British journal of preventive & social medicine最新文献

Certain features of the relationship between 11 measurements of weekly temperature and the number of deaths from ischaemic heart disease (IHD) within age groups in Greater London between 1970 and 1974 are described. Firstly, the correlation coefficients between age-specific deaths from IHD and each of the temperature variables are of a similar order. Secondly, in contrast, the linear regression coefficients between deaths and temperature are more variable and depend upon the particular measurement of temperature chosen. Thirdly, the proportional changes in the number of deaths with the temperature variables are similar within specific age groups; consequently it is suggested that deaths from IHD and temperature may be directly related.

In a study of a cohort of over 2000 children born between 1963 and 1965, the incidence of bronchitis and pneumonia during their first year of life was found to be associated with several family factors. The most important determinant of respiratory illness in these infants was an attack of bronchitis or pneumonia in a sibling. The age of these siblings, and their number, also contributed to this incidence. Parental respiratory symptoms, including persistent cough and phlegm, and asthma or wheezing, as well as parental smoking habits, had lesser but nevertheless important effects. Parental smoking, however, stands out from all other factors as the one most amenable to change in seeking to prevent bronchitis and pneumonia in infants.

Occupational groups are often described as being relatively healthy because their mortality rates are lower than those of the national average. Although correct this confuses the issue for those who are interested in assessing the effects of exposure to a particular chemical. In a further analysis of data collected in a study of all men ever exposed to vinyl chloride monomer in the manufacture of polyvinyl chloride in Great Britain, three factors have been shown to contribute to the low mortality rates that were observed. The three factors: the selection of a healthy population for employment, the survival in the industry of the healthier men, and the length of time that this population has been pursued, have been quantified. The mortality experience within five years of entering this industry was shown to be as low as 37% of that expected; for circulatory disease and respiratory disease it was as low as 21%. There was a progressive increase in standardized mortality ratio with the length of time since entry so that the effect had almost disappeared 15 years after entry. To avoid confounding the selection effect with the survival effect the latter was measured by separating men who survived 15 years after entering the industry according to whether or not they were still in the industry after this period. Those who had left experienced an overall standardized mortality ratio some 50% higher than those still in the industry. This effect, although consistent in the age groups between 25 and 74 years and for all cause groups studied, was greatest in those aged between 25 and 44 years and for lung cancer and respiratory disease.

A postal survey of a random sample of the population living near St Mary's Hospital, Paddington was taken to determine earlier experience in these people of blood pressure measurement and treatment. Eighty-five per cent of those who could return their questionnaires did so; eighty per cent of the respondents said they had had their blood pressure measured in the past, and 60% reported such a measurement during the previous three years. The respondents aged between 40 and 59 years were invited for a blood pressure screening measurement and 52% responded. Seventy-seven per cent of those found to be hypertensive on screening (systolic greater than or equal to 160 mmHg and/or diastolic greater than or equal to 100 mmHg) said they had had their blood pressure measured during the preceding three years. The reason for the poor control of hypertension in a community, therefore, is more likely to be a failure of doctors to take action on hypertension than a failure to detect it in the first place.

The purpose of this study was to discover any relationships which might exist between measurable variables recorded when a healthy group of men and women, aged 70 years and over, were examined and their subsequent survival time. It was found that height, body weight, systolic and diastolic blood pressures, haemoglobin, hand grip power, cardiothoracic ratio, and pulse rate are of no predictive value in the estimation of survival time. Survival is not influenced by marital status or occupational class. For both sexes the degree of kyphosis and age are useful predictive criteria in respect of survival time. However, much research work requires to be done to explain why many people die at the time they do.

Heights and weights were measured in 963 10-year-old children, whose weight data from the first year of life were available. Rapid weight gain in infancy was arbitrarily defined on the basis of sex-specific percentiles of weight gain at four-month intervals and from birth to 12 months. In girls, no significant association between rapid weight gain in infancy and overweight at 10 1/2 years was found. In boys, the association was significant for severe overweight (greater than 120% of standard weight for height). An estimation of the possible benefit of an intervention programme (food restriction in all male infants with rapid weight gain) showed, however, that at the very best 12% of the boys treated in this way could be expected to gain some benefit. The result of a correlation analysis between weight gain in infancy and change in height and relative weight between 7 and 10 1/2 years suggested that the factors which determined weight gain in infancy were no longer operative at ages between 7 and 10 1/2 years.

Serial measurements of urinary adrenaline, noradrenaline, and 11-hydroxycorticosteroid excretion were performed on 32 healthy men under two conditions of work stress; piecework and work on assembly line. A statistically significant increase in adrenaline, noradrenaline, and 11-hydroxycorticosteroids was observed for piecework and assembly line workers compared with salaried and 'ordinary' workers. The results support the assumption that psychosocial factors of an everyday type have significant effects on the sympathoadrenomedullary and adrenocortical function.

Right bundle branch block (RBBB) is occasionally encountered in young persons who lack any other evidence of overt cardiac disease (Hiss and Lamb, 1962; Lancaster, Schechter, and Massing, 1972). The block may be complete or incomplete, the latter being more common. Right bundle branch block has been studied in relation to body weight, obesity, serum cholesterol and glucose levels, and blood pressure, but the results have been negative (Ostrander, 1964; Kannel et al., 1962). Data presented here suggest that incomplete RBBB is related to vital capacity.

Infants of birthweight up to 2500 g born in 1966 in two district hospitals were followed-up until their school medical examination at six years. Neonatal mortality rates differed in the two cohorts despite similar maternal age, parity, and social class distribution; differences in the management of labour and in neonatal care may have been responsible. Numbers were small but the prevalence of mild or more severe handicaps among the survivors did not differ significantly between the cohorts; an improved mortality was not achieved at the expense of an increased overall morbidity, although there was a suggestion of a difference in cerebral palsy prevalence. It is suggested that the neonatal mortality rate in conjunction with the prevalence of handicaps among the survivors of low birthweight infants be used as an indicator of the efficacy of perinatal care.