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The impact of education and occupation on the employment status of cancer survivors.

We explored the effect of a diagnosis of cancer on employment according to cancer type, education, occupation, age, gender, mother tongue (Swedish or Finnish), calendar time and hospital district. All 12,542 new cancer cases diagnosed in 1987-1988 and 1992-1993, aged 15-60 years at the time of the diagnosis were identified from the Finnish Cancer Registry. The employment rate of the cancer survivors 2-3 years after the diagnosis was only 9% lower than their gender- and age-matched referents. However, we found that education and occupation modified the effect of cancer on the employment; the difference between cancer survivors and their referents in the probability of being employed was greater in the lower than in the higher educational groups. A modifying effect of education on the probability of employment was found among people with cancer of the lung, stomach, rectum and cervix uteri and those with cancers of the nervous system.

Adolescent↗

[Occupational hygiene and health status in welders of laser devices].

Welders-assemblers of the Quant-type laser devices are exposed to bright light flashes of plasma and laser exceeding in certain measurements the maximal allowed level. Such hazards induce disorders in eyes, autonomic nervous, circulatory and immune systems of workers. Impaired humoral immunity can lead to increased incidence of acute respiratory tract diseases. Prophylactic measures, including laser and flash shielding screens and drug therapy were suggested.

Adult↗

Gunshot versus nongunshot spinal cord injury: acute care and rehabilitation outcomes.

OBJECTIVE: To examine the impact of gunshot-caused spinal cord injury on acute and rehabilitative care outcome using a case control design. DESIGN: Two groups (i.e., gunshot- vs. nongunshot-caused spinal cord injury) of 212 individuals were matched case-for-case on age (i.e., within 10 yr), education, gender, race, marital status, primary occupation, impairment level, and Model System region. Outcome measures included length of hospital stay, functional status (FIM), treatment charges, and home discharge rates. RESULTS: The two groups did not differ in the length of stay during acute and rehabilitative care, charges during rehabilitative care, or postrehabilitation discharge placement. Several significant between-group differences in treatment procedures were noted (e.g., prevalence of spinal surgery), which may, in part, account for the higher acute-care charges among those persons with nongunshot-caused spinal cord injury. CONCLUSION: Once an individual is stabilized and admitted for rehabilitative care, gunshot etiology of spinal cord injury seems largely unrelated to the initial rehabilitation outcome.

Adult↗

Inequalities in low birth weight: parental social class, area deprivation, and "lone mother" status.

OBJECTIVE: To describe the extent of socioeconomic inequalities in low birth weight. To assess the relative benefits of measuring socioeconomic status by individual occupation, socioeconomic deprivation status of area of residence, or both, for describing inequalities and targeting resources. DESIGN: Analysis of birth registrations by registration status: joint compared with sole registrants ("lone mothers"), routinely recorded parental occupation (father's for joint registrants), and census derived enumeration district (ED) deprivation. SETTING: England and Wales, 1986-92. SUBJECTS: 471,411 births with coded parental occupation (random 10% sample) and birth weight. MAIN OUTCOME MEASURES: Proportion of low birth weight (< 2500 g) RESULTS: 34% of births to joint registrants in social classes IV and V, and 45% of births to sole registrants, were in the quintile of most deprived EDs. It was found that 6.8% of births were of low birth weight. Sole registrants were at higher risk (9.3% overall) than joint registrants, across all deprivation quintiles. For joint registrants, the socioeconomic risk gradient was similar by social class or area deprivation, but a greater gradient from 4.7% to 8.7% was found with combined classification. CONCLUSIONS: Up to 30% of low birth weight can be seen as being associated with levels of socioeconomic deprivation below that of the most affluent group, as measured in this study. Caution is needed when targeting interventions to high risk groups when using single indicators. For example, the majority of births to lone mothers and to joint registrants in social classes IV and V would be missed by targeting the most deprived quintile. There is a high degree of inequality in low birth weight according to social class, area deprivation and lone mother status. When using routinely recorded birth and census data, all three factors are important to show the true extent of inequalities.

Birth Weight↗

Cancers of the lip and oropharynx in different social and occupational groups in Finland.

