1
|
Scott LJ, Hidajat M, Burns EJ, Ure C, Hargreaves SC, Audrey S, Coffey M, Hare S, Siqueira N, Parrott S, Cook PA, de Vocht F. Does a local Alcohol Health Champion programme have a measurable impact on health and crime outcomes? A natural experiment evaluation of Communities in Charge of Alcohol (CICA) based on triangulation of methods. Addiction 2024; 119:499-508. [PMID: 37827515 DOI: 10.1111/add.16363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND AIM Drinking alcohol may cause harm to an individual's health and social relationships, while a drinking culture may harm societies as it may increase crime rates and make an area feel less safe. Local councils in Greater Manchester, UK, developed the Communities in Charge of Alcohol (CICA) intervention, in which volunteers were trained to give alcohol-related advice to the public and taught how to influence policies to restrict when, where and how alcohol is sold. As part of a larger study, the aim of the current project is to measure the impact of CICA on health and crime outcomes at the lower super output (LSOA) geographical aggregation. DESIGN Quantitative evaluation using four time series analytic methods (stepped-wedge design, and comparisons to local controls, national controls and synthetic controls) with findings triangulated across these methods. A cost-benefit analysis was carried out alongside the effectiveness analysis. SETTING AND PARTICIPANTS The general public in Greater Manchester, UK, between 2010 and 2020. MEASUREMENTS The primary outcome of interest was alcohol-related hospital admissions. Secondary outcomes were accident and emergency (A&E) attendances, ambulance callouts, recorded crimes and anti-social behaviour incidents. FINDINGS Triangulation of the results did not indicate any consistent effect on area-level alcohol-related hospital admissions, A&E attendances, ambulance callouts, reported crimes or anti-social behaviour associated with the implementation of CICA. The primary stepped-wedge analysis indicated an increase in alcohol-related hospital admissions following the implementation of CICA of 13.4% (95% confidence interval -3.3%, +30.1%), which was consistent with analyses based on other methods with point estimates ranging from +3.4% to 16.4%. CONCLUSION There is no evidence of a measurable impact of the Communities in Charge of Alcohol (CICA) programme on area-level health and crime outcomes in Greater Manchester, UK, within 3 years of the programme start. The increase in alcohol-related hospital admissions was likely the result of other temporal trends rather than the CICA programme. Possible explanations include insufficient follow-up time, too few volunteers trained, volunteers being unwilling to get involved in licensing decisions or that the intervention has no direct impact on the selected outcomes.
Collapse
Affiliation(s)
- Lauren J Scott
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Elizabeth J Burns
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Cathy Ure
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzy C Hargreaves
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Susan Hare
- School of Health and Society, University of Salford, Greater Manchester, UK
- Fallowfield Community Guardians c/o School of Health and Society, University of Salford, Greater Manchester, UK
| | | | - Steve Parrott
- Department of Health Sciences, University of York, York, UK
| | - Penny A Cook
- School of Health and Society, University of Salford, Greater Manchester, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West (ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| |
Collapse
|
2
|
Burns EJ, Hargreaves SC, Ure C, Hare S, Coffey M, Hidajat M, Audrey S, de Vocht F, Ardern K, Cook PA. 'A priori' external contextual factors and relationships with process indicators: a mixed methods study of the pre-implementation phase of 'Communities in Charge of Alcohol'. BMC Public Health 2022; 22:2224. [PMID: 36447172 PMCID: PMC9708132 DOI: 10.1186/s12889-022-14411-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/20/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND It is widely recognised that complex public health interventions roll out in distinct phases, within which external contextual factors influence implementation. Less is known about relationships with external contextual factors identified a priori in the pre-implementation phase. We investigated which external contextual factors, prior to the implementation of a community-centred approach to reducing alcohol harm called 'Communities in Charge of Alcohol' (CICA), were related to one of the process indicators: numbers of Alcohol Health Champions (AHCs) trained. METHODS A mixed methods design was used in the pre-implementation phase of CICA. We studied ten geographic communities experiencing both high levels of deprivation and alcohol-related harm in the North West of England. Qualitative secondary data were extracted from pre-implementation meeting notes, recorded two to three months before roll-out. Items were coded into 12 content categories using content analysis. To create a baseline 'infrastructure score', the number of external contextual factors documented was counted per area to a maximum score of 12. Descriptive data were collected from training registers detailing training numbers in the first 12 months. The relationship between the baseline infrastructure score, external contextual factors, and the number of AHCs trained was assessed using non-parametric univariable statistics. RESULTS There was a positive correlation between baseline infrastructure score and total numbers of AHCs trained (Rs = 0.77, p = 0.01). Four external contextual factors were associated with significantly higher numbers of lay people recruited and trained: having a health care provider to coordinate the intervention (p = 0.02); a pool of other volunteers to recruit from (p = 0.02); a contract in place with a commissioned service (p = 0.02), and; formal volunteer arrangements (p = 0.03). CONCLUSIONS Data suggest that there were four key components that significantly influenced establishing an Alcohol Health Champion programme in areas experiencing both high levels of deprivation and alcohol-related harm. There is added value of capturing external contextual factors a priori and then testing relationships with process indicators to inform the effective roll-out of complex interventions. Future research could explore a wider range of process indicators and outcomes, incorporating methods to rate individual factors to derive a mean score. TRIAL REGISTRATION ISRCTN81942890, date of registration 12/09/2017.
Collapse
Affiliation(s)
| | | | - Cathy Ure
- School of Health and Society, University of Salford, Manchester, UK
| | - Susan Hare
- Fallowfield Community Guardians c/o School of Health and Society, University of Salford, Manchester, UK
| | - Margaret Coffey
- School of Health and Society, University of Salford, Manchester, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kate Ardern
- School of Health and Society, University of Salford, Manchester, UK
| | - Penny A. Cook
- School of Health and Society, University of Salford, Manchester, UK
| |
Collapse
|
3
|
Ure C, Burns EJ, Hargreaves SC, Hidajat M, Coffey M, de Vocht F, Audrey S, Hare S, Ardern K, Cook PA. How can communities influence alcohol licensing at a local level? Licensing officers' perspectives of the barriers and facilitators to sustaining engagement in a volunteer-led alcohol harm reduction approach. Int J Drug Policy 2021; 98:103412. [PMID: 34461410 PMCID: PMC8689400 DOI: 10.1016/j.drugpo.2021.103412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 06/25/2021] [Accepted: 08/02/2021] [Indexed: 11/25/2022]
Abstract
Despite the World Health Organization's assertion that communities need to become involved in reducing alcohol harm, evidence of community engagement in alcohol licensing decision-making in England remains limited. The evaluation of the Communities in Charge of Alcohol (CICA) programme offers policymakers, Licensing authorities and public health practitioners, evidence regarding a specific volunteer-led, place-based approach, designed to enable community engagement in licensing with the aim of reducing localised alcohol harm. This study explored factors affecting the sustainable involvement of volunteers in alcohol licensing decision-making from six licensing officers' perspectives, through semi-structured interviews. Routinely collected crime, disorder, and hospital admissions data were reviewed for further context as proxy indicators for alcohol-related harm. Licensing officers perceived sustainable engagement to be impacted by: (i) the extent of alignment with statutory requirements and local political support; (ii) the ability of licensing officers to operationalise CICA and support local assets, and; (iii) the opportunity for, and ability of, volunteers to raise licensing issues. The perspectives of licensing officers indicate complexities inherent in seeking to empower residents to engage in licensing decision-making at a community level. These relate to statutory and political factors, funding, social norms regarding engagement in licensing decision-making, and the need for networks between critical actors including responsible authorities and communities. The evidence indicates that after increasing community capacity to influence alcohol availability decision-making at a local level, communities continue to struggle to influence statutory processes to affect alcohol availability where they live and work. More understanding of how to enable effective community engagement is required.
