EXPOSURE TO PM2.5 AND CAUSE-SPECIFIC MORTALITY RISK IN ADDITIONAL FOLLOW-UP OF THE HARVARD SIX CITIES STUDY: IDENTIFICATION OF SUSCEPTIBLE SUB-POPULATIONS

Abstract. Introduction. The work of civilian aviation pilots is characterized by heavy psychological and emotional stress in combination with other occupational factors. Such complex of adverse working conditions appears to be a risk for functional and somatic disorders, which may subsequently be reflected in the causes and rates of mortality in the distant period. The aim of this work is to study the mortality of retired civilian aviation pilots. Methods. A prospective cohort epidemiological study of civilian aviation pilots’ mortality. The cohort included 4513 male civilian aviation pilots of Russia who completed their employment and received employment pension. The follow-up period was 10 years (01.01.2010-31.12.2019), with 22156.9 person-years obtained. The age-specific mortality rates were calculated for 5-year age groups, the mortality risk was assessed using standardized mortality ratio (SMR) with 95% confidence interval (95% CI). The comparison group was the male Russian population. Results. As of 31.12.2019, out of 4513 civilian aviation pilots, 150 people deceased (3.3%). The age-specific mortality rates in the retired pilots’ cohort were lower in all age groups compared to the male Russian population, except for the 35-39 age group. The all-cause mortality risk for civilian aviation pilots was significantly lower compared to the male Russian population, SMR=0.31 (95%CL 0.26-0.36). Conclusion. Further research is required to determine the long-term effects of working conditions on civilian aviation pilots’ health. The follow-up period for the pilots’ cohort should be increases to 20 years and more.

Download Full-text

Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality

Heart ◽

10.1136/heartjnl-2017-312251 ◽

2017 ◽

Vol 104 (13) ◽

pp. 1076-1085 ◽

Cited By ~ 14

Author(s):

Mathias Seviiri ◽

Brigid M Lynch ◽

Allison M Hodge ◽

Yi Yang ◽

Danny Liew ◽

...

Keyword(s):

Lung Cancer ◽

Heart Rate ◽

Mortality Risk ◽

Resting Heart Rate ◽

Cox Models ◽

Risk Of Death ◽

Specific Mortality ◽

Melbourne Collaborative Cohort Study ◽

Trained Staff

ObjectiveMost studies investigating the association between resting heart rate (RHR) and mortality have focused on cardiovascular disease (CVD) mortality, and measured RHR at only one time point. We aimed to assess associations of RHR and changes in RHR over approximately a decade with overall and cause-specific mortality.MethodsWe used data from participants in the Melbourne Collaborative Cohort Study with RHR measures at baseline (1990–1994; n=41 386; 9846 deaths) and at follow-up (2003–2007; n=21 692; 2818 deaths). RHR measures were taken by trained staff, using Dinamap monitors. Cox models were used to estimate HR and 95% CI for the associations between RHR and mortality. Vital status and cause of death were ascertained until August 2015 and December 2013, respectively.ResultsAfter adjustment for confounders, including blood pressure and known medical conditions but not arrhythmias or atrial fibrillation, RHR was associated with a higher risk of death of similar magnitude for CVD (HR per 10 beats per minute (bpm)=1.11, 95% CI 1.07 to 1.16), cancer (HR=1.10, 95% CI 1.06 to 1.13) and other causes (HR=1.20, 95% CI 1.16 to 1.25). Higher mortality was observed for most cancer sites, including breast (HR=1.16, 95% CI 1.03 to 1.31), colorectal (HR=1.18, 95% CI 1.08 to 1.29), kidney (HR=1.27, 95% CI 1.03 to 1.57) and lung cancer (HR=1.19, 95% CI 1.10 to 1.29). Temporal increases in RHR were associated with higher mortality, particularly for individuals whose RHR increased by more than 15 bpm.ConclusionsRHR and changes in RHR over a decade are associated with mortality risk, including from causes other than CVD such as breast, colorectal or lung cancer. Monitoring of RHR may have utility in identifying individuals at higher mortality risk.

Download Full-text

Individual testosterone decline and future mortality risk in men

Acta Endocrinologica ◽

10.1530/eje-17-0280 ◽

2018 ◽

Vol 178 (1) ◽

pp. 121-128 ◽

Cited By ~ 6

Author(s):

Stine A Holmboe ◽

Niels E Skakkebæk ◽

Anders Juul ◽

Thomas Scheike ◽

Tina K Jensen ◽

...

