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Exposure to tobacco smoke in utero and the risk of stillbirth and death in the first year of life.

The authors examined the association between exposure to tobacco smoke in utero and the risk of stillbirth and infant death in a cohort of 25,102 singleton children of pregnant women scheduled to deliver at Aarhus University Hospital, Aarhus, Denmark, from September 1989 to August 1996. Exposure to tobacco smoke in utero was associated with an increased risk of stillbirth (odds ratio = 2.0, 95% confidence interval: 1.4, 2.9), and infant mortality was almost doubled in children born to women who had smoked during pregnancy compared with children of nonsmokers (odds ratio = 1.8, 95% confidence interval: 1.3, 2.6). Among children of women who stopped smoking during the first trimester, stillbirth and infant mortality was comparable with that in children of women who had been nonsmokers from the beginning of pregnancy. Conclusions were not changed after adjustment in a logistic regression model for the sex of the child; parity; or maternal age, height, weight, marital status, years of education, occupational status, and alcohol and caffeine intake during pregnancy. Approximately 25% of all stillbirths and 20% of all infant deaths in a population with 30% pregnant smokers could be avoided if all pregnant smokers stopped smoking by the sixteenth week of gestation.

Denmark↗

Current status of occupational health in Japan.

In Japan, the primary administrative authority of occupational health is the Ministry of Labour, and its legislative basis is the Industrial Safety and Health Law (ISH law). Occupational health is mandated by this law and its enforcement involves the appointment of an occupational health physician (OP) for workplaces with 50 or more workers, and a full-time OP for workplaces with 1000 or more workers. The actual percentage of appointments filled for the former group is 83.4 per cent, compared with 58.4 per cent for the latter. The estimated number of OPs is 34000, of which 2000 work full time. Worker health examination is mandatory for all workplaces and many OPs allocate considerable time to its implementation. Occupational health organizations provide occupational health services such as worker health examinations to meet the demand. Basic training courses for OPs are provided by the Japan Medical Association and advanced courses are provided by the University of Occupational and Environmental Health, Japan. The Ministry of Labour recently launched a plan to establish occupational health centres to assist OPs at prefectural and regional levels. A network of such centres is planned to span the country within the next seven years.

Humans↗

Principal lifetime occupation and cognitive impairment in a French elderly cohort (Paquid).

The purpose of the present study was to examine the relation between principal lifetime occupation and cognitive performance with the initial data collected (1988-1989) in a cohort of 3,777 community residents of the area of Bordeaux, France, aged 65 years and older. Subjects were considered as cognitively impaired if they scored under 24 on the French version of the mini-mental state examination. Cognitive impairment was found to vary significantly across the different occupational categories. Results of the logistic regression show that age, sex, and educational level are significantly related to cognitive impairment. Moreover, after controlling for these and other covariates, farmworkers (odds ratio (OR) = 6.1, 95% confidence interval (CI) 3.3-11.4), farm managers (OR = 2.9, 95% CI 1.6-5.1), domestic service employees (OR = 2.8, 95% CI 1.5-5.1), and blue-collar workers (OR = 2.5, 95% CI 1.4-4.4) had a higher risk of cognitive impairment than did subjects who had an intellectual occupation. Follow-up of the cohort will permit precise determination of the role of principal lifetime occupation in subsequent cognitive deterioration. Occupational status should be taken into consideration when studying brain aging.

Age Factors↗

Radiographic small lung opacities and pleural abnormalities in relation to smoking, urbanization status, and occupational asbestos exposure in Finland.

The role of smoking and an urban living environment in the etiology of radiographic pleural and pulmonary abnormalities was studied in a population sample that was representative of the Finnish adult population. A total of 7095 full-size chest radiographs were classified according to the International Labor Organization's 1980 classification of radiographs of pneumoconioses, with some modifications. The risk of bilateral pleural plaques was significantly higher among urban men (RR, 2.0) and women (RR, 3.8), even when adjusted for age and probability of occupational asbestos exposure and smoking. The risks of small lung opacities and abnormalities of the visceral pleura were not higher in urban areas. Risks of small lung opacities and thickening of the visceral pleura were positively associated with smoking, and the risk of small lung opacities was also higher among smokers than never-smokers in the population fraction with unlikely occupational asbestos exposure.

Adult↗

Maternal consumption of coffee during pregnancy and stillbirth and infant death in first year of life: prospective study.

