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PubMed1976

Five-year mortality in the city of Bergen, Norway, according to age, sex and blood pressure.

The City of Bergen was covered by a Mass Miniature Radiology Survey in 1963-64. On the initiative of the University of Bergen, examinations of BP were included. The initial survey has been reported previously (1). This analysis concerns the relationship between the 5 1/4-year cause-specific mortality and BP. Non-attenders have excess mortality in relation to attenders and this is mostly explained by a generally high mortality among bedridden people. The age-specific total mortality shows a clear pattern of a general increase with increasing BP. At high systolic BP levels, the 5-year mortality is independent of whether the age is 45 or 75. The systolic age-adjusted curve for males increases quite linearly, while the diastolic curve is more U-shaped. Thus, when comparing the predictive power of BP, allowance must be made for this fact. Using a second order polynomial prediction function, this conclusion is reversed. The mortality from cerebral stroke shows a dramatic increase with increasing BP. The diastolic curve shows a bend-off for high values, above 110 mmHg. This may be due to the offer of treatment which such patients received after the screening. Also the CHD mortality curve flattens for high BP values, especially for diastolic BP.

Adolescent↗
PubMed2004

Anemia and its treatment and outcomes in persons infected with human immunodeficiency virus.

BACKGROUND: Anemia is a common comorbidity with HIV. Before the highly active antiretroviral therapy (HAART) era, anemia was found to be associated with decreased survival. This study examined the prevalence of anemia since HAART's availability and the associations between anemia treatments and survival. STUDY DESIGN AND METHODS: Anemia prevalence in a cohort of HIV-infected persons was described. In a smaller cohort of HIV-infected anemic patients, survival was modeled with a time-dependent proportional hazards regression model adjusting for CD4+ T-lymphocyte count, plasma HIV RNA concentration load, hemoglobin (Hb) level, and other factors. RESULTS: Anemia (Hb level < 10.5 g/dL, or physician diagnosis) decreased from 13 to 5 percent (p < 0.05) in 1996 through 2001. Anemia prevalence was highest (24-35%) and did not decrease among patients with CD4 count less than 100 cells per mL. In total, 216 severely anemic HIV-infected individuals (mean Hb level, 8.1 g/dL) followed for a median of 13 months had a 37-percent mortality rate. Of these, 22 percent were untreated (13% mortality rate), 42 percent received transfusion alone (52% mortality), 12 percent received epoetin alfa alone (19% mortality), and 24 percent received both (47% mortality). Transfusion was associated with a threefold excess mortality risk, but epoetin alfa prescription was not associated with mortality. CONCLUSION: The prevalence of anemia decreased in the HAART era, and transfusion was positively associated with risk of death, suggesting limiting use of transfusions in nonemergency situations.

Adolescent↗
PubMed1985

Recent rise in supposedly stress dependent causes of death in psychiatric hospitals in Norway indicating increased "stress" in hospitals?

The present study comprises all deaths in Norwegian psychiatric hospitals in 1950-74 with the diagnosis of non-organic (functional) psychosis: 5106 deaths. Mortality declined in both sexes as did excess mortality which is now 1.7 times the general population in the male, and 2.3 times in the female sex. However, a significant rise in unnatural deaths (suicides and accidents) took place in both sexes during 1963-74, as mortality increased 2-3 times in comparison with 1950-62. This rise in unnatural deaths is probably directly related to the introduction of drug therapy, which created an increased need for protection of the hospital population. A challenge which the accompanying changes in the hospital environment have failed to meet. Cardio-vascular mortality increased considerably during 1963-74 in both sexes. The rise is most likely the combined result of an adverse effect of drug therapy in individual patients (obesity, physical inactivity, increased smoking habits), the reduced stress-relieving effect of hospitalisation through shorter stays in hospital and the liberalization policy. We may not yet have experienced the total adverse effect on mortality of the increase in behavioural risk factors in psychiatric patients. It is suggested that future mortality studies include psychiatric out-patients.

Adult↗
PubMed2006

Life expectancy benefits of gastric bypass surgery.

