Coronary deaths during Midsummer festival in Finland: miseries of long, light nights.

This paper examines whether the anomalous summer peak in deaths from coronary heart disease (CHD) in Finland could be attributed to adverse effects of the Midsummer festival and alcohol consumption during the festival. Daily deaths from CHD and alcohol poisoning in Finland, 1961-2014, that occurred during the 7 days centering on Midsummer Day were analysed in relation to deaths during 14 to 4 days before and 4 to 14 after Midsummer Day. Daily counts of deaths from CHD among persons aged 35-64 years were regressed on days around the Midsummer period by negative binomial regression. Mortality from CHD was highest on Midsummer Day (RR 1.25 (95% confidence interval 1.12-1.31), one day after the peak in deaths from alcohol poisonings. RR for CHD on Midsummer Day was particulary high (RR = 1.43; 1.09-1.86) in the 2000s, 30% of deaths being attributable to that day. In conclusion, the anomalous and prominent summer peak in deaths from CHD in Finland is an adverse consequence of the Midsummer festival. The most likely underlying reason is heavy alcohol consumption during the festival period, especially on Midsummer Eve. In the 2000s, one third of deaths from CHD on Midsummer Day are preventable.

Cold-related pain in the face, upper limbs, and lower body among Thai chicken industry workers: a cross-sectional study.

OBJECTIVE: There is limited information on cold-related pain (CRP) in various parts of the body among workers employed in cold environments. We, therefore, determined the prevalence of CRP among Thai chicken industry workers and attempted to identify vulnerable subgroups. METHODS: Four hundred and twenty-two workers in four chicken meat factories in Thailand were asked about CRP in the face, upper limbs, and lower body. The results were expressed as adjusted prevalence and prevalence differences [PD; in percentage points (pp)] and their 95% confidence intervals (CI). RESULTS: Overall, 80% of the subjects suffered from CRP in at least one site on the body: 66% in the upper limbs, 65% in the lower body, and 44% in the face. In most sites, CRP increased from the lowest to the highest educational level, notably in the nose with a PD of 36 pp [95% CI 23, 49]. Forklift drivers experienced knee pain [PD 21 pp (0, 41)], and manufacturing [PD 27 pp (15, 38)] and storage workers [PD 24 pp (10, 37)] experienced thigh pain more often than office workers, while office workers reported CRP in the cheeks, ears, wrists, and fingers more often than other workers. Women had more CRP than men in several body sites. CONCLUSIONS: The majority of workers suffered from CRP. Intensified protective measures should be targeted not only for forklift drivers and storage and manufacturing workers, but also for the highly educated as well as the office staff who showed excessive prevalence of CRP in several body sites.

Airborne pollen concentrations and daily mortality from respiratory and cardiovascular causes.

We conducted a time-series analysis of the relations between daily levels of allergenic pollen and mortality in the Helsinki Metropolitan Area with 153 378 deaths; 9742 from respiratory and 57 402 from cardiovascular causes. Daily (average) pollen counts of alder, birch, mugwort and grass were measured. In quasi-Poisson regression analysis, abundant alder pollen increased the risk of non-accidental deaths with an adjusted cumulative mortality rate ratio (acMRR) of 1.10 (95% CI 1.01-1.19) and of deaths from respiratory-diseases with acMRR of 1.78 (95% CI 1.19-2.65). Abundant mugwort pollen increased cardiovascular mortality (1.41, 1.02-1.95). These findings identify an important global public health problem.

Cold weather-related cardiorespiratory symptoms predict higher morbidity and mortality.

