Adjusted Prevalence Odds Ratio Research Articles

Risk of specific congenital abnormalities in offspring of women with diabetes

To assess the extent to which the increased risk of congenital abnormalities seen in women with pre-gestational insulin-treated diabetes mellitus is unspecific or related to the embryology of specific organs. Cases with congenital abnormalities were identified in the population-based Hungarian Congenital Abnormality Registry from 1980 to 1996 with two newborn children without congenital abnormality selected from the National Birth Registry as controls. We adjusted for parity, maternal age, and use of antipsychotic drugs. Among cases we found 63/22,843 babies with maternal diabetes compared with 50/38,151 in the control group [adjusted prevalence odds ratio (POR) 2.1; 95% CI 1.5-3.1]. The association was strongest for the following congenital abnormalities: renal agenesis (POR: 14.8; 95% CI, 3.5-62.1), obstructive congenital abnormalities of the urinary tract (POR: 4.3; 95% CI, 1.3-13.9), cardiovascular congenital abnormalities (POR: 3.4; 95% CI, 2.0-5.7), and multiple congenital abnormalities (POR: 5.0; 95% CI, 2.4-10.2). These data indicate that pre-gestational maternal diabetes is associated with strong teratogenic effects on the kidney, urinary tract, and heart, and strongly associated with multiple congenital abnormalities. We found no material association between diabetes and spinal congenital abnormalities and limb deficiencies.

Environmental Correlates of Physical Activity Among Individuals With Diabetes in the Rural Midwest

To determine the relationship between physical and social environment attributes and levels of physical activity in a population-based sample of diabetic individuals living in rural areas. Cross-sectional telephone survey data from rural communities of southeastern Missouri, Tennessee, and Arkansas were used. Logistic regression was used to calculate crude and adjusted prevalence odds ratios (PORs) and 95% CIs. A total of 278 (11%) individuals with diabetes were identified. Almost 37% of this group reported no leisure-time physical activity. Individuals with diabetes who reported regular physical activity were more likely to report better general health status, normal BMI, and no physical impairment. After adjustment, regular activity was positively associated with use of three or more facilities (POR 14.3, 95% CI 3.0-67.3) in the past 30 days, the availability of many nearby places to walk (2.3, 1.1-4.8), the availability of shoulders on streets (2.4, 1.3-4.5), often walking to nearby places (4.1, 2.0-8.3), and rating the community for physical activity as generally pleasant (2.3, 1.1-4.8). Additionally, the regular activity group was more likely to report their physician had helped make a plan to increase physical activity (2.8, 1.3-5.8) and followed up on their plan (2.2, 1.1-4.4). Social environment variables were not associated with physical activity after adjustment. Physical inactivity is a significant problem in rural diabetic populations. We have identified aspects of the social and physical environment that are positively associated with physical activity. Understanding the role of the environment may result in increased physical activity for individuals with diabetes.

The Relation of Occupational Organic Solvent Exposure to Symptom Reporting in a Sample of White and Chinese Midlife Women

This study examined the relation of occupational solvent exposure to menopausal and other symptoms in midlife women. We conducted a cross-sectional study of 480 Chinese and 494 white women, aged 40-55 years, in Northern California. Levels of exposure to organic solvents (none, low, medium, or high) were assigned to each current job using a job-exposure matrix. A lower proportion of women with low occupational organic solvent exposure reported hot flashes or night sweats than working women with no solvent exposure (adjusted prevalence odds ratio [APOR] = 0.48, 95% confidence interval [CI] = 0.19-1.21). A greater proportion of women with high solvent exposure reported forgetfulness than women with no exposure (APOR = 2.51, 95% CI = 1.12-5.63). Some symptom reporting in midlife women was related to their occupational organic solvent exposure.

