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PubMed2000

Improving telephone contact rates of patients discharged from the emergency department.

STUDY OBJECTIVE: This study investigated the rate of incorrect contact telephone numbers recorded during emergency department registration, and evaluated whether postdischarge contact rates can be improved by verifying the best contact number with the patient before discharge. METHODS: A prospective study was conducted with convenience sampling at a tertiary care hospital with an annual census of 60,000. Patients older than 18 years were enrolled, and the "unverified" telephone numbers recorded at registration were entered on the data sheet. Patients were then asked, "What number can we reach you at to discuss lab or x-ray results?" These "verified" numbers and additional demographic data were entered on the data sheet. Within 1 week, 3 calls were made to both the unverified and the verified numbers. Calls were considered successful if the patient, a friend, family member, or coworker was reached, or if the patient returned a message left on an answering machine. RESULTS: Four hundred eighteen patients (43% men) were enrolled; 72 (17%) patients provided a different best contact number than the one recorded on the chart. When unverified numbers were called, only 68.9% of patients were reachable, whereas when verified numbers were called, 81.8% of patients were contacted (P <.01). No statistical difference was found between patients who were successfully contacted and those who were not with regard to age, sex, race, or time of visit. Patients insured by health maintenance organizations were more likely to be reached (P =.02). CONCLUSION: Verification of a best contact telephone number significantly improves the ability to contact patients after ED discharge.

Adolescent↗
PubMed2000

Effects of handicap on life expectancy: the case of China.

The purpose of this study was to quantify and partition the expected years of life with and without handicap for the Chinese population according to various types of handicaps, age-sex groups and regions. A large-scale sample survey on handicapped persons conducted in 1987, and the 1990 population census constitute the basis for computing the expected years of life free of handicapped condition using the method proposed by Sullivan. The expected years of life with handicap for the Chinese population in childhood (0-14 y), working ages (15-64 y) and the elderly (65 y+) were 0.40, 1.78, and 3.44 for males and 0.34, 1.69, and 4.55 for females. For the Chinese males over 65 y of age, there were about 1.83 expected years of life with aural handicap and 0.59 expected years of life with ocular handicap. For the Chinese females over 65 y of age, there were about 1.87 expected years of life with aural handicap and 1.16 expected years of life with ocular handicap. The burden of living with handicap is greater for females and the elderly. This general pattern hold for all types of handicap except for skeletal handicap. The expected years of life with handicap for the Chinese population provide useful information for setting public health policies, despite the difficulty in making comparisons with the similar data in other countries.

Adolescent↗
PubMed2006

Monitoring recruitment success and cost in a randomized clinical trial.

Recruitment of older adults into research studies is challenging and, as a consequence, the recruitment period is often extended and more expensive than planned. This study monitored the effectiveness (number of subjects attracted) and cost of different recruitment strategies when recruiting edentulous elderly adults. Socio-demographic data were gathered and compared to 2001 Canadian census data. Advertisements in major Montreal newspapers attracted the most people (24.3%). However, the most economical recruitment method proved to be placement of ads in senior newspapers (dollar 73.74 per subject). The information gathered in this study will assist others in planning recruitment strategies for edentulous elderly populations.

Advertising↗
PubMedDate not supplied

Personal health practices of urban adults in Alabama: Davis Avenue Community Study.

The need to establish baseline data on and monitor the personal health practices and beliefs of adults in a community served by health care facilities is well documented. The purpose of the survey was to determine health care practices, personal health behaviors, and health services use of the adults living in the Davis Avenue Community (DAC), a six-census tract area located in Mobile, AL. The DAC's population is approximately 95 percent black. Using methods developed by the National Center for Health Statistics, 402 adults between the ages of 20 and 69 years were interviewed by telephone by trained personnel to ascertain the health-related characteristics of residents in this health services area. Information collected in this survey provided the staff of the Franklin Memorial Primary Health Center, who provide primary health care in the area, with an empirical base on which to plan and market health promotion and education programs for the health services area.