BACKGROUND: Symptoms perceived in cold weather reflect physiological responses to body cooling and may worsen the course of a pre-existing disease or precipitate disease events in ostensibly healthy individuals. However, the associations between cold-related symptoms and their health effects have remained unknown. We examined whether cold-related cardiac and respiratory symptoms perceived in cold weather predict future morbidity and mortality. METHODS: Cold-related symptoms were inquired in four national FINRISK surveys conducted in 1997, 2002, 2007, 2012 in Finland including altogether 17 040 respondents. A record linkage was made to national hospital discharge and cause-of-death registers. The participants were followed up until the first hospital admission due to a cardiovascular or respiratory disease or death, or until the end of 2015. The individual follow-up times ranged from 0 to 18 years (mean 11 years). The association of cold-related symptoms with morbidity and mortality was examined by Kaplan-Meyer and Cox-regression analyses. RESULTS: Cold-related cardiac [hazard ratio (HR), 1.76 and its 95% confidence interval (95% CI), 1.44-2.15] and combined cardiac and respiratory symptoms [1.50 (1.29-1.73)] were associated with hospitalization due to cardiovascular causes. The respective HRs for admissions due to respiratory causes were elevated for cold-related respiratory [1.22 (1.07-1.40)], cardiac [1.24 (0.88-1.75)] and cardiorespiratory [1.82 (1.50-2.22)] symptoms. Cold-related cardiorespiratory symptoms were associated with deaths from all natural [1.38 (1.11-1.72)], cardiovascular [1.77 (1.28-2.44)] and respiratory [2.19 (0.95-5.06)] causes. INTERPRETATION: Cold weather-related symptoms predict a higher occurrence of hospital admissions and mortality. The information may prove useful in planning measures to reduce cold-related adverse health effects.

Cold-related symptoms and performance degradation among Thai poultry industry workers with reference to vulnerable groups: a cross-sectional study.

BACKGROUND: Few studies have examined cold-related symptoms among cold workplace workers in Thailand. This study aimed to determine the prevalence of cold-related cardiorespiratory, circulatory, and general symptoms and performance degradation among Thai chicken industry workers and identify vulnerable groups. METHODS: Overall, 422 workers aged from 18 to 57 years at four chicken meat factories in Thailand were interviewed for cold-related symptoms and complaints. The results were expressed in terms of model-based adjusted prevalence and prevalence differences (PDs) in percentage points (pp) with 95% confidence intervals (CIs). RESULTS: In total, 76.1% of the respondents reported cold-related respiratory symptoms, 24.6% reported cardiac symptoms, 68.6% reported circulatory symptoms, and 72.1% reported general symptoms. In addition, 82.7% of the respondents reported performance degradation. Cold-related respiratory symptoms increased by PD 29.0 pp. (95% CI 23.4-34.6) from the lowest to the highest educational group, with a similar pattern observed in performance degradation. Forklift drivers and storage and manufacturing workers complained of cold-related respiratory symptoms more than office staff (PD 22.1 pp., 95% CI 12.8-31.3; 12.0 pp., 95% CI 2.4-21.6; and 17.5 pp., 95% CI 11.5-23.6, respectively); they also reported more performance degradation (PD 24.1 pp., 95% CI 17.0-31.2; 19.8 pp., 95% CI 14.1-25.6; and 14.8 pp., 95% CI 8.0-22.6, respectively). Weekly alcohol consumers reported more performance problems owing to cold (PD 18.2 pp., 95% CI 13.9-22.6) than non-consumers of alcohol. Cardiac and circulation symptoms were more common in women than men (PD 10.0 pp., 95% CI 1.1-18.9; and 8.4 pp., 95% CI 0.5-16.4, respectively). The age trend in performance issues was curved, with the highest prevalence among those aged 35-44 years, while the oldest workers (45-57 years) perceived less cold-related symptoms, particularly thirst. CONCLUSIONS: Cold-related symptoms and performance degradation were found to be common in this industry, with vulnerable groups comprising of highly educated workers, forklift drivers, storage and manufacturing workers, weekly alcohol consumers, aging workers, and women. The results demonstrate a need for further research on the adequacy of protection provided against the cold, particularly given that global warming will increase the contrast between cold workplaces and outdoor heat.

Diverse age-incidence patterns of atopic sensitization in an unselected Finnish population up to 12 years.

BACKGROUND: The temporal sequence in which allergic sensitization to different allergens emerges is not well characterized at the level of general population. OBJECTIVE: We describe the incidence patterns of atopic sensitization to different allergens from birth up to 12 years of age in an unselected Finnish population. METHODS: The study population comprised all children born between 2001 and 2006 identified from the nationwide population register as residents of the province of South Karelia, Finland (n = 5564). The results of allergy tests (22,380 results from skin prick tests, immunoglobulin E [IgE] antibodies, and open food challenges [OFCs], performed in 1827 children) were collected from patient records of all the health care units in the area. RESULTS: The incidence rates of positive results for food and animal allergens as well as positive OFCs for cow's milk showed prominent peaks at 5 months of age. Positive results for pollen allergens started to emerge after 1.5 years of age. The 12-year cumulative incidence of sensitization to food, animal, pollen, and any allergens was 12%, 8%, 10%, and 18%, respectively. The cumulative incidence of sensitization to house dust mites was 1% and to molds or latex less than 1%. Firstborn boys had the highest, and those who were not firstborn girls and children born in rural municipalities had the lowest early incidence of sensitization to inhalation allergens. CONCLUSION: In the unselected population, the atopic sensitization against food and animal allergens began before 6 months of age and was followed by sensitization to pollen allergens before 2 years of age. Primary prevention of sensitization to food and inhalation allergens should therefore occur in early infancy.