Seroprevalence of hepatitis C virus and associated risk behaviours: a population-based study in San Juan, Puerto Rico

Limited information about the epidemiology of hepatitis C virus (HCV) infection is available in Puerto Rico, one of the areas hardest hit by the human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic. We estimated the prevalence of HCV infection and identified correlates of seropositivity in the municipality of San Juan, Puerto Rico. A probability cluster design was employed to select a sample of households representative of the population aged 21-64 years in San Juan during 2001-2002. All 964 subjects completed a face-to-face interview to gather data on demographics and self-reported risk behaviours followed by venipuncture for HCV antibody testing. Variables that were at least marginally associated with HCV seroprevalence (P < 0.10) in the bivariate analyses were considered for inclusion into the multiple logistic regression model to estimate the adjusted prevalence odds ratio (POR). Overall weighted prevalence of HCV infection was 6.3% (95% CI 3.6-10.9%). A significant (P < 0.05) higher prevalence was observed among subjects with the following characteristics: age 30-49 (9.5%), male sex (10.6%), < or =12 years of education (9.6%), no health coverage (12.6%), lifetime heroin use (39.2%), lifetime cocaine use (39.6%), tattooing practices (34.2%), history of imprisonment (32.8%), and self-reported histories of hepatitis B virus infection (30.4%) and HIV/AIDS (92.1%). Multivariate logistic regression revealed that tattooing practices (POR = 8.9; 95% CI 1.7-44.7), lifetime cocaine use (POR = 5.5; 95% CI 2.2-13.5), blood transfusions prior to 1992 (POR = 4.0; 95% CI 1.6-10.1), lifetime heroin use (POR = 3.3; 95% CI 1.4-7.8), and history of imprisonment (POR = 2.3; 95% CI 1.1-4.9) remained significantly associated with HCV seropositivity. The large prevalence of HCV infection observed in Puerto Rican adults residing in San Juan suggest that HCV infection is an emerging public health concern and merits further investigation.

High Rate of Varicella Complications among Mexican‐Born Adults in Alabama

Our study examines risk factors for severe varicella in an outbreak among Mexican-born adults, and it compares susceptibility to infection and reliability of self-reported varicella history for these individuals with that for adults born in the United States in the outbreak locale, which may guide vaccination strategies. We interviewed case patients and non-case persons in the affected apartment complex and workplace, assessed disease history and susceptibility by testing for varicella-zoster virus immunoglobulin G antibodies, and reviewed the clinical data of case patients. Five of 18 case patients had serious complications for which they sought medical care; 1 was hospitalized for pneumonia, and 1 was hospitalized for Guillain-Barré syndrome. Only intense exposure (e.g., sharing a bed) was marginally associated with severe disease (P=.08). In the workplace, varicella susceptibility was higher among Mexican-born workers (20%) than among workers born in the United States (3%) (adjusted prevalence odds ratio, 5.4; 95% confidence interval, 2.3-14.8). Mexican-born persons had the highest positive predictive value of self-reported disease (100%) in predicting immunity, and those born in the United States had the lowest negative predictive value of self-reported history (10%) in predicting susceptibility. Varicella is a more serious disease among adults than among children, and Mexican-born adults living in the United States might have a higher risk of acquiring varicella than US-born adults. Varicella outbreaks involving adults should be prioritized for control efforts. Outbreaks can be prevented by vaccinating susceptible adults.

Disparities in routine physical examinations among in-school adolescents of differing Latino origins

Purpose To estimate the prevalence of routine physical examination among in-school adolescents of differing national Latino origins and to assess associations with gender, age, immigrant generational status, language spoken at home, parental education, poverty level, family structure, and insurance status. Methods Cross-sectional analysis of Wave I of the National Longitudinal Study of Adolescent Health conducted during 1995. Our sample was limited to adolescents in grades 7 through 12 of Mexican (n = 1657), Cuban (n = 490), Puerto Rican (n = 555), and Central/South American or Dominican (C/S American or DR) (n = 427) origins. We used multivariate logistic regression for survey data to conduct the data analyses. Results Mexican-origin adolescents were less likely to report a routine physical examination in the previous year, compared with other Latino populations [prevalence (95% confidence interval)]: Mexicans, 47.7 % (42.0% –53.6%], Cubans 67.6% (57.4%–76.4%), Puerto Ricans 65.2% (58.4%–71.4%), and C/S American or DR (57.0% [47.3–66.2]). Among Mexican-origin adolescents, having a college-educated parent or insurance was associated with receiving care (adjusted prevalence odds ratio [95% confidence interval]), 2.12 (1.37–3.30) and 1.80 (1.31–2.47), respectively. For Cuban-origin adolescents, first-generation immigrants were less likely to receive care (0.31 [0.14–0.70]), and those living in a single-parent home were more likely to receive care (2.83 [1.52–5.25]). Having a routine physical examination among adolescents of C/S American or DR origins was associated with incomes above the poverty level (2.29 [1.10–4.77] and insurance (2.33 [1.10–4.91]). Conclusions Reflecting the heterogeneity of Latino adolescents, the prevalence of routine physical examination and factors associated with it varied by national origin subgroup. These differences should be considered when developing strategies to better address the health needs of Latino youth.

