Prevalence Of Self-reported Symptoms Research Articles

344. Prevalence and Impact of Post-Acute Sequelae of COVID-19 Among People Experiencing Homelessness in King County, WA Between September 2020 - May 2021

BackgroundHomeless shelters are high risk settings for SARS-CoV-2 transmission. People experiencing homelessness (PEH) have high rates of chronic illness, and have been disproportionately affected by COVID-19. The burden of post-acute sequelae of COVID-19 (PASC) in PEH has not been well-studied and PEH may be uniquely affected due to barriers to medical care and the potential exacerbation of existing threats to health, housing, employment, and self-care. MethodsThe Seattle Flu Study conducted community-based surveillance for SARS-CoV-2 in nine homeless shelters from September 1, 2020 and May 31, 2021. Individuals with and without respiratory symptoms were tested for SARS-CoV-2 infection using a PCR assay. We completed follow-up surveys with shelter residents age ≥18 years at days 5, 10, 30 and 60+ after positive or inconclusive diagnosis with SARS-CoV-2 infection. Individuals were asked about residual symptoms, impact on activities of daily living, access to medical care, and health-related quality of life. ResultsOf 51 eligible participants, 22 (43%) completed a follow-up survey, with six at day 5 or 10 survey, 11 at day 30, and 18 at day 60+. The median time from enrollment to last follow-up survey was 77 (range 49-138) days. Five (23%) participants reported at least one symptom at day 0, five (83%) at day 5 or 10, eight (73%) at day 30 and seven (39%) at day 60+ (Figure 1). Eight (36%) reported at least one symptom on a day 30 or 60+ follow up survey that interfered or prevented their daily activities. Nine (41%) received medical care at the quarantine facility. Of those with symptoms persisting beyond day 10, four (30%) received medical care outside of a medical provider at the quarantine facility. Prevalence of self-reported symptoms at Day 0 (enrollment), Day 5 or 10, Day 30, and Day 60+ in shelter residents who tested positive or inconclusive for SARS-CoV-2.ConclusionPEH reported a high prevalence of persistent COVID-19 symptoms 30+ days after their SARS-CoV-2 detection. Few participants accessed medical care for their persistent illness. The impact of COVID-19 extends beyond acute illness and PASC may exacerbate existing challenges PEH face in health and wellbeing.Disclosures Helen Y. Chu, MD MPH, Bill and Melinda Gates Foundation (Consultant)Cepheid (Research Grant or Support)Ellume (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi-Pasteur (Research Grant or Support)

P–298 High prevalence of depression and anxiety in patients with endometriosis during the SARS-CoV–2 pandemic in Germany

