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PubMed2004

Factors associated with overweight and obesity in Quebec adults.

OBJECTIVE: To measure the independent correlates of excess body weight and obesity in Quebec in 1993 and 1997. DESIGN: A population-based, cross-sectional survey in three settings in the province of Quebec. SUBJECTS: A total of 10014 individuals aged 18-64 y. MEASUREMENTS: Excess body weight was defined as a body mass index (BMI) (self-reported weight and height) greater than or equal to 25 kg/m(2) and obesity as BMI greater than or equal to 30 kg/m(2). Data were collected by a questionnaire completed at home by the participants. Diet was assessed by a food frequency questionnaire. RESULTS: The correlates varied according to gender. While university achievement, smoking habit and physical activity level reduced the risk of excess body weight in both genders, increased dietary fat intake was positively associated with overweight and obesity in men only. In women, greater family income lowered the risk of having a BMI over 25. Increasing age, speaking a language other than French and living in a rural environment elevated the risk. CONCLUSION: Future interventions for the control of obesity should be gender-specific. Target groups should include individuals with low education, those living in rural environments and non-caucasian women. Dietary interventions should target men in particular.

Adolescent↗
PubMed1978

Favus: twenty indigenous cases in the province of Quebec.

Twenty indigenous cases of favus in two families residing in the province of Quebec were studied. Importantly, the disease, although active, remained undiagnosed for many years in most of the cases. The finding of active cases suggests that the disease is still endemic in regions previously described as harboring cases, namely the province of Quebec and possibly Kentucky.

Adult↗
PubMedDate not supplied

Total cholesterol/HDL cholesterol ratio vs LDL cholesterol/HDL cholesterol ratio as indices of ischemic heart disease risk in men: the Quebec Cardiovascular Study.

BACKGROUND: Total cholesterol (TC)/high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C)/HDL-C ratios are used to predict ischemic heart disease risk. There is, however, no consensus on which of these 2 indices is superior. The objective of the present study was to present evidence that the LDL-C/HDL-C ratio may underestimate ischemic heart disease risk in overweight hyperinsulinemic patients with high triglyceride (TG)-low HDL-C dyslipidemia. METHODS: A total of 2103 middle-aged men in whom measurements of the metabolic profile were performed in the fasting state were recruited from 7 suburbs of the Quebec metropolitan area. RESULTS: The relationship of LDL-C/HDL-C to TC/HDL-C ratios was examined among men in the Quebec Cardiovascular Study classified into tertiles of fasting TG levels. For any given LDL-C/HDL-C ratio, the TC/HDL-C ratio was higher among men in the top TG tertile (>168 mg/dL [>1.9 mmol/L]) than in men in the first and second TG tertiles. Adjustment of the TC/HDL-C ratio for LDL-C/HDL-C by covariance analysis generated significant differences in average TC/HDL-C ratios among TG tertiles (P<.001). Greater differences in features of the insulin resistance syndrome (insulinemia, apolipoprotein B, and LDL size) were noted across tertiles of the TC/HDL-C ratio than tertiles of the LDL-C/HDL-C ratio. CONCLUSION: Variation in the TC/HDL-C ratio may be associated with more substantial alterations in metabolic indices predictive of ischemic heart disease risk and related to the insulin resistance syndrome than variation in the LDL-C/HDL-C ratio.

Apolipoproteins B↗
PubMed2001

Effectiveness of a mass immunization campaign against serogroup C meningococcal disease in Quebec.