Collapse
Affiliation(s)
- Cathy Ure
- School of Health and Society, University of Salford, Allerton Building, M6 6PU, United Kingdom.
| | - Elizabeth J Burns
- School of Health and Society, University of Salford, Allerton Building, M6 6PU, United Kingdom
| | - Suzy C Hargreaves
- School of Health and Society, University of Salford, Allerton Building, M6 6PU, United Kingdom
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Margaret Coffey
- School of Health and Society, University of Salford, Allerton Building, M6 6PU, United Kingdom
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Suzanne Audrey
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Sue Hare
- Fallowfield Community Guardians c/o School of Health and Society, University of Salford, M6 6PU, United Kingdom
| | | | - Penny A Cook
- School of Health and Society, University of Salford, Allerton Building, M6 6PU, United Kingdom
| |
Collapse
|
4
|
de Vocht F, Martin RM, Hidajat M, Wakeford R. Quantitative Bias Analysis of the Association between Occupational Radiation Exposure and Ischemic Heart Disease Mortality in UK Nuclear Workers. Radiat Res 2021; 196:574-586. [PMID: 34370860 DOI: 10.1667/rade-21-00078.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 07/25/2021] [Indexed: 11/12/2022]
Abstract
The scientific question of whether protracted low-dose or low-dose-rate exposure to external radiation is causally related to the risk of circulatory disease continues to be an important issue for radiation protection. Previous analyses of a matched case-control dataset nested in a large cohort of UK nuclear fuel cycle workers indicated that there was little evidence that observed associations between external radiation dose and ischemic heart disease (IHD) mortality risk [OR = 1.35 (95% CI: 0.99-184) for 15-year-lagged exposure] could alternatively be explained by confounding from pre-employment tobacco smoking, BMI or blood pressure, or from socioeconomic status or occupational exposure to excessive noise or shiftwork. To improve causal inference about the observed external radiation dose and IHD mortality association, we estimated the potential magnitude and direction of non-random errors, incorporated sensitivity analyses and simulated bias effects under plausible scenarios. We conducted quantitative bias analyses of plausible scenarios based on 1,000 Monte Carlo samples to explore the impact of exposure measurement error, missing information on tobacco smoking, and unmeasured confounding, and assessed whether observed associations were reliant on the inclusion of specific matched pairs using bootstrapping with 10% of matched pairs randomly excluded in 1,000 samples. We further explored the plausibility that having been monitored for internal exposure, which was an important confounding factor in the case-control analysis for which models were adjusted, was indeed a confounding factor or whether it might have been the result of some form of selection bias. Consistent with the broader epidemiological evidence-base, these analyses provide further evidence that the dose-response association between cumulative external radiation exposure and IHD mortality is non-linear in that it has a linear shape plateauing at an excess risk of 43% (95% CI: 7-92%) on reaching 390 mSv. Analyses of plausible scenarios of patterns of missing data for tobacco smoking at start of employment indicated that this resulted in relatively little bias towards the null in the original analysis. An unmeasured confounder would have had to have been highly correlated (rp > 0.60) with cumulative external radiation dose to importantly bias observed associations. The confounding effect of "having been monitored for internal dose" was unlikely to have been a true confounder in a biological sense, but instead may have been some unknown factor related to differences over time and between sites in selection criteria for internal monitoring, possibly resulting in collider bias. Plausible patterns of exposure measurement error negatively biased associations regardless of the modeled scenario, but did not importantly change the shape of the observed dose-response associations. These analyses provide additional support for the hypothesis that the observed association between external radiation exposure and IHD mortality may be causal.
Collapse
Affiliation(s)
- Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom; and
| | - Richard M Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom; and
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom; and
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
5
|
Hayes L, Adams J, McCallum I, Forrest L, Hidajat M, White M, Sharp L. Age-related and socioeconomic inequalities in timeliness of referral and start of treatment in colorectal cancer: a population-based analysis. J Epidemiol Community Health 2021; 75:1-9. [PMID: 33055178 DOI: 10.1136/jech-2020-214232] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/11/2020] [Accepted: 06/20/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Poorer colorectal cancer survival in the UK than in similar countries may be partly due to delays in the care pathway. To address this, cancer waiting time targets were established. We investigated if socio-demographic inequalities exist in meeting cancer waiting times for colorectal cancer. METHODS We identified primary colorectal cancers (International Classification of Diseases, Tenth Revision C18-C20; n=35 142) diagnosed in the period 2001-2010 in the Northern and Yorkshire Cancer Registry area. Using multivariable logistic regression, we calculated likelihood of referral and treatment within target by age group and deprivation quintile. RESULTS 48% of the patients were referred to hospital within target (≤14 days from general practitioner (GP) referral to first hospital appointment); 52% started treatment within 31 days of diagnosis; and 44% started treatment within 62 days of GP referral. Individuals aged 60-69, 70-79 and 80+ years were significantly more likely to attend a first hospital appointment within 14 days than those aged <60 years (adjusted OR=1.23, 95% CI 1.12 to 1.34; adjusted OR=1.19, 95% CI 1.09 to 1.29; adjusted OR=1.30, 95% CI 1.18 to 1.42, respectively). Older age was significantly associated with lower likelihood of starting treatment within 31 days of diagnosis and 62 days of referral. Deprivation was not related to referral within target but was associated with lower likelihood of starting treatment within 31 days of diagnosis or 62 days of referral (most vs least: adjusted OR=0.82, 95% CI 0.74 to 0.91). CONCLUSIONS Older patients with colorectal cancer were less likely to experience referral delays but more likely to experience treatment delays. More deprived patients were more likely to experience treatment delays. Investigation of patient pathways, treatment decision-making and treatment planning would improve understanding of these inequalities.
