ORCID Profile
0000-0001-9223-0767
Current Organisation
University of Western Australia
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Public Health and Health Services | Epidemiology | Nursing | Family Care | Respiratory Diseases | Environmental And Occupational Health And Safety | Health and Community Services | Personality, Abilities And Assessment | Epidemiology | Sociology Not Elsewhere Classified | Population Trends and Policies | Midwifery | Mental Health Nursing | Criminology | Studies of Aboriginal and Torres Strait Islander Society | Paediatrics | Sociology | Environmental Sciences Not Elsewhere Classified |
ANZSRC Socio-Economic Objective (SEO)
Ability and disability | Social Structure and Health | Special education | Crime Prevention | Primary education | Child health | Expanding Knowledge in the Medical and Health Sciences | Justice and the law not elsewhere classified | Air quality | Aboriginal and Torres Strait Islander Health - Health Status and Outcomes | Environmental health | Respiratory system and diseases (incl. asthma) | Social structure and health | Health status (e.g. indicators of “well-being”) | Health Inequalities
Related Links
Publications
The relationship between changes in daily air pollution and hospitalizations in Perth, Australia 1992–1998: A case-crossover study
Publisher: Informa UK Limited
Date: 02-2006
DOI: 10.1080/09603120500397680
Abstract: A case-crossover study was undertaken to investigate the relationship between daily air pollutant concentrations and daily hospitalizations for selected disease categories in Perth, Western Australia. Daily measurements of particles (measured by nephelometry and PM2.5), photochemical oxidants (measured as ozone), nitrogen dioxide (NO2) and carbon monoxide (CO) concentrations were obtained from 1992 to 1998 via a metropolitan network of monitoring stations. Daily PM2.5 concentrations were estimated using monitored data, modelling and interpolation. Hospital morbidity data for respiratory, cardiovascular (CVD), gastrointestinal (GI) diseases, chronic obstructive pulmonary diseases (COPD) excluding asthma pneumonia/influenza diseases and asthma were obtained and categorized into all ages, less than 15 years and greater than 65 years. Gastrointestinal morbidity was used as a control disease. The data were analyzed using conditional logistic regression. The results showed a small number of significant associations for daily changes in particle concentrations, nitrogen dioxide and carbon monoxide for the respiratory diseases, CODP, pneumonia, asthma and CVD hospitalizations. Changes in ozone concentrations were not significantly associated with any disease outcomes. These data provide useful information on the potential health impacts of air pollution in an airshed with very low sulphur dioxide concentrations and lower nitrogen dioxide concentrations commonly found in many other cities.
The End Rheumatic Heart Disease in Australia Study of Epidemiology (ERASE) Project
Publisher: Informa UK Limited
Date: 11-2019
DOI: 10.2147/CLEP.S224621
Are 24-hour urine samples and creatinine adjustment required for analysis of inorganic arsenic in urine in population studies?
Publisher: Elsevier BV
Date: 03-2002
Inflammatory Responses to Individual Microorganisms in the Lungs of Children With Cystic Fibrosis
Publisher: Oxford University Press (OUP)
Date: 15-08-2011
DOI: 10.1093/CID/CIR399
Abstract: We hypothesized that the inflammatory response in the lungs of children with cystic fibrosis (CF) would vary with the type of infecting organism, being greatest with Pseudomonas aeruginosa and Staphylococcus aureus. A microbiological surveillance program based on annual bronchoalveolar lavage (BAL) collected fluid for culture and assessment of inflammation was conducted. Primary analyses compared inflammation in s les that grew a single organism with uninfected s les in cross-sectional and longitudinal analyses. Results were available for 653 s les from 215 children with CF aged 24 days to 7 years. A single agent was associated with pulmonary infection (≥10(5) cfu/mL) in 67 BAL s les, with P. aeruginosa (n = 25), S. aureus (n = 17), and Aspergillus species (n = 19) being the most common. These microorganisms were associated with increased levels of inflammation, with P. aeruginosa being the most proinflammatory. Mixed oral flora (MOF) alone was isolated from 165 BAL s les from 112 patients, with 97 of these s les having a bacterial density ≥10(5) cfu/mL, and was associated with increased pulmonary inflammation (P < .001). For patients with current, but not past, infections there was an association with a greater inflammatory response, compared with those who were never infected (P < .05). However, previous infection with S. aureus was associated with a greater inflammatory response in subsequent BAL. Pulmonary infection with P. aeruginosa, S. aureus, or Aspergillus species and growth of MOF was associated with significant inflammatory responses in young children with CF. Our data support the use of specific surveillance and eradication programs for these organisms. The inflammatory response to MOF requires additional investigation.
The Impact of Pneumococcal Vaccination on Bacterial and Viral Pneumonia in Western Australian Children
Publisher: Oxford University Press (OUP)
Date: 23-11-2018
DOI: 10.1093/CID/CIX923
Abstract: Pneumococcal conjugate vaccine (PCV) was included in Australia's National Immunisation Program for all children from 2005. We assessed the impact of PCV on all-cause and pathogen-specific pneumonia hospitalizations in Western Australian (WA) children aged ≤16 years. All hospitalizations with pneumonia-related International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification diagnosis codes occurring in WA-born children (1996-2012) were linked to pathology records. Age-specific incidence rate ratios and temporal trends for all-cause and pathogen-specific pneumonia hospitalizations were calculated before and after PCV introduction. Among 469589 births, there were 15175 pneumonia-related hospitalizations. Hospitalization rates were 6.7 (95% confidence interval, 6.4-6.9) times higher in Aboriginal than in non-Aboriginal children. Following PCV introduction, all-cause pneumonia hospitalizations showed significant declines across all age groups. A pathogen was identified in 2785 of 6693 (41.6%) pneumonia hospitalizations that linked to a pathology record. Respiratory syncytial virus (RSV) was most frequently identified, with RSV-associated pneumonia hospitalization rates of 89.6/100000 child-years in Aboriginal and 26.6/100000 child-years in non-Aboriginal children. The most common bacterial pathogen was Streptococcus pneumoniae in Aboriginal children (32.9/100000 child-years) and Mycoplasma pneumoniae in non-Aboriginal children (8.4/100000 child-years). Viral pneumonia rates declined in all children following PCV introduction, with the greatest declines seen in non-Aboriginal children declines in bacterial pneumonia were observed in non-Aboriginal children. Based on our ecological analyses, PCV seems to have had an impact on hospitalizations for pneumonia, suggesting that the pneumococcus is likely to play a role in both bacterial and viral pneumonia. Respiratory viruses remain an important pathogen in childhood pneumonia. Vaccines targeting respiratory viruses are needed to combat the residual burden of childhood pneumonia.