Study questionThe aim was to assess the prevalence of self-reported symptoms of depression and anxiety and the moderating factors influencing mental symptoms during the COVID–19 pandemic.Summary answerEndometriosis patients were at risk of developing mental disorders during the pandemic. Associated risk factors were: reduction of the social network and the employment status.What is known alreadyEndometriosis is a disease affecting up to 10% of women of fertile age. The leading symptoms are sub- or infertility and chronic pain. Additionally, the psychological impact on womeńs life is enormous. Women with endometriosis show higher rates of depression, anxiety and emotional distress, and these alterations in mental health were associated with the presence of pain rather than with the diagnosis of endometriosis. Additionally, a higher level of depression was observed in women with endometriosis.Study design, size, durationTo assess the impact of the government-imposed social distancing or quarantine on mental health, an online questionnaire was placed on internet platforms of endometriosis patients support groups between 6th and 27th April 2020. Data collection and analysis were performed anonymously. Recruitment was conducted via a direct link to the survey and an invitation to participate was distributed via the internet platforms of patients support groups.Participants/materials, setting, methods274 participants answered the Patient Health Questionnaire for Depression and Anxiety (PHQ–4), which screens for depression (PHQ–2), anxiety (GAD–2) and the level of psychological distress (PHQ–4). PHQ–2 and GAD–2 scores ≥ 3 are cut-off points between normal range and probable cases of mental disorders. A PHQ–4 score above 6 is indicative for severe symptoms. We used descriptive statistics to describe the study population. Correlates of depression and anxiety were identified using multivariate logistic regressions.Main results and the role of chanceWe showed that depression and anxiety were highly prevalent in endometriosis patients during the pandemic: 46.7% and 48.2% of participants showed scale scores of ≥ 3 on the PHQ–2 and GAD–2 scales, respectively.The mean PHQ–4 score was 5.72 (SD = 3.21), thus endometriosis patients were achieving significantly higher PHQ–4 sores (p < 0.001) than participants of a previously published study of the representative German population.Risk factors for higher probability of depressive disorders were the employment status (being employed, OR 2.890, p < 0.001), an important or severe reduction of the social network (OR 2.02, p < 0.05), having continuous pain (OR 1.83, p < 0.05) and high level of dysmenorrhea prior to the pandemic (OR 2.106, p < 0.05).Risk factors for higher probability of anxiety were the employment status (being employed, OR 2.697, p < 0.001), an important or severe reduction of the social network (OR 3.038, p < 0.01), and high level of dysmenorrhea prior to the pandemic (OR 1.750, p < 0.05).Endometriosis patients were at higher risk for developing mental health problems. The effective use of brief screening measures, such as PHQ–4, can be widely implemented even in the busy outpatient care of general practitioners and gynecologists and may help to reduce morbidity.Limitations, reasons for cautionWe used self-reports for assessment of anxiety and depression and those are susceptible to response bias, such as giving socially desirable responses. Moreover, as PHQ–4 is only a screening tool, the diagnosis must be confirmed in accordance to the appropriate DSM–V criteria.Wider implications of the findings: A better understanding of potential mental problems in endometriosis patients during stressful events, such as the COVID–19 pandemic or other comparable difficult environmental or social circumstances, is crucial for providing an optimal patient centered care in cases of upcoming stressful events.Trial registration numberNot applicable

Self-reported health in the vicinity of five wind power production areas in Finland

In many countries, some people living in the vicinity of wind power production areas report having symptoms that they intuitively associate with wind turbines. Recently public discussions have focused especially on wind turbine infrasound. However, scientific evidence supporting an association is lacking. The aim of this study was to assess the association between exposure to wind turbines and the prevalence of self-reported symptoms, diseases and medications.A cross-sectional questionnaire study (n = 2,828) was conducted in the vicinity of five wind power production areas in Finland in 2015–2016. Each area had 3–16 turbines with a nominal power of 2.4–3.3 MW. The response rate was 50% (n = 1,411). Continuous and categorised (≤ 2.5, > 2.5–5, > 5–10 km) distance between the respondents’ home and the closest wind turbine was used to represent exposure to wind turbines. Wind turbine sound pressure level outdoors could be reliably modelled only for the closest distance zone where the yearly average was 34 dB and maximum 43 dB.The data on symptoms (headache, nausea, dizziness, tinnitus, ear fullness, arrhythmia, fatigue, difficulties in falling asleep, waking up too early, anxiety, stress), diseases (hypertension, heart insufficiency, diabetes), and medications (analgesics for headache, joint/muscle pain and other pain, and medication for sleep disturbance, anxiety and depression, and hypertension) was obtained from the questionnaire. Logistic regression analyses were adjusted for age, sex, marital status, education, work situation, smoking, alcohol consumption, physical activity, body mass index, and hearing problems.Annoyance and sleep disturbance due to wind turbine noise were inversely associated with the distance to the closest wind turbine. The prevalence of symptoms, diseases and medications was essentially the same in all distance categories. In multivariate regression modelling, the odds ratio estimates were generally close to unity and statistically non-significant. Beyond annoyance and sleep disturbance, there were no consistent associations between exposure to wind turbines and self-reported health problems. The results do not support the hypothesis that broadband sound or infrasound from wind turbines could cause the proposed health problems.

EP32 Gastroparesis in Sjögren’s syndrome

EP32 Gastroparesis in Sjögren’s syndrome

The Tokyo subway sarin attack has long-term effects on survivors: A 10-year study started 5 years after the terrorist incident.

