US Males Research Articles

Zinc supplementation raises serum zinc and 5'-nucleotidase activities in healthy, USA middle-aged men.

Background: Many types of people have been noted to show less than maximum zinc functional status. One group that has not been examined is healthy middle-aged, non-vegetarian men in the USA. Aim: To determine if supplementation with zinc improves values for two plasma indicators of zinc status. Methods: Zinc arginate (30 mg zinc/day) was given for 6 weeks to healthy middle-aged men. Results: Supplementation produced statistically significant, but small increases in plasma values for zinc and activity of 5'-nucleotidase, a zinc enzyme. Conclusion: These results suggest that middle-aged, healthy, meat-eating US males tend to show close to maximal zinc functional status. However, such men may not have a safety margin in zinc stores that covers situations where higher than normal zinc needs develop.

Association between Sensitivity to Thyroid Hormone Indices and Bone Mineral Density in US Males.

Thyroid hormone is acknowledged as a pivotal factor in skeletal development and adult bone maintenance. However, available data about the relationship between sensitivity to thyroid hormone and bone mineral density (BMD) remain limited and conflicting. The purpose of the study was to explore the complex relationship between sensitivity to thyroid hormone indices and BMD using cross-sectional analysis. An overall sample of 3,107 males from the National Health and Nutrition Examination Survey (NHANES) was studied in the study. The thyroid hormone sensitivity indices included free triiodothyronine/tree thyroxine (FT3/FT4), thyroid-stimulating hormone index (TSHI), thyrotroph thyroxine resistance index (TT4RI), and thyroid feedback quantile-based index (TFQI). Given the complex study design and sample weights, the correlation between sensitivity to thyroid hormone indices and BMD was evaluated through multivariate linear regression models, and extra subgroup analyses were performed to examine the robustness of the results. Among the 3,107 participants, we demonstrated that FT3/FT4 was negatively correlated with lumbar BMD (β = -0.0.35, 95% CI: -0.084-0.013, P < 0.05). In the terms of central sensitivity to thyroid hormone, TFQI showed a significant negative relationship with the BMD of the lumbar (β = -0.018, 95% CI: -0.033 to -0.003, P < 0.05), total femur (β = -0.020, 95% CI: -0.035 to -0.006, P < 0.01), and femur neck (β = -0.018, 95% CI: -0.031 to -0.005, P < 0.01). In the subgroup analyses stratified by body mass index (BMI), the significant negative correlation between TFQI and lumbar BMD remained in the male participants with BMI between 18.5 and 24.9 kg/m2. Decreased indices of sensitivity to thyroid hormones are strongly associated with increased lumbar BMD, suggesting that the dysfunction of peripheral and central response to thyroid hormone might contribute to bone loss. In addition, FT3/FT4 and TFQI were considered to be the preferable indicators to guide the prevention and clinical treatment of osteoporosis.

Intergenerational social mobility and suicide risk by firearm and other means in US males

Firearms are the leading method of suicide in US men, and socioeconomic status (SES) is associated with suicide risk. In this 40-year mortality follow-up of a national cohort of US men, we examined if improved SES relative to one's family of origin, upward intergenerational social mobility (ISM), is associated with lowered risk for firearm suicide and suicide by other means in US men. Family of origin SES was assessed as part of Project Talent, a broad survey of US high school students in 1960. 42,766 men in the cohort completed follow-up surveys at age 29, assessing attained SES via education, occupation, and income. ISM was measured by change between harmonized SES composites. Mortality follow-up was conducted through age 70. Adjusting for baseline SES and race/ethnicity, a 1 standard deviation increase in SES was associated with a 31% reduction in firearm suicide risk later in the life course (HR [95% CI] = 0·69 [0·54, 0·88], P = 0·003), and a smaller, non-significant reduction in suicide by other means (HR [95% CI] = 0·80 [0·60, 1·07], P = 0·136). Traits associated with both suicide and SES attainment (cognitive ability, calm, impulsivity) only modestly attenuated this association. Upward ISM was more strongly associated with reduced firearm suicide risk in males with parents of low SES. The association between upward ISM and reduced firearm suicide mortality risk prevailed over ensuing decades. Policies improving social mobility in US males, particularly those of lower SES, may function as de-facto firearm suicide prevention strategies.

