scholarly journals Age and nationality in relation to injuries at sea among officers and non-officers: a study based on contacts from ships to Telemedical Assistance Service in Denmark

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e034502 ◽  
Author(s):  
Kimmo Herttua ◽  
Stine Gerdøe-Kristensen ◽  
Jan C Vork ◽  
Jesper Bo Nielsen

ObjectivesCharacterisation of worker injuries on board merchant ships is modest. Using telemedical service contacts in Denmark, we describe the worker injuries patterns and factors related to injury incidence.MethodsThe data for this study were based on contacts (n=1401) from ships to Telemedical Assistance Service (TMAS) in Denmark in 2004–2014, which were supplemented with data on the annual estimation of all seafarers from the Danish Maritime Authority (n=73 336). The final data included information on broad age groups, occupation and nationality. The outcomes were injuries from any cause and six broad categories of injuries characterised by anatomic location or type of injury.ResultsDuring the observation period of 11 years, there were 1401 contacts to TMAS due to injuries, of which 36% were in upper limb, 18% in lower limb and 13% in the head. Age-adjusted incidence rates for all injuries varied between 13.6 and 26.8 incidences per 1000 person-years in 2004–2014. In most types of injuries, younger and older seafarers had higher risk for injuries than seafarers aged 30–49 years. Depending on the type of injury, non-officers had threefold to fivefold increased odds of injuries compared with officers, the risk being highest for head injuries with an OR of 5.00 (95% CI 3.19 to 7.83). Non-officers from the European Union (EU) had higher risk in most types of injuries than non-officers from outside the EU, whereas the pattern of this risk was inverse among officers.ConclusionsThese findings suggest that non-officers and European seafarers have an increased risk for several types of injuries on board Danish-flagged merchant ships. Additionally, age affected risk with the younger (<30 years) and older (>50 years) seafarers having increased risk.

2020 ◽  
Vol 105 (10) ◽  
pp. 3134-3140 ◽  
Author(s):  
Trine Koch ◽  
Elvira V Bräuner ◽  
Alexander S Busch ◽  
Martha Hickey ◽  
Anders Juul

Abstract Context Gynecomastia, the proliferation of mammary glandular tissue in the male, is a frequent but little-studied condition. Available prevalence data are based on selected patient populations or autopsy cases with their inherent bias. Objective The objective of this work is to evaluate the age-related incidence and secular trends in gynecomastia in the general population. Design An observational, 20-year national registry study was conducted. Setting This population-based study used nationwide registry data. Participants Participants included all Danish males (age 0-80 years) with a first-time diagnosis of gynecomastia. Main Outcome Measures All Danish males (age 0-80 years) were followed up for incident diagnosis of gynecomastia in the Danish National Patient Registry from 1998 to 2017 using the International Codes of Diseases, 10th revision, and the Danish Health Care Classification System. Age-specific incidence rates were estimated. The hypothesis tested in this study was formulated prior to data collection. Results Overall, a total 17 601 males (age 0-80 years) were registered with an incident diagnosis of gynecomastia within the 20-year study period, corresponding to 880 new cases per year and an average 20-year incidence of 3.4 per 10 000 men (age 0-80 years). The average annual incidence was 6.5/10 000 in postpubertal males age 16 to 20 years and 4.6/10 000 in males age 61 to 80 years, with a respective 5- and 11-fold overall increase in these 2 age groups over the 20-year period. Conclusions The incidence of gynecomastia has dramatically increased over the last 20 years, implying that the endogenous or exogenous sex-steroid environment has changed, which is associated with other adverse health consequences in men such as an increased risk of prostate cancer, metabolic syndrome, type 2 diabetes, or cardiovascular disorders.


2018 ◽  
Vol 4 (1) ◽  
pp. e000321 ◽  
Author(s):  
Siobhán O’Connor ◽  
Peta L Hitchens ◽  
Lauren V Fortington

