scholarly journals Identifying Household Level Risk Factors for Unintentional House Fire Incidents, Injuries and Fatalities

Author(s):  
Samantha Turner ◽  
Sarah Rodgers ◽  
Ronan Lyons

ABSTRACTObjectivesUnintentional house fire incidents, injuries and deaths are a serious public health concern in the UK, which disproportionally affect certain groups in the population. Whilst house fires have decreased in recent years; growing financial pressures in the Fire and Rescue Services (FRSs) have resulted in funds dedicated to fire preventative activities becoming increasingly limited. To ensure ever limiting resources are targeted towards those households at greatest risk, it is essential the FRSs’ are accurately informed about the types of household at increased risk. The aim of this project is to undertake a large-scale case-control study, to identify the distinguishing household level risk factors associated with unintentional house fire incidents, injuries and deaths. ApproachUnintentional house fire incidents reported to the Welsh FRS between the years 2003-2008, were anonymised and incorporated into the Secure Anonymised Information Linkage (SAIL) Databank at the Farr Institute, Swansea University. 6943 case households (households which reported a fire to the FRS) were time-matched to 347,150 control households (case:control ratio 1:50). Individuals registered as living at these properties on the date of the fire were established using the Welsh Demographic Service (WDS) dataset. Household level variables will be created by linking case and control households to other demographic, health, educational and environmental datasets in SAIL. Conditional Logistic Regression will be used to estimate matched odds ratios and 95% confidence intervals. ResultsPotential risk factor variables were selected on the basis of a systematic review and theoretically plausible variables. Covariates include: household composition (e.g. age and gender of residents), socioeconomic status, educational attainment, smoking, alcohol consumption, mental health conditions, other health related conditions, mobility and sensory impairments and property related characteristics. Fire related circumstances (e.g. fire ignition source, presence of a smoke alarm) will also be investigated in logistic regression models exploring risk factors for injury and death. Results will be presented at the conference. ConclusionThis is the first large-scale analysis of risk factors for unintentional house fire incidents, injuries and deaths. The findings from this project will be translated into comprehensible infographics, designed to support the FRSs, other partner organisations and the general public, recognise high risk households in need of preventative interventions.

Author(s):  
Gerald A. Onwuegbuzie ◽  
Peter Alabi ◽  
Fatima Abdulai

Background: Obesity in Africa has remained a public health concern, which is been fueled by urbanization and its attendant lifestyle changes which includes less energy demanding jobs, sedentary lifestyle and adopting detrimental western eating habits. There are well established risk factors for stroke, however the association of obesity with that of stroke is less clear.Methods: This study was designed to determine whether abdominal obesity is independently associated with an increased risk of ischaemic stroke. It is a case control study of 113 patients in which structured questionnaire was administered to consecutive patients admitted into the medical wards. The controls were matched for age and sex from a database with participants of the population-based cohort study. Statistical analysis of data was performed using SAS software (SAS Institute) 9.4.Results: In the study 85% of the patients had hypertension, 50.5% had hypercholesterolemia and 33.6% had diabetes. The BMI was normal for most of the cases (23.3% vs. 76.7% p<0.0001) while the WHR was increased for most of the cases (70.9% vs. 29.1% p<0.0001). The statistical significance shows that WHR was more sensitive in assessing obesity than BMI. The logistic regression analysis, in model 1 unadjusted and model 2 adjusted for sex and age, BMI showed a positive association with risk of stroke (OR 1.10; 95% CI, 1.04-1.17; p=0.002) this association lost its significance in model 3 after adjusting for diabetes, hypertension and hypercholesterolemia (OR 1.04; 95% CI, 0.96-1.13; p=0.3751). The results of logistic regression analysis for WHR for model 1, model 2 and model 3 did not show any significance before and after adjustment.Conclusions: Abdominal obesity may increase the risk of ischemic stroke through conventional vascular risk factors, but not as an independent risk factor.


2021 ◽  
pp. 036354652110416
Author(s):  
Connor Lee Dow ◽  
Ryan G. Timmins ◽  
Joshua D. Ruddy ◽  
Morgan D. Williams ◽  
Nirav Maniar ◽  
...  