Keyword(s):

Mortality Risk ◽

Serum Levels ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Age Related ◽

National Mortality ◽

All Cause Mortality ◽

Specific Mortality ◽

Cox Proportional Hazard Models

Objective Male aging is characterized by a decline in testosterone (TS) levels with a substantial variability between subjects. However, it is unclear whether differences in age-related changes in TS are associated with general health. We investigated associations between mortality and intra-individual changes in serum levels of total TS, SHBG, free TS and LH during a ten-year period with up to 18 years of registry follow-up. Design 1167 men aged 30–60 years participating in the Danish Monitoring Trends and Determinants of Cardiovascular Disease (MONICA1) study and who had a follow-up examination ten years later (MONICA10) were included. From MONICA10, the men were followed up to 18 years (mean: 15.2 years) based on the information from national mortality registries via their unique personal ID numbers. Methods Cox proportional hazard models were used to investigate the association between intra-individual hormone changes and all-cause, CVD and cancer mortalities. Results A total of 421 men (36.1%) died during the follow-up period. Men with most pronounced decline in total TS (<10th percentile) had a higher all-cause mortality risk compared to men within the 10th to 90th percentile (hazard ratio (HR): 1.60; 95% confidence interval (CI): 1.08–2.36). No consistent associations were seen in cause-specific mortality analyses. Conclusion Our study showed that higher mortality rates were seen among the men who had the most pronounced age-related decline in TS, independent of their baseline TS levels.

Download Full-text

Association of changes in red meat consumption with total and cause specific mortality among US women and men: two prospective cohort studies

BMJ ◽

10.1136/bmj.l2110 ◽

2019 ◽

pp. l2110 ◽

Cited By ~ 33

Author(s):

Yan Zheng ◽

Yanping Li ◽

Ambika Satija ◽

An Pan ◽

Mercedes Sotos-Prieto ◽

...

Keyword(s):

Cohort Studies ◽

Mortality Risk ◽

Repeated Measures ◽

Prospective Cohort ◽

Meat Consumption ◽

Red Meat ◽

Processed Meat ◽

Prospective Cohort Studies ◽

Specific Mortality

Abstract Objective To evaluate the association of changes in red meat consumption with total and cause specific mortality in women and men. Design Two prospective cohort studies with repeated measures of diet and lifestyle factors. Setting Nurses’ Health Study and the Health Professionals Follow-up Study, United States. Participants 53 553 women and 27 916 men without cardiovascular disease or cancer at baseline. Main outcome measure Death confirmed by state vital statistics records, the national death index, or reported by families and the postal system. Results 14 019 deaths occurred during 1.2 million person years of follow-up. Increases in red meat consumption over eight years were associated with a higher mortality risk in the subsequent eight years among women and men (both P for trend<0.05, P for heterogeneity=0.97). An increase in total red meat consumption of at least half a serving per day was associated with a 10% higher mortality risk (pooled hazard ratio 1.10, 95% confidence interval 1.04 to 1.17). For processed and unprocessed red meat consumption, an increase of at least half a serving per day was associated with a 13% higher mortality risk (1.13, 1.04 to 1.23) and a 9% higher mortality risk (1.09, 1.02 to 1.17), respectively. A decrease in consumption of processed or unprocessed red meat of at least half a serving per day was not associated with mortality risk. The association between increased red meat consumption and mortality risk was consistent across subgroups defined by age, physical activity, dietary quality, smoking status, or alcohol consumption. Conclusion Increases in red meat consumption, especially processed meat, were associated with higher overall mortality rates.