Adult↗
PubMed1998

The geographical distribution of diagnostic medical and dental X-ray services in South Africa

AIM: The aim of this study was threefold, viz.: (i) to evaluate the availability and accessiblity of medical and dental X-ray services in South Africa; (ii) to evaluate geographical information systems (GIS) as a tool for management of health care technologies; and (iii) to guide policy and develop a process to provide optimal utilisation of X-ray services in South Africa. METHODS: Information supplied by the Department of Health on licensed X-ray equipment was integrated with census data and processed with GIS. Four key areas were assessed, viz. distribution, accessibility, age and availability of X-ray services in South Africa. RESULTS: The analysis shows a vast inequity in the distribution of X-ray services on a provincial as well as a district level, although on the national level the distribution of X-ray services meets the World health Organisation criteria. CONCLUSION: GIS is a useful tool in evaluating and planning of essential health services/techniques. However, care must be taken in interpreting the data on a macro level, as this masks vast inequities on the district level. RECOMMENDATIONS: The indicators of coverage should be expanded, similar reports should be prepared for the nine provinces, and these data should be integrated into the clinic planning programme. Radiological services should be added to and managed as part of an essential district health care technology package.

Journal Article↗
PubMed1997

Lipoprotein(a) as a determinant of coronary heart disease in young women.

BACKGROUND: Lipoprotein(a) [Lp(a)] appears to be a risk factor for coronary heart disease (CHD) in men. The role of Lp(a) in women, however, is less clear. METHODS AND RESULTS: We examined the ability of Lp(a) to predict CHD in a population-based case-control study of women 65 years of age or younger who lived in the greater Stockholm area. Subjects were all patients hospitalized for an acute CHD event between February 1991 and February 1994. Control subjects were randomly selected from the city census and were matched to patients by age and catchment area. Lp(a) was measured 3 months after hospitalization by use of an immunoturbidometric method (Incstar) calibrated to the Northwest Lipid Research Laboratories (coefficient of variation was < 9%). Of the 292 consecutive patients, 110 (37%) were hospitalized for an acute myocardial infarction, and 182 were hospitalized (63%) for angina pectoris. The mean age for both patients and control subjects was 56 +/- 7 years. Of participants, 74 patients (25%) and 84 control subjects (29%) were premenopausal. The distributions of Lp(a) were highly skewed in both patients and control subjects, with a range from 0.001 to 1.14 g/L. Age-adjusted odds ratio for CHD in the highest versus the lowest quartile of Lp(a) was 2.3 (95% confidence interval [CI], 1.4 to 3.7). After adjustment for age, smoking, education, body mass index, systolic blood pressure, total cholesterol, triglycerides, and HDL, the odds ratio was 2.9 (95% CI, 1.6 to 5.0). The odds ratios were similar when myocardial infarction and angina patients were compared with their respective control subjects. The odds ratios were 5.1 (95% CI, 1.4 to 18.4) and 2.4 (95% CI, 1.3 to 4.5) in premenopausal and postmenopausal women, respectively. CONCLUSIONS: These results suggest that Lp(a) is a determinant of CHD in both premenopausal and postmenopausal women.

Adult↗
PubMed2006

A prospective comparison of ultrasound-guided and blindly placed radial arterial catheters.

BACKGROUND: Arterial cannulation for continuous blood-pressure measurement and frequent arterial-blood sampling commonly are required in critically ill patients. OBJECTIVES: To compare ultrasound (US)-guided versus traditional palpation placement of arterial lines for time to placement, number of attempts, sites used, and complications. METHODS: This was a prospective, randomized interventional study at a Level 1 academic urban emergency department with an annual census of 78,000 patients. Patients were randomized to either palpation or US-guided groups. Inclusion criteria were any adult patient who required an arterial line according to the treating attending. Patients who had previous attempts at an arterial line during the visit, or who could not be randomized because of time constraints, were excluded. Enrollment was on a convenience basis, during hours worked by researchers over a six-month period. Patients in either group who had three failed attempts were rescued with the other technique for patient comfort. Statistical analysis included Fisher's exact, Mann-Whitney, and Student's t-tests. RESULTS: Sixty patients were enrolled, with 30 patients randomized to each group. Patients randomized to the US group had a shorter time required for arterial line placement (107 vs. 314 seconds; difference, 207 seconds; p = 0.0004), fewer placement attempts (1.2 vs. 2.2; difference, 1; p = 0.001), and fewer sites required for successful line placement (1.1 vs. 1.6; difference, 0.5; p = 0.001), as compared with the palpation group. CONCLUSIONS: In this study, US guidance for arterial cannulation was successful more frequently and it took less time to establish the arterial line as compared with the palpation method.

Blood Pressure↗
PubMed2003

Cyclobenzaprine with ibuprofen versus ibuprofen alone in acute myofascial strain: a randomized, double-blind clinical trial.

