Virginia agricultural health and safety survey.

This comprehensive study was conducted primarily to identify the common causes of agricultural injuries on active Virginia farms and to identify hazardous agricultural operations, exposure duration, and injuries associated with each hazardous operation. In addition, the influences of factors such as general health status of farmers, age, weight, and alcohol and tobacco use on injury were examined. This information will be used for the development of educational programs that will improve the safety of agricultural operations. The sample selected for the study included farms of 28 ha or more, operating on a full- or part-time basis. This stipulation was to ensure that all farms in the sample are active and that participants generated a major portion of their income from the farm. Of the 26,000 farms meeting this requirement, 1,650 were selected to participate in the study. A survey instrument was mailed to the farmers selected to collect the information needed for meeting the established objectives of the study. Approximately 19% of the surveys were returned. In terms of percentage injuries, livestock handling was the primary cause. This was followed by working in elevated locations, operating and repairing agricultural machinery, and heavy lifting. The activities carried out most frequently by the participants were: operating farm tractors, operating trucks/automobiles, using hand and power tools, and working with agricultural chemicals. The overall injury rate was 5.6 injuries per 100,000 h. The exposure to agricultural hazards appeared to have minimal or no effect on the health status of Virginia farmers. Farm workers in the 45 to 64 age group sustained the most injuries. Older, more experienced farmers reported fewer injuries because of limited exposure to hazards and work experience. The average age of Virginia farmers surveyed was 60. This is expected to rise because most respondents reported no plans to retire during the next five years. Based on the results, educational programs for improving the agricultural safety in Virginia should focus on aging farmers, hazardous agricultural activities, and weight control.

Impact of 'Mad Cow Disease' publicity on trends in meat and total vitamin A consumption in Geneva between 1993 and 2000.

BACKGROUND: In March 1996, revelations about the possible risk for humans of the 'mad cow disease' epidemic had a sudden impact on the diets of European populations. OBJECTIVE: To assess changes in meat and nutrient intakes in adults living in Geneva, Switzerland from 1993 to 2000. DESIGN: Independent annual cross-sectional surveys (4047 women and 4092 men total). MAIN OUTCOME MEASURE: Dietary habits assessed and compared to baseline (January 1993-April 1996) via validated semi-quantitative food-frequency questionnaire. RESULTS: Women beef abstainers increased from 8.9 to 14.9% in late 1996 (P<0.001) and 13.3% in 1997 (P<0.05); among meat consumers, in late 1996 meat/beef intakes declined -10/-12% (both P<0.05). From 1997 to 2000 most intake levels drifted back toward those at baseline, but chicken intakes were significantly (all P<0.05) greater each year (+19% in 2000 (P<0.001). Consistent but less dramatic changes were observed among men. From late 1996 until 2000, liver abstention was significantly (all P<0.05) greater (women from 60 to 78%; men from 61 to 73% in 2000; (both P<0.001). The only nutrient intakes that decreased significantly (all P<0.05) each year from 1997 through 2000 were retinol and total vitamin A women: -22% (P<0.001); -11% (P<0.05) respectively; men: -16% (P<0.001); -10% (P<0.05) respectively, in 2000). Total vitamin A intakes exceeded the dietary reference intake (DRI) for liver eaters (women 185%, men 153%), but were below the DRI for liver abstainers (women 83%; men 66%) in 2000. CONCLUSION: The decreases in beef and liver consumption since late 1996 led to the discovery of a long-term disparity in the retinol and total vitamin A intakes of liver eaters vs abstainers.

Age and risk factors for colon cancer (United States and Australia): are there implications for understanding differences in case-control and cohort studies?

