Economic burden of fire-related deaths in Finland, 2000-2010: Indirect costs using a human capital approach.

BACKGROUND: The aim of this study was to examine the indirect economic burden of fire-related deaths in Finland in the period 2000-2010. METHODS: The Human Capital (HC) approach was the main method used to estimate productivity losses due to fire-related deaths. Additionally, Potential Years of Life Lost (PYLL) due to deaths were reported. RESULTS: A total of 1090 fire-related deaths occurred in the period 2000-2010 within a population of some 5.4 million. The majority were male (76% vs 24%), with a mean age of 52 (CI: 51.0-53.2) years for males and 57 (CI: 54.6-59.6) for females; 24% (CI: 21.1-26.2%) of victims were over the retirement age. Most of the victims died of combustion gas poisoning (65%, CI: 61.8-67.6%), followed by burns (33%, CI: 30.6-36.3%). Alcohol was often involved and victims were often socially disadvantaged, with socioeconomic features significantly deviating from those of the general population. Annual PYLL ranged from 2094 (CI: 1861-2326) to 3299 (CI: 3008-3594), with an annual average PYLL of 2763 (CI: 2675-2851). PYLL per death fell in the study period from 34.3 (2000, CI: 31.0-37.7) to 24.6 (2010, CI: 21.8-27.6). The reduction is attributable to a decreasing fraction of young victims and an increase in average ages. CONCLUSIONS: Total productivity loss in the period 2000-2010 was c.a. EUR 342 million (CI: 330-354 million), giving an annual average of EUR 31.1 million (CI: 30.0-32.2 million), with the mean for a victim being EUR 0.315 million (CI: 0.30-0.33 million). The economic burden of deaths is considerable and this study remedies the lack of academic knowledge about the burden of fire-related deaths.

Factors associated with the need for information about medicines among pregnant women - a multinational internet-based survey.

BACKGROUND: Women frequently experience health problems and use medicines during pregnancy, and thus need information about their medicines. Knowledge about factors associated with medicine information needs is important for pharmacists when tailoring medication counseling for these pregnant women. OBJECTIVES: The aim was to investigate how socioeconomic factors, health literacy, health status, and use of medicines are associated with the need for drug information among pregnant women. METHODS: A cross-sectional internet-based survey was posted using the Questback program (www.questback.com) on 1-4 websites commonly used by pregnant women in the participating countries within the Americas, Europe, and Australia. Multivariate logistic regression analysis was used. Logistic regression analysis was used for multivariate analysis when measuring the association of maternal socio-demographics and health-related characteristics with the need for medicines information. RESULTS: A higher need for medicines information was associated with primiparity (OR 1.56, CI 1.40-1.75), age of 35+ years (OR 1.26, CI 1.03-1.54), university education (OR 1.33, CI 1.17-1.51), low health literacy (OR 1.96, CI 1.50-2.55), use of medication for chronic diseases (OR 2.67, CI 2.28-3.13), use of medication for acute illnesses (OR 1.88, CI 1.64-2.15), use of OTCs (2+ OTC medicines, OR 1.87, CI 1.60-2.20), use of herbal preparations (OR 1.57, CI 1.37-1.80), and region of residence in Eastern Europe (OR 2.36, CI 2.00-2.79) and Northern Europe (OR 1.26, CI 1.10-1.44). CONCLUSIONS: The need for medicines information among pregnant women increases with the number of health problems and use of both prescription and OTC medicines as well as herbal preparations. Women with lower health literacy express a higher need for medicines information. These groups are primary targets for intensified counseling.

Multiple information sources and consequences of conflicting information about medicine use during pregnancy: a multinational Internet-based survey.