Selected Articles from This Issue

Glioblastoma (GBM) is one of the most aggressive cancers and it is usually refractory to immunotherapies. EGFR variant III (EGFRvIII) is an EGFR mutation commonly present in GBM that generates a unique cell surface neoantigen in tumor cells. Here, Iurlaro and colleagues have designed and developed a novel T cell bispecific antibody (TCB) with specificity for EGFRvIII and CD3. The EGFRvIII-TCB promoted T cell activation and tumor cell killing in EGFRvIII-expressing patient-derived models, and induced tumor regression in GBM patient-derived xenografts (PDX). These results led to the clinical testing of the EGFRvIII-TCB for the treatment of EGFRvIII-expressing GBMs.Comparative oncology clinical trials, carried out in pet dogs with spontaneously occurring cancers, are increasingly recognized a valuable component of the anti-cancer drug discovery and development pathway. In this report, LeBlanc and colleagues conducted a clinical study of a novel orally bioavailable inhibitor of valosin-containing protein (VCP), CB-5339, in pet dogs with a variety of malignancies. This canine trial generated key pharmacokinetic and pharmacodynamic data, defined a tolerable dose and schedule, and discovered an efficacy signal in multiple myeloma. The data generated herein provided a foundation for future studies of this drug in humans with multiple myeloma as well as other tumor types.Glutamine metabolism has been considered an important mechanism for control of tumor growth and survival. Here, Yokoyama and colleagues describe the preclinical pharmacology and mechanism of action of the novel clinical stage glutamine antagonist, DRP-104 (sirpiglenastat). Broadly targeting all 10 glutamine metabolizing enzymes, DRP-104 leads to profound anti-tumor activity related to both direct effects on tumor metabolism as well as immune mediated activity via remodeling of the tumor microenvironment and induction of both innate and adaptive anti-tumor immunity. This unique activity shows promise for the treatment of various tumors including those resistant to immune checkpoint inhibitors.Prostate cancer is the second leading cause of cancer related deaths and most commonly diagnosed cancer in US males. Although androgen receptor-targeted therapies such as enzalutamide are initially effective for the treatment of advanced prostate cancer, resistance occurs frequently. Here, Ning and colleagues have demonstrated that Wnt5A/FZD2 signaling plays vital roles in conferring resistance to enzalutamide and the levels of their expression correlates with aggressive prostate cancer with shortened disease-free survival. Furthermore, a novel bioengineered BERA-Wnt5A siRNA construct significantly suppressed tumor growth and enhanced enzalutamide treatment, suggesting targeting Wnt5A could be developed as a potential therapy for advanced prostate cancer.

Eyestalk neuropeptide identification in the female red deep-sea crab, Chaceon quinquedens