The prevalence of heat-related cardiorespiratory symptoms: the vulnerable groups identified from the National FINRISK 2007 Study.

The prevalence of heat-related cardiorespiratory symptoms among vulnerable groups is not well known. We therefore estimated the prevalence of heat-related cardiorespiratory symptoms among the Finnish population and their associations with social and individual vulnerability factors. The data came from the National FINRISK 2007 Study, in which 4007 men and women aged 25-74 answered questions on heat-related cardiorespiratory symptoms in the Oulu Cold and Heat Questionnaire 2007. Logistic regression was used to calculate odds ratios (ORs), their 95 % confidence intervals (CIs), and model-predicted prevalence figures. The prevalence of heat-related cardiorespiratory symptoms was 12 %. It increased with age, from 3 % at the age of 25 years to 28 % at the age of 75 years. The symptoms were associated with pre-existing lung (OR 3.93; CI 3.01-5.13) and cardiovascular diseases (OR 2.27; 1.78-2.89); being a pensioner (OR 2.91; 1.65-5.28), unemployed (OR 2.82; 1.47-5.48), or working in agriculture (OR 2.27; 1.14-4.46) compared with working in industry; having only basic vs academic education (OR 1.98; 1.31-3.05); being female (OR 1.94; 1.51-2.50); being heavy vs light alcohol consumer (OR 1.89; 1.02-3.32); undertaking hard vs light physical work (OR 1.48;1.06-2.07); and being inactive vs active in leisure time (OR 1.97; 1.39-2.81). The adjusted prevalence of symptoms showed a wide range of variation, from 3 to 61 % depending on sex, age, professional field, education, and pre-existing lung and cardiovascular diseases. In conclusion, heat-related cardiorespiratory symptoms are commonly perceived among people with pre-existing lung or cardiovascular disease, agricultural workers, unemployed, pensioners, and people having only basic education. This information is needed for any planning and targeting measures to reduce the burden of summer heat.

Dog and cat exposure and respective pet allergy in early childhood.

BACKGROUND: The association of dog and cat exposure in early childhood with the incidence of respective allergies has remained controversial. The aim of the study was to obtain population-based evidence on the association of early exposure to dog or cat, or both, with dog and cat allergies. METHODS: The study population was identified from the nationwide population register comprising all children aged 1-4 yr (N = 4779) born between 2001 and 2005 and living in the province of South Karelia, Finland. Cross-sectional questionnaire data on pet exposure in infancy and physician-diagnosed pet allergies were obtained from 3024 participants and merged with longitudinally accumulated data on sIgE and skin prick tests indicating allergic sensitization abstracted from all patient records in the area. RESULTS: The adjusted relative incidence of positive test results (with 95% confidence intervals) was 2.69 (1.45-5.02) for dog and 5.03 (2.47-10.2) for cat allergens among children exposed to a respective pet alone compared with children without such exposure. The corresponding adjusted prevalence odds ratios for diagnosed dog and cat allergies were 1.75 (0.77-3.79) and 5.13 (2.30-11.4), respectively. The association between pet exposure and the incidence of positive test results was independent of parents' allergies. CONCLUSIONS: Early exposure to dog and cat at home is associated with a higher incidence of respective pet allergy during the first four years of life. Further evidence from population-based studies with longer follow-up is required to justify any recommendation concerning early pet contacts with a view to preventing pet allergies later in life.

Cold-related cardiorespiratory symptoms among subjects with and without hypertension: the National FINRISK Study 2002.