Disparities in routine physical examinations among in-school adolescents of differing Latino origins

Purpose To estimate the prevalence of routine physical examination among in-school adolescents of differing national Latino origins and to assess associations with gender, age, immigrant generational status, language spoken at home, parental education, poverty level, family structure, and insurance status. Methods Cross-sectional analysis of Wave I of the National Longitudinal Study of Adolescent Health conducted during 1995. Our sample was limited to adolescents in grades 7 through 12 of Mexican (n = 1657), Cuban (n = 490), Puerto Rican (n = 555), and Central/South American or Dominican (C/S American or DR) (n = 427) origins. We used multivariate logistic regression for survey data to conduct the data analyses. Results Mexican-origin adolescents were less likely to report a routine physical examination in the previous year, compared with other Latino populations [prevalence (95% confidence interval)]: Mexicans, 47.7 % (42.0% –53.6%], Cubans 67.6% (57.4%–76.4%), Puerto Ricans 65.2% (58.4%–71.4%), and C/S American or DR (57.0% [47.3–66.2]). Among Mexican-origin adolescents, having a college-educated parent or insurance was associated with receiving care (adjusted prevalence odds ratio [95% confidence interval]), 2.12 (1.37–3.30) and 1.80 (1.31–2.47), respectively. For Cuban-origin adolescents, first-generation immigrants were less likely to receive care (0.31 [0.14–0.70]), and those living in a single-parent home were more likely to receive care (2.83 [1.52–5.25]). Having a routine physical examination among adolescents of C/S American or DR origins was associated with incomes above the poverty level (2.29 [1.10–4.77] and insurance (2.33 [1.10–4.91]). Conclusions Reflecting the heterogeneity of Latino adolescents, the prevalence of routine physical examination and factors associated with it varied by national origin subgroup. These differences should be considered when developing strategies to better address the health needs of Latino youth.

Birth defects in Arkansas: is folic acid fortification making a difference?

Since 1998, fortification of grain products with folic acid has been mandated in the United States, in an effort to reduce the prevalence of neural tube defects (NTDs). Published reports have shown a reduction in the prevalence of spina bifida since fortification was mandated, but no published studies have reported a reduction in birth defects, other than NTDs, that are postulated to be associated with folic acid deficiency. This study was performed to determine if fortification has reduced the prevalence of NTDs and other birth defects in Arkansas. Using data from the Arkansas Reproductive Health Monitoring System, prevalences were computed for thirteen specific birth defects with prior evidence supporting a protective effect of folic acid or multivitamins. Prevalences were calculated using data for live births to Arkansas residents for 1993-2000. Exposure to folic acid fortification was classified by birth year as "pre-fortification" (1993-1995), "transition" (1996-1998) or "post-fortification" (1999-2000). Logistic regression analysis was used to compute crude and adjusted prevalence odds ratios comparing the identified time periods. Prevalences decreased between the pre- and post-fortification periods for spina bifida, orofacial clefts, limb reduction defects, omphalocele, and Down syndrome, but only the decrease in spina bifida was statistically significant (prevalence odds ratio 0.56; 95% confidence interval, 0.37, 0.83). In Arkansas, the prevalence of spina bifida has decreased since folic acid fortification of foods was implemented. Similar studies by other birth defects surveillance systems are needed to confirm a preventive effect of fortification for malformations other than spina bifida.

Fruit and vegetable consumption is inversely associated with blood pressure in a Mediterranean population with a high vegetable-fat intake: the Seguimiento Universidad de Navarra (SUN) Study.