Effects of asbestos and smoking on the levels and rates of change of lung function in a crocidolite exposed cohort in Western Australia
Publisher: BMJ
Date: 12-2004
Predictive value of non-specific bronchial challenge testing for respiratory symptoms and lung function in aluminium smelter workers
Publisher: BMJ
Date: 07-04-2020
DOI: 10.1136/OEMED-2019-106344
Abstract: To assess the predictive value of bronchial hyper-responsiveness (BHR) for the subsequent development of respiratory symptoms, airflow limitation and decline in lung function among aluminium smelter workers. An inception cohort study of new employees at two Australian aluminium smelters was conducted. Participants completed a modified British Medical Research Council respiratory questionnaire, spirometry and a methacholine bronchial challenge test at baseline and at annual follow-up reviews. BHR was defined as PD 20 ≤4000 µg. Poisson and mixed effects models were fitted to respiratory symptoms and lung function (forced expiratory volume in 1 s (FEV 1 ) and FEV 1 /forced vital capacity (FVC)). Baseline interview and lung function testing were completed by 278 workers, who were followed for a median of 4 years. BHR at baseline, present in 82 workers, was not associated with incident wheeze risk ratio (RR)=1.07 (95% CI 0.74 to 1.55) and cough RR=0.78 (95% CI 0.45, 1.35), but there was some increased risk of chest tightness RR=1.40 (95% CI 0.99, 1.98) after adjustment for age, sex, smoking and atopy. BHR at baseline was associated with lower FEV 1 and FVC, although the rate of annual decline in FEV 1 or FVC was similar between those with or without BHR. The specificity of BHR was 77% for wheeze, 70% for cough and 77% for chest tightness, but the sensitivity was poor, at 33%, 24% and 39%, respectively. Methacholine challenge testing at entry to employment was not sufficiently predictive of later adverse respiratory outcomes, and notwithstanding the study limitations is unlikely to be a useful pre-employment or preplacement screening test in the aluminium smelting industry.
The relationship between MECP2 mutation type and health status and service use trajectories over time in a Rett syndrome population
Publisher: Elsevier BV
Date: 2011
Assessment of the potential effect of incremental increases in folic acid intake on neural tube defects in Australia and New Zealand
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1111/J.1467-842X.2006.TB00851.X
Abstract: To estimate the number of neural tube defects that could be prevented in Australia and New Zealand by increasing levels of folic acid intake. Available data on prevalence of neural tube defects in Australia and New Zealand, folic acid supplement use and serum folate were used in a published model to estimate the number of neural tube defects that could be prevented in Australia and New Zealand for increments of folic acid intake from 0.1 mg daily to 1 mg daily. An increase of 0.2 mg folic acid per day was estimated to result in the prevention of 49 (95% CI 27-84) neural tube defects per year in Australia and 11 (95% CI 6-18) in New Zealand. A separate estimation for Indigenous Australians found that 0.2 mg of folic acid daily could prevent 7 (95% CI 4-11) neural tube defects in Indigenous infants per year. These data should be useful in considering primary preventive strategies for neural tube defects, including the possible introduction of mandatory fortification of food with folic acid. The estimates are imprecise because of limitations in the data used in the model. More representative and precise data on neural tube defects, serum folate levels and use of folic acid supplements from all Australian States and New Zealand are needed to refine the output from the model and to provide a baseline assessment of folate status against which to measure the effects of any future interventions to prevent neural tube defects.
No sex difference observed in the association between intra-uterine growth and risk of childhood acute lymphoblastic leukaemia
Publisher: Springer Science and Business Media LLC
Date: 08-09-2007
Probabilistic linkage of national immunisation and state-based health records for a cohort of 1.9 million births to evaluate Australia’s childhood immunisation program
Publisher: Swansea University
Date: 18-09-2017
Abstract: IntroductionSeveral countries have developed national immunisation registers, but only the Nordic countrieshave linked their registers to other health data in order to comprehensively evaluate the ‘real world’effectiveness of vaccines. Nordic countries can link datasets deterministically using the nationalperson identifier, but most countries, including Australia, don’t have such an identifier to enablethis type of linkage. ObjectivesTo describe the process for assembling a linked study cohort that will enable the conduct ofpopulation-based studies related to immunisation and immunisation policy. MethodsNational death and immunisation databases along with state health data (notifications of vaccinepreventable diseases, perinatal data, hospital admissions and emergency department presentations)up until December 2013 were probabilistically linked (using demographic details) for children bornbetween 1996 and 2012 in two states: Western Australia and New South Wales (42% of Australia’spopulation, combined). ResultsAfter exclusions there were 1.95 million children in the study cohort (live born children withboth a birth and perinatal record which represents 97.5% of all live births in the state perinataldata collections - our source population) and 18.0 million person years of follow up (mean: 9.2years per child). The characteristics of children in the cohort were generally similar to those onlyincluded in state perinatal databases and outcome measures were in keeping with expected figuresfrom unlinked data sources. However, the lack of a dynamic national population register meantimmigrants could not be included. ConclusionsWe have been able to develop a similarly comprehensive system to the Nordic countries based onprobabilistic linkage methods. Our experience should provide encouragement to other countrieswith national immunisation registers looking to establish similar systems.