Bariatric surgery is the most effective treatment for achieving sustained weight loss in morbidly obese patients. Although the use of gastric bypass is growing rapidly, the potential life expectancy benefits of the procedure are unknown. We created a Markov decision analysis model to examine the effect of gastric bypass surgery on life expectancy in morbidly obese patients (body mass index [BMI] = 40 kg/m2). Input assumptions for the model were obtained from published life tables (baseline mortality risks), epidemiologic studies (obesity-related excess mortality), and large case series (surgical outcomes). In our baseline analysis, a 40-year-old woman (BMI = 40 kg/m2) would gain 2.6 years of life expectancy by undergoing gastric bypass (38.7 years versus 36.2 years without surgery). In sensitivity analysis, life-years gained with surgery remained substantial when assumptions were varied across reasonable ranges for surgical mortality risk (1.0-3.0 years) and effectiveness (0.9-4.4 years). Life-years gained with gastric bypass surgery did not vary considerably by age and sex subgroups. Relative to other major surgical procedures, gastric bypass for morbid obesity is associated with substantial gains in life expectancy. Long- term data from prospective studies are needed to confirm this finding.

Adult↗
PubMed2005

Homocysteine levels in acromegaly patients.

Acromegaly is associated with a two to three-fold increase in mortality related predominantly to cardiovascular disease. The excess mortality is associated most closely with higher levels of growth hormone (GH). Survival in acromegaly may be normalized to a control age-matched rate by controlling GH levels; in particular, GH levels less than 2.5 ng/mL are associated with survival rates equal to those of the general population. Hyperhomocysteinemia has also been recognized as a risk factor for cardiovascular disease, yet there are limited data on the prevalence of hyperhomocysteinemia in patients with acromegaly. Eighteen acromegaly patients (7 male, 11 female, mean age 42.8 +/- 11.0 years) in our endocrine clinic consented to having the following tests performed: complete blood count (CBC), thyroid hormones, folic acid, vitamin B12, plasma homocysteine levels, uric acid, fibrinogen, CRP, fasting glucose, insulin, C-peptide, total serum cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, GH, insulin-like growth factor-1 (IGF-1) and GH levels after an oral glucose tolerance test (OGTT). By history, fourteen had macroadenomas and four had microadenomas; eight had hypertension; two had glucose intolerance, and four had diabetes. Fifteen had had transsphenoidal or transfrontal surgery: two had been cured, but 13 others were taking long-acting octreotide. Five patients had undergone radiotherapy and the acromegaly in two was treated primarily with long-acting octreotide. CBC, thyroid hormone, folic acid, and vit B12 levels were normal in all patients. We divided the patients into two groups according to mean GH levels after an OGTT: Group 1 (GH<2.5 ng/mL, n=10), and Group 2 (GH<2.5 ng/mL, n=8). Comparison of the two groups using Mann-Whitney U testing revealed statistically significant lower levels in Group 1 of the following parameters: GH (1.91 +/- 0.90 vs. 8.58 +/- 5.55 ng/mL, p=0.002), IGF-1 (338.30 +/- 217.90 vs. 509.60 +/- 293.58 ng/dL, p=0.06), GH after an OGTT (1.42 +/- 0.81 vs. 9.01 +/- 4.53 ng/mL, p=0.001), plasma homocysteine (12.85 +/- 4.47 vs. 18.20 +/- 4.99 micromol/L, p=0.05), total cholesterol (164.0 +/- 20.81 vs. 188.0 +/- 22.26 mg/dL, p=0.05) and LDL cholesterol (81.0 +/- 9.64 vs. 116.70 +/- 13.03 mg/dl, p=0.01). Differences between the other parameters were not significantly different. Acromegaly patients with high GH levels after an OGTT have much higher levels of homocysteine than patients with lower GH levels. The role of elevated homocysteine levels as an independent cardiovascular risk factor in the mortality of acromegaly patients should be determined in future studies.

Acromegaly↗
PubMed1985

Actuarial contributions to life table analysis.

The correct principles for the construction of life tables and more particularly select life tables were developed by actuaries in England in the first half of the 19th century. Actuaries explored the phenomenon of selection not only between the insured and annuitants but also in the general population, distinguishing among initial temporary selection, antiselection, and class selection. The conclusion was reached early that no such thing as an unselected population exists. Group life insurance experience among the actively employed has been shown to provide a more appropriate standard of expected mortality than general population death rates in studies of medical impairments and occupational hazards at ages under 65 years. Mortality rates derived from the Cancer Prevention Study can serve as a useful standard of expected mortality when the objective is determination of excess mortality compared with ostensibly healthy persons at ages 65 years and older.

