ABSTRACT
OBJECTIVE: In Germany, there is a lack of information on the correlation between tobacco use by adolescents and their utilization of medical care. The aim of this article is to identify possible early consequences of adolescent smoking. METHODS: We conducted a re-analysis of cross-sectional data of the baseline wave (2003-2006) of the German Health Survey for Children and Adolescents (KiGGS). To examine the association between current smoking status and utilization of medical care during the 12 months before the interview, prevalence of selected diseases was calculated, and stratified by smoking status. Besides, the proportion of adolescents who consulted a physician at least once and the total number of medical consultations were estimated. For the inpatient setting, information about the number of nights spent in a hospital was analyzed. In a multiple logistic regression, the association of smoking behavior with utilization of outpatient medical care was assessed, further adjusting for sociodemographic variables and comorbidities. RESULTS: The study population included 3 679 adolescents aged between 14 and 17 years. 49.1% were female and 31.7% were current smokers. Among smokers, there was an increased prevalence of cystitis (+87.0%) and bronchitis (+50.0%). Tobacco users consulted a general practitioner more frequently than non-smokers (+30.8%). As far as medical specialists are concerned, there were more consultations with psychiatrists (+171.4%) and psychologists (+94.4%), but there was no increase in the total number of visits. Additionally, smoking adolescents were more frequently hospitalized (+26.5%) and the stays were of longer duration (+19.7%). There was a statistically significant association between current tobacco use and a greater utilization of medical care (OR=1.20; 95%-CI: 1.02-1.40). CONCLUSIONS: Tobacco use among adolescents was associated with increased prevalence of certain diseases and a greater utilization of medical care. Nevertheless, whether there is a causal connection is still debatable. The KiGGS cohort study will provide opportunities to further clarify the observed association.
Subject(s)
Health Services , Tobacco Use , Adolescent , Child , Cohort Studies , Cross-Sectional Studies , Female , Germany , Health Surveys , HumansABSTRACT
During the five year period from early 1982 to 1986, we engaged in research concerning the chlorinated hydrocarbon content of eels (Anguilla anguilla L.) in the limnic water ecosystem of Berlin (West). The total count of analytical samples, taken at 11 different sampling points, comprised 370 samples, divided up into 41 collectives. Each fish was checked individually for the patterns of contamination with chlorinated hydrocarbons, especially DDT-, BHC-, and PCB-related compounds. The various areas of the Berlin water system develop different particularities as regards pollution. The northern part, consisting mainly of the Tegeler See and the Niederneuendorfer See above the Spree river junction, is in near-neutral condition as shown by rather low levels of chlorinated hydrocarbons in the eels. The Teltowkanal, as it is heavily affected by industrial and urban wastewater, shows considerable contamination of its fish population. Main pollutants are the BHC-isomers, including delta-BHC and the DDT-metabolites 4.4-DDD and 4.4-DDE, as well as higher and lower chlorinated biphenyls (PCB). The lower part of the Havel river, a lake system represented in this study by the fishing stations Stössensee, Pichelsdorfer Gemünd, Schwanenwerder and Pfaueninsel, is limnologically a changing zone characterized by the influx of Spree and Havel rivers and in part by the Teltowkanal, which is reflected in the composition of the organochlorine contamination as well. Three main fishing stations were chosen to represent typical conditions of the ecosystem (Niederneuendorfer See, Pfaueninsel, Teltowkanal) and the trends of concentration of organochlorines in eels were monitored.(ABSTRACT TRUNCATED AT 250 WORDS)