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Biomedical subjects

R R Monson

Publications and source records attributed to R R Monson.

At least 73 records · Page 4Linked to original sources
PubMed1988

Incidence of depression and anxiety: the Stirling County Study.

Prevalence studies in psychiatric epidemiology out-number incidence investigations by a wide margin. This report gives descriptive information about the incidence of depression and anxiety disorders in a general population. Using data gathered in a 16-year follow-up of an adult sample selected as part of the Stirling County Study (Canada), the incidence of these types of disorders was found to be approximately nine cases per 1,000 persons per year. The data suggest that for every man who became ill for the first time with one of these disorders, three women became ill. Incidence tended to be higher among relatively young persons. These incidence rates are consistent with prevalence rates of approximately 10 per cent to 15 per cent for depression and anxiety disorders aggregated together, given an estimated average duration of illness of about 10 years. It is concluded that these incidence rates are fairly realistic in view of evidence that disorders of these types tend to be chronic.

Adult↗
PubMed1988

Mortality in the US rayon industry.

A retrospective cohort study was undertaken of the mortality of men exposed to carbon disulfide in the US rayon industry. The cohort consisted of 10,418 men employed between 1957 and 1979. Deaths to mid-1983 were ascertained by the Social Security Administration and the National Death Index. Total mortality in the group was slightly lower than that of the comparable US population. There was no significant difference in overall mortality between the 4,448 employees who had held jobs with the greatest potential for exposure to carbon disulfide and the 3,311 workers who had no exposure. However, there was an excess of deaths from arteriosclerotic heart disease among the potentially most heavily exposed (242 deaths observed, 195.6 expected). An excess of deaths from suicide (29 observed, 18.8 expected) was seen in only one of the four plants.

Adult↗
PubMed1988

Adverse outcomes of pregnancy in women exposed to diethylstilbestrol in utero.

We analyzed data collected by interview and medical record review for 200 women exposed to diethylstilbestrol (DES) and 12,240 unexposed women to evaluate the relation between maternal DES exposure and outcomes of pregnancy. Low birth weight, short gestation, bleeding in the first trimester, toxemia, breech presentation and premature rupture of the membranes occurred more often among the exposed women. These relationships remained statistically significant after the use of linear regression and logistic regression analyses to control for multiple confounding factors. Both exposed women and their physicians should be aware of the possible relationship between maternal exposure to DES and late adverse outcomes of pregnancy. Close medical supervision of these women throughout pregnancy and delivery is recommended.

Demography↗
PubMed1987

Relative and absolute excess risks of coronary heart disease among women who smoke cigarettes.

We prospectively examined the incidence of coronary heart disease in relation to cigarette smoking in a cohort of 119,404 female nurses who were 30 to 55 years of age in 1976 and were free of diagnosed coronary disease. During six years of follow-up, 65 of the women died of fatal coronary heart disease and 242 had a nonfatal myocardial infarction. The number of cigarettes smoked per day was positively associated with the risk of fatal coronary heart disease (relative risk = 5.5 for greater than or equal to 25 cigarettes per day), nonfatal myocardial infarction (relative risk = 5.8), and angina pectoris (relative risk = 2.6). Even smoking 1 to 4 or 5 to 14 cigarettes per day was associated with a twofold to three-fold increase in the risk of fatal coronary heart disease or nonfatal infarction. Overall, cigarette smoking accounted for approximately half these events. The attributable (absolute excess) risk of coronary heart disease due to current smoking was highest among women who were already at increased risk because of older age, a parental history of myocardial infarction, a higher relative weight, hypertension, hypercholesterolemia, or diabetes. In contrast, former smokers had little, if any, increase in risk. These prospective data emphasize the importance of cigarette smoking as a determinant of coronary heart disease in women, as well as the markedly increased hazards associated with this habit in combination with other risk factors for this disease.

Adult↗
PubMed1987

Risk factors accounting for racial differences in the rate of premature birth.