CONTEXT: An outbreak of meningococcal disease in Quebec province prompted a mass immunization program. The impact of this campaign on the epidemiology of meningococcal disease has not been studied. OBJECTIVES: To study the impact of a mass immunization campaign using polysaccharide vaccine on the epidemiology of meningococcal disease (MCD) and to assess serogroup C vaccine effectiveness (VE). DESIGN, SETTING, AND SUBJECTS: Analysis of MCD cases reported in Quebec from 1990 to 1998, before and after the mass immunization campaign was conducted during the winter of 1992-1993, when 84% of residents aged 6 months to 20 years (the target population, approximately 1.9 million individuals) were vaccinated. MAIN OUTCOME MEASURES: Incidence of MCD in 1990-1998; incidence of culture-proven serogroup C MCD between April 1, 1993, and March 31, 1998, compared among vaccinated and unvaccinated persons in the target population. RESULTS: The incidence of serogroup C disease decreased after the mass immunization campaign, from 1.4 per 100 000 in 1990-1992 to 0.3 per 100 000 in 1993-1998, and the overall incidence of other serogroups remained stable at 0.7 per 100 000, with a small increase in the proportion of cases caused by serogroup Y (P =.009). Protection from serogroup C MCD was indicated in the first 2 years after vaccine administration (VE, 65%; 95% confidence interval [CI], 20%-84%), but not in the next 3 years (VE, 0%; 95% CI, -5% to 65%). Vaccine effectiveness was strongly related to age at vaccination: 83% (95% CI, 39%-96%) for ages 15 through 20 years, 75% (95% CI, - 17% to 93%) for ages 10 through 14 years, and 41% (95% CI, -106% to 79%) for ages 2 through 9 years. There was no evidence of protection in children younger than 2 years; all 8 MCD cases in this age group occurred in vaccinees. CONCLUSIONS: Serogroup C polysaccharide vaccine is effective for controlling outbreaks in teenaged individuals but should not be used in children younger than 2 years. The mass campaign did not induce significant serogroup switching.

Adolescent↗
PubMed1995

Fibers in lung tissues of mesothelioma cases among miners and millers of the township of Asbestos, Quebec.

Twenty cases of mesothelioma among miners of the township of Asbestos, Quebec, Canada, have been reported. To further explore the mineral characteristics of various fibrous material, we studied the fibrous inorganic content of postmortem lung tissues of 12 of 20 available cases. In each case, we measured concentrations of chrysotile, amosite, crocidolite, tremolite, talc-anthophyllite, and other fibrous minerals. The average diameter, length, and length-to-diameter ratio of each type of fiber were also calculated. For total fibers > 5 microns, we found > 1,000 asbestos fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 8 cases, chrysotile in 6 cases, crocidolite in 4 cases, and talc anthophyllite in 5 cases. Among cases with asbestos fibers, the tremolite count was highest in 7 cases, chrysotile in 3 cases, and crocidolite in 2 cases. The geometric mean concentrations of fibers > or = 5 microns were in the following decreasing order: tremolite > crocidolite > chrysotile > other fibers > talc-anthophyllite > amosite. For total fibers < 5 microns, we found > 1,000 fibers per mg tissue (f/mg) in all cases; tremolite was above 1,000 f/mg in 12 cases, chrysotile in 8 cases, crocidolite in 7 cases, and talc-anthophyllite in 6 cases. Tremolite was highest in 8 cases, chrysotile in 2 cases, and crocidolite and amosite in 2 cases. The geometric mean concentrations of fibers < 5 microns were in the following decreasing order: tremolite > other fibers > chrysotile > crocidolite > talc-anthophyllite > amosite. We conclude, on the basis of the lung burden analyses of 12 mesothelioma cases from the Asbestos township of Quebec, that the imported amphibole (crocidolite and amosite) were the dominant fibers retained in the lung tissue in 2/12 cases. In 10/12 cases, fibers from the mine site (chrysotile and tremolite) were found at highest counts; tremolite was clearly the highest in 6, chrysotile in 2, and 2 cases had about the same counts for tremolite and chrysotile. If a relation of fiber burden-causality of mesothelioma is accepted, mesothelioma would be likely caused by amphibole contamination of the plant in 2/12 cases and by the mineral fibers (tremolite and chrysotile) from the mine site in the 10 other cases.

Aged↗
PubMed2005

Humeral cross-sectional morphology from 18th century Quebec prisoners of war: Limits to activity reconstruction.

