Psychosocial stress among Danish vicars.

BACKGROUND: Burnout and depression are common among clergy members of several religions and denominations. Despite this, no studies have analysed whether differences in psychosocial workloads between vicars and others explain their higher prevalence of stress-related symptoms. AIMS: To test the hypothesis that elements of the job strain model (high work demands, low decision latitude and/or low job support) are mediators of the excess prevalence of stress-related health complaints among vicars compared with other employees in the Church of Denmark. METHODS: Data for this cross-sectional study were collected by means of a self-administered questionnaire sent to all employees in 500 Danish parishes (n = 2254). RESULTS: The study response rate was 73%, 35% of respondents were vicars and 43% were female. Compared with other employees, vicars felt quiet and relaxed less often (53 versus 67%), had less time for pleasure and relaxation (28 versus 11%) and felt happy and satisfied (53 versus 67%) less often. Vicars had significantly higher quantitative, cognitive and emotional work demands, lower work support, less influence on whom to collaborate with and less influence on their workload. Psychosocial workloads were more favourable for the vicars who had greater influence on job decisions and on job organization. The higher prevalence of stress-related symptoms among vicars was strongly modified by high work demands, in particular high quantitative demands. CONCLUSIONS: The higher prevalence of stress-related symptoms among vicars could largely be attributed to high-quantitative work demands.

ABO phenotypes and inflammation-related predictors of lung cancer mortality: the Copenhagen Male Study - a 16-year follow-up.

Inflammation and genetic susceptibility influence the risk of lung cancer. Previous studies suggest that the inflammatory response may depend upon ABO phenotype. The hypothesis that the association with lung cancer mortality risk of lifestyle and occupational factors previously linked to inflammation would depend upon ABO phenotype was tested in a long-term follow-up of 3,346 male subjects aged 53-74 yrs. During a 16-yr period, 170 (5.1%) of the male subjects died due to lung cancer; 84 (5.9%) of phenotype O, 70 (4.9%) of phenotype A and 16 (3.2%) of phenotype B/AB. In addition to cumulative tobacco consumption, high salt intake long-term occupational dust exposure, high fat intake and consumption of alcohol were significantly predictive of lung cancer mortality for phenotype O subjects. After multivariable adjustment, the hazard ratios associated with the first three of these factors were 2.31, 2.08 and 1.67, respectively. Compared with abstainers, the hazard ratios for males drinking 1-10 wine drinks x week(-1) and males drinking >10 wine drinks x week(-1) were 1.65 and 2.02, respectively. Among phenotype A subjects, only cumulative tobacco consumption was associated with lung cancer mortality risk. The predictive role of inflammation-related risk factors for lung cancer mortality was significantly stronger among males of phenotype O than A.

C-reactive protein, heart rate variability and prognosis in community subjects with no apparent heart disease.

OBJECTIVES: Increased C-reactive protein (CRP) and reduced heart rate variability (HRV) both indicate poor prognosis. An inverse association between HRV and CRP has been reported, suggesting an interaction between inflammatory and autonomic systems. However, the prognostic impact of this interaction has not been studied. We thus investigated the prognostic impact of CRP, HRV and their combinations. DESIGN: Population-based study. SUBJECTS: A total of 638 middle-aged and elderly subjects with no apparent heart disease from community. METHODS: All were studied by clinical and laboratory examinations, and 24-h Holter monitoring. Four time domain measures of HRV were studied. All were prospectively followed for up to 5 years. RESULTS: Mean age was 64 years (55-75). During the follow-up, 46 total deaths and 11 cases of definite acute myocardial infarction were observed. Both CRP and three of four HRV measures were significantly associated with increased rate of death or myocardial infarction. In a Cox model with CRP >or=2.5 microg mL(-1), standard deviation for the mean value of the time between normal complexes

Airborne occupational exposure, ABO phenotype, and risk of obesity.