Collapse
Affiliation(s)
- Louise Hayes
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Iain McCallum
- Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Lynne Forrest
- University of Edinburgh School of GeoSciences, Edinburgh, UK
| | - Mira Hidajat
- University of Bristol School of Social and Community Medicine, Bristol, UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| |
Collapse
|
6
|
de Vocht F, Hidajat M, Martin RM, Agius R, Wakeford R. Ischemic Heart Disease Mortality and Occupational Radiation Exposure in a Nested Matched Case-Control Study of British Nuclear Fuel Cycle Workers: Investigation of Confounding by Lifestyle, Physiological Traits and Occupational Exposures. Radiat Res 2020; 194:431-444. [DOI: 10.1667/rade-19-00007.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 07/13/2020] [Indexed: 11/12/2022]
Affiliation(s)
- Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Richard M. Martin
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2PS, United Kingdom
| | - Raymond Agius
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
| | - Richard Wakeford
- Centre for Occupational and Environmental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, M13 9PL, United Kingdom
| |
Collapse
|
7
|
Hidajat M, de Vocht F. Occupational zoonoses potential in Southeast Asia. Occup Med (Lond) 2020; 70:323-326. [DOI: 10.1093/occmed/kqaa082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
8
|
Hidajat M, McElvenny DM, Ritchie P, Darnton A, Mueller W, Agius RM, Cherrie JW, de Vocht F. Lifetime cumulative exposure to rubber dust, fumes and N-nitrosamines and non-cancer mortality: a 49-year follow-up of UK rubber factory workers. Occup Environ Med 2020; 77:316-323. [PMID: 31974293 DOI: 10.1136/oemed-2019-106269] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 12/19/2019] [Accepted: 12/31/2019] [Indexed: 01/14/2023]
Abstract
OBJECTIVES To examine associations between occupational exposures to rubber dust, rubber fumes and N-nitrosamines and non-cancer mortality. METHODS A cohort of 36 441 males aged 35+ years employed in British rubber factories was followed-up to 2015 (94% deceased). Competing risk survival analysis was used to assess risks of dying from non-cancer diseases (respiratory, urinary, cerebrovascular, circulatory and digestive diseases). Occupational exposures to rubber dust, rubber fumes, N-nitrosamines were derived based on a population-specific quantitative job-exposure matrix which in-turn was based on measurements in the EU-EXASRUB database. RESULTS Exposure-response associations of increased risk with increasing exposure were found for N-nitrosomorpholine with mortality from circulatory diseases (subdistribution hazard ratio (SHR) 1.17; 95% CI 1.12 to 1.23), ischaemic heart disease (IHD) (SHR 1.19; 95% CI 1.13 to 1.26), cerebrovascular disease (SHR 1.19; 95% CI 1.07 to 1.32) and exposures to N-nitrosodimethylamine with respiratory disease mortality (SHR 1.41; 95% CI 1.30 to 1.53). Increased risks for mortality from circulatory disease, IHD and digestive diseases were found with higher levels of exposures to rubber dust, rubber fumes and N-nitrosamines sum, without an exposure-dependent manner. No associations were observed between rubber dust, rubber fumes and N-nitrosamines exposures with mortality from asthma, urinary disease, bronchitis, emphysema, liver disease and some digestive diseases. CONCLUSIONS In a cohort of rubber factory workers with 49 years of follow-up, increased risk for mortality from circulatory, cerebrovascular, respiratory and digestive diseases were found to be associated with cumulative occupational exposures to specific agents.
Collapse
Affiliation(s)
- Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Peter Ritchie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Andrew Darnton
- Statistics and Epidemiology Unit, Health and Safety Executive, Bootle, UK
| | - William Mueller
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Raymond M Agius
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - John W Cherrie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, Edinburgh, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
9
|
Hidajat M, McElvenny DM, Ritchie P, Darnton A, Mueller W, van Tongeren M, Agius RM, Cherrie JW, de Vocht F. Healthy worker effects explain differences in internal and external comparisons in a rubber industry cohort study. Occup Environ Med 2019; 76:781. [PMID: 31515445 DOI: 10.1136/oemed-2019-106083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Accepted: 08/20/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Mira Hidajat
- Population Health Sciences, University of Bristol, Bristol, UK
| | | | | | - Andrew Darnton
- Statistics and Epidemiology Unit, Health and Safety Executive Bootle Headquarters, Bootle, Sefton, UK
| | | | - Martie van Tongeren
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | - Raymond M Agius
- Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
| | | | - Frank de Vocht
- Population Health Sciences, University of Bristol, Bristol, UK
| |
Collapse
|
10
|
Hidajat M, McElvenny DM, Mueller W, Ritchie P, Cherrie JW, Darnton A, Agius RM, Kromhout H, de Vocht F. Job-exposure matrix for historical exposures to rubber dust, rubber fumes and n-Nitrosamines in the British rubber industry. Occup Environ Med 2019; 76:259-267. [PMID: 30772817 PMCID: PMC6581116 DOI: 10.1136/oemed-2018-105182] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 12/10/2018] [Accepted: 12/31/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To develop a quantitative historical job-exposure matrix (JEM) for rubber dust, rubber fumes and n-Nitrosamines in the British rubber industry for 1915-2002 to estimate lifetime cumulative exposure (LCE) for a cohort of workers with 49 years follow-up. METHODS Data from the EU-EXASRUB database-rubber dust (n=4157), rubber fumes (n=3803) and n-Nitrosamines (n=10 115) collected between 1977 and 2002-were modelled using linear mixed-effects models. Sample year, stationary/personal measurement, industry sector and measurement source were included as fixed explanatory variables and factory as random intercept. Model estimates and extrapolations were used to construct a JEM covering all departments in both sectors of the rubber manufacturing industries for the years 1915-2002. JEM-estimates were linked to all cohort members to calculate LCE. Sensitivity analyses related to assumptions about extrapolation of time trends were also conducted. RESULTS Changes in rubber dust exposures ranged from -6.3 %/year (crude materials/mixing) to -1.0 %/year (curing) and -6.5 %/year (crude materials/mixing) to +0.5 %/year (finishing, assembly and miscellaneous) for rubber fumes. Declines in n-Nitrosamines ranged from -17.9 %/year (curing) to -1.3 %/year (crude materials and mixing). Mean LCEs were 61 mg/m3-years (rubber dust), 15.6 mg/ m3-years (rubber fumes), 2483.2 µg/m3-years (n-Nitrosamines sum score), 18.6 µg/m3-years (N-nitrosodimethylamine) and 15.0 µg/m3-years (N-itrosomorpholine). CONCLUSIONS All exposures declined over time. Greatest declines in rubber dust and fumes were found in crude materials and mixing and for n-Nitrosamines in curing/vulcanising and preprocessing. This JEM and estimated LCEs will allow for evaluation of exposure-specific excess cancer risks in the British rubber industry.
