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2. Interconnectivity between molecular subtypes and tumor stage in colorectal cancer

Author

Coebergh van den Braak, Robert, vander Hoorn, S, Sieuwerts, Anieta, Tuynman, JB, Smid, Marcel, Wilting, Saskia, Martens, John, Punt, CJ, Foekens, John, Medema, JP, IJzermans, J.N.M., Vermeulen, L, Coebergh van den Braak, Robert, vander Hoorn, S, Sieuwerts, Anieta, Tuynman, JB, Smid, Marcel, Wilting, Saskia, Martens, John, Punt, CJ, Foekens, John, Medema, JP, IJzermans, J.N.M., and Vermeulen, L

Published
2020

7. Random errors in the measurement of 10 cardiovascular risk factors

Author

Whitlock, G, Clark, T, Vander Hoorn, S, Rodgers, A, Jackson, R, Norton, R, and MacMahon, S

Abstract

Random errors in the measurement of 10 commonly investigated cardiovascular risk factors (systolic and diastolic blood pressure, blood cholesterol, blood glucose, pulse rate, body mass index (BMI), cigarette consumption, passive smoking, alcohol intake and physical exercise) were assessed in a general population cohort (n = 2517) and a workforce cohort (n = 8008). Random errors were estimated from regression dilution ratios (lower ratios imply greater random error, and a ratio of one implies no random error). All of the risk factors, except for BMI (which had regression dilution ratios of 0.93 and 0.98 in the two cohorts), were measured with substantial levels of random error. Particularly low regression dilution ratios were observed for physical exercise (0.28 and 0.39) and pulse rate (0.47 and 0.56). For each of these risk factors, with the possible exception of BMI, associations with long-term average values could be importantly biased toward the null unless appropriate corrections are made.

Published
2016
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8. The global cardiovascular risk transition: associations of four metabolic risk factors with national income, urbanization, and Western diet in 1980 and 2008

Author

Danaei, G., Singh, G., Paciorek, C., Lin, J., Cowan, M., Finucane, M., Farzadfar, F., Stevens, G., Riley, L., Lu, Y., Rao, M., Ezzati, M., Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt, G., Abdeen, Z., Abdella, N., Rahim, H., Addo, J., Aekplakorn, W., Afifi, M., Agabiti Rosei, E., Aguilar Salinas CA, Agyemang, C., Ali, M., Al Nsour, M., Al Nuaim AR, Ambady, R., Aro, P., Azizi, F., Barbagallo, C., Barbieri, M., Barceló, A., Barreto, S., Barros, H., Bautista, L., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Bontha, B., Botana, M., Bovet, P., Breckenkamp, J., Breteler, M., Broda, G., Brown, I., Bursztyn, M., Cabrera de León, A., Campos, H., Cappuccio, F., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C., Chaouki, N., Chatterji, S., Chen, Z., Chen, C., Choi, J., Chua, L., Cífková, R., Cobiac, L., Cooper, R., Corsi, A., Costanza, M., Craig, C., Dankner, R., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, W., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C., Fan, J., Ferreccio, C., Fezeu, L., Firmo, J., Florez, H., Fornés, N., Fowkes, F., Franceschini, G., Frisk, F., Fuchs, F., Fuller, E., Getz, L., Giampaoli, S., Gómez, L., Gomez Zumaquero JM, Graff Iversen, S., Grant, J., Guerrero Carvajal, R., Gulliford, M., Gupta, R., Gupta, P., Gureje, O., Hansen, T., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W., Herrera, V., Ho, S., Holdsworth, M., Hollman Frisman, G., Hopman, W., Hussain, A., Husseini, A., Ibrahim, M., Ikeda, N., Jacobsen, B., Jaddou, H., Jafar, T., Janghorbani, M., Jasienska, G., Joffres, M., Jonas, J., Kadiki, O., Kalter Leibovici, O., Kamadjeu, R., Karalis, I., Kastarinen, M., Katz, J., Keinan Boker, L., Kelly, P., Khalilzadeh, O., Khang, Y., Kiechl, S., Kim, K., Kiyohara, Y., Kobayashi, J., Krause, M., Kubínová, R., Kurjata, P., Kusuma, Y., Lam, T., Langhammer, A., Lawes, C., Le, C., Lee, J., Lévy Marchal, C., Li, Y., Lim, S., Lim, T., Lin, X., Lin, C., Lin, H., Lind, L., Lissner, L., Liu, X., Lopez Jaramillo, P., Lorbeer, R., Ma, G., Ma, S., Macià, F., Maclean, D., Maggi, S., Magliano, D., Makdisse, M., Mancia, G., Mannami, T., Marques Vidal, P., Mbanya, J., McFarlane Anderson, N., Miccoli, R., Miettola, J., Minh, H., Miquel, J., Miranda, J., Mohamed, M., Mohan, V., Mohanna, S., Mokdad, A., Mollentze, W., Morales, D., Morgan, K., Muiesan, L., Muntoni, S., Nabipour, I., Nakagami, T., Nangia, V., Nemesure, B., Neovius, M., Nerhus, K., Nervi, F., Neuhauser, H., Nguyen, M., Ninomiya, T., Noale, M., Oh, S., Ohkubo, T., Olivieri, O., Önal, A., Onat, A., Oróstegui, M., Ouedraogo, H., Pan, W., Panagiotakos, D., Panza, F., Park, Y., Passos, V., Pednekar, M., Peres, M., Pérez, C., Pérez Fernández, R., Pichardo, R., Phua, H., Pistelli, F., Plans, P., Polakowska, M., Poulter, N., Prabhakaran, D., Qiao, Q., Rafiei, M., Raitakari, O., Ramos, L., Rampal, S., Rampal, L., Rasmussen, F., Reddy, K., Redon, J., Revilla, L., Reyes García, V., Roaeid, R., Rodriguez Artalejo, F., Rojas Martinez, R., Ronkainen, K., Rosero Bixby, L., Roth, G., Sachdev, H., Sánchez, J., Sanisoglu, S., Sans, S., Sarraf Zadegan, N., Scazufca, M., Schaan, B., Schapochnik, N., Schelleman, H., Schneider, I., Schooling, C., Schwarz, B., Sekuri, C., Sereday, M., Serra Majem, L., Shaw, J., Shera, A., Shi, Z., Shiri, R., Shu, X., Silva, D., Silva, E., Simons, L., Smith, M., Söderberg, S., Soebardi, S., Solfrizzi, V., Sonestedt, E., Soysal, A., Stattin, P., Stein, A., Stergiou, G., Stessman, J., Sudo, A., Suka, M., Sundh, V., Sundquist, K., Sundström, J., Swai, A., Tai, E., Tambs, K., Tesfaye, F., Thomas, G., Thorogood, M., Tilvis, R., Tobias, M., Torheim, L., Trenkwalder, P., Tuomilehto, J., Tur, J., Tzourio, C., Uhernik, A., Ukoli, F., Unwin, N., Vander Hoorn, S., Vanderpump, M., Varo, J., Veierød, B., Velásquez Meléndez, G., Verschuren, M., Viet, L., Villalpando, S., Vioque, J., Vollenweider, P., Volpato, S., Wang, N., Wang, Y., Ward, M., Waspadji, S., Welin, L., Wilhelmsen, L., Willeit, J., Woodward, M., Xavier, A., Xu, F., Xu, L., Yamamoto, A., Yang, G., Yang, X., Yeh, L., Yoon, J., You, Q., Yu, Z., Zhang, J., Zhang, L., Zheng, W., Zhou, M., Danaei G, Singh GM, Paciorek CJ, Lin JK, Cowan MJ, Finucane MM, Farzadfar F, Stevens GA, Riley LM, Lu Y, Rao M, Ezzati M and Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group, Aamodt G, Abdeen Z, Abdella NA, Rahim HF, Addo J, Aekplakorn W, Afifi MM, Agabiti-Rosei E, Aguilar Salinas CA, Agyemang C, Ali MM, Al-Nsour M, Al-Nuaim AR, Ambady R, Aro P, Azizi F, Barbagallo CM, Barbieri MA, Barceló A, Barreto SM, Barros H, Bautista LE, Benetos A, Bjerregaard P, Björkelund C, Bo S, Bobak M, Bonora E, Bontha BV, Botana MA, Bovet P, Breckenkamp J, Breteler MM, Broda G, Brown IJ, Bursztyn M, Cabrera de León A, Campos H, Cappuccio FP, Capuano V, Casiglia E, Castellano M, Castetbon K, Cea L, Chang CJ, Chaouki N, Chatterji S, Chen Z, Chen CJ, Choi JS, Chua L, Cífková R, Cobiac LJ, Cooper RS, Corsi AM, Costanza MC, Craig CL, Dankner RS, Dastgiri S, Delgado E, Dinc G, Doi Y, Dong GH, Dorsi E, Dragano N, Drewnowski A, Eggertsen W, Elliott P, Engeland A, Erem C, Esteghamati A, Fall CH, Fan JG, Ferreccio C, Fezeu L, Firmo JO, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Fuchs FD, Fuller EL, Getz L, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff-Iversen S, Grant JF, Guerrero Carvajal R, Gulliford MC, Gupta R, Gupta PC, Gureje O, Hansen TW, Hata J, He J, Heim N, Heinrich J, Hemmingsson T, Hennis A, Herman WH, Herrera VM, Ho S, Holdsworth M, Hollman Frisman G, Hopman WM, Hussain A, Husseini A, Ibrahim M, Ikeda N, Jacobsen BK, Jaddou HY, Jafar TH, Janghorbani M, Jasienska G, Joffres MR, Jonas JB, Kadiki OA, Kalter-Leibovici O, Kamadjeu RM, Karalis I, Kastarinen MJ, Katz J, Keinan-Boker L, Kelly P, Khalilzadeh O, Khang YH, Kiechl S, Kim KW, Kiyohara Y, Kobayashi J, Krause MP, Kubínová R, Kurjata P, Kusuma YS, Lam TH, Langhammer A, Lawes CM, Le C, Lee J, Lévy-Marchal C, Li Y, Lim S, Lim TO, Lin X, Lin CC, Lin HH, Lind L, Lissner L, Liu X, Lopez-Jaramillo P, Lorbeer R, Ma G, Ma S, Macià F, MacLean DR, Maggi S, Magliano DJ, Makdisse M, Mancia G, Mannami T, Marques-Vidal P, Mbanya JC, McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, Miranda J, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Önal AE, Onat A, Oróstegui M, Ouedraogo H, Pan WH, Panagiotakos DB, Panza F, Park Y, Passos VM, Pednekar MS, Peres MA, Pérez C, Pérez-Fernández R, Pichardo R, Phua HP, Pistelli F, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KK, Redon J, Revilla L, Reyes-García V, Roaeid RB, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sánchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJ, Schooling C, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Silva DA, Silva E, Simons LA, Smith M, Söderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, Stattin P, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundström J, Swai AB, Tai E, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik AI, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierød B, Velásquez-Meléndez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Wilhelmsen L, Willeit J, Woodward M, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh LC, Yoon JS, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, ACS - Amsterdam Cardiovascular Sciences, APH - Amsterdam Public Health, and Public and occupational health

Subjects
Gerontology, Adult, Male, Risk, medicine.medical_specialty, Settore MED/09 - Medicina Interna, Measures of national income and output, Population, Hypercholesterolemia, OBESIDADE, Blood Pressure, Global Health, Body Mass Index, Age Distribution, Risk Factors, cardiovascular disease, Physiology (medical), Diabetes mellitus, risk factors, Epidemiology, medicine, Diabetes Mellitus, Humans, Obesity, Risk factor, Sex Distribution, education, Developing Countries, Cholesterolo, education.field_of_study, business.industry, Urbanization, Feeding Behavior, Middle Aged, medicine.disease, Blood pressure, Cholesterol, Socioeconomic Factors, Cardiovascular Diseases, Hypertension, Western World, Female, Cardiology and Cardiovascular Medicine, business, Body mass index, Demography
Abstract

Background— It is commonly assumed that cardiovascular disease risk factors are associated with affluence and Westernization. We investigated the associations of body mass index (BMI), fasting plasma glucose, systolic blood pressure, and serum total cholesterol with national income, Western diet, and, for BMI, urbanization in 1980 and 2008. Methods and Results— Country-level risk factor estimates for 199 countries between 1980 and 2008 were from a previous systematic analysis of population-based data. We analyzed the associations between risk factors and per capita national income, a measure of Western diet, and, for BMI, the percentage of the population living in urban areas. In 1980, there was a positive association between national income and population mean BMI, systolic blood pressure, and total cholesterol. By 2008, the slope of the association between national income and systolic blood pressure became negative for women and zero for men. Total cholesterol was associated with national income and Western diet in both 1980 and 2008. In 1980, BMI rose with national income and then flattened at ≈Int$7000; by 2008, the relationship resembled an inverted U for women, peaking at middle-income levels. BMI had a positive relationship with the percentage of urban population in both 1980 and 2008. Fasting plasma glucose had weaker associations with these country macro characteristics, but it was positively associated with BMI. Conclusions— The changing associations of metabolic risk factors with macroeconomic variables indicate that there will be a global pandemic of hyperglycemia and diabetes mellitus, together with high blood pressure in low-income countries, unless effective lifestyle and pharmacological interventions are implemented.