BACKGROUND: We have previously found a quite strong interplay between occupational airborne pollutants, ABO phenotypes, and risk of ischaemic heart disease (IHD), with long-term exposure being associated with a significantly increased risk among men with phenotype O, and not among men with other ABO phenotypes. We suggested that the biological pathway could be a stronger systemic inflammatory response in men with blood group O. Several inflammatory mediators likely to increase the risk of IHD have recently been linked also to obesity, suggesting that long-term exposure to airborne pollutants might play a role in the aetiology of obesity. Accordingly, we tested the hypothesis that long-term occupational exposure to airborne pollutants would be more strongly associated with obesity in men with phenotype O than in men with other ABO phenotypes. DESIGN: Cross-sectional exposure-response study taking into account potential confounders. SETTING: The Copenhagen Male Study. SUBJECTS: A total of 3290 men aged 53-74 y. MAIN OUTCOME MEASURE: Prevalence of obesity (BMI > or =30 (kg/m2)). RESULTS: Overall, no differences were found in the prevalence of obesity between men with the O phenotype (n=1399) and men with other phenotypes (n=1891), 8.6 and 9.0%. However, only among men with the O phenotype was long-term occupational exposure (at least 5 y of frequent exposure) to various respirable airborne pollutants: dust, asbestos, soldering fumes, welding fumes, organic solvents, fumes from lacquer, paint or varnish, toxic components, breath irritants, stench or strongly smelling products, and irritants (other than breath irritants or contagious components) associated with an increased prevalence of obesity. Statistically, the strongest univariate associations were found for asbestos exposure, welding fumes, and breath irritants. Odds ratios (95% confidence limits) for these factors were 3.7 (1.8-7.6), 2.7 (1.6-4.4), and 2.6 (1.5-4.4), respectively. This particular relationship of airborne exposures with obesity in men with phenotype O was supported in multivariate analysis including interaction terms and taking into account a number of potential confounders. In contrast, no gene-environment interactions with obesity were found with respect to ABO phenotypes and a number of nonrespirable exposures. CONCLUSION: The finding of a quite strong interplay between long-term exposure to airborne pollutants, ABO phenotypes, and risk of obesity may open up new possibilities for clarifying mechanisms underlying the global obesity epidemic.

The Lewis blood group--a new genetic marker of obesity.

In a cross-sectional epidemiological study including 3290 men aged 53-75 y, mean=63, we tested the hypothesis that the Lewis phenotype Le(a-b-) is a genetic marker of obesity. All men were Lewis typed and measurements were made of height, weight, neck circumference, and hip fat fold. Obesity was defined as a body mass index >/=30 kg/m(2). Totally 291 men (8.8%) were obese; 9.6% of the men had the Le(a-b-) phenotype. Le(a-b-) men had a higher prevalence of obesity than others, 15.6 vs 8.1%, odds ratio (95% confidence interval): 2.1(1.5-2.9), P<0.001. The etiological fraction, that is, the excess prevalence of obesity in the study population due to the Le(a-b-) phenotype, was approximately 10%. The frequency of the Le(a-b-) phenotype may vary substantially in different populations. Identification of this new genetic marker of obesity may, for example, contribute to the explanation of individual and ethnic differences in the prevalence of obesity.

Assessment of environmental tobacco smoke exposure: urinary cotinine concentrations in children are strongly associated with the house dust concentrations of nicotine at home.

In the present study the possibility of using nicotine in house dust as an index of environmental tobacco smoke (ETS) exposure was evaluated in an environmental investigation of 23 children with asthma. A standardized procedure for house dust sampling of nicotine with a filter holder connected to a vacuum cleaner, for a defined time and area was developed (F-nicotine). Also, house dust sampling was carried out from the vacuum cleaner bags of the homes (VC-nicotine). There was a larger variation in VC-nicotine (13-655, median 66 microg/g) compared with F-nicotine (15-393 median 156 microg/g). There were statistically significant associations between an inquiry data based ETS exposure index on the one hand, and urinary cotinine concentrations in children (U-cotinine), F-nicotine and VC-nicotine of their homes, on the other. The strong correlation between U-cotinine and F-nicotine (rs = 0.93; P < 0.0001) indicates that the new standardized house dust sampling method should be useful in ETS exposure assessment. However, further validation by a larger sample size with repeated measurements in the same homes is needed.

Airborne occupational exposure, ABO phenotype and risk of ischaemic heart disease in the Copenhagen Male Study.