Data from two population-based case-control studies were used to investigate the effect of age on colon cancer risk. Dietary intake data were assessed from a study conducted in Utah (United States) between 1979 and 1983; reproductive data were assessed from a study conducted in Adelaide (Australia) between 1979 and 1980. Data from both studies were assessed for their impact on those less than 65 years of age and those 65 or more years of age. Intake of energy, fat, and protein had a greater impact on risk among older men than among younger men. Risk estimates for the upper quartile of intake relative to the lowest quartile of intake were 8.5 (95 percent confidence interval [CI] = 1.7-43.0) for energy, 8.2 (CI = 1.6-41.3) for protein, and 7.2 (CI = 1.6-31.4) for total fat for older men, while comparable risk estimates were 2.4 (CI = 0.6-9.1) for energy, 3.0 (CI = 0.7-13.6) for protein, and 1.9 (CI = 0.5-7.1) for total fat among younger men. Similar trends were seen for older women for energy and protein. beta-carotene decreased colon cancer risk among younger men (odds ratio [OR] = 0.4, CI = 0.1-1.2) and women (OR = 0.1, CI = 0.1-0.5), although not among older men (OR = 1.2, CI = 0.3-4.9) and women (OR = 1.9, CI = 0.6-64). Calcium decreased risk of colon cancer among older men (OR = 0.1, CI = < 0.1-0.8) and younger women (OR = 0.2, CI = < 0.1-0.7).(ABSTRACT TRUNCATED AT 250 WORDS)

The need for a strict methodology in dietary surveys: the experience of the WHO Osteoporosis Project.

There are three basic dietary data collection tools: direct weighing, diet diaries and diet recalls. Each technique has inherent strengths and weaknesses. Direct weighing requires great cooperation from the participants, is expensive and time consuming; diary methods tend to distort usual intake patterns, while retrospective data collection methods are subject to respondent memory bias. Therefore, there are differences in study outcomes depending on the methodologies used; comparisons of data collected in different studies would only be possible if a standardized method were utilized. The Project on Osteoporosis of the World Health Organization is a cross-national study, designed to explore the differences in the incidence of hip fracture and to ascertain risk and protective factors for bone loss and fractures in the older populations in different countries. The objective of the diet assessment is to evaluate the role of diet on osteoporotic hip fracture, and on loss of bone mass. Major effort during the preparation of the proposal was devoted to the development of strategies for assessing the validity and reliability of the instruments selected and the comparability of the results obtained in the participating countries. Such strategies include re-interviews of the participants, proxy interviews and comparisons of data obtained by the food frequency method and those recorded in diaries.

Tobacco, alcohol, coffee, and caffeine as risk factors for colon cancer in a low-risk population.

We used data from a population-based case-control study to examine how use of tobacco products and consumption of alcohol, coffee, and caffeine relate to colon cancer in Utah. We hypothesized that low use of these substances is one factor contributing to the low colon cancer incidence in Utah and could help explain the low risk associated for colon cancer with being a member of the Church of Jesus Christ of Latter-day Saints. In females, we observed little or no increase in risk of colon cancer from smoking cigarettes or from consumption of alcohol, caffeine, or coffee. Males who used pipes, however, experienced an increased risk for colon cancer (OR = 4.1, 95% CI = 1.3-12.3). Risk for colon cancer associated with alcohol use was greatly attenuated after adjusting for caffeine and pipe use in males; males who consumed higher levels of caffeine during the two to three years prior to the interview were at higher risk than males who consumed low levels of caffeine (OR = 2.0, 95% CI = 1.0-4.2); similar associations were observed for coffee consumption. Nonuse of these substances could explain the low colon cancer incidence rates observed in members of the Church of Jesus Christ of Latter-day Saints and Utah males.

Diet and colon cancer: assessment of risk by fiber type and food source.

