ABSTRACT
During the period 1981-1983, 19 cases of Guillain-Barré syndrome (GBS) occurred in residents of Larimer County, Colorado, for an incidence of 4.0 cases per 100,000 population per year, compared with 1.2 cases per 100,000 per year in 1975-1980 (p less than 0.05). The higher incidence of GBS in 1981-1983 may represent an unusual chance occurrence, since no patient characteristics or predisposing events could be found to explain the increase. Nevertheless, the findings demonstrate that over a period of as long as 3 years, the crude average annual incidence of GBS in a large, well-defined population may exceed by twofold the upper limit of the previously reported range (0.6 to 1.9 cases per 100,000 per year).
Subject(s)
Polyradiculoneuropathy/epidemiology , Colorado , HumansABSTRACT
BACKGROUND: In the late 1980s, evidence of an epidemic of craniosynostosis in Colorado included reports of clusters from selected high-altitude communities and an investigation showing the high and rapidly rising rates of surgically corrected synostosis. Some evidence suggested that local diagnostic practice could account for the epidemic. OBJECTIVE: To determine the contributions of any excess rates of disease occurrence, surgery-based ascertainment, and diagnosis to the reported epidemic. DESIGN: Population-based birth prevalence study with diagnostic evaluation. SETTING: The Colorado Department of Health, April 15, 1986, to July 14, 1989. PATIENTS OR OTHER PARTICIPANTS: Children in the Craniosynostosis Registry or state birth record files. MAIN OUTCOME MEASURES: Birth prevalence was estimated from registry and birth record data; case classification by suture type and malformation patterns were determined by review of radiographs and medical records. RESULTS: The period birth prevalence of radiographically confirmed nonsyndromic synostosis was 14.1 per 10,000 live births. Of a total of 605 children, 307 (51%) had definite radiographic evidence of synostosis, for which the intrarater reliability was good (except for the coronal suture on plain films) and the interrater reliability was fair or good (except for the metopic suture on plain films). Between the first and third years, case reports fell from 347 to 103. CONCLUSIONS: Diagnostic criteria strongly influenced the rate of synostosis. The rate of radiographically confirmed synostosis was within the range of published estimates. Low diagnostic thresholds, which changed over time, created the semblance of a severe statewide epidemic and may have obscured excess rates of disease at high altitude.
Subject(s)
Craniosynostoses/diagnostic imaging , Craniosynostoses/epidemiology , Colorado/epidemiology , Craniosynostoses/classification , Humans , Infant , Infant, Newborn , Observer Variation , Prevalence , Registries/statistics & numerical data , Skull/diagnostic imaging , Tomography, X-Ray ComputedSubject(s)
Indians, North American , Kidney Neoplasms/epidemiology , Black or African American , Female , Humans , Kidney Neoplasms/mortality , Male , OklahomaSubject(s)
Urinary Bladder Neoplasms/epidemiology , Adult , Age Factors , Aged , Female , Humans , Male , Middle Aged , Oklahoma , Racial Groups , Sex Factors , Urbanization , Urinary Bladder Neoplasms/mortalitySubject(s)
Salmonella Infections/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Oklahoma , Retrospective StudiesSubject(s)
Rheumatic Fever/epidemiology , Rheumatic Heart Disease/epidemiology , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , OklahomaABSTRACT
The relation between various risk factors and adenocarcinoma of the lung was evaluated in a case-control study. Subjects were selected from the Colorado Central Cancer Registry from 1979-1982 in the Denver metropolitan area. A total of 102 (50 males and 52 females) adenocarcinoma case interviews and 131 (65 males and 66 females) control interviews were completed. The control group consisted of persons with cancers of the colon and bone marrow. The risk estimates associated with cigarette smoking were significantly elevated among males (odds ratio (OR) = 4.49) and females (OR = 3.95) and were found to increase significantly (p less than 0.01) with increasing levels of cigarette smoking for both males and females. For adenocarcinoma in females, the age- and smoking-adjusted odds ratios at different levels of passive smoke exposure followed an increasing overall trend (p = 0.05). After additional adjustment for potential confounders, prior cigarette use remained the most significant predictor of risk of adenocarcinoma among males and females. Analysis restricted to nonsmoking females revealed a risk of adenocarcinoma of 1.68 (95% confidence interval (Cl) = 0.39-2.97) for passive smoke exposure of four or more hours per day. Neither sex showed significantly elevated risk for occupational exposures, although males bordered on significance (OR = 2.23, 95% Cl = 0.97-5.12). The results suggest the need to develop cell type-specific etiologic hypotheses.
Subject(s)
Adenocarcinoma/etiology , Air Pollutants/poisoning , Lung Neoplasms/etiology , Aged , Epidemiologic Methods , Female , Humans , Male , Middle Aged , Occupations , Risk , Smoking , Socioeconomic Factors , Tobacco Smoke PollutionABSTRACT
In June, 1976, the authors conducted a cross-sectional survey of a community near a cadmium smelter in Denver, Colorado, to evaluate human cadmium absorption and its possible health effects. In 1975 the mean annual airborne cadmium concentration in an area about 1 km from the smelter was 0.023 microgram/m3; the mean concentration in a comparison area 13 km distant was 0.003 microgram/m3. Whole blood and urine specimens were collected from 250 individuals residing within 2 km of the smelter and from a control population of 105 residents in the comparison area. There were no significant differences (p greater than .05) in whole blood or urine cadmium concentrations, as determined by flameless atomic absorption spectrophotometry, between persons in the two areas. The median blood and urine cadmium concentrations of residents within 1 km of the smelter were 0.05 and 0.09 microgram/100 ml, compared with 0.07 and 0.08 microgram/100 ml for control area residents. However, the difference between blood cadmium levels for smokers and nonsmokers was statistically significant (p less than .01). The median blood cadmium concentration for smokers was 0.21 microgram/100 ml compared with 0.04 microgram/100 ml for nonsmokers. Other laboratory determinations of blood and urine showed no evidence of a cadmium effect on hematopoietic or renal function.
Subject(s)
Cadmium/metabolism , Environmental Exposure , Absorption , Adolescent , Adult , Aged , Air Pollution , Cadmium/blood , Cadmium/urine , Child , Child, Preschool , Colorado , Female , Humans , Infant , Male , Middle Aged , SmokingABSTRACT
This population-based case-control study was designed to investigate risk indicators for the occurrence of the birth defect craniosynostosis in Colorado. A total of 173 children who underwent craniectomy for craniosynostosis and 759 children without craniosynostosis were included in the study. Multivariable logistic regression analysis of birth certificate data showed that male sex (odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.1-2.2), maternal five-year age "increase" (OR = 1.3, 95% CI = 1.1-1.5), plural birth (OR = 3.0, 95% CI = 1.2-7.1) and black maternal race (OR = 0.0, 95 per cent CI = 0.0-0.6) were independently associated with craniosynostosis. There was a weak positive association between craniosynostosis and the altitude of the town closest to the maternal residence, but no association was found with maternal education, marital status, number of previous births, or previous pregnancy termination. The association of craniosynostosis with plural birth is consistent with the hypothesis of fetal head constraint.