Donald Wilson

Periodontal Disease and Incident Diabetes a Seven-year Study

Diabetes is associated with a high prevalence of periodontal disease, but little is known about the effects of periodontal disease on incident diabetes. In total, 5848 non-diabetic individuals aged 30-59 yrs who completed a health examination were analyzed in this study. They were divided into three categories: no pathological pockets, moderate periodontitis, or severe periodontitis. Incident diabetes was defined as newly diagnosed cases with fasting plasma glucose > 125 mg/dL. Cox proportional hazards models estimated the effect of periodontitis on incident diabetes during a seven-year follow-up period. Moderate and severe periodontitis was significantly associated with an increased risk of diabetes in unadjusted analyses, but the magnitude of the association decreased after full adjustment [hazard ratio (HR) = 1.00, 95% confidence interval (95% CI) = 0.77-1.30 and HR = 1.28, 95% CI = 0.89-1.86, respectively]. Our findings do not indicate an apparent association between periodontitis and incident diabetes, although there was a tendency for increased risk.

Determination of thyroid volume by ultrasonography among schoolchildren in Philippines.

Objective. Iodine deficiency is defined by the goiter and the urinary iodine concentration. However, a lack of local thyroid volume reference data resulted in the vague definition of goiter, especially in school-aged children. The aim of this paper was to determine the thyroid volumes by ultrasonography in schoolchildren aged 6 to 12 years living in Cagayan areas in Philippine. Methods. Cross-sectional thyroid ultrasonographic data of 158 schoolchildren aged 6–12 years from Tuguegarao and Lagum in Cagayan valley, Philippine were used. Thyroid volumes were compared based on logistic issue and urban and rural area and compared with other previously reported data. Results. The mean values of thyroid volume in Tuguerago and Lagum were 2.99 ± 1.34 mL and 2.42 ± 0.92 mL. The thyroid size was significantly in association with age (P < 0.00), weight (P < 0.00), height (P < 0.00), and BSA (P < 0.00) by Pearsons correlation. The median thyroid volumes of schoolchildren investigated in this study were generally low compared to international reference data by age group but not by BSA. Conclusions. We propose for the first time local reference ultrasound values for thyroid volumes in 6–12 aged schoolchildren that should be used for monitoring iodine deficiency disorders.

Association of psychological well-being with oral conditions in Japanese workers.

Association of Psychological Well‐Being with Oral Conditions in Japanese Workers: Reiko Ide, et al. Department of Clinical Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health—Although the effect of disorders on psychological well‐being is well‐known, there are few studies focusing on oral conditions at the worksite. The present study examined the association between psychological well‐being and oral conditions of Japanese workers. A cross‐sectional study was performed using data from 1381 Japanese civil service officers aged 20–59 yr old. Psychological well‐being was measured with the 12‐item version of the General Health Questionnaire (GHQ‐12) in a comprehensive health questionnaire, while measures for oral condition included self‐rated oral health, oral symptoms and clinical indicators: dental caries, periodontal status and number of missing teeth. The mean GHQ scores according to the levels of each oral condition were estimated by analysis of variance, separately for males and females. Higher scores corresponded to poorer psychological well‐being. Age, gender, smoking and type of occupation were adjusted in a multivariate analysis. Psychological well‐being was not associated significantly with dental caries, periodontal status or number of missing teeth. The adjusted means of the GHQ scores for ‘conscious of appearance of mouth’ were significantly different among the categories for both genders (male: p<0.001, female: p=0.018). For five of six oral symptoms, the adjusted means of GHQ scores were lowest for those respondents who rated their oral symptoms as ‘never or hardly ever.‘ Our results did not show that psychological well‐being was associated with oral conditions measured by clinical indicators. However, an association was found between some oral symptoms and psychological well‐being. Absence of oral symptoms seems to be related to better psychological well‐being.

The Effects of Smoking on Dental Care Utilization and Its Costs in Japan

Smoking has been established as an important risk factor for periodontal disease and tooth loss. The purpose of this study was a prospective evaluation of the effects of smoking on dental care utilization and its costs, based on data from 5712 males aged 20–59 yrs. Age, dental health behavior, and history of diabetes were adjusted in a multivariate analysis. Current smokers accrued 14% higher dental care costs than never-smokers over a five-year period. This difference in annual dental care costs was mainly attributable to the increased percentage of participants in the ‘higher dental care cost’ category among current smokers. There was no clear trend identified for the dose-dependent effects of smoking on dental care utilization and its costs. Past smokers incurred lower dental care costs compared with current smokers. Smoking may have played a key role in the increment of dental care utilization and its costs via deterioration in oral conditions.

Hazardous Metal Pollution in the Republic of Fiji and the Need to Elicit Human Exposure

The fact that hazardous metals do not bio-degrade or bio-deteriorate translates to long-lasting environmental effects. In the context of evidently rapid global industrialization, this ought to warrant serious caution, particularly in developing countries. In the Republic of Fiji, a developing country in the South Pacific, several different environmental studies over the past 20 years have shown levels of lead, copper, zinc and iron in sediments of the Suva Harbor to be 6.2, 3.9, 3.3 and 2.1 times more than the accepted background reference levels, respectively. High levels of mercury have also been reported in lagoon shellfish. These data inevitably warrant thorough assessment of the waste practices of industries located upstream from the estuaries, but in addition, an exposure and health impact assessment has never been conducted. Relevant government departments are duty-bound, at least to the general public that reside in and consume seafood from the vicinities of the Suva Harbor, to investigate possible human effects of the elevated hazardous metal concentrations found consistently in 20 years of surface sediment analysis. Furthermore, pollution of the intermediate food web with hazardous metals should be investigated, regardless of whether human effects are eventually confirmed present or not.