This study uses measures of cross-sectional robusticity and asymmetry (based on humeral areal and inertial cross-sectional components) to test a prediction from bone remodeling theory that a physically active 18th century Quebec prisoner of war sample (N = 25) should have more robust and asymmetrical humeri than a nonphysically active 20th century New Mexico suburbanite sample (N = 27). Narrative accounts document that prisoners of war engaged in labor-intensive activities, and these activities were confirmed by observations of osteoarthritis and other pathologies. The suburbanite sample, for the most part, did not engage in such activities. The prisoners had higher levels of pathology than the suburbanites (e.g., 80% vs. 22% osteoarthritis; F = 17.95, P < 0.01). For robusticity, the populations did not differ significantly in total area, cortical area, moment areas of inertia about the mediolateral plane, or polar moment area of inertia. The Quebec prison sample did have significantly higher values for moment areas of inertia about the anteroposterior plane. For asymmetry, the populations did not differ in any values (total area, cortical area, moment areas of inertia about the mediolateral plane, moment areas of inertia about the anteroposterior plane, or polar moment of inertia). Thus, examinations of cross-sectional robusticity and asymmetry failed to conclusively confirm the hypothesis that intensive labor leads to changes in humeral morphology. Possible explanations for the lack of differences are discussed, such as poor diet impeding bone remodeling. Nevertheless, the one significant finding suggests that cross-sectional shape is more useful in reconstructing activity patterns than amount of bone in a cross section. Results from this study join those from other recent investigations to suggest that additional controls are required before cross-sectional differences may be confidently attributed to activity patterns.

Anatomy, Cross-Sectional↗
PubMed2006

Retrospective analysis of utilization patterns and cost implications of coxibs among seniors in Quebec, Canada: what is the potential impact of the withdrawal of rofecoxib?

OBJECTIVE: In September 2004, the manufacturer of rofecoxib announced a voluntary worldwide withdrawal of the drug. The impact of this withdrawal on drug budgets is unclear. This study evaluated average daily doses and costs of rofecoxib and celecoxib and concomitant use of gastroprotective agents (GPAs) in elderly patients with osteoarthritis (OA) or rheumatoid arthritis (RA) in Quebec, prior to the rofecoxib withdrawal. METHODS: This retrospective cohort study used prescription drug and medical service data from the Quebec government health agency administrative database and included coxib users > or =66 years of age with OA or RA who filled > or =3 consecutive rofecoxib or celecoxib prescriptions in 2001-2002. Results were adjusted for gastrointestinal risk factors and other patient baseline characteristics. RESULTS: Data were analyzed for 11,975 rofecoxib and 12,480 celecoxib users. Mean daily dosages were 20.7 mg for rofecoxib and 231.3 mg for celecoxib. Rofecoxib users consumed a mean +/- SD of 0.95 +/- 0.43 pills per day, and celecoxib users took 1.34 +/- 0.65 pills per day. Mean +/- SD unadjusted daily acquisition costs were $1.18 +/- $0.53 (Canadian) for rofecoxib and $1.45 +/- $0.74 for celecoxib. After adjusting for patient baseline characteristics, the mean daily acquisition cost for rofecoxib was $0.25 lower than for celecoxib. Rofecoxib users were less likely than celecoxib users to fill a GPA coprescription (odds ratio 0.88; 95% confidence interval 0.81, 0.95). Subgroup analyses yielded comparable results. CONCLUSION: Celecoxib appears to be a more expensive therapeutic option than rofecoxib due to a relatively higher daily dose and tablet consumption.

Aged↗
PubMed1993

Genetic epidemiology of autosomal recessive spastic ataxia of Charlevoix-Saguenay in northeastern Quebec.

