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PubMed1989

Farm equipment injuries in a rural county, 1980 through 1985: the emergency department as a source of data for prevention.

Incidence rates of injury related to farm machinery were estimated for Athens County, Ohio, using data generated as part of the National Electronic Injury Surveillance System (NEISS) of the Consumer Product Safety Commission. The study period was 1980 through 1985. The service area of the principal hospital in the county, which participates in NEISS, closely approximates the population of the county. The population of the entire county and the rural farm population, based on US Census data, were used as denominators in calculation of rates. There were 147 injuries related to farm machinery over a six-year period, 14 of which were coded as occupational. One hundred twelve (84.2%) of these injury victims were men. The annual incidence rate per 1,000 rural farm resident population was 25.6 per 1,000 for children under the age of 14 years and was 55.6 per 1,000 for adults age 25 to 34 years. Annual rates for adults age 35 and up ranged from 13 to 19 per 1,000 rural farm residents. The annual number of tractor rollover injuries decreased during this study period, while the annual numbers of other tractor injuries did not change. Hospital emergency department visits can be used to document the need for and to evaluate injury prevention measures.

Accidents, Occupational↗
PubMedDate not supplied

[Cancer mortality in the counties of Catalonia (1983-1989)].

OBJECTIVES: To compare mortality among counties (comarques) in Catalonia, Spain for the most frequent malignant tumors. METHODS: Overall mortality data and for five specific tumor sites were analyzed for a five-year period (1983-1989). Crude and site-specific mortality rates were computed. The comparison between counties was adjusted for the 1986 population of Catalonia using the direct method. Comparative mortality ratios (CMR) were obtained for each county with respect to Catalonia. RESULTS: Overall cancer mortality was higher in the Barcelonès for men and in Osona form women. The CMR for men in the Barcelonès was the highest for cancer of the trachea, bronchi and lungs; the CMR in Solsonès was the highest for stomach cancer, while in Cerdanya it was the highest for colorectal cancer. Among women, the highest CMR for cancer of the trachea, bronchi and lungs was in Montsià, whereas for breast cancer it was Baix Empordà, and Alt Urgell for stomach cancer. CONCLUSIONS: Comparative analyses of cancer mortality by county in Catalonia and sex underscores differences in its distribution, allowing the orientation of cancer control policies and research to be developed in each geographical area.

Breast Neoplasms↗
PubMed2003

Historical and current atmospheric deposition to the epilithic lichen Xanthoparmelia in Maricopa County, Arizona.

Spatial patterns of atmospheric deposition of trace elements to an epilithic lichen were assessed using a spatial grid of 28 field sites in 1998 throughout Maricopa County, Arizona, USA. In addition, samples of Xanthoparmelia spp. from Arizona State University lichen herbarium material (1975-1976) was utilized for a limited number of sites in order to explore temporal trends. The lichen material was cleaned, wet digested and analyzed by ICP-MS for a suite of elemental concentrations [antimony (Sb), cadmium (Cd), cerium (Ce), chromium (Cr), cobalt (Co), copper (Cu), dysprosium (Dy), europium (Eu), gadolinium (Gd), gold (Au), holmium (Ho), lead (Pb), lutetium (Lu), neodymium (Nd), nickel (Ni), palladium (Pd), platinum (Pt), praseodymium (Pr), samarium (Sm), scandium (Sc), silver (Ag), terbium (Tb), thulium (Tm), tin (Sn), uranium (U), ytterbium (Yb), yttrium (Y), and zinc (Zn)]. Cluster analysis and principal component analysis suggest three major factors, which, depending on regional aerosol fractionation, explain most of the variation in elemental signatures: (1) a group of widely distributed rare earth elements (2) a highly homogenous Co, Cr, Ni, and Sc component representing the influence of mafic rocks, and (3) anthropogenic emissions. Elemental concentrations in Maricopa County lichens were generally comparable to those reported for relatively unpolluted areas. Only highly urbanized regions, such as the greater Phoenix Metropolitan Area and the NW corner of the county, exhibited elevated concentrations for Zn, Cu, Pb, and Cd. Lead levels in lichens have fallen over the last 30 years by 71%, while Zn concentrations for some regions have increased by as much as 245%. From the spatial pattern of elemental deposition for Cd, Cu, Ni, Pr, Pb, and Cu, we infer that agriculture, mining, industrial activities, and traffic probably are the major air pollutant sources in Maricopa County.