OBJECTIVE: To study the association between coffee consumption during pregnancy and the risk of stillbirth and infant death in the first year of life. DESIGN: Prospective follow up study. SETTING: Aarhus University Hospital, Denmark, 1989-96. PARTICIPANTS: 18 478 singleton pregnancies in women with valid information about coffee consumption during pregnancy. MAIN OUTCOME MEASURES: Stillbirth (delivery of a dead fetus at > or =28 weeks' gestation) and infant death (death of a liveborn infant during the first year of life). RESULTS: Pregnant women who drank eight or more cups of coffee per day during pregnancy had an increased risk of stillbirth compared with women who did not drink coffee (odds ratio=3.0, 95% confidence interval 1.5 to 5.9). After adjustment for smoking habits and alcohol intake during pregnancy, the relative risk of stillbirth decreased slightly. Adjustment for parity, maternal age, marital status, years of education, occupational status, and body mass index did not substantially change the estimates of association. There was no significant association between coffee consumption and death in the first year of life after adjustment for smoking habits during pregnancy. CONCLUSION: Drinking coffee during pregnancy is associated with an increased risk of stillbirth but not with infant death.

Coffee↗

Scottish national survey of tuberculosis notifications 1993 with special reference to the prevalence of HIV seropositivity.

BACKGROUND: The study sought to determine the contribution of HIV seropositivity to the arrest of decline in tuberculosis notifications in Scotland. METHODS: Survey forms relating to each tuberculosis notification in 1993 were completed by the notifying consultant. Voluntary anonymous HIV testing of tuberculosis cases aged under 65 was requested. Age, sex, ethnic status, country of birth, employment status, occupation, previous tuberculosis, contact status, risk factors for HIV infection, HIV serostatus of cases aged under 65, site, radiological extent, and bacteriological status of tuberculous disease were determined. RESULTS: Five hundred and seventy four cases of tuberculosis were originally notified, of which 77 (14%) subsequently proved to be non-tuberculous and were therefore denotified. Of the 497 cases 423 (85%) were white and 58 (12%) were from the Indian subcontinent. Eighty five per cent of patients from the Indian subcontinent were aged < 55 years whereas 64% of white patients were aged > 55 years. Pulmonary disease was found in 74%, non-pulmonary in 22%, and combined disease in 4% of patients. Of 242 HIV tests performed, three were positive and five other HIV positive patients were known, giving an HIV positivity rate of 1.6% of all tuberculosis notifications in 1993. Annual notification rates for Scotland were 9.7 per 10(5) before and 8.7 per 10(5) after exclusion of previously treated cases; rates were 8.4 per 10(5) for the white population and 179 per 10(5) for those from the Indian subcontinent. CONCLUSIONS: The study documents the distribution of tuberculous disease in Scotland by age, sex, site, and ethnic group for the first time. Notification practices, with respect to denotification, need to be improved. Infection with HIV is presently uncommon in cases of tuberculosis in Scotland but continued vigilance is essential.

Adolescent↗

Status of occupational cancer in Lithuania.

Because industrialization in Lithuania started only about 50 years ago, occupational cancer is only now becoming an important issue. This article describes the situation of occupational cancer in Lithuania: research, exposures to carcinogens, regulation, and legal practice. Epidemiologic studies of work-related cancers have shown increased risks among cement, textile, and asbestos-cement workers. In 1997, 28% of employed workers in Lithuania were exposed to carcinogens. A legislation system regulating exposures to carcinogens, harmonized with European Directives, has recently been created. In 1995-2003, there were 5,652 new cases of occupational diseases. However, occupational cancers are seriously underdiagnosed--only one case of cancer was diagnosed as occupational. Establishment of a system that would enable diagnosis, certification, and compensation of cases of occupational neoplasms is essential in Lithuania.

Carcinogens↗

Cognitive processing and its relationship to symptoms and social functioning in schizophrenia.

This study analyses the relationship between contextual processing ability and symptom and social status in schizophrenia. The results showed that current symptom status is related to occupational status, and contextual processing is related to current symptom status and employment history. Current symptom severity in chronic schizophrenics may indicate an increased frequency and/or duration of symptom episodes in the past, and therefore an increase in the periods in which contextual processing was disturbed, which would therefore account for the observed decrease in work achievements.

Adult↗