There is evidence that a diet rich in fruit and vegetables reduces blood pressure (BP). Characteristically, the Mediterranean diet is rich in plant-derived foods and also in fat, but studies conducted in Mediterranean countries to relate diet to BP are scarce. We studied the association between fruit and vegetable consumption and BP in a cross-sectional analysis of 4393 participants in the Seguimiento Universidad de Navarra (SUN) Study, an ongoing dynamic cohort study in Spain. Diet was measured using a food-frequency questionnaire previously validated in Spain. Fat represented more than 37 % total energy intake. Subjects were considered to have undiagnosed hypertension if they reported systolic BP > or = 140 mmHg or diastolic BP > or = 90 mmHg, and not a medical diagnosis of hypertension. The adjusted prevalence odds ratio of undiagnosed hypertension (upper v. lowest quintile) was 0.58 (95 % CI 0.36, 0.91; P for trend 0.01) for vegetable consumption and 0.68 (95 % CI 0.43, 1.09; P for trend 0.10) for fruit consumption. Comparing those in the highest quintile of both fruit and vegetable consumption with those in the lowest quintile of both food groups, the prevalence odds ratio was 0.23 (95 % CI 0.10, 0.55; P = 0.001), after adjusting for risk factors for hypertension and other dietary exposures. In a Mediterranean population with an elevated fat consumption, a high fruit and vegetable intake is inversely associated with BP levels.

Possible association between different congenital abnormalities and use of different sulfonamides during pregnancy.

The objective of the study presented here was to check the debated human teratogenic potential of sulfonamide drugs. Five different sulfonamides such as sulfamethazine, sulfathiourea, sulfamethoxypyridazine, sulfamethoxydiazine and the combination of sulfamethazine-sulfathiourea-sulfamethoxypyridazine were differentiated. Cases with congenital abnormalities were compared with their matched controls without congenital abnormalities in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities between 1980 and 1996. Of 38,151 newborn infants without any congenital abnormalities (control group), 163 (0.4%) had mothers who were treated with the sulfonamides studied during pregnancy, while of 22,843 cases with congenital abnormalities, 140 (0.6%) had mothers who were treated with the sulfonamides studied during pregnancy. The analysis of cases and matched controls indicated a higher rate of cardiovascular malformation (adjusted prevalence odds ratios [POR] with 95% CI: 3.5, 1.9-6.4) and clubfoot (adjusted POR with 95% CI: 2.6, 1.1-6.2) in infants born to mothers with sulfonamide treatment in the second and third months of pregnancy. The detailed analysis of different sulfonamides showed a possible association between cardiovascular malformations (adjusted POR with 95%; CI: 6.5, 2.6-15.9), particularly ventricular septal defect (17.1, 1.3-141.1) and sulfamethoxydiazine during the second and third months of pregnancy. In addition, a possible association was found between clubfoot and sulfathiourea, both during the entire pregnancy (adjusted POR with 95% CI: 2.3, 1.2-4.3) and in the second and third months of gestation (3.9, 1.1-13.8). Thus, maternal treatment of sulfamethoxydiazine may cause ventricular septal defect, while sulfathiourea may induce clubfoot; however, further studies are needed to verify or reject these associations.

Condom effectiveness for reducing transmission of gonorrhea and chlamydia: the importance of assessing partner infection status.

This analysis examined the importance of differential exposure to infected partners in epidemiologic studies of latex condom effectiveness for prevention of sexually transmitted infections. Cross-sectional, enrollment visit data were analyzed from Project RESPECT, a trial of counseling interventions conducted at five publicly funded US sexually transmitted disease clinics between 1993 and 1997. The association between consistent condom use in the previous 3 months and prevalent gonorrhea and chlamydia (Gc/Ct) was compared between participants known to have infected partners and participants whose partner infection status was unknown. Among 429 participants with known Gc/Ct exposure, consistent condom use was associated with a significant reduction in prevalent gonorrhea and chlamydia (30% vs. 43%; adjusted prevalence odds ratio = 0.42, 95% confidence interval: 0.18, 0.99). Among 4,314 participants with unknown Gc/Ct exposure, consistent condom use was associated with a lower reduction in prevalent gonorrhea and chlamydia (24% vs. 25%; adjusted prevalence odds ratio = 0.82, 95% confidence interval: 0.66, 1.01). The number of unprotected sex acts was significantly associated with infection when exposure was known (p for trend < 0.01) but not when exposure was unknown (p for trend = 0.73). Restricting analyses to participants with known exposure to infected partners provides a feasible and efficient mechanism for reducing confounding from differential exposure to infected partners in condom effectiveness studies.