Published
2013

9. National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3·0 million participants

Author

Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, Ezzati M, Salinas CA, Al Nsour M, Ali MM, Al Nuaim AR, Ambady R, Antonio M, Azizi F, Barbieri M, Barros H, Bautista LE, Bjerregaard P, Björkelund C, Bovet P, Brekenkamp J, Bursztyn M, de León AC, Campos H, Capuano V, Castetbon K, Chang CJ, Chen CJ, Choi JS, Chua L, Cífková R, Costanza MC, Eggertsen RW, Esteghamati A, Fan JG, Ferreccio C, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Giampaoli S, Gómez LF, Gomez Zumaquero JM, Graff Iversen S, Carvajal RG, Gupta R, Hansen TW, Hata J, He J, Herrera VM, Ho SC, Frisman GH, Ikeda N, Jaddou HY, Jafar TH, Janghorbani M, Joffres MR, Jonas JB, Kadiki OA, Karalis I, Kastarinen MJ, Katz J, Khalilzadeh O, Khang YH, Kiechl S, Kobayashi J, Kubínová R, Lam TH, Lawes CM, Lee J, Lim S, Lin HH, Lin X, Lin CC, Ma S, MacLean DR, Magliano DJ, Mannami T, Marques Vidal P, Miettola J, Miquel JF, Miranda JJ, Mohamed MK, Mohan V, Mokdad A, Mollentze WF, Morales DD, Muiesan LM, Nabipour I, Nangia V, Nerhus KA, Neuhauser H, Oh SW, Ohkubo T, Onat A, Oróstegui M, Pan WH, Panagiotakos DB, Panza F, Passos VM, Pérez C, Pichardo R, Phua HP, Polakowska M, Rafiei M, Ramos LR, Reddy KK, Redon J, Revilla L, Roaeid RB, Ronkainen K, Roth GA, Sanisoglu SY, Sarraf Zadegan N, Schooling CM, Schwarz B, Silva E, Simons LA, Solfrizzi V, Stein AD, Stessman J, Suka M, Swai AB, Tai ES, Thomas GN, Thorogood M, Tuomilehto JO, Unwin N, Vander Hoorn S, Vanderpump MP, Volpato S, Welin LX, Willeit J, Woodward M, Xu L, Yamamoto A, Yang X, Yeh LC, Yoon JS, You Q, Zhang J., BARBAGALLO, Carlo Maria, and Farzadfar F, Finucane MM, Danaei G, Pelizzari PM, Cowan MJ, Paciorek CJ, Singh GM, Lin JK, Stevens GA, Riley LM, Ezzati M, Salinas CA, Al Nsour M, Ali MM, Al-Nuaim AR, Ambady R, Antonio M, Azizi F, Barbagallo CM, Barbieri M, Barros H, Bautista LE, Bjerregaard P, Björkelund C, Bovet P, Brekenkamp J, Bursztyn M, de León AC, Campos H, Capuano V, Castetbon K, Chang CJ, Chen CJ, Choi JS, Chua L, Cífková R, Costanza MC, Eggertsen RW, Esteghamati A, Fan JG, Ferreccio C, Florez HJ, Fornés NS, Fowkes FG, Franceschini G, Frisk F, Giampaoli S, Gómez LF, Gomez-Zumaquero JM, Graff -Iversen S, Carvajal RG, Gupta R, Hansen TW, Hata J, He J, Herrera VM, Ho SC, Frisman GH, Ikeda N, Jaddou HY, Jafar TH, Janghorbani M, Joffres MR, Jonas JB, Kadiki OA, Karalis I, Kastarinen MJ, Katz J, Khalilzadeh O, Khang YH, Kiechl S, Kobayashi J, Kubínová R, Lam TH, Lawes CM, Lee J, Lim S, Lin HH, Lin X, Lin CC, Ma S, MacLean DR, Magliano DJ, Mannami T, Marques-Vidal P, Miettola J, Miquel JF, Miranda JJ, Mohamed MK, Mohan V, Mokdad A, Mollentze WF, Morales DD, Muiesan LM, Nabipour I, Nangia V, Nerhus KA, Neuhauser H, Oh SW, Ohkubo T, Onat A, Oróstegui M, Pan WH, Panagiotakos DB, Panza F, Passos VM, Pérez C, Pichardo R, Phua HP, Polakowska M, Rafiei M, Ramos LR, Reddy KK, Redon J, Revilla L, Roaeid RB, Ronkainen K, Roth GA, Sanisoglu SY, Sarraf-Zadegan N, Schooling CM, Schwarz B, Silva E, Simons LA, Solfrizzi V, Stein AD, Stessman J, Suka M, Swai AB, Tai ES, Thomas GN, Thorogood M, Tuomilehto JO, Unwin N, Vander Hoorn S, Vanderpump MP, Volpato S, Welin LX, Willeit J, Woodward M, Xu L, Yamamoto A, Yang X, Yeh LC, Yoon JS, You Q, Zhang J.

Subjects
Gerontology, Adult, Male, medicine.medical_specialty, Uncertainty interval, Population, Hypercholesterolemia, Socioeconomic Factor, Global Health, Southeast asia, Nutrition Policy, Health examination, blood, Total cholesterol, Epidemiology, Global health, Medicine, Humans, education, education.field_of_study, business.industry, Population mean, Bayes Theorem, General Medicine, Health Survey, Health Surveys, Adult, Bayes Theorem, Cholesterol, blood, Female, Health Surveys, Humans, Hypercholesterolemia, drug therapy, Income, Male, Nutrition Policy, Socioeconomic Factors, World Health, drug therapy, Cholesterol, Socioeconomic Factors, World Health, Income, lipids (amino acids, peptides, and proteins), Female, business, Demography, Human
Abstract

Summary Background Data for trends in serum cholesterol are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants; set intervention priorities; and evaluate national programmes. Previous analyses of trends in serum cholesterol were limited to a few countries, with no consistent and comparable global analysis. We estimated worldwide trends in population mean serum total cholesterol. Methods We estimated trends and their uncertainties in mean serum total cholesterol for adults 25 years and older in 199 countries and territories. We obtained data from published and unpublished health examination surveys and epidemiological studies (321 country-years and 3·0 million participants). For each sex, we used a Bayesian hierarchical model to estimate mean total cholesterol by age, country, and year, accounting for whether a study was nationally representative. Findings In 2008, age-standardised mean total cholesterol worldwide was 4·64 mmol/L (95% uncertainty interval 4·51–4·76) for men and 4·76 mmol/L (4·62–4·91) for women. Globally, mean total cholesterol changed little between 1980 and 2008, falling by less than 0·1 mmol/L per decade in men and women. Total cholesterol fell in the high-income region consisting of Australasia, North America, and western Europe, and in central and eastern Europe; the regional declines were about 0·2 mmol/L per decade for both sexes, with posterior probabilities of these being true declines 0·99 or greater. Mean total cholesterol increased in east and southeast Asia and Pacific by 0·08 mmol/L per decade (−0·06 to 0·22, posterior probability=0·86) in men and 0·09 mmol/L per decade (−0·07 to 0·26, posterior probability=0·86) in women. Despite converging trends, serum total cholesterol in 2008 was highest in the high-income region consisting of Australasia, North America, and western Europe; the regional mean was 5·24 mmol/L (5·08–5·39) for men and 5·23 mmol/L (5·03–5·43) for women. It was lowest in sub-Saharan Africa at 4·08 mmol/L (3·82–4·34) for men and 4·27 mmol/L (3·99–4·56) for women. Interpretation Nutritional policies and pharmacological interventions should be used to accelerate improvements in total cholesterol in regions with decline and to curb or prevent the rise in Asian populations and elsewhere. Population-based surveillance of cholesterol needs to be improved in low-income and middle-income countries. Funding Bill & Melinda Gates Foundation and WHO.

Published
2011
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11. Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting

Author

Meng, Z, Newman, L, Rowley, J, Vander Hoorn, S, Wijesooriya, NS, Unemo, M, Low, N, Stevens, G, Gottlieb, S, Kiarie, J, Temmerman, M, Meng, Z, Newman, L, Rowley, J, Vander Hoorn, S, Wijesooriya, NS, Unemo, M, Low, N, Stevens, G, Gottlieb, S, Kiarie, J, and Temmerman, M

Abstract

BACKGROUND: Quantifying sexually transmitted infection (STI) prevalence and incidence is important for planning interventions and advocating for resources. The World Health Organization (WHO) periodically estimates global and regional prevalence and incidence of four curable STIs: chlamydia, gonorrhoea, trichomoniasis and syphilis. METHODS AND FINDINGS: WHO's 2012 estimates were based upon literature reviews of prevalence data from 2005 through 2012 among general populations for genitourinary infection with chlamydia, gonorrhoea, and trichomoniasis, and nationally reported data on syphilis seroprevalence among antenatal care attendees. Data were standardized for laboratory test type, geography, age, and high risk subpopulations, and combined using a Bayesian meta-analytic approach. Regional incidence estimates were generated from prevalence estimates by adjusting for average duration of infection. In 2012, among women aged 15-49 years, the estimated global prevalence of chlamydia was 4.2% (95% uncertainty interval (UI): 3.7-4.7%), gonorrhoea 0.8% (0.6-1.0%), trichomoniasis 5.0% (4.0-6.4%), and syphilis 0.5% (0.4-0.6%); among men, estimated chlamydia prevalence was 2.7% (2.0-3.6%), gonorrhoea 0.6% (0.4-0.9%), trichomoniasis 0.6% (0.4-0.8%), and syphilis 0.48% (0.3-0.7%). These figures correspond to an estimated 131 million new cases of chlamydia (100-166 million), 78 million of gonorrhoea (53-110 million), 143 million of trichomoniasis (98-202 million), and 6 million of syphilis (4-8 million). Prevalence and incidence estimates varied by region and sex. CONCLUSIONS: Estimates of the global prevalence and incidence of chlamydia, gonorrhoea, trichomoniasis, and syphilis in adult women and men remain high, with nearly one million new infections with curable STI each day. The estimates highlight the urgent need for the public health community to ensure that well-recognized effective interventions for STI prevention, screening, diagnosis, and treatment are made more widel

Published
2015

12. Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Cholesterol). National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321country-years and 3·0 million participants