The reliability of a food frequency questionnaire for use among adolescents
Publisher: Springer Science and Business Media LLC
Date: 24-06-2009
DOI: 10.1038/EJCN.2009.44
Abstract: Accurate measurement of dietary intake is essential for understanding the long-term effects of adolescent diet on chronic disease risk. However, adolescents may have limited food knowledge and ability to quantify portion sizes and recall dietary intake. Therefore, food frequency questionnaires (FFQs) deemed appropriate for use among adults may not be suitable for adolescents. To evaluate an FFQ in comparison with a 3-day food record (FR) in 14-year olds participating in a population-based cohort study in Western Australia. Nutrient intakes estimated by a semi-quantitative FFQ were compared with those from a 3-day FR using Bland & Altman limits of agreement (LOA), tertile classifications and Pearson's correlation coefficients. A total of 785 adolescents provided data from both dietary methods. Mean agreement between the FR and FFQ ranged from 73 (starch) to 161% (vitamin C). The LOA ranged from 27 (retinol) to 976% (carotene), with most nutrients being overestimated by the FFQ. For most nutrients, agreement between the two methods varied significantly with the magnitude of intake. Pearson's r ranged from 0.11 (polyunsaturated fats) to 0.52 (riboflavin). The FFQ classified 80 to 90% of subjects' nutrient intakes into the same or adjacent tertile as their FR. Boys performed slightly better for all of these indices. Agreement between in idual FFQ and FR nutrient intakes was less than ideal. However, the FFQ was able to correctly rank a reasonable proportion of adolescents.
Malignant mesothelioma: current conundrums over risk estimates and whither electron microscopy for diagnosis
Publisher: Informa UK Limited
Date: 1997
Asbestos‐related disease
Publisher: Wiley
Date: 05-2011
DOI: 10.1111/J.1445-5994.2011.02451.X
Abstract: Inhalation of airborne asbestos fibres causes several diseases. These include asbestosis, lung cancer, malignant mesothelioma as well as pleural effusion, discrete (plaques) or diffuse benign pleural fibrosis and rolled atelectasis. The lag time between exposure and the development of disease may be many decades, thus the health risks of asbestos continue to be relevant despite bans on the use of asbestos and improvements in safety regulations for those who are still exposed. Asbestos was mined and used extensively in Australia for over 100 years and Australia is now experiencing part of a worldwide epidemic of asbestos-related disease. This review provides insight into the history and epidemiology of asbestos-related disease in Australia and discusses relevant clinical aspects in their diagnosis and management. The past and current medico-legal aspects of asbestos as well as currently evolving areas of research and future projections are summarized.
Support for 2 variants of eczema
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.JACI.2005.06.038
Abstract: Studies investigating the natural history and risk factors for eczema have historically considered eczema as a single entity, without regard for the in idual's atopic status. The association between atopy and eczema is complex, and as many as (2/3) of patients with eczema are not atopic. To investigate the risk factors for eczema in relation to the child's atopic status in a cohort of high-risk children. A prospective birth cohort of 263 children was followed for 5 years and closely examined for eczema. Antenatal and postnatal data on environmental exposures were collected by interview. Skin prick test to define atopic status was performed at 6 months and 2 and 5 years of age. Of the subjects, 66.1% had eczema in the first 5 years, and the majority (85.5%) reported onset of rash in the first year. A third of those with eczema were not atopic (nonatopic/intrinsic eczema). Children with atopic eczema (extrinsic eczema) were more likely to be male, to have been breast-fed longer, and to have a history of food allergies, allergic rhinitis, and current wheeze. Nonatopic eczema was more common in girls, and an association was found with early daycare attendance. This study supports the presence of 2 variants of eczema: atopic eczema occurring early in childhood and nonatopic eczema with early daycare attendance. It is likely that environmental factors have a different effect on these 2 variants of eczema, and future studies should thus consider eczema as 2 variants in determining the effect of attributable risks.
Interpregnancy intervals and adverse birth outcomes in high-income countries: An international cohort study
Publisher: Public Library of Science (PLoS)
Date: 19-07-2021
DOI: 10.1371/JOURNAL.PONE.0255000
Abstract: Most evidence for interpregnancy interval (IPI) and adverse birth outcomes come from studies that are prone to incomplete control for confounders that vary between women. Comparing pregnancies to the same women can address this issue. We conducted an international longitudinal cohort study of 5,521,211 births to 3,849,193 women from Australia (1980–2016), Finland (1987–2017), Norway (1980–2016) and the United States (California) (1991–2012). IPI was calculated based on the time difference between two dates—the date of birth of the first pregnancy and the date of conception of the next (index) pregnancy. We estimated associations between IPI and preterm birth (PTB), spontaneous PTB, and small-for-gestational age births (SGA) using logistic regression (between-women analyses). We also used conditional logistic regression comparing IPIs and birth outcomes in the same women (within-women analyses). Random effects meta-analysis was used to calculate pooled adjusted odds ratios (aOR). Compared to an IPI of 18–23 months, there was insufficient evidence for an association between IPI months and overall PTB (aOR 1.08, 95% CI 0.99–1.18) and SGA (aOR 0.99, 95% CI 0.81–1.19), but increased odds of spontaneous PTB (aOR 1.38, 95% CI 1.21–1.57) in the within-women analysis. We observed elevated odds of all birth outcomes associated with IPI ≥60 months. In comparison, between-women analyses showed elevated odds of adverse birth outcomes for month and month IPIs. We found consistently elevated odds of adverse birth outcomes following long IPIs. IPI shorter than 6 months were associated with elevated risk of spontaneous PTB, but there was insufficient evidence for increased risk of other adverse birth outcomes. Current recommendations of waiting at least 24 months to conceive after a previous pregnancy, may be unnecessarily long in high-income countries.