Download Full-text

Trends in Diabetes Subgroups and Their Risk for All-Cause, Cardiovascular Disease and Diabetes-Specific Mortality in the US: A Data-Driven Reproducible Machine Learning Approach

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.863 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A423-A423

Author(s):

Neftali Eduardo Antonio-Villa ◽

Luisa Fernández-Chirino ◽

Arsenio Vargas-Vazquez ◽

Jessica Paola Bahena-López ◽

Omar Yaxmehen Bello-Chavolla

Keyword(s):

Cardiovascular Disease ◽

Mortality Risk ◽

Mexican Americans ◽

Diabetes Prevalence ◽

Data Driven ◽

Diabetes Diagnosis ◽

The Us ◽

Specific Mortality ◽

Over Time

Abstract Background: Diabetes has been described as a heterogeneous entity which can be studied through data-driven subgroups (obesity related [MOD], severe-insulin deficient [SIID], severe-insulin resistant [SIRD] and age-related diabetes [MARD]). However, trends in prevalence and mortality risk are still unclear. Aims: To analyze diabetes subgroup trends and to evaluate mortality risk in the US. Methods: Data and follow-up causes of mortality (all-cause, cardiovascular disease, and diabetes specific) was collected from NHANES cycles 1999–2018. Subgroup diabetes classification was performed using the self-normalizing neural networks algorithm using clinical parameters (HbA1c, time since diabetes diagnosis, HOMA2-IR, HOMA2-B, and BMI) proposed by Bello-Chavolla et al (https://bit.ly/3jSm1xv). Prevalence was estimated using sample weights. 2-year cycles were used as a continuous variable to evaluate the biannual change (BC) of the overall prevalence of diabetes and subgroups. Trends were stratified according to race. Cox-proportional and Fine-Gray semiparametric hazard regression models were used to evaluate mortality risk. Results: Data from 59,204 adult subjects was extracted for trend analysis. Follow-up information was obtained for 3,980 subjects. Diabetes prevalence in the US increased from 8.2% (95%CI 7.8–8.6) in 1999–2000 to 13.9% (95% CI 13.4–14.4) in 2017–2018 (BC 1.38%, 95% CI 1.20–1.56, p<0.001). Non-Hispanic Blacks had the largest increase in diabetes prevalence (BC: 1.40%, 95%CI 0.71–2.08, p=0.027), followed by Non-Hispanic Whites (BC: 1.36%, 95%CI 1.13–1.58, p<0.001), and Mexican Americans (BC: 1.33%, 95%CI 1.20–1.54, p<0.001). Regarding diabetes subgroups, MARD had the highest prevalence, with a moderate increase over time; however, MOD had the greatest increase over time (1.5%, [95%CI 1.2–1.8] to 4.5% [95%CI 4.0–5.0]; BC: 0.73% [95%CI 0.60–0.86], p<0.01). Both SIRD and SIID had non-significant increases in prevalence during the studied period. Non-Hispanic Blacks had an increase in the prevalence in MOD and SIID, Mexican Americans in MOD and SIRD, and non-Hispanic Whites in MOD and MARD. Compared with MOD, the risk for all-cause mortality was higher for MARD (HR 2.9 95% CI: 2.1–3.9), SIRD (HR 2.0 95% CI: 1.5–2.8), and SIID (HR 1.6 95% CI: 1.1–2.3). For CVD mortality, only MARD (HR 2.8 95% CI: 1.4–5.7) and SIRD (HR 2.5 95% CI: 1.2–5.3) displayed higher risk. For diabetes-specific mortality, only MARD (HR 2.2 95% CI: 1.3–3.7) was associated. Conclusion: There is an overall increase in diabetes prevalence and its subgroups from 1999 to 2018; MORD had the highest increase. The risk for all-cause, CVD and diabetes-specific mortality was different among subgroups. Our results supports the use of diabetes subgroups for a better understanding of diabetes and its complications.

Download Full-text

The Association between Health Insurance and All-Cause, Cardiovascular Disease, Cancer and Cause-Specific Mortality: A Prospective Cohort Study

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051525 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1525 ◽

Cited By ~ 1

Author(s):

Liying Song ◽

Yan Wang ◽

Baodong Chen ◽

Tan Yang ◽

Weiliang Zhang ◽

...