How fiber in the diet is related to the development of colon cancer was assessed in a population-based study conducted on 231 cases and 391 controls in Utah between 1979 and 1983. Crude fiber consistently decreased risk associated with colon cancer in both males [odds ratio (OR) = 0.4] and females (OR = 0.5). Dietary fiber, as analyzed by the method of A. S. Bitner, and neutral detergent fiber were not consistently related to colon cancer risk. Of the noncellulose polysaccharides examined, mannose and galactose were protective against cancers in the ascending colon in males (ORs = 0.5 and 0.3, respectively), whereas galactose and uronic acid were protective against cancers in the ascending colon in females (ORs = 0.5). Highest quartiles of intake of fruits and vegetables were also associated with a decreased risk of colon cancer in males (ORs = 0.3 and 0.6, respectively) and in females (ORs = 0.6 and 0.3, respectively) compared with lowest quartile of intake, whereas high intake of grains was not protective.

Dietary calcium intake as a mitigating factor in colon cancer.

A population-based case-control study was conducted in Utah to test the hypothesis that calcium decreases the risk of developing colon cancer. A total of 231 cases and 391 controls were identified and interviewed between 1979 and 1982. A quantitative food frequency instrument was used to ascertain individual dietary intake two years prior to diagnosis for the cases and two years prior to interview for the controls. Calcium, calcium per 1,000 calories, and total dairy product consumption were used as indicators of dietary calcium intake. Categories of dietary intake were determined by the distribution of these variables in the control population. A protective effect was observed for males for intake of calcium (odds ratio (OR) = 0.48), calcium per 1,000 calories (OR = 0.35), and total diary products (OR = 0.49). The magnitude of the protective effect from calcium intake increased after adjusting for intake of calories (OR = 0.41), protein (OR = 0.31), and fat (OR = 0.46). Calcium provided less of a protective effect in females, with the odds ratio for calcium being 0.50, 0.55, and 0.56 after adjusting for calories, protein, and fat, respectively. Risk associated with calories, protein, and fat also increased after adjusting for calcium. Of interest is an odds ratio of 5.30 in males for protein after adjusting for calcium. A biologic mechanism is presented to help explain the role of calcium in the development of colon cancer.

Calcium and colon cancer: a review.

The role of dietary calcium as a protective factor in the etiology of colon cancer is reviewed by examining data from ecological and analytical epidemiological studies. Biological evidence that explains the mechanisms whereby calcium intake could alter risk of developing colon cancer is also presented. The data reviewed here in general support the hypothesis that dietary calcium is linked to colon cancer in a protective manner, and that it may be one component in the etiology of colon cancer which alters an individual's risk of developing the disease.

Health objectives for the nation: moving toward the 1990s.

The 1990 Objectives are an outgrowth of the 1979 Surgeon General's Report, Healthy People, which identified a set of five broad goals for improving the health of the American public through the decade of the 1980s. A year later, more than 500 health experts from the government and the private sector met to develop specific quantifiable objectives for each of the areas outlined in Healthy People. Fifteen topics, including improved nutrition, were used to formulate a framework for 227 objectives that give directions for a national program of health promotion and disease prevention. In 1980, the Public Health Service published the report Promoting Health/Preventing Disease: Objectives for the Nation. A mid-course review of the 1990 objectives has been conducted, and the results were published in 1986. In the nutrition area, it is apparent that some overall progress has been made, but data are insufficient to assess progress on several objectives, and others are unlikely of achievement by 1990. Ultimately, however, the success of the objectives depends on the recognition that they are national, not federal, goals that require commitment to their implementation by both the public and the private sector.

Energy intake: its relationship to colon cancer risk.

A case-control study was conducted to assess the role of diet in the etiology of colon cancer. Diet was measured by means of a comprehensive quantifiable food frequency history instrument in 246 cases and 484 controls drawn from the general population of Utah. Each subject's diet was described by major nutrient groups and total energy based on the nutritional content of foods reported. Cases reported higher daily food intake 5 years preceding diagnosis than controls [men, rate ratio (RR) = 2.5; women, RR = 3.6], as measured by total energy content of the diet. Higher risk of colon cancer with increasing energy intake was independent of stage of disease at diagnosis and obesity, as measured by body mass. Fat, protein, and carbohydrate intake all had elevated RRs but could not be assessed as risk factors independent of energy intake because of their strong correlations with total calories. Due to the higher energy intake of the cases, odds ratios for the daily intake of dietary fiber and vitamins A and C were also greater than 1. However, adjusting for caloric intake removed this effect, and dietary fiber showed a weak protective effect. Total energy intake must be evaluated before attempting to assign a causal role to any food or nutrient that may be postulated to play a role in colon cancer.

