Sami Heistaro

Chronic disease risk factors in rural Australia: results from the greater green triangle risk factor surveys.

The aim of this article was to assess the level and prevalence of major chronic disease risk factors among rural adults. Two cross-sectional surveys were carried out in 2004 and 2005 in the southeast of South Australia and the southwest of Victoria. Altogether 891 randomly selected persons aged 25 to 74 years participated in the studies. Surveys included a self-administered questionnaire, physical measurements, and a venous blood specimen for lipid analyses. Two thirds of participants had cholesterol levels ≥5.0 mmol/L. The prevalence of high diastolic blood pressure (≥90 mm Hg) was 22% for men and 10% for women in southeast of South Australia, and less than 10% for both sexes in southwest of Victoria. Two thirds of participants were overweight or obese (body mass index ≥25 kg/m2). About 15% of men and slightly less women were daily smokers. The abnormal risk factor levels underline the need for targeted prevention activities in the Greater Green Triangle region. Continuing surveillance of levels and patterns of risk factors is fundamentally important for planning and evaluating preventive activities.

Serum cotinine predicts bronchial obstruction regardless of self-reported smoking history.

Background: We studied ability of serum cotinine and detailed history of smoking to predict bronchial obstruction. Methods: The baseline study was done during the Mini-Finland Health Survey in 1980 and the follow-up study during the Health 2000 Survey in 2000 for a total of 662 persons free from bronchial obstruction at baseline. Spirometric values of the ratio of forced expiratory volume in one second to forced vital capacity (FEV%) <80% were defined as moderate and <70% as severe bronchial obstruction at follow-up. Cotinine was determined from frozen serum samples collected at baseline. Results: For those who reported at baseline not to smoke currently but whose serum cotinine (≥100 μg/l) indicated active smoking, the age- and sex-adjusted odds ratio of bronchial obstruction at follow-up was 2.55 (95% CI 1.26—5.19) compared with the ‘‘true non-smokers’’ (<100 μg/l). Among current smokers, after adjustment for age, sex, pack years, daily consumption of cigarettes, and inhalation of smoke, the odds ratio of moderate and severe bronchial obstruction was 1.61 (95% CI 1.12— 2.32) and 1.97 (95% CI 1.10—3.54) per an increment of one standard deviation (367 μg/l) in serum cotinine. The predictive value of all the interview measures of past or current smoking was clearly lower. Conclusions: Serum cotinine concentration is a useful predictor for development of obstruction. Smoking history alone may be insufficient in risk factor studies focusing on smoking-related diseases.