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PubMed1999

Male factors and socioeconomic indicators correlate with the risk of spontaneous abortion.

No less than 10% of clinically recognised pregnancies end as spontaneous abortions and the recurrence risk is high. Due to lack of data and appropriate study design only little is known about preventable causes of miscarriage. The aim of this study was to estimate the effect of paternal and environmental factors by studying reproductive histories in population based cohorts. We based the study upon two cohorts. The 'abortion cohort' consisted of 55 259 women who had a hospitalised spontaneous abortion in Denmark between 1980 and 1992 and who had a subsequent non-terminated pregnancy. The 'birth cohort'was based upon a 5% random sample of all women who in the same time period gave birth and subsequently had a non-terminated pregnancy (11 269 women). Data on change of partner, residence, mother's social status or occupation between the two pregnancies were linked to these two cohorts using the personal identification numbers and information stored in several population registers. Change of partner reduced the recurrence risk of spontaneous abortion substantially (OR = 0.59; 95 CI 0.52-0.67), but also changes in social status or job reduced the recurrence risk significantly. Changing the municipality of residence to a low risk area (based upon the geographical distribution of spontaneous abortions) reduced the risk of spontaneous abortion in both cohorts. A paternal effect on the recurrence risk of spontaneous abortion cannot be ruled out but environmental factors also play a role.

Journal Article↗
PubMed2005

[The role of social inequality for adolescent health].

PURPOSE: The aim of the study was to investigate socioeconomic differences in adolescent health in Germany. METHODS: Findings are based on data from 5650 11- to 15-year-old German pupils participating in the cross-national study "Health Behaviour in School-age Children" in 2002. RESULTS: Extend and occurrence of health inequalities depended largely on the selected health out comes. Moreover, there were marked gender-specific differences in respect of socioeconomic differences in health. For both, boys and girls, results showed a strong effect of socioeconomic status (parental occupation and family affluence) on overweight. Allergies yielded comparable results in respect of socioeconomic differences. On the other hand, social inequalities had an influence on psychological health mainly in girls. This effect was found for the number as well as for the extent of socioeconomic health differences. No health inequalities were found in respect of injuries, life satisfaction and underweight, independent of gender. CONCLUSIONS: The influence of social inequalities on adolescents' health was considerably more complex and more stratified than expected. The analysis indicates that the special characteristics of adolescence need to be taken into account in the discussion of social inequalities in health. The fact that young people's health is probably less influenced by social inequality then it is during other parts of the life course points attention to adolescence as an important stage for preventive efforts.

Adolescent↗
PubMed1991

Socioeconomic and cultural differentials in age at marriage and the effect on fertility in Nepal.

Age at marriage is one of the factors that influence the fertility behaviour of women, particularly in a society like Nepal where contraceptive use is low. Socioeconomic and cultural factors, particularly religion and ethnicity, are important variables in determining age at marriage in Nepal. Fertility was negatively related with age at marriage. Marriage duration had a greater influence on fertility than age at marriage, although these were strongly correlated.

Adolescent↗
PubMed2007

Indicators for occupational health surveillance.

Each year, millions of the estimated 140 million U.S. workers are injured on the job or become ill from exposure to hazards at work. These work-related injuries and illnesses result in substantial human and economic costs for workers, employers, and society; estimated direct and indirect costs of work-related injuries and illnesses are approximately $170 billion annually. In 1998, the Council of State and Territorial Epidemiologists (CSTE) and CDC's National Institute for Occupational Safety and Health (NIOSH) convened a work group that identified priority occupational health conditions to be placed under surveillance, addressed cross-cutting surveillance concerns, and made recommendations regarding the role of states in a comprehensive nationwide surveillance system for work-related disease, injuries, and hazards. CSTE recommendations led to the generation of 19 occupational health indicators (OHIs) and one Employment Demographic Profile, which were developed during 2001-2003. The OHIs complement other guidelines for state-based occupational health surveillance to address overall state and national goals to improve public health. These OHIs are intended to help states build occupational health capacity by providing them with tools to collect and generate important, basic information concerning the occupational health status of the state population and to identify areas in which to focus prevention efforts. In 2005, CSTE released a report compiling OHI data from 13 states. NIOSH provides funding for the OHIs because they are now a required component of state-based cooperative agreements for occupational health surveillance. This report introduces the OHIs and describes CSTE's approach to developing this new occupational health surveillance tool.

Accidents, Occupational↗
PubMed2002

Sex differences in the association of socioeconomic status with obesity.