Collapse
Affiliation(s)
- Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - William Mueller
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Peter Ritchie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - John W Cherrie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
- Institute of Biological Chemistry, Biophysics and –Bioengineering, Heriot Watt University, Edinburgh, UK
| | - Andrew Darnton
- Statistics and Epidemiology Unit, Health and Safety Executive, Bootle, UK
| | - Raymond M Agius
- Centre for Occupational and Environmental Health, Centre for Epidemiology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Hans Kromhout
- Environmental Epidemiology Division, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
11
|
Hidajat M, McElvenny DM, Ritchie P, Darnton A, Mueller W, van Tongeren M, Agius RM, Cherrie JW, de Vocht F. Lifetime exposure to rubber dusts, fumes and N-nitrosamines and cancer mortality in a cohort of British rubber workers with 49 years follow-up. Occup Environ Med 2019; 76:250-258. [PMID: 30772818 PMCID: PMC6581114 DOI: 10.1136/oemed-2018-105181] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 12/11/2018] [Accepted: 12/31/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To quantitatively evaluate exposure-response associations between occupational exposures to rubber dust, fumes and N-nitrosamines and cancer mortality in the UK rubber industry. METHODS Competing risk survival analyses were used to examine cancer mortality risk in a cohort of 36 441 males aged 35+ years employed in the British rubber industry in 1967, followed up to 2015 (94% mortality). Exposure measurements are based on a population-specific quantitative job-exposure matrix for rubber dust, rubber fumes and N-nitrosamines from the EU-EXASRUB project. RESULTS Exposure (lifetime cumulative (LCE))-response associations were found for N-nitrosomorphiline and all cancers (subdistribution HR (SHR) 1.48, 95% CI 1.39 to 1.57) and cancers of the bladder, stomach, multiple myeloma, oesophagus, prostate and pancreas, as well as for N-nitrosodimethylamine and all cancers (SHR 2.08, 95% CI 1.96 to 2.21) and cancers of the bladder, stomach, leukaemia, multiple myeloma, prostate and liver. LCE to the N-nitrosamines sum were associated with increased risks from all cancers (SHR 1.89, 95% CI 1.78 to 2.01) and cancers of the lung, non-Hodgkin's lymphoma and brain. LCE to rubber dust and fumes are associated with increased mortality from all cancers (rubber dust SHR 1.67, 95% CI 1.58 to 1.78; rubber fumes SHR 1.91, 95% CI 1.80 to 2.03) and cancers of the bladder, lung, stomach, leukaemia, multiple myeloma, non-Hodgkin's lymphoma, oesophagus, prostate, pancreas and liver. CONCLUSIONS Consistent with previous studies, N-nitrosamines exposures are associated with mortality from cancers of the bladder, lung, stomach, leukaemia, multiple myeloma, oesophagus, prostate, pancreas and liver. The long follow-up with nearly complete mortality enabled estimations of lifetime cancer mortality risk from occupational exposures in the rubber industry.
Collapse
Affiliation(s)
- Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Peter Ritchie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Andrew Darnton
- Statistics and Epidemiology Unit, Health and Safety Executive, Bootle, UK
| | - William Mueller
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Martie van Tongeren
- Centre for Occupational and Environmental Health, Centre for Epidemiology, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Raymond M Agius
- Centre for Occupational and Environmental Health, Centre for Epidemiology, School of Health Sciences, The University of Manchester, Manchester, UK
| | - John W Cherrie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
12
|
McElvenny DM, Mueller W, Ritchie P, Cherrie JW, Hidajat M, Darnton AJ, Agius RM, de Vocht F. British rubber and cable industry cohort: 49-year mortality follow-up. Occup Environ Med 2018; 75:848-855. [PMID: 30269103 DOI: 10.1136/oemed-2017-104834] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 08/30/2018] [Accepted: 09/04/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND The International Agency for Research on Cancer (IARC) has determined there is sufficient evidence that working in the rubber manufacturing industry increases the risk of cancers of the stomach, lung, bladder and leukaemia and lymphoma. OBJECTIVES To examine mortality patterns of a prospective cohort of men from the rubber and cable manufacturing industries in Great Britain. METHODS SMRs were calculated for males aged 35+ years at start of follow-up in 1967-2015 using the population of England and Wales as the external comparator. Tests for homogeneity and trends in SMRs were also completed. RESULTS For all causes, all malignant neoplasms, non-malignant respiratory diseases and circulatory diseases, SMRs were significantly elevated, and also particularly for cancers of the stomach (SMR=1.26,95% CI 1.18 to 1.36), lung (1.25,95% CI 1.21 to 1.29) and bladder (1.16,95% CI 1.05 to 1.28). However, the observed deaths for leukaemia, non-Hodgkin's lymphoma (NHL) and multiple myeloma were as expected. Bladder cancer risks were elevated only in workers exposed to antioxidants containing 1-naphthylamine and 2-naphthylamine. CONCLUSIONS This study provides evidence of excess risks in the rubber industry for some non-cancer diseases and supports IARC's conclusions in relation to risks for cancers of the bladder, lung and stomach, but not for leukaemia, NHL or multiple myeloma.
Collapse
Affiliation(s)
| | - William Mueller
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - Peter Ritchie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
| | - John W Cherrie
- Research Division, Institute of Occupational Medicine, Edinburgh, UK
- Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot-Watt University, Edinburgh, UK
| | - Mira Hidajat
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Andrew J Darnton
- Statistics Branch-Epidemiology Unit, Health and Safety Executive, Merseyside, UK
| | - Raymond M Agius
- Centre for Occupational and Environmental Health, Centre for Epidemiology, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Frank de Vocht
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|
13
|
Hayes L, Forrest L, Adams J, Hidajat M, Ben-Shlomo Y, White M, Sharp L. Age-related inequalities in colon cancer treatment persist over time: a population-based analysis. J Epidemiol Community Health 2018; 73:34-41. [DOI: 10.1136/jech-2018-210842] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 11/03/2022]
Abstract
BackgroundOlder people experience poorer outcomes from colon cancer. We examined if treatment for colon cancer was related to age and if inequalities changed over time.MethodsData from the UK population-based Northern and Yorkshire Cancer Registry on 31 910 incident colon cancers (ICD10 C18) diagnosed between 1999–2010 were obtained. Likelihood of receipt of: (1) cancer-directed surgery, (2) chemotherapy in surgical patients, (3) chemotherapy in non-surgical patients by age, adjusting for sex, area deprivation, cancer stage, comorbidity and period of diagnosis, was examined.ResultsAge-related inequalities in treatment exist after adjustment for confounding factors. Patients aged 60– 69, 70–79 and 80+ years were significantly less likely to receive surgery than those aged <60 years (multivariable ORs (95% CI) 0.84(0.74 to 0.95), 0.54(0.48 to 0.61) and 0.19(0.17 to 0.21), respectively). Age-related differences in receipt of surgery and adjuvant chemotherapy (but not chemotherapy in non-surgical patients) narrowed over time for the ’younger old’ (aged <80 years) but did not diminish for the oldest patients.ConclusionsAge inequality in treatment of colon cancer remains after adjustment for confounders, suggesting age remains a major factor in treatment decisions. Research is needed to better understand the cancer treatment decision-making process, and how to influence this, for older patients.