Actuarial Analysis↗
PubMed1980

Dust exposure and mortality in chrysotile mining, 1910-75.

We report a further follow-up of a birth cohort of 11 379 workers exposed to chrysotile. The cohort consisted of 10 939 men and 440 women, born 1891-1920, who had worked for at least a month in the mines and mills of Asbestos and Thetford Mines in Quebec. For all subjects, length of service and estimates of accumulated dust exposure were obtained, with a smoking history for the vast majority. Three methods of analysis, two based on the "man-years" methods, the other a "case-and-multiple-controls" approach, gave results consistent with one another and with previous analyses. By the end of 1975, 4463 men and 84 women had died. Among men, the overall excess mortality, 1926-75 was 2% at Asbestos and 10% at Thetford Mines, much the dustier region. The women, mostly employed at Asbestos, had a standardised mortality ratio (SMR) all causes, 1936-75) of 0.90. Analysis of deaths 20 years or more after first employment showed that in men with short service (less than five years) there was no discernible correlation with dust exposure. Among men employed at least 20 years, there were clear excesses in those exposed to the heaviest dust concentrations. Reanalysis in terms of exposure to age 45 showed definite and consistent trends for SMRs for total mortality, for lung cancer, and for pneumoconiosis to be higher the heavier the exposure. The response to increasing dose was effectively linear for lung cancer and for pneumoconiosis. Lung cancer deaths occurred in non-smokers, and showed a greater increase of incidence with increasing exposure than did lung cancer in smokers, but there was insufficient evidence to distinguish between multiplicative and additive risk models. There were no excess deaths from laryngeal cancer, but a clear association with smoking. Ten men and one woman died from pleural mesothelioma. If the only subjects studied had been the 1904 men with at least 20 years' employment in the lower dust concentrations, averaging 6.6 million particles per cubic foot (or about 20 fibres/cc), excess mortality would not have been considered statistically significant, except for pneumoconiosis. The inability of such a large epidemiological survey to detect increased risk at what, today, are considered unacceptable dust concentrations, and the consequent importance of exposure-response models are therefore emphasised.

Accidents↗
PubMed2004

Preoperative delta-MELD score does not independently predict mortality after liver transplantation.

Changes in model for end-stage liver disease (MELD) score of > or = 5 points over 30 days (delta-MELD) is an independent predictor for death in patients awaiting liver transplantation. The aim of the current study was to determine if a positive change in MELD score occurring over the 30 days immediately prior to liver transplantation was predictive of posttransplant mortality. MELD scores from the day of transplantation and 30 days prior to transplantation were calculated for 1510 UNOS patients and used to compute a delta-MELD score. Multivariate modeling determined predictors of posttransplant mortality. Patients with a preoperative delta-MELD > or = 5 had higher absolute MELD scores at transplant, shorter mean posttransplant survival and higher mortality. However, multivariate analysis showed that none of the excess mortality was attributable to the high delta-MELD score (p = 0.43 for delta-MELD > or = 5) and the majority of the excess risk was attributable to absolute MELD score (p < 0.001) at the time of transplantation. Mortality of patients with rapidly worsening chronic liver disease who undergo transplantation depends substantially on absolute MELD score at the time of transplantation but not the rate of change immediately preceding transplant. Allocation policymakers should consider that a high delta-MELD in the immediate pretransplant period does not indicate greater posttransplant mortality.

Female↗
PubMed2002

Surveillance for influenza--United States, 1997-98, 1998-99, and 1999-00 seasons.