OBJECTIVES: To test the hypothesis that long-term occupational exposure to airborne pollutants is a stronger risk factor for ischaemic heart disease (IHD) in men with blood type O than in men with other ABO phenotypes. DESIGN: Cross-sectional and prospective study taking into account potential confounders. SETTING: The Copenhagen Male Study. SUBJECTS: 3321 men aged 53-74 years. MAIN OUTCOME MEASURE: Lifetime prevalence of myocardial infarction and incidence of IHD in an 8-year follow-up among men without overt cardiovascular disease. RESULTS: Among men with phenotypes other than O no association was found between airborne pollutant exposure and IHD risk. Among men with blood type O (P = 1417, 42%), 4.7% had a history of myocardial infarction, as compared with 5.7% among men with other phenotypes (P = 1904, 58%). Long-term occupational exposure (> 5 years of exposure) to various airborne pollutants: soldering fumes, welding fumes and plastic fumes was associated with a significantly increased lifetime prevalence of myocardial infarction. Odds ratios (95% confidence limits) for these factors were 3.0 (1.6-5.8), P = 0.002, 2.1 (1.05-4.2), P = 0.05, and 8.3 (2.6-27.0), P = 0.003. In an 8-year follow-up a similar though weaker association was found with a significantly increased risk for those exposed long term to soldering fumes: 1.8 (1.0-3.2), P = 0.05. CONCLUSION: The finding of a quite strong interplay between airborne pollutants, ABO phenotypes, and risk of IHD, may open up new possibilities for clarifying the roles of the ABO blood group and air pollution as cardiovascular risk factors.

[Beer, wine, spirits and mortality]. / Øl, vin, spiritus og dØdelighed.

A population based cohort study investigates the association between alcohol intake and mortality from all causes, coronary heart disease and cancer. The design is prospective with baseline assessment of intake of beer, wine and spirits, smoking habits, educational level, physical activity, and body mass index and a total of 257,859 person-years follow-up on mortality. A total of 4,833 participants died, of these 1,075 from coronary heart disease and 1,552 of cancer. Compared with non-drinkers, light drinkers who avoided wine, had a relative risk of death from all causes of 0.90 (0.82-0.99) and those who drank wine had a relative risk of 0.66 (0.55-0.77). Heavy drinkers who avoided wine were at higher risk of death from all causes than were heavy drinkers who included wine in their alcohol intake. Wine drinkers had significantly lower mortality from both coronary heart disease and cancer than did non-wine drinkers (p = 0.007 and p = 0.004, respectively). In conclusion, wine intake may have a beneficial effect on all cause mortality that is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.

[Beer, wine, spirits and mortality. Results from a prospective population study]. / Øl, vin, spiritus og dødelighed. Resultater fra Hovedstadens Center for Prospektive Befolkningsstudier.

INTRODUCTION: The aim of the present population-based cohort study was to examine the association between alcohol intake and mortality from all causes, coronary heart disease, and cancer. METHODS: A prospective population study with baseline assessment of beer, wine and spirit consumption, smoking habits, educational level, physical activity, and body mass index in a total of 257,859 person-years follow-up on mortality. RESULTS: A total of 4833 participants died, 1075 of these from coronary heart disease and 1552 of cancer. Compared with non-drinkers, light drinkers, who avoided wine, had a relative risk of death from all causes of 0.90 (0.82-0.99) and those who drank wine had a relative risk of 0.66 (0.55-0.77). Heavy drinkers, who avoided wine, were at higher risk of death from all causes than were heavy drinkers, who included wine in their alcohol consumption. Wine drinkers had a significantly lower mortality from both coronary heart disease and cancer than had non-wine drinkers (p = 0.007 and p = 0.004, respectively). CONCLUSION: A moderate consumption of wine may have a beneficial effect on all causes of mortality, which is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.

Socioeconomic status and ischaemic heart disease mortality in middle-aged men: importance of the duration of follow-up. The Copenhagen Male Study.