ObjectivesThe Tokyo subway sarin attack in 1995 was an unprecedented act of terrorism that killed 13 people and sickened more than 6,000. The long-term somatic and psychological effects on its victims remain unknown.MethodsWe conducted analyses on the self-rating questionnaire collected annually by the Recovery Support Center (RSC) during the period from 2000 to 2009. The RSC is the only organization that has large-scale follow-up data about sarin attack victims. The prevalence of self-reported symptoms was calculated over 10 years. We also evaluated the prevalence of posttraumatic stress response (PTSR), defined as a score ≥ 25 on the Japanese-language version of the Impact of Event Scale–Revised. The multivariate Poisson regression model was applied to estimate the risk ratios of age, gender, and year factor on the prevalence of PTSR.ResultsSubjects were 747 survivors (12% of the total) who responded to the annual questionnaire once or more during the study period. The prevalence of somatic symptoms, especially eye symptoms, was 60–80% and has not decreased. PTSR prevalence was 35.1%, and again there was no change with time. The multivariate Poisson regression model results revealed “old age” and “female” as independent risk factors, but the passage of time did not decrease the risk of PTSR.ConclusionsAlthough symptoms in most victims of the Tokyo subway sarin were transient, this large-scale follow-up data analysis revealed that survivors have been suffering from somatic and psychological long-term effects.

Urinary Mercury Levels Among Workers in E-waste Shops in Nakhon Si Thammarat Province, Thailand.

ObjectivesTo determine urinary mercury levels in e-waste workers in Southern Thailand and the airborne mercury levels in the e-waste shops where they worked, to describe the associations between urinary and airborne mercury levels, and to evaluate the prevalence of mercury exposure-related health effects among e-waste workers.MethodsA cross-sectional study was conducted by interviewing 79 workers in 25 e-waste shops who lived in Nakhon Si Thammarat Province, Thailand. Information on general and occupational characteristics, personal protective equipment use, and personal hygiene was collected by questionnaire. Urine samples were collected to determine mercury levels using a cold-vapor atomic absorption spectrometer mercury analyzer.ResultsThe e-waste workers’ urinary mercury levels were 11.60±5.23 μg/g creatinine (range, 2.00 to 26.00 μg/g creatinine) and the mean airborne mercury levels were 17.00±0.50 μg/m3 (range, 3.00 to 29.00 μg/m3). The urinary and airborne mercury levels were significantly correlated (r=0.552, p<0.001). The prevalence of self-reported symptoms was 46.8% for insomnia, 36.7% for muscle atrophy, 24.1% for weakness, and 20.3% for headaches.ConclusionsPersonal hygiene was found to be an important protective factor, and should therefore be stressed in educational programs. Employers should implement engineering measures to reduce urinary mercury levels and the prevalence of associated health symptoms among e-waste workers.

Prevalence of self-reported symptoms of sexually transmitted infections, knowledge and sexual behaviour among youth in semi-rural Tanzania in the period of adolescent friendly health services strategy implementation

BackgroundGlobal evidence shows that sexually transmitted infections (STIs) prevalence and sexual risk behaviours are high among youth, and knowledge about STIs is low. In Tanzania, there is limited recent evidence regarding these issues. The aim of this study was to describe the health seeking behaviour of youth reporting STI symptoms in semi-rural Tanzania and to evaluate the association of socio-demographic characteristics, STI knowledge and sexual risk behaviour with STI symptom reporting.MethodsThis was a cross-sectional study involving 2251 sexually experienced youth (15–24 years), who participated in a larger baseline survey of a cohort within Ifakara town. Interview data were electronically collected by trained field workers. Logistic regression analysis was used to identify factors that influence the risk of reporting STI symptoms within the past year, using Stata 12.1.ResultsThe prevalence of self-reported STI symptoms in the past year was 19.9%. Almost all of youth had heard of STIs and 32.7% of youth could mention at least one sign. 34.4% had sought care for their STI symptoms, the majority at private facilities. Only 20% of HIV-STI co-infected youth was aware of their HIV status.Youth with more knowledge of STI symptoms reported to have had symptoms more often (OR = 1.28; 95% CI 1.01–1.62), and those reporting having first sex at 16 or under were more likely to report STI symptoms than those who delayed to 17–19 years (OR 1.27; 95% CI 1.003–1.62).ConclusionThese findings highlight the need to improve the implementation of Adolescent Friendly Health Services available in Tanzania (especially in semi-rural areas). The inclusion of private facilities and pharmacies in AFHS scale-up would potentially raise the level of STI knowledge, lower the STI prevalence and reduce HIV incidence among youth.