Background: Hamstring strain injuries are the most common injuries in team sports. Biceps femoris long head architecture is associated with the risk of hamstring injury in soccer. To assess the overall predictive ability of architectural variables, risk factors need to be applied to and validated across different cohorts. Purpose: To assess the generalizability of previously established risk factors for a hamstring strain injury (HSI), including demographics, injury history, and biceps femoris long head (BFlh) architecture to predict HSIs in a cohort of elite Australian football players. Study Design: Cohort study; Level of evidence, 3. Methods: Demographic, injury history, and BFlh architectural data were collected from elite soccer (n = 152) and Australian football (n = 169) players at the beginning of the preseason for their respective competitions. Any prospectively occurring HSIs were reported to the research team. Optimal cut points for continuous variables used to determine an association with the HSI risk were established from previously published data in soccer and subsequently applied to the Australian football cohort to derive the relative risk (RR) for these variables. Logistic regression models were built using data from the soccer cohort and utilized to estimate the probability of an injury in the Australian football cohort. The area under the curve (AUC) and Brier score were the primary outcome measures to assess the performance of the logistic regression models. Results: A total of 27 and 30 prospective HSIs occurred in the soccer and Australian football cohorts, respectively. When using cut points derived from the soccer cohort and applying these to the Australian football cohort, only older athletes (aged ≥25.4 years; RR, 2.7 [95% CI, 1.4-5.2]) and those with a prior HSI (RR, 2.5 [95% CI, 1.3-4.8]) were at an increased risk of HSIs. Using the same approach, height, weight, fascicle length, muscle thickness, pennation angle, and relative fascicle length were not significantly associated with an increased risk of HSIs in Australian football players. The logistic regression model constructed using age and prior HSIs performed the best (AUC = 0.67; Brier score = 0.14), with the worst performing model being the one that was constructed using pennation angle (AUC = 0.53; Brier score = 0.18). Conclusion: Applying cut points derived from previously published data in soccer to a dataset from Australian football identified older age and prior HSIs, but none of the modifiable HSI risk factors, to be associated with an injury. The transference of HSI risk factor data between soccer and Australian football appears limited and suggests that cohort-specific cut points must be established.


2021 ◽  
Author(s):  
Robert W Aldridge ◽  
Helen Pineo ◽  
Ellen Fragaszy ◽  
Max Eyre ◽  
Jana Kovar ◽  
...  

Background: Household overcrowding is associated with increased risk of infectious diseases across cultures and countries. Limited data exist in England and Wales linking household overcrowding and risk of COVID-19. We used data collected from the Virus Watch cohort to examine the association between overcrowded households and infection to pandemic coronavirus SARS-CoV-2. Methods: The Virus Watch study is a household community cohort of acute respiratory infections in England & Wales that began recruitment in June 2020. We calculated the persons per room for each household and classified accommodation as overcrowded when the number of rooms was fewer than the number of people. We considered two primary outcomes - PCR-confirmed positive SARS-CoV-2 antigen tests and laboratory confirmed SARS-CoV-2 antibodies (Roche Elecsys anti-N total immunoglobulin assay). We used mixed effects logistic regression models that accounted for household structure to estimate the association between household overcrowding and SARS-CoV-2 infection. Results: The proportion of participants with a positive SARS-CoV-2 PCR result was highest in the overcrowded group (6.6%; 73/1,102) and lowest in the under-occupied group (2.9%; 682/23,219). In a mixed effects logistic regression model that included age, sex, ethnicity, household income and geographical region as fixed effects, and a household-level random effect, we found strong evidence of an increased odds of having a positive PCR SARS-CoV-2 antigen result (Odds Ratio 3.67; 95% CI: 1.91, 7.06; p-value < 0.001) and increased odds of having a positive SARS-CoV-2 antigen result in individuals living in overcrowded houses (2.99; 95% CI: 1.14, 7.81; p-value =0.03) compared to people living in under-occupied houses. Discussion: Public health interventions to prevent and stop the spread of SARS-CoV-2 should consider the much greater risk of infection for people living in overcrowded households and pay greater attention to reducing household transmission. There is an urgent need to better recognise housing as a leading determinant of health in the context of a pandemic and beyond.