OBJECTIVES: The predictive value of some risk factors may diminish with increasing duration of follow-up. This study was performed to elucidate the role of socioeconomic status as a risk factor for ischaemic heart disease (IHD) mortality in middle-aged men, testing the hypothesis that the role of mediators of the association of socioeconomic status with risk of IHD would diminish with increasing length of follow-up. METHODS: A cohort of 5249 men aged 40-59 was established in 1971. Baseline data on social class and other confounder variables were collected, and the cohort was followed through registers for 8, 15, and 22 years. In all, 5028 without a history of myocardial infarction or angina pectoris were included in the follow-up. Four factors associated with either occupation or lifestyle were strong mediators of the association found between social class and risk of fatal IHD, and were more common in the lower social classes (classes IV and V): occasional demand for vigorous activity at work, low leisure time physical activity level, high alcohol consumption, and smoking. RESULTS: After the first 8 years, 78 men had died due to IHD, after 15 years: 222, and after 22 years: 411. Compared with social classes I, II, and III, the age-adjusted relative risk (RR) with 95% CI for classes IV and V was 1.69, P < 0.05 after the first 8 years; adjusted for the above potential risk factors the RR dropped to 1.09, P = NS. Corresponding RR after 15 years were 1.67, P < 0.001 and 1.33, P = NS; and after 22 years, 1.59, P < 0.001 and 1.36, P < 0.05. CONCLUSIONS: Risk factors with an uneven social distribution related to occupation and lifestyle were strong mediators of the association of socioeconomic status with risk of IHD. A quite strong explanatory potential persisted but diminished with length of follow-up.

Low triglycerides-high high-density lipoprotein cholesterol and risk of ischemic heart disease.

BACKGROUND: A high triglyceride (TG)--low high-density lipoprotein cholesterol (HDL-C) level (TG > or =1.60 mmol/L [> or =142 mg/dL] and HDL-C < or =1.18 mmol/L [< or =46 mg/dL]) is associated with a high risk of ischemic heart disease (IHD), whereas a low TG--high HDL-C level (TG < or =1.09 [< or =97 mg/dL] and HDL-C > or =1.48 mmol/L [> or =57 mg/dL]) is associated with a low risk. Conventional risk factors tend to coexist with high TG--low HDL-C levels. We tested the hypothesis that subjects with conventional risk factors would still have a low risk of IHD if they had low TG--high HDL-C levels. METHODS: Observational cohort study of 2906 men aged 53 to 74 years free of IHD at baseline. RESULTS: During 8 years, 229 subjects developed IHD. Stratified by conventional risk factors-low-density lipoprotein cholesterol level (< or =4.40 mmol/L or >4.40 mmol/L [< or =170 mg/dL or >170 mg/dL] [median value]), hypertensive status (blood pressure >150/100 mm Hg or taking medication), level of physical activity (>4 h/wk or < or =4 h/wk), and smoking status (nonsmokers vs smokers)-the incidence in men with high TG--low HDL-C levels was 9.8% to 12.2% in the low-risk and 12.2% to 16.4% in the high-risk strata; the corresponding values in men with low TG--high HDL-C concentrations were 4.0% to 5.1% and 3.7% to 5.3%, respectively. Based on an estimate of attributable risk, 35% of IHD might have been prevented if all subjects had had low TG--high HDL-C levels. CONCLUSION: Men with conventional risk factors for IHD have a low risk of IHD if they have low TG--high HDL-C levels.

Exposure to cold and draught, alcohol consumption, and the NS-phenotype are associated with chronic bronchitis: an epidemiological investigation of 3387 men aged 53-75 years: the Copenhagen Male Study.

OBJECTIVES: This study was performed to estimate the strength of association between chronic bronchitis and lifetime exposure to occupational factors, current lifestyle, and the NS-phenotype in the MNS blood group among middle aged and elderly men. METHODS: The study was carried out within the frameworks of the Copenhagen Male Study. Of 3387 men 3331 men with a mean age of 63 (range 53-75) years could be classified by prevalence of chronic bronchitis. As well as the completion of a large questionnaire on health, lifestyle, and working conditions, all participants had a thorough examination, including measurements of height and weight and blood pressure and a venous blood sample was taken for the measurement of serum cotinine and MNS typing; 16.5% of the men had the NS-phenotype. Chronic bronchitis was defined as cough and phlegm lasting 3 months or more for at least 2 years; 14.6% had chronic bronchitis. RESULTS: Smoking and smoke inhalation were the factors most strongly associated with prevalence of chronic bronchitis. There were three major new findings: (a) long term (>5 years) occupational exposure to cold and draught was associated with a significantly increased prevalence of chronic bronchitis; compared with others, and adjusted for confounders, the odds ratio (OR) with 95% confidence interval (95% CI) was 1.4 (1.1 to 1.7), p=0.004; (b) a significant J shaped association existed between alcohol use and bronchitis, p<0.001, with the lowest prevalence found among moderate users; (c) a significant gene by environment association existed between smoking and the NS-phenotype in the MNS blood group; only among smokers was the NS-phenotype associated with a significantly decreased risk of chronic bronchitis, OR 0.67 (0.47-0.97), p=0.02. Other well known associations between dust, fumes, and even exposure to solvents and bronchitis were confirmed. CONCLUSION: The results emphasise the multifactorial nature of chronic bronchitis, and show some hitherto unrecognised associations between cold and draught exposure, alcohol consumption, and the NS-phenotype and chronic bronchitis.