BACKGROUND: Exposure to cold weather increases blood pressure (BP) and may aggravate the symptoms and influence the prognosis of subjects with a diagnosis of hypertension. We tested the hypothesis that subjects with hypertension alone or in combination with another cardiovascular disease (CVD) experience cold-related cardiorespiratory symptoms more commonly than persons without hypertension. This information is relevant for proper treatment and could serve as an indicator for predicting wintertime morbidity and mortality. METHODS: A self-administered questionnaire inquiring of cold-related symptoms was obtained from 6591 men and women aged 25-74 yrs of the FINRISK Study 2002 population. BP was measured in association with clinical examinations. Symptom prevalence was compared between subjects with diagnosed hypertensive disease with (n = 395) or without (n = 764) another CVD, untreated diagnosed hypertension (n = 1308), measured high BP (n = 1070) and a reference group (n = 2728) with normal BP. RESULTS: Hypertension in combination with another CVD was associated with increased cold-related dyspnoea (men: adjusted odds ratio 3.94, 95% confidence interval 2.57-6.02)/women: 4.41, 2.84-6.86), cough (2.64, 1.62-4.32/4.26, 2.60-6.99), wheezing (2.51, 1.42-4.43/;3.73, 2.08-6.69), mucus excretion (1.90, 1.24-2.91/2.53, 1.54-4.16), chest pain (22.5, 9.81-51.7/17.7, 8.37-37.5) and arrhythmias (43.4, 8.91-211/8.99, 3.99-20.2), compared with the reference group. Both diagnosed treated hypertension and untreated hypertension and measured high BP resulted in increased cardiorespiratory symptoms during the cold season. CONCLUSION: Hypertension alone and together with another CVD is strongly associated with cold-related cardiorespiratory symptoms. As these symptoms may predict adverse health events, hypertensive patients need customized care and advice on how to cope with cold weather.

Heat-related thermal sensation, comfort and symptoms in a northern population: the National FINRISK 2007 study.

BACKGROUND: The occurrence of subjective symptoms related to heat strain in the general population is unknown. The present study aimed to describe the temperatures considered to be comfortable or hot and the prevalence of heat-related complaints and symptoms in the Finnish population. METHODS: Four thousand and seven men and women aged 25-74 years, participants of the National FINRISK 2007 study, answered a questionnaire inquiring about the ambient temperatures considered to be hot and the upper limit of comfortable and about heat-related complaints and symptoms. The age trends in threshold temperatures and symptom prevalence were examined in 1-year groups by gender after smoothing with loess regression. The prevalence estimates were also adjusted for age. RESULTS: The temperature considered as hot averaged 26°C and the upper limit for thermal comfort was 22°C. Both temperatures declined with age (from 25 to 74 years) by 1-5°C. Approximately 80% of the subjects reported signs or symptoms of heat strain in warm weather, mostly thirst (68%), drying of mouth (43%), impaired endurance (43%) and sleep disturbances (32%). Cardiac and respiratory symptoms were reported by 6 and 7%, respectively, and their prevalence increased up to the age of 75 years. The exception was thirst, whose prevalence declined with age. Most symptoms and complaints were more prevalent in women than men. CONCLUSIONS: A large percentage of this northern European population suffers from heat-related complaints. Information on these is an aid in assessing the burden of summer heat on population health and is a prerequisite for any rational planning of pre-emptive measures.

Body mass index and overweight in relation to residence distance and population density: experience from the Northern Finland birth cohort 1966.

BACKGROUND: The effect of urban sprawl on body weight in Finland is not well known. To provide more information, we examined whether body mass index (BMI) and the prevalence of overweight are associated with an individual's distance to the local community centre and population density in his/her resident area. METHODS: The sample consisted of 5363 men and women, members of the Northern Finland Birth Cohort 1966 (NFBC), who filled in a postal questionnaire and attended a medical checkup in 1997, at the age of 31 years. Body mass index (BMI; kg/m(2)) and the prevalence of overweight (BMI ≥ 25.0 kg/m(2)) were regressed on each subject's road distance to the resident commune's centre and on population density in the 1 km(2) geographical grid in which he/she resided, using a generalized additive model. Adjustments were made for sex, marital status, occupational class, education, leisure-time and occupational physical activity, alcohol consumption and smoking. RESULTS: The mean BMI among the subjects was 24.7 kg/m(2), but it increased by increasing road distance (by 1.3 kg/m(2) from 5-10 to 20-184 km) and by decreasing population density (by 1.7 kg/m(2) from 1000-19,192 to 1-5 inhabitants/km(2)). The respective increases in overweight (overall prevalence 41%) were 13 per cent units for distance and 14 per cent units for population density. Adjusted regressions based on continuous explanatory variables showed an inverse L-shaped pattern with a mean BMI of 24.6 kg/m(2) at distances shorter than 5 km and a rise of 2.6 kg/m(2) at longer distances, and an increase of 2.5 kg/m(2) from highest to lowest population density. The associations with road distance were stronger for women than men, while the sex difference in association with population density remained indeterminate. CONCLUSIONS: We conclude that young adults in Northern Finland who live far away from local centres or in the most sparsely populated areas are fatter than those who live close to local centres or in densely populated areas. The likely explanations include variations in everyday physical activity in different residential environments, although causality of the associations remains to be confirmed.