Collapse
|
14
|
Jordan H, Hidajat M, Payne N, Adams J, White M, Ben-Shlomo Y. What are older smokers' attitudes to quitting and how are they managed in primary care? An analysis of the cross-sectional English Smoking Toolkit Study. BMJ Open 2017; 7:e018150. [PMID: 29146649 PMCID: PMC5695521 DOI: 10.1136/bmjopen-2017-018150] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/07/2017] [Accepted: 10/11/2017] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES To investigate whether age is associated with access to smoking cessation services. DESIGN Data from the Smoking Toolkit Study 2006-2015, a repeated multiwave cross-sectional household survey (n=181 157). SETTING England. PARTICIPANTS Past-year smokers who participated in any of the 102 waves stratified into age groups. OUTCOME MEASURES Amount smoked and nicotine dependency, self-reported quit attempts and use of smoking cessation interventions. Self-report of whether the general practitioner (GP) raised the topic of smoking and made referrals for pharmacological support (prescription of nicotine replacement therapies (NRTs)) or other support (counselling or support groups). RESULTS Older smokers (75+ years) were less likely to report that they were attempting to quit smoking or seek help from a GP, despite being less nicotine-dependent. GPs raised smoking as a topic equally across all age groups, but smokers aged 70+ were more likely not to be referred for NRT or other support (ORs relative to 16-54 years; 70-74 years 1.27, 95% CI 1.03 to 1.55; 75-79 years 1.87, 95% CI 1.43 to 2.44; 80+ years 3.16, 95% CI 2.20 to 4.55; p value for trend <0.001). CONCLUSIONS Our findings suggest that there are potential missed opportunities in facilitating smoking cessation in older smokers. In this large population-based study, older smokers appeared less interested in quitting and were less likely to be offered support, despite being less addicted to nicotine than younger smokers. It is unclear whether this constitutes inequitable access to services or reflects informed choices by older smokers and their GPs. Future research is needed to understand why older smokers and GPs do not pursue smoking cessation. Service provision should consider how best to reduce these variations, and a stronger effectiveness evidence base is required to support commissioning for this older population so that, where appropriate, older smokers are not missing out on smoking cessation therapies and the health benefits of cessation at older ages.
Collapse
Affiliation(s)
- Hannah Jordan
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Mira Hidajat
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Nick Payne
- Section of Public Health, School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
| | - Jean Adams
- MRC Epidemiology Unit & CEDAR, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Martin White
- MRC Epidemiology Unit & CEDAR, School of Clinical Medicine, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| |
Collapse
|
15
|
Salway SM, Payne N, Rimmer M, Buckner S, Jordan H, Adams J, Walters K, Sowden SL, Forrest L, Sharp L, Hidajat M, White M, Ben-Shlomo Y. Identifying inequitable healthcare in older people: systematic review of current research practice. Int J Equity Health 2017; 16:123. [PMID: 28697768 PMCID: PMC5505033 DOI: 10.1186/s12939-017-0605-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/13/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There is growing consensus on the importance of identifying age-related inequities in the receipt of public health and healthcare interventions, but concerns regarding conceptual and methodological rigour in this area of research. Establishing age inequity in receipt requires evidence of a difference that is not an artefact of poor measurement of need or receipt; is not warranted on the grounds of patient preference or clinical safety; and is judged to be unfair. METHOD A systematic, thematic literature review was undertaken with the objective of characterising recent research approaches. Studies were eligible if the population was in a country within the Organisation for Economic Co-operation and Development and analyses included an explicit focus on age-related patterns of healthcare receipt including those 60 years or older. A structured extraction template was applied. Extracted material was synthesised in thematic memos. A set of categorical codes were then defined and applied to produce summary counts across key dimensions. This process was iterative to allow reconciliation of discrepancies and ensure reliability. RESULTS Forty nine studies met the eligibility criteria. A wide variety of concepts, terms and methodologies were used across these studies. Thirty five studies employed multivariable techniques to produce adjusted receipt-need ratios, though few clearly articulated their rationale, indicating the need for great conceptual clarity. Eighteen studies made reference to patient preference as a relevant consideration, but just one incorporated any kind of adjustment for this factor. Twenty five studies discussed effectiveness among older adults, with fourteen raising the possibility of differential effectiveness, and one differential cost-effectiveness, by age. Just three studies made explicit reference to the ethical nature of healthcare resource allocation by age. While many authors presented suitably cautious conclusions, some appeared to over-stretch their findings concluding that observed differences were 'inequitable'. Limitations include possible biases in the retrieved material due to inconsistent database indexing and a focus on OECD country populations and studies with English titles. CONCLUSIONS Caution is needed among clinicians and other evidence-users in accepting claims of healthcare 'ageism' in some published papers. Principles for improved research practice are proposed.
Collapse
Affiliation(s)
- Sarah M. Salway
- School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Nick Payne
- School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Melanie Rimmer
- School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Stefanie Buckner
- Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 0SR UK
| | - Hannah Jordan
- School of Health & Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA UK
| | - Jean Adams
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, CB2 0QQ UK
| | - Kate Walters
- Centre for Ageing & Population Studies, Department of Primary Care & Population Health, University College London, Rowland Hill Street, London, NW3 2PF UK
| | - Sarah L. Sowden
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon, Tyne NE2 4AX UK
| | - Lynne Forrest
- Administrative Data Research Centre, University of Edinburgh, Edinburgh Bioquarter, 9 Little France Road, Edinburgh, EH16 4UX UK
| | - Linda Sharp
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon, Tyne NE2 4AX UK
| | - Mira Hidajat
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| | - Martin White
- MRC Epidemiology Unit, University of Cambridge, School of Clinical Medicine, Cambridge, CB2 0QQ UK
- Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Newcastle upon, Tyne NE2 4AX UK
| | - Yoav Ben-Shlomo
- School of Social and Community Medicine, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS UK
| |
Collapse
|
16
|
Hidajat M, McElvenny D, MacCalman L, Alexander C, Cherrie J, Darnton A, Agius R, Vocht FD. P029 Lifetime cancer risk in the british rubber industry. a retrospective cohort with 45 year follow-up. Cancer 2016. [DOI: 10.1136/oemed-2016-103951.354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
17
|
Zimmer Z, Hidajat M, Saito Y. Changes in total and disability-free life ex-pectancy among older adults in China: Do they portend a compression of morbidity? ACTA ACUST UNITED AC 2015. [DOI: 10.18063/ijps.2015.01.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purpose of this research is to determine whether disability-free life expectancy (DFLE) in China has been increasing more rapidly than total life expectancy (TLE). Such a scenario would be consistent with a compression of morbidity, a situation that is especially desirable in a country experiencing rapid population aging and gains in old-age longevity. Us-ing the Chinese Longitudinal Healthy Longevity Study, an exponential survival regression is used to calculate TLE. The Sullivan method is then employed for computing DFLE. Results for a 65 and older sample are compared across data collected during two periods, the first with a 2002 baseline and a 2005 follow-up (N=15,641) and the second with a 2008 baseline and a 2011 follow-up (N=15,622). The first comparison is by age and sex. The second comparison divides the sample further by rural/urban residence and education. The ratio of DFLE/TLE across periods provides evidence of whether older Chinese are living both longer and healthier lives. The findings are favorable for the total population aged 65+, but improvements are only statistically significant for females. Results also suggest heterogeneous compression occurring across residential status with the urban population experiencing more favorable changes than their rural counterparts. Results both portend a compression of morbidity and continuing dis-advantage for rural residents who may not be participating in population-wide improvements in health.