Abstract P1-10-06: Hypofractionated nodal radiotherapy (RT) did not increase arm morbidity compared to conventional fractionated nodal RT

Abstract Purpose: Regional nodal radiation therapy (RT) can cause adverse arm symptoms and lymphedema. Hypofractionation (HF), defined as &amp;gt;2 Gy/fraction, improves convenience but whether it increases arm morbidity is unclear. This study evaluates patient-reported arm symptoms in women treated with HF compared to conventional fractionation (CF) RT (defined as ≤2Gy/fraction). Materials / Methods: Provincial cancer registries were used to identify subjects who received 3D, CT-planned nodal RT for pT1-3 pN0-2 M0 breast cancer from 2007-2009 in British Columbia and 2008 – 2010 in Alberta, Canada. Treatment eras were selected to enable sufficient follow-up time to develop late arm symptoms. Following research ethics approval, eligible patients were mailed an explanation letter and an externally validated, Self-reported Arm Symptom Scale (SASS) survey. The SASS included 8 questions about arm symptoms, with responses on a 5-point Likert scale regarding arm/hand problems (numbness, pain, stiffness, immobility and swelling), and 5 questions related to activities of daily living (ADL). Clinicopathologic characteristics and SASS scores were compared between HF vs. CF nodal RT cohorts using non-parametric analysis (on ordinal and scale responses) and binned chi-squared analysis (comparison for responses of 1 vs. &amp;gt; 1). Results: 800/1759 eligible patients returned a completed survey (45.5%). Upon detailed chart review of responders, 92 cases with recurrence or metastasis were excluded. The remaining 708 cases formed the study cohort. Of these, 406 (57%) patients received HF RT (modal dose/fractionation 40 Gy/15 fractions (fx) and 45 Gy/20 fx), and 302 (43%) received CF RT (45 Gy/25 fx, 48-50 Gy/25 fx, and 50.4 Gy/28 fx). A boost was delivered to the breast in 22% of subjects, equally by fractionation group (p=0.31). Median time interval since RT completion was 5.67 years. The mean age at diagnosis was 59.0 in HF vs 53.8 years in CF-treated cohorts (p&amp;lt;0.001). The mean # positive (n=3) and excised (n=12) nodes were similar between fractionation cohorts (p=0.44). Primary tumor size was marginally larger in the CF group (2.8 vs. 2.7 cm, p=0.03). 42.9% of patients were treated with partial mastectomy with no significant difference in fractionation (p=0.54). Overall, 602 (75.3%) patients received chemotherapy. A trend toward increased use of CF after chemotherapy was observed (78.8% vs. 72.7%, p=0.07). The mean sums of responses for the arm symptoms / ADL components of the SASS were 12.5 / 7.6 vs. 13.3 / 7.9 for the HF and CF groups respectively (p=0.17 / 0.85). On analysis of individual questions, the CF group had a higher prevalence of self-reported symptoms, including shoulder stiffness (p=0.04), trouble moving the arm (p=0.02), and ability to reach overhead (p&amp;lt;0.01). There was no difference in self-reported arm swelling between the two groups (p=0.57). Conclusion: Hypofractionated nodal RT was not associated with an increase in patient-reported arm symptoms or disability compared to conventional fractionated nodal RT. Subjects treated with CF RT reported more disability in certain aspects of arm and shoulder function. These data support the use of shorter fractionation when the regional lymph nodes are part of the therapeutic target. Citation Format: Leong N, Truong P, Tankel K, Kwan W, Weir L, Olivotto I. Hypofractionated nodal radiotherapy (RT) did not increase arm morbidity compared to conventional fractionated nodal RT [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-10-06.

Task distribution, work environment, and perceived health discomforts among Indian ceramic workers.

The study examined the work environment of Indian ceramics workers and assessed associations between work hazards, work category, and self-reported symptoms. The multi-method ergonomic review technique (MMERT) checkpoints was used for work analysis and prevalence of self-reported symptoms among 329 male workers. Ambient temperature and relative humidity in ceramic industries were 39.9°C and 17.4% respectively. Musculoskeletal discomfort was observed as a primary complaint; especially lower extremity pain (45%). Load handlers and machine operators had the highest levels of work hazards, including high skill requirement, strenuous work posture, poor commitment by the organization. Poor job autonomy, task clarity, hot workplace, inappropriate workplace design, inadequate auxiliary support, and mental overload were significantly associated with self-reported symptoms (P < 0.001). Work categories are associated with work hazards and may lead to various health symptoms among ceramic workers. Control of workplace hazards may lower rates of symptoms and thus may lead to improved health, productivity, and well-being. Am. J. Ind. Med. 59:1145-1155, 2016. © 2016 Wiley Periodicals, Inc.