In a hospital-based cohort of 8903 black and white women, we investigated medical and socioeconomic risk factors that may explain the known increase in premature births among black women. Among the medical conditions examined, only the maternal hematocrit level (or some related factor) explained a substantial proportion (60 percent) of the increased rate of premature births to black women. Four economic, demographic, and behavioral predictors of prematurity were also examined: age less than 20 years, single marital status, receiving welfare support, and not having graduated from high school. The number of these socioeconomic risk factors occurring in a woman was strongly predictive of premature birth of her infant, regardless of the particular risk factors present. The presence of any one factor was associated with a moderate increase in the risk of prematurity (7.0 percent as compared with 4.6 percent with no risk factors present); the presence of two or more characteristics was associated with a much higher risk (11.2 percent). When the number of these four risk factors pertaining to an individual woman was taken into account, race was no longer a significant predictor of premature birth (odds ratio, 1.22; 95 percent confidence interval, 0.94 to 1.59). When both the maternal hematocrit level and the number of the four socioeconomic risk factors were taken into account, essentially all of the racial variation in prematurity was explained, with the odds ratio for prematurity among blacks being 1.03 (95 percent confidence interval, 0.79 to 1.35). We conclude that the racial difference in the rate of premature birth is attributable to specific medical and socioeconomic characteristics.

Adult↗
PubMed1987

Affective disorders and mortality. A general population study.

A 16-year prospective study of a general population sample indicates that those who had reported a depression and/or anxiety disorder at baseline experienced 1.5 times the number of deaths expected on the basis of rates for a large reference population. As part of the Stirling County Study (Canada), the information was gathered from 1003 adults through structured interviews and was analyzed by means of a diagnostic computer program. The risk for mortality was assessed using external and internal standards, controlling for the effects of age and sex as well as for the presence of self-reported physical disorders at baseline. Increased risk was found to be significantly associated with affective but not physical disorders and with depression but not generalized anxiety. When this evidence about mortality was combined with information about subsequent psychiatric morbidity among survivors, 82% of those who were depressed at baseline had a poor outcome.

Adult↗
PubMed1987

Cancer mortality after multiple fluoroscopic examinations of the chest.

Total cancer deaths were not increased among 2,074 women and 1,277 men who were fluoroscopically examined an average of 73 and 91 times, respectively, during lung-collapse therapy for tuberculosis (TB). Patients who did not receive this form of therapy (2,141 women and 1,418 men) and general population rates were used for comparison. All subjects were discharged alive from eight TB sanatoria in Massachusetts between 1930 and 1954; the average follow-up was 23 years. Deaths due to breast cancer were not increased among exposed females [standardized mortality ratio (SMR) = 1.0, n = 24], and SMRs greater than 2.1 could be excluded with 95% confidence. In contrast to other series, our inability to detect a breast cancer excess was likely due to lower breast doses (66 rad) and higher average ages at exposure (28 yr) and thus lower sensitivity. A deficit of lung cancer among exposed males and females was observed (SMR = 0.8, n = 26), even though increased risks have been observed among other populations exposed to similar dose levels. The estimated average lung dose was 91 rad, and SMRs greater than 1.2 for lung cancer could be excluded with 95% confidence. Overall, this study indicates that the radiation hazard of multiple low-dose exposures experienced over many years is not greater than currently accepted estimates for breast and lung cancer. For lung cancer the radiogenic risk may be less than predicted from high-dose, single-exposure studies.

Adult↗
PubMed1986

Diagnosis and outcome: depression and anxiety in a general population.

An assessment of the long-term outcome for depression and anxiety disorders in a general population was made as part of the Stirling County Study. Measuring outcome as a dichotomy between experiencing recurrent episodes or not during a 17-year cohort interval, it was found that 56% of the 'cases' had a poor prognosis. While sex, age and level of severity were not significantly related to outcome, an initial diagnosis of depression was predictive of unfavourable prognosis. Only a few of these 'cases' received psychiatric specialty treatment. Some disorders in the community appear, however, to be as serious as those that come to the attention of psychiatrists.