Body mass index is associated with lumbar disc degeneration in young Finnish males: subsample of Northern Finland birth cohort study 1986.

BACKGROUND: The role of environmental factors in lumbar intervertebral disc degeneration (DD) in young adults is largely unknown. Therefore, we investigated whether body mass index (BMI), smoking, and physical activity are associated with lumbar DD among young adults. METHODS: The Oulu Back Study (OBS) is a subpopulation of the 1986 Northern Finland Birth Cohort (NFBC 1986) and it originally included 2,969 children. The OBS subjects received a postal questionnaire, and those who responded (N = 1,987) were invited to the physical examination. The participants (N = 874) were invited to lumbar MRI study. A total of 558 young adults (325 females and 233 males) underwent MRI that used a 1.5-T scanner at the mean age of 21. Each lumbar intervertebral disc was graded as normal (0), mildly (1), moderately (2), or severely (3) degenerated. We calculated a sum score of the lumbar DD, and analyzed the associations between environmental risk factors (smoking, physical activity and weight-related factors assessed at 16 and 19 years) and DD using ordinal logistic regression, the results being expressed as cumulative odds ratios (COR). All analyses were stratified by gender. RESULTS: Of the 558 subjects, 256 (46%) had no DD, 117 (21%) had sum score of one, 93 (17%) sum score of two, and 92 (17%) sum score of three or higher. In the multivariate ordinal logistic regression model, BMI at 16 years (highest vs. lowest quartile) was associated with DD sum score among males (COR 2.35; 95% CI 1.19-4.65) but not among females (COR 1.29; 95% CI 0.72-2.32). Smoking of at least four pack-years was associated with DD among males, but not among females (COR 2.41; 95% CI 0.99-5.86 and 1.59; 95% 0.67-3.76, respectively). Self-reported physical activity was not associated with DD. CONCLUSIONS: High BMI at 16 years was associated with lumbar DD at 21 years among young males but not among females. High pack-years of smoking showed a comparable association in males, while physical activity had no association with DD in either gender. These results suggest that environmental factors are associated with DD among young males.

Self-Assessed Threshold Temperature for Cold among Poultry Industry Workers in Thailand.

The self-assessed threshold temperature for cold in the workplace is not well known. We asked 392 chicken industry workers in Thailand what they regard as the cold threshold (CT) and compared subgroups of workers using linear and quantile regressions by CT sextiles (percentiles P17, P33, P50, P67, and P83, from warmest to coldest). The variables of interest were sex, office work, and sedentary work, with age, clothing thermal insulation, and alcohol consumption as adjustment factors. The mean CT was 14.6 °C. Office workers had a 6.8 °C higher mean CT than other workers, but the difference ranged from 3.8 °C to 10.0 °C from P17 to P83. Sedentary workers had a 2.0 °C higher mean CT than others, but the difference increased from 0.5 °C to 3.0 °C through P17-P83. The mean CT did not differ between sexes, but men had a 1.6-5.0 °C higher CT at P17-P50 (>20 °C) and a 5.0 °C lower CT at P83 (<10 °C). The CT was relatively high at warm (≥10 °C), dry (relative humidity <41%), and drafty (air velocity > 0.35 m/s) worksites. We conclude that office, sedentary, and female workers and those working at warm, dry, and draughty sites are sensitive to the coldest temperatures, whereas male workers are sensitive even to moderate temperatures.

Heredity of food allergies in an unselected child population: an epidemiological survey from Finland.