Prevalence of Self-reported Symptoms After Gastric Bypass Surgery for Obesity.

Population-based studies on the prevalence of symptoms after Roux-en-Y gastric bypass (RYGB) surgery are sparse. Knowledge about possible predictors of these symptoms is important for prevention. To examine patients' overall well-being and the prevalence and predictors of medical, nutritional, and surgical symptoms after RYGB surgery, and their association with quality of life. A survey was conducted from March 3 to July 31, 2014, among 2238 patients who underwent RYGB surgery between January 1, 2006, and December 31, 2011, in the Central Denmark Region. A comparison cohort of 89 individuals who were matched with patients according to sex and body mass index but who did not undergo RYGB surgery were surveyed as a point of reference. Data analysis was conducted from September 1, 2014, to June 25, 2015. Prevalence and severity (based on contacts with health care system, ranging from no contact to hospitalization) of self-reported symptoms following RYGB surgery. Prevalence ratios (PRs) of symptoms associated with different predictors were computed. The association between number of symptoms and quality of life was investigated using the Spearman rank correlation coefficient. Of 2238 patients undergoing RYGB surgery, 1429 (63.7%) responded to the survey. Among these patients, 1266 (88.6%) reported 1 or more symptoms a median of 4.7 years after RYGB surgery. Mean age at the time of the survey was 47.1 years (range, 26.9-68.0 years), and 286 were men (20.0%). A total of 1219 of 1394 patients (87.4%) reported that their well-being was improved after vs before RYGB surgery, while 113 (8.1%) reported reduced well-being. Symptoms after RYGB surgery were reported by 1266 patients (88.6%); 966 patients (67.6%) had been in contact with the health care system about their symptoms vs 31 [34.8%] of those in the comparison group, and 416 (29.1%) had been hospitalized vs 6 [6.7%] of those in the comparison group. The symptoms most commonly leading to health care contact after RYGB surgery were abdominal pain (489 [34.2%]), fatigue (488 [34.1%]), and anemia (396 [27.7%]). The risk of symptoms was higher among women (crude PR, 1.23; 95% CI, 1.11-1.37), among patients younger than 35 years (PR, 1.24; 95% CI, 1.13-1.36), among smokers (PR, 1.11; 95% CI, 1.02-1.20), among unemployed persons (PR, 1.15; 95% CI, 1.06-1.24), and in those with surgical symptoms before RYGB surgery (PR, 1.34; 95% CI, 1.25-1.43). Quality of life was inversely associated with the number of symptoms (r = -0.30; P < .001). Most patients reported improved well-being after RYGB surgery, but the prevalence of symptoms was high and nearly one-third of patients were hospitalized, 4- to 5-fold more than among the comparison group. Predictors of symptoms included young age, female sex, smoking, and experiencing symptoms before RYGB surgery. Development of weight loss procedures with fewer subsequent symptoms should be a high priority.

Mental Health Symptoms Among Student Service Members/Veterans and Civilian College Students

Objective: The aim of this study was to investigate if and to what extent student service members/veterans differ from civilian college students in the prevalence of self-reported symptoms of poor mental health. Participants: The Fall 2011 implementation of the American College Health Association–National College Health Assessment included 27,774 respondents from 44 colleges and universities. Methods: Participants were matched using propensity scores, and the prevalence of symptoms was compared using logistic regression and zero-inflated negative binomial regression models. Results: The odds of feeling overwhelmed in the last 12 months were significantly lower among student service members/veterans with a history of hazardous duty (odd ratio [OR] = 0.46, adjusted p value <.05) compared with civilian students. Military service, with and without hazardous duty deployment, was not a significant predictor of the total number of symptoms of poor mental health. Conclusions: Current student service members/veterans may not be disproportionately affected by poor psychological functioning.