Eyestalk-derived neuropeptides, primarily the crustacean hyperglycemic hormone (CHH) neuropeptide family, regulate vitellogenesis in decapod crustaceans. The red deep-sea crab, Chaceon quinquedens, a cold-water species inhabiting depths between 200 and 1800 m, has supported a small fishery, mainly harvesting adult males in the eastern US for over 40 years. This study aimed to understand the role of eyestalk-neuropeptides in vitellogenesis in C. quinquedens with an extended intermolt stage. Chromatography shows two CHH and one MIH peak in the sinus gland, with a CHH2 peak area four times larger than CHH1. The cDNA sequence of MIH and CHH of C. quinquedens is isolated from the eyestalk ganglia, and the qPCR assay shows MIH is significantly higher only at ovarian stages 3 than 4 and 5. However, MIH transcript and its neuropeptides do differ between stages 1 and 3. While CHH transcripts remain constant, its neuropeptide levels are higher at stages 3 than 1. Additionally, transcriptomic analysis of the de novo eyestalk ganglia assembly at ovarian stages 1 and 3 found 28 eyestalk neuropeptides. A GIH/VIH or GSH/VSH belonging to the CHH family is absent in the transcriptome. Transcripts per million (TPM) values of ten neuropeptides increase by 1.3 to 2.0-fold at stage 3 compared to stage 1: twofold for Bursicon α, followed by CHH, AKH/corazonin-like, Pyrokinin, CCAP, Glycoprotein B, PDH1, and IDLSRF-like peptide, and 1.3-fold of allatostatin A and short NP-F. WXXXRamide, the only downregulated neuropeptide, decreases TPM by ∼ 2-fold at stage 3, compared to stage 1. Interestingly, neuroparsin with the highest TPM values remains the same in stages 1 and 3. The mandibular organ-inhibiting hormone is not found in de novo assembly. We report that CHH, MIH, and eight other neuropeptides may play a role in vitellogenesis in this species.

COVID-19 vaccination not associated with increased risk of erectile dysfunction.

Although mRNA COVID‐19 vaccines have proven to be safe and effective against SARS‐CoV‐2, vaccination rates have slowed, with some individuals citing impotence as a concern. Therefore, we conducted a survey of the US males to evaluate the impact of COVID‐19 vaccination on erectile function. We hypothesized that vaccinated men would not have a higher risk of ED compared to unvaccinated men. Amazon Mechanical Turk (MTurk) was utilized to survey the US adult male population between August 26 and September 2, 2021. Survey participation was open to 1000 males over the age of 18 and currently living in the United States regardless of vaccination status or the past medical history of COVID‐19. Selection criteria included respondents ≥45 years old, no history of physician‐diagnosed ED, biologically born, and identify as male. Participants completed an anonymous 16‐question survey that included a multidimensional scale used to evaluate ED, the International Index of Erectile Function (IIEF‐5). Among vaccinated men, the median IIEF‐5 score was 20 [16–24] compared to 22 [17.5–25] in the unvaccinated group (p = 0.195). The multivariable‐adjusted analysis demonstrated that vaccination against COVID‐19 was not associated with increased risk of ED. Overall, this cross‐sectional survey showed that COVID‐19 vaccination was not associated with an increased risk of erectile dysfunction in males 45 years and older.

Sex Differences in the Association of E-cigarette and Cigarette Use and Dual Use With Self-Reported Hypertension Incidence in US Adults.

While there is some evidence and conceptual plausibility that tobacco product use is associated with hypertension incidence and that this association varies by sex, extant longitudinal research had been conducted prior to the emergence of e-cigarette and dual e-cigarette and cigarette use. Data were analyzed from the US Population Assessment of Tobacco and Health study for adults with no lifetime history of hypertension at wave 1 (2013-2014) who completed waves 2-4 follow-up surveys (2014-2018; n = 16 434). Sex-stratified weighted covariate-adjusted multivariable Cox regression models were used to examine the association between established current e-cigarette or cigarette exclusive or dual-use (as a time-varying and time-lagged regressor) and subsequent self-reported hypertension onset. Weighted cumulative hypertension incidence by wave 4 varied by waves 1-3 e-cigarette, cigarette, and dual use status in females (nonuse [incidence: 9.9%], exclusive e-cigarette use [11.8%], exclusive cigarette use [14.8%], dual-use [12.4%]; p = .003 for omnibus differences among all groups) but not males (nonuse [12.6%], exclusive e-cigarette use [9.7%], exclusive cigarette use [13.7%], dual-use [9.3%]; p = .231). Among females, exclusive cigarette (vs. no) use (hazard ratio: 1.69, 95%CI 1.21 to 2.34; p = .002), but not exclusive e-cigarette or dual-use, was significantly associated with subsequent hypertension. Dose-response models were suggestive that consistent exclusive e-cigarette or dual-use versus nonuse across multiple may be associated with hypertension among females, but results were nonsignificant. The association of e-cigarette, cigarette, and dual use with hypertension may differ by sex, whereby exclusive cigarette use could be a prospective risk factor for subsequent self-reported hypertension in US adult females. This nationally representative cohort study provides the very first evidence of whether there are prospective associations of established e-cigarette and cigarette use and dual use with future hypertension onset among US adult females and males. We found that exclusive cigarette smoking was associated with an increased risk of incident hypertension among females, but not males. We observed a trend of a dose-response relationship between e-cigarette use and risk of incident hypertension among female exclusive e-cigarette users or dual e-cigarette and cigarette users. Our study will contribute to understanding the chronic health risks of vaping to prevent the potential long-term e-cigarette use-related health burden.