Author

Farzadfar, F, Finucane, Mm, Danaei, G, Pelizzari, Pm, Cowan, Mj, Paciorek, Cj, Singh, Gm, Lin, Jk, Stevens, Ga, Riley, Lm, collaborators Farzadfar F, Ezzati M., Ezzati, M, Salinas, Ca, Al Nsour, M, Ali, Mm, Al Nuaim AR, Ambady, R, Antonio, M, Azizi, F, Barbagallo, Cm, Barbieri, M, Barros, H, Bautista, Le, Bjerregaard, P, Björkelund, C, Bovet, P, Brekenkamp, J, Bursztyn, M, de León AC, Campos, H, Capuano, V, Castetbon, K, Chang, Cj, Chen, Cj, Choi, Js, Chua, L, Cífková, R, Costanza, Mc, Eggertsen, Rw, Esteghamati, A, Fan, Jg, Ferreccio, C, Florez, Hj, Fornés, Ns, Fowkes, Fg, Franceschini, G, Frisk, F, Giampaoli, S, Gómez, Lf, Gomez Zumaquero JM, Graff Iversen, S, Carvajal, Rg, Gupta, R, Hansen, Tw, Hata, J, He, J, Herrera, Vm, Ho, Sc, Frisman, Gh, Ikeda, N, Jaddou, Hy, Jafar, Th, Janghorbani, M, Joffres, Mr, Jonas, Jb, Kadiki, Oa, Karalis, I, Kastarinen, Mj, Katz, J, Khalilzadeh, O, Khang, Yh, Kiechl, S, Kobayashi, J, Kubínová, R, Lam, Th, Lawes, Cm, Lee, J, Lim, S, Lin, Hh, Lin, X, Lin, Cc, Ma, S, Maclean, Dr, Magliano, Dj, Mannami, T, Marques Vidal, P, Miettola, J, Miquel, Jf, Miranda, Jj, Mohamed, Mk, Mohan, V, Mokdad, A, Mollentze, Wf, Morales, Dd, Muiesan, Maria Lorenza, Nabipour, I, Nangia, V, Nerhus, Ka, Neuhauser, H, Oh, Sw, Ohkubo, T, Onat, A, Oróstegui, M, Pan, Wh, Panagiotakos, Db, Panza, F, Passos, Vm, Pérez, C, Pichardo, R, Phua, Hp, Polakowska, M, Rafiei, M, Ramos, Lr, Reddy, Kk, Redon, J, Revilla, L, Roaeid, Rb, Ronkainen, K, Roth, Ga, Sanisoglu, Sy, Sarraf Zadegan, N, Schooling, Cm, Schwarz, B, Silva, E, Simons, La, Solfrizzi, V, Stein, Ad, Stessman, J, Suka, M, Swai, Ab, Tai, Es, Thomas, Gn, Thorogood, M, Tuomilehto, Jo, Unwin, N, Vander Hoorn, S, Vanderpump, Mp, Volpato, S, Welin, Lx, Willeit, J, Woodward, M, Xu, L, Yamamoto, A, Yang, X, Yeh, Lc, Yoon, Js, You, Q, and Zhang, J.

Published
2011

13. An international randomised placebo-controlled trial of a four-component combination pill ('polypill') in people with raised cardiovascular risk

Author

PILL Collaborative Group, Rodgers A, Patel A, Berwanger O, Bots M, Grimm R, Grobbee DE, Jackson R, Neal B, Neaton J, Poulter N, Rafter N, Raju PK, Reddy S, Thom S, Vander Hoorn S, and Webster R

Subjects
Risk, Adult, Male, Internationality, Adolescent, General Science & Technology, Cardiovascular Agents, Blood Pressure, Middle Aged, Placebos, Drug Combinations, Young Adult, Cholesterol, Cardiovascular Diseases, Humans, Female, Aged
Abstract

BACKGROUND:There has been widespread interest in the potential of combination cardiovascular medications containing aspirin and agents to lower blood pressure and cholesterol ('polypills') to reduce cardiovascular disease. However, no reliable placebo-controlled data are available on both efficacy and tolerability. METHODS:We conducted a randomised, double-blind placebo-controlled trial of a polypill (containing aspirin 75 mg, lisinopril 10 mg, hydrochlorothiazide 12.5 mg and simvastatin 20 mg) in 378 individuals without an indication for any component of the polypill, but who had an estimated 5-year cardiovascular disease risk over 7.5%. The primary outcomes were systolic blood pressure (SBP), LDL-cholesterol and tolerability (proportion discontinued randomised therapy) at 12 weeks follow-up. FINDINGS:At baseline, mean BP was 134/81 mmHg and mean LDL-cholesterol was 3.7 mmol/L. Over 12 weeks, polypill treatment reduced SBP by 9.9 (95% CI: 7.7 to 12.1) mmHg and LDL-cholesterol by 0.8 (95% CI 0.6 to 0.9) mmol/L. The discontinuation rates in the polypill group compared to placebo were 23% vs 18% (RR 1.33, 95% CI 0.89 to 2.00, p = 0.2). There was an excess of side effects known to the component medicines (58% vs 42%, p = 0.001), which was mostly apparent within a few weeks, and usually did not warrant cessation of trial treatment. CONCLUSIONS:This polypill achieved sizeable reductions in SBP and LDL-cholesterol but caused side effects in about 1 in 6 people. The halving in predicted cardiovascular risk is moderately lower than previous estimates and the side effect rate is moderately higher. Nonetheless, substantial net benefits would be expected among patients at high risk. TRIAL REGISTRATION:Australian New Zealand Clinical Trials Registry ACTRN12607000099426.

Published
2011

14. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and5·4 million participants

Author

Danaei, G, Finucane, Mm, Lin, Jk, Singh, Gm, Paciorek, Cj, Cowan, Mj, Farzadfar, F, Stevens, Ga, Lim, Ss, Riley, Lm, Ezzati, M, Abdeen, Z, Agyemang, C, Al Nsour, M, Ali, Mm, Ambady, R, Babu, Bv, Barbagallo, Cm, Barceló, A, Barreto, S, Barros, H, Bautista, Le, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León, Ac, Casiglia, E, Castetbon, K, Chatterji, S, Chen, Z, Chen, Cj, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Dankner, Rs, Dong, Gh, Elliott, P, Erem, C, Esteghamati, A, Fan, Jg, Ferreccio, C, Firmo, Jo, Fornés, Ns, Fuchs, Fd, Getz, L, Giampaoli, S, Gómez, Lf, Graff Iversen, S, Carvajal, Rg, Gulliford, Mc, Gupta, P, Gureje, O, Hansen, Tw, He, J, Heinrich, J, Hennis, A, Herrera, Vm, Sc, Ho, Ibrahim, Mm, Ikeda, N, Jafar, Th, Joffres, Mr, Jonas, Jb, Kamadjeu, Rm, Karalis, I, Kastarinen, Mj, Katz, J, Kelly, P, Khalilzadeh, O, Khang, Yh, Kiechl, S, Kim, Kw, Kobayashi, J, Kubínová, R, Kusuma, Ys, Lam, Th, Lawes, Cm, Le, C, Lee, J, Lin, X, Lin, Hh, Lin, Cc, Liu, X, Lorbeer, R, Ma, S, Ma, G, Magliano, Dj, Makdisse, M, Mancia, G, Mbanya, Jc, Miettola, J, Minh, Hv, Miranda, Jj, Mohamed, Mk, Mohan, V, Mokdad, Ah, Morales, Dd, Morgan, K, Muiesan, Maria Lorenza, Muntoni, S, Nabipour, I, Nangia, V, Neuhauser, H, Ninomiya, T, Olivieri, O, Onal, Ae, Onat, A, Oróstegui, M, Panagiotakos, Db, Panza, F, Pednekar, Ms, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Plans, P, Poulter, N, Raitakari, Ot, Rampal, S, Rampal, L, Redon, J, Revilla, L, Roaeid, Rb, Rojas Martinez, R, Sanisoglu, Sy, Sans, S, Schelleman, H, Schneider, Ij, Silva, Da, Silva, E, Simons, La, Smith, M, Soebardi, S, Solfrizzi, V, Stein, Ad, Stergiou, Gs, Stessman, J, Suka, M, Tambs, K, Tesfaye, F, Thorogood, M, Tilvis, Rs, Trenkwalder, P, Tuomilehto, Jo, Tzourio, C, Vander Hoorn, S, Vanderpump, Mp, Verschuren, M, Vioque, J, Waspadji, S, Wilhelmsen, L, Willeit, J, Woodward, M, Xavier, Aj, Xu, L, Yang, G, Yeh, Lc, Yoon, Js, You, Q, and Zhou, M.

Subjects
Blood Pressure, Epidemiology, Epidemiology, Blood Pressure
Published
2011

15. National, regional, and global trends in systolic blood pressure since 1980: systematic analysis of health examination surveys and epidemiological studies with 786 country-years and 5•4 million participants

Author

Danaei, G, Finucane, Mm, Lin, Jk, Singh, Gm, Cowan, Mj, Paciorek, Cj, Farzadfar, F, Stevens, Ga, Riley, Lm, Ezzati, M, Abdeen, Z, Agyemang, C, Al Nsour, M, Ali, Mm, Ambady, R, Babu, Bv, Barbagallo, Cm, Barceló, A, Barreto, S, Barros, H, Bautista, Le, Bjerregaard, P, Björkelund, C, Bo, Simona, Bobak, M, Bonora, E, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León AC, Casiglia, E, Castetbon, K, Chatterji, S, Chen, Z, Chen, Cj, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Dankner, Rs, Dong, Gh, Elliott, P, Erem, C, Esteghamati, A, Fan, Jg, Ferreccio, C, Firmo, Jo, Fornés, Ns, Fuchs, Fd, Getz, L, Giampaoli, S, Gómez, Lf, Graff Iversen, S, Carvajal, Rg, Gulliford, Mc, Gupta, P, Gureje, O, Hansen, Tw, He, J, Heinrich, J, Hennis, A, Herrera, Vm, Ho, Sc, Ibrahim, Mm, Ikeda, N, Jafar, Th, Joffres, Mr, Jonas, Jb, Kamadjeu, Rm, Karalis, I, Kastarinen, Mj, Katz, J, Kelly, P, Khalilzadeh, O, Khang, Yh, Kiechl, S, Kim, Kw, Kobayashi, J, Kubínová, R, Kusuma, Ys, Lam, Th, Lawes, Cm, Le, C, Lee, J, Lin, X, Lin, Hh, Lin, Cc, Liu, X, Lorbeer, R, Ma, S, Ma, G, Magliano, Dj, Makdisse, M, Mancia, G, Mbanya, Jc, Miettola, J, Minh, Hv, Miranda, Jj, Mohamed, Mk, Mohan, V, Mokdad, Ah, Morales, Dd, Morgan, K, Muiesan, Lm, Muntoni, S, Nabipour, I, Nangia, V, Neuhauser, H, Ninomiya, T, Olivieri, O, Onal, Ae, Onat, A, Oróstegui, M, Panagiotakos, Db, Panza, F, Pednekar, Ms, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Plans, P, Poulter, N, Raitakari, Ot, Rampal, S, Rampal, L, Redon, J, Revilla, L, Roaeid, Rb, Rojas Martinez, R, Sanisoglu, Sy, Sans, S, Schelleman, H, Schneider, Ij, Silva, Da, Silva, E, Simons, La, Smith, M, Soebardi, S, Solfrizzi, V, Stein, Ad, Stergiou, Gs, Stessman, J, Suka, M, Tambs, K, Tesfaye, F, Thorogood, M, Tilvis, Rs, Trenkwalder, P, Tuomilehto, Jo, Tzourio, C, Vander Hoorn, S, Vanderpump, Mp, Verschuren, M, Vioque, J, Waspadji, S, Wilhelmsen, L, Willeit, J, Woodward, M, Xavier, Aj, Xu, L, Yang, G, Yeh, Lc, Yoon, Js, You, Q, and Zhou, M.