Adaptation, Psychological↗
PubMed1986

Observations on the healthy worker effect.

Follow-up mortality data from ten groups of employed persons are compared to the mortality rates of the United States general population. Comparisons related to the healthy worker effect (HWE) are computed. As measured by a relative comparison, the standardized mortality ratio (SMR), the HWE is seen to have a dynamic phase and a plateau phase in relation to length of follow-up. In contrast, the HWE as measured by an absolute comparison has little relationship to length of follow-up. Age at entrance into follow-up is strongly related to the absolute risk of mortality, but has little or no relation to the relative risk (SMR). Issues related to the evaluation and minimization of the healthy worker effect are discussed.

Adult↗
PubMed1985

Mortality among rubber workers: X. Reclaim workers.

This study evaluated the mortality experience of 1,352 white and 438 nonwhite men who worked in the rubber-reclaiming division of a large rubber manufacturing company. In comparisons of mortality of white reclaim workers with that of nonreclaim workers rate ratios were 2.7 for esophageal cancer (six observed deaths among reclaim workers), 2.1 for bladder cancer (seven observed deaths), and 4.5 for multiple myeloma (six observed deaths). The excess of bladder cancer among white reclaim workers may be associated with their employment in other high-risk areas of the plant, whereas no such explanation was found for the excesses of esophageal cancer and multiple myeloma. Overall, the lung cancer mortality rate of white reclaim workers was similar to the rate of US white males and other white rubber workers. There was a 50% excess of lung cancer deaths among nonwhite reclaim workers compared with other nonwhite rubber workers. However, this observation is based on small numbers, and no firm conclusions can be reached about the risk of lung cancer associated with reclaim operations in this group of rubber workers.

Esophageal Neoplasms↗
PubMed1985

Mortality among rubber workers: IX. Curing workers.

This research examined mortality among 1,152 white male production workers employed in the tire-curing department of a large rubber manufacturing plant. To determine whether these men had any cause-specific mortality excesses, their experience was compared with that of both the U.S. white male general population and a group of production workers at the same plant who had not worked in the curing division. Both types of comparisons indicated that the curing workers experienced excess mortality from lung cancer. There were 45 deaths from lung cancer among curing workers compared to 24.6 expected based on the age- and calendar period-specific rates of other rubber workers. In addition, the mortality rate ratio for pneumonia was 2.2 for curing relative to noncuring workers. These findings are consistent with the results of other studies and suggest that occupational exposures may have contributed to the development of pulmonary disease among curing workers.

Age Factors↗
PubMed1985

Epidemiology of neonatal hyperbilirubinemia.

Interview and record review data from 12,023 singleton deliveries were analyzed to determine the relationships between neonatal hyperbilirubinemia (10 mg/dL or greater) and maternal characteristics. Confounding variables were controlled by multiple logistic regression analysis. There was a statistically significant positive relationship between hyperbilirubinemia and low birth weight, Oriental race, premature rupture of membranes, breast-feeding, neonatal infection, use of the "pill" at time of conception, instrumental delivery, and history of first trimester bleeding. Maternal smoking and black race were negatively related to hyperbilirubinemia and statistically significant. In this study, other previously suspected etiologic factors such as epidural anesthesia, parity, use of oxytocin in labor, and white race were not associated with hyperbilirubinemia.

Adult↗
PubMed1984

Discontinued use of intrauterine contraceptive device and pregnancy loss.

To evaluate the risk of spontaneous abortion among former intrauterine contraceptive device (IUD) users, we compared the contraceptive history of 328 women with a spontaneous abortion up to 28 weeks' gestation with that of 1715 women having a term delivery. A similar percentage of case and comparison subjects reported prior IUD use as well as IUD use within the year before pregnancy. However, IUD use lasting more than 12 months was associated with a 1.5-fold increase in the crude risk of spontaneous abortion up to 28 weeks' gestation (p less than 0.05), a 1.8-fold increased risk of first-trimester spontaneous abortion, and a 1.7-fold increased risk of incomplete abortion (p less than 0.01). The results were not altered by control of individual confounding factors. When confounding factors were controlled simultaneously in a multiple logistic regression analysis, the relative risks were 1.4, 1.7 and 1.6, respectively; however, they were no longer statistically significant. The results suggest that prolonged IUD use may be associated with a modest increase in risk of subsequent spontaneous abortion.