Selected Articles from This Issue

Prostate cancer is the most frequently diagnosed cancer and second leading cause of cancer death in US males. Androgen receptor (AR) is the best-known therapeutic target for prostate cancer. Here, Cole and colleagues have identified a novel small molecule, (+)-JJ-74-138, that directly binds to the AR and non-competitively inhibits AR activity. Furthermore, this small molecule shows efficacy in vitro and in vivo in models resistant to clinically available AR antagonists that competitively inhibit the binding of androgens to AR. Further development of non-competitive AR antagonists like (+)-JJ-74-138 shows promise treating tumors resistant to current AR targeting therapies.Epigenetic modulation has recently emerged as an immune evasion mechanism in cancer. The co-dependence of G9A and EZH2 histone methyltransferases in regulating gene transcription led to the development of the dual G9A/EZH2 inhibitor, HKMTI-1-005. In this highlighted manuscript, Spiliopoulou and colleagues demonstrate that treatment with HKMTI-1-005 derepresses transcription of immunostimulatory gene networks and achieves robust engraftment of tumor-infiltrating lymphocytes in the Trp53‒/‒ ID8 mouse model of ovarian cancer. Immune infiltration was accompanied by tumor growth inhibition and an improvement in survival. Collectively these results support further development of epigenetic modifiers as an anti-cancer strategy.The high mortality of PDAC attributes to early metastasis at diagnosis and chemoresistance partly driven by mutant p53. PDAC cells are predisposed to ferroptosis. New therapeutics capable of inducing ferroptosis and inhibiting PDAC metastasis are highly desirable. This study by Li, et al reports a small molecule compound MMRi62 bearing these two capabilities. This study shows MMRi62 inhibits PDAC proliferation in vitro and in vivo by induction of ferroptosis via induced lysosomal degradation of ferritin heavy chain and inhibits metastasis in vivo which involves proteasomal degradation of mutant p53.Zammarchi and colleagues describe the development of ADCT-601, a novel pyrrolobenzodiazepine dimer-based antibody-drug conjugate targeting AXL, a well-known tyrosine kinase receptor implicated in numerous aspects of tumor development, progression, and resistance to cancer therapies. Zammarchi and colleagues present original data outlining the mode of action of ADCT-601 when used as monotherapy, both in vitro and in vivo, in tumor models of different origins, including a monomethyl auristatin E-resistant lung cancer model, and in combination with olaparib in an ovarian cancer model; preclinical evaluation of its safety and tolerability is also reported. Altogether, the data presented warrant further evaluation of ADCT-601 in the clinical setting.