Published
2011

16. Risk of death or hospital admission among community-dwelling older adults living with dementia in Australia

Author

You, EC, Dunt, DR, White, V, Vander Hoorn, S, Doyle, C, You, EC, Dunt, DR, White, V, Vander Hoorn, S, and Doyle, C

Abstract

BACKGROUND: Older people living with dementia prefer to stay at home to receive support. But they are at high risk of death and/or hospital admissions. This study primarily aimed to determine risk factors for time to death or hospital admission (combined) in a sample of community-dwelling older people living with dementia in Australia. As a secondary study purpose, risk factors for time to death were also examined. METHODS: This study used the data of a previous project which had been implemented during September 2007 and February 2009. The original project had recruited 354 eligible clients (aged 70 and over, and living with dementia) for Extended Aged Care At home Dementia program services during September 2007 and 2008. Client information and carer stress had been collected from their case managers through a baseline survey and three-monthly follow-up surveys (up to four in total). The principal data collection tools included Global Deterioration Scale, Modified Barthel Index, Instrumental-Dependency OARS, Adapted Cohen-Mansfield Agitation Inventory, as well as measures of clients' socio-demographic characteristics, service use and diseases diagnoses. The sample of our study included 284 clients with at least one follow-up survey. The outcome variable was death or hospital admission, and death during six, nine and 16-month study periods. Stepwise backwards multivariate Cox proportional hazards analysis was employed, and Kaplan-Meier survival analysis using censored data was displayed. RESULTS: Having previous hospital admissions was a consistent risk factor for time to death or hospital admission (six-month: HR = 3.12; nine-month: HR = 2.80; 16-month: HR = 2.93) and for time to death (six-month: HR = 2.27; 16-month: HR = 2.12) over time. Previously worse cognitive status was a consistent risk factor over time (six- and nine-month: HR = 0.58; 16-month: HR = 0.65), but no previous use of community care was only a short-term risk factor (six-month: HR = 0.42) for ti

Published
2014

18. The Age-Specific Quantitative Effects of Metabolic Risk Factors on Cardiovascular Diseases and Diabetes: A Pooled Analysis

Author

Wang, G, Singh, GM, Danaei, G, Farzadfar, F, Stevens, GA, Woodward, M, Wormser, D, Kaptoge, S, Whitlock, G, Qiao, Q, Lewington, S, Di Angelantonio, E, vander Hoorn, S, Lawes, CMM, Ali, MK, Mozaffarian, D, Ezzati, M, Wang, G, Singh, GM, Danaei, G, Farzadfar, F, Stevens, GA, Woodward, M, Wormser, D, Kaptoge, S, Whitlock, G, Qiao, Q, Lewington, S, Di Angelantonio, E, vander Hoorn, S, Lawes, CMM, Ali, MK, Mozaffarian, D, and Ezzati, M

Abstract

BACKGROUND: The effects of systolic blood pressure (SBP), serum total cholesterol (TC), fasting plasma glucose (FPG), and body mass index (BMI) on the risk of cardiovascular diseases (CVD) have been established in epidemiological studies, but consistent estimates of effect sizes by age and sex are not available. METHODS: We reviewed large cohort pooling projects, evaluating effects of baseline or usual exposure to metabolic risks on ischemic heart disease (IHD), hypertensive heart disease (HHD), stroke, diabetes, and, as relevant selected other CVDs, after adjusting for important confounders. We pooled all data to estimate relative risks (RRs) for each risk factor and examined effect modification by age or other factors, using random effects models. RESULTS: Across all risk factors, an average of 123 cohorts provided data on 1.4 million individuals and 52,000 CVD events. Each metabolic risk factor was robustly related to CVD. At the baseline age of 55-64 years, the RR for 10 mmHg higher SBP was largest for HHD (2.16; 95% CI 2.09-2.24), followed by effects on both stroke subtypes (1.66; 1.39-1.98 for hemorrhagic stroke and 1.63; 1.57-1.69 for ischemic stroke). In the same age group, RRs for 1 mmol/L higher TC were 1.44 (1.29-1.61) for IHD and 1.20 (1.15-1.25) for ischemic stroke. The RRs for 5 kg/m(2) higher BMI for ages 55-64 ranged from 2.32 (2.04-2.63) for diabetes, to 1.44 (1.40-1.48) for IHD. For 1 mmol/L higher FPG, RRs in this age group were 1.18 (1.08-1.29) for IHD and 1.14 (1.01-1.29) for total stroke. For all risk factors, proportional effects declined with age, were generally consistent by sex, and differed by region in only a few age groups for certain risk factor-disease pairs. CONCLUSION: Our results provide robust, comparable and precise estimates of the effects of major metabolic risk factors on CVD and diabetes by age group.

Published
2013

19. Exercise rehabilitation for patients with critical illness: a randomized controlled trial with 12 months of follow-up

Author

Denehy, L, Skinner, EH, Edbrooke, L, Haines, K, Warrillow, S, Hawthorne, G, Gough, K, Vander Hoorn, S, Morris, ME, Berney, S, Denehy, L, Skinner, EH, Edbrooke, L, Haines, K, Warrillow, S, Hawthorne, G, Gough, K, Vander Hoorn, S, Morris, ME, and Berney, S

Abstract

INTRODUCTION: The purpose of this trial was to investigate the effectiveness of an exercise rehabilitation program commencing during ICU admission and continuing into the outpatient setting compared with usual care on physical function and health-related quality of life in ICU survivors. METHODS: We conducted a single-center, assessor-blinded, randomized controlled trial. One hundred and fifty participants were stratified and randomized to receive usual care or intervention if they were in the ICU for 5 days or more and had no permanent neurological insult. The intervention group received intensive exercises in the ICU and the ward and as outpatients. Participants were assessed at recruitment, ICU admission, hospital discharge and at 3-, 6- and 12-month follow-up. Physical function was evaluated using the Six-Minute Walk Test (6MWT) (primary outcome), the Timed Up and Go Test and the Physical Function in ICU Test. Patient-reported outcomes were measured using the Short Form 36 Health Survey, version 2 (SF-36v2) and Assessment of Quality of Life (AQoL) Instrument. Data were analyzed using mixed models. RESULTS: The a priori enrollment goal was not reached. There were no between-group differences in demographic and hospital data, including acuity and length of acute hospital stay (LOS) (Acute Physiology and Chronic Health Evaluation II score: 21 vs 19; hospital LOS: 20 vs 24 days). No significant differences were found for the primary outcome of 6MWT or any other outcomes at 12 months after ICU discharge. However, exploratory analyses showed the rate of change over time and mean between-group differences in 6MWT from first assessment were greater in the intervention group. CONCLUSIONS: Further research examining the trajectory of improvement with rehabilitation is warranted in this population. TRIAL REGISTRATION: The trial was registered with the Australian New Zealand Clinical Trials Registry ACTRN12605000776606.

Published
2013

20. Mortality after hip fracture: regional variations in New Zealand

Author

Walker N, Norton R, Vander Hoorn S, Rodgers A, MacMahon S, Taane Clark, and Gray H

Subjects
Aged, 80 and over, Male, Age Distribution, Logistic Models, Residence Characteristics, Odds Ratio, Humans, Female, Middle Aged, Sex Distribution, Aged, Femoral Neck Fractures, New Zealand
Abstract

To determine the 35-day and one-year mortality rates following a hospital admission for hip fracture, among individuals aged 60 years or older in New Zealand.New Zealand Health Information Service mortality data for the years 1988 to 1992 were examined to determine the case fatality rate among individuals aged 60 years or older admitted to hospital for fractures of the neck of femur (ICD-9 N-code 820). Case fatality rates assessed at 35 days and one year after admission to hospital were examined by age, gender, year of admission, place of residence, area health board region and cause of death.Between 1988 and 1992, the case fatality rate was 8% within 35 days of admission to hospital and 24% within one year of admission. Case fatality rates were found to be twice as high in men compared to women and four to five times higher in individuals aged 85 years and older, compared to people aged between 60 and 64 years. The only regional difference in hip fracture mortality was found in the Canterbury area health board region, which had a 30% higher rate of hip fracture mortality compared to all regions combined. The two main cited underlying causes of death after hip fracture were accidental falls (ICD E880-E888) and ischaemic heart disease (ICD 410-414).Over three-quarters of individuals aged 60 years or older who are hospitalised with a hip fracture in New Zealand survive for at least one year after admission. However, significant variations in mortality exist with age and gender. These data highlight the importance of preventive strategies for hip fracture in older people and the need to identify ways of improving post-admission care.

Published
1999

21. Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study

Author

Maddison, R, Foley, L, Ni Mhurchu, C, Jull, A, Jiang, Y, Prapavessis, H, Rodgers, A, Vander Hoorn, S, Hohepa, M, Schaaf, D, Maddison, R, Foley, L, Ni Mhurchu, C, Jull, A, Jiang, Y, Prapavessis, H, Rodgers, A, Vander Hoorn, S, Hohepa, M, and Schaaf, D

Abstract

Background: Childhood obesity has reached epidemic proportions in developed countries. Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity. Active video games, where players physically interact with images onscreen, may have utility as a novel intervention to increase physical activity and improve body composition in children. The aim of the Electronic Games to Aid Motivation to Exercise (eGAME) study is to determine the effects of an active video game intervention over 6 months on: body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels in overweight children. Methods/Design: Three hundred and thirty participants aged 10-14 years will be randomized to receive either an active video game upgrade package or to a control group (no intervention). Discussion: An overview of the eGAME study is presented, providing an example of a large, pragmatic randomized controlled trial in a community setting. Reflection is offered on key issues encountered during the course of the study. In particular, investigation into the feasibility of the proposed intervention, as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12607000632493. © 2009 Maddison et al; licensee BioMed Central Ltd.

Published
2009

22. International physical activity questionnaire (IPAQ) and New Zealand physical activity questionnaire (NZPAQ): A doubly labelled water validation

Author

Maddison, R, Ni Mhurchu, C, Jiang, Y, Vander Hoorn, S, Rodgers, A, Lawes, CMM, Rush, E, Maddison, R, Ni Mhurchu, C, Jiang, Y, Vander Hoorn, S, Rodgers, A, Lawes, CMM, and Rush, E

Abstract

Background: Accurate measurement of physical activity is a pre-requisite for monitoring population health and for evaluating effective interventions. The International Physical Activity Questionnaire (IPAQ) is used as a comparable and standardised self-report measure of habitual physical activity of populations from different countries and socio-cultural contexts. The IPAQ has been modified to produce a New Zealand physical activity questionnaire (NZPAQ). The aim of this study was to validate the IPAQ and NZPAQ against doubly labelled water (DLW). Method: Total energy expenditure (TEE) was measured over a 15-day period using DLW. Activity-related energy expenditure (AEE) was estimated by subtracting the energy expenditure from resting metabolic rate and thermic effect of feeding from TEE. The IPAQ (long form) and NZPAQ (short form) were completed at the end of each 7-day period. Activity-related energy expenditure (IPAQAEE and NZPAQAEE) was calculated from each questionnaire and compared to DLWAEE. Results: Thirty six adults aged 18 to 56 years (56% female) completed all measurements. Compared to DLWAEE, IPAQAEE and NZPAQAEE on average underestimated energy expenditure by 27% and 59%, respectively. There was good agreement between DLWAEE and both IPAQAEE and NZPAQAEE at lower levels of physical activity. However there was marked underestimation of questionnaire-derived energy expenditure at higher levels of activity. Conclusion: Both the IPAQ and NZPAQ instruments have a demonstrated systematic bias toward underestimation of physical activity-related energy expenditure at higher levels of physical activity compared to DLW. Appropriate calibration factors could be used to correct for measurement error in physical activity questionnaires and hence improve estimation of AEE. © 2007 Maddison et al; licensee BioMed Central Ltd.

Published
2007

23. Rethinking the 'diseases of affluence' paradigm: Global patterns of nutritional risks in relation to economic development

Author

Ezzati, M, Vander Hoorn, S, Lawes, CMM, Leach, R, James, WPT, Lopez, AD, Rodgers, A, Murray, CJL, Ezzati, M, Vander Hoorn, S, Lawes, CMM, Leach, R, James, WPT, Lopez, AD, Rodgers, A, and Murray, CJL

Abstract

Background: Cardiovascular diseases and their nutritional risk factors - including overweight and obesity, elevated blood pressure, and cholesterol - are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. Methods and Findings: We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies. BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about I$5,000 (international dollars) and peaked at about I$12,500 for females and I$17,000 for males. Cholesterol's point of inflection and peak were at higher income levels than those of BMI (about I$8,000 and I$18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI. Conclusions: When considered together with evidence on shifts in income-risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol. © 2005 Ezzati et al.