STUDY OBJECTIVE: We evaluate the analgesic and side effects of adding cyclobenzaprine to ibuprofen in emergency department patients with acute myofascial strain. METHODS: A randomized, prospective, double-blind study was conducted at an urban teaching ED with an annual census of 44,000. One hundred two patients aged 18 to 70 years with acute myofascial strain caused by minor trauma within the prior 48 hours were included, and 77 patients completed the protocol. Each patient received a single dose of 800 mg of ibuprofen in the ED and a vial of 6 capsules containing 800 mg of ibuprofen to take every 8 hours as needed after discharge from the ED. In addition, 51 patients received a single dose of 10 mg of cyclobenzaprine and a vial of 6 capsules containing 10 mg of cyclobenzaprine to take every 8 hours as needed after discharge from the ED; the remaining 51 patients received an identically labeled placebo capsule and vial of placebo capsules to take every 8 hours as needed after discharge from the ED. Patients rated the intensity of their pain on a 100-mm visual analog scale (VAS) at baseline; 30, 60, 90, 120, and 180 minutes; and 24 and 48 hours after treatment. Telephone follow-up was obtained at 24 and 48 hours, and side effects were elicited at 24 and 48 hours by means of open-ended questioning. RESULTS: The patients in each group were similar with regard to diagnosis and baseline pain score. The number of patients who did not complete the protocol and the number of those who required additional analgesia were similar in both groups. Over the 48 hours of the protocol, the mean VAS score for the combination group decreased from 60.4 to 35.6, and the mean VAS score for the ibuprofen alone group decreased from 62.2 to 35.4. The mean VAS scores between groups across time was not statistically significant (P =.962, repeated-measures analysis of variance). At both 24 and 48 hours, central nervous system side effects were reported more frequently in the patients receiving cyclobenzaprine (16 [42%] versus 7 [18%] at 24 hours and 15 [39%] versus 5 [13%] at 48 hours, respectively). CONCLUSION: In ED patients with acute myofascial strain, the addition of cyclobenzaprine to ibuprofen does not improve analgesia but is associated with a greater prevalence of central nervous system side effects.

Adolescent↗
PubMed1998

An analysis of the geographical distribution of severe malaria in children in Kilifi District, Kenya.

BACKGROUND: Although malaria is known to be a major cause of child mortality and morbidity throughout sub-Saharan Africa there are few detailed studies of malaria mortality rates and incidence of severe malarial disease in defined communities. We have studied the geographical pattern of admissions to hospital with severe malaria and the stability of this pattern over time in Kilifi District on the Kenyan Coast. METHODS: Over a 2-year period all children under 5 years of age with severe malaria admitted to the district hospital and living in a rural study population of about 50,000 people were identified. Annual censuses were carried out in the study area, and all households were mapped using a hand-held satellite navigation system. The resulting databases were linked using a geographical information system (GIS). RESULTS: Using methods originally developed for the study of the geographical distribution of childhood leukaemia we assessed the spatial pattern of hospital admission rates for severe malaria. As expected, admission rates were significantly higher in children with easier access to the hospital. For example, those living more than 25 km from the hospital had admission rates which were about one-fifth of those for children living within 5 km of the hospital. Those living more than 2.5 km from the nearest road had admission rates that were about half of those for children living within 0.5 km of a road. We also investigated short-term local fluctuations in severe malaria and found evidence of space-time clustering of severe malaria. CONCLUSIONS: Hospital admission rates for severe malaria are higher in households with better access to hospital than in those further away. The finding of space-time clusters of severe malaria suggests that it would be of value to conduct case-control studies of environmental, genetic and human behavioural factors involved in the aetiology of the disease.

Animals↗
PubMed1992

Estimates from two survey designs: national hospital discharge survey.

