A case-control study of use of postmenopausal female hormone supplements in relation to the risk of large bowel cancer.

Postmenopausal female hormone use has been associated with a reduced risk of colon cancer. We assessed the relation of use of these supplements to the risk of large bowel cancer. The data were collected in a case-control study of large bowel cancer conducted in Massachusetts. Control subjects were matched to incident cases of carcinoma of the colon or rectum on age, gender, and town precinct. The analysis was restricted to women who experienced a natural menopause or had had a hysterectomy with or without removal of the ovaries (292 colon cancer cases and 112 rectal cancer cases and their matched controls). Use of female hormone supplements was associated with a decreased risk of colon cancer among recent users (odds ratio, 0.6; 95% confidence interval, 0.4-1.0) and long duration (5+ years) of use (odds ratio, 0.5; 95% confidence interval, 0.3-0.9). The association with long duration of use appeared to be independent of recency of use and screening practices and was apparent for late-stage cancer. Hormone supplement use was not associated with a reduced risk of rectal cancer. Our results add to the evidence for a decreased risk of colon cancer associated with use of female hormone supplements.

Water preparation practices in south Kalimantan, Indonesia.

This study investigated water preparation practices, water sources, and sanitation measures in 400 households in four villages in Banjar district of South Kalimantan, Indonesia. A survey of randomly selected households in each of the four villages was undertaken during the season of low prevalence of diarrhoeal disease (February-March 1989). A follow-up survey of the same households was conducted 6 months later to measure prevalence during the peak season. Twenty-three in-depth interviews were carried out with key persons in local villages. Observations on behaviour in the local food stalls were recorded. The results of the study indicate that 97% of the households report that they regularly boil their drinking water. However, 37% of the households regularly or occasionally mix boiled with unboiled water for drinking, or use unboiled water alone. The mixing of boiled with unboiled water is particularly frequent in the preparation of 'cold tea', a popular drink in households and food stalls. The occasional or regular use of unboiled water varies by ethnicity, education and literacy, and economic status. The use of unboiled water is associated with higher rates of childhood diarrhoeas in the households studied.

A community trial involving religious leaders to improve water preparation hygiene as part of diarrheal disease prevention in South kalimantan, indonesia.

In an earlier study we found that there is a habit of mixing boiled and unboiled water to prepare drinks, particularly cold tea, in South Kalimantan, Indonesia. Ulamas (Islamic religious leaders) have a very influential role in that community. This study was designed to implement and evaluate a health educational campaign using local ulamas. Three study communities were selected. The first intervention area received education through Al Quran (Koranic) reading clubs. In the second area the intervention was implemented by home visits as well as by Al Quran reading clubs, since participation in Al Quran reading clubs was low. The third area served as the control. A message and intervention development was designed by the ulamas and the investigators using sarasehan (ulamas' meeting). A positive impact on knowledge and practices of drinking water preparation was observed in the first area where the community members were active participants in the Al Quran reading club. Involving ulamas in a health education campaign was indicated to be effective in changing knowledge and practices.