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Deaths Decreased (death + decreased)
Selected AbstractsOccupational exposure to UV light and mortality from multiple sclerosis,AMERICAN JOURNAL OF INDUSTRIAL MEDICINE, Issue 5 2009M. Westberg MD Abstract Background The etiology of multiple sclerosis (MS) is largely unknown; low exposure to ultraviolet (UV) light has been a suggested risk factor. The aim of this study was to investigate whether occupational exposure to UV light reduces the risk of death from MS. Methods The cohort was based on all individuals in the Swedish census in 1980. All MS-related deaths were identified in the national registry of causes of death. A job-exposure matrix was developed to classify the occupational exposure to UV light. Results MS was recorded as a cause of the death for 839 individuals. The risk of MS-related death decreased with increasing occupational exposure to UV light. The relative risk adjusted for age, sex, and socioeconomic status was 0.48 (95% CI 0.28,0.80) in the high-exposure group and 0.88 (95% CI 0.73,1.06) in the intermediate-exposure group. Conclusions Occupational exposure to UV light was associated with a reduced risk of MS. Our findings are corroborated by previous observations that UV light has a preventive role in the development of MS, although the possibility of reversed causality cannot be completely ruled out. Am. J. Ind. Med. 52:353,357, 2009. © 2009 Wiley-Liss, Inc [source] Living longer with a greater health burden , changes in the burden of disease and injury in the Northern Territory Indigenous population between 1994,1998 and 1999,2003AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 2010Yuejen Zhao Abstract Objective: To measure changes over time in the burden of disease for Northern Territory (NT) Indigenous and non-Indigenous population. Methods: The numbers, and crude and age-adjusted rates of disability adjusted life years (DALY) were calculated for periods 1994,1998 and 1999,2003. A measure of information bias was developed to adjust for the tendency of years lost to disability (a component of DALY) to increase over time because of increasing data availability. The jackknife method was used for DALY uncertainty assessment. Results: The all-cause DALY rate was stable for the non-Indigenous population, but increased for the Indigenous population. For both populations, the burden of premature death decreased while the burden of disability increased. For the Indigenous population, there were substantial increases in DALY rates for type 2 diabetes, depression, nephritis/nephrosis, suicide and sense organ disorders. Conclusions: The burden of disease for Indigenous people increased over the study periods, with improvement in the burden of fatal outcomes more than offset by substantial increase in the prevalence and severity of non-fatal conditions. Implications: The paradoxical shift of living longer with a greater health burden has not been previously reported for Indigenous Australians, and highlights the critical importance of prevention for sustaining life expectancy improvement and managing escalation of health costs. This study also demonstrated the usefulness of the DALY to monitor population health. [source] Unintentional methadone-related overdose death in New Mexico (USA) and implications for surveillance, 1998,2002ADDICTION, Issue 2 2005Nina Shah ABSTRACT Aims To determine death rates from methadone over time, to characterize methadone-related death and to discuss public health surveillance of methadone-related death. Design We analyzed medical examiner data for all unintentional drug overdose deaths in New Mexico, USA, between 1998 and 2002. Measurements Age-adjusted death rates for methadone-related death, logistic regression models for likelihood of methadone-related death among all unintentional drug overdose deaths and bivariate comparisons within methadone-related death. Findings Of 1120 drug overdose deaths during this period, there were 143 (12.8%) methadone-related deaths; the death rate decreased over the time period, averaging 1.6 per 100 000. Of 143 methadone-related deaths, 22.4% were due to methadone alone, 23.8% were due to methadone/prescription drugs (no illicit drugs), 50.3% were due to methadone/illicit drugs and 3.5% were due to methadone/alcohol. These groups were significantly different in demographics, health history and circumstances of death. Of 79 