Natural course and incidence of non-organ specific autoantibodies (NOSA) and HCV infection in the general population: A nested case-control study of the dionysos cohort

ObjectivesPeople with epilepsy (PWE) have a higher mortality rate than the general population. Epilepsy-related deaths have increased despite all-cause mortality decreasing in the general population pre-COVID-19. We hypothesised that clinical and lifestyle factors may identify people more at risk.DesignWe used a retrospective cohort study to explore cause of death and a nested case–control study to identify risk factors.SettingWe explored factors associated with mortality using primary care population data from 1 April 2004 to 31 March 2014. Data were obtained from the Clinical Practice Research Datalink which compiles anonymised patient data from primary care in the UK. Cause of death data was supplemented from the Office of National Statistics when available.ParticipantsThe analysis included 70 431 PWE, with 11 241 registered deaths.ResultsThe number of deaths within the database increased by 69% between the first and last year of the study. Epilepsy was considered as a contributing cause in approximately 45% of deaths of PWE under 35. Factors associated with increased risk of death included attendance at emergency departments and/or emergency admissions (OR 3.48, 95% CI 3.19 to 3.80), antiepileptic drug (AED) polytherapy (2 AEDs: OR 1.60, 95% CI 1.51 to 1.71; 3 AEDs: OR 2.06, 95% CI 1.86 to 2.29; 4+AEDs: OR 2.62, 95% CI 2.23 to 3.08), status epilepticus (OR 2.78, 95% CI 1.64 to 4.71), depression (OR 1.67, 95% CI 1.57 to 1.76) and injuries (OR 1.54, 95% CI 1.43 to 1.67). No seizures in the prior year (OR 0.52, 95% CI 0.41 to 0.65).ConclusionOur results add to existing evidence that deaths in epilepsy are increasing. Future studies could focus on identifying PWE at high risk and addressing them with clinical interventions or better self-management. Identifying specific risk factors for younger people should be a priority as epilepsy may be a factor in close to half of deaths of PWE under 35 years of age.

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1065Diesel exposure and bladder cancer in contemporary Western Australian miners

International Journal of Epidemiology ◽

10.1093/ije/dyab168.623 ◽

2021 ◽

Vol 50 (Supplement_1) ◽

Author(s):

Nita Sodhi-Berry ◽

Peter Franklin ◽

Susan Peters ◽

Alison Reid ◽

Arthur (Bill) Musk ◽

...

Keyword(s):

Bladder Cancer ◽

General Population ◽

Elemental Carbon ◽

Case Control Study ◽

Case Control ◽

Engine Exhaust ◽

Diesel Engine Exhaust ◽

Nested Case Control ◽

Western Australian ◽

Control Study

Abstract Background Diesel engine exhaust (DEE) is classified as a potential carcinogen for bladder cancer in humans by the International Agency for Research on Cancer. We aimed to compare bladder cancer incidence in Western Australian miners against the general population and determine if there was an association with DEE, measured as Elemental Carbon. Methods A whole-of-population cohort of 218,846 Western Australian miners employed during 1996-2013 was followed-up until June-2017. DEE exposure data was derived from work histories and collated with administrative State-wide cancer and death data. Standardised Incidence Ratios (SIRs) were calculated to compare rates with the general population. A nested case-control study design with matching on attained age was used. Conditional logistic regression was done to calculate Odds Ratios (ORs) for cumulative Elemental Carbon exposure (unlagged and 15-year lagged), after adjusting for smoking pack-years. Results Ninety cases (88 males) were observed and 180,377 controls selected. Miners had lower bladder cancer incidence than the general population (Observed=90; Expected=135.60; SIR:0.66, 95%CI:0.53-0.80). Within miners, DEE exposure was not found to be statistically significantly associated with bladder cancer (unlagged: OR = 0.75, 95%CI: 0.43-1.31; and 15-year lagged: OR = 0.59, 95%CI:0.25-1.40), after adjusting for smoking pack-years (unlagged and lagged OR:1.02, 95%CI:1.01-1.03). Conclusions Miners had lower risk of bladder cancer than the general population. DEE exposure was not associated with bladder cancer in this nested case-control study of contemporary Western Australian miners. Key messages Diesel engine exhaust was not found to be associated with bladder cancer in miners.

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Epidemiology and risk factors for hepatitis C virus infection in a high-prevalence population

Epidemiology and Infection ◽

10.1017/s0950268818000080 ◽

2018 ◽

Vol 146 (4) ◽

pp. 508-514 ◽

Cited By ~ 1

Author(s):

M. A. Fill ◽

L. A. Sizemore ◽

M. Rickles ◽

K. C. Cooper ◽

C. M. Buecker ◽

...

Keyword(s):

Risk Factor ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Drug Use ◽

Case Control Study ◽

Case Control ◽

Hcv Infection ◽

History Of ◽

Nested Case Control ◽

Control Study

AbstractTo understand increasing rates of hepatitis C virus (HCV) infection in Tennessee, we conducted testing, risk factor analysis and a nested case–control study among persons who use drugs. During June–October 2016, HCV testing with risk factor assessment was conducted in sexually transmitted disease clinics, family planning clinics and an addiction treatment facility in eastern Tennessee; data were analysed by using multivariable logistic regression. A nested case–control study was conducted to assess drug-using risks and behaviours among persons who reported intranasal or injection drug use (IDU). Of 4753 persons tested, 397 (8.4%) were HCV-antibody positive. HCV infection was significantly associated with a history of both intranasal and IDU (adjusted odds ratio (aOR) 35.4, 95% confidence interval (CI) 24.1–51.9), IDU alone (aOR 52.7, CI 25.3–109.9), intranasal drug use alone (aOR 2.6, CI 1.8–3.9) and incarceration (aOR 2.7, CI 2.0–3.8). By 4 October 2016, 574 persons with a reported history of drug use; 63 (11%) were interviewed further. Of 31 persons who used both intranasal and injection drugs, 26 (84%) reported previous intranasal drug use, occurring 1–18 years (median 5.5 years) before their first IDU. Our findings provide evidence that reported IDU, intranasal drug use and incarceration are independent indicators of risk for past or present HCV infection in the study population.

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