Collapse
|
18
|
Abstract
Research has implicated religious activity as a health determinant, but questions remain, including whether associations persist in places where Judeo-Christian religions are not the majority; whether public versus private religious expressions have equivalent impacts, and the precise advantage expressed as years of life. This article addresses these issues in Taiwan. 3,739 Taiwanese aged 53+ were surveyed in 1999, 2003, and 2007. Mortality and disability were recorded. Religious activities in public and private settings were measured at baseline. Multistate life-tables produced estimates of total life expectancy and activity of daily living (ADL) disability-free life expectancy across levels of public and private religious activity. There is a consistent positive gradient between religious activity and expectancy with greater activity related to longer life and more years without disability. Life and ADL disability-free life expectancies for those with no religious affiliation fit in between the lowest and highest religious activity groups. Results corroborate evidence in the West. Mechanisms that intervene may be similar in Eastern religions despite differences in the ways in which popular religions are practiced. Results for those with no affiliation suggest benefits of religion can be accrued in alternate ways.
Collapse
|
19
|
Gerstorf D, Ram N, Mayraz G, Hidajat M, Lindenberger U, Wagner GG, Schupp J. Late-life decline in well-being across adulthood in Germany, the United Kingdom, and the United States: Something is seriously wrong at the end of life. Psychol Aging 2010; 25:477-85. [PMID: 20545432 DOI: 10.1037/a0017543] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Throughout adulthood and old age, levels of well-being appear to remain relatively stable. However, evidence is emerging that late in life well-being declines considerably. Using long-term longitudinal data of deceased participants in national samples from Germany, the United Kingdom, and the United States, we examined how long this period lasts. In all 3 nations and across the adult age range, well-being was relatively stable over age but declined rapidly with impending death. Articulating notions of terminal decline associated with impending death, we identified prototypical transition points in each study between 3 and 5 years prior to death, after which normative rates of decline steepened by a factor of 3 or more. The findings suggest that mortality-related mechanisms drive late-life changes in well-being and highlight the need for further refinement of psychological concepts about how and when late-life declines in psychosocial functioning prototypically begin. (PsycINFO Database Record (c) 2010 APA, all rights reserved).
Collapse
Affiliation(s)
- Denis Gerstorf
- Department of Human Development and Family Studies, Pennsylvania State University, University Park, PA 16802, USA.
| | | | | | | | | | | | | |
Collapse
|
20
|
Abstract
We report a case of haemolytic due to the use of piperacillin-tazobactam in a 50-year-old woman. Since 2002 4 other cases were reported. Either the presence of piperacillin as tazobactam can induce haemolysis. In all cases discontinuating the drugs resolves the haemolysis. Although drug-induced haemolytic anaemia due to piperacillin-tazobactam is rare, the common use of this antibioticum in the critical care setting should alert the physician as a possible culprit in cases of haemolytic anaemia.
Collapse
Affiliation(s)
- I Dapper
- Intensive Care Unit, AZ Monica, Antwerpen, Belgium.
| | | | | | | | | | | | | |
Collapse
|
21
|
Osselaer JC, Cazenave JP, Lambermont M, Garraud O, Hidajat M, Barbolla L, Tardivel R, Defoin L, Waller C, Mendel I, Raidot JP, Kandel G, De Meuter R, Fabrigli P, Dehenau D, Arroyo JL, Padrón F, Gouezec H, Corral M, Jacquet M, Sundin D, Lin L, Corash L. An active haemovigilance programme characterizing the safety profile of 7437 platelet transfusions prepared with amotosalen photochemical treatment. Vox Sang 2008; 94:315-23. [DOI: 10.1111/j.1423-0410.2007.01035.x] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
22
|
Marques Da Costa C, Dupont E, Van der Cruys M, Andrien M, Hidajat M, Song M, Stene JJ. Earlier Occurrence of Severe Alopecia Areata in HLA-DRB1*11-Positive Patients. Dermatology 2006; 213:12-4. [PMID: 16778420 DOI: 10.1159/000092831] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2005] [Accepted: 01/29/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alopecia areata (AA) is a polygenic immune-mediated disorder affecting the hair follicle for which an association with human leukocyte antigen HLA-DRB1*11 has been described. OBJECTIVE Two parameters including age of onset and extent of the disease (patchy AA and AT/AU forms) were correlated with the presence or absence of HLA-DRB1*11 and its alleles in 88 severe AA patients. METHODS Patients and healthy controls were typed for HLA-DR and -DQ by molecular method. RESULTS Among AA patients, 37.5% (a proportion rising to 72% when taking patients who began their first patch before the age of 20 years) were positive for HLA-DRB1*11 compared to 21.2% healthy controls (p = 0.004, RR = 2.1). DRB1*11-positive status was associated with earlier development of the first AA patch, at the mean age of 16 years compared to 27 years (p = 0.003) in DRB1*11-negative patients. Among the DRB1*11 alleles, the presence of DRB1*1104 was associated with the earliest occurrence of AA. CONCLUSION Our data indicate that the HLA system largely through DRB1*1104 allele influences AA onset rather than extension considering patchy AA and AT/AU.
Collapse
Affiliation(s)
- C Marques Da Costa
- Department of Dermatology, Hôpital Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | | | | | | | | | | | | |
Collapse
|
23
|
Hale G, Jacobs P, Wood L, Fibbe WE, Barge R, Novitzky N, Toit C, Abrahams L, Thomas V, Bunjes D, Duncker C, Wiesneth M, Selleslag D, Hidajat M, Starobinski M, Bird P, Waldmann H. CD52 antibodies for prevention of graft-versus-host disease and graft rejection following transplantation of allogeneic peripheral blood stem cells. Bone Marrow Transplant 2000; 26:69-76. [PMID: 10918407 DOI: 10.1038/sj.bmt.1702477] [Citation(s) in RCA: 136] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Graft-versus-host disease (GVHD) is a major cause of mortality and morbidity after allogeneic bone marrow transplantation, but can be avoided by removing T lymphocytes from the donor bone marrow. However, T cell depletion increases the risk of graft rejection. In this study, two strategies are used to overcome rejection: (1) use of high doses of stem cells obtained from peripheral blood (PBSC), (2) admixture with a CD52 monoclonal antibody in order to deplete both donor and residual recipient lymphocytes. Two antibodies are compared: CAMPATH-1G (rat IgG2b) and its humanized equivalent CAMPATH-1H (human IgG1). A total of 187 consecutive patients at six centers received PBSC transplants from HLA-matched siblings between 1997 and 1999. A wide spectrum of diseases, both malignant and non-malignant, was included. The recovery of CD34+ cells after antibody treatment was close to 100%. The risk of acute GVHD (grade 2 to 4) was 11% in the CAMPATH-1G group and 4% in the CAMPATH-1H group (P = NS). The risk of chronic GVHD (any grade) was 11% in the CAMPATH-1G group and 24% in the CAMPATH-1H group (P = 0.03) but the risk of extensive chronic GVHD was only 2%. The overall risk of graft failure/rejection was 2%, not significantly different between the two antibodies. Antibody treatment was equally effective at concentrations between 10 microg/ml and 120 microg/ml and it made no significant difference to the outcome whether the patients received post-transplant immunosuppression or not (87% did not). Transplant-related mortality in this heterogenous group of patients (including high-risk and advanced disease) was 22% at 12 months. It is proposed that treatment of peripheral blood stem cells with CAMPATH-1H is a simple and effective method for depleting T cells which may be applicable to both autologous and allogeneic transplants from related or unrelated donors. Special advantages of this approach are the simultaneous depletion of donor B cells (which reduces the risk of EBV-associated lymphoproliferative disease) and the concomitant infusion of CAMPATH-1H to deplete residual recipient T cells and thus prevent graft rejection.