Association of pre‐pregnancy weight and birth defects
Publisher: Wiley
Date: 04-2010
Pleural Plaques and the Risk of Lung Cancer in Asbestos-exposed Subjects
Publisher: American Thoracic Society
Date: 2020
Mode of birth and risk of infection-related hospitalisation in childhood
Publisher: Public Library of Science (PLoS)
Date: 19-11-2020
DOI: 10.1371/JOURNAL.PMED.1003429
Abstract: The proportion of births via cesarean section (CS) varies worldwide and in many countries exceeds WHO-recommended rates. Long-term health outcomes for children born by CS are poorly understood, but limited data suggest that CS is associated with increased infection-related hospitalisation. We investigated the relationship between mode of birth and childhood infection-related hospitalisation in high-income countries with varying CS rates. We conducted a multicountry population-based cohort study of all recorded singleton live births from January 1, 1996 to December 31, 2015 using record-linked birth and hospitalisation data from Denmark, Scotland, England, and Australia (New South Wales and Western Australia). Birth years within the date range varied by site, but data were available from at least 2001 to 2010 for each site. Mode of birth was categorised as vaginal or CS (emergency/elective). Infection-related hospitalisations (overall and by clinical type) occurring after the birth-related discharge date were identified in children until 5 years of age by primary/secondary International Classification of Diseases , 10th Revision (ICD-10) diagnosis codes. Analysis used Cox regression models, adjusting for maternal factors, birth parameters, and socioeconomic status, with results pooled using meta-analysis. In total, 7,174,787 live recorded births were included. Of these, 1,681,966 (23%, range by jurisdiction 17%–29%) were by CS, of which 727,755 (43%, range 38%–57%) were elective. A total of 1,502,537 offspring (21%) had at least 1 infection-related hospitalisation. Compared to vaginally born children, risk of infection was greater among CS-born children (hazard ratio (HR) from random effects model, HR 1.10, 95% confidence interval (CI) 1.09–1.12, p 0.001). The risk was higher following both elective (HR 1.13, 95% CI 1.12–1.13, p 0.001) and emergency CS (HR 1.09, 95% CI 1.06–1.12, p 0.001). Increased risks persisted to 5 years and were highest for respiratory, gastrointestinal, and viral infections. Findings were comparable in prespecified subanalyses of children born to mothers at low obstetric risk and unchanged in sensitivity analyses. Limitations include site-specific and longitudinal variations in clinical practice and in the definition and availability of some data. Data on postnatal factors were not available. In this study, we observed a consistent association between birth by CS and infection-related hospitalisation in early childhood. Notwithstanding the limitations of observational data, the associations may reflect differences in early microbial exposure by mode of birth, which should be investigated by mechanistic studies. If our findings are confirmed, they could inform efforts to reduce elective CS rates that are not clinically indicated.
Lung Disease at Diagnosis in Infants with Cystic Fibrosis Detected by Newborn Screening
Publisher: American Thoracic Society
Date: 15-07-2009
Erratum to: Exposure to household painting and floor treatments, and parental occupational paint exposure and risk of childhood brain tumors: results from an Australian case-control study
Publisher: Springer Science and Business Media LLC
Date: 20-06-2014
The Diagnosis and Attribution of Asbestos-related Diseases in an Australian Context
Publisher: Informa UK Limited
Date: 2007
Abstract: Predictions of future cases of mesothelioma in Australia to the year 2020 are in the order of a total of 10,000 new cases. Compensation claims are testing the attribution in a particular case between occupational asbestos exposure and lung cancer. The cost of the problem necessitates clarifying and standardizing the criteria for a confident diagnosis of asbestos-related disease. The possibility of differences in criteria that determine attribution of asbestos to a disease prompted a consensus meeting of pathologists, epidemiologists, physicians, oncologists, radiologists, and others to define current thinking and to agree on an Australian document based on the scientific evidence for establishing diagnoses and attribution data of asbestos-related diseases in Australia. The participants' findings are reported.
The relation of breastfeeding and body mass index to asthma and atopy in children: A prospective cohort study to age 6 years
Publisher: American Public Health Association
Date: 1994
Abstract: Objectives. We investigated the relationship between breastfeeding, asthma and atopy, and child body mass index (BMI). Methods. From a prospective birth cohort (n = 2860) in Perth, Western Australia, 2195 children were followed up to age 6 years. Asthma was defined as doctor-diagnosed asthma and wheeze in the last year, and atopy was determined by skin prick test of 1596 children. Breastfeeding, BMI, asthma, and atopy were regressed allowing for confounders and the propensity score for overweight. Results. Using fractional polynomials, we found no association between breastfeeding and overweight. Less exclusive breastfeeding was associated with increased asthma and atopy, and BMI increased with asthma. Conclusions. Less exclusive breastfeeding leads to increases in child asthma and atopy and a higher BMI is a risk factor for asthma.
Asbestos‐related disease from recycled hessian superphosphate bags in rural Western Australia
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1111/J.1467-842X.2006.TB00840.X
Abstract: To describe the dissemination of asbestos fibres within the Western Australian community. A case report. A 60-year-old female was referred for investigation of calcified pleural plaques. On questioning, she recalled exposure to asbestos as a child on the family farm. She had shaken hessian bags prior to recycling to the fertiliser supplier. Her father survived to 90 years. Her mother died from malignant pleural mesothelioma. Four of five siblings had shaken the bags, two had radiographic evidence of pleural plaques while two others had not had recent chest x-rays. It appears that the use of recycled hessian bags for the fertiliser industry was endemic in the State during the period 1943-66. It is possible that many farmers and their families have had similar exposure to asbestos. The risk of developing an asbestos-related disease is not restricted to any specific social or employment groups within the Australian community.
Epidemiology of seasonal influenza infection in pregnant women and its impact on birth outcomes
Publisher: Cambridge University Press (CUP)
Date: 29-09-2017
DOI: 10.1017/S0950268817001972
Abstract: Seasonal influenza can cause significant morbidity in pregnant women. Much of the existing epidemiological evidence on influenza during pregnancy has focused on the 2009 A/H1N1 pandemic. To measure the epidemiological characteristics of seasonal influenza infection among pregnant women and the impact on infant health, a cohort of 86 779 pregnancies during the influenza season (2012–2014) was established using probabilistic linkage of notifiable infectious disease, hospital admission, and birth information. A total of 192 laboratory-confirmed influenza infections were identified (2·2 per 1000 pregnancies), 14·6% of which were admitted to hospital. There was no difference in the proportion of infections admitted to hospital by trimester or subtype of infection. Influenza B infections were more likely to occur in second trimester compared with influenza A/H3N2 and influenza A/H1N1 infections (41·3%, 23·6%, and 33·3%, respectively), and on average, infants born to women with influenza B during pregnancy had 4·0% (95% CI 0·3–7·6%) lower birth weight relative to optimal compared with infants born to uninfected women ( P = 0·03). Results from this linked population-based study suggest that there are differences in maternal infection by virus type and subtype and support the provision of seasonal influenza vaccine to pregnant women.