Sun-safe practices in U.S. youth and their parents: role of caregiver on youth sunscreen use

Background There is a limited understanding of the social influences, such as the role of parents on youth sun-safe practices, that may reduce the risk of developing skin cancer later in life. Methods This study examined the degree of correlation in sun-safe practices between youth and their parents and assessed independent parental factors of youth sunscreen use in a 1998 cross-sectional, population-based telephone survey of U.S. youth (11- to 18-year-olds) and their parents/caregivers (N=1192 pairs of youth and parents). Results Sunscreen-use practices between youth and their parents were significantly correlated, albeit small. Youth were significantly more likely to use sunscreen frequently if their parents applied it frequently on themselves. Multivariate analysis revealed three independent parental factors associated with frequent youth sunscreen use: Their parent reported to insist frequently that the child uses sunscreen (adjusted prevalence odds ratio [aPOR]=2.4, 95% confidence interval [CI], 1.6–3.8); parent reported no difficulty with protecting their child from the sun (aPOR=1.4, 95% CI, 1.1–1.9); and parent's own frequency of sunscreen use (aPOR=1.3, 95% CI, 0.9–1.8). Conclusions Sun-safe practices were correlated between parent–child pairs and parental factors exerted a positive role on youth sunscreen-use frequency. These data may guide further sociobehavioral and intervention research for the design of skin cancer prevention programs in schools and communities to improve levels of sun-safe practices.

Oral pyridoxine during pregnancy : potential protective effect for cardiovascular malformations.

To study the human risk and benefit of oral pyridoxine (vitamin B6) treatment during pregnancy. The analysis of cases with 25 congenital abnormality (CA) groups and their all-matched controls without CAs in the population-based dataset of the large Hungarian Case-Control Surveillance of Congenital Abnormalities, 1980-1996. 22,843 cases of pregnant women who had newborns or fetuses with CAs and 38,151 pregnant women who had newborn infants without any CAs (control group). Prevalence of pyridoxine use in early pregnancy among mothers of cases with different CAs and control mothers with infants without any CA. 2013 (8.8%) case mothers and 4086 (10.7%) control mothers were treated with pyridoxine (adjusted prevalence odds ratio [POR] 0.8; 95% confidence interval [CI] 0.7, 0.9). The analysis of cases with different defects and their all-matched controls did not indicate any obvious teratogenic potential of pyridoxine use during the second and third months of gestation, i.e. in the critical period for the development of most major CAs. However, some protective effect was found for cardiovascular malformations (adjusted POR 0.8; 95% CI 0.7, 0.9). Treatment with pyridoxine during pregnancy does not indicate a teratogenic risk to the fetus, but may provide some protective effect for cardiovascular malformations.

Presence of asthma risk factors and environmental exposures related to upper respiratory infection-triggered wheezing in middle school-age children.

Viral respiratory infections and exposure to environmental constituents such as tobacco smoke are known or suspected to trigger wheezing/asthma exacerbations in children. However, few population-based data exist that examine the relationship between wheezing triggered by viral respiratory infections and environmental exposures. In this investigation we used population-based data to evaluate differences in exposures between symptomatic middle school-age children who did and did not report wheezing triggered by viral respiratory infections. As part of the North Carolina School Asthma Survey (NCSAS), a 66-question data instrument was used to collect information from children enrolled in North Carolina public middle schools during the 1999-2000 school year. Associations between exposures and upper respiratory infection-triggered wheezing (URI-TW) among symptomatic children were examined using adjusted prevalence odds ratios (PORs). Video methods developed for the International Study of Asthma and Allergies in Childhood were used to assess wheezing. Among the 33,534 NCSAS symptomatic participants, positive associations were observed between most exposures and URI-TW. Reported presence of all allergy variables (PORs ranging from 2.11 to 2.45) was more strongly associated with URI-TW than either smoking or other exposures. Presence of URI-TW was higher at increasing levels of tobacco smoke exposure, but no apparent dose-response effect was observed for other indoor air pollutants. URI-TW in middle school children is most associated with reported allergen sensitivity, relative to other asthma risk factors and environmental exposures. Data from this investigation may be useful in developing assessment, screening, and targeting strategies to improve asthma and wheezing management in children.

