Mortality Rates Of Residents Research Articles

Mortality risk associated to arsenic exposure after a major disaster. Results from the Manfredonia occupational cohort study 1976–2021

BackgroundOn September 1976, due to the explosion of an ammonia-washing column at the petrochemical plant in Manfredonia (Italy), 39 tonnes of arsenic were released into the atmosphere, contaminating the plants and the neighbourhoods close to it. The aim of this study is to present the results of a 45-year follow up of exposed workers with a focus on residential exposure. MethodsWe contacted Italian General Registries Offices and updated the vital status of persons involved in the clean-up activities following the disaster. The outcome of interest was the overall and cause-specific mortality. An accelerated failure time (AFT) approach was used when appropriate to model the risk of mortality. Results1772 workers contributing 67,743 person years were considered in the analysis. For overall mortality, results of the age-adjusted AFT model show an accelerator factor of 0.89 (95%CI 0.80–0.99) among contract workers, which means a shortening of survival in comparison to the reference category (plastic area workers). When accounting for latency greater than 20 years, higher mortality rates for lung cancer were observed among workers residing in Manfredonia. DiscussionAn increased risk of mortality among workers who were more exposed to arsenic during the clean-up activities has been observed. In fact, a loss of 5 years of life among more exposed workers was calculated. Furthermore, the mortality rates of residents in Manfredonia were higher than those of workers residing elsewhere.

Factors associated with adverse outcomes during influenza outbreaks in aged care facilities

ObjectiveTo explore factors associated with adverse outcomes during influenza outbreaks in residential aged care facilities. MethodsA retrospective cohort study of all outbreaks reported to three Sydney metropolitan Public Health Units during 2017. ResultsA total of 123 outbreaks affected 1,787 residents and 543 staff. Early notification to a Public Health Unit was associated with shorter outbreak duration (p<0.001; B=0.674). Resident attack rates and resident mortality rates were lower in outbreaks notified early, on univariate analysis (p=0.034 and p=0.048 respectively) but not on an adjusted model. Staff attack rates were significantly associated with resident attack rates (p=0.001; B=0.736). Data on staff vaccination rates was incomplete and reported coverage rates were low (median 39%). Resident vaccination coverage ≥95% was associated with shorter outbreak duration in univariate testing but not on an adjusted model. ConclusionsEarly public health notification is associated with improved outbreak parameters; sick staff may pose a risk to residents, yet vaccination rates are low. Resident vaccination may also be valuable. Implications for public healthMeasures that facilitate early PHU involvement in influenza outbreaks should be implemented, such as compulsory reporting requirements and processes that permit easier notification through technology. Actions that enhance staff and resident vaccination coverage should also be undertaken.

A Review of Recent Advances in Research on PM2.5 in China.

PM2.5 pollution has become a severe problem in China due to rapid industrialization and high energy consumption. It can cause increases in the incidence of various respiratory diseases and resident mortality rates, as well as increase in the energy consumption in heating, ventilation, and air conditioning (HVAC) systems due to the need for air purification. This paper reviews and studies the sources of indoor and outdoor PM2.5, the impact of PM2.5 pollution on atmospheric visibility, occupational health, and occupants’ behaviors. This paper also presents current pollution status in China, the relationship between indoor and outdoor PM2.5, and control of indoor PM2.5, and finally presents analysis and suggestions for future research.

Abstract B75: Diversity in cancer mortality within Hispanic populations in the United States - Prevailing patterns and atypical findings