PROBLEM/CONDITION: In the United States, influenza epidemics occur nearly every winter and are responsible for substantial morbidity and mortality, including an average of approximately 114,000 hospitalizations and 20,000 deaths/year. REPORTING PERIOD: This report summarizes both actively and passively collected U.S. influenza surveillance data from October 1997 through September 2000. DESCRIPTION OF SYSTEM: During each October-May in the period covered, CDC received weekly reports from 1) approximately 120 World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories in the United States regarding influenza virus isolations; 2) approximately 230, 375, and 430 sentinel physicians during 1997-98, 1998-99, and 1999-00, respectively, regarding their total number of patient visits and the number of visits for influenza-like illness (ILI); and 3) state and territorial epidemiologists regarding estimates of local influenza activity. WHO collaborating laboratories also submitted influenza isolates to CDC for antigenic analysis. Throughout the year, the vital statistics offices in 122 cities reported weekly on deaths related to pneumonia and influenza (P&I). RESULTS: During the 1997-98 influenza season, influenza A(H3N2) was the most frequently isolated influenza virus type/subtype. Influenza A(H1N1) and B viruses were reported infrequently. The proportion of respiratory specimens testing positive for influenza peaked at 28% in late January. The longest period of sustained excess mortality (when the percentage of deaths attributed to P&I exceeded the epidemic threshold) was 10 consecutive weeks. P&I mortality peaked at 9.8% in January. Visits for ILI to sentinel physicians exceeded baseline levels for 7 weeks and peaked at 5% in mid-January through early February. A total of 45 state epidemiologists reported regional or widespread activity at the peak of the season. During the 1998-99 season, influenza A(H3N2) viruses predominated; however, influenza B viruses were also identified throughout the United States. Influenza A(H1N1) viruses were identified rarely. The proportion of respiratory specimens testing positive for influenza peaked at 28% in early February. P&I mortality exceeded the epidemic threshold for 12 consecutive weeks and peaked at 9.7% in early March. Visits for ILI to sentinel physicians exceeded baseline levels for 7 weeks and peaked at 5% in early through mid-February. Forty-three state epidemiologists reported regional or widespread activity at the peak of the season. During the 1999-00 season, influenza A(H3N2) viruses predominated, but influenza A(H1N1) and B viruses also were identified. The proportion of respiratory specimens testing positive for influenza peaked at 31% in mid- to late December. The proportion of deaths attributed to P&I exceeded the epidemic threshold for 13 consecutive weeks and peaked at 11.2% in mid-January. Visits to sentinel physicians for ILI exceeded baseline levels 4 consecutive weeks and peaked at 6% in late December. Forty-four state epidemiologists reported regional or widespread activity at the peak of the season. INTERPRETATION: Influenza A(H1N1), A(H3N2), and B viruses circulated during 1997-2000, but influenza A(H3N2) was the most frequently reported virus type/subtype during all three seasons. Influenza A(H3N2) is the virus type/subtype most frequently associated with excess P&I mortality. Influenza activity during all three seasons occurred at moderate to severe levels, and excess P&I mortality was reported during > or = 10 weeks each year. PUBLIC HEALTH ACTIONS: CDC conducts active national surveillance during each October-May to detect the emergence and spread of influenza virus variants and to monitor influenza-related morbidity and mortality. Surveillance data are provided weekly throughout the influenza season to public health officials, WHO, and health-care providers and are used to guide vaccine strain selection, prevention and control activities, and patient care. Influenza vaccination is the most effective means for reducing the yearly effect of influenza. Typically, one or two of the influenza vaccine component viruses are updated each year so that vaccine strains will closely match circulating viruses. Surveillance data will continue to be used to select vaccine strains and to monitor the match between vaccine strains and the currently circulating viruses.

Disease Outbreaks↗
PubMed2004

Mortality following blood culture in premature infants: increased with Gram-negative bacteremia and candidemia, but not Gram-positive bacteremia.

OBJECTIVE: To describe survival following nosocomial bloodstream infections and quantify excess mortality associated with positive blood culture. STUDY DESIGN: Multicenter cohort study of premature infants. RESULTS: First blood culture was negative for 4648/5497 (78%) of the neonates--390/4648 (8%) died prior to discharge. Mortality prior to discharge was 19% in the 161 infants with Gram-negative rod (GNR) bacteremia, 8% in the 854 neonates with coagulase negative staphylococcus (CONS), 6% in the 169 infants infected with other Gram-positive bacteria (GP-o), and 26% in the 115 neonates with candidemia. The excess 7-day mortality was 0% for Gram-positive organisms and 83% for GNR bacteremia and candidemia. Using negative blood culture as referent, GNR [hazard ratio (HR)=2.61] and candidemia (HR=2.27) were associated with increased mortality; CONS (HR=1.08) and GP-o (HR=0.97) were not. CONCLUSIONS: Nosocomial GNR bacteremia and candidemia were associated with increased mortality but Gram-positive bacteremia was not.

Bacteremia↗
PubMed2005

Mortality in childhood-onset type 1 diabetes: a population-based study.