OBJECTIVES: This study investigated socioeconomic predictors of obesity in men and women. METHODS: Data from the 1996 Health Survey for England were used to compare odds ratios for obesity by education, occupation, and 2 economic markers after control for age, marital status, and ethnicity. RESULTS: Obesity risk was greater among men and women with fewer years of education and poorer economic circumstances and among women, but not men, of lower occupational status. CONCLUSIONS: Higher educational attainment and higher socioeconomic status were associated with a lower risk of obesity in both men and women, whereas higher occupational status was associated with a lower risk only for women. The implications of these findings for understanding causes and prevention of obesity are discussed.

Adolescent↗
PubMed1997

Risk of tuberculin conversion according to occupation among health care workers at a New York City hospital.

Concern about the risk to health care workers of occupationally acquired tuberculosis has resulted in extensive and frequently revised guidelines from the Centers for Disease Control and Prevention (CDC). Most recent studies, however, have determined that community, rather than occupational, exposure is the more significant risk for tuberculin conversion. To assess the relative contribution of community versus occupational risk, we reviewed the health records of 1,303 persons employed from 1991 to 1994 at St. Clare's Hospital in New York City, a hospital with a high tuberculosis case-rate. Demographic information included age, gender, postal zone of residence, country of birth, and BCG vaccination status, while occupations were placed into one of five groups. In multivariate analysis, occupation was significantly associated with risk of tuberculin conversion, while postal zone of residence was not. The group that included housekeeping, laundry, and security personnel and the physician-nurse group had the highest conversion rates. After implementation of CDC guidelines, there was a significant improvement in the employee tuberculin conversion rate. At our hospital, occupation was strongly associated with risk of tuberculin conversion.

Female↗
PubMed1977

[State of disease and social situation of adult hemophiliacs].

54 adult patients suffering from hemophilia responded to a questionnaire regarding their state of illness and social situation. As far as state of the illness was concerned items pertained to type of hemophilia, factor activity, degree of physical handicap, number of bleedings and hospitalizations as well as etiology of bleedings. Social data contained items on marital status, education, occupation and leisure activities. The handicap of the illness as well as the possibility of positive social integration is underlined by the findings of the study.

Persons with Disabilities↗
PubMed2005

Low socioeconomic status as a risk factor for asthma, rhinitis and sensitization at 4 years in a birth cohort.

BACKGROUND: The relation between socioeconomic status and allergic diseases in childhood is controversial. Some studies have proposed childhood asthma to be more common in families with low socioeconomic status, while sensitization to airborne allergens seems to be more frequent in individuals with higher socioeconomic status in childhood. OBJECTIVE: To assess the relation between socioeconomic status and asthma, rhinitis and sensitization in an unselected prospective birth cohort. METHODS: Four thousand and eighty-nine families with children born 1994-1996 in predefined areas of Stockholm answered questionnaires on environmental factors, socioeconomic status (parental occupation), and symptoms of allergic disease at birth, 1, 2 and 4 years of age. Blood samples taken at 4 years from 2614 children were analysed for specific IgE to common airborne and food allergens. Odds ratios (OR) and 95% confidence intervals (CI) for various outcomes in relation to socioeconomic status were estimated with a multiple logistic regression model, adjusting for potential confounders such as heredity for allergic diseases, maternal smoking, short duration of breastfeeding and house construction. RESULTS: There was a decreasing risk of asthma and rhinitis with increasing socioeconomic status. The OR for asthma was 0.33 (95% CI 0.17-0.66) and for rhinitis 0.50 (0.32-0.79) comparing the highest and the lowest socioeconomic groups, with a tendency to stronger effects in those with heredity for allergic disease. The risk of sensitization to food allergens also decreased with increasing socioeconomic status; OR 0.65 (0.41-1.02) in the highest socioeconomic group (Ptrend=0.03), which was not clearly seen for airborne allergens. CONCLUSION: Asthma, rhinitis and sensitization is more common in lower than in higher socioeconomic groups after adjustment for traditional risk factors. This may be related to additional uncontrolled differences in life style and environmental exposures between the groups, and calls for further studies.

Age of Onset↗
PubMed1992

Seroprevalence of anti-HCV in an urban child population: a pilot survey in a developing area, Cameroon.