The heredity of food allergies (FA) has not previously been addressed in a large unselected child population. Our target population comprised all children born from April 2001 to March 2006 resident in one province of South-East Finland (n c. 6000), as identified from the national population register. In a questionnaire survey conducted in 2005-2006, data were obtained on allergic manifestations (FA symptoms, atopic rash, allergic asthma, hay fever/pollen allergy, or animal allergy) in the biologic parents of 3800 children (64% of the total). Concurrently with the survey but independently of it, results of specific immunoglobulin E antibodies (sIgE), skin prick tests (SPT), and open food challenges (OFC) in the offspring were collected from patient records throughout the province. Up to the age of 4 yr, the incidences of any positive FA test, a positive SPT or sIgE for food items, and a positive OFC in these children were threefold higher if both parents reported having an allergic manifestation and twofold higher if either mother or father had such a manifestation when compared with children whose parents did not report any of these conditions. The estimated risk of any positive FA test increased by a factor of 1.3 (95% CI 1.2-1.4) for each additional allergic manifestation in the parents. Positive FA tests in the offspring were relatively strongly associated with the reports of allergic phenotypes and the number of these phenotypes in their biologic parents.

Real-life epidemiology of food allergy testing in Finnish children.

BACKGROUND: The cumulative incidence of parental-reported symptoms of food allergy (FA) during the first years of life is estimated to exceed 30%. However, the occurrence and determinants of FA testing in a general child population have remained unknown. METHODS: The study population comprised all 5920 children aged 0-4 yr in the province of South Karelia, Finland, identified from the nationwide population register. The study included a questionnaire survey and a retrospective collection of FA test results (skin prick tests, IgE antibodies, or open food challenges) from the patient records of the entire study population. The questionnaire and patient record data were linked together on an individual basis with the parents' permission. RESULTS: A total of 5849 FA tests had been performed on 961 children. By the age of 4 yr, the cumulative incidence of FA testing was 18% for any food item; 17% for essential items (milk, egg, cereals) and 9% for other food items. Essential food items had been tested in 90% of children who reportedly had a physician-diagnosed FA for these. The incidence of testing was 30% higher in boys than in girls and twofold higher among the offspring whose either or both parents reportedly had some allergic manifestation. CONCLUSIONS: A large proportion of children are subjected to FA testing in their early years. This result shows the need to evaluate the financial burden of FA testing and to improve current testing practices.

SKARP--A population-based cohort study of childhood food-associated symptoms perceived by parents and food allergies diagnosed by physicians: design, methods and participation.

BACKGROUND: Few epidemiological studies exist on food-associated symptoms and allergies in large unselected child populations. AIMS: To describe the design, methods and participation rate of the South Karelian Allergy Research Project (SKARP), a population-based epidemiological study on food-associated symptoms and physician-diagnosed food allergies. METHODS: The study population of 5,973 children born between 2001 and 2006 and resident in the province of South Karelia, Finland, was identified from the nationwide population register. The parents received a questionnaire to be returned at their child's annual visit to the child health clinic, where supplementary interviews were performed. Results of allergy tests (skin prick tests, immunoglobulin E antibodies and open food challenges) performed on participants and non-participants were collected from the relevant health care units in the area. RESULTS: Participation rates in the questionnaire study were 54% (644/1,194) among the parents of neonates and 69% (3308/4,779) among those of the children aged 1 to 4 years. Cooperation with the child health clinics and mailing of a reminder questionnaire improved participation by 8 and 10 percentage points, respectively. The final participation rate seemed to be unaffected by whether the child had or had not been tested for suspected allergy. CONCLUSIONS: A reasonably good participation rate and almost complete coverage of allergy tests were achieved thanks to successful cooperation with the child health clinics and test laboratories. This baseline study forms a representative database to estimate the occurrence of food-associated symptoms, physician-diagnosed food allergies and allergy testing in the general population.

Smoking differences between employees in faculties of the University of Tartu, Estonia, and changes during the country's transition.

