Lack of association between cancer incidence and residence near petrochemical industry in the San Francisco Bay area.

Estimated age-adjusted incidence rates for cancer during 1971--77 among Kaiser Foundation Health Plan (KFHP) members living in a portion of the San Francisco Bay area (SFBA) characterized by a heavy concentration of petroleum and chemical industries were compared to estimated rates among KFHP members in the remainder of the SFBA. One hundred fifty-four comparisons were done for 41 selected cancer sites. The number of significant differences did not appear inconsistent with what might be expected by chance alone; furthermore, in most of these instances the so-called exposed area showed the lower rate. These findings provided some assurance that place of residence near petrochemical industries is not associated with increased cancer risk.

Serum glucose levels and alcohol-consumption habits in a large population.

Using information from approximately 100,000 multiphasic check-ups performed in these facilities, we have found an association between alcohol-drinking habits and serum glucose values one hour after an oral challenge with 75 gm. of glucose. There was a positive dose-response relation between reported alcohol intake and serum glucose level over the most common range of alcohol intake. Serum glucose levels were highest in the group who consumed six to eight alcoholic drinks per day. However, among those who said they took nine or more drinks per day, mean serum glucose levels were significantly lower than in the six-to-eight-drink group. These relations persisted when the analysis was controlled for the effects of age, sex, race, adiposity, time since last food intake, time of day, previously known diabetes, and previously known liver disease. A search of the literature failed to uncover a complete explanation for these phenomena.

Alcohol, tobacco, and hypertension.

In many studies of diverse populations it has been found that persons drinking relatively large amounts of alcohol tend to have higher blood pressures. In the Kaiser-Permanente study of about 87,000 persons, this alcohol-blood pressure association was not attributable to demographic characteristics, adiposity, reported salt use, smoking, or coffee consumption, nor could it be explained by underreporting of alcohol consumption. If the relationship is a causal one, the pathogenesis is not yet established; direct mechanisms or the effects of withdrawal from alcohol are possible explanations. The Kaiser-Permanente data suggest that about 5% of hypertension in the general population may be due to the consumption of three or more alcoholic drinks per day. Alcohol use shows a positive relation to some sequelae of hypertension but not others; the outstanding exception is coronary heart disease which is negatively related to alcohol intake, probably through different mechanisms. In most studies, cigarette smokers have shown similar or slightly lower blood pressures than non smokers. The degree to which this is due to the thinner body build of smokers, on the average, is not well established; nor is the degree to which a stronger negative relation of smoking to blood pressure might be masked by concomitant alcohol use.

Physiologic measures in men with and without vasectomies.

PIP: Blood pressure, hematologic and blood chemistry measurements, and serologic tests for syphilis were performed on 4385 vasectomized and 13,155 age- and race-matched, nonvasectomized men who had multiphasic health checkups as members of a large prepaid medical care program in California. The study was carried out from 1977 through 1980. Age distributions of the vasectomized and nonvasectomized men were identical, 33% of both groups being 40 years old or younger, 33% being 41-50, and 34% being 51 or older. 37% of the vasectomized men had their vasectomies 10 or more years before their examination. Systolic blood pressure was slightly but significantly lower and potassium was slightly but significantly higher in the vasectomized group. All other differences were small and not biologically important. These data agree with other studies of vasectomized humans, in which no association of vasectomy with adverse health outcomes, including atherosclerosis, has been found.^ieng

Egg counts utilizing trichrome-stained smears from polyvinyl alcohol (PVA)-preserved fecal specimens.

A simple method of making egg counts on fecal specimens is described. It utilizes PVA-preserved stool, yields a permanent stained slide, and is as accurate and reproducible as other methods in common use.

Changes after quitting cigarette smoking.