Association between pesticide exposure and sleep health among a representative sample of US adults: evidence from NHANES 2009\u20132014

BackgroundData suggest that pesticides interact with the melatonin receptor, which may influence sleep. However, the link between pesticides and sleep remains unexplored among the general adult population. This study evaluated unstratified and sex-stratified associations between urinary pesticide exposure (N = 4,478) and self-reported acute household pesticide exposure (N = 14,956), with sleep health outcomes within a nationally representative sample of US adults.MethodsData from the National Health and Nutrition Examination Surveys (NHANES) 2009–2014 were combined for analysis of aim 1 and aim 2. Urinary pesticide metabolite concentrations served as biomarkers of pesticide exposure. Acute household pesticide exposure (if any chemical products were used in the home in the past seven days to control pests) was self-reported (yes/no). Insufficient sleep duration (< 7 h/night) and trouble sleeping (yes/no) were self-reported. Log-binomial regression models that accounted for complex survey weights and adjusted for confounders were used to compute prevalence ratios and 95% CI.ResultsLog urinary 3-phenoxybenzoic acid (3-PBA) was related to a higher probability of insufficient sleep [1.09 (95% CI: 1.00, 1.20), p = 0.04] and trouble sleeping [1.14 (95% CI: 1.02, 1.27), p = 0.02] among males. Self-reported acute household pesticide exposure was associated with a higher probability of insufficient sleep duration [1.16 (95% CI: 1.02, 1.32), p = 0.03] and trouble sleeping [1.20 (95% CI: 1.01, 1.44), p = 0.04] in the unstratified sample. Sex-stratified findings showed that associations between acute household pesticide exposure and trouble sleeping only persisted among males [1.69 (95% CI: 1.27, 2.24), p < .001].ConclusionsIn summary, acute pesticide exposure may be detrimental to adult sleep health, particularly among US males.

Vaccine initiation and 3-dose series completion of 4vHPV vaccine among US insured males 2012–2016

ObjectiveThe quadrivalent human papillomavirus vaccine (4vHPV, GARDASIL®), was approved in the US in 2009 for use in males aged 9 to 26 for the prevention of HPV-related genital warts, and in 2010 for the prevention of certain HPV-related anogenital diseases. A regimen was approved in 2016 for those who initiate the vaccine series between the ages of 9 to 14 years. We describe patterns of 4vHPV administration among US males before this modification. MethodsThe study used a US health insurance claims database, and included males, age 9 to 26 years, who initiated 4vHPV between 2012 and 2016. Time from first dose to subsequent doses was estimated. Logistic regression identified factors associated with regimen completion. ResultsAmong 100,786 males who initiated 4vHPV (corresponding to ∼ 13% of male birth cohorts), 50,573 (50.2%) and 25,763 (25.6%) received a second and third dose, respectively. Annual administration was common, with 47% of males receiving 3 doses over 3 years (1 dose per year) as compared to 12% receiving the 3-dose series in the recommended 6-month timeframe. Receipt of 4vHPV was 2.2 (range 1.5 to 2.9) times as likely to occur in summer months compared to other times of the year. Individuals aged 18 to 21 years and those living in Western states or rural regions were less likely to complete the 3-dose regimen. ConclusionsThe real-world patterns of 4vHPV vaccination observed, particularly the low uptake and regimen completion, suggest that better strategies are needed for males to improve 4vHPV vaccine use in males.

Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016

ObjectiveTo compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of...

Like father, like son? A comparison of absolute and relative intergenerational labour income mobility in Germany and the US

Are children better off than their parents? This highly debated question in politics and economics is investigated by analysing the trends in absolute and relative intergenerational labour income mobility for Germany and the US. High quality panel data is used for this purpose; the SOEP for Germany and the PSID for the US. In Germany, 67% of sons born between 1955 and 1975 earned a significantly higher real long-run labour income than their fathers. Those with fathers from the lowest earnings bracket were particularly mobile in absolute terms. In contrast, the fraction of US sons earning more than their fathers is 60% on average for the same cohorts. Their share decreased from 66% in the 1956–60 birth cohort to 48% in the 1971–75 birth cohort, while it changed very little in Germany. Overall, absolute as well as relative labour income mobility is larger in Germany than in the US. This indicates that economic growth has been distributed more broadly in Germany than in the US. While the majority of German males has been able to share in the country’s rising prosperity and are better off than their fathers, US males continue to lose ground. Hence, Chetty et al. (Science 356:398–406, 2017) seem to be right when they say that the American Dream is slowly fading away.