Air Pollutants↗
PubMed2001

Referral to autopsy: effect of antemortem cardiovascular disease: a population-based study in Olmsted County, Minnesota.

PURPOSE: Autopsy studies can provide insight into disease trends and their determinants, including data on the prevalence of atherosclerosis. However, such studies are subject to autopsy bias, which limits their generalizability to the source population. The impact of this bias on autopsy based estimates of time trends in heart disease prevalence is unknown. To report on the trends over time in autopsy rates in Olmsted County, MN, to examine the association between clinical diagnoses of cardiovascular diseases (CVDs) and referral to autopsy and how this association may have changed over time. METHODS: We examined the trends in autopsy rates between 1979 and 1994 in Olmsted County, and the association between antemortem characteristics including cardiovascular diagnoses and autopsy referral. RESULTS: From 1979 to 1994, a total of 9110 residents died in Olmsted County. The average annual autopsy rate was 30%. Autopsy rates declined from 36% in 1979 to 23% in 1994, corresponding to an average decline of 0.6%/year (p < 0.01). Referral to autopsy was positively associated with younger age, male sex, in-hospital place of death, antemortem diagnoses of myocardial infarction (MI) or peripheral vascular disease (PVD), and earlier calendar period. There was no evidence of an interaction between calendar period and any of these predictor variables. Antemortem diagnosis of heart failure was associated with a decrease in the odds of referral to autopsy over time as compared to persons without such diagnosis. CONCLUSIONS: In Olmsted County, autopsy rates, although declining over time, have remained on average approximately 30%. Antemortem diagnoses of MI or PVD are associated with autopsy referral but this association did not change over time. While the greater decline overtime in the use of autopsy observed among decedents with an antemortem diagnosis of congestive heart failure (CHF) deserves further studies, the present findings reduce the concern for bias of time trends in the prevalence of atherosclerosis by changes in the clinical characteristics of decedents referred to autopsy.

Adult↗
PubMed2000

The epidemiology of ovarian cancer: a population-based study in Olmsted County, Minnesota, 1935-1991.

PURPOSE: To determine trends in incidence and survival between 1935 and 1991 and to evaluate risk factors for ovarian cancer among Olmsted County, Minnesota women. METHODS: All newly diagnosed cases of ovarian cancer among Olmsted County women in 1975-1991 were identified using the medical records linkage system of the Rochester Epidemiology Project. In order to assess trends, incidence rates in the subset of Rochester women were compared with Rochester rates for 1935-1974. Survival was evaluated by the Kaplan-Meier product-limit method. A case-control analysis of risk factors compared Olmsted County women with invasive epithelial ovarian cancer and an age-matched group of women from the community by logistic regression. RESULTS: Altogether, 129 Olmsted County women were newly diagnosed with ovarian cancer in 1975-1991. The age-adjusted (to 1970 United States whites) incidence rate was 22.5 per 100,000 person-years. Median survival from initial diagnosis was 3.7 years. Compared to an equal number of controls, the 103 women with invasive epithelial disease were more likely to be nulliparous (odds ratio [OR] 1.9; 95% CI 0.95-3.9) but less likely to have a history of thyroid disease (OR 0.4; 95% CI 0.2-0.8), hypertension (OR 0.4; 95% CI 0.1-0.9) or nonsteroidal estrogen use (OR 0.5; 95% CI 0.2-0.9). Prior hysterectomy (OR 0.5; 95% CI 0.2-0.9) and unilateral oophorectomy (OR 0.2; 95% CI 0.04-0.7) were also associated with reduced risk. CONCLUSION: The incidence of ovarian cancer in this community in 1975-1991 was little changed from rates 20 years earlier. There has been some improvement in survival from ovarian cancer in this population compared to 1935-1974, but still less than 50% survive for 5 years. Prior hysterectomy and unilateral oophorectomy appear protective for ovarian cancer.