Environmental and social determinants of acute rheumatic fever
Publisher: Cambridge University Press (CUP)
Date: 2019
DOI: 10.1017/S0950268818003527
Abstract: Acute rheumatic fever (ARF), an auto-immune response to a group A Streptococcus infection and precursor to rheumatic heart disease (RHD), remains endemic in many socio-economically disadvantaged settings. A Global Resolution on ARF and RHD was recently adopted at the 71st World Health Assembly where governments committed to improving efforts to prevent and control ARF and RHD. To inform these efforts, the objectives of this study were to examine associations between childhood ARF in the UK between 1958 and 1969 and a range of environmental and social factors. Of 17 416 children from the nationally representative birth cohort of the National Child Development Study, ARF was reported in 23 children during early childhood (between birth and the 7-year follow-up) and in 29 additional children during middle childhood (between the 7- and 11-year follow-ups). Risk factors associated with ARF in both early and middle childhood were: a large family size attendance at a private nursery or class a history of nephritis, kidney or urinary tract infections and a history of throat or ear infections. Risk factors for ARF in early childhood alone were families with fathers in a professional or semi-professional occupation and families who moved out of their local neighbourhood. Risk factors in late childhood alone included overcrowding and free school meals. These data suggest that prevention strategies in ARF endemic settings may be enhanced by targeting, for ex le, new members entering a community and children in environments of close contact, such as a nursery or shared bedrooms.
Developing evidence-based recommendations for optimal interpregnancy intervals in high-income countries: protocol for an international cohort study
Publisher: BMJ
Date: 2019
DOI: 10.1136/BMJOPEN-2018-027941
Abstract: Short interpregnancy interval (IPI) has been linked to adverse pregnancy outcomes. WHO recommends waiting at least 2 years after a live birth and 6 months after miscarriage or induced termination before conception of another pregnancy. The evidence underpinning these recommendations largely relies on data from low/middle-income countries. Furthermore, recent epidemiological investigations have suggested that these studies may overestimate the effects of IPI due to residual confounding. Future investigations of IPI effects in high-income countries drawing from large, population-based data sources are needed to inform IPI recommendations. We aim to assess the impact of IPIs on maternal and child health outcomes in high-income countries. This international longitudinal retrospective cohort study will include more than 18 million pregnancies, making it the largest study to investigate IPI in high-income countries. Population-based data from Australia, Finland, Norway and USA will be used. Birth records in each country will be used to identify consecutive pregnancies. Exact dates of birth and clinical best estimates of gestational length will be used to estimate IPI. Administrative birth and health data sources with % coverage in each country will be used to identify maternal sociodemographics, pregnancy complications, details of labour and delivery, birth and child health information. We will use matched and unmatched regression models to investigate the impact of IPI on maternal and infant outcomes, and conduct meta-analysis to pool results across countries. Ethics boards at participating sites approved this research (approval was not required in Finland). Findings will be published in peer-reviewed journals and presented at international conferences, and will inform recommendations for optimal IPI in high-income countries. Findings will provide important information for women and families planning future pregnancies and for clinicians providing prenatal care and giving guidance on family planning.
Childhood folate, B6, B12, and food group intake and the risk of childhood brain tumors: results from an Australian case–control study
Publisher: Springer Science and Business Media LLC
Date: 20-03-2015
DOI: 10.1007/S10552-015-0562-Z
Abstract: The etiology of childhood brain tumors (CBT) is poorly understood, but dietary factors could be involved. In this case-control study of CBT, the possible associations of childhood intake of dietary and supplemental folate, vitamin B6, and vitamin B12 with the risk of CBT were investigated, along with various food groups. Cases diagnosed between 2005 and 2010 were identified from 10 pediatric oncology centers in Australia and controls by nationwide random-digit dialling. For study children of ages 3-14 years, diet in the year before diagnosis (or recruitment) was assessed using food frequency questionnaires. Folate intake was adjusted for bioavailability, and dietary micronutrient intake was energy-adjusted. Micronutrients and food groups were analyzed using logistic regression adjusting for relevant confounders. Principal components analysis was conducted to assess food group intake patterns for analysis. Food and micronutrient data were available for 216 cases and 523 controls. Folate intake was associated with a reduced risk of CBT overall (odds ratio for highest tertile vs. lowest: 0.63, 95% confidence interval 0.41, 0.97) and particularly low-grade gliomas (odds ratio for highest tertile vs. lowest: 0.52, 95% confidence interval 0.29, 0.92). Vitamin B6 and B12 intake was not associated with CBT risk, nor was processed meat. High folate intake during childhood may reduce the risk of CBT. This potentially important finding needs to be corroborated in other studies. If replicated, these results could have important implications for public health recommendations regarding diet during childhood.
Risk of childhood acute lymphoblastic leukaemia following parental occupational exposure to extremely low frequency electromagnetic fields
Publisher: Springer Science and Business Media LLC
Date: 13-09-2011
DOI: 10.1038/BJC.2011.365
Serum levels of folate, lycopene, Β-carotene, retinol and vitamin e and prostate cancer risk
Publisher: Springer Science and Business Media LLC
Date: 04-08-2010
Abstract: Previous studies relating increased serum levels of folate and fat-soluble vitamins to prostate cancer risk have variously shown null associations or to either decrease or increase the risk of developing prostate cancer. Prospective studies of serum folate levels have been reported to show a null association and increased serum levels to either decrease or increase the risk of subsequently developing prostate cancer. Similarly, serum β-carotene and lycopene levels have either been reported to be inversely correlated or not associated with prostate cancer risk. Using a prospective nested case-control study design, which minimized the possibility of disease effects on serum-vitamin concentrations, we report null associations for serum concentrations of folate, lycopene, β-carotene, vitamin A and vitamin E, and subsequent development of prostate cancer.