Published
2005

24. Rethinking the 'diseases of affluence' paradigm: Global patterns of nutritional risks in relation to economic development

Author

Novotny, T, Ezzati, M, Vander Hoorn, S, Lawes, CMM, Leach, R, James, WPT, Lopez, AD, Rodgers, A, Murray, CJL, Novotny, T, Ezzati, M, Vander Hoorn, S, Lawes, CMM, Leach, R, James, WPT, Lopez, AD, Rodgers, A, and Murray, CJL

Abstract

BACKGROUND: Cardiovascular diseases and their nutritional risk factors--including overweight and obesity, elevated blood pressure, and cholesterol--are among the leading causes of global mortality and morbidity, and have been predicted to rise with economic development. METHODS AND FINDINGS: We examined age-standardized mean population levels of body mass index (BMI), systolic blood pressure, and total cholesterol in relation to national income, food share of household expenditure, and urbanization in a cross-country analysis. Data were from a total of over 100 countries and were obtained from systematic reviews of published literature, and from national and international health agencies. BMI and cholesterol increased rapidly in relation to national income, then flattened, and eventually declined. BMI increased most rapidly until an income of about ID 5,000 (international dollars) and peaked at about ID 12,500 for females and ID 17,000 for males. Cholesterol's point of inflection and peak were at higher income levels than those of BMI (about ID 8,000 and ID 18,000, respectively). There was an inverse relationship between BMI/cholesterol and the food share of household expenditure, and a positive relationship with proportion of population in urban areas. Mean population blood pressure was not correlated or only weakly correlated with the economic factors considered, or with cholesterol and BMI. CONCLUSIONS: When considered together with evidence on shifts in income-risk relationships within developed countries, the results indicate that cardiovascular disease risks are expected to systematically shift to low-income and middle-income countries and, together with the persistent burden of infectious diseases, further increase global health inequalities. Preventing obesity should be a priority from early stages of economic development, accompanied by population-level and personal interventions for blood pressure and cholesterol.

Published
2005

25. Comparative quantification of health risks: Conceptual framework and methodological issues

Author

Murray, CJL, Ezzati, M, Lopez, AD, Rodgers, A, Vander Hoorn, S, Murray, CJL, Ezzati, M, Lopez, AD, Rodgers, A, and Vander Hoorn, S

Abstract

Reliable and comparable analysis of risks to health is key for preventing disease and injury. Causal attribution of morbidity and mortality to risk factors has traditionally been conducted in the context of methodological traditions of individual risk factors, often in a limited number of settings, restricting comparability. In this paper, we discuss the conceptual and methodological issues for quantifying the population health effects of individual or groups of risk factors in various levels of causality using knowledge from different scientific disciplines. The issues include: comparing the burden of disease due to the observed exposure distribution in a population with the burden from a hypothetical distribution or series of distributions, rather than a single reference level such as non-exposed; considering the multiple stages in the causal network of interactions among risk factor(s) and disease outcome to allow making inferences about some combinations of risk factors for which epidemiological studies have not been conducted, including the joint effects of multiple risk factors; calculating the health loss due to risk factor(s) as a time-indexed "stream" of disease burden due to a time-indexed " stream" of exposure, including consideration of discounting; and the sources of uncertainty. © 2003 Murray et al; licensee BioMed Central Ltd.

Published
2003

28. Improving child survival through environmental and nutritional interventions: the importance of targeting interventions toward the poor.

Author

Gakidou E, Oza S, Vidal Fuertes C, Li AY, Lee DK, Sousa A, Hogan MC, Vander Hoorn S, Ezzati M, Gakidou, Emmanuela, Oza, Shefali, Vidal Fuertes, Cecilia, Li, Amy Y, Lee, Diana K, Sousa, Angelica, Hogan, Margaret C, Vander Hoorn, Stephen, and Ezzati, Majid

Abstract

Context: The United Nations Millennium Development Goals (MDGs) set targets related to important global poverty, health, and sustainability issues. A critical but underinvestigated question for planning and allocating resources toward the MDGs is how interventions related to one MDG might affect progress toward other goals.Objectives: To estimate the reduction in child mortality as a result of interventions related to the environmental and nutritional MDGs (improving child nutrition and providing clean water, sanitation, and fuels) and to estimate how the magnitude and distribution of the effects of interventions vary based on the economic status of intervention recipients.Design, Setting, and Population: Population-level comparative risk assessment modeling the mortality effects of interventions on child nutrition and environmental risk factors, stratified by economic status. Data on economic status, child underweight, water and sanitation, and household fuels were from the nationally representative Demographic and Health Surveys for 42 countries in Latin America and the Caribbean, South Asia, and sub-Saharan Africa. Data on disease-specific child mortality were from the World Health Organization. Data on the hazardous effects of each MDG-related risk factor were from systematic reviews and meta-analyses of epidemiological studies.Main Outcome Measure: Child mortality, stratified by comparable international quintiles of economic status.Results: Implementing interventions that improve child nutrition and provide clean water and sanitation and clean household fuels to all children younger than 5 years would result in an estimated annual reduction in child deaths of 49,700 (14%) in Latin America and the Caribbean, 0.80 million (24%) in South Asia, and 1.47 million (31%) in sub-Saharan Africa. These benefits are equivalent to 30% to 48% of the current regional gaps toward the MDG target on reducing child mortality. Fifty percent coverage of the same environmental and nutritional interventions, as envisioned by the MDGs, would reduce child mortality by 26,900, 0.51 million, and 1.02 million in the 3 regions, respectively, if the interventions are implemented among the poor first. These reductions are 30% to 75% larger than those expected if the same 50% coverage first reached the wealthier households, who nonetheless are in need of similar interventions.Conclusions: Interventions related to nutritional and environmental MDGs can also provide substantial gains toward the MDG of reducing child mortality. To maximize the reduction in childhood mortality, such integrated management of interventions should prioritize the poor. [ABSTRACT FROM AUTHOR]

Published
2007

32. Nutrition and the burden of disease in New Zealand: 1997-2011.

Author

Stefanogiannis N, Lawes CMM, Turley M, Tobias M, Vander Hoorn S, Mhurchu C, Rodgers A, Stefanogiannis, Niki, Lawes, Carlene M M, Turley, Maria, Tobias, Martin, Hoorn, Stephen Vander, Mhurchu, Cliona Ni, and Rodgers, Anthony

Abstract

Objective: To estimate the burden of disease due to selected nutrition-related risk factors (high total blood cholesterol, high systolic blood pressure, high body mass index (BMI) and inadequate vegetable and fruit intake) in 1997, as well as the burden that could potentially be avoided in 2011 if small, favourable changes in the current risk factor distribution were to occur.Design: Data on risk factor levels, disease burden and risk associations were combined using comparative risk assessment methodology, a systematic approach to estimating both attributable and avoidable burden of disease. Disease outcomes assessed varied according to risk factor and included ischaemic heart disease, stroke, type 2 diabetes mellitus and selected cancers.Setting: New Zealand.Results: Approximately 4500 deaths (17% of all deaths) in 1997 were attributable to high cholesterol, 3500 (13%) to high blood pressure, 3000 (11%) to high BMI and 1500 (6%) to inadequate vegetable and fruit intake. Taking prevalence overlap into account, these risk factors were estimated jointly to contribute to approximately 11 000 (40%) deaths annually in New Zealand. Approximately 300 deaths due to each risk factor could potentially be avoided in 2011 if modest changes were made to each risk factor distribution.Conclusions: High cholesterol, blood pressure and BMI, as well as inadequate vegetable and fruit intake, are major modifiable causes of death in New Zealand. Small changes in the population distribution of these risk factors could have a major impact on population health within a decade. [ABSTRACT FROM AUTHOR]

Published
2005
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33. Mortality attributable to higher-than-optimal body mass index in New Zealand.

Author

Mhurchu C, Turley M, Stefanogiannis N, Lawes CMM, Rodgers A, Vander Hoorn S, Tobias M, Ni Mhurchu, Cliona, Turley, Maria, Stefanogiannis, Niki, Lawes, Carlene M M, Rodgers, Anthony, Vander Hoorn, Stephen, and Tobias, Martin

Abstract

Objectives: To estimate the burden of mortality in New Zealand due to higher-than-optimal body mass index (BMI) in 1997, as well as mortality that could be avoided in 2011 with feasible changes in mean population BMI.Setting: New Zealand.Design: Comparative risk assessment methodology was used to estimate the attributable and avoidable mortality due to high BMI. Outcomes assessed were ischaemic heart disease (IHD), ischaemic stroke, type 2 diabetes mellitus, colorectal cancer and postmenopausal breast cancer.Results: In 1997, 3154 deaths (11% of all deaths) in New Zealand were due to higher-than-optimal BMI (>21 kg m(-2)). This amounted to 83% of diabetes deaths, 24% of IHD deaths, 15% of ischaemic stroke deaths and 4% of all cancer deaths. If the projected increase in mean population BMI by 2011 was limited to 1.0 kg m(-2) rather than 1.3 kg m(-2), approximately 385 deaths could be prevented annually, mainly from diabetes.Conclusions: These results quantify the importance of higher-than-optimal BMI as a major modifiable cause of premature death in New Zealand. Intervention policies that would have only modest effects on slowing the rate of increase in mean population BMI by 2011 could still prevent hundreds of deaths annually. [ABSTRACT FROM AUTHOR]

Published
2005
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34. Estimates of global and regional potential health gains from reducing multiple major risk factors.

Author

Ezzati M, Vander Hoorn S, Rodgers A, Lopez AD, Mathers CD, Murray CJL, Comparative Risk Assessment Collaborating Group, Ezzati, Majid, Hoorn, Stephen Vander, Rodgers, Anthony, Lopez, Alan D, Mathers, Colin D, and Murray, Christopher J L

Abstract

Background: Estimates of the disease burden due to multiple risk factors can show the potential gain from combined preventive measures. But few such investigations have been attempted, and none on a global scale. Our aim was to estimate the potential health benefits from removal of multiple major risk factors.Methods: We assessed the burden of disease and injury attributable to the joint effects of 20 selected leading risk factors in 14 epidemiological subregions of the world. We estimated population attributable fractions, defined as the proportional reduction in disease or mortality that would occur if exposure to a risk factor were reduced to an alternative level, from data for risk factor prevalence and hazard size. For every disease, we estimated joint population attributable fractions, for multiple risk factors, by age and sex, from the direct contributions of individual risk factors. To obtain the direct hazards, we reviewed publications and re-analysed cohort data to account for that part of hazard that is mediated through other risks.Results: Globally, an estimated 47% of premature deaths and 39% of total disease burden in 2000 resulted from the joint effects of the risk factors considered. These risks caused a substantial proportion of important diseases, including diarrhoea (92%-94%), lower respiratory infections (55-62%), lung cancer (72%), chronic obstructive pulmonary disease (60%), ischaemic heart disease (83-89%), and stroke (70-76%). Removal of these risks would have increased global healthy life expectancy by 9.3 years (17%) ranging from 4.4 years (6%) in the developed countries of the western Pacific to 16.1 years (43%) in parts of sub-Saharan Africa.Interpretation: Removal of major risk factors would not only increase healthy life expectancy in every region, but also reduce some of the differences between regions. The potential for disease prevention and health gain from tackling major known risks simultaneously would be substantial. [ABSTRACT FROM AUTHOR]

Published
2003
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35. Global and regional mortality from ischaemic heart disease and stroke attributable to higher-than-optimum blood glucose concentration: comparative risk assessment

Author

Danaei, G., Lawes, C.M., Vander Hoorn, S., Murray, C.J., and Ezzati, M.