The methodology for the National Hospital Discharge Survey (NHDS) has been revised in several ways. These revisions, which were implemented for the 1988 NHDS, included adoption of a different hospital sampling frame, changes in the sampling design (in particular the implementation of a three-stage design), increased use of data purchased from abstracting service organizations, and adjustments to the estimation procedures used to derive the national estimates. To investigate the effects of these revisions on the estimates of hospital use from the NHDS, data were collected from January through March of 1988 using both the old and the new survey methods. This study compared estimates based on the old and the new survey methods for a variety of hospital and patient characteristics. Although few estimates were identical across survey methodologies, most of the variations could be attributed to sampling error. Estimates from two different samples of the same population would be expected to vary by chance even if precisely the same methods were used to collect and process the data. Because probability samples were used for the old and new survey methodologies, sampling error could be measured. Approximate relative standard errors were calculated for the estimates using the old and new survey methods. Taking these errors into account, less than 10 percent of the estimates were found to differ across survey methodologies at the 0.05 level of significance. Because a large number of comparisons were made, 5 percent of the estimates could have been found to be significantly different by chance alone. When there were statistically significant differences in nonmedical data, the new methods appeared to produce more accurate estimates than the old methods did. Race was more likely to be reported using the new methods. "New" estimates for hospitals in the West Region and government-owned hospitals were more similar than the corresponding "old" estimates to data from the census of hospitals conducted by the American Hospital Association. The numerous significant differences in estimates for bed size categories between the two survey methodologies reflected the change in the universe and definition of beds for the new survey. Few statistically significant differences were found in the medical data using the old and the new survey methods. Two main differences, in estimates for cataract and alcohol dependence syndrome, may have resulted from problems with the new survey. A measurement error, reporting outpatients to the NHDS, is one possible explanation of the higher estimates for diagnosis of cataract using the new survey methods.(ABSTRACT TRUNCATED AT 400 WORDS)

Bias↗
PubMed1986

Improving the accuracy of intercensal estimates and postcensal projections of the civilian noninstitutional population: a parameterization of institutional prevalence rates.

The authors first note that current official U.S. population estimates and projections are based on the assumption that certain characteristics of the institutionalized population remain constant between censuses. The article "examines the empirical validity of this assumption by using data from the decennial censuses for 1940-1980 and, in light of substantial decade to decade changes in the age patterns of the institutional proportions for sex- and race-specific populations, seeks to develop alternative methods." As part of these alternative methods, "parametric curves are fit to the age-specific institutional proportions for each population for each decade. A study of the observed historical variation in the parameters of these curves then leads to some suggestions about how their shapes can be estimated between censuses and projected beyond the latest available census to provide more accurate estimates and projections of the civilian noninstitutional population." This is a revised version of a paper originally presented at the 1984 Annual Meeting of the Population Association of America (see Population Index, Vol. 50, No. 3, Fall 1984, p. 439).

Age Factors↗
PubMed2002

Follow-up of serious offender patients in the community: multiple methods of tracing.

Longitudinal studies of people with mental disorder are important in understanding outcome and intervention effects but attrition rates can be high. This study aimed to evaluate use of multiple record sources to trace, over 12 years, a one-year discharge cohort of high-security hospital patients. Everyone leaving such a hospital in 1984 was traced until a census date of 31 December 1995. Data were collected from several national databases (Office for National Statistics (ONS), Home Office (HO) Offenders' Index, Police National Computer Records, the Electoral Roll) and by hand-searching responsible agency records (HO, National Health Service). Using all methods, only three of the 204 patients had no follow-up information. Home Office Mental Health Unit data were an excellent source, but only for people still under discharge restrictions (<50% after eight years). Sequential tracing of hospital placements for people never or no longer under such restrictions was laborious and also produced only group-specific yield. The best indicator of community residence was ONS information on general practitioner (GP/primary care) registration. The electoral roll was useful when other sources were exhausted. Follow-up of offenders/offender-patients has generally focused on event data, such as re-offending. People untraced by that method alone, however, are unlikely to be lost to follow-up on casting a wider records net. Using multiple records, attrition at the census was 38%, but, after certain assumptions, reduced further to 5%.

Adult↗
PubMed2005

Long-term survival after acute myocardial infarction is lower in more deprived neighborhoods.

BACKGROUND: As part of the Worcester Heart Attack Study, a community-wide study examining changes over time in the incidence and long-term case-fatality rates of greater Worcester, Mass, residents hospitalized with confirmed acute myocardial infarction (AMI), we investigated the hypothesis that census tract-level socioeconomic position is an important predictor of survival after hospital discharge for AMI, after adjusting for demographic and clinical characteristics. METHODS AND RESULTS: Data were available for 3423 confirmed cases of AMI among metropolitan Worcester residents during the 4 study years of 1995, 1997, 1999, and 2001 who were followed up through the end of 2002. The mean age among patients was 69 years, and 58% were men. Using a multilevel Cox proportional hazards regression model, we estimated a 30% higher death rate after AMI for patients living in census tracts with the most residents living below the poverty line compared with patients living in the wealthiest census tracts (relative risk=1.30; 95% CI, 1.08 to 1.56). Similarly, patients living in census tracts with the highest proportion of residents with less than a high school education experienced a 47% higher death rate than patients living in census tracts with the lowest proportion of residents with less than a high school education (relative risk=1.47; 95% CI, 1.15 to 1.88). CONCLUSIONS: Within a medium-sized urban area, there are important variations in survival after hospital discharge for AMI that are associated with socioeconomic position. These associations persist after adjustment for demographic and clinical characteristics. Reasons for these differences warrant further investigation.