Soluble mesothelin in effusions: a useful tool for the diagnosis of malignant mesothelioma
Publisher: BMJ
Date: 27-02-2007
A screening tool to identify risk for bronchiectasis progression in children with cystic fibrosis
Publisher: Wiley
Date: 12-10-2022
DOI: 10.1002/PPUL.25712
Abstract: The marked heterogeneity in cystic fibrosis (CF) disease complicates the selection of those most likely to benefit from existing or emergent treatments. We aimed to predict the progression of bronchiectasis in preschool children with CF. Using data collected up to 3 years of age, in the Australian Respiratory Early Surveillance Team for CF cohort study, clinical information, chest computed tomography (CT) scores, and biomarkers from bronchoalveolar lavage were assessed in a multivariable linear regression model as predictors for CT bronchiectasis at age 5–6. Follow‐up at 5–6 years was available in 171 children. Bronchiectasis prevalence at 5–6 was 134/171 (78%) and median bronchiectasis score was 3 (range 0–12). The internally validated multivariate model retained eight independent predictors accounting for 37% (adjusted R 2 ) of the variance in bronchiectasis score. The strongest predictors of future bronchiectasis were: pancreatic insufficiency, repeated intravenous treatment courses, recurrent lower respiratory infections in the first 3 years of life, and lower airway inflammation. Dichotomizing the resulting prediction score at a bronchiectasis score of above the median resulted in a diagnostic odds ratio of 13 (95% confidence interval [CI], 6.3–27) with positive and negative predictive values of 80% (95% CI, 72%–86%) and 77% (95% CI, 69%–83%), respectively. Early assessment of bronchiectasis risk in children with CF is feasible with reasonable precision at a group level, which can assist in high‐risk patient selection for interventional trials. The unexplained variability in disease progression at in idual patient levels remains high, limiting the use of this model as a clinical prediction tool.
Blood micronutrients and DNA damage in children
Publisher: Wiley
Date: 26-08-2015
Abstract: Maintenance of normal cellular phenotype depends largely on accurate DNA replication and repair. DNA damage causes gene mutations and predisposes to cancer and other chronic diseases. Growing evidence indicates that nutritional factors are associated with DNA damage in adults here, we investigate these associations in children. We conducted a cross-sectional study among 462 healthy children 3, 6, and 9 years of age. Blood was collected and micronutrient levels were measured. The cytokinesis-block micronucleus cytome assay was used to measure chromosomal DNA damage (micronuclei, nucleoplasmic bridges, and nuclear buds) in lymphocytes. Cell apoptosis, necrosis, and the nuclear ision index were also measured. Nine loci in genes involved in folate metabolism and DNA repair were genotyped. Data were analyzed using linear regression with adjustment for potential confounders. Plasma calcium was positively associated with micronuclei and necrosis, and α-tocopherol negatively associated with apoptosis, nuclear ision index, and nucleoplasmic bridges lutein was positively associated with nucleoplasmic bridges. α-tocopherol was positively associated with necrosis. DNA damage in healthy children may be influenced by blood micronutrient levels and certain genotypes. Further investigation of associations between nutritional status and genomic integrity in children is needed to shed additional light on potential mechanisms.
The mortality of women exposed environmentally and domestically to blue asbestos at Wittenoom, Western Australia
Publisher: BMJ
Date: 11-2008
Abstract: Knowledge of mortality patterns following exposure to asbestos has been determined mostly from cohort studies of men who were exposed to asbestos in their workplace. Women are more likely to have obtained their asbestos exposure domestically or from their environment. 2552 women and girls are documented to have lived in the blue asbestos mining and milling township of Wittenoom between 1943 and 1992 and were not involved in asbestos mining or milling. Quantitative asbestos exposure measurements were derived from periodic dust surveys undertaken in the industry and around the township. Death records were obtained for the period 1950-2004. Standardised mortality ratios (SMRs) were calculated to compare the Wittenoom women's mortality with that of the Western Australian female population. There were 425 deaths, including 30 from malignant mesothelioma. There was excess mortality for all causes of death (SMR = 1.13), all neoplasms (SMR = 1.42), symptoms, signs and ill defined conditions (SMR = 6.35), lung cancer (SMR = 2.15) and pneumoconiosis (SMR = 11.8). Mortality from cancer of the ovary (SMR = 1.52), upper aerodigestive cancers (SMR = 2.70) and tuberculosis (SMR = 5.38) was increased but not significantly. The risk of death from mesothelioma was increased, but not significantly, in residents known to have lived with or washed the clothes of an Australian Blue Asbestos Company asbestos worker (HR = 2.67, 95% CI 0.77 to 9.21 HR = 2.61, 95% CI 0.85 to 7.99, respectively). Women who were former residents of Wittenoom, exposed to asbestos in their environment or in their home, have excess cancer mortality, including mesothelioma, compared with the Western Australian female population.
Prenatal stress and risk of behavioral morbidity from age 2 to 14 years: The influence of the number, type, and timing of stressful life events
Publisher: Cambridge University Press (CUP)
Date: 18-04-2011
DOI: 10.1017/S0954579411000241
Abstract: The maternal experience of stressful events during pregnancy has been associated with a number of adverse consequences for behavioral development in offspring, but the measurement and interpretation of prenatal stress varies among reported studies. The Raine Study recruited 2900 pregnancies and recorded life stress events experienced by 18 and 34 weeks' gestation along with numerous sociodemographic data. The mother's exposure to life stress events was further documented when the children were followed-up in conjunction with behavioral assessments at ages 2, 5, 8, 10, and 14 years using the Child Behavior Checklist. The maternal experience of multiple stressful events during pregnancy was associated with subsequent behavioral problems for offspring. Independent (e.g., death of a relative, job loss) and dependent stress events (e.g., financial problems, marital problems) were both significantly associated with a greater incidence of mental health morbidity between age 2 and 14 years. Exposure to stressful events in the first 18 weeks of pregnancy showed similar associations with subsequent total and externalizing morbidity to events reported at 34 weeks of gestation. These results were independent of postnatal stress exposure. Improved support for women with chronic stress exposure during pregnancy may improve the mental health of their offspring in later life.