Hepatitis C Virus (HCV) is the principal agent of non-A, non-B hepatitis and its spread in the community is not well defined. We evaluated the prevalence of anti-HCV (ortho ELISA System) in 696 children (4-14 years) in Kumba, Cameroon. Children were selected by systematic random sampling in six primary schools. A seroprevalence of 14.5% (101 children) was found which increased steadily with age. No significant differences were observed with respect to sex or to family size. There was a highly significant association both with parents' social class, the lowest class presenting a 2.2-fold risk factor, and with area of residence, suburban children showing a significantly higher prevalence (P less than 0.01). These results suggest that Cameroon is endemic for HCV infection, that children are infected at an early age and that infection increases with age. We can therefore hypothesize that transmission of HCV infection in this population is from child to child. Furthermore, the infection seems to be influenced by social factors but not by demographic ones.

Adolescent↗
PubMed1991

Perinatal transmission of HIV-1: lack of impact of maternal HIV infection on characteristics of livebirths and on neonatal mortality in Kigali, Rwanda.

We present the baseline results of a prospective cohort study on the perinatal transmission of HIV-1 in Kigali, Rwanda. HIV-1-antibody testing was offered to all women of urban origin delivering a live newborn at the maternity ward of the Centre Hospitalier de Kigali from November 1988 to June 1989; 218 newborns of 215 HIV-positive mothers were matched to 218 newborns of 216 HIV-negative mothers. The matching criteria were maternal age and parity. No differences in socioeconomic characteristics were observed between HIV-positive and HIV-negative women. HIV-positive mothers more frequently reported a history of at least one death of a previously born child (P less than 0.01) and a history of abortion (P less than 0.001). Most of the HIV-positive women were asymptomatic, but 72.4% of them had a CD4; CD8 ratio less than 1 versus 10.1% in the HIV-negative group (P less than 0.001). The frequency of signs and symptoms was not statistically different in the two groups, except for a history of herpes zoster or chronic cough, which was more frequent among HIV-positive women. The rates of prematurity, low birth weight, congenital malformations and neonatal mortality were comparable in the two groups. However, infants of HIV-positive mothers had a mean birth weight 130 g lower than the infants of HIV-negative mothers (P less than 0.01). The impact of maternal HIV-1 infection on the infant seems limited during the neonatal period.

Abortion, Spontaneous↗
PubMed1995

Changes in rates of depressive symptoms in a Japanese working population: life-table analysis from a 4-year follow-up study.

To investigate the effects of demographic variables on changes in rates of depressive symptoms in a non-clinical population, a 4-year follow-up study was conducted on a total of 6378 employees of a Japanese electrical company. Data were collected five times at 1-year intervals (T0-T4) using a questionnaire that included the Zung Self-rating Depression Scale (SDS). Of the non-depressed (i.e. having a SDS score of 47 or less) at baseline (N = 4857), 14% were found depressed at least once during T1-T4. Younger, never married, female and blue-collar workers were significantly at greater risk for becoming depressed during the follow-up period (P < 0.05). Of the depressed at baseline (N = 505), 20% were depressed every time during T1-T4. Younger workers were significantly at greater risk for persistence of depressive symptoms during the follow-up period (P < 0.05). The results suggested that age is associated with both occurrence and persistence of depressive symptoms, while gender, marital status and occupation are associated only with the occurrence.

Adolescent↗
PubMed1997

Variation in incidences of tuberculosis in subgroups of South African gold miners.

OBJECTIVES: To determine risk factors and to identify groups at high risk of tuberculosis (TB) among South African gold miners. METHODS: A retrospective cohort analysis was carried out with hospital and personnel databases on a random sample of the workforce of Freegold Mines, served by Ernest Oppenheimer Hospital, Welkom, South Africa. The outcome measure of interest was a reported first episode of TB while employed at Freegold. A person-years analysis was carried out to estimate incidence ratios between different categories of age group, period, cumulative service, mining occupation, and silicosis status. A separate analysis was carried out on a subgroup of men (non-random) whose HIV status was known. RESULTS: The main finding of the study was that TB was more strongly associated with age than expected with a rate ratio of reported incidence of 21 for the oldest age group compared with the youngest, after adjustment for period, cumulative service, occupation, and silicosis status. There was also a significant association between TB and occupations such as drilling with a rate ratio of 2.3 compared with low dust surface and maintenance workers, after adjustment for age, period, cumulative service, and silicosis. Analysis of the HIV tested subgroup showed that these results are unlikely to be the result of confounding due to HIV infection. Prevalence of HIV in this group has been rising sharply since 1991, but the increase was slowing towards the end of the study period. CONCLUSION: A profile of mineworkers who are at high risk of TB can be defined by age, mining occupation, silicosis status, and HIV infection with predicted rates of 100/1000 person-years. TB screening programmes should take special cognisance of high risk groups of gold miners.

Adolescent↗