Aged↗
PubMedDate not supplied

Prehospital and emergency department analgesia for air-transported patients with fractures.

OBJECTIVE: To evaluate prehospital and receiving emergency department (ED) analgesia administration in air-transported patients with isolated fractures. METHODS: The study was a retrospective descriptive analysis of flight and hospital records. Study patients were consecutive adults (not pharmacologically paralyzed) with fractures undergoing scene or interfacility helicopter transport during 1994-1996. The study aeromedical program uses two helicopters staffed by a nurse/paramedic flight crew providing protocol-guided care. The receiving ED was in an urban academic Level I trauma center (annual census 65,000). Primary data collected were timing and amount of prehospital and ED analgesia. Analysis was mainly descriptive, with chi-square and nonparametric methods used to compare patients who did and did not receive intratransport fentanyl. RESULTS: 130 patients with isolated fractures underwent air transport during the study period 1994-1996. Of these, 98 (75.4%) received intratransport fentanyl; 20 of 98 (20.4%) received no analgesia in the receiving ED. Patients who did receive repeat analgesia in the receiving ED (n = 78, 79.6% of those receiving prehospital fentanyl) had a median interval of 42.5 minutes (interquartile range 25-100) between ED arrival and analgesia administration; only 62.8% of these patients received their ED analgesia within 60 minutes of arrival. CONCLUSIONS: Some patients receiving intratransport fentanyl received no ED analgesia, and those who did receive ED analgesia often had administration delays surpassing the clinical half-life of intratransport-administered fentanyl. Further study should investigate whether setting-specific analgesia practice differences reflect true differences in analgesia needs, overmedication by prehospital providers, or undermedication by ED staff.

Adult↗
PubMedDate not supplied

[The EPICARDIAN project, a cohort study on cardiovascular diseases and risk factors among the elderly in Spain: methodological aspects and major demographic findings].

BACKGROUND: Despite a greater incidence of ischemic heart disease among individuals over age 65, most cardiovascular research has been focused on the middle-aged adult population. To date no cohort study on this population have been made in Spain. This study is aimed as reviewing the role and methodology of cohort studies as an epidemiological tool absolutely essential for researching the prevalence and incidence of angina, AMI, stroke and the major cardiovascular risk factors. METHODS: Cohort study in three areas of Spain (Lista district in Madrid), Arevalo (Avila) and Begonte (Lugo). Age and sex stratified random sample by based on the municipal censuses of each area and municipality (n = 5.079). Two-stage initial cohort assessment: home survey structured for the screening ischemic heart disease and classic risk factors (hypertension, dyslipemia, diabetes and smoking habit) and clinical assessment for case confirmation. In the follow-up phase the MONICA project "cold pursuit" method modified for pinpointing and investigating indicent cases was used, employing all of the hospital and primary care clinical records for confirming the cardiovascular event. Data was also requested from the Spanish National Institute of Statistics as to the cause and date of death of the deceased individuals in the cohort. RESULTS: The overall AMI prevalence was 4% (95% CI: 3.4%, 4.5%); definite plus probable AMI being 6.2% (95% CI: 5.5-6.9). The definite AMI prevalence was higher among the mean 6.7% (95% CI: 5.63-7.79) than among the women, 2% (95% CI: 1.51-2.55) (p < 0.001). Hypertension prevalence according to JNCV1 criteria was 68%, hypercholesterolemia 26.4% according to NCEP criteria, diabetes prevalence 13.4% according to WHO criteria, and 11.3% were smokers. The cumulative incidence for a 3.2-year period for nonfatal definite AMI was 1.4% (95% CI: 1.1-1.8); 1.1% (95% CI: 0.74-1.37) probable AMI: 1.17 (IC95%: 0.824-1.48) for fatal definite AMI or death due to AMI and 1.13% (IC 95%: 0.824-1.48) for sudden death. CONCLUSIONS: The elderly population included in this study shows a high prevalence of cardiovascular risk factors, as well as ischemic heart disease incidence rates three times higher than those of the middle-aged adult population in Spain. The risk profile for women is significantly worse than for men, which may be due to the higher death rate at earlier ages among men.

Age Distribution↗
PubMed1997

Influence of nativity on cancer mortality among black New Yorkers.

