Disability among US Army Veterans vaccinated against anthrax.

Context: To protect troops against the use of anthrax as a biological weapon, the US Department of Defense began an anthrax vaccination program in 1998. 14 years after the inception of the vaccination program, there is no evidence suggesting vaccination against anthrax carries long-term health risks for Active Duty Soldiers.

Objective: To investigate the association between Anthrax Vaccine Adsorbed (AVA) received while on Active Duty and subsequent disability determined by the Veterans Benefits Administration.

Risk of disability for US army personnel vaccinated against anthrax, 1998-2005.

To evaluate the potential for long-term or delayed onset health effects, we extended a previous cohort study of disability separation from the army associated with vaccination against anthrax. Analyses included stratified Cox proportional hazards and multiple logistic regression models. Forty-one percent of 1,001,546 soldiers received at least one anthrax vaccination; 5.

Effectiveness of an external ankle brace in reducing parachuting-related ankle injuries.

Outside-the-boot parachute ankle braces (PABs) worn during US Army paratrooper training have been shown to reduce the risk of severe ankle injuries. In spite of evidence to the contrary, anecdotal reports continue to suggest increases in risk of other types of injury, and the cost of obtaining and periodically replacing the PAB has been used to justify its discontinued use. The authors identified inpatient and outpatient treatment for injuries during US Army paratrooper training.

Mortality in the German porcelain industry 1985-2005: first results of an epidemiological cohort study.

Objectives: To evaluate mortality due to lung cancer, silicosis, renal cancer, renal disease and other causes among German porcelain production workers potentially exposed to crystalline silica.

Methods: Seventeen thousand six hundred forty-four medical surveillance participants (1985-1987) were followed through 2005 for mortality. Cause-specific Standardized Mortality Ratios (SMR) and 95% confidence intervals were estimated.

Prolonged acute mechanical ventilation, hospital resource utilization, and mortality in the United States.

Objective: Adjusted costs of mechanical ventilation (MV) are $1,500 per patient-day. We compared the prevalence, characteristics, and outcomes of MV < 96 hrs (MV < 96) and prolonged acute MV (PAMV) of > or = 96 hrs' duration in a representative sample of U.S.

Clinical epidemiological study of employees exposed to surfactant blend containing perfluorononanoic acid.

Introduction: An epidemiological study was conducted of a perfluorononanoic acid (PFNA) surfactant blend, to investigate whether clinical differences were apparent between employees who were potentially exposed to the surfactant and those who were not exposed. The surfactant blend, which is related to other previously studied perfluorinated materials, is used in the production of some high-performance polymers.

Methods: All 630 individuals employed at a polymer production facility using PFNA (CAS No 72968-38-8) at any time between 1 January 1989 and 1 July 2003 were included in the cohort.

A cohort mortality study of employees in the U.S. carbon black industry.

Objectives: The objectives of this study are to evaluate historical mortality patterns, especially due to cancers, among employees of the U.S. carbon black industry and to address the methodological shortcomings of previous U.

Lung cancer mortality in the German chromate industry, 1958 to 1998.

Objectives: We conducted a mortality study of two German chromate production facilities and evaluated possible dose-response relationships between hexavalent chromium exposure and lung cancer.

Methods: Mortality was followed-up through 1998 and limited to those employed since each plant converted to a no-lime production process. More than 12,000 urinalysis results of chromium levels were available, as was smoking information.

Low-level hexavalent chromium exposure and rate of mortality among US chromate production employees.

Objective: Although numerous studies have reported an elevated lung cancer risk among chromium chemical production employees, few studies have focused on employees hired after major process changes and enhanced industrial hygiene controls were implemented.

Methods: This study examines the mortality experience of two post-change cohorts of chromate production employees constituting the current US chromium chemical industry.

Results: Mortality among chromium chemical workers generally was lower than expected on the basis of national and state-specific referent populations.

Evaluation of the exposure-response relationship of lung cancer mortality and occupational exposure to hexavalent chromium based on published epidemiological data.

Some have suggested a threshold mechanism for the carcinogenicity of exposure to hexavalent chromium, Cr(VI). We evaluated the nature of the exposure-response relationship between occupational exposure to Cr(VI) and respiratory cancer based on results of two recently published epidemiological cohort studies. The combined cohort comprised a total of 2,849 workers employed at two U.

Dose-response and risk assessment of airborne hexavalent chromium and lung cancer mortality.

This study evaluates the dose-response relationship for inhalation exposure to hexavalent chromium [Cr(VI)] and lung cancer mortality for workers of a chromate production facility, and provides estimates of the carcinogenic potency. The data were analyzed using relative risk and additive risk dose-response models implemented with both Poisson and Cox regression. Potential confounding by birth cohort and smoking prevalence were also assessed.

Lung cancer mortality among chromate production workers.

Aims: To assess mortality in 1997 among 493 former workers of a US chromate production plant employed for at least one year between 1940 and 1972.

Methods: Cohort members were followed for mortality to 31 December 1997. Standardised mortality ratios (SMRs) were calculated for selected cause specific categories of death including lung cancer.

Cause-specific mortality among Kelly Air Force Base civilian employees, 1981-2001.

In response to concerns about occupational and environmental exposures, and a perceived cluster of amyotrophic lateral sclerosis (ALS) in the community, the mortality experience among 31,811 civilian employees who worked for at least 1 year between 1981 and 2000 at Kelly Air Force Base, Texas was ascertained. A total of 3264 deaths occurred through October 31, 2001. Overall, significant deficits in mortality were observed for all causes of death and all cancers combined.