Birth outcome of 1886 pregnancies after exposure to phenoxymethylpenicillin in utero

To examine the risk of congenital abnormalities, preterm birth and low birth weight after exposure to phenoxymethylpenicillin in utero. A population-based follow-up study in the County of North Jutland, Denmark. Birth outcome for 1886 women, who redeemed prescriptions for phenoxymethylpenicillin during pregnancy was compared with the outcome for 9263 women who did not redeem any prescription during pregnancy. The prevalence of congenital abnormalities in 654 users of phenoxymethylpenicillin with or without other drugs during the first trimester was 4.6% compared with 3.6% in the reference group, giving a prevalence odds ratio of 1.25 (95% CI: 0.84-1.86). The prevalence odds ratio was 1.35 (95% CI: 0.59-3.08) in 131 women who were exposed to phenoxymethylpenicillin only. Nine cardiovascular abnormalities were found, giving an adjusted prevalence odds ratio of 1.74 (95% CI: 0.83-3.65). The prevalence odds ratios of preterm birth and low birth weight were 0.83 (95% CI: 0.66-1.04) and 1.02 (95% CI: 0.71-1.47), respectively. We found no significantly increased risk of congenital abnormalities, including cardiovascular abnormalities, preterm birth, or low birth weight in women who purchased phenoxymethylpenicillin during pregnancy.

Assessment of the factors associated with flavivirus seroprevalence in a population in Southern Vietnam.

Dengue and Japanese encephalitis flaviviruses cause severe disease and are hyperendemic in southern Vietnam. This study assesses associations between sociodemographic factors and flavivirus seroprevalence in this region. Sera were collected from 308 community and hospital-based subjects between April 1996 and August 1997 and tested with an indirect ELISA. The factors associated with seroprevalence were assessed using multivariate logistic regression. In this first report of adjusted prevalence odds ratios (POR) for flavivirus infection in Vietnam, seropositivity was associated with increasing age in children (multiple regression coefficients for a child compared to an adult = -4.975 and for age in children = 0.354) and residence in the city compared to surrounding rural districts. The association with age indicates that subjects were most likely to have acquired infection in early childhood. This is key to the design of Vietnamese health education and immunization programmes.

Exposure to hexahydrophthalic and methylhexahydrophthalic anhydrides--dose-response for sensitization and airway effects.

This study clarified the exposure-response relationships for the organic acid anhydrides (OAA) hexahydrophthalic (HHPA) and methylhexahydrophthalic (MHHPA) anhydrides and the development of specific immunoglobulin (IG) E and G antibodies and work-related symptoms. In an epoxy resin-using factory, air levels of OAA were determined by gas chromatography-mass spectrometry. Occupational, smoking, and medical histories (questionnaire) were obtained for 154 exposed workers and 57 referents. Work-related symptoms of the eyes and airways were recorded, and OAA metabolites were analyzed in urine. A skin-prick test with common allergens and conjugates of OAA were performed. Specific IgE (radioallergosorbent test) and IgG (enzyme-linked immumosorbent assay) antibodies were determined in serum, and spirometry was performed. Air levels of the OAA were low (HHPA < 1 to 94, MHHPA < 3 to 77 microg/m3) and associated with the concentrations of the OAA metabolites in urine. Furthermore, for the exposed workers, there were high prevalences of sensitization (IgE 22%, IgG 21%), which correlated with the exposure. Neither atopy nor smoking increased this risk significantly. Furthermore, work-related symptoms were more prevalent among the exposed workers than among the referents (eyes 23% versus 14%, nose 28% versus 16%, nose bleeding 8% versus 0%, lower airways 10% versus 4%), and they were related to the exposure (adjusted prevalence odds ratios (POR) in the highest group 7.7, 3.6 and 17, respectively) and the IgE levels (POR 4.9, 3.1 and 5.6, respectively). In spite of the very low OAA levels in the air and metabolites in the urine, there were high and exposure-related risks of specific IgE and IgG sensitization and of work-related symptoms for the eyes, nose (especially bleeding), and lower airways.