Adult↗
PubMed1998

Epidemiology of major trauma and trauma deaths in Los Angeles County.

BACKGROUND: Our objective was to study population-based trauma-related injuries and deaths in the county of Los Angeles and to identify trends and progress towards meeting the "Year 2000 National Health Objectives." STUDY DESIGN: We did a retrospective study for the year 1996. Data were obtained from the Trauma Registry of the Emergency Medical Services of the Department of Health Services, and the Coroner's Department of the County of Los Angeles. Traumatic injuries and deaths per 100,000 of the population were calculated according to mechanism, race, age, and gender. RESULTS: During 1996, there were 12,136 major trauma admissions in the 13 trauma centers in Los Angeles County. Another 1,929 victims died at the scene or were certified dead at nontrauma centers and were taken to the Coroner's Department (total 14,065 victims). The overall major injury rate was 151.0 per 100,000 population and the death rate was 30.9 per 100,000. The trauma death rate per 100,000 population was 56.4 for African-Americans, 33.5 for Hispanics, 26.3 for Caucasians, and 11.6 for Asians. Homicides were the leading cause of traumatic deaths (45.3%) followed by traffic accidents (31.9% of deaths). Firearms were responsible for 3,899 major injuries or deaths (41.7 per 100,000 population). The overall homicide rate per 100,000 population was 14.0, with a much higher rate for African-Americans (40.4 per 100,000) and Hispanics (18.7 per 100,000) than Caucasians (4.0 per 100,000) or Asians (3.4 per 100,000). African-American males were at very high risk for homicide (73.3 per 100,000), and in the age group 15 to 34 years, this problem reaches epidemic proportions (164.2 per 100,000). Traffic accidents accounted for 69.0 major injuries and 9.6 deaths per 100,000 people. Males were at significantly higher risk of dying in traffic accidents than females. People over 60 years of age were at significantly higher risk of traffic-accident death than younger people, for both passenger and pedestrian groups (p < 0.01). Firearm-related suicides were responsible for 4.6 deaths per 100,000 population. Caucasian males over 65 years were at much higher risk of suicide by penetrating trauma (29.5 per 100,000) than were Hispanics (6.3 per 100,000), Asians (5.4 per 100,000), or African-Americans (no deaths) in the same gender and age group. CONCLUSIONS: Trauma remains a major health problem in the county of Los Angeles. Despite the significant reduction of intentional trauma in 1996, it still exceeds national figures and is much higher than the targeted "Year 2000 National Health Objectives." Aggressive prevention strategies need to focus on the population groups at excessive risks of injury by assault, traffic accidents, and suicides.

Accidents, Traffic↗
PubMed1994

Municipal drinking water and cryptosporidiosis among persons with AIDS in Los Angeles County.

To assess unfiltered drinking water as a source of cryptosporidium infection in patients with the acquired immunodeficiency syndrome (AIDS) the prevalence of cryptosporidiosis among persons with AIDS in Los Angeles County was assessed by water service area. One water distributor, serving approximately 60% of the county's residents (area B), has consistently employed filtration. The other company, which serves the remainder of the county (area A), did not institute filtration until mid-December 1986. This difference provided a 'natural experiment' in which to assess the effect of municipal water filtration on the level of cryptosporidiosis among persons with AIDS. The prevalence of cryptosporidiosis among AIDS patients was compared for the two water service areas for the time period (1983-6) preceding the implementation of filtration in area A. From 1983 to 1986 the age-standardized prevalence of cryptosporidiosis among AIDS patients was 32% lower in area A (4.2%), which received unfiltered water, than in area B (6.2%). Following addition of filtration in area A, the prevalence of cryptosporidiosis among AIDS patients decreased by 20%; however, a decline, of 47%, was also observed in area B. The similar baseline levels of cryptosporidiosis and the corresponding post-filtration decline in both areas suggest that filtration had no effect on levels of cryptosporidiosis among persons with AIDS. Thus it does not appear that municipal drinking water is an important risk factor for cryptosporidiosis in AIDS patients residing in Los Angeles County.