Epidemiology of constipation in São Paulo, Brazil: a population-based study

Objective:Epidemiologic data on constipation in South America are limited. The main objective of this study was to assess the prevalence of self-reported symptoms of constipation in Brazil.Methods:Telephone and personal surveys were conducted among community-dwelling adults in homes with land-based telephones in São Paulo. Data were weighted by numbers of adults, total residents, and telephones in each household. To account for potential nonresponse and noncoverage bias, results were further adjusted according to Brazilian census data.Results:Among 4570 households contacted, 3050 adults (66.7%) participated. Respondents (mean [SE] age: 42.6 [2.7] years) were primarily women (53.1%). A minority of all respondents reported symptoms consistent with constipation, including a perception of incomplete voiding in 8.0%; expending efforts to defecate in 7.6%; ≤2 stools weekly in 9.0%; and hard stools in 12.7%. Prevalences of these symptoms and efforts to manage them were more frequent in women (P ≤ 0.004), but most were not significantly associated with advancing age. With increasing age, proportions of respondents with ≤2 stools per week declined (P = 0.001), whereas use of bowel enemas (P = 0.026) and digital maneuvers to disimpact stool increased (P < 0.001). Despite frequent constipation symptoms, the vast majority of respondents did not report using prescription medications, but some used natural remedies (29.5%) and/or laxatives (13.4%).Conclusions:Symptoms of constipation are prevalent in São Paulo, particularly among women. On the other hand, most survey respondents did not use medications or other remedies that manage this condition. These findings may point to an unmet gastrointestinal treatment need. Future research is needed to corroborate our findings in rural settings and to further evaluate potential predictors and consequences of constipation in South America.

Correlations between self-reported symptoms and psychosocial factors of perpetrators with domestic violence in China: a population-based sample.

Domestic violence (DV) is not only a devastating societal problem, but also a severe medical and mental health problem worldwide. Our previous study has shown that perpetrators were with higher prevalence of self-reported symptoms than that of controls. This study based on our former large scale population-based samples is aimed to further explore the correlations between the symptoms and psychosocial factors of the perpetrators with DV. It was helpful to provide some insight into possible strategies for clinicians to reduce the symptoms of the perpetrators with DV in China. From our former population-based epidemiological samples, 1098 households with a history of DV in preceding year, 318 perpetrators with DV were randomly selected. Face-to-face interviews were conducted. Symptom Checklist-90 (SCL-90) was administrated to check and classify the symptoms of perpetrators, Eysenck's personality questionnaire (EPQ), trait coping style questionnaire (TCSQ), life events scale (LES) and social supporting rating scale (SSRS) were administrated to evaluate the psychosocial factors of perpetrators. The correlation analysis was used to analyze the relationships between the symptoms and psychosocial factors of perpetrators of DV. The global and all subscale scores of SCL-90 were significantly positively correlated with EPQ-N, negative TCSQ and negative LES scores (P < 0.01). The global score of SCL-90 was negatively correlated with both objective and subjective SSRS (P < 0.01). The negative LES and negative TCSQ were significantly positively correlated with EPQ-N (P < 0.01). Negative TCSQ was significantly positively correlated with negative LES and negatively correlated with subjective SSRS (P < 0.01). The self-reported symptoms of perpetrators with DV were strongly correlated with their psychosocial factors, such as the neurotic personality, negative coping style, more negative life events and less subjective social supports. It suggested bio-psycho-socially oriented interventions were necessary to buffer the symptoms of perpetrators with DV.