Autosomal recessive spastic ataxia of Charlevoix-Saguenay (ARSACS) is a disorder that has an elevated frequency in Saguenay-Lac-St-Jean (SLSJ) and Charlevoix, two geographically isolated regions in the past of northeastern Quebec. The incidence at birth and the carrier rate in SLSJ were estimated at 1/1,932 liveborn infants and 1/22 inhabitants, respectively, for the period 1941-1985. The mean inbreeding coefficient was twice higher and the mean kinship coefficient 3 times higher among the ARSACS families than among control families. In the SLSJ region, the birth places of the ARSACS individuals and their parents did not show a clustered distribution. The genealogical reconstruction suggests that the high incidence of ARSACS in SLSJ and Charlevoix is likely to be the result of a founder effect. Because the disease is apparently unknown elsewhere in the world and a high proportion of French Canadians presently living in eastern Quebec have ancestors coming from Perche, a small region in France, it also suggests that a unique mutation accounts for most, if not all, of the ARSACS cases known in these regions.

Consanguinity↗
PubMed2006

Validity of asthma diagnoses recorded in the Medical Services database of Quebec.

The goal of this study was to evaluate the validity of asthma diagnoses recorded in the Medical Services (physician billing) database of the Canadian province of Quebec. The predictive positive value (PPV) and predictive negative value (PNV) of two operational definitions of asthma based on diagnoses recorded in the database were evaluated. Patients 16-80 years old treated by a respiratory or a family physician in 2002 were selected from the database. The diagnosis derived from the Medical Services database was compared to the diagnosis written in the patient's medical chart. The PPV and PNV of the first operational definition based on one asthma diagnosis or more recorded in the database over a 1-year period were found to be 0.75 and 0.96 for respiratory physicians and 0.67 and 0.99 for family physicians, for patients 16-44 years old. The PPV increased to 0.78 for family physicians and to 0.77 for respiratory physicians when the second operational definition based on two diagnoses of asthma or more was used. Results tended to be lower for 45-80 years old patients. We conclude that diagnoses recorded in the Medical Services database of Quebec are valid to identify patients with asthma.

Adolescent↗
PubMed1995

Low birth weight and preterm births among infants born to women living near a municipal solid waste landfill site in Montreal, Quebec.

Using data from the Quebec birth registration file, case-control analyses were conducted in order to evaluate the risk of low birth weight (< 2500 g), very low birth weight (< 1500 g), preterm birth (< 37 completed weeks), and small for gestational age (< third percentile) among infants born to women living near a municipal solid waste landfill site in a densely populated area of Montreal, Quebec. Potential exposure to vapors and gases (biogas) was defined in terms of exposure zones around the site. A set of reference areas was selected to be similar to these exposure zones on a number of key sociodemographic factors. Odds ratios (OR) adjusted for variables on the birth file were calculated using logistic regression. Low birth weight was significantly elevated in the exposure zone proximal to the site (adjusted OR = 1.20; 1107 exposed cases; 95% confidence interval: 1.04-1.39). Excess risks were also observed for small for gestational age, but the association was not as strong as for low birth weight (adjusted OR = 1.09; 951 exposed cases; 95% confidence interval: 0.96-1.24). No significant positive associations were observed for very low birth weight or for preterm birth. Because it was not possible to evaluate the effects of all potentially important confounding factors and because detailed environmental exposure assessments were not available, it is not possible to conclude definitively whether low birth weight and small for gestational age are associated with exposure to biogas. Further studies at this and at other landfill sites are warranted in order to confirm or refute these observations and to investigate other possible adverse reproductive outcomes.

Case-Control Studies↗
PubMed2001

The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 1. Nonaccidental mortality.