Lewis phenotypes, leisure time physical activity, and risk of ischaemic heart disease: an 11 year follow up in the Copenhagen male study.

OBJECTIVE: To test the hypothesis that the predictive value for risk of fatal ischaemic heart disease associated with Lewis phenotypes depends on the level of leisure time physical activity. DESIGN: Prospective study controlling for alcohol, tobacco, serum cotinine, blood pressure, body mass index, serum lipids, work related physical activity, and social class. SETTING: The Copenhagen male study, Denmark. SUBJECTS: 2826 white men aged 53-75 years without overt cardiovascular disease; 266 (9.4%) had the Le(a-b-) phenotype. MAIN OUTCOME MEASURE: Incidence of death from ischaemic heart disease during 11 years. RESULTS: 107 men died of ischaemic heart disease. Among men with a low level of leisure time physical activity (

Type of alcohol consumed and mortality from all causes, coronary heart disease, and cancer.

BACKGROUND: Although the J-shaped relation between alcohol intake and mortality has been reproduced in many large cohort studies, the question of whether the effects of beer, wine, and spirits differ remains controversial. OBJECTIVE: To examine the relation between intake of different types of alcohol and death from all causes, coronary heart disease, and cancer. DESIGN: Pooled cohort studies in which intake of beer, wine, and spirits; smoking status; educational level; physical activity; and body mass index were assessed at baseline. SETTING: Copenhagen, Denmark. PARTICIPANTS: 13 064 men and 11 459 women 20 to 98 years of age. MEASUREMENTS: Number of deaths and time to death from all causes, coronary heart disease, and cancer during follow-up. RESULTS: During 257 859 person-years of follow-up, 4833 participants died. J-shaped relations were found between total alcohol intake and mortality at various levels of wine intake. Compared with nondrinkers, light drinkers who avoided wine had a relative risk for death from all causes of 0.90 (95% CI, 0.82 to 0.99) and those who drank wine had a relative risk of 0.66 (CI, 0. 55 to 0.77). Heavy drinkers who avoided wine were at higher risk for death from all causes than were heavy drinkers who included wine in their alcohol intake. Wine drinkers had significantly lower mortality from both coronary heart disease and cancer than did non-wine drinkers (P = 0.007 and P = 0.004, respectively). CONCLUSION: Wine intake may have a beneficial effect on all-cause mortality that is additive to that of alcohol. This effect may be attributable to a reduction in death from both coronary heart disease and cancer.

Socioeconomic status, ABO phenotypes and risk of ischaemic heart disease: an 8-year follow-up in the Copenhagen Male Study.

OBJECTIVES: The association of socioeconomic status with the risk of ischaemic heart disease is only partly explained by the uneven distribution of conventional risk factors. We tested the hypothesis that an uneven socioeconomic distribution of ABO phenotypes could contribute to the explanation. DESIGN: A prospective study controlling for age and other relevant potential confounders: smoking, physical activity, wine consumption, height, weight, serum lipids, blood pressure, hypertension, type II diabetes, serum selenium concentration and soldering fumes exposure. SETTING: The Copenhagen Male Study, Denmark. STUDY PARTICIPANTS: Two thousand, nine hundred and ninety-three men aged 53-74 years without overt ischaemic heart disease. MAIN OUTCOME MEASURE: Incidence of ischaemic heart disease in an 8-year follow-up. RESULTS: Two hundred and forty-two men (8.1%) had a first ischaemic heart disease event. There was no association between socioeconomic status and the ABO blood group phenotypes and, in accordance with this, ABO phenotype was not a confounder for the association of socioeconomic status with the risk of ischaemic heart disease. However, ABO blood group was a strong risk or effect modifier. Only among men with the O phenotype was socioeconomic status (social classes IV and V versus social classes I, II and III) associated with a significant excess risk (relative risk 1.7, 95% confidence interval 1.1-2.7 and P = 0.02 after adjustment for confounders; the corresponding relative risks among the A and B/AB phenotypes comparing low social classes with the higher social classes were 1.08 (P = 0.77) and 1.08 (P = 0.89), respectively). CONCLUSION: ABO phenotypes did not contribute directly to the explanation of socioeconomic inequalities in the risk of ischaemic heart disease. However, the finding of ABO phenotypes being effect modifiers for the association of socioeconomic status with the risk of ischaemic heart disease may open up new possibilities of clarifying the roles of socioeconomic status and ABO blood group as cardiovascular disease risk factors.