Risk of cancer among children with birth defects: A novel approach
Publisher: Wiley
Date: 24-03-2015
DOI: 10.1002/BDRA.23364
Abstract: Associations between birth defects (BDs) and childhood cancers have been studied previously and have identified several specific birth defect-cancer associations. No studies have examined the risk after exclusion of known associations. We analyzed data from high-quality population-based registers of BDs and cancers for Western Australian births 1982 to 2007. The cohort comprised 641,036 babies still alive at 90 days. Two experts independently reviewed all 120 births with a BD and a cancer to determine whether the cancer was congenital, caused by the BD, known to be associated with the BD or otherwise. These categories were used in sensitivity analyses. Cox regression was used to estimate hazard ratios (HRs) for any cancer and specific cancers associated with any BD and specific BDs. The HR for any cancer among children with any BD was 1.96 (95% confidence interval, 1.59-2.43). The HR for any cancer among children with a BD not known to be related to a cancer (n = 57) was 1.19 (95% confidence interval, 0.91-1.56). The HR for the latter association among children diagnosed with cancer before 5 years of age was 1.74 (95% confidence interval, 1.28-2.37). This novel approach aimed to prevent inflated HRs arising from reverse causation, and allow identification of associations beyond those already well documented. Larger studies using this method are needed to explore currently undocumented associations between BDs and cancers.
Using record linkage to examine testing patterns for respiratory viruses among children born in Western Australia
Publisher: Cambridge University Press (CUP)
Date: 02-03-2017
DOI: 10.1017/S0950268817000413
Abstract: Changes in respiratory pathogen testing can affect disease burden estimates. Using linked data, we describe changes in respiratory virus testing among children born in Western Australia in 1996–2012. We extracted data on respiratory specimens from these children from birth to age 9 years. We estimated testing rates by age, year, Aboriginal status and geographical location. Predictors of testing among children hospitalised at least once before their 10th birthday were identified using logistic regression. We compared detection methods for respiratory viruses from nasal/nasopharyngeal (NP) specimens by age and year. Of 83 199 virology testing records in 2000–2012, 80% were nasal/NP specimens. Infants aged month had the highest testing rates. Testing rates in all children increased over the study period with considerable yearly fluctuations. Among hospitalised children, premature children weeks gestation had over three times the odds of being tested (95% CI 3·47–4·13) than those born at term. Testing using molecular methods increased from 5% to 87% over the study period. Proportion of positive s les increased from 36·3% to 44·4% ( P 0·01) this change was greatest in children aged 2–9 years. These findings will assist in interpreting results from future epidemiology studies assessing the pathogen-specific burden of disease.
Histological grading of breast cancer: a study of reproducibility of consensus grading
Publisher: Elsevier BV
Date: 12-1995
Impact of Scoliosis Surgery on Activities of Daily Living in Females With Rett Syndrome
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-1970
Long-term effects of aluminium dust inhalation
Publisher: BMJ
Date: 08-10-2013
DOI: 10.1136/OEMED-2013-101487
Abstract: During the 1950s and 1960s, aluminium dust inhalation was used as a potential prophylaxis against silicosis in underground miners, including in Australia. We investigated the association between aluminium dust inhalation and cardiovascular, cerebrovascular and Alzheimer's diseases in a cohort of Australian male underground gold miners. We additionally looked at pneumoconiosis mortality to estimate the effect of the aluminium therapy. SMRs and 95% CI were calculated to compare mortality of the cohort members with that of the Western Australian male population (1961-2009). Internal comparisons on duration of aluminium dust inhalation were examined using Cox regression. Aluminium dust inhalation was reported for 647 out of 1894 underground gold miners. During 42 780 person-years of follow-up, 1577 deaths were observed. An indication of increased mortality of Alzheimer's disease among miners ever exposed to aluminium dust was found (SMR=1.38), although it was not statistically significant (95% CI 0.69 to 2.75). Rates for cardiovascular and cerebrovascular death were above population levels, but were similar for subjects with or without a history of aluminium dust inhalation. HRs suggested an increasing risk of cardiovascular disease with duration of aluminium dust inhalation (HR=1.02, 95% CI 1.00 to 1.04, per year of exposure). No difference in the association between duration of work underground and pneumoconiosis was observed between the groups with or without aluminium dust exposure. No protective effect against silicosis was observed from aluminium dust inhalation. Conversely, exposure to aluminium dust may possibly increase the risk of cardiovascular disease and dementia of the Alzheimer's type.
A decade of data linkage in Western Australia: strategic design, applications and benefits of the WA data linkage system
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/AH080766
Abstract: Objectives: The report describes the strategic design, steps to full implementation and outcomes achieved by the Western Australian Data Linkage System (WADLS), instigated in 1995 to link up to 40 years of data from over 30 collections for an historical population of 3.7 million. Staged development has seen its expansion, initially from a linkage key to local health data sets, to encompass links to national and local health and welfare data sets, genealogical links and spatial references for mapping applications. Applications: The WADLS has supported over 400 studies with over 250 journal publications and 35 graduate research degrees. Applications have occurred in health services utilisation and outcomes, aetiologic research, disease surveillance and needs analysis, and in methodologic research. Benefits: Longitudinal studies have become cheaper and more complete deletion of duplicate records and correction of data artifacts have enhanced the quality of information assets data linkage has conserved patient privacy community machinery necessary for organised responses to health and social problems has been exercised and the commercial return on research infrastructure investment has exceeded 1000%. Most importantly, there have been unbiased contributions to medical knowledge and identifiable advances in population health arising from the research.