Social status and occupation-specific risks of cancers of the lip, tongue, mouth and pharynx were studied in a nationwide series of 2369 men and 809 women diagnosed in Finland in 1971-1985 and recorded in the files of the Finnish Cancer Registry. Codes for social status (four classes) and occupation (336 categories) were drawn from the files of the 1970 Population Census. The standardised incidence rates (SIR) were defined as the ratios of observed and expected numbers of cases, the expected ones being based on the sex, age, site and calendar period-specific incidence rates in the Finnish population. The SIR of lip cancer in the lowest social class was five times that of the highest one, thus indicating the effects of social class differences in smoking habits. The effect of outdoor work on the development of lip cancer was also strongly supported by this study. The social class-adjusted SIR for fisherman was 2.7 (95% C.I. 1.3-5.0), for forestry managers 2.2 (1.2-3.6), for timber workers 1.9 (1.2-2.9) and for farmers 1.8 (1.2-2.6). For cancers of the oral cavity and pharynx there was no clear correlation with social class. However, the SIR for these cancers among farmers was significantly reduced. The occupation-specific SIRs pointed more to alcohol than smoking aetiology. In the case of cancer of the tongue, no aetiological clues whatsoever could be found. The role of direct occupational factors in the aetiology of any of these cancers seemed to be minimal.

Female↗

Status of patients presently living 9 to 13 years after orthotopic heart transplantation.

BACKGROUND: Heart transplantation has a dramatic impact on both life expectancy and quality of life in patients with terminal heart failure. The aim of the study was to evaluate psychologic, social, occupational, and somatic status of patients living long-term, 9 to 13 years after orthotopic heart transplantation. PATIENTS AND METHODS: Seventy-seven of 182 patients who received transplants between July 1983 and January 1988 in Hannover (1983-1985; n = 69 patients) and Berlin (1986-1988; n = 113 patients) have survived up to now, 9 to 13 years after transplantation (mean, 10 years 4 months). The patients and their medical records (eg, cardiac catheter studies, echocardiography) were examined to assess their somatic status. Psychologic, social, and occupational status and quality of life data were assessed by combination of self-rating questionnaires (the Short Form Health Survey Questionnaire, Giessener Beschwerdebogen [the Giessen Subjective Complaints List], the Sickness Impact Profile, and the Hospital Anxiety and Depression Scale) and semistructured interviews. RESULTS: Ninety-one percent of the patients were in New York Heart Association functional class I (70%) or II (21%). The results of the psychologic investigation revealed a definite impact of the side effects of chronic immunosuppression; however, overall, the quality of life rating was within the normal range. Sixty-seven (86%) patients were married, 51 (66%) patients were retired, 17 (22%) worked full-time or part-time, and 9 (12%) were housewife or houseman. Four male patients have fathered five healthy children 1 to 10 years after the transplantation. More than 75% of the patients had normal systolic ventricular function (mean left ventricular ejection fraction, 0.63). Coronary angiograms were normal or with minor wall irregularities in 86% (n = 66 patients), and revealed severe obstructions in 14% (n = 11). Normal function of all valves was found in one-third of the patients, tricuspid valve incompetence was not found or was insignificant in 87% (n = 67 patients) and severe in 8% (n = 10). Six patients had undergone tricuspid valve replacement, invariably for structural valve defects attributable to biopsy injuries. Fifty-eight patients (75%) exhibited various degrees of compensated renal insufficiency, 7 of them were on chronic hemodialysis, and 2 patients have undergone kidney transplantation. Hepatic function was normal in 68% (n = 52) of the patients, and 1 patient has developed liver cirrhosis. Osteoporosis was diagnosed of the discrete form in 7 (9%) and of a significant degree in 24 patients (31%); 38.5% (n = 30) complained of symptoms of polyneuropathy. CONCLUSIONS: The patients surviving 9 to 13 years after orthotopic heart transplantation are mostly in good physical status, the quality of life is comparable to the general population, and only a few of them have significantly limited in their life style. They do show the substantial chronic side effects of long-term immunosuppression, remaining treatment-dependent for a lifetime.

Adolescent↗

[Hygienic evaluation of work conditions, health status and determination of occupational risk for engineers and technicians in civil aviation].