decedents (55.2%) with a known source of methadone, 68 obtained methadone through a physician prescription (31 for methadone maintenance treatment (MMT), 27 for managing pain and 10 had unknown reason for prescription). Conclusions Methadone-related death rates and the proportion of methadone-related death among all drug overdose deaths decreased in New Mexico from 1998 to 2002. It is important for surveillance of methadone-related death to assess multiple drug causes, not just underlying cause. Also, methadone for pain management must be examined alongside MMT and when possible, methadone co-intoxication should be described in the context of other drugs causing death. [source] Trends of mortality and causes of death among HIV-infected patients in Taiwan, 1984,2005HIV MEDICINE, Issue 7 2008C-H Yang Background The aim of this study was to analyse the trends of mortality and causes of death among HIV-infected patients in Taiwan from 1984 to 2005. Methods Registered data and death certificates for HIV-infected patients from Taiwan Centers for Disease Control were reviewed. Mortality rate and causes of deaths were compared among patients whose HIV diagnosis was made in three different study periods: before the introduction of highly active antiretroviral therapy (HAART) (pre-HAART: from 1 January 1984 to 31 March 1997), in the early HAART period (from 1 April 1997 to 31 December 2001), and in the late HAART period (from 1 January 2002 to 31 December 2005). A subgroup of 1161 HIV-infected patients (11.4%) followed at a university hospital were analysed to investigate the trends of and risk factors for mortality. Results For 10 162 HIV-infected patients with a mean follow-up of 1.97 years, the mortality rate of HIV-infected patients declined from 10.2 deaths per 100 person-years (PY) in the pre-HAART period to 6.5 deaths and 3.7 deaths per 100 PY in the early and late HAART periods, respectively (P<0.0001). For the 1161 patients followed at a university hospital (66.8% with CD4 count <200 cells/,L), HAART reduced mortality by 89% in multivariate analysis, and the adjusted hazard ratio for death was 0.28 (95% confidence interval 0.24, 0.33) in patients enrolled in the late HAART period compared with those in the pre-HAART period. Seventy-six per cent of the deaths in the pre-HAART period were attributable to AIDS-defining conditions, compared with 36% in the late HAART period (P<0.0001). The leading causes of non-AIDS-related deaths were sepsis (14.7%) and accidental death (8.3%), both of which increased significantly throughout the three study periods. Compared with patients acquiring HIV infection through sexual contact, injecting drug users were more likely to die from non-AIDS-related causes. Conclusions The mortality of HIV-infected patients declined significantly after the introduction of HAART in Taiwan. In the HAART era, AIDS-related deaths decreased significantly while deaths from non-AIDS-related conditions increased. [source] Shift in the burden of cancer towards older people , a retrospective population-based studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 6 2007S. Ahmad Summary Cancer is age-related. However, oncology and palliative medicine services focus on the needs of younger and middle-aged adults. This study examined trends in cancer deaths across age in Wales over the last 20 years. All Wales death certificates from 1981 to 2001 were examined for total and cancer deaths. Place of death and age were noted. Total deaths decreased from 35 015 in 1981 to 32 966 in 2001 while cancer deaths increased from 7369 (21.1% of all deaths) to 8292 (25.2%). Deaths due to cancer increased in the over 85 years from 9.1% to 13.1%, 75,84 years (17.1,25.2%), 65,74 years (25,35.7%), 45,64 years (33.5,40.4%) and fell from 18.3% to 16.1% in those under 44 years. Cancer deaths over 75 years increased from 33.6% of cancer deaths in 1981 to 50.1% in 2001. Cancer deaths in the community decreased from 2713 in 1981 to 2153 in 2001 and increased in hospital from 4398 to 5185 and care homes from 258 to 954. The increase in hospital cancer deaths is mainly because of 75,84 year olds (1207,1840), and the over 85 years (294,740). Half of all cancer deaths are now in those over 75 years. Cancer deaths have shifted from the community to hospital and care homes mainly because of cancer in older people. Services need to be developed to target this population. [source] | ||||||||||