BackgroundThe most recent report on hospital-treated horse-riding injuries in Victoria was published 20 years ago. Since then, injury countermeasures and new technology have aimed to make horse riding safer for participants. This study provides an update of horse-riding injuries that required hospital treatment in Victoria and examines changes in injury patterns compared with the earlier study.MethodsHorse-riding injuries that required hospital treatment (hospital admission (HA) or emergency department (ED) presentations) were extracted from routinely collected data from public and private hospitals in Victoria from 2002–2003 to 2015–2016. Injury incidence rates per 100 000 Victorian population per financial year and age-stratified and sex-stratified injury incidence rates are presented. Poisson regression was used to examine trends in injury rates over the study period.ResultsED presentation and HA rates were 31.1 and 6.6 per 100 000 person-years, increasing by 28.8% and 47.6% from 2002 to 2016, respectively. Female riders (47.3 ED and 10.1 HA per 100 000 person-years) and those aged between 10 and 14 years (87.8 ED and 15.7 HA per 100 000 person-years) had the highest incidence rates. Fractures (ED 29.4%; HA 56.5%) and head injuries (ED 15.4%; HA 18.9%) were the most common injuries. HA had a mean stay of 2.6±4.1 days, and the mean cost per HA was $A5096±8345.ConclusionHorse-riding injuries have remained similar in their pattern (eg, types of injuries) since last reported in Victoria. HA and ED incidence rates have increased over the last 14 years. Refocusing on injury prevention countermeasures is recommended along with a clear plan for implementation and evaluation of their effectiveness in reducing injury.


Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 3773-3773
Author(s):  
Adam Mendizabal ◽  
Paul H Levine

Abstract Abstract 3773 Background: Age at diagnosis of CML varies by race in the United States with median occurring around ages 54 and 63 among Black and White patients, respectively. The treatment paradigm shifted when Imatinib was approved in 2001 for treatment of CML. More recently, second generation tyrosine kinase inhibitors (TKI) have also been used for treatment of CML. Differences in outcomes by race have been previously reported prior to the TKI treatment period. We aimed to assess whether the earlier age at diagnosis resulted in differential trends in age-adjusted incidence rates and survival outcomes by race in the post-Imatinib treatment period. Methods: Data from the Surveillance, Epidemiology, and End Results (SEER) 18 Registries were extracted for diagnoses between 2002 and 2009 based on the assumption that cases diagnosed after 2002 would be treated with TKI's. CML was defined according to the International Classification of Diseases for Oncology 3rd edition code 9863 (CML-NOS) and 9875 (CML-Philadelphia Chromosome Positive). Cases diagnosed by autopsy or death certificate only were excluded. Incidence rates are expressed per 100,000 person-years and age-adjusted to the 2000 US Standard Population. Black/White incidence rate ratios (IRRBW) are shown with corresponding 95% confidence intervals (CI). Kaplan-Meier estimates of CML-specific survival (CPS) and overall survival (OS) were estimated at 5-years post-diagnosis with the event being time to CML-specific death or any death, respectively. Stratified Cox proportional hazards models were constructed to assess the impact of age and race on the risk of death expressed as a hazard ratio (HR). Results: Since 2002, 6,632 patients diagnosed with CML were reported to the SEER 18 registries including 5,829 White patients (87.9%) and 803 Black patients (12.1%) with 57% being male. The age-adjusted incidence rate for Blacks was 1.18 (95% CI, 1.10–1.27) per 100,000 and 1.12 (95% CI, 1.09–1.27) per 100,000 for Whites. The corresponding IRRBW was 1.06 (95% CI, 0.98– 1.14). When considering 20-year age-groups, Blacks had higher incidence rates in the 20–39 and 40–59 age groups; IRRBW of 1.26 (95% CI, 1.06–1.49; p=0.0073) and 1.23 (95% CI, 1.09–1.39; p=0.0007), respectively. No statistically significant differences in IRRBW were seen within the 0–19, 60–79 and 80+ age-groupings although Whites have higher non-significant incidence rates in the latter 2 age-groups. Differences in IRRBW prompted an assessment of survival to determine if the excess incidence observed in the younger age groups corresponded with a worse survival. CPS at 5-years was 85.5% (95% CI, 84.3–86.6). In univariate analysis, age was an important predictor of outcome (p<0.0001) with patients diagnosed after age 80 having the worse outcomes (OS: 58.3%), followed by patients diagnosed between 60 and 79 years (OS 84.7%), 0–19 years (OS: 87.1%), 40–59 years (OS: 90.2%), and 20–39 years (OS: 92.6%). When considering all age-groups, race was not a significant predictor of death (HR 0.91; 95% CI, 0.72–1.15). However, in a stratified analysis with 20-year age groups, Blacks had an increased risk of death as compared to Whites (Figure 1) in the 20–39 age group (HR: 2.94; 95% CI, 1.72–5.26; p<0.0001) and the 40–59 age group (HR: 1.67; 95% CI, 1.22–2.27; p=0.0069) while no differences were seen within the 0–19, 60–79 and 80+ age groups. Conclusions from OS models were similar to that of the CPS models. Conclusions: Through this analysis of population-based cancer registry data collected in the US between 2002 and 2009, we show that Blacks have a younger age at diagnosis with higher incidence rates observed in the 20–39 and 40–59 age-groups as compared to Whites. Both CPS and OS outcomes differed by race and age. Similar to the differences observed with the incidence rates, survival was worse in Blacks diagnosed within the 20–39 and 40–59 age-groups as compared to Whites. Although outcomes have globally improved in patients with CML since the advent of tyrosine kinase inhibitors, the persistence of incidence heterogeneity and poorer survival among Blacks warrants further attention. Access to care may be a possible reason for the differences observed but further studies are warranted to rule out biological differences which may be causing an earlier age at onset and poorer survival. Disclosures: No relevant conflicts of interest to declare.