2020 ◽  
Vol 9 (4) ◽  
Author(s):  
Megan McGlone ◽  
Emily Long

Background: Recent evidence has shown that young adults experience significant levels of loneliness, and those with long-standing illness or disability (LSID) may be particularly vulnerable. This study investigated whether young adults with LSID were more likely to experience loneliness than their ‘healthy’ peers, after accounting for key socio-contextual and health-related factors associated with loneliness.Design and Methods:  The sample consists of 4510 16-24-year-old individuals from Wave 9 of the UK Household Longitudinal Study (UKHLS). Loneliness was measured using the UCLA 3-item loneliness scale, in addition to a direct indicator of frequency of loneliness. Correlation tests measured associations between both measures of loneliness and LSID. Ordinal logistic regression was used to examine the association between LSID and UCLA loneliness, after accounting for key demographic and socio-contextual variables.Results: Results from the correlation tests demonstrated significant associations between LSID and both measures of loneliness. Results from the ordinal logistic regression models indicated that chronic illness was significantly associated with loneliness, after accounting for various demographic, social, and well-being factors. In addition, individuals with fewer close friends reported higher loneliness, as did those with poorer mental health, and low well-being scores. Younger participants, age brackets 16-18 and 19-21, were found to report higher loneliness than the individuals aged 22-24-year-old.Conclusions: Overall, the study found significant evidence of associations between the presence of LSID and loneliness in young adults (16-24 years old), suggesting these individuals are at an increased risk of loneliness, and could be a focus for future public health interventions.


2010 ◽  
Vol 138 (10) ◽  
pp. 1427-1438 ◽  
Author(s):  
C. A. FEATHERSTONE ◽  
R. REICHEL ◽  
L. C. SNOW ◽  
R. H. DAVIES ◽  
K. H. CHRISTIANSEN ◽  
...  

SUMMARYA cross-sectional study into risk factors for Salmonella was undertaken using data gathered from 252 fattening turkey flocks in the UK. The data was derived from the EU baseline survey conducted during 2006 and 2007, in addition to a voluntary questionnaire. Multivariate logistic regression models identified significant risk factors for Salmonella spp. and Salmonella Typhimurium. A decreased risk of Salmonella spp. infection was associated with a history of intestinal illness in the sampled flock (OR 0·17), the use of wood shavings as litter (OR 0·21), use of disinfectant in the cleaning process (OR 0·25), incineration of dead birds on farm (OR 0·29), seasonal production (OR 0·31), farm staff also working with cattle (OR 0·31), and the presence of pigs on neighbouring farms (OR 0·38). The risk of isolating Salmonella spp. varied according to the company from which the poults were sourced. A reduced risk of S. Typhimurium infection was associated with the use of wax blocks to control rodents (OR 0·09), using mains water (OR 0·19) and having a Salmonella test programme (OR 0·23). An increased risk of S. Typhimurium infection was associated with storage of items around the turkey house (OR 5·20), evidence of mice (OR 4·71) and a soil surface surrounding the turkey house (OR 2·70). This study therefore identifies a number of important practical measures which can be implemented by farmers and veterinarians within the turkey industry to assist in the control of salmonellosis at the farm level.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hiroya Yamada ◽  
Koji Suzuki ◽  
Ryosuke Fujii ◽  
Miyuki Kawado ◽  
Shuji Hashimoto ◽  
...  

AbstractPrimary prevention of premature death is a public health concern worldwide. Circulating microRNAs (miRNAs) have been described as potential diagnostic biomarkers for diseases as cancer and cardiovascular disease (CVD). This case-cohort study aimed to investigate the potential relationship between circulating miRNAs and the risk of premature death. A total of 39,242 subjects provided baseline serum samples in 1988–1990. Of these, 345 subjects who died of intrinsic disease (< 65 years old) and for which measurable samples were available were included in this study. We randomly selected a sub-cohort of 879 subjects. Circulatring miR-21, miR-29a, and miR-126 were determined using qRT-PCR. Conditional logistic regression models were used to analyse the data with respect to stratified miRNA levels. Multivariable logistic regression revealed that subjects with high circulating miR-21 and miR-29a individual levels had a significantly higher risk of total death, cancer death, and CVD death than those with medium miR-21 and miR-29a individual levels. Conversely, subjects with low circulating miR-126 levels had a significantly higher risk of total death than those with medium levels. This suggests that circulating miRNAs are associated with the risk of premature death from cancer and CVD, identifying them as potential biomarkers for early detection of high-risk individuals.


2015 ◽  
Vol 57 (3) ◽  
pp. 269-272 ◽  
Author(s):  
Edgar KOYOC-CARDEÑA ◽  
Anuar MEDINA-BARREIRO ◽  
Francisco Javier ESCOBEDO-ORTEGÓN ◽  
Jorge Carlos RODRÍGUEZ-BUENFIL ◽  
Mario BARRERA-PÉREZ ◽  
...  