AIDS-Related Opportunistic Infections↗
PubMed1997

Sociodemographic characteristics of severely mentally ill clients in rural and urban counties.

Sociodemographic differences between rural and urban clients with severe mental illness (SMI) are explored using approaches which extend research in this area beyond limitations found in the few existing studies. Sixteen hundred adult clients from 18 Wisconsin counties are classified according to the degree of rurality of their counties of residence, using two definitions: a dichotomous metropolitan-non-metropolitan grouping and population density. There are significant differences between rural and urban clients for age, gender, and marital status, but not education or income. Young (18-35 years), unmarried males are more likely to live in more densely populated counties. Older (65 and older) women who are currently or previously married are more likely to live in less densely populated counties.

Adolescent↗
PubMed2004

Habitat-related variation in infestation of lizards and rodents with Ixodes ticks in dense woodlands in Mendocino County, California.

During the spring and early summer of 2002, we examined the relative importance of Borrelia-refractory lizards (Sceloporus occidentalis, Elgaria spp.) versus potential Borrelia burgdorferi sensu lato (s.l.)-reservoirs (rodents) as hosts for Ixodes pacificus immatures in 14 woodland areas (six oak, five mixed oak/Douglas fir, and three redwood/tanoak areas) distributed throughout Mendocino County, California. Lizards were estimated to serve as hosts for 93-98% of all larvae and > or =99.6% of all nymphs infesting lizards or rodents in oak woodlands and oak/Douglas fir sites in the southern part of the county. In redwood/tanoak woodlands and oak/Douglas fir sites in northern Mendocino County, the contribution of rodents to larval feedings reached 36-69% but lizards still accounted for 94-100% of nymphal bloodmeals. From late April to mid-June, I. pacificus larvae were recovered from 95 to 96% of lizards and dusky-footed woodrats (Neotoma fuscipes) and from 59% of Peromyscus spp. mice. In contrast, 99% of lizards but few woodrats (15%) and none of the mice were infested by nymphs. Comparisons of tick loads for 19 lizard-Peromyscus spp. mouse pairings, where the lizard and mouse were captured within 10m of each other, revealed that the lizards harbored 36 times more larvae and >190 times more nymphs than the mice. In oak woodlands, loads of I. pacificus larvae decreased from late April/early May to late June for S. occidentalis lizards but increased for Peromyscus spp. mice. We conclude that the relative utilization of Borrelia-refractory lizards, as compared to rodents, by I. pacificus larvae was far higher in dry oak woodlands than in moister habitats such as redwood/tanoak and oak/Douglas fir woodlands in northern Mendocino County. Non-lizard-infesting potential enzootic vectors of B. burgdorferi s.l. (I. angustus and I. spinipalpis) were recorded from rodents in three of six oak woodland areas, two of five oak/Douglas fir woodland areas, and two of three redwood/tanoak woodland areas.

Animals↗
PubMed2000

Perinatal deaths in a Norwegian county 1986-96 classified by the Nordic-Baltic perinatal classification: geographical contrasts as a basis for quality assessment.