Abstract

Background: Cardiovascular mortality risk increases continuously with blood glucose, from concentrations well below conventional thresholds used to define diabetes. We aimed to quantify population-level effects of all higher-than-optimum concentrations of blood glucose on mortality from ischaemic heart disease and stroke worldwide. Methods: We used population distribution of fasting plasma glucose to measure exposure to higher-than-optimum blood glucose. We collated exposure data in 52 countries from individual-level records in population health surveys, systematic reviews, and data provided by investigators. Relative risks for ischaemic heart disease and stroke mortality were from a meta-analysis of more than 200@?000 participants in the Asia-Pacific region, with adjustment for other cardiovascular risk factors. Results: In addition to 959@?000 deaths directly assigned to diabetes, 1@?490@?000 deaths from ischaemic heart disease and 709@?000 from stroke were attributable to high blood glucose, accounting for 21% and 13% of all deaths from these conditions. 1.8 million of these 2.2 million cardiovascular deaths (84%) were in low-and-middle-income countries (1@?224@?000 for ischaemic heart disease, 623@?000 for stroke). 792@?000 (53%) of deaths from ischaemic heart disease and 345@?000 (49%) from stroke that were attributable to high blood glucose were in men. Largest numbers of deaths attributable to this risk factor from ischaemic heart disease were in low-and-middle-income countries of South Asia (548@?000) and Europe and Central Asia (313@?000), and from stroke in South Asia (215@?000) and East Asia and Pacific (190@?000). Interpretation: Higher-than-optimum blood glucose is a leading cause of cardiovascular mortality in most world regions. Programmes for cardiovascular risk and diabetes management and control at the population level need to be more closely integrated.

Published
2006
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41. Distribution of major health risks: Findings from the global burden of disease study

Author

Rodgers, A., Ezzati, M., Vander Hoorn, S., Lopez, A.D., Lin, R.-B., Murray, C.J.L., Fishman, S., Caulfield, L.E., de Onis, M., Blössner, M., Hyder, A.A., Mullany, L., Black, R.E., Stoltzfus, R.J., Rice, A.J., West, K.P., Lawes, C., Law, M., Elliott, P., MacMahon, S., James, W.P.T., Jackson-Leach, R., Ni Mhurchu, C., Kalamara, E., Shayeghi, M., Rigby, N.J., Nishida, C., Lock, K., Pomerleau, J., Causer, L., McKee, M., Bull, F.C., Dixon, T., Ham, S., Neiman, A., Pratt, M., Rehm, J., Room, R., Monteiro, M., Gmel, G., Graham, K., Rehn, N., Sempos, C.T., Frick, U., Jernigan, D., Degenhardt, L., Hall, W., Warner-Smith, M., Lynskey, M., Slaymaker, E., Walker, N., Armstrong, T., Collumbien, M., Gerressu, M., Cleland, J., Prüss-Ustun, A., Kay, D., Fewtrell, L., Bartram, J., Cohen, A., Anderson, R., Ostro, B., Dev Pandey, K., Krzyzanowski, M., Künzli, N., Gutschmidt, K., Pope, A., Romieu, I., Samet, J., Smith, K., Smith, K.R., Mehta, S., Feuz, M., Landrigan, P., Ayuso, J.L., McMichael, A., Campbell-Lendrum, D., Kovats, S., Edwards, S., Wilkinson, P., Tanser, F., Le Sueur, D., Schlesinger, M., Andronova, N., Nicholls, R., Wilson, T., Hales, S., Concha, M., Imel Nelson, D., Fingerhut, M., Leigh, J., Corvalan, C., Driscoll, T., Kyle Steenland, N., Punnett, L., Tak, S.W., Phillips, S., Hauri, A.M., Armstrong, G.L., Hutin, Y.J.F., Andrews, G., Corry, J., Issakidis, C., Slade, T., Swanston, H., Blakely, T., Kieft, C., Wilson, N., Woodward, A., Rodgers, A., Ezzati, M., Vander Hoorn, S., Lopez, A.D., Lin, R.-B., Murray, C.J.L., Fishman, S., Caulfield, L.E., de Onis, M., Blössner, M., Hyder, A.A., Mullany, L., Black, R.E., Stoltzfus, R.J., Rice, A.J., West, K.P., Lawes, C., Law, M., Elliott, P., MacMahon, S., James, W.P.T., Jackson-Leach, R., Ni Mhurchu, C., Kalamara, E., Shayeghi, M., Rigby, N.J., Nishida, C., Lock, K., Pomerleau, J., Causer, L., McKee, M., Bull, F.C., Dixon, T., Ham, S., Neiman, A., Pratt, M., Rehm, J., Room, R., Monteiro, M., Gmel, G., Graham, K., Rehn, N., Sempos, C.T., Frick, U., Jernigan, D., Degenhardt, L., Hall, W., Warner-Smith, M., Lynskey, M., Slaymaker, E., Walker, N., Armstrong, T., Collumbien, M., Gerressu, M., Cleland, J., Prüss-Ustun, A., Kay, D., Fewtrell, L., Bartram, J., Cohen, A., Anderson, R., Ostro, B., Dev Pandey, K., Krzyzanowski, M., Künzli, N., Gutschmidt, K., Pope, A., Romieu, I., Samet, J., Smith, K., Smith, K.R., Mehta, S., Feuz, M., Landrigan, P., Ayuso, J.L., McMichael, A., Campbell-Lendrum, D., Kovats, S., Edwards, S., Wilkinson, P., Tanser, F., Le Sueur, D., Schlesinger, M., Andronova, N., Nicholls, R., Wilson, T., Hales, S., Concha, M., Imel Nelson, D., Fingerhut, M., Leigh, J., Corvalan, C., Driscoll, T., Kyle Steenland, N., Punnett, L., Tak, S.W., Phillips, S., Hauri, A.M., Armstrong, G.L., Hutin, Y.J.F., Andrews, G., Corry, J., Issakidis, C., Slade, T., Swanston, H., Blakely, T., Kieft, C., Wilson, N., and Woodward, A.

Abstract

Most analyses of risks to health focus on the total burden of their aggregate effects. The distribution of risk-factor-attributable disease burden, for example by age or exposure level, can inform the selection and targeting of specific interventions and programs, and increase cost-effectiveness. METHODS AND FINDINGS: For 26 selected risk factors, expert working groups conducted comprehensive reviews of data on risk-factor exposure and hazard for 14 epidemiological subregions of the world, by age and sex. Age-sex-subregion-population attributable fractions were estimated and applied to the mortality and burden of disease estimates from the World Health Organization Global Burden of Disease database. Where possible, exposure levels were assessed as continuous measures, or as multiple categories. The proportion of risk-factor-attributable burden in different population subgroups, defined by age, sex, and exposure level, was estimated. For major cardiovascular risk factors (blood pressure, cholesterol, tobacco use, fruit and vegetable intake, body mass index, and physical inactivity) 43%-61% of attributable disease burden occurred between the ages of 15 and 59 y, and 87% of alcohol-attributable burden occurred in this age group. Most of the disease burden for continuous risks occurred in those with only moderately raised levels, not among those with levels above commonly used cut-points, such as those with hypertension or obesity. Of all disease burden attributable to being underweight during childhood, 55% occurred among children 1-3 standard deviations below the reference population median, and the remainder occurred among severely malnourished children, who were three or more standard deviations below median. CONCLUSIONS: Many major global risks are widely spread in a population, rather than restricted to a minority. Population-based strategies that seek to shift the whole distribution of risk factors often have the potential to produce substantial reductions in dis

44. Feasibility, design and conduct of a pragmatic randomized controlled trial to reduce overweight and obesity in children: The electronic games to aid motivation to exercise (eGAME) study.

Author

Maddison R, Foley L, Mhurchu CN, Jull A, Jiang Y, Prapavessis H, Rodgers A, Vander Hoorn S, Hohepa M, Schaaf D, Maddison, Ralph, Foley, Louise, Mhurchu, Cliona Ni, Jull, Andrew, Jiang, Yannan, Prapavessis, Harry, Rodgers, Anthony, Vander Hoorn, Stephen, Hohepa, Maea, and Schaaf, David

Abstract

Background: Childhood obesity has reached epidemic proportions in developed countries. Sedentary screen-based activities such as video gaming are thought to displace active behaviors and are independently associated with obesity. Active video games, where players physically interact with images onscreen, may have utility as a novel intervention to increase physical activity and improve body composition in children. The aim of the Electronic Games to Aid Motivation to Exercise (eGAME) study is to determine the effects of an active video game intervention over 6 months on: body mass index (BMI), percent body fat, waist circumference, cardio-respiratory fitness, and physical activity levels in overweight children.Methods/design: Three hundred and thirty participants aged 10-14 years will be randomized to receive either an active video game upgrade package or to a control group (no intervention).Discussion: An overview of the eGAME study is presented, providing an example of a large, pragmatic randomized controlled trial in a community setting. Reflection is offered on key issues encountered during the course of the study. In particular, investigation into the feasibility of the proposed intervention, as well as robust testing of proposed study procedures is a critical step prior to implementation of a large-scale trial. [ABSTRACT FROM AUTHOR]

Published
2009
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46. Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: A comparative risk assessment

