad. This figure is in accord with the estimates derived from the survivors of the atomic bomb explosions in Hiroshima and Nagasaki and among patients with ankylosing spondylitis treated with X irradiation. However, the finding of no excess risk of leukemia among women treated with irradiation for cancer of the cervix (Hutchison, 1968) suggests that the simple assumption of a linear dose-response relationship for leukaemia is incorrect, at least when high doses of radiation are delivered to a small volume of marrow.

Age Factors↗