The article deals with hygienic evaluation of work conditions, health state and determining occupational risk for engineers and technicians servicing aircrafts. The main hazards, according to the authors, are work intensity, high noise levels, air pollution with chemicals and unfavorable microclimate. A complex of prophylactic measures was justified.

Adult↗

Occupational exposure to optical radiation and the ocular health status of glassblowers.

The occupational radiation exposure levels and the ocular health status of a sample of glassblowers in southern Ontario were evaluated. The form of ocular protection was also assessed. Measurements of radiant emissions from different molten glass materials were carried out. A total of six glassblowing installations, 15 glassblowers and 42 non-glassblowers participated in the study. The spectral transmittances of samples of the protective lenses were obtained. Tonometry, biomicroscopy, ophthalmoscopy, pachometry, Schirmer tear test, endothelial photography were completed on all the volunteering subjects. The glassblowers' ocular findings were compared to those of non-glassblowers. No indication of cataract was observed among this group of glassblowers. Although, a preponderance of grade 2 polymegethism among the glassblowers (47% compared to 11% in non-glassblowers) was found, there was no significant difference in their ocular health. Variation in the corneal irradiance from occupational exposure was obtained, and in addition, the use of protective lenses was found to be inappropriate. In order to prevent against any long-term chronic pathologic effect, the use of appropriate ocular protection is advised.

Adult↗

Adult outcome of hyperactive boys. Educational achievement, occupational rank, and psychiatric status.

OBJECTIVE: The paucity of data concerning the long-term natural history of attention-deficit hyperactivity disorder (ADHD), a common childhood psychiatric disorder, prompted a longitudinal study to investigate the adult sequelae of the childhood disorder. DESIGN: Prospective study, follow-up intervals ranging from 13 to 19 years (mean, 16 years), with blind systematic clinical assessments. SUBJECTS: Ninety-one white males (mean age, 26 years), representing 88% of a cohort systematically diagnosed as hyperactive in childhood, and 95 (95%) of comparison cases of similar race, gender, age, whose teachers had voiced no complaints about their school behavior in childhood. RESULTS: Probands had significantly higher rates than comparisons of ADHD symptoms (11% vs 1%), antisocial personality disorders (18% vs 2%), and drug abuse disorders (16% vs 4%). Significant comorbidity occurred between antisocial and drug disorders. Educational and occupational achievements were significantly compromised in the probands. These disadvantages were independent of psychiatric status. We did not find increased rates of affective or anxiety disorders in the probands. CONCLUSIONS: Childhood ADHD predicts specific adult psychiatric disorders, namely antisocial and drug abuse disorders. In the adolescent outcome of this cohort, we found that these disturbances were dependent on the continuation of ADHD symptoms. In contrast, in adulthood, antisocial and drug disorders appeared, in part, independent of sustained ADHD. In addition, regardless of psychiatric status, ADHD placed children at relative risk for educational and vocational disadvantage. The results do not support a relationship between childhood ADHD and adult mood or anxiety disorders.

Adolescent↗

A 15-year longitudinal study of Halstead-Reitan neuropsychological test performance.

Using a two-stage growth curve analysis, change over time in performance on tests in the Halstead-Reitan Battery and Average Impairment Rating (AIR) was assessed for 53 individuals who varied in age and health status. In the first stage of the analysis, estimated slope and intercept values were calculated for each individual by regressing longitudinal data points on time. In the second stage, estimated slope and intercept values obtained in the first-stage analysis were regressed on age at entry into the study with statistical control for health status, education, occupation, and gender. Control for health status had an insignificant influence on magnitude of associations between age and test performance. Age-at-entry into the study was associated with statistically significant increasing change over time (poorer performance) for tests placing relatively heavy demands on speed of psychomotor performance and for AIR.

Adult↗

A study of social classification in age reporting in rural West Bengal.

The author examines "the nature and extent of age misreporting in the various socio-economic classes based on a sample survey conducted by the Indian Statistical Institute, Calcutta in the villages of the districts around Calcutta in 1978." The results show considerable variation among the various social groups, with higher errors reported for Muslims, manual laborers, and women, particularly literate women.

Age Factors↗