BACKGROUND: A previous study found marked differences in smoking between employees in various university faculties in Tartu, Estonia, soon after the disruption of communism. The present study was conducted to see whether such differences still exist and how the patterns had changed during the country's first transitional decade. METHODS: All employees at the University of Tartu (UT) were surveyed for smoking habits by means of a questionnaire in 1992 and 2003. The present paper is based on respondents whose faculty or workplace was known (1390 people in 1992, 1790 in 2003). Smoking differences were assessed in terms of regression-based adjusted figures. RESULTS: While 20% of the male employees smoked daily in 1992, 13% did so in 2003, the figures for females being 10% and 7%, respectively. The prevalence of men's daily smoking varied between faculties and other workplaces in the range 4-30% in 1992, and 0-24% in 2003, with corresponding ranges of 3-21% and 0-10% among females. Men in the medical faculty in both surveys, and those in the faculty of philosophy in the second survey showed higher rates than men in most other faculties, as did women in the faculty of law in the first survey and those in the faculty of philosophy in the second. The figures were usually low in the faculties of sports & exercise, physics & chemistry and mathematics. The sex pattern was reversed in the faculty of law and also in that of economics, where the women smoked more than the men. CONCLUSIONS: Even in this low-smoking academic community, wide smoking differences existed between the faculties and other workplaces. Faculties where physical or mental performance is of prime importance are leading the way towards a smoke-free community, while men in the faculty of philosophy and, paradoxically, men in the medical faculty are lagging behind. The reversed sex ratio in the faculties of law and economics may indicate women's intensified drive for equality in this transitional society. We assume that different professional cultures may introduce variations in smoking patterns, thereby modifying the course of the smoking epidemic.

Workplace Cold and Perceived Work Ability: Paradoxically Greater Disadvantage for More vs. Less-Educated Poultry Industry Workers in Thailand.

The association between worksite temperature and perceived work ability (WA) in various educational classes remains unknown. Therefore, we interviewed 286 poultry industry workers in Thailand about their WA and linked their responses to worksite temperature. WA was based on the self-assessment of current work ability compared with their lifetime best ability (scores 0-10). Education was classified as high (university or vocational school) or low (less education). Temperature was classified as cold (-22-10°C) or warm (10-23°C). WA and the occurrence of a low WA were regressed on worksite temperature, education, and their interaction with the adjustment for sex, age, job category, physical work strain, moving between cold and warm sites, thermal insulation of clothing, relative humidity, and air velocity. The average worksite temperature was 10°C for high- and 1°C for low-educated workers. The average WA score was 8.32 (SD, 1.33; range, 4-10) and classified as low (<8) in 23% of the workers. In highly-educated workers, the adjusted mean WA decreased from 9.11 in the warm areas to 8.02 in the cold areas and the prevalence of a low WA increased from 11 to 30%, while no significant change was observed in less-educated workers. The WA score was estimated to decline by 10% more (95% CI, 4-16%) in the cold areas for the more vs. less-educated workers and the prevalence of a poor WA was estimated to increase 3.09 times (95% CI, 1.43-5.45) more. Highly-educated workers in this industry are a risk group that should be given customized advice.

Climate Warming and Occupational Heat and Hot Environment Standards in Thailand.

BACKGROUND: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38-41oC to 42-44oC. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work-rest regimen. This study examined whether the present standard still protects most workers. METHODS: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants' workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. RESULTS: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5oC, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44-2.48) in odds for having symptoms. CONCLUSION: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.

Association of biomass fuel use with reduced body weight of adult Ghanaian women.

The association of biomass fuel use with body weight has never been investigated. We therefore examined the effect of biomass fuel use on body weight of adult Ghanaian women. Data from the 2014 Ghana Demographic and Health Survey, a nationally representative population-based survey was analysed for this study. A total of 4751 women who had anthropometric (height and weight) data qualified for inclusion in this study. In linear regression modelling, charcoal use resulted in 3.08 kg (95% CI: 2.04, 4.12) and 0.81 kg/m2 (95%CI: 0.29, 1.33) reduction in weight and body mass index (BMI), respectively, compared to clean fuel (electricity, liquefied petroleum gas and natural gas) use. Use of wood resulted in much higher reduction in weight and BMI. In modified Poisson regression, charcoal users had 19% (Adjusted Prevalence Ratio [aPR] = 0.81; 95%CI: 0.71, 0.92) and 29% (aPR = 0.71; 95%CI: 0.61, 0.83) decreased risk of overweight and obesity, respectively, compared to clean fuel users. Wood users had much higher decreased risk of overweight and obesity. In conclusion, biomass fuel use was associated with reduced body weight and BMI of Ghanaian women and is the first report on the relationship. However, it is important that our findings are confirmed and the biological mechanisms elucidated through rigorous study designs.