Keyword(s):

Mortality Risk ◽

Private Insurance ◽

Cox Proportional Hazards ◽

Current Evidence ◽

Insurance Status ◽

Public Insurance ◽

Risk Of Mortality ◽

Increased Risk ◽

Specific Mortality

The purpose of this study was to evaluate the association of insurance status with all-cause and cause-specific mortality. A total of 390,881 participants, aged 18–64 years and interviewed from 1997 to 2013 were eligible for a mortality follow-up in 31 December 2015. Cox proportional hazards models were used to calculate the hazards ratios (HR) and 95% confidence intervals (CI) to determine the association between insurance status and all-cause and cause-specific mortality. The sample group cumulatively aged 4.22 million years before their follow-ups, with a mean follow-up of 10.4 years, and a total of 22,852 all-cause deaths. In fully adjusted models, private insurance was significantly associated with a 17% decreased risk of mortality (HR = 0.83; 95% CI = 0.80–0.87), but public insurance was associated with a 21% increased risk of mortality (HR = 1.21; 95% CI = 1.15–1.27). Compared to noninsurance, private coverage was associated with about 21% lower CVD mortality risk (HR = 0.79, 95% CI = 0.70–0.89). In addition, public insurance was associated with increased mortality risk of kidney disease, diabetes and CLRD, compared with noninsurance, respectively. This study supports the current evidence for the relationship between private insurance and decreased mortality risk. In addition, our results show that public insurance is associated with an increased risk of mortality.

Download Full-text

Association of disability with mortality in the Spanish adult non-institutionalised population

Journal of Epidemiology & Community Health ◽

10.1136/jech-2021-217421 ◽

2021 ◽

pp. jech-2021-217421

Author(s):

Javier Damián ◽

Alicia Padron-Monedero ◽

Javier Almazán-Isla ◽

Fernando J García López ◽

Jesús de Pedro-Cuesta ◽

...

Keyword(s):

Mortality Risk ◽

Adult Population ◽

Community Dwelling ◽

Mortality Data ◽

Standard Population ◽

All Cause Mortality ◽

Specific Mortality ◽

Nationally Representative ◽

Rate Ratios

BackgroundThere are scant studies focused on measuring the association between disability and all-cause mortality based on large representative national samples of the community-dwelling adult population; moreover, the number of such studies which also include cause-specific mortality is yet lower.MethodsLongitudinal cohort study that used baseline data from 162 381 adults who participated in a countrywide disability survey (2008). A nationally representative sample was selected and interviewed in their homes. We present data on people ≥18 years. Disability was considered as any substantial limitation found on a list of 44 life activities that have lasted or are expected to last more than 1 year and originate from an impairment. Cause-specific mortality data were obtained from the Spanish Statistical Office. Subjects contributed follow-up time from baseline interview until death or the censoring date (31 December 2017). We computed standardised rate ratios (SRRs), with age, sex, living with a partner and education level distribution of the total group as standard population.ResultsAdults with disability (11%) had an adjusted mortality rate more than twice as high as adults without disability (SRR 2.37, 95% CI 2.24 to 2.50). The increased mortality risk remained over the 10-year follow-up period. Mortality due to diseases of the nervous system (SRR 4.86, 95% CI 3.93 to 6.01), diseases of the musculoskeletal system (SRR 3.45, 95% CI 2.18 to 5.47), infectious diseases (SRR 3.38, 95% CI 2.27 to 5.01) and diabetes mellitus (SRR 3.56, 95% CI 2.71 to 4.68) was particularly high in those with disability.ConclusionsAll-cause mortality rates are markedly higher among adults with disability. Preventive measures and health promotion initiatives are needed to reduce mortality risk in this population. Special attention should be paid to disabled people with certain specific diseases.

Download Full-text

Emergency Department Admission and Mortality Rate for Suicidal Behavior

Crisis ◽

10.1027/0227-5910/a000282 ◽

2014 ◽

Vol 35 (6) ◽

pp. 406-414 ◽

Cited By ~ 10

Author(s):

Raimondo Maria Pavarin ◽

Angelo Fioritti ◽

Francesca Fontana ◽

Silvia Marani ◽

Alessandra Paparelli ◽

...