This study longitudinally investigated the association between Triatoma dimidiata infestation, triatomine infection with Trypanosoma cruzi and household/backyard environmental characteristics in 101 homesteads in Molas and Yucatan, Mexico, between November 2009 (rainy season) and May 2010 (dry season). Logistic regression models tested the associations between insect infestation/infection and potential household-level risk factors. A total of 200 T. dimidiata were collected from 35.6% of the homesteads, mostly (73%) from the peridomicile. Of all the insects collected, 48% were infected with T. cruzi. Infected insects were collected in 31.6% of the homesteads (54.1% and 45.9% intra- and peridomiciliary, respectively). Approximately 30% of all triatomines collected were found in chicken coops. The presence of a chicken coop in the backyard of a homestead was significantly associated with both the odds of finding T. dimidiata (OR = 4.10, CI 95% = 1.61-10.43, p = 0.003) and the presence of triatomines infected with T. cruzi (OR = 3.37, CI 95% = 1.36-8.33, p = 0.006). The results of this study emphasize the relevance of chicken coops as a putative source of T. dimidiata populations and a potential risk for T. cruzi transmission.


2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 24-24
Author(s):  
Kosj Yamoah ◽  
Michael Hiroshi Johnson ◽  
Voleak Choeurng ◽  
Kasra Yousefi ◽  
Zaid Haddad ◽  
...  

24 Background: Numerous studies have reported a significantly higher incidence of PCa and/or adverse pathological features associated with African-American men compared to European-American men. Less however is known about the genomic disparities that exist between these two groups. In this report we compared the race-specific expression of biomarkers linked to PCa pathogenesis in a matched cohort of AA and EA men. Methods: PCa data from AA and EA patients were analyzed from four medical centers. Cases were matched based on CAPRA-S within each institution for a total sample size of 300 (121-AA; 179-EA). The distribution of mRNA expression levels of 20 validated biomarkers associated with PCa initiation and progression was compared by race using a false-discovery-rate adjusted Mann-Whitney U, and logistic regression models. Conditional logistic regression models were used to evaluate the interaction between race and biomarker expression for predicting pathologic T3 PCa. Results: Of 20 biomarkers interrogated, 6 showed statistically significant differential expression in AA compared with EA men in one or more statistical models. These include TMPRSS2-ERG (p<0.001), AMACR (p<0.001), SPINK1 (p=0.005), AR (p=0.018), SRD5A2 (p=0.005), and GSTP1 (p=0.021). Dysregulation of MYCBP (p=0.043) increases risk of pT3 disease in AA but decreases the risk in EA men, while the reverse is true for AMACR (p=0.013), TMPRSS2-ERG (p=0.026), FOXP1 (p=0.016), and GSTP1 (p=0.032). Loss-of-function mutation for tumor suppressors PTEN (p=0.046), TP53 (p=0.042), and RB1 (p=0.027), and dysregulation of AR (p=0.015), EZH2 (p=0.043), NKX3-1 (p=0.024), SRD5A2 (p=0.032), and SPOP (p=0.032) increased risk of pT3 disease for both AA and EA men. Conclusions: We have identified a subset of PCa biomarkers that predict risk of clinico-pathologic outcomes in a race-dependent manner. These biomarkers may in part explain the biological contribution to racial disparity in PCa outcomes between EA and AA men.


Author(s):  
Dana Tzur Bitan ◽  
Israel Krieger ◽  
Khalaf Kridin ◽  
Doron Komantscher ◽  
Yochai Scheinman ◽  
...  

Abstract Objective Individuals with schizophrenia may be at an increased risk for COVID-19 morbidity due to the disease characteristics. In this study, we aimed to explore the odds of significant COVID-19 morbidity and mortality among schizophrenia patients while controlling for potential sociodemographic and medical confounders. Methods Schizophrenia patients and age-and-sex matched controls (total n = 51 078) were assessed for frequency of COVID-19 positivity, hospitalizations, and mortality. The odds for COVID-19-associated hospitalization and mortality were calculated using logistic regression models, while controlling for age, sex, marital status, sector, socioeconomic status, diabetes, ischemic heart disease, hypertension, hyperlipidemia, obesity, smoking, and chronic obstructive pulmonary disease. Results Individuals with schizophrenia were less likely to test positive for COVID-19; however, they were twice as likely to be hospitalized for COVID-19 (OR 2.15 95% CI 1.63–2.82, P &lt; .0001), even after controlling for sociodemographic and clinical risk factors (OR 1.88 95% CI 1.39–2.55, P &lt; .0001). Furthermore, they were 3 times more likely to experience COVID-19 mortality (OR 3.27 95% CI 1.39–7.68, P &lt; .0001), compared to controls. Conclusions We found evidence of associations between schizophrenia and increased COVID-19 morbidity and mortality compared to controls regardless of sociodemographic and medical factors. As these patients present with a combination of potential risk factors for mortality, efforts should be made to minimize the effects of the pandemic on this vulnerable population.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 23.2-24
Author(s):  
V. Molander ◽  
H. Bower ◽  
J. Askling