This study was undertaken to determine whether variations in concentrations of particles in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in nonaccidental mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particulates and gaseous pollutants. Total sulfates were also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We estimated associations for PM(2.5), PM(10), total suspended particles, coefficient of haze (COH), extinction coefficient, and sulfates. We used coefficient of haze, extinction coefficient, and Sutton sulfates to predict fine particles and sulfates for days that were missing. To estimate the associations between nonaccidental mortality and ambient air particles, we regressed the logarithm of daily counts of nonaccidental mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. There were 140,939 residents of Montreal who died during the study period. We found evidence of associations between daily nonaccidental deaths and most measures of particulate air pollution. For example, the mean percentage increase (MPC) for an increase of total suspended particles of 28.57 microg/m(3) (interquartile range, IQ), evaluated at lag 0 days, was 1.86% (95% confidence interval (CI): 0.00-3.76%), and for an increase of coefficient of haze (IQ=18.5 COH units per 327.8 linear m) the MPC was 1.44% (95% CI: 0.75-2.14%). These results are similar to findings from other studies (the mean percentage increase in nonaccidental deaths for a 100 microg/m(3) increase in daily total suspended particles was 6.7%). We also found increases for fine particles and for inhalable particles, but the confidence intervals included unity. All measures of sulfates showed increased daily mortality; e.g., the MPC for sulfates from fine particles (IQ=3.51 microg/m(3)) was 1.86% (95% CI: 0.40-3.35%). We generally found higher excesses in daily mortality for persons 65 years of age and for exposures averaged across lags 0, 1, and 2 days. The slope of the association between daily mortality and ambient air particles in Montreal, which has lower levels of pollution than most major urban centers, is similar to that reported in most other industrialized cities. This study therefore provides further evidence that the association is linear and that any threshold effect, should it exist, would be found at lower levels of air pollution than those found in Montreal.

Aged↗
PubMed2001

The association between daily mortality and ambient air particle pollution in Montreal, Quebec. 2. Cause-specific mortality.

This study was undertaken to determine whether variations in concentrations of particulates in the ambient air of Montreal, Quebec, during the period 1984 to 1993, were associated with daily variations in cause-specific daily mortality. Fixed-site air pollution monitors in Montreal provided daily mean levels of various measures of particles and gaseous pollutants. Total sulfate was also measured daily (1986-1993) at a monitoring station 150 km southeast of the city (Sutton, Quebec). We used coefficient of haze (COH), extinction coefficient, and sulfate from the Sutton station to predict fine particles and sulfate from fine particles for days that were missing. We estimated associations between cause-specific mortality and PM(2.5), PM(10), predicted fine particles and fine sulfate particles, total suspended particles, coefficient of haze, extinction coefficient, and total sulfate measured at the Sutton station. We selected a set of underlying causes of death, as recorded on the death certificates, as the endpoint and then regressed the logarithm of daily counts of cause-specific mortality on the daily mean levels for the above measures of particulates, after accounting for seasonal and subseasonal fluctuations in the mortality time series, non-Poisson dispersion, weather variables, and gaseous pollutants. We found positive and statistically significant associations between the daily measures of ambient particle mass and sulfate mass and the deaths from respiratory diseases and diabetes. The mean percentage change in daily mortality (MPC), evaluated at the interquartile range for pollutants averaged over the day of death and the preceding 2 days, for deaths from respiratory diseases was MPC(COH)=6.90% (95% CI: 3.69-10.21%), MPC(Predicted PM2.5)= 9.03% (95% CI: 5.83- 12.33%), and MPC(Sutton sulfate)=4.64% (95% CI: 2.46-6.86%). For diabetes, the corresponding estimates were MPC(COH)=7.50% (95% CI: 1.96-13.34%), MPC(Predicted PM2.5)=7.59% (95% CI: 2.36-13.09%), and MPC(Sutton sulfate)=4.48% (95% CI: 1.08-7.99%). Among individuals older than 65 years at time of death, we found consistent associations across our metrics of particles for neoplasms and coronary artery diseases. Associations with sulfate mass were also found among elderly persons who died of cardiovascular diseases and of lung cancer. These associations were consistent with linear relationships. The associations found for respiratory diseases and for cardiovascular diseases, especially in the elderly, are in line with some of the current hypotheses regarding mechanisms by which ambient particles may increase daily mortality. The positive associations found for cancer and for diabetes may be understood through a general hypothesis proposed by Frank and Tankersley, who suggested that persons in failing health may be at higher risk for external insults through the failure of regulating physiological set points. The association with diabetes may be interpreted in light of recent toxicological findings that inhalation of urban particles in animals increases blood pressure and plasmatic levels of endothelins that enhance vasoconstriction and alter electrophysiology. Further research to confirm these findings and to determine whether they are causal is warranted.

