U.S. Blue Water Navy Veterans of the Vietnam War: Comparisons from the Vietnam Era Health Retrospective Observational Study (VE-HEROeS).

Background: US Vietnam War Blue Water Navy veterans (BWN) conducted military operations on Vietnam's offshore waters and likely experienced various war-related exposures. The overall health of the BWN has never been systematically studied. Purpose: Describe and compare BWN's health with other servicemembers and non-veterans of the Vietnam era. Materials and methods: Survey of 45 067 randomly selected US Vietnam War theatre and non-theatre veterans and 6885 non-veterans. Results: For 22 646 male respondents, self-reported health was contrasted by veteran status defined as BWN (n=985), theatre veterans (n=6717), non-theatre veterans (n=10 698) and non-veterans (n=4246). Exposure was service in the Vietnam War theatre. Collected were demographics, military service characteristics, lifestyle factors and health conditions. Adjusted odds ratios (aOR) were calculated using multivariable logistic regression. Controlling for cigarette smoking and other covariates, respiratory cancer risk was highest in BWN vs other veterans (theatre: aOR 1.65; 95% CI 1.09, 2.50; non-theatre: aOR 1.77; 1.13, 2.77) and to non-veterans (aOR 1.78; 1.15, 2.74). Other findings showed BWN's health risks between theatre and non-theatre veterans. Conclusion: There was a higher risk for respiratory cancers in BWN. Other risks were less than theatre veterans but greater than non-theatre or non-veterans, indicating a potential role of military exposures in BWN's health.

Race/ethnicity differences in the prevalence of noise-induced hearing loss in a group of metal fabricating workers.

The National Institute of Occupational Safety and Health rates noise-induced hearing loss as one of the top 10 work-related problems, involving at least 11 million workers. This retrospective study examines the differences between pure-tone hearing loss and race/ethnicity in 216 white and 70 non-white male metal fabricating workers. Significant variables upon univariate analysis found to be associated with race/ethnicity were mean years of employment and proportion of time worked without hearing protection. Among whites, the permanent threshold average for 1, 2, 3 and 5 kHz was 25.99 dB, compared with 17.71 dB in non-whites (P < 0.01). Backwards stepwise regression indicated that race/ethnicity, after being adjusted for years of employment, was the major-effect variable. The results of this study suggest that occupational noise exposure alone does not alone account for the racial hearing differences.

Age-related changes in the prevalence of smell/taste problems among the United States adult population. Results of the 1994 disability supplement to the National Health Interview Survey (NHIS).

Information about the prevalence of disorders of the chemical senses has been limited. In the late 1970s, the consensus among experts convened by the National Institutes of Health (NIH) was that more than 2 million adults in the United States had a disorder of smell or taste. A large, nonrandom survey conducted by the National Geographic Society in 1987 found that 1% of their 1.2 million respondents could not smell 3 or more of 6 odorants using a 'scratch and sniff' test. Age was an important factor, with a decline beginning in the second decade of life. No comparable data have been available for taste, although it has been suggested that the sense of taste remains more robust with age. The National Institute on Deafness and Other Communication Disorders (NIDCD), NIH, began collaborating with the National Center for Health Statistics (NCHS) in 1993 to acquire information on the prevalence of smell/taste problems using the Disability Supplement to the National Health Interview Survey (NHIS). This survey was administered to approximately 42,000 randomly-selected households (representing about 80,000 adults over 18 years of age) in 1994. Adjusted national estimates derived from this survey showed a prevalence of 2.7 million (1.4%) U.S. adults with an olfactory problem. Also, 1.1 million (0.6%) adults reported a gustatory problem. When smell or taste problems were combined, 3.2 million (1.65%) adults indicated a chronic chemosensory problem. The prevalence rates increased exponentially with age. Almost 40% with a chemosensory problem (1.5 million) were 65 years of age or greater. In a multivariate analysis, the individual's overall health status, other sensory impairments, functional limitations (including difficulty standing or bending), depression, phobia, and several other health-related characteristics were associated with an increase in the rate of chemosensory disorders.