Abstract Introduction: Hispanics are the largest minority population in the United States (US), numbering 55 million. Cancer is the leading cause of death among Hispanic men and women. Differences in the burden of cancer mortality within Hispanic subpopulations have not been systematically quantified in the US, largely due to challenges in the data, and the focus on only three Hispanic populations, Mexicans, Puerto Ricans and Cubans. Methods: Cancer mortality rates of residents of Florida were computed, specifically focusing on the 6 different Hispanic populations: Mexicans, Puerto Ricans, Cubans, Central Americans, South Americans, and Dominicans. Hispanic subgroup membership was ascertained based on race, ethnicity and birthplace. Population data was derived from the Census 2010. We compared the cancer mortality of Hispanics as an aggregate group as well as the 6 subgroups to cancer mortality of non-Hispanic whites (NHW) and blacks (NHB) using age-adjusted mortality ratios obtained from negative binomial regression models. Results: We analyzed 205,369 cancer deaths from 2008-2012, of which 22,042 occurred in Hispanic populations. The overall mortality rates were lower for Hispanics (159 and 100 per 100,000 for males and females, respectively) than for NHW (204 for males and 145 for females per 100,000), largely attributable to low rates of lung and breast cancers, possibly due to lower tobacco prevalence and a history of higher fertility among Hispanics. However, Hispanics had a higher risk of death than NHW for two infection-related cancers, liver and stomach, particularly elevated for Mexicans, Central Americans, and Puerto Ricans. There was no difference between Hispanics, RR=0.97 (95% CI: 0.84-1.13) and NHW women for cervical cancer mortality, except among Puerto Rican women, who had a higher risk than NHW, RR=1.34 (95% CI: 1.02-1.75). Cubans had the highest mortality burden of all Hispanic subgroups for colorectal cancer, RR=1.10 (95% CI: 1.01-1.20), prostate cancer, RR=1.15 (95% CI: 1.07-1.25), and endometrial cancer RR=1.22 (95% CI: 1.06-1.41) compared to NHW. Dominican men had a significantly higher risk, RR=1.87 (95% CI: 1.43-2.46) of prostate cancer death than NHW men. Discussion: Hispanics overall had lower cancer mortality compared to NHW and NHB, yet there is compelling heterogeneity within the Hispanic population. Cubans and Puerto Ricans had significantly higher rates than Central Americans, Dominicans, South Americans, and especially Mexicans. The finding that the highest cancer mortality rates are found among the populations with longer immigration and/or settlement histories, especially in diet and obesity-related cancers such as colorectal, endometrial, and prostate suggests that acculturation plays a role in the cancer mortality burden among Hispanics. Yet, a few Hispanic subgroups diverge significantly from common patterns, with additional implications for Public Health. Meriting attention is the high colorectal cancer mortality among Cubans, liver cancer mortality among Puerto Rican men and women, and prostate cancer mortality among Dominican males. Citation Format: Paulo S. Pinheiro, Karen E. Callahan, Hongbin Jin. Diversity in cancer mortality within Hispanic populations in the United States - Prevailing patterns and atypical findings. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B75.

The new asylums in the community: severely ill psychiatric patients living in psychiatric supported housing facilities. A Danish register-based study of prognostic factors, use of psychiatric services, and mortality

Reorganization of psychiatric treatment in Denmark involved a declining number of psychiatric long-stay beds and an increasing number of psychiatric supported housing facilities in the community. Very few studies have focused on the population in such facilities. Information was generated combining addresses of supported psychiatric housing facilities with information from the Danish Civil Registration System to create a case register of persons living in supported psychiatric housing facilities. Through linkage with the Danish Psychiatric Central Register, we examined predictors of becoming a resident in a psychiatric housing facility, use of psychiatric services around the time of entrance to a supported psychiatric housing facility, and mortality rates for residents in a psychiatric housing facility compared to non-residents and to persons in the general population who never experienced a psychiatric admission. We identified schizophrenia as the strongest diagnostic predictor of becoming a resident in a supported psychiatric housing facility, followed by organic mental disorders, substance abuse, and affective disorder. In addition, the higher the number of psychiatric bed days, the higher the risk. Compared to the years before the first entrance to a supported psychiatric housing facility, the number of bed days in the year following the first entrance dropped more among residents than among comparable psychiatric patients. Mortality rates were slightly higher among residents in a supported psychiatric housing facility than among comparable psychiatric patients, but more than tenfold higher when compared to the general population of Danes. The vast majority of persons who became residents in supported psychiatric housing facilities had previously been diagnosed with schizophrenia, schizophrenia-like disorders, and organic mental disorders, and a large proportion had substance abuse and a high use of bed days. Moving into such a facility reduced the number of bed days.