P.J.S. Hamilton

Employment grade and coronary heart disease in British civil servants.

The relationship between grade of employment, coronary risk factors, and coronary heart disease (CHD) mortality has been investigated in a longitudinal study of 17 530 civil servants working in London. After seven and a half years of follow-up there was a clear inverse relationship between grade of employment and CHD mortality. Men in the lowest grade (messengers) had 3.6 times the CHD mortality of men in the highest employment grade (administrators). Men in the lower employment grades were shorter, heavier for their height, had higher blood pressure, higher plasma glucose, smoked more, and reported less leisure-time physical activity than men in the higher grades. Yet when allowance was made for the influence on mortality of all of these factors plus plasma cholesterol, the inverse association between grade of employment and CHD mortality was still strong. It is concluded that the higher CHD mortality experienced by working class men, which is present also in national statistics, can be only partly explained by the established coronary risk factors.

SMOKING AND OTHER RISK FACTORS FOR CORONARY HEART-DISEASE IN BRITISH CIVIL SERVANTS

A five-year follow-up of 18 403 male British civil servants between the age of 40 and 64, who had been the subject of an earlier clinical survey found 277 deaths from coronary heart-disease (C.H.D.). After adjusting for age, current cigarette smoking, systolic and diastolic blood-pressure, and blood-cholesterol were shown to be related to both the prevalence of one or more indices of cardiac ischaemia and to the risk of cardiac death. Neither blood-glucose two hours after a 50 g load nor weight/height showed any such simple linear association with mortality. Multivariate analysis confirmed that the main risk factors were independently related to cardiac morbidity and mortality. Irrespective of blood-pressure or plasma-cholesterol, current cigarette smokers thus had a higher risk of C.H.D. death than those not smoking cigarettes.

Studies on onchocerciasis in the United Cameroon Republic. II. Comparison of onchocerciasis in rain-forest and Sudan-Savanna

Abstract The results of an onchocerciasis survey of total populations aged 5 years and over in 16 heavily infected villages in Cameroon rain-forest and savanna zones are reported. Using standardized parasitological and clinical techniques the same observers examined the intensity of infection and clinical manifestations in 1,098 cases in the rain-forest and compared them with those found in 1,128 cases in the savanna. The following Table summarizes the main findings:- Rainforest Savana Prevalence of nodules 80–90% 60–70% Mean number of nodules per person +++ ++ Microfilarial skin density ++ −++ Skin atrophy ++ +++ Shin depigmentation +++ + Groin lymphadenopathy +++ ++ Hanging groin ++ + Microfilarial invasion of cornea ++ +++ Microfilarial invasion of anterior chmaber +++ +++ Microfilarial invasion of vitreous + ++ Snowflake corneal opacities ++ + Sclerosing keratitis + +++ Iritis + +++ Optic atrophy + + Choroidoretinitis + + Blindness 2.0% 5.1% + =at low level ++ =at medium level +++ at high level It is suggested that the differences between rain-forest and savanna may be due to variations in host response resulting from differences in the intensity and patterns of transmission. Different pathogenicity of the rain-forest and savanna strains of parasite is also considered to be of importance, and it is suggested that concomitant infections may influence the immunological response. Hormonal factors are considered to be important in influencing the differences in the patterns and severity of infections between males and females.

Studies on onchocerciasis in the United Cameroon Republic. I. Comparison of populations with and without Onchocerca volvulus

Abstract The results of an onchocerciasis survey of total populations aged 5 years and over in 22 village groups in Cameroon rain-forest and savanna are reported. Using standardized techniques the same observers examined skin and eye lesions in 2,678 persons infected with O. volvulus , and compared them with lesions in 1,156 persons in whom the parasite was not detected.