Postdiagnostic dairy products intake and colorectal cancer survival in US males and females

To evaluate the association between postdiagnostic dairy intake and survival among patients with colorectal cancer (CRC). This study analyzed data from the Nurses' Health Study (NHS) and the Health Professionals Follow-up Study (HPFS). Postdiagnostic dairy intake and other dietary and lifestyle factors were obtained from validated questionnaires. Individual dairy items including milk, cheese, yogurt, and so on were reported, and total, high-fat, and low-fat dairy intakes were derived. A total of 1753 eligible CRC cases were identified until 2012, from which 703 deaths were documented after a median follow-up time of 8.2 y, and 242 were due to CRC. Overall, when comparing those who consumed 21+servings/wk with<7 servings/wk, postdiagnostic total dairy intake did not show significant associations with CRC-specific mortality (HR: 1.35; 95% CI: 0.85, 2.13) or overall mortality (HR: 1.28; 95% CI: 0.98, 1.67). However, high-fat dairy, including whole milk and cream cheese, was positively associated with overall mortality (HR: 1.33; 95% CI: 1.08, 1.65) but not significantly with CRC-specific mortality (HR: 1.31; 95% CI: 0.91, 1.90) when comparing those who consumed 10.5+servings/wk with<3.5 servings/wk. For the same comparison, low-fat dairy, including skim or nonfat milk and cottage cheese, was inversely associated with overall mortality (HR: 0.74; 95% CI: 0.59, 0.92) but not CRC-specific mortality (HR: 0.91; 95% CI: 0.63, 1.29). Total dairy products intake did not show significant association with CRC-specific or overall mortality. However, high intake of high-fat dairy products was associated with increased mortality, whereas low-fat dairy was associated with lower risk of overall mortality.

Prevalence of Genital Human Papillomavirus by Age and Race/Ethnicity Among Males.

Genital and oral cancers are often caused by human papillomavirus (HPV) types that can be prevented through HPV vaccination. Since HPV is sexually transmitted, knowledge of penile prevalence of vaccine-type HPV among US males can help predict potential disparities in these cancers. This study examines penile HPV prevalence by age and race/ethnicity among males. This study was a secondary analysis of publicly available data from the National Health and Nutrition Examination Survey (NHANES). Using data from penile swab samples collected from males between 2013 and 2016, the prevalence of 4vHPV and 9vHPV vaccine types was examined across age groups and by race/ethnicity. Logistic regression models adjusting for demographics, sexual behavior, and circumcision were examined to determine whether associations remained after accounting for confounders. Among 2548 males evaluated, HPV infection prevalence differed by race/ethnicity, with Black males exhibiting a higher prevalence of HPV. Examination of 4vHPV type prevalence by age group showed that 18-26-year-old males had a lower prevalence than older age groups. After controlling for confounders, 4vHPV prevalence was only significantly elevated among 27-34-year-old males, those who were single, and males with ≥3 lifetime sex partners. In adjusted models, 9vHPV type prevalence remained elevated among Black males compared with White males. Variations in 9vHPV type prevalence between Black and White individuals indicate future disparities in HPV-related genital cancers may continue in the United States during the next decade. Revaccinating certain populations with the 9vHPV vaccine may be appropriate to help mitigate this.