High triglycerides and low HDL cholesterol and blood pressure and risk of ischemic heart disease.

Treatment of high blood pressure (BP) has not produced the expected reduction in risk of ischemic heart disease (IHD). Subjects with high BP often have the metabolic syndrome X, an aggregation of abnormalities in glucose and lipid metabolism. We tested the hypothesis that the BP level would be less predictive of risk of IHD in those with high triglycerides (TG) and low HDL cholesterol (HDL-C), the characteristic dyslipidemia in the metabolic syndrome than in those without. Baseline measurements of fasting lipids, systolic BP (SBP), diastolic BP (DBP), and other risk factors were obtained in 2906 men, age 53 to 74 years, free of overt cardiovascular disease. High TG/low HDL-C was defined as TG >1.59 mmol/L and HDL-C <1.18 mmol/L. Within an 8-year period, 229 men developed IHD. In men with high TG/low HDL-C, the incidence of IHD according to SBP (<120, 120 to 140, >140 mm Hg) was 12.5%, 12.9%, and 10.0% (P=NS), respectively, and according to DBP, the incidence of IHD was (<75, 75 to 90, >90 mm Hg) 13.7%, 10.6%, and 13.7% (P=NS), respectively. The corresponding figures for other men were 5.2%, 8. 0%, and 9.7% for SBP (P<0.001), and 6.1%, 7.5%, and 9.9% for DBP (P<0.03). In conclusion, the BP level did not predict the risk of IHD in those with high TG/low HDL-C. This finding may explain the reason lowering BP has not produced the expected reduction in IHD.

All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work.

BACKGROUND: Physical activity is associated with low mortality in men, but little is known about the association in women, different age groups, and everyday activity. OBJECTIVE: To evaluate the relationship between levels of physical activity during work, leisure time, cycling to work, and sports participation and all-cause mortality. DESIGN: Prospective study to assess different types of physical activity associated with risk of mortality during follow-up after the subsequent examination. Mean follow-up from examination was 14.5 years. SETTING: Copenhagen University Hospital, Copenhagen, Denmark. PARTICIPANTS: Participants were 13,375 women and 17,265 men, 20 to 93 years of age, who were randomly selected. Physical activity was assessed by self-report, and health status, including blood pressure, total cholesterol level, triglyceride levels, body mass index, smoking, and educational level, was evaluated. MAIN OUTCOME MEASURE: All-cause mortality. RESULTS: A total of 2,881 women and 5,668 men died. Compared with the sedentary, age- and sex-adjusted mortality rates in leisure time physical activity groups 2 to 4 were 0.68 (95% confidence interval, 0.64-0.71), 0.61 (95% confidence interval, 0.57-0.66), and 0.53 (95% confidence interval, 0.41-0.68), respectively, with no difference between sexes and age groups. Within the moderately and highly active persons, sports participants experienced only half the mortality of nonparticipants. Bicycling to work decreased risk of mortality in approximately 40% after multivariate adjustment, including leisure time physical activity. CONCLUSIONS: Leisure time physical activity was inversely associated with all-cause mortality in both men and women in all age groups. Benefit was found from moderate leisure time physical activity, with further benefit from sports activity and bicycling as transportation.

[Shift work, social class and ischemic heart disease in middle-aged and elderly men. A 22-year follow-up in the "Copenhagen Male Study"]. / Skiftearbejde, socialklasse og iskaemisk hjertesygdom hos midaldrende og aeldre maend. 22-års opfølgning i "Copenhagen Male Study".