Keyword(s):

Emergency Department ◽

Metropolitan Area ◽

Suicidal Behavior ◽

Mortality Risk ◽

Illicit Drugs ◽

Attempted Suicide ◽

Cox Model ◽

Emergency Department Admission ◽

Completed Suicide

Background: The international literature reports that for every completed suicide there are between 8 and 22 visits to an Emergency Department (ED) for attempted suicide/suicidal behavior. Aims: To describe the characteristics of admission to emergency departments (EDs) for suicide-related presenting complaints in the metropolitan area of Bologna; to estimate the risk for all-cause mortality and for suicide; to identify the profiles of subjects most at risk. Method: Follow-up of patients admitted to the EDs of the metropolitan area of Bologna between January 2004 and December 2010 for attempted suicide. A Cox model was used to evaluate the association between sociodemographic variables and the general mortality risk. Results: We identified 505 cases of attempted suicide, which were more frequent for female subjects, over the weekend, and at night (8:00 p.m./8:00 a.m.). The most used suicide methods were psychotropic drugs, sharp or blunt objects, and jumping from high places. In this cohort, 3.6% of subjects completed suicide (4.5% of males vs. 2.9% of females), 2.3% within 1 year of the start of follow-up. The most common causes of death were drug use and hanging. In the multivariate analysis, those who used illicit drugs 24 hr prior to admission to the ED (hazard ratio [HR] = 3.46, 95% CI = 1.23–9.73) and patients who refused the treatment (HR = 6.74, 95% CI = 1.86–24.40) showed an increased mortality risk for suicide. Conclusion: Deliberate self-harm patients presenting to the ED who refuse treatment represent a specific target group for setting up dedicated prevention schemes.

Download Full-text

Taxonomic signatures of cause-specific mortality risk in human gut microbiome

Nature Communications ◽

10.1038/s41467-021-22962-y ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Aaro Salosensaari ◽

Ville Laitinen ◽

Aki S. Havulinna ◽

Guillaume Meric ◽

Susan Cheng ◽

...

Keyword(s):

Mortality Risk ◽

Gut Microbiome ◽

Human Gut ◽

Cross Sectional ◽

Microbiome Composition ◽

Human Gut Microbiome ◽

Non Invasive ◽

Sequencing Technologies

AbstractThe collection of fecal material and developments in sequencing technologies have enabled standardised and non-invasive gut microbiome profiling. Microbiome composition from several large cohorts have been cross-sectionally linked to various lifestyle factors and diseases. In spite of these advances, prospective associations between microbiome composition and health have remained uncharacterised due to the lack of sufficiently large and representative population cohorts with comprehensive follow-up data. Here, we analyse the long-term association between gut microbiome variation and mortality in a well-phenotyped and representative population cohort from Finland (n = 7211). We report robust taxonomic and functional microbiome signatures related to the Enterobacteriaceae family that are associated with mortality risk during a 15-year follow-up. Our results extend previous cross-sectional studies, and help to establish the basis for examining long-term associations between human gut microbiome composition, incident outcomes, and general health status.

Download Full-text

Risk assessment in precapillary pulmonary hypertension: a comparative analysis

Respiratory Research ◽

10.1186/s12931-021-01624-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Thomas Sonnweber ◽

Eva-Maria Schneider ◽

Manfred Nairz ◽

Igor Theurl ◽

Günter Weiss ◽

...

Keyword(s):

Risk Assessment ◽

Pulmonary Hypertension ◽

High Risk ◽

Risk Stratification ◽

Risk Prediction ◽

Mortality Risk ◽

Assessment Tool ◽

Risk Models ◽

Non Invasive

Abstract Background Risk stratification is essential to assess mortality risk and guide treatment in patients with precapillary pulmonary hypertension (PH). We herein compared the accuracy of different currently used PH risk stratification tools and evaluated the significance of particular risk parameters. Methods We conducted a retrospective longitudinal observational cohort study evaluating seven different risk assessment approaches according to the current PH guidelines. A comprehensive assessment including multi-parametric risk stratification was performed at baseline and 4 yearly follow-up time-points. Multi-step Cox hazard analysis was used to analyse and refine risk prediction. Results Various available risk models effectively predicted mortality in patients with precapillary pulmonary hypertension. Right-heart catheter parameters were not essential for risk prediction. Contrary, non-invasive follow-up re-evaluations significantly improved the accuracy of risk estimations. A lack of accuracy of various risk models was found in the intermediate- and high-risk classes. For these patients, an additional evaluation step including assessment of age and right atrium area improved risk prediction significantly. Discussion Currently used abbreviated versions of the ESC/ERS risk assessment tool, as well as the REVEAL 2.0 and REVEAL Lite 2 based risk stratification, lack accuracy to predict mortality in intermediate- and high-risk precapillary pulmonary hypertension patients. An expanded non-invasive evaluation improves mortality risk prediction in these individuals.

Download Full-text