BACKGROUND: Cancer is the second leading cause of death in U. S., and blacks have higher cancer death rates than whites. The authors conducted an analysis to determine the influence of birthplace on cancer mortality among blacks in New York City. METHODS: Death records for New York City from 1988 through 1992 were linked to the 1990 U. S. Census data. Age-adjusted cancer death rates by race and birthplace were computed. The experience of black residents born in the South and Northeast of the U. S. and in Caribbean countries were compared with that of New York City whites. RESULTS: The cancer mortality rate of blacks exceeded that of whites for males (512.6 vs. 385.6 per 100,000 per year), but was similar for females (270.8 vs. 270.6). However, cancer death rates of Southern-born black males (615.7) were substantially higher than those of black males born in the Northeast (419.1) or the Caribbean (352.4). Carcinomas of the lung, prostate, breast, and colon/rectum accounted for >50% of all cancer deaths. Lung carcinoma mortality varied greatly by birthplace, with Caribbean-born blacks (63.5 and 19.2 for males and females, respectively) having approximately one-third the death rates of Southern-born blacks (187.8 and 52.5 for males and females, respectively), and <50% that of New York City whites (108.7 and 53.2 for males and females, respectively). These differences were present in each age category, but were most pronounced among those age 45-64 years. In striking contrast, death rates from prostate carcinoma were highest in Caribbean-born black men, and this was especially apparent in persons age > or = 65 years. CONCLUSIONS: The generally higher cancer mortality of blacks compared with whites masks even greater intraracial heterogeneity revealed through stratification by birthplace. In general, Caribbean-born blacks are at lower risk of cancer mortality than other blacks, and whites, but their advantage does not hold for prostate carcinoma, for which Caribbean-born men had the highest mortality rate.

Adult↗
PubMed1998

The incidence of borderline ovarian tumors in Israel: a population-based study.

BACKGROUND: In hospital-based studies, one-eighth of ovarian cancers have been considered borderline ovarian tumors (BOTs). Population-based data regarding the incidence of BOTs are lacking in the international literature. The authors' objectives were to measure the incidence of BOT in Israel and compare rates among ethnic groups (based on ethnic group and country of birth) for the years 1985-1993. METHODS: The authors analyzed data reported to a nationwide cancer registry. Population estimates by subpopulation were derived from census and intercensus estimates, which were based on an updated population registry. RESULTS: The age-adjusted standard rate (ASR) for the entire population was 10.6 per million (95% confidence interval [CI], 9.2-12.0) for the period 1985-1993. Significant differences in ASR were observed among ethnic subgroups, with the lowest incidence among non-Jews (ASR, 5.0 per million; 95% CI, 0.7-9.3) and the highest among new immigrants from the former Soviet Union (FSU) who had been arriving since 1989 (ASR, 22.7 per million; 95% CI: 14.2-31.3). Between the periods 1985-1989 and 1990-1993, the ASR for Jews nearly doubled (rate ratio, 1.86; 95% CI, 1.1-2.5). This near-doubling was influenced, but not wholly accounted for, by the immigration from FSU and was observed in all ethnic subgroups. CONCLUSIONS: The variations in the incidence rates of BOT among ethnic groups may be related to differences in fertility patterns, use of fertility drugs, and genetic predisposition. The pattern of near-doubling in rates may reflect biases caused by increased detection or shifts in the classification of ovarian tumors; if they are real, a biologic explanation is needed.

Adenocarcinoma, Mucinous↗
PubMed2002

Occupational exposures and the risk of ovarian cancer in Sweden.

BACKGROUND: Studies of occupational exposures and ovarian cancer, often limited by few subjects or proportionate mortality data, have yielded inconsistent results. METHODS: Swedish women employed in 1960, 1970, or during both years were followed from 1971 to 1989 using census data linked to nationwide cancer and death registries. A total of 9,591 ovarian cancer cases were identified among 1,670,517 women. Poisson regression was used to estimate the relative risk of ovarian cancer in specific occupational groups and in women exposed to particular occupational exposures defined by job exposure matrices. We lacked data on reproductive factors. RESULTS: Jobs associated with elevated ovarian cancer rates in this and previous studies include dry cleaning, telegraph and telephone work, paper packaging, and graphic and printing work. In contrast to results of some previous studies, we found that hairdressers and beauticians were not at increased risk of ovarian cancer. Organic dusts, aromatic amines, aliphatic and aromatic hydrocarbons are suggested as specific etiologic agents. CONCLUSIONS: In this large study, we have confirmed some results from smaller studies and identified some new relationships that need to be confirmed elsewhere.

Adult↗