Evaluation of quantitative CT vertebral bone mineral density measurement and the Singh index in elderly females with hip fractures--a case control study.

This study aims to evaluate the ability of quantitative computed tomography (QCT) bone mineral density (BMD) measurement of vertebral bodies to predict risk of hip fracture. We also examine the predictive value of the radiographic Singh index and its relationship to the vertebral BMD. The vertebral BMD (using a QCT protocol) and radiographic Singh index were evaluated in 86 white females who had sustained a hip fracture after minor trauma. 86 age-matched female controls were also studied. All patients were post-menopausal, the age range was 52-95 years. BMD values were found to be low in both the study group and controls; there was no statistically significant difference between the groups. A low Singh index did not correlate with hip fracture, nor did it correlate with low vertebral BMD measurement. We conclude that vertebral BMD and radiographic Singh index are not reliable predictors of hip fracture in the elderly female.

An investigation of brain tumours and other malignancies in an agricultural research institute.

A historical cohort study was carried out in an agricultural research institute in the Republic of Ireland to investigate a perceived excess of cancer deaths among employees. The objectives of the study were (a) to confirm whether or not total or cause specific death rates among selected employees were higher than expected based on national figures, and to quantify any excess, and (b) to identify centres and employee grades associated with any excess risk. The cohort comprised all administrative, research, and technical staff employed for at least two years between 1960 and 1980, giving a final total for analysis of 1323 employees. Employment history was categorised by place of work and employment grade. Deaths among the cohort were identified and causes of deaths verified. Overall the cohort had a lower than expected mortality compared with national rates (O/E = 0.67). Female deaths were too few for analysis but, among the male employees, there was an excess of all cancers (O/E = 1.24; 95% confidence interval (95% CI) 0.8-1.9), in particular brain cancer (O/E = 4.69; 95% CI 1.2-11.4) and bladder cancer (O/E = 9.31, 95% CI 1.9-27.2). The pattern of brain tumour deaths was consistent with an occupational aetiology but it was not possible to identify specific exposures associated with the excess. All four cases occurred among research workers in the plant and soil science area. The pattern of bladder cancers was difficult to interpret. The authors are at present participating in a multicentre study to further investigate cancer risk in laboratory workers.

Hypothermia and mortality and morbidity. An epidemiological analysis.

STUDY OBJECTIVE: The aim was to identify socioeconomic variables associated with deaths and hospital admissions due to hypothermia and to quantify the risk due to ambient outside temperature. DESIGN: The study was a survey of deaths and hospital admissions due to hypothermia (ICD 991.6), for the period 1979-85 inclusive, identified from death certificates and Hospital Inpatient Enquiry (HIPE) data. SETTING: The study included all deaths and hospital admissions due to hypothermia (1979-85) in the 26 counties of the Republic of Ireland, population 3.5 million. SUBJECTS: All deaths coded during the study period as being due to hypothermia and all persons admitted to hospital during the study period for whom hypothermia was recorded as a discharge diagnosis in HIPE data. MEASUREMENTS AND MAIN RESULTS: Demographic data and date of death/diagnosis were obtained from both data sets. Complete national temperature records were obtained from the meteorological service and a temperature was assigned to each case representing ambient outside temperature at which hypothermia developed. Risk of hypothermia at a given temperature was obtained by dividing the number of cases at that temperature by the appropriate person-years of exposure of the entire national population. Incidence of and mortality from hypothermia doubled with each 5 degrees C and 4 degrees C fall in temperature respectively; the majority of deaths and hospital admissions occurred between October and March. Incidence and mortality increased with age and men had 30% higher case fatality than women. Single men had four times the incidence and 6.5 times the mortality, and single women had double the incidence and four times the mortality of married men and women respectively. Low population density was also an important risk marker. CONCLUSIONS: The risk of hypothermia due to ambient outside temperature has been quantified and a high risk group was identified. A combination of statutory support measures and good neighbourliness could prevent illness and deaths from hypothermia.

A case-control study of head and neck cancer in the Republic of Ireland.

A retrospective case-control study of 200 patients with head and neck cancer, and 200 controls matched for age and sex, confirmed the importance of tobacco and alcohol consumption in the aetiology of malignant tumours of the upper gastrointestinal and upper respiratory tracts. A male-female ratio of 3:1 was found, and the association of smoking with laryngeal cancer and of alcohol with cancer of the tongue was particularly strong. A significant excess of alcohol-related occupations was found among the cases. These findings are discussed.

A study of breast cancer in Irish women.

In a study of 100 women with breast cancer and 200 unaffected women the epidemiological characteristic of breast cancer most commonly described--namely, an excess of nonparous women among cases when compared with controls, was not observed. It is suggested that two factors, a dearth of first births born to mothers under 20 years of age and an unusually high proportion of first births when aged 30 years or more, are responsible for this finding. No association was found between breast cancer and socioeconomic status, marital status, age at marriage, age at first pregnancy, parity, or age at menarche. Significant associations with breast cancer included age at natural menopause, hysterectomy, and breast trauma. These findings are discussed.

Study of coronary risk factors related to physical activity in 15 171 men.

Physical activity, both at work and during leisure, was assessed in 15 171 men aged 25-74 years. Heavy leisure activity was associated with lower mean serum cholesterol levels and blood pressure. In men under 60 years the same negative association was also noted between leisure activity and relative weight and cigarette smoking. Different degrees of physical activity at work were not associated with any differences in these risk factors, nor did the level of exercise at work seem to influence the negative association between leisure activity and risk factors. Heavy leisure activity in young and middle-aged men is associated with lower levels of certain coronary risk factors and, therefore, a lower risk of coronary heart disease. The often-reported reduction in coronary morbidity and mortality with physical exercise may not be the direct effect of the exercise itself.