Abortion, Incomplete↗
PubMed1984

Association of Ureaplasma urealyticum in the placenta with perinatal morbidity and mortality.

We investigated the presence of ureaplasmas, mycoplasmas, chlamydiae, fungi, aerobic and anaerobic bacteria, and cytomegalovirus in fetal membranes and evaluated their association with perinatal morbidity and mortality. We cultured 801 placentas from three groups of subjects (144 who died in the perinatal period, 452 neonates admitted to the intensive-care unit, and 205 controls). Ureaplasma urealyticum, Mycoplasma hominis, or both were isolated from 21 per cent of placentas of premature and term infants who died in the perinatal period, 25 per cent of those admitted to intensive care, and 11 per cent of controls. Gestational age and birth weight were inversely related to isolation of ureaplasma, and chorioamnionitis was positively related to isolation. The presence of ureaplasmas in the placenta suggests the transcervical migration of these microorganisms from the lower genitourinary tract. These data show a strong association between ureaplasma infection of the placenta and low birth weight of the neonate and suggest that the association is causal.

Adult↗
PubMed1984

Mortality among rubber workers: VII. Aerospace workers.

This study evaluated cause-specific mortality among 3,161 men who were employed in the aerospace division of a rubber manufacturing company. Compared to other production workers at the plant, aerospace workers in deicer and fuel cell manufacturing jobs experienced a 60% excess of deaths from lung cancer. Deicer and fuel cell workers who were under 65 years of age had lung cancer rates that were approximately twice those of other rubber workers of comparable age. Aerospace division employees also had elevated rates of bladder cancer, leukemia, lymphoma, and multiple myeloma. However, detailed analyses suggested that, with the exception of lung cancer, these cancer excesses were not likely to be attributable to employment in the aerospace division.

Adult↗
PubMed1984

Mortality among rubber workers: VIII. Industrial products workers.

This report compares the mortality experience of 6,533 men employed in the industrial products division of a rubber manufacturing company with that of U.S. males and of other rubber workers. For most causes of death the mortality rates of industrial products workers were lower than those of U.S. males and similar to those of other rubber workers. Relative to other rubber workers, men in the industrial products division had a 50% excess of deaths from lymphoma, a 90% excess of deaths from multiple myeloma, and a 20% excess of deaths from bladder cancer during the study period. The excesses of lymphoma and multiple myeloma were strongest during recent follow-up in 1970-78 (observed/expected deaths: 10/4.3 for lymphoma; 10/4.4 for multiple myeloma), whereas bladder cancer mortality was not excessive during this calendar period.

Aged↗
PubMed1984

Work and pregnancy.

Pregnancy outcomes of 7,155 women who worked between one and nine months of pregnancy were compared with outcomes of 4,018 women who were not employed. There were no differences in rates of prematurity, Apgar score, birthweight, perinatal death rate, or malformation prevalence. Working women were divided into those who left employment during the first eight months and those who worked all nine months. The latter had a lower rate of adverse outcome than the other working group and the nonworking group. This indicates that working to term in the absence of contraindications does not impose an added risk on mother or infant. After control of confounding by parity and other relevant factors, an increased risk of prolonged gestational age was seen among primiparous working women. There was an increased risk of fetal distress among those women leaving work prior to nine months who were having their third or subsequent child. A small decrease in birth weight was seen among women who left work prior to term but not among those who worked all nine months. Overall the results are reassuring that working during pregnancy is not in itself a risk factor for adverse outcome.

Adolescent↗