Author

Danaei, G, Lu, Y, Singh, Gm, Carnahan, E, Stevens, Ga, Cowan, Mj, Farzadfar, F, Lin, Jk, Finucane, Mm, Rao, M, Khang, Yh, Riley, Lm, Mozaffarian, D, Lim, Ss, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, Na, Rahim, Hf, Addo, J, Aekplakorn, W, Afifi, Mm, Agabiti Rosei, E, Salinas, Ca, Agyemang, C, Ali, Mk, Ali, Mm, Al Nsour, M, Al Nuaim AR, Ambady, R, Di Angelantonio, E, Aro, P, Azizi, F, Babu, Bv, Bahalim, An, Barbagallo, Cm, Barbieri, Ma, Barceló, A, Barreto, Sm, Barros, H, Bautista, Le, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, Enzo, Botana, Ma, Bovet, P, Breckenkamp, J, Breteler, Mm, Broda, G, Brown, Ij, Bursztyn, M, de León AC, Campos, H, Cappuccio, Fp, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, Cj, Chaouki, N, Chatterji, S, Chen, Cj, Chen, Z, Choi, Js, Chua, L, Cífková, R, Cobiac, Lj, Cooper, Rs, Corsi, Am, Costanza, Mc, Craig, Cl, Dankner, Rs, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, Gh, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, Ch, Fan, Jg, Ferreccio, C, Fezeu, L, Firmo, Jo, Florez, Hj, Fornés, Ns, Fowkes, Fg, Franceschini, G, Frisk, F, Fuchs, Fd, Fuller, El, Getz, L, Giampaoli, S, Gómez, Lf, Gomez Zumaquero JM, Graff Iversen, S, Grant, Jf, Carvajal, Rg, Gulliford, Mc, Gupta, R, Gupta, Pc, Gureje, O, Gutierrez, Hr, Hansen, Tw, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, Wh, Herrera, Vm, Ho, S, Holdsworth, M, Frisman, Gh, Hopman, Wm, Hussain, A, Husseini, A, Ibrahim, Mm, Ikeda, N, Jacobsen, Bk, Jaddou, Hy, Jafar, Th, Janghorbani, M, Jasienska, G, Joffres, Mr, Jonas, Jb, Kadiki, Oa, Kalter Leibovici, O, Kamadjeu, Rm, Kaptoge, S, Karalis, I, Kastarinen, Mj, Katz, J, Keinan Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, Kw, Kiyohara, Y, Kobayashi, J, Krause, Mp, Kubínová, R, Kurjata, P, Kusuma, Ys, Lam, Th, Langhammer, A, Lawes, Cm, Le, C, Lee, J, Lévy Marchal, C, Lewington, S, Li, Y, Lim, To, Lin, X, Lin, Cc, Lin, Hh, Lind, L, Lissner, L, Liu, X, Lopez Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, Dr, Maggi, S, Magliano, Dj, Makdisse, M, Mancia, G, Mannami, T, Marques Vidal, P, Mbanya, Jc, McFarlane Anderson, N, Miccoli, R, Miettola, J, Minh, Hv, Miquel, Jf, Miranda, Jj, Mohamed, Mk, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, Wf, Morales, Dd, Morgan, K, Muiesan, Lm, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, Ka, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, Sw, Ohkubo, T, Olivieri, Oliviero, Önal, Ae, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, Wh, Panagiotakos, Db, Panza, F, Park, Y, Passos, Vm, Pednekar, Ms, Pelizzari, Pm, Peres, Ma, Pérez, C, Pérez Fernández, R, Pichardo, R, Phua, Hp, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, Ot, Ramos, Lr, Rampal, S, Rampal, L, Rasmussen, F, Reddy, Kk, Redon, J, Revilla, L, Reyes García, V, Roaeid, Rb, Robinson, Ca, Rodriguez Artalejo, F, Rojas Martinez, R, Ronkainen, K, Rosero Bixby, L, Roth, Ga, Sachdev, Hs, Sánchez, Jr, Sanisoglu, Sy, Sans, S, Sarraf Zadegan, N, Scazufca, M, Schaan, Bd, Schapochnik, N, Schelleman, H, Schneider, Ij, Schooling, Cm, Schwarz, B, Sekuri, C, Sereday, Ms, Serra Majem, L, Shaw, J, Shera, As, Shi, Z, Shiri, R, Shu, Xo, Silva, Da, Silva, E, Simons, La, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, Ad, Stergiou, Gs, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, Ab, Tai, Es, Tambs, K, Tesfaye, F, Thomas, Gn, Thorogood, M, Tilvis, Rs, Tobias, M, Torheim, Le, Trenkwalder, P, Tuomilehto, Jo, Tur, Ja, Tzourio, C, Uhernik, Ai, Ukoli, Fa, Unwin, N, Hoorn, Sv, Vanderpump, Mp, Varo, Jj, Veierød, Mb, Velásquez Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Yx, Ward, M, Waspadji, S, Welin, Lx, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, Xavier, Aj, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, Lc, Yoon, Js, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, Zhou, M, Ward, M., Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration, Danaei, G., Lu, Y., Singh, G.M., Carnahan, E., Stevens, G.A., Cowan, M.J., Farzadfar, F., Lin, J.K., Finucane, M.M., Rao, M., Khang, Y.H., Riley, L.M., Mozaffarian, D., Lim, S.S., Ezzati, M., Aamodt, G., Abdeen, Z., Abdella, N.A., Rahim, H.F., Addo, J., Aekplakorn, W., Afifi, M.M., Agabiti-Rosei, E., Salinas, C.A., Agyemang, C., Ali, M.K., Ali, M.M., Al-Nsour, M., Al-Nuaim, A.R., Ambady, R., Di Angelantonio, E., Aro, P., Azizi, F., Babu, B.V., Bahalim, A.N., Barbagallo, C.M., Barbieri, M.A., Barceló, A., Barreto, S.M., Barros, H., Bautista, L.E., Benetos, A., Bjerregaard, P., Björkelund, C., Bo, S., Bobak, M., Bonora, E., Botana, M.A., Bovet, P., Breckenkamp, J., Breteler, M.M., Broda, G., Brown, I.J., Bursztyn, M., de León, A.C., Campos, H., Cappuccio, F.P., Capuano, V., Casiglia, E., Castellano, M., Castetbon, K., Cea, L., Chang, C.J., Chaouki, N., Chatterji, S., Chen, C.J., Chen, Z., Choi, J.S., Chua, L., Cífková, R., Cobiac, L.J., Cooper, R.S., Corsi, A.M., Costanza, M.C., Craig, C.L., Dankner, R.S., Dastgiri, S., Delgado, E., Dinc, G., Doi, Y., Dong, G.H., Dorsi, E., Dragano, N., Drewnowski, A., Eggertsen, R., Elliott, P., Engeland, A., Erem, C., Esteghamati, A., Fall, C.H., Fan, J.G., Ferreccio, C., Fezeu, L., Firmo, J.O., Florez, H.J., Fornés, N.S., Fowkes, F.G., Franceschini, G., Frisk, F., Fuchs, F.D., Fuller, E.L., Getz, L., Giampaoli, S., Gómez, L.F., Gomez-Zumaquero, J.M., Graff-Iversen, S., Grant, J.F., Carvajal, R.G., Gulliford, M.C., Gupta, R., Gupta, P.C., Gureje, O., Gutierrez, H.R., Hansen, T.W., Hata, J., He, J., Heim, N., Heinrich, J., Hemmingsson, T., Hennis, A., Herman, W.H., Herrera, V.M., Ho, S., Holdsworth, M., Frisman, G.H., Hopman, W.M., Hussain, A., Husseini, A., Ibrahim, M.M., Ikeda, N., Jacobsen, B.K., Jaddou, H.Y., Jafar, T.H., Janghorbani, M., Jasienska, G., Joffres, M.R., Jonas, J.B., Kadiki, O.A., Kalter-Leibovici, O., Kamadjeu, R.M., Kaptoge, S., Karalis, I., Kastarinen, M.J., Katz, J., Keinan-Boker, L., Kelly, P., Khalilzadeh, O., Kiechl, S., Kim, K.W., Kiyohara, Y., Kobayashi, J., Krause, M.P., Kubínová, R., Kurjata, P., Kusuma, Y.S., Lam, T.H., Langhammer, A., Lawes, C.M., Le, C., Lee, J., Lévy-Marchal, C., Lewington, S., Li, Y., Lim, T.O., Lin, X., Lin, C.C., Lin, H.H., Lind, L., Lissner, L., Liu, X., Lopez-Jaramillo, P., Lorbeer, R., Ma, G., Ma, S., Macià, F., MacLean, D.R., Maggi, S., Magliano, D.J., Makdisse, M., Mancia, G., Mannami, T., Marques-Vidal, P., Mbanya, J.C., McFarlane-Anderson, N., Miccoli, R., Miettola, J., Minh, H.V., Miquel, J.F., Miranda, J.J., Mohamed, M.K., Mohan, V., Mohanna, S., Mokdad, A., Mollentze, W.F., Morales, D.D., Morgan, K., Muiesan, L.M., Muntoni, S., Nabipour, I., Nakagami, T., Nangia, V., Nemesure, B., Neovius, M., Nerhus, K.A., Nervi, F., Neuhauser, H., 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McFarlane-Anderson N, Miccoli R, Miettola J, Minh HV, Miquel JF, J Miranda JJ, Mohamed MK, Mohan V, Mohanna S, Mokdad A, Mollentze WF, Morales DD, Morgan K, Muiesan LM, Muntoni S, Nabipour I, Nakagami T, Nangia V, Nemesure B, Neovius M, Nerhus KA, Nervi F, Neuhauser H, Nguyen M, Ninomiya T, Noale M, Oh SW, Ohkubo T, Olivieri O, Onal AE, Onat A, Orostegui M, Ouedraogo H, Pan W-A, Panagiotakos DB, Panza F, Park Y, Passos VMA, Pednekar MS, Pelizzari PM, Peres MA, Perez C, Perez-Fernandez R, Pichardo R, Hwee Pin Phua, Francesco Pistelli, Plans P, Polakowska M, Poulter N, Prabhakaran D, Qiao Q, Rafiei M, Raitakari OT, Ramos LR, Rampal S, Rampal L, Rasmussen F, Reddy KKR, Josep Redon J, Revilla L, Reyes-GarciaV, Roaeid RB, Robinson CA, Rodriguez-Artalejo F, Rojas-Martinez R, Ronkainen K, Rosero-Bixby L, Roth GA, Sachdev HS, Sanchez JR, Sanisoglu SY, Sans S, Sarraf-Zadegan N, Scazufca M, Schaan BD, Schapochnik N, Schelleman H, Schneider IJC, Schooling CM, Schwarz B, Sekuri C, Sereday MS, Serra-Majem L, Shaw J, Shera AS, Shi Z, Shiri R, Shu XO, Santos Silva DA, Silva E, Simons LA, Smith M, Soderberg S, Soebardi S, Solfrizzi V, Sonestedt E, Soysal A, StattinP, Stein AD, Stergiou GS, Stessman J, Sudo A, Suka M, Sundh V, Sundquist K, Sundstrom J, Swai AB, Tai ES, Tambs K, Tesfaye F, Thomas GN, Thorogood M, Tilvis RS, Tobias M, Torheim LE, Trenkwalder P, Tuomilehto JO, Tur JA, Tzourio C, Uhernik A, Ukoli FA, Unwin N, Vander Hoorn S, Vanderpump MP, Varo JJ, Veierod MB, Velasquez-Melendez G, Verschuren M, Viet L, Villalpando S, Vioque J, Vollenweider P, Volpato S, Wang N, Wang YX, Ward M, Waspadji S, Welin LX, Whitlock G, Wilhelmsen L, Willeit J, Woodward M, Wormser D, Xavier AJ, Xu F, Xu L, Yamamoto A, Yang G, Yang X, Yeh L-C, Yoon J-S, You Q, Yu Z, Zhang J, Zhang L, Zheng W, Zhou M, Danaei, G, Lu, Y, Singh, G, Carnahan, E, Stevens, G, Cowan, M, Farzadfar, F, Lin, J, Finucane, M, Rao, M, Khang, Y, Riley, L, Arian, D, Lim, S, Ezzati, M, Aamodt, G, Abdeen, Z, Abdella, N, Rahim, H, Addo, J, Aekplakorn, W, Afifi, M, Agabiti-Rosei, E, Salinas, C, Agyemang, C, Ali, M, Al-Nsour, M, Al-Nuaim, A, Ambady, R, Angelantonio, E, Aro, P, Azizi, F, Babu, B, Bahalim, A, Barbagallo, C, Barbieri, M, Barceló, A, Barreto, S, Barros, H, Bautista, L, Benetos, A, Bjerregaard, P, Björkelund, C, Bo, S, Bobak, M, Bonora, E, Botana, M, Bovet, P, Breckenkamp, J, Breteler, M, Broda, G, Brown, I, Bursztyn, M, de León, A, Campos, H, Cappuccio, F, Capuano, V, Casiglia, E, Castellano, M, Castetbon, K, Cea, L, Chang, C, Chaouki, N, Chatterji, S, Chen, C, Chen, Z, Choi, J, Chua, L, Cífková, R, Cobiac, L, Cooper, R, Corsi, A, Costanza, M, Craig, C, Dankner, R, Dastgiri, S, Delgado, E, Dinc, G, Doi, Y, Dong, G, Dorsi, E, Dragano, N, Drewnowski, A, Eggertsen, R, Elliott, P, Engeland, A, Erem, C, Esteghamati, A, Fall, C, Fan, J, Ferreccio, C, Fezeu, L, Firmo, J, Florez, H, Fornés, N, Fowkes, F, Franceschini, G, Frisk, F, Fuchs, F, Fuller, E, Getz, L, Giampaoli, S, Gómez, L, Gomez-Zumaquero, J, Iversen, S, Grant, J, Carvajal, R, Gulliford, M, Gupta, R, Gupta, P, Gureje, O, Gutierrez, H, Hansen, T, Hata, J, He, J, Heim, N, Heinrich, J, Hemmingsson, T, Hennis, A, Herman, W, Herrera, V, Ho, S, Holdsworth, M, Frisman, G, Hopman, W, Hussain, A, Husseini, A, Ibrahim, M, Ikeda, N, Jacobsen, B, Jaddou, H, Jafar, T, Janghorbani, M, Jasienska, G, Joffres, M, Jonas, J, Kadiki, O, Kalter-Leibovici, O, Kamadjeu, R, Kaptoge, S, Karalis, I, Kastarinen, M, Katz, J, Keinan-Boker, L, Kelly, P, Khalilzadeh, O, Kiechl, S, Kim, K, Kiyohara, Y, Kobayashi, J, Krause, M, Kubínová, R, Kurjata, P, Kusuma, Y, Lam, T, Langhammer, A, Lawes, C, Le, C, Lee, J, Lévy-Marchal, C, Lewington, S, Li, Y, Lim, T, Lin, X, Lin, C, Lin, H, Lind, L, Lissner, L, Liu, X, Lopez-Jaramillo, P, Lorbeer, R, Ma, G, Ma, S, Macià, F, Maclean, D, Maggi, S, Magliano, D, Makdisse, M, Mancia, G, Mannami, T, Marques-Vidal, P, Mbanya, J, McFarlane-Anderson, N, Miccoli, R, Miettola, J, Minh, H, Miquel, J, Miranda, J, Mohamed, M, Mohan, V, Mohanna, S, Mokdad, A, Mollentze, W, Morales, D, Morgan, K, Lorenza M Muiesan, N, Muntoni, S, Nabipour, I, Nakagami, T, Nangia, V, Nemesure, B, Neovius, M, Nerhus, K, Nervi, F, Neuhauser, H, Nguyen, M, Ninomiya, T, Noale, M, Oh, S, Ohkubo, T, Olivieri, O, Önal, A, Onat, A, Oróstegui, M, Ouedraogo, H, Pan, W, Panagiotakos, D, Panza, F, Park, Y, Passos, V, Pednekar, M, Pelizzari, P, Peres, M, Cynthia Pérez, N, Pérez-Fernández, R, Pichardo, R, Phua, H, Pistelli, F, Plans, P, Polakowska, M, Poulter, N, Prabhakaran, D, Qiao, Q, Rafiei, M, Raitakari, O, Ramos, L, Rampal, S, Rampal, L, Rasmussen, F, Reddy, K, Redon, J, Revilla, L, Reyes-García, V, Roaeid, R, Robinson, C, Rodriguez-Artalejo, F, Rojas-Martinez, R, Ronkainen, K, Rosero-Bixby, L, Roth, G, Sachdev, H, Sánchez, J, Sanisoglu, S, Sans, S, Sarraf-Zadegan, N, Scazufca, M, Schaan, B, Schapochnik, N, Schelleman, H, Schneider, I, Schooling, C, Schwarz, B, Sekuri, C, Sereday, M, Serra-Majem, L, Shaw, J, Shera, A, Shi, Z, Shiri, R, Shu, X, Silva, D, Silva, E, Simons, L, Smith, M, Söderberg, S, Soebardi, S, Solfrizzi, V, Sonestedt, E, Soysal, A, Stattin, P, Stein, A, Stergiou, G, Stessman, J, Sudo, A, Suka, M, Sundh, V, Sundquist, K, Sundström, J, Swai, A, Tai, E, Tambs, K, Tesfaye, F, Thomas, G, Thorogood, M, Tilvis, R, Tobias, M, Torheim, L, Trenkwalder, P, Tuomilehto, J, Tur, J, Tzourio, C, Uhernik, A, Ukoli, F, Unwin, N, Hoorn, S, Vanderpump, M, Varo, J, Veierød, M, Velásquez-Meléndez, G, Verschuren, M, Viet, L, Villalpando, S, Vioque, J, Vollenweider, P, Volpato, S, Wang, N, Wang, Y, Ward, M, Waspadji, S, Lennart X Welin, N, Whitlock, G, Wilhelmsen, L, Willeit, J, Woodward, M, Wormser, D, André J Xavier, N, Xu, F, Xu, L, Yamamoto, A, Yang, G, Yang, X, Yeh, L, Yoon, J, You, Q, Yu, Z, Zhang, J, Zhang, L, Zheng, W, and Zhou, M