Collapse
Affiliation(s)
- G Hale
- Sir William Dunn School of Pathology, University of Oxford, Oxford, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Voorter C, Chatelain B, Sintnicolaas K, Tilanus M, Hidajat M, van den Berg-Loonen E. Identification of a new DPB1 allele (DPB1*7901) by sequence-based typing. Tissue Antigens 1998; 52:193-5. [PMID: 9756411 DOI: 10.1111/j.1399-0039.1998.tb02286.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- C Voorter
- Tissue Typing Laboratory, University Hospital Maastricht, The Netherlands
| | | | | | | | | | | |
Collapse
|
25
|
Rozemuller EH, Allebes WA, van den Berg-Loonen EP, Hidajat M, van der Zwan AW, Tilanus MG, Joosten I. DPB1*7601, a novel DPB1 variant in the Caucasoid population. Tissue Antigens 1998; 51:663-5. [PMID: 9694361 DOI: 10.1111/j.1399-0039.1998.tb03011.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A new DPB1 allele has been identified in a Caucasoid individual, DPB1*7601. The sequence of the complete second exon has been confirmed by cloning and subsequent sequencing. This allele differs by one amino acid, at codon 36, from DPB1*1401, as indicated by SBT and PCR-SSP analysis. The amino-acid motif introduced by the change is shared by DPB1*0401 and some rare alleles. It remains unclear whether the change is due to interallelic microgen conversion or a single point mutation.
Collapse
Affiliation(s)
- E H Rozemuller
- Department of Pathology, University Hospital Utrecht, The Netherlands
| | | | | | | | | | | | | |
Collapse
|
26
|
Criel A, Mecucci C, Wlodarska I, Meeus P, Stul M, Cassiman JJ, Louwagie A, Van Hoof A, Hidajat M, Van den Berghe H. Trisomy 12 does not correlate with EBV infection in chronic B-cell leukemias. Cancer Genet Cytogenet 1995; 82:80-1. [PMID: 7627941 DOI: 10.1016/0165-4608(94)00272-d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
MESH Headings
- Base Sequence
- Chromosomes, Human, Pair 12
- DNA Primers/chemistry
- DNA, Viral/analysis
- Herpesviridae Infections/pathology
- Herpesvirus 4, Human/genetics
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/microbiology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Molecular Sequence Data
- Trisomy
- Tumor Virus Infections/pathology
Collapse
Affiliation(s)
- A Criel
- Department of Hematology, A.Z. St. Jan, Brugge, Belgium
| | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Billiet J, Criel A, van Vuchelen J, Hidajat M, Van Hoof A, Louwagie A, Michielssen P. Relationship between nuclear morphology and DNA content in large cell lymphomas. Anal Quant Cytol Histol 1994; 16:339-44. [PMID: 7530957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The relationship between DNA content and nuclear morphology in large cell lymphomas (LCLs) was investigated on lymph node imprints. Mean maximum nuclear diameter (mean MND), nuclear shape and chromatin pattern were evaluated microscopically on May-Grünwald-Giemsa-stained slides. DNA content and nuclear area were measured on Feulgen-stained slides by image analysis. Twelve of the 24 cases were DNA diploid and 12 tetraploid. The DNA diploid cases were characterized by medium large (mean MND 11.2-13.7 microns), round nuclei with a fine chromatin pattern. The DNA tetraploid cases had significantly (P < .01) larger (mean MND 13.0-19.1 microns) nuclei and a higher frequency of coarse chromatin pattern, nuclear irregularities and multilobation. One of the researchers, unaware of the DNA index, could predict the ploidy level in 80% of cases on morphology. The linear coefficient of correlation between mean MND and mean nuclear area was 0.84. We also found that nuclear area increased as the cell moved through the cell cycle. DNA content, related to ploidy and position in the cell cycle, is an important explanation for the variable nuclear morphology in LCLs.
Collapse
Affiliation(s)
- J Billiet
- Department of Hematology and Pathology, Algemeen Ziekenhuis Sint-Jan, Brugge, Belgium
| | | | | | | | | | | | | |
Collapse
|
28
|
Criel A, Wlodarska I, Meeus P, Stul M, Louwagie A, Van Hoof A, Hidajat M, Mecucci C, Van den Berghe H. Trisomy 12 is uncommon in typical chronic lymphocytic leukaemias. Br J Haematol 1994; 87:523-8. [PMID: 7993792 DOI: 10.1111/j.1365-2141.1994.tb08307.x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The incidence of trisomy 12 was studied by conventional chromosome analysis in 111 patients referred as B-cell chronic lymphocytic leukaemia (B-CLL). Fluorescent in situ hybridization (FISH) was also applied in 34 of those patients with either a normal karyotype or no analysable mitoses. By karyotyping, trisomy 12 was present in 11.7% (13/111), whereas additional FISH increased the incidence to 14.4% (16/111). When subdividing our cases in either typical CLL (n = 90), fulfilling the FAB classification criteria, or atypical CLL (n = 21), with one or more variations from those criteria, the incidence of +12 by metaphase analysis was 3% and 48%, respectively. Additional FISH increased the incidence to 4% and 57%. The most common aberration in atypical CLL was FMC7 positivity (n = 11), followed by CD5 negativity (n = 8), strong surface immunoglobulin staining (n = 7) and atypical morphology (n = 6). Trisomy 12 could only be demonstrated in a small proportion of neoplastic cells in all positive cases. By FISH and/or karyotyping, all available samples at diagnosis of the disease were positive.
Collapse
Affiliation(s)
- A Criel
- Department of Haematology, A.Z. Sint-Jan, Brugge, Belgium
| | | | | | | | | | | | | | | | | |
Collapse
|
29
|
Criel A, Billiet J, Vandenberghe E, van den Berghe H, Louwagie A, Hidajat M, Vanhoof A. Leukaemic intermediate lymphocytic lymphomas: analysis of twelve cases diagnosed by morphology. Leuk Lymphoma 1992; 8:381-7. [PMID: 1290963 DOI: 10.3109/10428199209051018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Twelve cases of leukaemic intermediate diffuse lymphocytic lymphoma (ILL), diagnosed by morphology, were analysed. The morphology of the ILL cells was so typical that it allowed ready distinction from chronic lymphocytic leukaemia (CLL) and other related B cell disorders. All cases were of B derivation, had strong mu and chi or lambda immunoglobulin (Ig) staining, were CD5 and FMC7 positive and CD10 negative. Cytogenetic abnormalities were found in 8 patients all having t(11;14)(q13;q32). DNA analysis revealed a relatively high incidence of hypoploidy. At diagnosis all the patients (9 males, 5 females; median age 68) had a low degree of absolute lymphocytosis but the disease was advanced and mostly widespread. The course of the disease appears to be aggressive and incurable with conventional combination chemotherapy.