Aged↗
PubMed1991

Isolation of encephalomyocarditis virus among stillborn and post-weaning pigs in Quebec.

Encephalomyocarditis (EMC) virus was isolated from aborted fetuses and lungs of suckling pigs from three Quebec pig farms that experienced outbreaks of reproductive failure in sows and respiratory problems in suckling and post-weaning piglets. Multifocal interstitial pneumonia and mild non-suppurative myocarditis and meningoencephalitis were the more significant histopathological lesions observed in piglets. Vero cells were found to be more sensitive than BHK-21 cells and pig cell lines for primary isolation of EMC virus. The Quebec EMC virus isolates were highly virulent for mice and were antigenically related to reference strain of EMC virus as demonstrated by indirect immunofluorescence, seroneutralization and Western immunoblotting. Specific virus neutralization antibody titers up to 1:12,800 were detected in samples of thoracic or abdominal fluids of the aborted fetuses.

Abortion, Veterinary↗
PubMed2005

Prevalence of musculoskeletal pain and associated factors in the Quebec working population.

BACKGROUND: While the determinants of musculoskeletal pain are numerous, few studies conducted among workers have taken into account, altogether, physical factors, psychosocial factors (personal and work-related) and individual characteristics. OBJECTIVES: To estimate the 1-year prevalence of musculoskeletal pain in the Quebec working population by gender and anatomical site, and to determine which factors are associated with these prevalence figures. METHODS: Data came from the 1998 Quebec Health Survey and included 9,496 individuals. One-year period prevalences for neck pain, back pain and pain in the upper and lower extremities were calculated for men and women. Logistic regression analyses were conducted to estimate the associations between individual, physical and psychosocial work factors, on one hand, and musculoskeletal pain in the four body regions, on the other hand. RESULTS: For both genders back pain was the most frequent musculoskeletal symptom that had disturbed their activities during the past year. The largest difference between genders was observed for neck pain (women: 18%; men: 11%). Multivariate analyses indicated that physical and psychosocial work factors, as well as psychological variables, were associated with musculoskeletal pain in different body regions. Body mass index was associated only with pain in lower extremities for both genders. CONCLUSIONS: The results of this study suggest that interventions aimed at reducing musculoskeletal pain should take into account personal and work-related psychosocial variables, in addition to physical workload.

Adult↗
PubMed2006

Biological monitoring of exposure to organophosphate pesticides in children living in peri-urban areas of the Province of Quebec, Canada.

OBJECTIVE: This study was undertaken to assess the exposure to organophosphate (OP) pesticides in children from peri-urban areas of the Province of Quebec, Canada, through measurements of semi-specific alkylphosphate (AP) metabolites. METHODS: Eighty-nine children aged between 3 and 7 years were recruited via pamphlets sent to day-care centers. A first morning urine void was collected early in the spring of 2003 prior to summertime, which is the usual period of outdoor pesticide use. During summertime, up to five more first morning voids were repeatedly collected, at 72-h intervals, over a 13-day period. The potential determinants of exposure were assessed by a questionnaire at the time of urine collection. RESULTS: Methylphosphate metabolites were detectable in 98.2% of the 442 samples analyzed while ethylphosphates were detected in 86.7% of the samples. The geometric mean concentration (GM) of the total AP metabolites was 61.7 mug/g creatinine (range: 2.7-1967.3 mug/g creatinine). The difference in urinary AP concentrations between samples collected during spring and summer was non-significant (P=0.08). There was also no significant difference in the mean AP concentrations between summer samples of individuals living in municipalities where outdoor pesticide use is or is not restricted (P=0.25). However, the presence of a pet in the house was associated with an increase in AP concentrations during spraying season (P=0.02). Pesticides were seldom used, as reported by the questionnaire. A significant correlation was also observed (P<0.001) between the urinary AP concentrations in samples provided by siblings at the same time period. CONCLUSIONS: Mean concentrations of AP were generally higher than those reported in other studies. The observed exposure apparently occurred mainly through the dietary ingestion of OP residues. These data raise questions on the levels of OP residues in Quebec food and the possibility that our participants consumed more fruits and vegetables than those in other studies.