BACKGROUND: A wide variety of information sources on medicines is available for pregnant women. When using multiple information sources, there is the risk that information will vary or even conflict. OBJECTIVE: The objective of this multinational study was to analyze the extent to which pregnant women use multiple information sources and the consequences of conflicting information, and to investigate which maternal sociodemographic, lifestyle, and medical factors were associated with these objectives. METHODS: An anonymous Internet-based questionnaire was made accessible during a period of 2 months, on 1 to 4 Internet websites used by pregnant women in 5 regions (Eastern Europe, Western Europe, Northern Europe, Americas, Australia). A total of 7092 responses were obtained (n=5090 pregnant women; n=2002 women with a child younger than 25 weeks). Descriptive statistics and logistic regression analysis were used. RESULTS: Of the respondents who stated that they needed information, 16.16% (655/4054) used one information source and 83.69% (3393/4054) used multiple information sources. Of respondents who used more than one information source, 22.62% (759/3355) stated that the information was conflicted. According to multivariate logistic regression analysis, factors significantly associated with experiencing conflict in medicine information included being a mother (OR 1.32, 95% CI 1.11-1.58), having university (OR 1.33, 95% CI 1.09-1.63) or other education (OR 1.49, 95% CI 1.09-2.03), residing in Eastern Europe (OR 1.52, 95% CI 1.22-1.89) or Australia (OR 2.28, 95% CI 1.42-3.67), use of 3 (OR 1.29, 95% CI 1.04-1.60) or >4 information sources (OR 1.82, 95% CI 1.49-2.23), and having ≥2 chronic diseases (OR 1.49, 95% CI 1.18-1.89). Because of conflicting information, 43.61% (331/759) decided not to use medication during pregnancy, 30.30% (230/759) sought a new information source, 32.67% (248/759) chose to rely on one source and ignore the conflicting one, 25.03% (190/759) became anxious, and 2.64% (20/759) did nothing. Factors significantly associated with not using medication as a consequence of conflicting information were being pregnant (OR 1.75, 95% CI 1.28-2.41) or experiencing 3-4 health disorders (OR 1.99, 95% CI 1.10-3.58). Women with no chronic diseases were more likely not to take medicines than women with ≥2 chronic diseases (OR 2.22, 95% CI 1.47-3.45). Factors significantly associated with becoming anxious were >4 information sources (OR 2.67, 95% CI 1.70-4.18) and residing in Eastern Europe (OR 0.57, 95% CI 0.36-0.90). CONCLUSIONS: Almost all the pregnant women used multiple information sources when seeking information on taking medicines during pregnancy and one-fifth obtained conflicting information, leading to anxiety and the decision not to use the medication. Regional, educational, and chronic disease characteristics were associated with experiencing conflicting information and influenced the decision not to use medication or increased anxiety. Accurate and uniform teratology information should be made more available to the public.

Medicines information needs during pregnancy: a multinational comparison.

OBJECTIVES: The aim was to assess the perceived needs of medicines information and information sources for pregnant women in various countries. DESIGN: Cross-sectional internet-based study. SETTING: Multinational. PARTICIPANTS: Pregnant women and women with children less than 25 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES: The need for information about medicines was assessed by a question: 'Did you need information about medicines during the course of your pregnancy?' A list of commonly used sources of information was given to explore those that are used. RESULTS: Altogether, 7092 eligible women responded to the survey (5090 pregnant women and 2002 women with a child less than 25 weeks). Of the respondents, 57% (n=4054, range between different countries 46-77%) indicated a need for information about medicines during their pregnancy. On average, respondents used three different information sources. The most commonly used information sources were healthcare professionals-physicians (73%), pharmacy personnel (46%) and midwifes or nurses (33%)-and the internet (60%). There were distinct differences in the information needs and information sources used in different countries. CONCLUSIONS: A large proportion of pregnant women have perceived information needs about medicines during pregnancy, and they rely on healthcare professionals. The internet is also a widely used information source. Further studies are needed to evaluate the use of the internet as a medicines information source by pregnant women.

Cancer risk near a polluted river in Finland.

The River Kymijoki in southern Finland is heavily polluted with polychlorinated dibenzo-p-dioxins and dibenzofurans and may pose a health threat to local residents, especially farmers. In this study we investigated cancer risk in people living near the river (less than 20.0 km) in 1980. We used a geographic information system, which stores registry data, in 500 m times 500 m grid squares, from the Population Register Centre, Statistics Finland, and Finnish Cancer Registry. From 1981 to 2000, cancer incidence in all people (N = 188884) and in farmers (n = 11132) residing in the study area was at the level expected based on national rates. Relative risks for total cancer and 27 cancer subtypes were calculated by distance of individuals to the river in 1980 (reference: 5.0-19.9 km, 1.0-4.9 km, less than 1.0 km), adjusting for sex, age, time period, socioeconomic status, and distance of individuals to the sea. The respective relative risks for total cancer were 1.00, 1.09 [95% confidence interval (CI), 1.04-1.13], and 1.04 (95% CI, 0.99-1.09) among all residents, and 1.00, 0.99 (95% CI, 0.85-1.15), and 1.13 (95% CI, 0.97-1.32) among farmers. A statistically significant increase was observed for basal cell carcinoma of the skin (not included in total cancers) in all residents less than 5.0 km. Several other common cancers, including cancers of the breast, uterine cervix, gallbladder, and nervous system, showed slightly elevated risk estimates at less than 5.0 km from the river. Despite the limitations of exposure assessment, we cannot exclude the possibility that residence near the river may have contributed to a small increase in cancer risk, especially among farmers.