Collapse
MESH Headings
- Aged
- Aneuploidy
- Antigens, CD/analysis
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Biomarkers, Tumor
- Chromosomes, Human, Pair 11/ultrastructure
- Chromosomes, Human, Pair 14/ultrastructure
- DNA, Neoplasm/analysis
- Diagnosis, Differential
- Female
- Humans
- Immunoglobulin Fragments/analysis
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Lymphoma, B-Cell/classification
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, B-Cell/mortality
- Lymphoma, B-Cell/pathology
- Lymphoma, Non-Hodgkin/classification
- Lymphoma, Non-Hodgkin/drug therapy
- Lymphoma, Non-Hodgkin/pathology
- Male
- Middle Aged
- Neoplasm Proteins/analysis
- Survival Rate
- Translocation, Genetic
Collapse
Affiliation(s)
- A Criel
- Department of Haematology, A.Z. St. Jan, Brugge, Belgium
| | | | | | | | | | | | | |
Collapse
|
30
|
Abstract
Increased plasma fibronectin levels are a highly sensitive and specific predictor of gestational hypertension. Of a total of 105 apparently healthy normotensive primigravid women seen at the outpatient clinic, 10 with increased plasma levels of fibronectin (mean +/- 2 SD), were compared with 14 controls. Parameters of early vascular damage (laminin, preprocollagen III), platelet activation (beta-thromboglobulin, platelet factor 4), and coagulation (thrombin-antithrombin III complexes, fibrinopeptide A) were measured at regular (weekly or monthly) intervals. Abnormal values of laminin (p less than 0.005) and fibronectin (p less than 0.0001) were found up to 4 weeks before the onset of clinical disease. Levels of beta-thromboglobulin (p less than 0.0001) were also elevated at least 4 weeks before the appearance of clinical symptoms. Our results show that increased levels of laminin, fibronectin, and platelet activation, as indicated by beta-thromboglobulin levels, are preclinical features of gestational hypertension and indicate that vascular damage has occurred. Fibrin formation would appear to occur later.
Collapse
Affiliation(s)
- V C Ballegeer
- Department of Obstetrics and Gynecology, A.Z. Sint-Jan, Brugge, Belgium
| | | | | | | | | | | |
Collapse
|
31
|
Hidajat M, Deckx H, Van Eygen M, Logghe N, Criel A. Neonatal alloimmune thrombocytopenic purpura induced by anti-Bak(a): a case report and review of the literature. Acta Clin Belg 1989; 44:377-82. [PMID: 2629446 DOI: 10.1080/17843286.1989.11718046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We report a case of neonatal alloimmune thrombocytopenic purpura after an uneventful pregnancy. The baby had systemic purpura at birth and his platelet count was 6 X 10(9)/1. He was treated with maternal platelets and one week later his platelets were normalized. It was the second pregnancy of the mother; she received a blood transfusion after the delivery of her first child. The mother was HLA DR3 positive, an antigen frequently implicated in neonatal alloimmune thrombocytopenic purpura. The antibody reacted with both P1A1 positive and negative platelets which excluded anti-P1A1 type, the antibody most involved in neonatal alloimmune thrombocytopenia. This antibody reacted with platelets of 46 out of 53 random donors (87%); this approached the 90.8% frequency of Bak(a) reported in the Netherlands. Later this antibody was typed as anti-Bak(a). A discussion and a review of the literature is given.
Collapse
|
32
|
Rummens JL, Verfaillie C, Criel A, Hidajat M, Vanhoof A, Van den Berghe H, Louwagie A. Elliptocytosis and schistocytosis in myelodysplasia: report of two cases. Acta Haematol 1986; 75:174-7. [PMID: 3092535 DOI: 10.1159/000206114] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Marked elliptocytosis and schistocytosis are described as unusual manifestations of haematopoietic dysplasia in two patients. The first patient, whose history was negative for inherited haemolytic anaemias, presented these prominent features on his first admission; 22 months later he developed an acute myeloblastic leukaemia. In the second patient, followed since 4 years for an autoimmune thrombocytopenic purpura, elliptocytosis and schistocytosis appeared 17 months before a pancytopenia established. The patient is now on follow-up and is treated for a refractory anaemia. In both cases bone marrow examinations revealed the typical criteria for myelodysplasia and this diagnosis was confirmed by cytogenetic analysis.
Collapse
|
33
|
Rummens JL, Hidajat M, Van Hoof A, Louwagie A, Criel A. Evaluation of an immunoenzymatic method for staining haematological cell populations using monoclonal antibodies. Acta Clin Belg 1986; 41:319-27. [PMID: 2435100 DOI: 10.1080/22953337.1986.11719169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
|
34
|
Louwagie A, Criel A, Verfaillie CM, Valcke YJ, Lamberts H, Hidajat M, Mecucci C, Van den Berghe H. Philadelphia-positive T-acute lymphoblastic leukemia. Cancer Genet Cytogenet 1985; 16:297-300. [PMID: 3872163 DOI: 10.1016/0165-4608(85)90236-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
A case of typical T-acute lymphoblastic leukemia (T-ALL) is reported in which, at diagnosis, 100% of bone marrow metaphases showed a Philadelphia (Ph) translocation, t(9;22). These cells completely disappeared following chemotherapy. The significance of the Ph chromosome in T and B leukemic cells is discussed.
Collapse
|
35
|
Criel AM, Hidajat M, Clarysse A, Verwilghen RL. Drug dependent red cell antibodies and intravascular haemolysis occurring in patients treated with 9 hydroxy-methyl-ellipticinium. Br J Haematol 1980; 46:549-56. [PMID: 7437333 DOI: 10.1111/j.1365-2141.1980.tb06011.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Eleven patients were treated weekly with a new cytostatic drug, 9-hydroxy-methyl-ellipticinium (9 HME). Eight were treated for longer than 4 weeks and three of these developed a drug dependent antibody reacting with normal red cells. In two of these patients acute intravascular haemolysis occurred, one with oliguric renal failure; in the third patient the drug was stopped as soon as the antibody was detected. In all three patients the antibody developed after 4 weeks of treatment. It was IgM, agglutinated normal red cells and bound complement only in the presence of the drug. No antibodies could be detected in the patient's serum reacting with normal platelets in the presence of the drug. The incidence of haemolysis with this drug is much higher than seen with other drugs causing immune-complex haemolysis. Studies done with closely related substances suggest that the antigenic site of the drug is related to the group attached to carbon atom 9.
Collapse
|