Sexual Behavior Among US Adults: New Sex Partners and Number of Lifetime Sex Partners, NHANES 2013–2016 and NSFG 2011–2015

Sexual behavior information can provide context for understanding rates of sexually transmitted infections (STI) and inform potential impact of interventions. We used 2013–2016 National Health and Nutrition Examination Survey (n = 4930) and 2011–2015 National Survey of Family Growth (n = 16,643) data from sexually experienced 20–44-year old US females and males to estimate the number of lifetime and past year partners and percent with a new past year partner overall and by marital status, in 5-year age groups. Group differences were qualitatively assessed. Estimates from both surveys were comparable. The median number of lifetime sex partners ranged from 4.2 to 5.2 across age groups among females and was higher among older (9.1) than younger (4.6) males, persons with a new past year partner than those without, and persons widowed/divorced/separated/never married than those married/living with partner. Percents with ≥ 2 past year partners and a new past year partner were highest in the youngest age group and lower with age. Percent with a new past year partner was 19–46 percentage points higher in persons widowed/divorced/separated/never married (range 21.7–56.4%) compared to persons married/living with partner (range 2.7–12.4%). In the USA, there are differences in sexual behaviors by gender, age, and marital status. The percent of adults with a new sex partner is lower with increasing age; however, a portion of all subgroups reported having had a new sex partner in the past year indicating some adults remain at risk of acquiring an STI. These data can help inform policies for STI screening and other interventions.

Social network structure and composition in former NFL football players

Social networks have broad effects on health and quality of life. Biopsychosocial factors may also modify the effects of brain trauma on clinical and pathological outcomes. However, social network characterization is missing in studies of contact sports athletes. Here, we characterized the personal social networks of former National Football League players compared to non-football US males. In 303 former football players and 269 US males, we found that network structure (e.g., network size) did not differ, but network composition (e.g., proportion of family versus friends) did differ. Football players had more men than women, and more friends than family in their networks compared to US males. Black players had more racially diverse networks than White players and US males. These results are unexpected because brain trauma and chronic illnesses typically cause diminished social relationships. We anticipate our study will inform more multi-dimensional study of, and treatment options for, contact sports athletes. For example, the strong allegiances of former athletes may be harnessed in the form of social network interventions after brain trauma. Because preserving health of contact sports athletes is a major goal, the study of social networks is critical to the design of future research and treatment trials.

Proportionate mortality study of unionized maintenance of way railroad workers.

Railroad maintenance of way (MOW) workers are exposed to many workplace hazards, including diesel fuel and exhaust, ballast (silica) dust, asbestos, solvents, herbicides, welding fumes, heavy rolling equipment, vibration and extreme weather. Due to the number of excess deaths we found in a companion standardized mortality ratio (SMR) study for union members <65 years, we hypothesized that these workers may have elevated mortality risks among all ages for many chronic conditions. Proportionate mortality ratios (PMRs) were calculated for 37 661 male MOW workers ages 20 and older who were members of the Brotherhood of Maintenance of Way Employes Division (BMWED). A data set was submitted to the National Death Index (NDI) to identify decedents and to determine cause of death for workers who died between 1979 and 2014. The CDC WONDER database was used to determine expected mortality for US males. For certain diseases and cancers the SMR and PMR findings have parallel mortality excesses. Examples include septicaemia and anaemia; diabetes; chronic obstructive pulmonary disease (COPD); nephritis; and transportation accidents. Among cancers, we found excess oesophageal, stomach, colorectal, lung, prostate, kidney and in situ cancers. Two excess SMR findings were not replicated in the PMR assessment-Alzheimer's and Parkinson's disease. The PMR findings suggest that some of the mortality excesses from the SMR study are elevated, which adds support to their being consistently raised among BMWED members. The shared excess causes of death in the PMR and SMR studies should be focused on for future prevention and surveillance activities.