2019 ◽  
Vol 12 (1) ◽  
pp. 28-34
Author(s):  
Angela Gebert ◽  
Markus Gerber ◽  
Uwe Pühse ◽  
Philippe Gassmann ◽  
Hanspeter Stamm ◽  
...  

Background: There is a lack of data regarding the epidemiology of soccer injuries and the particular accidents in specific non-professional soccer populations. The aim of this study was to analyse incidence, causes and characteristics of soccer injuries, taking into account different settings of organised (amateur) and non-organised soccer. Methods: A random sample of persons who had sustained an injury while playing soccer and reported this injury to the Swiss National Accident Insurance Fund (Suva) was retrospectively consulted. 705 injuries were analysed involving three main settings (soccer games, soccer training, non-organised soccer) and different amateur soccer leagues. Results: Knee injuries (p=0.01) and head injuries (p=0.005) were observed more frequently in games than in non-organised soccer. Injuries caused by contact with an opponent and foul play occurred more frequently in games than in training (p<0.001) or non-organised soccer (p≤0.001). Injury incidence was substantially higher for players of 30+/40+ leagues (18.7 injuries per 1000 hours) than for players of other leagues (1st-3rd amateur leagues: 8.5, p=0.002; 4th-5th amateur leagues: 9.4, p=0.007; female leagues: 8.2, p=0.006; junior leagues: 6.7, p<0.001). Conclusion: With respect to injury characteristics, causes and injury incidence, essential differences between various non-professional soccer settings exist suggesting that a more specific approach in injury prevention may generate positive effects.


2021 ◽  
Vol 21 (3) ◽  
pp. 209-216
Author(s):  
Muzahem Al-Hashimi ◽  
Safwan Nathem Rashed

Cervical cancer is the most common cancer in Iraq. This study aimed to examine the spatial pattern and high-risk clusters of cervical cancer in different areas of Iraq (except the Kurdish region) during the period 2010-2015. The age-adjusted incidence rates (AAIRs), age-specific incidence rates (ASIRs), and annual percent changes (APCs) were calculated for 2010–2015. We used three techniques of spatial statistical analysis which are Global spatial autocorrelation, Getis-Ord Gi* statistic, and Anselin Local Moran’s  statistic to investigate spatial clustering and outliers. Over the period 2000-2015, 1037 cases were diagnosed with AAIR of incidence of (3.521 per 100,000). Depending on AAIRs, we found cervical cancer incidence was highest (8.212 per 100,000) in the age group of 60-69 years old. The APC of cervical cancer age-specific rates has significantly risen for the age groups 60-69 only. We identified spatial high-risk clusters for incidence. The cluster was mainly located in the center of Iraq (Baghdad, Najaf, Kerbala, and Babil provinces), the central-eastern part of Iraq (Diyala province), and the southern part of Iraq (Basrah province). While the provinces in the northern and northeastern parts of Iraq, as well as the western province, had relatively lower AAIRs from cervical cancer. A spatial cluster pattern for the incidence of cervical cancer in Iraq was revealed, which will be valuable for improving the allocation of health resources in Iraq.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e17005-e17005
Author(s):  
Rakesh Mandal ◽  
Binay Kumar Shah

e17005 Background: Information on trend of Chronic Myeloid Leukemia (CML) incidence rate is scant. This study was conducted to evaluate the time trends of CML incidence rates among Caucasians in the U.S. Methods: We used the Surveillance, Epidemiology, and End Results (SEER) Program to extract annual age-adjusted incidence rates of CML from 1973-2008 for <60yr and >60yr age groups classified by gender. Trends of incidence rates were evaluated using the National Cancer Institute’s Joinpoint Regression Program (v 3.5.2). The maximum number of joinpoints used was 4. The annual percentage change (APC %) for the final selected joinpoint model for each cohort is shown in the table. Results: The annual age-adjusted CML incidence rates for 1973 vs. 2008 were 0.72/0.67, 5.67/4.47, 0.93/0.67, and 10.5/8.5 per 100,000 population for the 4 cohorts: women (<60yr, >60yr) and men (<60yr, >60yr), respectively. Among Caucasian women (>60yr), the incidence rate decreased significantly from 5.58/100,000 in 2001 to 4.47/100,000 in 2008 (APC= -3.08, CI -5.8 to -0.3, p = 0.004). The incidence trend from 1973-2001 was stable for this cohort (APC=0.1, CI -0.3 to 0.5). The incidence trends among women <60yr, men <60yr, and men >60yr were stable from 1973-2008. Conclusions: The annual age-adjusted incidence rates of chronic myeloid leukemia among older (>60 year) Caucasian women has declined sharply from 2001-2008. The rate change is unexplained. It may help generate hypotheses regarding risk factors for CML. [Table: see text]


Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Jane C Khoury ◽  
Tracy Madsen ◽  
Kathleen Alwell ◽  
Charles J Moomaw ◽  
Heidi Sucharew ◽  
...  

Background: We previously reported an increased incidence of stroke in the population with diabetes. This was particularly pronounced in those under 65 years of age. With guidelines now including glycemic monitoring during hospitalization, we examined incidence attributable to diabetes in 2010 and 2015. Methods: Ischemic strokes in the 5-county Greater Cincinnati/Northern Kentucky region were ascertained, then physician verified, at all 15 area hospitals using ICD-9 codes 430 to 436 or ICD10 codes I60 to I68. First ever ischemic strokes in patients aged 20 years and older were included in this analysis. Population age-specific rates of diabetes were estimated using the 2009-2010 and 2015-2016 NHANES databases, then applied to local population numbers, extracted from the US Census Bureau website, to estimate the denominator for calculation of incidence rates. Incidence rates were adjusted by age race and sex, as appropriate, to the 2010 US population. Diabetes was defined as reported in the electronic medical record or glycohemoglobin A1c &gt 6.4% during hospitalization. Results: There were a total of 4141 ischemic strokes; 55% female and 22% black. Stroke rates continue to be substantially higher in those with diagnosed diabetes, than those without diabetes overall and for those less than 65 years in both time periods, as well as those 65 years and older except for the black population in 2010. Racial disparities continue in both the less than 65 and 65 years and older age groups. Stroke rates were higher for Blacks in the less than 65 year age group for those both with and without diabetes; with risk ratios ranging from 1.3 to 2.7. Of note the stroke rate has decreased between 2010 and 2015 for those with diabetes <65 years of age. (Table) Conclusions: The population with diabetes continues to be at increased risk of stroke, especially in those less than 65 years of age and those of black race.


2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0040
Author(s):  
Jack J. Zhou ◽  
Patrick Morrissey ◽  
Neil V. Shah ◽  
Aakash M. Patel ◽  
James P. Doran ◽  
...  

Objectives: Female youth ice hockey players are an overlooked population. No national study has established incidence rates for injuries in female youth ice hockey. The objective of this study was to establish incidence rates by injury location, diagnosis, and mechanism of injury using USA Hockey sanctioned age divisions. Methods: The National Electronic Injury Surveillance System (NEISS) was queried for all ice hockey injuries (product code 1279) from January 1, 2007 to December 31, 2016. Cases involving players over the age of 19 and males were excluded. Each injury’s narrative text field was reviewed to determine mechanism of injury. Data was analyzed using (IBM®, v24). Comparisons of incidence by age were made using student’s two sample t-test with 95% confidence interval. Trend analyses were performed using a linear regression. USA Hockey membership statistics were used to establish population at risk and calculate incidence rates. All incidence rates were reported per 10,000 person-years. Results: A total of 384 patients, representing an estimated 10,398 ice hockey-related injuries, presented to NEISS-participating United States emergency departments. During the study period, female youth ice hockey players increased significantly from 44,678 in 2007 to 57,792 in 2016 (p=3.9x10-5, R-squared=0.89, ß =0.94). The overall number of injuries, however, only slightly increased from 992 in 2007 to 1,042 in 2016 (p=ns). Thus, the incidence rate (IR) of injuries fell from 222.1 to 180.2 during the study period. The most commonly injured body parts were the head (n=3048, IR=554.5), trunk (n=1399, IR=256.4), knee (n=1127, IR=169), shoulder (n=704, IR=153.3) and ankle (n=591, IR=120.2). The most common diagnoses were strain/sprain (n=2002, IR=417.7), contusion (n=1877, IR= 348), internal organ injury (n=1863, IR=320), concussion (n=1112, IR=218) and fracture (n=1255, IR=202). The top mechanisms of injury were player-to-player contact (n= 3016, IR=535), falls (n=2249, IR=380.9), and contact with boards (n=942, IR=165.8). The incidence rate of injuries increased with age; The 0-8, 9-10, 11-12, 13-14, 15-16 and 17-19 age divisions had IR’s of 24, 84, 226, 381, 360, and 750, respectively. The player-to-player mechanism of injury also increased with age. The largest IR gap between ages fell between the 11-12 and 13-14 age groups, similar to what has been observed in male ice hockey studies. Player-to-player contact is the leading mechanism of injury in all age groups except the 0-8 age group. Head injuries increased with age division: 0-8 (n=15, IR=1), 9-10 (n=153, IR=17.4), 11-12 (n=598, IR=67.2), 13-14 (n=885, IR=115.1), 15-16 (n=650, IR=121.6) and 17-19 (n=746, IR=232.2). The two most common diagnoses of head injuries were concussion (36%) and internal organ injury (61%), both of these diagnoses increasing with age. In fact, concussion diagnosis increased significantly between each age group (p<0.01). Conclusion: We established the first collection of injury incidence rates for female ice hockey gleaned from a national database. Though body checking is illegal at all levels of women’s ice hockey, player-to-player contact prevailed as the leading mechanism of injury in all but the 0-8 age division. It was also the leading mechanism for the most common injury sites, including the head. This study laid bare an unspoken but long understood fact of the girl’s game that body checking is common and major contributor to the game’s injury burden.