Background:Patients with rheumatoid arthritis (RA) are at increased risk for venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) (1). Several established risk factors of VTE, such as age, immobilization and comorbid conditions, occur more often patients with RA (2). In addition, inflammation may in itself also increase VTE risk by upregulating procoagolatory factors and causing endothelial damage (3). Recent reports indicate an increased risk of VTE in RA patients treated with JAK-inhibitors (4), pointing to the need to better understand how inflammation measured as clinical RA disease activity influences VTE risk.Objectives:To investigate the relationship between clinical RA disease activity and incidence of VTE.Methods:Patients with RA were identified from the Swedish Rheumatology Quality Register (SRQ) between July 1st2006 and December 31st2017. Clinical rheumatology data for these patients were obtained from the visits recorded in SRQ, and linked to national registers capturing data on VTE events and comorbid conditions. For each such rheumatologist visit, we defined a one-year period after the visit and determined whether a VTE event had occurred within this period or not. A visit followed by a VTE event was categorized as a case, all other visits were used as controls. Each patient could contribute to several visits. The DAS28 score registered at the visit was stratified into remission (0-2.5) vs. low (2.6-3.1), moderate (3.2-5.1) and high (>5.1) disease activity. Logistic regression with robust cluster standard errors was used to estimate the association between the DAS28 score and VTE.Results:We identified 46,311 patients with RA who contributed data from 320,094 visits. Among these, 2,257 visits (0.7% of all visits) in 1345 unique individuals were followed by a VTE within the one-year window. Of these, 1391 were DVT events and 866 were PE events. Figure 1 displays the absolute probabilities of a VTE in this one-year window, and odds ratios for VTE by each DAS28 category, using DAS28 remission as reference. The one-year risk of a VTE increased from 0.5% in patients in DAS28 remission, to 1.1% in patients with DAS28 high disease activity (DAS28 above 5.1). The age- and sex-adjusted odds ratio for a VTE event in highly active RA compared to RA in remission was 2.12 (95% CI 1.80-2.47). A different analysis, in which each patient could only contribute to one visit, yielded similar results.Figure 1.Odds ratios (OR) comparing the odds of VTE for DAS28 activity categories versus remission. Grey estimates are from unadjusted logistic regression models, black estimates are from logistic regression models adjusted for age and sex. Absolute one-year risk of VTE are estimated from unadjusted models.Conclusion:This study demonstrates a strong association between clinical RA inflammatory activity as measured through DAS28 and risk of VTE. Among patients with high disease activity one in a hundred will develop a VTE within the coming year. These findings highlight the need for proper VTE risk assessment in patients with active RA, and confirm that patients with highly active RA, such as those recruited to trials for treatment with new drugs, are already at particularly elevated risk of VTE.References:[1]Holmqvist et al. Risk of venous thromboembolism in patients with rheumatoid arthritis and association with disease duration and hospitalization. JAMA. 2012;308(13):1350-6.[2]Cushman M. Epidemiology and risk factors for venous thrombosis. Semin Hematol. 2007;44(2):62-9.[3]Xu J et al. Inflammation, innate immunity and blood coagulation. Hamostaseologie. 2010;30(1):5-6, 8-9.[4]FDA. Safety trial finds risk of blood clots in the lungs and death with higher dose of tofacitinib (Xeljanz, Xeljanz XR) in rheumatoid arthritis patients; FDA to investigate. 2019.Acknowledgments:Many thanks to all patients and rheumatologists persistently filling out the SRQ.Disclosure of Interests:Viktor Molander: None declared, Hannah Bower: None declared, Johan Askling Grant/research support from: JA acts or has acted as PI for agreements between Karolinska Institutet and the following entities, mainly in the context of the ARTIS national safety monitoring programme of immunomodulators in rheumatology: Abbvie, BMS, Eli Lilly, Merck, MSD, Pfizer, Roche, Samsung Bioepis, Sanofi, and UCB Pharma


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