Sun Exposure and Sun-Protection Behaviors and Attitudes among U.S. Youth, 11 to 18 Years of Age

Background. Adolescence is a high-risk period for the development of melanoma and nonmelanocytic skin cancers later in life. This study examines the prevalence and correlates of sun-protection practices among U.S. youth.Methods. During July–October, 1998, a national, population-based telephone survey was conducted (N = 1,192 paired interviews of youth and their parents). Weighted prevalence and adjusted prevalence odds ratios and 95% confidence intervals were estimated. Multiple logistic regression analyses examined associations between sociodemographics, attitudes, and other modifiable correlates to specific behaviors.Results. Routinely practiced sun-protection behaviors among youth on sunny days were wearing sunglasses (32%) or long pants (21%), staying in the shade (22%), and applying sunscreen (31%). Fifty-eight percent used a sunscreen with SPF ≥15 when at the beach or pool. Age, sex, and sun sensitivity were associated with substantial variation in some sun-protection behaviors. Factors associated with specific sun-protection behaviors included a lower appeal to tanning, a higher perceived benefit of sun protection, and information from family and friends about sun protection.Conclusion. Effective sun protection is practiced by less than one-third of U.S. youth. This baseline survey will help to monitor progress in skin cancer prevention in this critical age group in the future.

Commercial tattooing as a potentially important source of hepatitis C infection. Clinical epidemiology of 626 consecutive patients unaware of their hepatitis C serologic status.

Tattooing in commercial tattoo parlors is known to transmit blood-borne viral infections, including hepatitis C virus (HCV), in other countries, but its contribution to the high population prevalence of HCV infection in the United States has been incompletely evaluated. Risk factors for blood-borne infection were assessed by physician's interview of 626 consecutive patients undergoing medical evaluation for spinal problems in 1991 and 1992 while unaware of their HCV status. Later all were screened for HCV infection with enzyme-linked immunosorbent assay (EIA-1 and EIA-2), and positives were confirmed with second-generation recombinant immunoblot assay (RIBA). Forty-three patients were seropositive for HCV (sample prevalence 6.9%, population-standardized prevalence 2.8%). Logistic regression analysis identified 4 independent risk factors for HCV infection: injection-drug use (adjusted prevalence odds ratio [OR] = 23.0; 95% confidence intervals [CI] = 7.5-70.6), ancillary hospital jobs held by men (OR = 9.6; 95% CI = 3.8-24.3), tattoos from commercial tattoo parlors (OR = 6.5; 95% CI = 2.9-14.8), and drinking > or = 3 6-packs of beer per month (OR = 4.0; 95% CI = 1.8-8.7). If causal, these 4 risk factors account for 91% of HCV infections, with tattooing explaining 41%, heavy beer drinking 23%, injection-drug use 17%, and ancillary health care jobs for men 8%. Transfusions, promiscuous sexual activity, bone grafts, acupuncture, perinatal or intimate transmission in families, and other modes were not independently associated with serologic evidence of HCV infection. Unlikely to be explained by confounding or incomplete disclosure of other risk factors, tattooing in commercial tattoo parlors may have been responsible for more HCV infections than injection-drug use.

Time spent watching television, sleep duration and obesity in adults living in Valencia, Spain.

To analyse the association of time watching television (TV) and physical activity with obesity in the Mediterranean area of Spain with the highest prevalence of obesity. Cross-sectional study. Valencia Region in Spain. A representative sample of 814 men and 958 women, aged 15 y and older, participating in a Health and Nutrition Survey conducted in 1994. Height and weight were directly measured during home interviews. The outcome measure was obesity, defined as a body mass index > or = 30 kg/m2. Covariates were self-reported hours of TV viewing, physical activity habits, sleeping duration, age, gender, educational level, smoking and marital status. Prevalence odds ratios (POR) estimated by logistic regression were used as effect measures. Obese people reported to spend more time watching TV (mean +/- s.d.: 3.6 +/- 1.5 h/day) than non-obese ones (3.0 +/- 1.4 h/day), and less sleeping time. In multivariate analysis, obesity was associated with TV viewing, sleeping time and physical activity at work. People watching TV > 4 h/day showed a higher adjusted prevalence odds ratio of obesity, POR = 2.38 (95% confidence interval, 1.54-3. 69), compared with those watching TV < or = 1 h/day. People who reported to sleep > or = 9 h/day presented a lower POR of obesity than those sleeping < or = 6 h/day, POR = 0.43 (0.27-0.67). Statistically significant dose-responses were observed for both associations, so that the prevalence odds ratio of obesity was 30% higher for each hour of increased TV viewing and 24% lower for each additional hour of sleeping time. In addition, the prevalence of obesity was lowest among single people, those more physically active at work, and those with a high educational level. Time spent watching television and a low physical activity at work were related to obesity in adults. The inverse association between obesity and sleep duration deserves further research.