Changes in cardiorespiratory symptoms and coronary disease risk indicators over an average 1 1/2-year period were assessed in 9392 persistent cigarette smokers and 3825 persons who quit smoking between two multiphasic checkups. The prevalence of questionnaire-reported chronic cough fell markedly in subjects who quit a one-or-more-pack/day habit (e.g., from 11.2% to 1.8% in white men, p less than 0.001). However, chest pain, shortness of breath and exertional leg pain showed no consistent improvement in quitters compared with persistent smokers. Weight gain was about 2-3 lbs greater in quitters, but changes in blood pressure were small and not consistent across race-sex groups, nor were there consistent differences between persistent smokers and quitters in trends in trends in vital capacity, cholesterol or prevalence of ECG abnormality. Quitting was associated with increase in serum uric acid levels of about 0.2-0.5 mg/dl and relative falls in hemoglobin, leukocyte count and serum glucose levels, all consistent with smoker-nonsmoker differences previously found in cross-sectional studies. Except for the small increases in weight and uric acid levels, quitting smoking did not appear to increase risk of coronary heart disease by other mechanisms.

Thinness and mortality.

The relationship of thinness to mortality was examined in White adult members of the Kaiser Permanente Medical Care Program who had at least three multiphasic health checkups between 1964 and 1972, with mortality follow-up through 1980. A detailed comparison was performed of the mortality patterns of "thin" (decile 1 of Quetelet's index) and "average" weight (deciles 4 and 5) cohort members who were age 40-79 years and free of illness at the beginning of follow-up. Thin male (relative risk 1.6, 95 per cent confidence limits 1.0, 2.6) and female (R.R. 2.1, 95 per cent C.L. 1.1, 3.9) current cigarette smokers were at increased risk of mortality compared with average weight smokers. Unmeasured differences between thin and average weight smokers with respect to quantity of cigarettes smoked may have contributed to the apparent association of thinness with mortality in smokers. Thinness was not associated with increased mortality in never smokers and ex-smokers (R.R. 1.0 in men and women). As association of long-term weight loss with mortality was present in thin and average weight men and in thin women.

Alcohol use, myocardial infarction, sudden cardiac death, and hypertension.

Studying coronary risk factors, this article concludes that: regular use of alcohol may protect against major coronary events; regular use of three or more drinks daily is a probable risk factor for hypertension; the relations of alcohol use to coronary disease, hypertension, and cardiomyopathy are disparate.

Lung function and risk of myocardial infarction and sudden cardiac death.

In a serach for risk factors for myocardial infarction and sudden cardiac death, the mean total vital capacity as measured at multiphasic health checkups was lower in persons who later had a first myocardial infarction than in risk-factor-matched controls (3.17 vs. 3.29 liters, 395 pairs, P less than 0.05) and non-risk-factor-matched controls (3.16 vs. 3.41 liters, 401 pairs, P less than 0.001). Findings were little affected by age and height adjustment and were similar for sudden cardiac death. The first-second vital capacity was also inversely related to later development of these conditions, but the ratio of that measurement to total vital capacity was not. Heavy smoking, productive cough, exertional dyspnea and cardiac enlargement were associated with diminished total capacity. However, exclusion of subjects with these findings did not reduce the predictive value of total vital capacity. Diminished vital capacity deserves continued attention as a possible coronary risk factor. Its relation to subsequent coronary events is not well explained.

Alcohol use and cardiovascular disease: the Kaiser-Permanente experience.

Earlier studies of Kaiser-Permanente data have indicated that regular use of alcohol is associated with a reduced risk of major coronary events and that regular use of three or more drinks is associated with an increased prevalence of hypertension. A new study of hospitalizations in relation to alcohol use confirms this disparity in relations between alcohol use and cardiovascular disease and suggests that alcoholic cardiomyopathy has a relatively low incidence. An inverse relation between alcohol use and hospitalizations for cholelithiasis raises the possibility of a common pathogenic mechanism linking alcohol to coronary events and cholelithiasis. Overall risk of cardiovascular disease seems lower among users of two or fewer drinks daily than among either nondrinkers or heavier drinkers.