Journal of epidemiology and population health最新文献

Background: Hearing dysfunction following ototoxic or intensive cancer treatments is an underreported late effect among survivors of childhood and adolescent acute leukemia. The AUD&LEA project is the first study to examine, in a large cohort of childhood acute leukemia survivors: 1. the associated factors of hearing loss; 2. the association of hearing loss and the life of the individuals.

Methods: The AUD&LEA (AUDition & Leucémie Enfants et Adolescents) project was a cross-sectional study. The participants were included in the French LEA cohort which includes 18 French medical teams. The inclusion criteria of the patients were: childhood acute leukemia survivors, diagnosed before the age of 18 and after 1980, had a valid response (yes or no) regarding auditory sequela, and alive on December 31, 2022. The following data were collected: sociodemographics and clinical data, quality of life and schooling course.

Results: Among 6145 individuals, 1.45 % (95 % confidence interval [1.11-1.69 %]) persons were classified having a hearing loss. Compared to the individuals without hearing loss, those with hearing loss were significantly younger at the diagnosis and presented more often an acute myeloid disease. They also reported the worst level of quality of life and more often grade retention.

Conclusion: Hearing loss should have consequences in the quality of life and the schooling course. It is essential to carry out systematic screening during and after the implicated treatments.

Since 2013, air pollution has been recognised as a definite carcinogen by the IARC (International Agency for Research on Cancer). This follows major international epidemiological studies, which now show that people living in a polluted environment are more likely to die of lung cancer. Worldwide, air pollution is the second leading cause of premature death and is estimated to be responsible for around 14 % of lung cancers. Fine particles (PM2.5) are particularly studied for their carcinogenic potential, and recent discoveries have given us a better understanding of their pathophysiological link with certain types of cancer, particularly those harboring mutations in Epidermal Growth Factor Receptor (EGFR). The lung-cancer research community and clinical scientists should work to reduce sources of atmospheric pollution in the interests of public health, which must be accompanied by an effective fight against climate change, main announced cause of a deterioration in the quality of our common air.

Introduction: Multimorbidity, defined as the coexistence of two or more chronic diseases, is common. It is not well-understood how multimorbidity differs by sex and socioeconomic status.

Methods: Cross-sectional data from the UK Biobank in 2006-10 were used. Socioeconomic status was determined from area-based deprivation and individual education level. Multimorbidity was defined as having two or more chronic diseases, identified through linked hospital-admission data between 1995 and 2022. Modified Poisson regression was used to estimate age-adjusted prevalence relative risks (RRs) and women-to-men ratio of RRs with 95 % confidence intervals (CIs) for association of socioeconomic status with multimorbidity.

Results: A total of 502,364 individuals (54 % women) were included. Forty two percent of women and 48 % of men had multimorbidity, with the most common disease combination being cancer and hypertension, and hypertension being the most common single condition in both sexes (68 % of men and 58 % of women). The age-adjusted risk of multimorbidity was higher in men than in women (RR, 1.12, 95 % CI, 1.11-1.13). Compared to those in the least deprived areas, the age-adjusted risk of multimorbidity in the most deprived areas was 1.36 (95% CI, 1.33 1.38) in women, and 1.29 (95% CI, 1.27-1.31) in men, with a women-to-men ratio of RRs of 1.05 (95 % CI, 1.02-1.08).

Conclusion: Multimorbidity is more common in individuals with lower socioeconomic status, and men have a higher age-adjusted risk than women. The association between area-based deprivation and multimorbidity is stronger in women than men, emphasizing the need for tailored interventions that address both sex and socioeconomic disparities in multimorbidity.

Background: Tobacco smoking is a well-established risk factor for severe acute COVID-19 outcomes, but evidence regarding its role in Long COVID is limited and inconsistent. This study investigated whether pre-pandemic smoking independently predicted Long COVID and assessed mediation by long-standing illness or disability in a nationally representative cohort.

Methods: We analysed data from Waves 10 (2018-19) and 14 (2022-23) of the UK Household Longitudinal Study. Smoking status (current vs non-smoker) and covariates (age, sex, education, income satisfaction, ethnicity, rural/urban residence) were measured at baseline (Wave 10). Long COVID, defined as symptoms lasting ≥12 weeks following initial COVID-19 infection, was assessed at follow-up (Wave 14). Logistic regression was used to estimate the total association between smoking and Long COVID. We then applied generalized structural equation modelling and parametric causal mediation analysis, specifying long-standing illness or disability at baseline as the mediator.

Results: Among 11,944 participants, 1097 (9.2 %) reported Long COVID symptoms at follow-up. In the unadjusted model, smoking was associated with increased odds of Long COVID (odds ratio [OR] = 1.22, 95 % CI: 1.00-1.48, p = 0.05), although this was only borderline significant. After adjusting for demographic and socioeconomic factors, the association was no longer statistically significant (adjusted OR = 1.11, 95 % CI: 0.91-1.35, p = 0.32). The structural equation model indicated that smoking was associated with higher likelihood of long-standing illness or disability at baseline (β = 0.461, 95 % CI: 0.33-0.59, p <0.001, log-odds scale), which in turn predicted Long COVID (β = 0.435, 95 % CI: 0.30-0.57, p <0.001, log-odds scale). Mediation analysis revealed a small but statistically significant indirect effect of smoking on Long COVID operating through long-standing illness or disability (risk difference = 0.0057, 95 % CI: 0.0020-0.0095, p = 0.003), but no significant direct effect (risk difference = 0.0027, 95 % CI: -0.0144 to 0.0199, p = 0.76).