Child↗
PubMedDate not supplied

Health care technology in Canada (with special reference to Quebec).

In Canada, all citizens are insured for health services. Health care is a provincial responsibility. The federal role is limited to health care financing, health protection including regulation of pharmaceuticals, and environmental health. The health care system represents a balance among government direction, consumer choice, and provider autonomy. Canada has largely controlled the costs of health care by funding and management mechanisms, the most important of which is the global budget formula used to fund hospitals. This paper discusses the Canadian health care system, with particular emphasis on the province of Quebec. In 1988, the provincial government of Quebec established the first Canadian body dedicated to technology assessment. Since then, a national coordinating office and several other provincial bodies have developed. The work of these and other evaluation efforts has had a growing influence on technology management decisions, particularly those dealing with procurement of capital-intensive technologies. Expanding this influence into the realm of technology use, especially for low-cost, high-volume technologies, remains a challenge.

Canada↗
PubMed1986

Cardiovascular mortality as it relates to the geographic distribution of employment in non-metropolitan Quebec.

This exploratory analysis examines relationships between employment-specific cardiovascular mortality and certain spatially-based potential risk factors. Standard mortality ratios (SMRs) are mapped on the basis of non-metropolitan primary and secondary employment basins of Quebec. In order to control for geographical anomalies, the data are broken down into three spatial grids: employment basins with the employment poles, employment basins without the employment poles and the employment poles (municipalities) taken alone. This cartography suggests a certain number of cardiovascular disease-prone employment areas in Quebec. Linkage analysis and principal components analysis are used to simplify and clarify the complex relationships that exist among selected independent variables (potential risk factors) and multiple regression analysis is used to identify the functional relationships between these employment, geographic and demographic variables and the study's dependent variable (ischaemic heart disease and cerebrovascular mortality) in the form of standard mortality ratios (SMRs). Cardiovascular mortality (SMRs) are found to be related negatively to an employment age-factor and, in the case of women, negatively to agricultural employment, marginally and positively to pulp and paper employment. It would appear that outside the very large cities in areas of primary and industrial employment, men are at greater risk of cardiovascular mortality during their working lives than those who are over the age of 65. Although it was not possible to establish strong positive links between most employment sectors and cardiovascular mortality, it is possible to conclude that there is a negative association for men between textile employment and cerebrovascular mortality; that in the case of women, those who work in agriculture are less at risk than women who are working in industrial employment. There is also some statistical evidence that there is an association between women in the pulp and paper industry and cardiovascular risk levels. This research provides some clues as to the need to investigate certain areas of employment that may be creating unnecessary risks to health, especially in the case of female workers.

Adult↗
PubMed1986

The effects of Quebec home aid services on the utilization profile of sociosanitory resources: a substitution study.

The development of home aid services in Quebec is based on the hypothesis that this new program will help to maintain at home people who would otherwise be institutionalized and also contribute to reducing costs in the health care sector. Accordingly, home aid services can be viewed as a substitute for conventional health care services. This study evaluates utilization modifications of health care services subsequent to the introduction of a home-aid program in October 1977. A modified, non-equivalent, control group design was used on a target population including all residents aged 65 or more in one region of Quebec. Multiple regression was used to explain variations in resources utilization in relation to population characteristics and different health care settings. Results for the utilization of hospitals are discussed. We discovered that the anticipated substitutive effects of a home-aid program on the use of health care services cannot be ascertained.

Activities of Daily Living↗