Agreement between laboratory tests and self-reports of alcohol, tobacco, caffeine, marijuana and other drug use in post-partum women.

The agreement between self-reported consumption of several drugs and laboratory tests used to detect their use is examined. Post-partum women (N = 108) enrolled in a research study participated in a detailed interview covering alcohol and caffeine ingestion, tobacco smoking and use of marijuana and other psychoactive drugs. They also kept a 4-day record of their use of these substances. Blood and urine samples were taken and a physical exam done at the close of the record period. Laboratory tests to detect use of alcohol, tobacco, caffeine, marijuana and other drugs were carried out and the results compared to self-reported drug use in the interview and the record. The degree of agreement depended on the drug taken, the test used and the pattern of drug use in the sample. Sporadic or infrequent consumption related poorly to laboratory tests, especially those that were designed as screening tools. Regular consumption could be identified with greater accuracy. However, the group associations evident between self-reports of drug use and laboratory results were not sufficient to guarantee that subjects were correctly classified. Error in both self-report and the decision made from laboratory values must be taken into account in determining the confidence that should be placed in the data and the conclusions drawn from it.

Preventing fetal alcohol effects: effectiveness of a demonstration project.

The Pregnancy and Health Program (PHP) was established in 1979 to develop effective methods of intervening in maternal alcohol abuse during pregnancy in a metropolitan US community. Services provided over a two-year period included public and professional education, an alcohol and pregnancy information and crisis telephone line, screening for alcohol problems in selected prenatal clinics, treatment and support for women concerned about their drinking during a pregnancy, and help for children possibly affected in utero by alcohol. Evaluation of PHP's educational programmes showed significant increases in awareness and knowledge of the risks associated with drinking during pregnancy, among both the public and health professionals in the community. Information was provided by telephone to over 2400 persons, including one in every 44 pregnant women in the community. A total of 304 pregnant women were personally given information as well as treatment for alcohol problems when necessary. For women seen personally, a significant decrement in drinking was associated with programme entry, which was in turn related to healthier infants at birth. This two-year programme established that intervention in pregnancy drinking is essential and feasible. Screening techniques developed by PHP simplify detection of excessive drinking. Education coupled with effective screening and referral to treatment when needed make reduction of fetal alcohol effects a goal within reach for all communities.

Bladder cancer and alcoholic beverage consumption.

A population-based case-control study of bladder cancer was conducted in 10 geographic areas in the United States. Risk of bladder cancer was not related to overall alcohol intake, nor to amounts of wine, beer, or spirits consumed. Alcohol also did not interact with known or suspected bladder carcinogens to increase risk, and no evidence was found that indirect mechanisms associated with alcohol ingestion the risk of bladder cancer.