International food component data system.

The International Network of Food Data Systems planning conference recommends establishing nomenclature and a system of coding for use in INFOODS. The International Food Naming System would facilitate collection, tabulation, storing, and retrieval of information. The system consists of two files for each food: one describing the name in a standardized manner and another reporting chemical and biological data. The two files are linked by International Food Number (IFN). Food names consist of controlled terms called facets: origin, part, process, stage of maturity, and grade. Within each facet, such elements as genus, species, variety (scientific name) and generic name, breed or kind, and strain (English name) are defined. Elements are assigned numerical codes to facilitate sorting and storage. Carefully defined standard descriptions are used in each facet. Each descriptor is assigned an alphabetic code, an unlimited number allowing an open-ended flexible system. IFN may be incorporated into a computerized data management system and stored data searched and sorted for information retrieval on given parameters, e.g., country, state, laboratory, or kind of package. Data can be summarized to obtain averages, ranges, and standard deviations. Summarized data, linked with the International Food Names by the IFN, may be printed out in desired format.

Serum hexosaminidase as a possible biomarker for human cancer.

The levels of total serum hexosaminidase and of its heat stable isozyme (beta-hexosaminidase) were determined in the sera of subjects bearing ovarian and other female genital cancers and of control subjects. The assays were carried out on a double blind basis. Total hexosaminidase levels were significantly elevated in sera of subjects with female genital cancers and in subjects with ovarian cancer. Levels of beta-hexosaminidase were elevated in all subjects with genital cancer. The hexosaminidase assay may be a convenient biomarker for human cancer since earlier studies have shown that total and beta-hexosaminidase levels are elevated in sera of most cancer patients studied.

Zinc and copper in infant diets.

The diets of 59 healthy Utah infants were examined for nutritional adequacy. The analysis included zinc and copper intake calculated from new assays of zinc and copper in commercial baby foods and table foods obtained at local retail outlets. Group averages showed adequate dietary intake, with copper the limiting nutrient. Zinc-to-copper ratios were only slightly higher than suggested.

The need for comprehensive diet studies to assess the relation of lipids to cancer.

Dietary lipids have been linked by both basic research and epidemiological evidence to the etiology of some cancers. It is yet unclear which lipid(s) may be active in the carcinogenic process, but one promising hypothesis concerns the interaction of cholesterol metabolites, considered a risk factor for colon cancer, and dietary fiber which may have a protective role. A multidisciplinary case control study currently underway is investigating the relationship and possible mode of action of fiber and bile acids on colon cancer. The study has epidemiological, biochemical, and pharmacological components that have been designed to integrate data on the intake and fate of lipids, dietary fiber, and other nutritional parameters in colon cancer cases and matched controls and in animal models. Subcomponents of the study deal specifically with the characterization of dietary fiber constituents and their in vivo effect on lipid metabolism.

Colon cancer in a low-risk population.

Data are presented on colon mortality in Utah. For the years 1950 to 1969, the state population had 34% fewer deaths from colon cancer than the average United States population. Colon cancer incidence was also studied for the years 1966 to 1970, both for the state and for a large subgroup (Mormons) who abstain from tobacco and alcohol for religious reasons; the colon cancer incidence of Mormons was 37% below the United States average, and that of non-Mormons was 18% below the United States average. A preliminary dietary survey found little difference in meat, fat, and fiber consumption between the population of Utah and that of the United States as a whole.