OBJECTIVE: To describe the age- and sex-specific mortality in a cohort of young type 1 diabetic patients and to analyze the causes of death with special focus on suicide, accidents, and unexplained deaths. RESEARCH DESIGN AND METHODS: A population-based incident childhood diabetes register, covering onset cases since 1 July 1977, was linked to the Swedish Cause of Death Register up to 31 December 2000. The official Swedish population register was used to calculate age- and sex-standardized mortality rates (SMRs), excluding neonatal deaths. To analyze excess risks for specific diagnoses, case subjects were compared with five nondiabetic control subjects, matched by age, sex, and year of death. Death certificates were collected for all case and control subjects. For case subjects with an unclear diagnosis, hospital records and/or forensic autopsy reports were obtained. RESULTS: Mean age- and sex-SMR was 2.15 (95% CI 1.70-2.68) and tended to be higher among females (2.65 vs. 1.93, P = 0.045). Mean age at death was 15.2 years (range 1.2-27.3) and mean duration 8.2 years (0-20.7). Twenty-three deaths were clearly related to diabetes; 20 died of diabetic ketoacidosis. Only two case subjects died with late diabetes complications (acute coronary infarction). Thirty-three case subjects died with a diagnosis not directly related to diabetes; 7 of them committed suicide, and 14 died from accidents. There was no significant difference in traffic accidents (odds ratio 1.02 [95% CI 0.40-2.37]). Obvious suicide tended to be increased but not statistically significantly so (1.55 [0.54-3.89]). Seventeen diabetic case subjects were found deceased in bed without any cause of death found at forensic autopsy. Only two of the control subjects died of similar unexplained deaths. CONCLUSIONS: In a well-developed health care system, there is still a significant excess mortality in young type 1 diabetic patients. We confirm a very large proportion of unexplained deaths in bed, which should be further studied. There is no clear excess death rate caused by suicide or traffic accidents among young diabetic subjects.

Accidents↗
PubMed1997

Mortality analysis of complete right and left bundle branch block in a selected community population.

A twenty year follow up of a selected, community population with complete right and left bundle branch block is reviewed by comparative mortality analysis. In this population, where cases and controls were free of hypertension and heart disease at entry, the presence of complete right bundle branch block does not have excess mortality. Complete left bundle branch block exhibits excess total and cardiac mortality.

Adult↗
PubMed1980

Health risks associated with residence near a primary copper smelter: a preliminary report.

Mortality for three groups of ICD codes covering acute, chronic, and malignant respiratory diseases were studied for adult white women in communities near or adjacent to primary copper smelting facilities in the United States between 1968 and 1975, a period when women had not as yet entered the industrial work force. A previous comprehensive survey, sponsored by the EPA, of all U.S. counties used multiple regression analysis as a method of statistical surveillance to assess the association of mortality with industrial activity. This preliminary study suggested an excess mortality from nonmalignant respiratory diseases in copper mining and smelting counties. We directly examined town mortality rates for white female residents, aged 35 to 74, in eight U.S. copper smelting communities and compared them to demographically and geographically matched communities without industries likely to produce significant air pollution, using death certificates obtained from state sources. Site-specific air quality data were also obtained for these communities. Our direct examination of community death rates for copper smelting towns confirmed the preliminary observation at the county level of an excess risk from acute respiratory diseases but did not detect evidence of an elevated mortality from chronic respiratory diseases or cancer of the respiratory tract.

Adolescent↗
PubMedDate not supplied

Burden of mortality and morbidity from dementia.

The purpose of this study was to estimate severity-specific mortality and to quantify the global health burden of dementia by assessing the time spent disabled with dementia and the life years lost due to dementia. We used mortality data from the Rotterdam study, a population-based prospective study in the 55+-year age range to calculate overall and severity-specific excess mortality for the demented. Lost life years were calculated by decomposing the (mixed) Dutch life table of 1990-1992 in two populations, the demented and the healthy, using prevalence and excess (all cause) mortality. Healthy life loss was calculated by a modified Sullivan technique, weighting for disease severity. Our results indicated that mortality was increased in the demented, in all age, sex, and severity groups. Mortality rate ratios were 2.1 (men) and 2.3 (women), with ranges of 1.7-3.4 (men) and 2.0-3.1 (women), depending on severity. Fifty-five-year-old men lose 1.2 life years due to morbidity and mortality and 0.7 life years due to mortality resulting from dementia. Women lose 3.1 and 1.9 life years, respectively. This population-based study provides evidence that mortality is increased in the demented at all stages, including minimal dementia. The quantified health impact on the general population is in the same order as that of lung cancer or stroke.