Potential molecular approaches for the early diagnosis of lung cancer (Review)

Lung cancer is the leading cause of mortality from cancer among men and women worldwide. More individuals die each year of lung cancer than of colon, breast and prostate cancer combined. Despite new diagnostic techniques, the overall 5-year survival rate remains at approximately 15% and the majority of patients still present with advanced disease. Therefore, lung cancer is the most lethal cancer at present. Diagnosing and treating cancer at its early stages, ideally during the precancerous stages, could increase the 5-year survival rate by 3-4‑fold, with the possibility of cure. To date, no screening method has been shown to decrease the disease-specific mortality rate. This review describes issues related to early lung cancer screening and their rationale, the management of primary cancers detected by screening and the different approaches that have been tested for cancer screening; these include imaging techniques, bronchoscopies and molecular screening, such as analysis of epigenomics using different noninvasive or invasive sources, such as blood, sputum, bronchoscopic samples and exhaled breath.

Awareness of Asbestos and Action Plans for Its Exposure can Help Lives Exposed to Asbestos

Despite the fact that asbestos is a known carcinogen to humans, it is still used in industrialized countries, especially Asian countries. The global incidence of asbestos-related diseases (ARDs) due to the past use of asbestos, continues to increase, although many countries have adopted a total ban on asbestos use. The implementation of effective strategies to eliminate ARDs is therefore an important challenge in Asia, where asbestos is still mined and consumed. Collaborative efforts and strategies at the local and international levels are vital, in the pursuit toward the elimination of ARDs in this region.

Chest pain in asbestos and silica-exposed workers

BACKGROUND Chest pain may be the first symptom of developing respiratory malignancy, particularly in subjects with asbestos exposure, yet little information exists on this topic. AIMS To investigate chest pain in a cohort of subjects exposed to asbestos and silica dust applying for compensation. METHODS Cross-sectional study using a standardized questionnaire. Data collection included: smoking history, Medical Research Council scales of exercise capacity and respiratory symptoms. RESULTS We studied 621 subjects. Six disease groups were categorized: asbestosis (n = 27), diffuse pleural thickening (DPT) (132), asbestosis and DPT (14), silicosis (26), pleural plaques only (160) and healthy subjects with a history of dust exposure (256). Crude prevalence rates of chest pain were high, with chest pain approximately twice as common in subjects with asbestos-related disorders and silicosis as in healthy subjects, with an overall frequency of ~40%. However, when other variables were taken into account in a multivariate analysis the differences between groups disappeared. The factor most significantly related to chest pain was age. CONCLUSIONS Chest pain is apparently common in subjects with asbestos-related disorders and silicosis, but after adjustment for other variables, no increased prevalence was apparent in subjects with pleural disorders. More sophisticated questionnaires and dedicated imaging are required to elucidate this further.

Recent Trends in ILO Conventions Related to Occupational Safety and Health

The present study was conducted to analyze the ratification status of International Labour Organization (ILO) conventions related to occupational safety and health (OSH) by ILO member states in terms of national indicators (length of ILO membership and national income status) and regional affiliation. 17 conventions designated as OSH-related by the 2003 International Labour Conference were examined. In general, countries with longer ILO membership ratified higher numbers of conventions related to OSH. With some variation, long-membership countries had the largest number of ratifications, followed by middle- and short-membership countries in all regions. There were also incremental increases in the number of ratifications for OSH-related conventions according to the national income status. Common regional characteristics that could not be explained by the factors studied also existed. Future efforts to increase ratification at an international level will need to consider the factors influencing ratification practice among the member states.

A predictive equation to adjust for clinical variables in soluble mesothelin-related protein (SMRP) levels

Abstract Background: Malignant mesothelioma (MM) is an aggressive pleural tumor which is difficult to diagnose in its early stages. Thus, biomarkers for MM including soluble mesothelin-related protein (SMRP) are currently an area of intense research interest. However, SMRP is affected by several factors other than malignancy which need to be taken into account in the individual patient. This study aimed to evaluate factors required to adjust SMRP levels for such variables and produce a useful prediction equation for clinical application. Methods: Serum SRMP levels were measured in 535 subjects formerly exposed to asbestos and silica, including many with asbestos-related disorders (ARDs). Linear regression analyses were used to quantify the strength and “direction” of the relationship between SMRP and several independent variables, and 2×2 tables were used to determine the diagnostic accuracy of SMRP levels, taking into account clinical variables. Results: SMRP levels were affected by age and glomerular filtration rate (GFR), which were strong confounders in this study. Body mass index (BMI) was also an initial confounder but lost significance after other factors were taken into account. SMRP was also affected by smoking. Poor sensitivity (15.1%) for SMRP values among subjects with non-malignant asbestos-related disorders was found when compared to currently healthy subjects with a history of asbestos exposure. Conclusions: The present study proposes an equation based on age and GFR to improve diagnostic accuracy of SMRP. The poor sensitivity of SMRP found in this study suggests that further work is needed to find new candidate biomarkers for diagnosing early stage MM.