BACKGROUND: Quality assessment of perinatal care can be carried out by classifying perinatal deaths. In the following we have analyzed the geographical contrasts in perinatal deaths according to the Nordic-Baltic perinatal death classification in a sparsely populated Norwegian county. MATERIAL AND METHODS: All stillbirths (> or =28 weeks of gestation) and neonatal deaths (gestational age > or =22 weeks; death < or =28 days) in 1986-96 from Nordland county (240,000 inhabitants) were classified. For comparison the county was geographically divided into six general local hospital areas and one central hospital area. RESULTS: The classification showed a well acceptable inter and intra observer variation. One hundred and seventy-one stillbirths and 155 neonatal deaths were analyzed. The death rate (pr 1,000 births) for single, non-malformed, antenatal stillbirths was higher in the central hospital area than in the local hospital areas (3.22 vs. 2.02). The death rate for extreme preterm infants (22-27 weeks of gestation) was on the other hand higher in the local hospital areas (2.45 vs. 1.05). One of the general local hospital areas was singled out with an especially high neonatal death rate among extreme preterm infants. This was to some extent explained by the death of extreme preterm twins and triplets. CONCLUSION: The Nordic-Baltic perinatal death classification system is a consistent and reproducible tool also for studying perinatal death in restricted geographical areas. The observed contrasts in perinatal deaths were used as basis for programs aimed at improving perinatal care. The observation of an unexplained increased number of antenatal stillbirths in the central hospital area resulted in a program for prospective recording and better characterization of the placenta and umbilical cord. Proposals for a better antenatal program preventing extreme preterm birth of twins for the whole county has been launched. In utero transfer to a hospital with a neonatal intensive care unit seems crucial in improving the prognosis for these infants.

Age Factors↗
PubMed1991

Cancers of the prostate and breast among Japanese and white immigrants in Los Angeles County.

Using age-adjusted incidence rates and proportional incidence ratios, the risks of prostate cancer and breast cancer in three racial/ethnic groups - Spanish-surnamed whites, other whites and Japanese - were studied in Los Angeles County native residents and compared with those in immigrants and representative 'homeland' populations. An algorithm based on social security numbers was developed and utilised to estimate age at immigration for non-US-born Los Angeles County cancer patients. For prostate cancer, the incidence rates in Los Angeles County were much higher than those in the homelands for each racial/ethnic group. However, prostate cancer rates of immigrants were similar to those of US-born patients in the Spanish-surnamed white and Japanese populations, regardless of age at immigration. For breast cancer, the incidence rates in Los Angeles County were also high compared with those in the homelands. However, the timing of immigration to the US was important in determining breast cancer risk. When social security numbers indicated that migration occurred later in life, rates for breast cancer were substantially lower than when migration occurred early, although they were still much higher than in the homeland populations. These findings suggest that environmental factors in early life rather than in later life are important in the etiology of breast cancer and that later life events can substantially impact the likelihood of developing clinically detectable prostate cancer.

Age Factors↗
PubMedDate not supplied

HIV prevention outreach in black communities of three rural north Florida counties.

Literature to guide HIV prevention outreach for southeastern rural blacks is limited despite the increasing prevalence of HIV infection in this population. Three men and one woman conducted HIV prevention outreach in three north Florida rural counties in teams of two. The workers received five days of training in additional homework assignments. The workers used HIV/AIDS outreach surveys to guide their 10- to 15-minute outreach visits. Five hundred seventy-four outreach contacts with blacks were made between January and June 2001 (329 in County 1, 176 in County 2, and 69 in County 3) with 347 women and 227 men. Eighty-four percent of the persons contacted accepted literature, 47.5% accepted male condoms, and 31.9% accepted female condoms. More women (99.4%) were knowledgeable about HIV/AIDS than men (92.5%), and they reported taking precautions against infection more often than men (98% vs. 90.3%). Many blacks in rural north Florida were receptive to an HIV prevention outreach program that provided information, literature, and condoms on the street and in homes. These findings suggest that HIV prevention outreach should be expanded to reach more rural blacks, who are increasingly at risk for HIV infection.

Adolescent↗
PubMed2006

Changes in the prevalence of pre-eclampsia in Akershus County and the rest of Norway during the past 35 years.