Subjects
Male, Settore MED/09 - Medicina Interna, kidney disease, Endocrinology, Diabetes and Metabolism, humanos, coste de las enfermedades, Disease, Global Health, Cohort Studies, Endocrinology, Cost of Illness, cardiovascular disease, Health Transition, Risk Factors, transición sanitaria, estudios prospectivos, Renal Insufficiency, Chronic -- complications -- epidemiology -- mortality, evaluación de riesgos, Renal Insufficiency, Prospective Studies, Chronic, estudios de cohortes, Metabolic Syndrome, education.field_of_study, diabetes, Mortality rate, Age Factors, Cardiovascular Diseases, Diabetes Complications, Female, Health Surveys, Humans, Metabolic Syndrome X, Renal Insufficiency, Chronic, Risk Assessment, Sex Factors, Spatio-Temporal Analysis, Internal Medicine, Cardiovascular Diseases -- complications -- epidemiology -- mortality, Cardiovascular disease,Diabetes Mellitus, chronic kidney disease, Diabetes Complications -- epidemiology -- mortality, Sciences bio-médicales et agricoles, Diabetes and Metabolism, encuestas de salud, análisis temporoespacial, Risk assessment, complicaciones de la diabetes, insuficiencia renal, medicine.medical_specialty, Cardiovascular disease, diabetes mortality, Population, enfermedades cardiovasculares, Metabolic Syndrome X -- complications -- epidemiology -- mortality, Article, chronic kidney disease, mortality, Internal medicine, Environmental health, Diabetes mellitus, medicine, factores de riesgo, Risk factor, education, business.industry, medicine.disease, Relative risk, Cardiovascular Diseases/complications, Cardiovascular Diseases/epidemiology, Cardiovascular Diseases/mortality, Diabetes Complications/epidemiology, Diabetes Complications/mortality, Metabolic Syndrome X/complications, Metabolic Syndrome X/epidemiology, Metabolic Syndrome X/mortality, Renal Insufficiency, Chronic/complications, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/mortality, business, Kidney disease
Abstract

High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes that was attributable to these four cardiometabolic risk factors for all countries and regions from 1980 to 2010., 0, info:eu-repo/semantics/published

Published
2014
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47. The mortality burden attributable to wood heater smoke particulate matter (PM 2.5 ) in Australia.

Author

Borchers-Arriagada N, Vander Hoorn S, Cope M, Morgan G, Hanigan I, Williamson G, and Johnston FH

Subjects
Particulate Matter analysis, Smoke adverse effects, Wood chemistry, Australia epidemiology, Environmental Exposure analysis, Air Pollutants analysis, Air Pollution analysis
Abstract

Air pollution is the leading environmental risk factor for mortality worldwide. In Australia, residential wood heating is the single largest source of pollution in many regions of the country. Estimates around the world and in some limited locations across Australia have shown that the health burden attributable to wood heating PM 2.5 is considerable, and that there is great potential to reduce this burden. Here, we aimed to calculate the mortality burden attributable to wood heating emissions (WHE)-related PM 2.5 throughout Australia and estimate the potential health benefits of reducing WHE-related air pollution, by replacing wood heaters with cleaner heating technologies. In summary, we used a four-stage process to (1) compile a nationwide WHE inventory, (2) generate annual exposure estimates of WHE-PM 2.5 , (3) estimate the annual mortality burden attributable to wood heater use across Australia for the year 2015, and (4) assess the potential health benefits of replacing existing wood heaters with cleaner heating technologies. We estimated that population weighted WHE-PM 2.5 exposure across Australia for 2015 ranged between 0.62 μg/m 3 and 1.35 μg/m 3 , with differing exposures across State/Territories. We estimated a considerable mortality burden attributable to WHE-PM 2.5 ranging between 558 (95 % CI, 364-738) and 1555 (95 % CI, 1180-1740) deaths annually, depending on the scenario assessed. We calculated that replacing 50 % of the current wood heater stock, with zero or lower emission technologies could produce relevant health benefits, of between $AUD 1.61 and $AUD 1.93 billion per year (303-364 attributable deaths). These findings provide a preliminary and likely conservative assessment of the health burden of wood heater smoke across Australia, and an estimation of the potential benefits from replacing the current wood heater stock with cleaner technologies. The results presented here underscore the magnitude of the health burden attributable to wood heating in Australia., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Nicolas Borchers-Arriagada reports financial support was provided by The Centre for Air pollution, energy and health Research (CAR). Stephen Vander Hoorn reports financial support was provided by The Centre for Air pollution, energy and health Research (CAR)., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2024
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49. Long-term exposure to outdoor air pollution and risk factors for cardiovascular disease within a cohort of older men in Perth.

Author

Vander Hoorn S, Murray K, Nedkoff L, Hankey GJ, Flicker L, Yeap BB, Almeida OP, Norman P, Brunekreef B, Nieuwenhuijsen M, and Heyworth J

Subjects
Aged, Australia epidemiology, Cardiovascular Diseases blood, Cholesterol, HDL blood, Cohort Studies, Confidence Intervals, Confounding Factors, Epidemiologic, Environmental Monitoring, Geography, Humans, Male, Particulate Matter analysis, Regression Analysis, Risk Factors, Time Factors, Triglycerides blood, Air Pollution adverse effects, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Environmental Exposure adverse effects
Abstract

While there is clear evidence that high levels of pollution are associated with increased all-cause mortality and cardiovascular mortality and morbidity, the biological mechanisms that would explain this association are less understood. We examined the association between long-term exposure to air pollutants and risk factors associated with cardiovascular disease. Air pollutant concentrations were estimated at place of residence for cohort members in the Western Australian Centre for Health and Ageing Health in Men Study. Blood samples and blood pressure measures were taken for a cohort of 4249 men aged 70 years and above between 2001 and 2004. We examined the association between 1-year average pollutant concentrations with blood pressure, cholesterol, triglycerides, C-reactive protein, and total homocysteine. Linear regression analyses were carried out, with adjustment for confounding, as well as an assessment of potential effect modification. The four pollutants examined were fine particulate matter, black carbon (BC), nitrogen dioxide, and nitrogen oxides. We found that a 2.25 μg/m3 higher exposure to fine particulate matter was associated with a 1.1 percent lower high-density cholesterol (95% confidence interval: -2.4 to 0.1) and 4.0 percent higher serum triglycerides (95% confidence interval: 1.5 to 6.6). Effect modification of these associations by diabetes history was apparent. We found no evidence of an association between any of the remaining risk factors or biomarkers with measures of outdoor air pollution. These findings indicate that long-term PM2.5 exposure is associated with elevated serum triglycerides and decreased HDL cholesterol. This requires further investigation to determine the reasons for this association., Competing Interests: The authors have declared that no competing interests exist.

Published
2021
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50. Avoidable Mortality Attributable to Anthropogenic Fine Particulate Matter (PM 2.5 ) in Australia.

Author

Hanigan IC, Broome RA, Chaston TB, Cope M, Dennekamp M, Heyworth JS, Heathcote K, Horsley JA, Jalaludin B, Jegasothy E, Johnston FH, Knibbs LD, Pereira G, Vardoulakis S, Vander Hoorn S, and Morgan GG

Subjects
Australia epidemiology, Child, Child, Preschool, Humans, Infant, Infant, Newborn, Life Expectancy, Air Pollution adverse effects, Air Pollution analysis, Environmental Exposure adverse effects, Mortality, Particulate Matter analysis, Particulate Matter toxicity
Abstract

Ambient fine particulate matter <2.5 µm (PM 2.5 ) air pollution increases premature mortality globally. Some PM 2.5 is natural, but anthropogenic PM 2.5 is comparatively avoidable. We determined the impact of long-term exposures to the anthropogenic PM component on mortality in Australia. PM 2.5 -attributable deaths were calculated for all Australian Statistical Area 2 (SA2; n = 2310) regions. All-cause death rates from Australian mortality and population databases were combined with annual anthropogenic PM 2.5 exposures for the years 2006-2016. Relative risk estimates were derived from the literature. Population-weighted average PM 2.5 concentrations were estimated in each SA2 using a satellite and land use regression model for Australia. PM 2.5 -attributable mortality was calculated using a health-impact assessment methodology with life tables and all-cause death rates. The changes in life expectancy (LE) from birth, years of life lost (YLL), and economic cost of lost life years were calculated using the 2019 value of a statistical life. Nationally, long-term population-weighted average total and anthropogenic PM 2.5 concentrations were 6.5 µg/m 3 (min 1.2-max 14.2) and 3.2 µg/m 3 (min 0-max 9.5), respectively. Annually, anthropogenic PM 2.5 -pollution is associated with 2616 (95% confidence intervals 1712, 3455) deaths, corresponding to a 0.2-year (95% CI 0.14, 0.28) reduction in LE for children aged 0-4 years, 38,962 (95%CI 25,391, 51,669) YLL and an average annual economic burden of $6.2 billion (95%CI $4.0 billion, $8.1 billion). We conclude that the anthropogenic PM 2.5 -related costs of mortality in Australia are higher than community standards should allow, and reductions in emissions are recommended to achieve avoidable mortality.

Published
2020
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