Historical cohort study of 10 109 men in the North American vinyl chloride industry, 1942-72: update of cancer mortality to 31 December 1995.

Objectives: To update and assess mortality from neoplasms to 31 December 1995 among 10 109 men employed in a job exposed to vinyl chloride for at least 1 year between 1942 and 1972 at any of 37 North American factories. Previous analyses indicated associations between employment in vinyl production and increased mortality risk from cancers of the liver and biliary tract, due to increased mortality from angiosarcoma of the liver, and brain cancer.

Methods: Standardised mortality ratio (SMR) analyses, overall and stratified by several work related variables, were conducted with United States and state reference rates.

Video display terminal workstation improvement program: II. Ergonomic intervention and reduction of musculoskeletal discomfort.

The effects of an ergonomic intervention on musculoskeletal discomfort in 118 video display terminal (VDT) users were assessed 1 year after intervention. The intervention consisted of recommended changes to workstations, which were based on the evaluation of 15 ergonomic characteristics. Compliance with the intervention was at least 75% for most workstation characteristics.

Video display terminal workstation improvement program: I. Baseline associations between musculoskeletal discomfort and ergonomic features of workstations.

Associations between selected sites of musculoskeletal discomfort and ergonomic characteristics of the video display terminal (VDT) workstation were assessed in analyses controlling for demographic, psychosocial stress, and VDT use factors in 273 VDT users from a large administrative department. Significant associations with wrist/hand discomfort were seen for female gender; working 7+ hours at a VDT; low job satisfaction; poor keyboard position; use of new, adjustable furniture; and layout of the workstation. Significantly increased odds ratios for neck/shoulder discomfort were observed for 7+ hours at a VDT, less than complete job control, older age (40 to 49 years), and never/infrequent breaks.

Comparing food intake using the Dietary Risk Assessment with multiple 24-hour dietary recalls and the 7-Day Dietary Recall.

The Dietary Risk Assessment (DRA) is a brief dietary assessment tool used to identify dietary behaviors associated with cardiovascular disease. Intended for use by physicians and other nondietitians, the DRA identifies healthful and problematic dietary behaviors and alerts the physician to patients who require further nutrition counseling. To determine the relative validity of this tool, we compared it to the 7-Day Dietary Recall (an instrument developed to assess intake of dietary fat) and to the average of 7 telephone-administered 24-hour dietary recalls.

Risk factors for psychological stress among international business travellers.

Objectives: This study investigated sources of self reported psychological stress among international business travellers at the World Bank, following up on a previous study showing that travellers submitted more insurance claims for psychological disorders. Hypotheses were that work, personal, family, and health concerns, as well as time zone travel, contribute to travel stress.

Methods: A travel survey was developed from focus groups and consisted of questions about these potential sources of travel stress.

The patient exit interview as an assessment of physician-delivered smoking intervention: a validation study.

In evaluating the efficacy of physician-delivered counseling interventions for health behavior changes such as smoking cessation, a major challenge is determining the degree to which interventions are implemented by physicians. The Patient Exit Interview (PEI; J. Ockene et al.

Development and testing of a seven-day dietary recall. Dietary Assessment Working Group of the Worcester Area Trial for Counseling in Hyperlipidemia (WATCH).

Using multiple 24-hr recalls (24HR) we tested the Seven Day Dietary Recall (7DDR) developed to assess nutrient exposures, especially lipids, in dietary interventions and other clinical trials requiring measurement of effect over moderate time periods. A total of 261 individuals in three studies completed a 7DDR at the end of a 3- to 5-week period during which 3 to 7 24HR were telephone-administered on randomly selected days. One of these studies and data from one additional study (total n = 678) allowed us to test the ability of the 7DDR to predict serum lipid changes in an intervention setting.

Attitudes toward risk factor behavior of relatives of cancer patients.

Background: Targeted health promotion requires an identifiable subpopulation which is accessible, at increased risk, receptive to input, and receptive to change. Relatives of recently diagnosed cancer patients may meet these criteria and have not previously been investigated as recipients of preventive education regarding smoking and diet.

Methods: This study investigates these factors, beliefs regarding perceived susceptibility to cancer, and attitudes toward behavior change in 101 relatives of 50 patients with smoking-related cancers, breast cancer, and other diet-related cancers.

Physician training for patient-centered nutrition counseling in a lipid intervention trial.

Background: We examined the effect of a 3-hr training program on physicians' lipid intervention knowledge, attitudes, and skills. The program teaches physicians skills to conduct a brief dietary risk assessment and provide patient-centered counseling to enable patients with elevated lipids to change their dietary patterns.

Method: The training is part of a randomized trial of lipid-lowering interventions, the Worcester Area Trial for Counseling in Hyperlipidemia.

Outcomes of a 21-day drug detoxification program: retention, transfer to further treatment, and HIV risk reduction.

We investigated the outcomes of a 21-day inpatient drug detoxification and rehabilitation program including length of stay, transfer to further treatment, and HIV risky behavior. Clients (n = 567) were predominantly White, male, currently unemployed, and their treatment was not covered by third party payment. 78% were detoxified with methadone.

The Physician-Delivered Smoking Intervention Project: factors that determine how much the physician intervenes with smokers.

Objective: To determine factors that affect how much physicians trained to use a patient-centered smoking intervention intervene with their smoking patients.

Design: Forty internal medicine residents and ten internal medicine attending physicians trained in a patient-centered counseling approach were randomized to an algorithm condition (provision of intervention algorithm at each patient visit) or a no-algorithm condition. Smoking intervention steps used by physicians with patients were assessed with Patient Exit Interviews (PEIs).