BACKGROUND: Pre-eclampsia, the etiology of which is unknown, is an important cause of maternal morbidity and mortality. In Norway there has been a substantial change in lifestyle since 1970. Akershus is a growing urban county. The aim of this study was to identify changes in the prevalence of pre-eclampsia in Akershus County and the rest of Norway during the past 35 years. METHODS: The study is population-based and retrospective. Deliveries are registered per inhabitant and pre-eclampsia per delivery. Prevalence and prevalence ratios are calculated with 95% confidence intervals. Poisson regression analysis is used for assessment of trends. RESULTS: The frequency of deliveries declined from 1.9% to 1.4% for Akershus County and from 1.7% to 1.3% in the rest of Norway. The prevalence of pre-eclampsia increased from 3.1% to 3.7% for Akershus County and from 3.3% to 4.5% in the rest of Norway. CONCLUSIONS: The increase in the prevalence of pre-eclampsia and the difference between Akershus and the rest of Norway are not likely to be explained by changes in genetic material. Altered registration routines throughout Norway since 1998 may influence the observations, and better registration routines may contribute to the observed lower prevalence in Akershus. Changes in lifestyle factors most likely explain the overall increase in the prevalence of pre-eclampsia.

Adult↗
PubMedDate not supplied

Gastric cancer in New Mexico counties with significant deposits of uranium.

Several counties in northern New Mexico display high rates of mortality from gastric cancer. Significant differences in sex-specific, age-adjusted, average annual stomach cancer mortality rates among whites from 1970-1979 were found between counties with significant deposits of uranium compared to those without significant deposits. These results remained unchanged when either socioeconomic status or Hispanic ethnicity were considered. Additional research needs to consider individual characteristics and competing risk factors for individuals with gastric cancer in these counties. A working hypothesis is that residents of counties with significant deposits of uranium are exposed to higher-than-average environmental levels of radionuclides such as radon and radon daughters, or to trace elements such as arsenic, cadmium, selenium, and lead which are commonly found in areas with uranium deposits.

Environmental Exposure↗
PubMedDate not supplied

Breast cancer risk and residence near industry or traffic in Nassau and Suffolk Counties, Long Island, New York.

A case-control interview study was used to evaluate the relationship between breast cancer risk and residential proximity to industrial facilities and traffic for pre- and postmenopausal women in Nassau and Suffolk Counties on Long Island, New York. A geographic information system was used to assign industry and traffic counts to 1-km2 grid cells (5-kM2 grid cells for traffic) and to assign potential exposure values to study subjects, based on 20-y residential histories. A significantly elevated risk of breast cancer was observed among postmenopausal subjects who were ever potentially exposed to chemical facilities (Nassau County adjusted odds ratio [OR] = 1.61, 95% confidence interval [95% CI] = 1.06-2.43; Suffolk County adjusted OR = 1.58, 95% CI = 0.71-3.51. This elevated risk, however, was not observed among premenopausal subjects. Risk increased for post-menopausal subjects as number of chemical facilities increased from one (adjusted OR = 1.45, 95% CI = 0.93-2.25) to two or more (adjusted OR = 3.47, 95% CI = 1.06-11.38). Crude and adjusted ORs for high traffic density were elevated among Nassau--but not Suffolk--county subjects and were not significant statistically.

Adult↗
PubMedDate not supplied

An assessment of the tumorigenic properties of a Hudson County soil sample heavily contaminated with hexavalent chromium.

During much of this century, Hudson County, New Jersey, was a major center for the processing of chromium ore. Some of the residue from this processing was used in landfills and in construction materials throughout the county and, in some cases, in highly populated areas. Given that it is widely accepted that exposure to hexavalent chromium compounds poses a risk for the development of respiratory-tract cancer, concerns were raised that individuals who worked or resided in chromium-contaminated areas might be at increased risk for the development of respiratory cancer. To address these concerns, we evaluated a Hudson County soil sample-heavily contaminated with chromium ore residue (Cr(+6) concentration at 5 895 mg/kg)-with respect to its carcinogenic potential to the respiratory tract of Sprague-Dawley rats. Groups of animals were given repeated intratracheal exposures to one of four materials: (1) Hudson County chromium-contaminated soil (CCS), (2) CCS augmented with calcium chromate (CaCrO4), (3) CaCrO4 alone, or (4) control soil. Nominal total doses of Cr(+6) for each respective group were 324 microg/kg, 7,975 microg/kg, 8,700 microg/kg, and 0.02 microg/kg. Incidences of malignant tumors and nephritis were not elevated in any group. Four primary lung tumors appeared in animals that received CCS + CaCrO4, and one primary lung tumor appeared in the group treated with CaCrO4 alone. These incidences were not significant statistically, but the rare spontaneous occurrence of these tumors in Sprague-Dawley rats suggested that they were treatment related. No primary lung tumors appeared in the control or CCS-treated groups.