Association of Peripheral Neuropathy with Erectile Dysfunction in US Men

BackgroundPeripheral neuropathy and erectile dysfunction are common conditions that have both been linked to cardiovascular disease and its risk factors, especially diabetes. The aim of this study was to assess the association of large-fiber peripheral neuropathy with erectile dysfunction in adult US males with and without diabetes. MethodsWe included all men aged ≥40 years from the 2001-2002 National Health and Nutrition Examination Survey (NHANES) with data on erectile dysfunction and peripheral neuropathy (n = 1213, including 206 men with diabetes). Erectile dysfunction was assessed by a single question during a self-paced, computer-assisted self-interview. Peripheral neuropathy was evaluated using standardized 10-g monofilament testing, which assesses lower extremity sensation. We used logistic regression to examine the association of peripheral neuropathy with erectile dysfunction overall and stratified by diabetes status, adjusting for demographic and cardiovascular risk factors. ResultsThe prevalence of peripheral neuropathy was 26.1% (51.2% in men with diabetes and 22.5% in men without diabetes). There was a significant independent association of peripheral neuropathy with erectile dysfunction overall (odds ratio [OR] 1.71, 95% confidence interval [CI], 1.20-2.43) and among US adult men without diabetes (OR 1.68; 95% CI, 1.11-2.56). The association in adults with diabetes was not statistically significant (OR 1.29; 95% CI, 0.39-4.26), possibly owing to limited power in this subgroup. ConclusionsOur study suggests that decreased lower extremity sensation, even in the absence of diabetes, is common and a novel risk factor for erectile dysfunction.

Occurrence rates of haemophilia among males in the United States based on surveillance conducted in specialized haemophilia treatment centres.

Estimates of the size and characteristics of the US haemophilia population are needed for healthcare planning and resource needs assessment. A network of comprehensive haemophilia treatment centres (HTCs) located throughout the United States receives federal support for diagnosis and management of haemophilia and other rare bleeding disorders. Estimate the incidence and prevalence of haemophilia among US males using the HTC network. During the period 2012-2018, de-identified surveillance data were collected on all males who visited an HTC that included year of birth, gender, race, Hispanic ethnicity, residence zip code, haemophilia type and severity. Data from all patients were used to calculate period prevalence by haemophilia type, severity and state of residence. Data from a subset of patients born 1995-2014 were used to estimate incidence rates over the 20-year period. During the period, 21748 males with haemophilia visited the HTCs resulting in an age-adjusted prevalence of 15.7 cases per 100000 males (12 for haemophilia A and 3.7 for haemophilia B). Prevalence was higher among whites (15.1) than blacks (12.4) or Hispanics of either race (12.4). State-specific prevalence varied from 1.6 to 23.3 cases per 100000. Based on 9587 males born during the index period, the average haemophilia incidence was 1 case per 4334 live male births. Based on these data, we estimate that there are between 29 761 and 32 985 males with haemophilia living in the United States today, the majority of whom receive comprehensive care in specialized clinical centres.

Male Mortality Trends in the United States, 1900-2010: Progress, Challenges, and Opportunities.

Male mortality fell substantially during the past century, and major causes of death changed. Building on our recent analysis of female mortality trends in the United States, we examined all-cause and cause-specific mortality trends at each decade from 1900 to 2010 among US males. We conducted a descriptive study of age-adjusted death rates (AADRs) for 11 categories of disease and injury stratified by race (white, nonwhite, and, when available, black), the excess of male mortality over female mortality ([male AADR - female AADR]/female AADR), and potential causes of persistent excess of male mortality. We used national mortality data for each decade. From 1900 to 2010, the all-cause AADR declined 66.4% among white males and 74.5% among nonwhite males. Five major causes of death in 1900 were pneumonia and influenza, heart disease, stroke, tuberculosis, and unintentional nonmotor vehicle injuries; in 2010, infectious conditions were replaced by cancers and chronic lower respiratory diseases. The all-cause excess of male mortality rose from 9.1% in 1900 to 65.5% in 1980 among white males and a peak of 63.7% in 1990 among nonwhite males, subsequently falling among all groups. During the last century, AADRs among males declined more slowly than among females. Although the gap diminished in recent decades, exploration of social and behavioral factors may inform interventions that could further reduce death rates among males.