2006 ◽  
Vol 36 (11) ◽  
pp. 1541-1550 ◽  
Author(s):  
PAUL FEARON ◽  
JAMES B. KIRKBRIDE ◽  
CRAIG MORGAN ◽  
PAOLA DAZZAN ◽  
KEVIN MORGAN ◽  
...  

Background. The incidence of schizophrenia in the African-Caribbean population in England is reported to be raised. We sought to clarify whether (a) the rates of other psychotic disorders are increased, (b) whether psychosis is increased in other ethnic minority groups, and (c) whether particular age or gender groups are especially at risk.Method. We identified all people (n=568) aged 16–64 years presenting to secondary services with their first psychotic symptoms in three well-defined English areas (over a 2-year period in Southeast London and Nottingham and a 9-month period in Bristol). Standardized incidence rates and incidence rate ratios (IRR) for all major psychosis syndromes for all main ethnic groups were calculated.Results. We found remarkably high IRRs for both schizophrenia and manic psychosis in both African-Caribbeans (schizophrenia 9·1, manic psychosis 8·0) and Black Africans (schizophrenia 5·8, manic psychosis 6·2) in men and women. IRRs in other ethnic minority groups were modestly increased as were rates for depressive psychosis and other psychoses in all minority groups. These raised rates were evident in all age groups in our study.Conclusions. Ethnic minority groups are at increased risk for all psychotic illnesses but African-Caribbeans and Black Africans appear to be at especially high risk for both schizophrenia and mania. These findings suggest that (a) either additional risk factors are operating in African-Caribbeans and Black Africans or that these factors are particularly prevalent in these groups, and that (b) such factors increase risk for schizophrenia and mania in these groups.


2016 ◽  
Vol 36 (3) ◽  
pp. 291-296 ◽  
Author(s):  
Simon Duquennoy ◽  
Clémence Béchade ◽  
Christian Verger ◽  
Maxence Ficheux ◽  
Jean-Philippe Ryckelynck ◽  
...  

Introduction This study was carried out to examine whether or not elderly patients on peritoneal dialysis (PD) had an increased risk of peritonitis. Methods This was a retrospective cohort study based on data from the French Language Peritoneal Dialysis Registry. We analyzed 8,396 incident patients starting PD between January 2003 and December 2010. The end of the observation period was 31 December 2012. Patients were separated into 2 age groups: up to 75 and over of 75 years old. Results Among 8,396 patients starting dialysis there were 3,173 patients older than 75. When using a Cox model, no association was found between age greater than 75 years and increased risk of peritonitis (hazard ratio [HR]: 0.97 [0.88 – 1.07]). Diabetes (HR: 1.14 [1.01 – 1.28] and continuous ambulatory PD (HR: 1.13 [1.04 – 1.23]) were significantly associated with a higher risk of peritoneal infection whereas nurse-assisted PD was associated with a lower risk of peritonitis (HR: 0.85 [0.78 – 0.94]. In the analysis restricted to the 3,840 self-care PD patients, there was no association between age older than 75 years and risk of peritonitis. Conclusion The risk of peritonitis is not increased in elderly patients on PD in a country where assisted PD is available.


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