Shift work has been reported as a risk factor for ischaemic heart disease. Most studies have only partly controlled for social class differences, a recognized risk factor for ischaemic heart disease (IHD), and the relative risk of 1.4 could be a result of confounding. The Copenhagen Male Study was established in 1971 as a prospective cohort study of 5,249 men, and included questions on working time, social class and other potential confounders. The cohort was followed through registers for 22 years. Risk of IHD and all cause mortality did not differ between shift and day workers, the adjusted relative risk for IHD being 0.9 (0.7-1.1). Restriction to social class III led to lower risk estimates, with an adjusted relative risk of 0.7 (0.5-1.0). The study gave no support to the hypothesis that shift work is an independent risk factor for IHD. The role of shift work as an independent risk factor for IHD is still controversial.

State of health after deployment in the Persian Gulf. The Danish Gulf War Study.

BACKGROUND: Multiple symptoms have been reported in American Gulf War Veterans including headache, fatigue, impaired short-term memory, sleep disturbances, agitation, respiratory symptoms, muscle and joint pain, diseases of the skin, and intermittent fever. The Danish Gulf War Study was performed to clarify if a corresponding pattern existed among Danes having served in the Persian Gulf during and mainly after the conflict. MATERIAL AND METHODS: A cross-sectional study was performed during the period January 1997 to January 1998 which included 821 subjects who had been deployed in the Persian Gulf within the period August 2 1990 until December 31 1997. Of 686 (83.6%) subjects who participated in the study, 95% had been engaged in peace keeping operations after the war. A group consisting of randomly selected age- and gender matched controls, comprised 231 of 400 potential participants (57.7%). All participants underwent clinical and paraclinical examinations, and had an interview based on a previously completed questionnaire. RESULTS: Unspecific symptoms such as repeated fits of headache, fatigue, memory and concentration difficulties, sleep disturbances, agitation, dyspnea, diseases of the skin, and intermittent fever, were significantly more frequent among Danish Gulf War Veterans, p < 0.05, than among controls; no association was found with respect to muscle and joint pain. The higher symptom prevalence among Gulf War Veterans was observed for conditions which had made their first appearance during or after the Gulf War. The prevalence of symptoms which made their first appearance before August 2 1990 was similar for both groups. CONCLUSION: Except for musculo-skeletal symptoms, this study demonstrated a pattern of symptoms among Danish Gulf War Veterans consistent with the findings among American Gulf War Veterans. Considering that American Gulf War Veterans were predominantly deployed during the armament phase and the brief war phase, and that Danish Gulf War Veterans were predominantly deployed after the war in peace keeping missions, the results indicate the existence of some common risk factors independent of war action.

[Health status after serving in the Gulf war area. The Danish Gulf War Study]. / Helbredsstatus efter udstationering i Golfkrigsområdet. The Danish Gulf War Study.

Increased symptom reporting has been found in American Gulf War Veterans. The symptoms comprise headache, fatigue, impaired short-term memory, sleep disturbances, agitation, respiratory symptoms, muscle and joint pain, diseases of the skin, and intermittent fever. This cross-sectional study was performed to clarify whether a corresponding pattern existed among Danes having served in the Persian Gulf during and mainly after the Gulf War. The investigation took place during the period January 1997 to January 1998 and included 821 subjects who had been deployed in the Persian Gulf within the period August 2, 1990 until December 31, 1997. Of 686 (83.6%) subjects who participated in the study, 95% had been engaged in peace keeping operations after the war. A group consisting of randomly selected age- and gender matched controls, comprised 231 of 400 potential participants (57.7%). All participants underwent clinical and paraclinical examinations, and had an interview based on a previously completed questionnaire. Unspecific symptoms such as repeated fits of headache, fatigue, memory and concentration difficulties, sleep disturbances, agitation, dyspneoa, diseases of the skin, and intermittent fever, were significantly more frequent among Danish Gulf War Veterans (p < 0.05) than among controls; no association was found with respect to muscle and joint pain. The higher symptom prevalence among Gulf War Veterans was observed for conditions which had made their first appearance during or after the Gulf War. The prevalence of diseases and symptoms which had made their first appearance before August 2, 1990 was similar for both groups. This study demonstrated a pattern of diseases and symptoms among Danish Gulf War Veterans consistent with the findings among American Gulf War Veterans. Considering that American Gulf War Veterans were predominantly deployed during the armament phase and the brief war phase, and that Danish Gulf War Veterans were predominantly deployed after the war restoring peace, the results indicate the existence of some common risk factors independent of war action.