Prevalence of Bruxism Awareness In Istanbul, Turkey

The reported prevalence of symptoms related to bruxism varies in the general population because of different investigative methodologies, operational definitions, clinical criteria, and samples of population. Awareness of bruxism in the general population is 15% to 23%, however, this rate increases to 50% to 90% in clinical studies. The aim of this study was to investigate the prevalence of self-reported symptoms associated with bruxism in Istanbul, Turkey and to analyze the correlation between bruxism and factors such as age, gender, marital status, and occupation. Seven-hundred-ninety-five (795) adult subjects who resided in the city of Istanbul were interviewed by telephone about their age, gender, marital status, occupation, and description of the prevalence of bruxism awareness. The overall prevalence of clenching teeth was 45.7% and that of grinding teeth was 21.6%. Women responded positively to the questions more often than men. The data showed significant differences between males and females, regarding clencing teeth OR: 1.41 (95%CI: 1.05-1.87), difficulty opening OR: 2.64 (95% CI: 1.63-4.26), headache on awakening OR: 2.28 (95% CI: 1.58-3.27) joint sounds OR: 1.72 (95% CI: 1.24-2.38), sore on awakening OR: 2.97 (95% CI: 1.91-4.61), influence in daily activity (OR: 2.26 CI: 1.38-3.67). Tooth wear in the married group was higher than the single group. Age distribution showed significant differences related to grinding teeth, tooth wear and joint sounds. There were statistically significant differences between bruxism and job categories. As a conclusion, this study suggest an association between bruxism and stressful events such as marital status and job problems.

Multiple sexual partnership mediates the association between early sexual debut and sexually transmitted infection among adolescent and young adult males in Nigeria

Objectives To assess the relationship between early sexual debut, risky sexual behaviours and sexually transmitted infections (STIs) among young males.Methods The study was cross-sectional analytical in design and involved 1278 Nigerian males aged 15–24 years. Logistic regression was used in assessing the statistical relationship between early sexual debut (<16 years) and self-reported STIs (history of at least one of three symptoms – painful urination, genital discharge, and genital ulcer/sore – within the past 12 months), with demographic factors, sexual behaviours and psychosocial measures controlled for.Results The prevalence of self-reported symptoms was 4.2% for genital discharge, 4.1% for painful urination, and 2.0% for genital sore/ulcer. Overall, 6.8% had STI symptom(s). At bivariate analysis, early sexual debut (p = 0.021), multiple partners (p < 0.001), concurrent partners (p = 0.002), and sex with casual/commercial partners (p = 0.013) were associated with STIs. At multivariate analysis, early sexual debut (odds ratio [OR] = 2.12, 95% confidence interval [CI] = 1.17–3.84) remained significantly associated with STIs. Multiple sexual partnership (OR = 2.00, 95% CI = 1.13–3.52) was also significantly associated with STIs, and is a mediator of the association between early debut and STI.Conclusions Multiple sexual partners and early sexual debut are associated with STIs among adolescent and young adult males.

Prevalence of self-reported symptoms and consequences related to inhalation of airborne chemicals in a Danish general population

To estimate the prevalence and consequences of self-reported symptoms related to inhalation of airborne chemicals in a Danish general population. A random sample of 18-69-year-old individuals (n = 6,000) was drawn from the Danish Civil Registration System. A questionnaire on self-reported symptoms related to inhalation of 11 categories of airborne chemicals was mailed to the population. Respondents who reported symptoms received an additional questionnaire to verify the reported symptoms and to characterise factors related to the initial onset of symptoms. The response rate to the primary questionnaire was 71%. A total of 1,134 individuals (27%, 95% CI 25-28) reported symptoms related to inhalation of airborne chemicals, 141 individuals (3.3%, 95% CI 2.8-3.9) reported adjustments of social life or occupational conditions due to symptoms, whereas 20 individuals (0.5%, 95% CI 0.3-0.7) had made adjustments of both social life and occupational conditions. Women reported more exposures as annoying than men and had more symptoms related to inhalation of airborne chemicals (P < 0.001). However, sex had no effect on the reporting of adjustments of social life or occupational conditions (P = 0.54). Symptoms related to inhalation of airborne chemicals were common in this general population, and a minority reported that these symptoms affected social life or occupational conditions. Women as compared to men reported more symptoms but not adjustments of social life or occupational conditions.

