Annals of Epidemiology最新文献

英文中文

Acute gastrointestinal symptoms associated with oil spill exposures among U.S. coast guard responders to the Deepwater Horizon oil spill 深水地平线 "号漏油事件中美国海岸警卫队救灾人员接触漏油后出现的急性胃肠道症状

IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology

Pub Date : 2024-09-24 DOI: 10.1016/j.annepidem.2024.09.004

Purpose

Research investigating gastrointestinal (GI) symptoms from oil spill-related exposures is sparse. We evaluated prevalent GI symptoms among U.S. Coast Guard responders deployed to the Deepwater Horizon oil spill cleanup.

Methods

Crude oil (via skin contact, inhalation, or ingestion routes), combined crude oil/oil dispersant exposures, other deployment exposures, deployment characteristics, demographics, and acute GI symptoms during deployment (i.e., nausea/vomiting, diarrhea, stomach pain, and constipation) were ascertained cross-sectionally via a post-deployment survey (median time between deployment end and survey completion 185 days) (N = 4885). Log-binomial regression analyses were employed to calculate prevalence ratios (PRs) and 95 % confidence intervals (CI). Effect modification was evaluated.

Results

In adjusted models, responders in the highest (versus lowest) tertile of self-reported degree of skin contact to crude oil were more than twice as likely to report nausea/vomiting (PR=2.45; 95 %CI, 1.85–3.23), diarrhea (PR=2.40; 95 %CI, 2.00–2.88), stomach pain (PR=2.51; 95 %CI, 2.01–3.12), and constipation (PR=2.21; 95 %CI, 1.70–2.89). Tests for trend were statistically significant (p < 0.05). Results were similar for crude oil exposure via inhalation and ingestion. Higher PRs for all symptoms were found with combined crude oil/dispersant exposure than with crude oil exposure alone.

Conclusions

These results indicate positive associations between self-reported crude oil and combined crude oil/oil dispersant exposures and acute GI symptoms.

目的对石油泄漏相关暴露引起的胃肠道 (GI) 症状的研究很少。我们评估了部署到 "深水地平线 "溢油清理工作中的美国海岸警卫队救灾人员中普遍存在的胃肠道症状。方法调查了原油（通过皮肤接触、吸入或摄入途径）、原油/石油分散剂综合暴露、其他部署暴露、部署特征、人口统计学以及部署期间的急性胃肠道症状（即恶心/呕吐、腹泻、胃痛和便秘）、恶心/呕吐、腹泻、胃痛和便秘）通过部署后调查（部署结束与调查完成之间的中位时间为 185 天）横向确定（N = 4885）。采用对数二项式回归分析计算流行率 (PR) 和 95 % 置信区间 (CI)。结果在调整后的模型中，自我报告皮肤接触原油程度最高（相对于最低）三等分组中的应答者报告恶心/呕吐的可能性是其他应答者的两倍多（PR=2.45；95 %CI，1.85-3.23）、腹泻（PR=2.40；95 %CI，2.00-2.88）、胃痛（PR=2.51；95 %CI，2.01-3.12）和便秘（PR=2.21；95 %CI，1.70-2.89）的可能性高出一倍。趋势检验具有统计学意义（P < 0.05）。通过吸入和摄入接触原油的结果类似。结论这些结果表明，自我报告的原油和原油/石油消散剂联合暴露与急性消化道症状之间存在正相关。

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引用次数: 0

Gestational diabetes mellitus, body mass index, and cardiometabolic multimorbidity: A prospective cohort study 妊娠糖尿病、体重指数和心脏代谢多病症：前瞻性队列研究

IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Annals of Epidemiology

Pub Date : 2024-09-23 DOI: 10.1016/j.annepidem.2024.09.002

Purpose

Gestational diabetes mellitus (GDM) could increase the risks of type 2 diabetes mellitus (T2DM) and cardiovascular disease. However, evidence on its association with cardiometabolic multimorbidity (CMM) was limited. This study aimed to evaluate the association between GDM and the prevalence, incidence, patterns, and progression of CMM; and the role of body mass index (BMI) in such association.

Methods

This study included 203,372 women who have given birth in UK Biobank. The diagnoses of GDM and cardiometabolic diseases (including stroke, coronary heart disease [CHD], and T2DM) were reported by participants or obtained through linkage to inpatient hospital data until 31st December 2020. BMI was assessed at the baseline assessment. CMM was defined as having two or more of included cardiometabolic diseases. Logistic regression models and Cox proportional hazard models were used to assess the association between GDM and CMM, and the modifications on both additive and multiplicative scales were assessed to evaluate the effect of BMI on such association.

Results

A total of 1217 women had a history of GDM, 2351 participants had CMM at the end of follow-up and 1601 was newly diagnosed during follow-up. GDM was associated with higher prevalence (odds ratio [OR]=4.64, 95 % confidence interval [95 % CI]=3.54–6.08) and incidence (hazard ratio [HR]=3.62, 95 % CI=2.62–5.00) of CMM. In particular, GDM was associated with higher odds of T2DM, coexisting T2DM and vascular disease, and T2DM followed by vascular disease. Formal testing for effect modification suggested multiplicative modification by BMI for the association between GDM and incident CMM.

Conclusions

GDM was associated with CMM in women’s late life, with multiplicative modification effects of BMI. Our results suggest that maternal and lifestyle interventions (e.g., weight management) are warranted for the primary and secondary prevention of CMM, particularly in women with a history of GDM.

目的妊娠期糖尿病（GDM）会增加罹患 2 型糖尿病（T2DM）和心血管疾病的风险。然而，有关妊娠糖尿病与心脏代谢多病症（CMM）之间关系的证据却很有限。本研究旨在评估 GDM 与 CMM 的患病率、发病率、模式和进展之间的关系，以及体重指数（BMI）在这种关系中的作用。截至 2020 年 12 月 31 日，GDM 和心血管代谢疾病（包括中风、冠心病 [CHD] 和 T2DM）的诊断由参与者报告，或通过与住院患者数据的连接获得。体重指数在基线评估时进行评估。CMM定义为患有两种或两种以上所包含的心脏代谢疾病。采用逻辑回归模型和Cox比例危险模型评估GDM与CMM之间的关联，并评估BMI对这种关联的影响。GDM与较高的CMM患病率（几率比[OR]=4.64，95 % 置信区间[95 % CI]=3.54-6.08）和发病率（危险比[HR]=3.62，95 % CI=2.62-5.00）相关。特别是，GDM 与 T2DM、T2DM 与血管疾病并存以及 T2DM 后患血管疾病的几率较高相关。对效应修正的正式测试表明，BMI 对 GDM 与 CMM 事件之间的关联有乘法修正作用。我们的研究结果表明，孕产妇干预和生活方式干预（如体重管理）可用于 CMM 的一级和二级预防，尤其适用于有 GDM 病史的妇女。

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引用次数: 0

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IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

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Pub Date : 2024-09-01 DOI: 10.1016/j.annepidem.2024.07.088

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IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

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IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

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Pub Date : 2024-09-01 DOI: 10.1016/j.annepidem.2024.07.071

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IF 3.3 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

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Pub Date : 2024-09-01 DOI: 10.1016/j.annepidem.2024.07.084

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