Conclusion: Smoking did not independently predict Long COVID, but may increase vulnerability indirectly through pre-existing long-standing illness or disability.

Purpose: Claims databases are used to examine diseases' and comorbidities' occurrences. However, the date of diagnosis is not available in those databases. Among the population of French adults at-risk of pneumococcal or influenza infections (i.e. patients with immunocompromised status or chronic medical conditions), three chronic diseases were selected for this study. The aim of the study was to determine the effect of the length of the lookback period on the incidence estimates of heart failure (HF), chronic liver disease, and HIV/AIDS using a claims database.

Methods: This retrospective longitudinal observational study was performed using secondary pseudonymized data from the French National Health Data System (SNDS). Prevalent patients with the three diseases in 2020 were identified using algorithms published by the National Health Insurance. The incident patients were those without any disease-identifying criterion during the lookback period of interest -which varied for the purpose of the study from 3 to 57 months. The overestimation of the incident population was computed for each lookback period length.

Results: With a 1-year lookback period, the incidences of patients with HF, chronic liver disease, and HIV/AIDS were overestimated by 20.3 %, 19.2 %, and 12.0 %, respectively. The 5 % overestimation threshold was reached with a lookback period of 3.75 years, 2.5 years and 1.75 years, for HF, chronic liver disease, and HIV/AIDS, respectively.

Conclusion: The choice of the length of the lookback period for estimating incidence is an important methodological point. Depending on the disease and the length of the lookback period, the overestimation of incidence estimates varies.

Background: There is limited understanding of how well Canadian children and youth with long-term health conditions adhere to the 24-hour movement guideline recommendations.

Objective: This study compared adherence to 24-hour movement guidelines between Canadian children and youth with and without long-term health conditions.

Methods: Cross-sectional data from the 2023 Canadian Health Survey on Children and Youth (CHSCY), conducted by Statistics Canada, were used for this national study (n=22,142). Long-term health condition status included responses of "yes" or "no" for 11 conditions. Adherence to physical activity (≥60 minutes/day of moderate-to-vigorous physical activity [MVPA]), recreational screen time (≤2 hours/day), and sleep duration (9-11 hours/night for children aged 5-13 years or 8-10 hours/night for adolescents aged 14-17 years) recommendations were parent-reported (children aged 5-11 years) or self-reported (youth aged 12-17 years). Logistic regression analyses examined the association between status of long-term health conditions and adherence to 24-hour movement guideline recommendations, with adjustments for covariates.

Results: Children and youth without long-term health conditions were more likely to meet guidelines for MVPA (adjusted odds ratio [aOR]: 1.29, 95% confidence interval [CI]: 1.18-1.41), recreational screen time (aOR: 1.21, 95% CI: 1.10-1.34), and all three guideline recommendations combined (aOR: 1.35, 95% CI: 1.21-1.52). Subgroup analyses stratified by long-term health conditions showed that individuals without anxiety disorders, mood disorders, learning disabilities, attention deficit disorder, or autism spectrum disorder had better adherence to movement behaviour guidelines.

Conclusion: There is a significant gap in adherence to the 24-hour movement guidelines among children and youth with long-term health conditions. Future research is needed to better understand the factors influencing adherence to the different movement behaviours.

Objective: To analyze practices of vertebroplasties in France for traumatic vertebral fractures, changes in the time between diagnosis and treatment, length of hospitalization after the procedure.

Materials and methods: A nationwide, exhaustive, population-based cohort study was performed from 2013 to 2021 using the French National Uniform Hospital Discharge Data Set Database (PMSI). The data included several parameters such as age, sex, dates of admission and discharge, length of stay, diagnoses, procedures, and hospital characteristics. A specific analysis was performed for traumatic vertebral fractures, after admission to emergency department.

Results: The study included 89 709 people who underwent 102 055 vertebroplasties between 2013 and 2021. The number of vertebroplasties per year increased continuously from 7 189 in 2013 to 15 067 in 2021. Traumatic fracture was the most frequent indication for vertebroplasty. The average time from diagnosis to vertebroplasty decreased from 42.5 days in 2014 to 38.2 days in 2021. There was an increase in same-day hospitalizations and a significant decrease of 36 % in the length of hospitalization after vertebroplasty for traumatic vertebral fractures. The proportion of traumatic vertebral fractures treated by vertebroplasty significantly increased, from 4.4 % to 9 %, while medical treatment decreased.

Conclusion: Vertebroplasty is becoming more and more popular for treating stable vertebral fractures, particularly for traumatic causes. The time interval between diagnosis and treatment decreased, and there was a shift towards same-day hospitalization. This study highlights the need for collaboration between clinicians and interventional radiologists for early diagnosis and treatment to efficiently manage patients' pain.