The Prevalence and Risk Factors for Occupational Voice Disorders in Teachers

Objective: Occupational voice disorders in Poland account for over 25% of all occupational diseases. The aim of the study was to assess the prevalence of voice problems in the general population of Polish teachers, and identify risk factors for developing voice pathology. Patients and Methods: The study group comprised 425 female full-time teachers (most of them primary and secondary school, age ranging from 23 to 61 years) and 83 non-teacher women (control) whose jobs did not involve vocal effort, matched for age to the study group. All participants were subjected to a survey using an extensive questionnaire, and to laryngological, phoniatric and videostroboscopic examinations. Results: The overall lifetime vocal symptoms were more frequent in the teachers than in the non-teachers (69 vs. 36%), and in particular it related to permanent and recurrent hoarseness, and dryness in the throat. Mean number of the voice symptoms was 3.21 in teachers and 1.98 in controls (p < 0.001). Abnormal (non-euphonic) voice, neck muscle hypertension during phonation and incorrect resonator function were also significantly more frequent in the teachers. Mean maximum phonation time was shorter in teachers than in the controls (14.3 vs. 15.9 s, p < 0.01). Occupational voice disorders and hyperfunctional dysphonia (that is thought to predispose to such pathology) were found in 32.7% of teachers and 9.6% of control subjects. The probability of developing incomplete glottal closure (odds ratio 13.2x; 95% CI: 1.8–96.8) and hyperfunctional dysphonia (odds ratio 2.7; 95% CI: 1.14–6.44) were significantly higher in the teacher group versus non-teachers. A significant positive relationship was found in teachers between the prevalence of hyperfunctional dysphonia and strained phonation, neck muscle hypertension, instability of voice, self-assessed hyperarousal, and lifetime vocal effort index (years of employment as a teacher × hours of professional activity/week). The prevalence of vocal nodules and incomplete glottal closure were correlated with incorrect phonation technique parameters, but not with psychological factors. No correlation was found with environmental variables, such as classroom temperature, humidity, airborne dust. Conclusion: The prevalence of self-reported symptoms and clinical signs of voice disorders is around 2–3 times more frequent in Polish female teachers than in non-teachers. Lifetime vocal effort, incorrect technique of phonation and psychological predisposition seem to constitute major risk factors for developing occupational voice disorders.

The prevalence of self-reported symptoms of respiratory disease and community belief about the severity of pollution from various sources

It is postulated that health effects of air pollution may be direct and indirect through people's perception about the severity of pollution and concerns over its impact on their health. A cross sectional postal survey of some 6,559 households was conducted in the area of Ellesmere Port and Neston Borough Council. A total of 3,402 (51.9%) usable questionnaires were returned and included in the subsequent analyses. Childhood asthma was associated with central heating. Adult asthma was associated with the number of people in the house who had ever smoked and 'crowding'. General adult respiratory symptoms were associated with perception of industrial air pollution and neighbour noise in univariable but not multivariable analyses. In the multivariable model number of people in the household who had ever smoked, exposure to traffic fume pollution, crowding and living in rented accommodation. This suggests a complex relationship between actual levels of pollution (though not directly measured in this study), social deprivation, socio-behavioural factors and people's perceptions about pollution. A model of the relationship of these factors is proposed and it is argued that studies of the health impact of air pollution that concentrate only on chemical exposure will be flawed unless they are placed in the context of perception and socio-behavioural factors.

Depressive symptoms and suicidal behavior among general population adolescents and young adults across Greece

SummaryThe authors conducted a home survey investigating the prevalence of self-reported symptoms of depression, suicidal ideation and suicidal attempts among a probability nationwide sample of 1316 adolescents aged 12-17 and 1114 young adults aged 18-24. Depressive symptoms were detected by the use of the Center for Epidemiologic Studies-Depression scale. 20.3% of adolescents and 35.7% of young adults were characterized as being depressed. Similar differences between the two age groups in the prevalence rates of suicidal ideation and attempts were observed. Suicide attempters of both age groups reported a higher number of depressive symptoms compared with the non attempters. Characteristics that distinguished the suicide attempters from the total sample were low rates of school attendance, use of substances, previous psychiatric help-seeking and additional mental health problems in families.

Assessment of acute health effects from the Medfly Eradication Project in Santa Clara County, California.

Surveys were performed to assess the acute health effects of aerial application of malathion bait over a large urban area. Three indirect attempts to assess utilization of health care services were made: (1) surveillance of a major hospital emergency department was undertaken, (2) ambulance dispatches were reviewed, and (3) emergency treatments for asthma at a university hospital were reviewed. These assessments were negative but insensitive. Prevalence of self-reported symptoms was assessed with two surveys that were subject to severe time constraints. Personal interviews of the same individuals, before and after the spraying, were conducted: one was conducted by telephone and the other by residential visit. Results indicated no detectable increase in acute morbidity. Also, after the spraying, there was a decrease in anxiety-related symptoms.