A 1-year follow-up of prescribing patterns of analgesics in primary health care

Assessing the concentrations of polar organic microcontaminants from point sources in the aquatic environment: measure or model?

To carry out meaningful ecotoxicity studies on novel polar organic microcontaminants, it is essential to know what concentrations wildlife may be exposed to. Traditionally these values were obtained by analytical chemistry, but in recent years GIS water quality models have been developed which may offer a quick and reliable way of getting the same information. Thus, two ways of obtaining basically the same information now exist, and an issue, therefore, arises as to which method is the most appropriate to use in which situation. To address this issue we have critically reviewed and compared measuring and modeling approaches for the determination of sewage effluent and river water concentrations of organic microcontaminants. Where model predictions and chemical measurements can be directly compared in sewage effluents, receiving waters, and across catchments, reported model mean values have all been within 1 order of magnitude of the measured values, with typically no more than a 3- or 4-fold difference. Interlaboratory chemical analysis of some organic microcontaminants in effluents in the challenging ng/L range have provided results which have varied from one another by a similar margin. No such comparison has been carried out yet for GIS water quality models to determine variation in predicted concentrations. As the level of ecotoxicological effects of many chemicals is often considerably higher than the reported measured or modeled values, such errors that might occur will often be of no consequence. But due to their extraordinary potency, much more accuracy is required with some natural and synthetic hormones. Significantly, modeling is no more complex to conduct when dealing with contaminants at ng/L compared with mg/L concentrations, but the same cannot be said for chemical analysis. A combination of modeling and measuring techniques will give the greatest confidence in risk assessment.

Use of analgesics in Sweden--the importance of sociodemographic factors, physical fitness, health and health-related factors, and working conditions

In this study, factors related to analgesic use-independent of their association with pain-were studied in the general Swedish population. These included sociodemographics, health and health-related factors, physical fitness and working conditions. Data from the Swedish Survey of Living Conditions for the two-year period 1988/89 were used. In this survey a random sample (n = 13,295, response rate 79.4%) of the Swedish population aged 16 years and older was interviewed about health, medication use and related matters, among other things. In all, 35% of the population used analgesics at least once during a two-week period, and analgesic use was more than 50% higher among women than men. Analgesic use was less common among those aged 45-64 years and 65-74 years than those 18-44, after controlling for all other variables. The study showed that self-perceived poor health and pain explain much analgesic use. Analgesic use is further explained by lifestyle, sleeping problems, and health care utilization. Marital status, educational level, socioeconomic status, social network and working conditions were found to be of minor importance.

The Tromsø Study: frequency and predicting factors of analgesic drug use in a free-living population (12-56 years)

In a cross-sectional survey carried out in Tromsø in 1986-7, 19,137 men and women aged 12-56 years from the general population were asked about their use of drugs during the preceding 14 days. Use of analgesics was very common. On average 28% of the women and 13% of the men had used analgesics. Drug use due to menstruation discomfort contributed only partly to the gender difference. Drug use was independent of age from 20 years of age. Factors having an impact on analgesic drug use were analyzed by logistic regression. The most significant predictors of analgesic use were suffering from headache (OR = 14.2(women) OR = 24.4(men)) and infections (OR = 2.0(women) OR = 2.4(men)). Drug users also tended to suffer from symptoms of depression (women) and sleeplessness (men). Lifestyle and sociodemographic factors were also significant predictors, but were of marginal importance (OR < 1.5) compared with occurrence of pain and infections.