Animals↗
PubMedDate not supplied

Correlation analysis of pesticide use data and cancer incidence rates in California counties.

California, the leading agricultural state in the United States, has maintained a population-based cancer registry since 1988, and it also maintains a comprehensive, state-wide pesticide reporting system. Data on cancer incidence and pesticide use reporting are available, by county, for all 58 counties in California. Average annual age-adjusted cancer incidence rates (1988-1992), on a county-, sex-, and race/ethnicity-specific basis, were obtained from the California Cancer Registry (CCR), which maintains the population-based cancer registry throughout California. Pesticide use data (i.e., pounds of active ingredient applied annually in each county) were obtained from the California Department of Pesticide Regulation for 1993. Investigators used Pearson product-moment correlation coefficients (r) to correlate age-adjusted incidence rates for selected cancers with the use data for selected pesticides. For most sex- and race/ethnicity-specific groups, the correlation coefficients were very close to zero or negative in sign, indicating no correlation between pesticide use and cancer incidence. There were, however, several exceptions, particularly in Hispanic males for whom the following correlations were observed: leukemia and atrazine (r=.40), leukemia and 2,4-dichlorophenoxyacetic acid (r=.41), leukemia and captan (r=.46), atrazine and brain cancer (r=.54), and atrazine and testicular cancer (r=.41). For black males, we observed the following: atrazine and prostate cancer (r=.67) and Captan and prostate cancer (r=.49). In females, only a few of the correlations were elevated. Although most of the correlations examined in this analysis were not elevated, several of those in the Hispanic and black male populations were. These segments of the population have traditionally been employed as farm workers in California and have had the greatest potential for exposure to pesticides. This was an ecological study for which no data about exposure to pesticides at the individual level were available for analysis. In addition, no latency period was allowed between potential exposure and diagnosis with cancer. However, the results obtained in two minority groups who represented the majority of farm workers in the fields suggested that additional research studies, in which more rigorous study designs are used, should be conducted in those groups.

Age Distribution↗
PubMedDate not supplied

Coccidioidomycosis in Tulare County, California, 1991: reemergence of an endemic disease.

In 1991, 1208 cases of coccidioidomycosis were reported to the California Department of Health Services, compared with an annual average of 450 during 1986-90. We conducted a study in Tulare County to define the epidemiology of the disease and identify risk factors for severe disease, focusing on the epidemic period September 1991-December 1991. To identify cases, we used data from the Coccidioidomycosis Serology Laboratory at the University of California, Davis, other laboratories, and the Tulare County Health Department's coccidioidomycosis reporting system. We compared patients who were hospitalized with those who were not to determine risk factors for severe disease. We identified 128 cases of acute coccidioidomycosis diagnosed between 1 September and 31 December 1991 (attack rate 41/100,000); south central Tulare County had the highest attack rate. Thirty-five (27%) case-patients were hospitalized. Male sex (relative risk (RR) 2.5, 95% confidence interval (CI) 1.2-5.0), black people and Asian races (RR 4.8, 95% CI 2.4-9.6), and age > or = 20 years (RR 8.3, 95% CI 1.2-57.4) were univariately significant and remained independently associated with hospitalization in multivariate analysis. The 1991 Tulare County outbreak of coccidioidomycosis was part of a much larger outbreak that began in California during 1991 and continued through 1993. The outbreak was preceded by an unusually rainy spring. Although dust reduction measures during times of increased coccidioidomycosis incidence can help reduce exposure, definitive control awaits the development of a safe, effective vaccine.

Adult↗