Selection of neighborhood controls for a study of factors related to the diagnosis of cervical cancer.

The level of effort required to generate neighborhood controls for a statewide matched case-control study of cervical cancer was investigated, with the aim of identifying hard-to-reach demographic subgroups. Cross reference telephone directories were used to identify households on the same street as the case. Letters were then sent to the households, followed by 'phone calls. A total of 2920 households were contacted to obtain 147 controls. Overall, 63.6% of age-eligible contacts participated in the study. In 49.3% of all households the major reason for not obtaining a control was "no age-eligible women". Level of effort required to obtain a matched control was greater for black women than for white women--on average 24 letters and 40 'phone calls for black women vs 12 letters and 20 calls for white women. Fewer eligible younger women refused to be interviewed than older. No marked differences were noted when the data were stratified by urban-rural area of residence.

Is NIDDM a risk factor for noise-induced hearing loss in an occupationally noise exposed cohort?

Little is known about what factors, other than chronic exposure to noise, predispose individuals to noise-induced hearing loss (NIHL). The current retrospective study was designed to identify risk factors for NIHL in a population of 229 men [age 55-68 (mean = 63 years)] employed at a metal assembly plant. All men had been chronically occupationally noise-exposed for approximately 30 years (> or = 89 dBA) with an average Ea noise emission level) of 104.5. The clinical examination included a pure-tone threshold audiometric evaluation, discrimination of speech in background noise [W-22 Max (> 60% indicating better hearing)], blood pressure measurement, evaluation of lifestyle (alcohol consumption, cigarette smoking, noisy hobbies) and occupational and military history. Severe NIHL was defined as > or = 65 db loss at 3, 4 or 6 kHz in at least one ear +/- 20 db threshold in the contralateral ear. History of non-insulin dependent diabetes mellitus (NIDDM) was reported by 16.4% of the 146 men with severe NIHL compared to 4.8% of the 83 men without severe NIHL (odds ratio = 3.9, C.I. 1.2-11.9, P = 0.05). Simultaneous evaluation of several potential risk factors using a multiple logistic regression indicates that the significant predictors of severe NIHL were diabetes (P < 0.05), Ea (P < 0.05) and age (P < 0.05). These results suggest that a person with NIDDM who is also occupationally noise-exposed is more likely to develop severe NIHL than those without NIDDM. Longitudinal studies are necessary to confirm the temporal relationship between NIDDM and NIHL and to determine the exact mechanisms that are involved with this increased risk of hearing loss.

Noise-induced hearing loss: a possible marker for high blood pressure in older noise-exposed populations.

The present study assessed the relationships among occupational noise exposure, noise-induced hearing loss, and high blood pressure. The study population consisted of 245 retired metal assembly workers from Pittsburgh aged 56 to 68 with chronic noise exposure of 30 or more years at greater than or equal to 89 dBA. Results of the audiometric testing indicated 52% of the younger workers (ages 56 to 63) have severe noise-induced hearing loss (greater than or equal to 65 dBA loss at 3, 4, or 6 kHz) and 67% of older workers (ages 64 to 68). Body mass index and alcohol intake were significantly related to systolic and diastolic blood pressure. Among older men, there was a marginally significant increased prevalence of high blood pressure (greater than or equal to 90 mm diastolic or taking blood pressure medicine) among those with severe noise-induced hearing loss (P = .05). Moreover, another measure of hearing loss at high frequencies, speech discrimination score in noise (measured in the better ear), referred to as the W-22 MAX score, was also found to be related to the prevalence of high blood pressure in the older (64 to 68) age group (P less than .05). Multiple regression analysis revealed W-22 MAX and severe noise-induced hearing loss were independent predictors of hypertension in the older, but not in the younger group of retired workers.