Aged↗
PubMed2004

Obesity in adolescence and adulthood and the risk of adult mortality.

UNLABELLED: BACKGROUND There are few long-term follow-up data on the relation between body mass index (BMI) in adolescence and in adulthood, and between adolescent BMI and adult mortality. The present study explores these relations. METHODS: In Norwegian health surveys during 1963-1999, height and weight were measured for 128,121 persons in a standardized way both in adolescence (age 14-19 years) and 10 or more years later. Persons were followed for an average of 9.7 years after the adult measurement. Cox proportional hazard regression models were used to study the association between adolescent and adult BMI and mortality. RESULTS: The odds ratio of obesity (BMI >/=30) in adulthood increased steadily with BMI in adolescence, from 0.2 for low BMI up to 16 for very high BMI. Very high adolescent BMI was associated with 30-40% higher adult mortality compared with medium BMI. Adjusting for adult BMI explained most of the association of adolescent obesity and mortality, especially among men. Adjustment for smoking did not change the results. CONCLUSIONS: Obesity in adolescence tends to persist into adulthood. Adolescent obesity is also connected to excess mortality, but this excess seems to be explained mostly by obesity in adulthood. High BMI in adolescence seems to be predictive of both adult obesity and mortality.

Adolescent↗
PubMed1977

Ischemic heart disease and work stress in West German sea pilots.

A mortality study of sea pilots operating in the Federal Republic of Germany was undertaken following a similar study in Britain. An excess mortality from cardiac disease in this occupational group compared with the male population of Hamburg was noted--a finding similar to the previous British study. This excess is most noticeable in the 31 to 50 year old group in which the pilots experienced 22 cardiac deaths while only four would have been expected, based on Hamburgs males mortality experience. Furthermore, in the decade 1950-59, the pilots experienced 30 cardiac deaths compared to an expected ten. Present estimates suggest that the pilots' mortality is now similar to the general population rate. Although this excess cardiac mortality is probably related to established coronary artery disease risk factors, occupational stress may also be involved. There was a statistically significant rise in catecholamines during three pilotage operations for each of five volunteer pilots (p less than 0.01). A detailed work load study is required to clarify the role of stress and close occupational surveillance of pilots is needed.

Adult↗
PubMed1999

The burden of mortality of diabetes mellitus in The Netherlands.

Our objective was to estimate the excess mortality and the reduction in life expectancy related to diabetes mellitus. We developed a life table to describe the Dutch population in two states, diabetic and non-diabetic, using age- and sex-specific prevalence of diabetes mellitus and risks of dying for diabetic subjects. We compared the calculated excess deaths with registered deaths. The cause-of-death registration practice underestimates diabetes-related mortality. The method used in this study, combining mortality data with data from epidemiologic studies, provides an assessment of the impact of diabetes on the Dutch population.

Aged↗
PubMed2006

[Genitourinary diseases mortality in mercury miners].

OBJECTIVES: To study the mortality due to genitourinary diseases in mercury miners. POPULATION AND METHODS: 3.998 workers exposed to mercury in Minas de Almadén y Arrayanes S.A. were studied. The follow-up period was a century, since 1,895 to 1,994. It was completed assessing the vital status and the basic cause of death, in case of fatalities. Standardized Mortality Ratios by age, sex and calendar period were calculated. Expected deaths were obtained from age, sex and calendar period specific rates for the Spanish and Castilla-La Mancha populations. RESULTS: A significant increase in mortality due to genitourinary diseases was found (CIE-9 codes 580 to 629), being significant with respect to the total population for nephritis, nephrotic syndrome and nephrosis, with SMR of 1.69 an 95% CI 1.18 to 2.34. Mortality excesses due to nephritis, nephrotic syndrome and nephrosis were higher in the metallurgy workers than in miners. A Poisson multivariate regression detected a positive trend in the mortality due to nephritis and nephrosis associated to the exposure length, with the risk increasing fivefold after 30 years of exposure to mercury. CONCLUSIONS: This paper shows an excess in the mortality due to genitourinary diseases, specially in nephritis, nephrotic syndrome and nephrosis, whose estimation and significance increases when compared to the population of Castilla-La Mancha.

Cohort Studies↗