Physical and Mental Health of Mothers Caring for a Child With Rett Syndrome
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2006
Abstract: OBJECTIVES. Our goal was to investigate the physical and mental health of mothers who care for a child with Rett syndrome. METHODS. We assessed maternal physical and mental health by using the SF-12 version 1 physical component summary and mental component summary scores as the outcome measures of interest. Mothers (n = 135) of children with Rett syndrome completed the SF-12 measure as part of the Australian Rett Syndrome Study in 2002. The analysis investigated linear relationships between physical and mental health scores and maternal, family, and child characteristics. RESULTS. Mothers ranged in age from 21 to 60 years and their children from 3 to 27 years. Nearly half of these mothers (47.4%) indicated that they worked full-time or part-time outside the home, and 41% had a combined family (gross) income of & Australian dollars. The resultant model for physical health demonstrated that the following factors were positively associated with better maternal physical health: the mother working full-time or part-time outside the home, having some high school education, having private health insurance, the child not having breathing problems in the last 2 years, the child not having home-based structured therapy, and high scores on the Family Resource Scale (indicating adequacy of time resources for basic and family needs). The resultant model for mental health demonstrated that the following factors were positively associated with better maternal mental health: the mother working full-time or part-time outside the home, the child not having a fracture in the last 2 years, lesser reporting of facial stereotypes and involuntary facial movements, being in a well-adjusted marriage, and having low stress scores. CONCLUSIONS. Our study suggests that the most important predictors of maternal physical and emotional health are child behavior, caregiver demands, and family function.
Histological grading of breast carcinomas: A study of interobserver agreement
Publisher: Elsevier BV
Date: 08-1995
DOI: 10.1016/0046-8177(95)90010-1
Abstract: Interobserver variation in the histological grading of breast carcinoma was investigated using the hypothesis that optimal fixation, more precise grading guidelines, some experience, the use of training and test sets, and a comparison of results with an expert group might allow higher levels of agreement. For the training sets sections from 50 consecutive cases of breast carcinoma received at the Sir Charles Gairdner Hospital (SCGH) and fixed in both B5 and buffered formal saline (BFS) were graded by consensus of three pathologists at the SCGH and independently by consensus of two pathologists at the Nottingham City Hospital (NCH) using a modified Scarff-Bloom-Richardson histological grading system with guidelines as suggested by NCH pathologists. The section quality and degree of preservation of nuclear morphology were judged by NCH pathologists to be superior for B5-fixed material. Complete agreement in grade between SCGH and NCH results was achieved for 83.3% of B5-fixed cases and 73.5% of BFS-fixed cases (P = .05) with relative disagreement rates (RDRs) of 0.15 and 0.29 and kappa statistic values of 0.73 and 0.58, respectively. Approximately 80% complete agreement was achieved for tubule formation, nuclear score, and mitotic count, with RDRs ranging from 0.19 to 0.27 and kappa values from 0.46 to 0.69. There was a consistent bias in the SCGH results toward a higher tubule score in both B5- and BFS-fixed material because of a difference in interpretation of cribriform or complex gland patterns and a consistent bias in SCGH results toward a lower nuclear size leomorphism score for B5 and BFS material. For the test set sections from 50 further consecutive cases of breast cancer fixed in B5 were examined using similar criteria but taking into account the sources of error shown by the training set. Approximately 80% complete agreement was again achieved for grade components and grade (RDRs, 0.18 and 0.72). Systematic bias was reduced in the test set, but no other improvement was observed. Of the tumors designated as grade I by NCH, 87.5% were called grade I tumors by SCGH in the B5 training set, 84.6% in the B5 test set, and 66.6% in the BFS training set. The levels of agreement shown in both the training and test sets were satisfactory and represented a significant improvement over our previous study, suggesting that experience and precise grading guidelines are of value. The similar levels of agreement in training and test sets suggest that reasonable results can be achieved without direct training by expert groups.(ABSTRACT TRUNCATED AT 400 WORDS)
P143 Mortality in the western australian mining industry (1996-2011)
Publisher: BMJ Publishing Group Ltd
Date: 09-2016
Maternal consumption of coffee and tea during pregnancy and risk of childhood ALL: Results from an Australian case-control study
Publisher: Springer Science and Business Media LLC
Date: 27-11-2011
DOI: 10.1007/S10552-010-9688-1
Abstract: To investigate whether maternal coffee and/or tea consumption during the last 6 months of pregnancy was associated with risk of childhood ALL. Data on coffee and tea drinking during pregnancy from 337 case mothers and 697 control mothers were analyzed using unconditional multivariable logistic regression. A meta-analysis of our findings with those of previous studies was also conducted. There was little evidence of an overall association between maternal coffee consumption and risk of ALL: OR 0.89 (95% CI 0.61, 1.30), although there was some suggestion that higher levels of intake might increase the risk in children of non-smoking mothers: OR for 2+ cups/day = 1.44 (95% CI 0.85, 2.42) this was supported by our meta-analysis. Risk was also elevated among cases with chromosomal translocations. The overall OR for maternal tea consumption was 0.82 (95% CI 0.56, 1.18), although the OR for T-cell ALL was 0.21 (95% CI 0.08, 0.51). Among ALL cases with translocations, the ORs for tea consumption tended to be elevated: OR = 1.70 (95% CI 0.79-3.68) for 2+ cups/day. The observed increased risk associated with coffee and tea consumption may be confined to ALL with translocations. These associations should be explored further in large international consortia.
Fetal growth and risk of childhood acute lymphoblastic leukemia: Results from an australian case-Control study
Publisher: Oxford University Press (OUP)
Date: 28-05-2009
DOI: 10.1093/AJE/KWP117
Abstract: The relation between intrauterine growth and risk of childhood acute lymphoblastic leukemia was investigated in an Australian population-based case-control study that included 347 cases and 762 controls aged <15 years recruited from 2003 to 2006. Information on proportion of optimal birth weight, a measure of the appropriateness of fetal growth, was collected from mothers by questionnaire. Data were analyzed by using logistic regression. Risk of acute lymphoblastic leukemia was positively associated with proportion of optimal birth weight the odds ratio for a 1-standard-deviation increase in proportion of optimal birth weight was 1.18 (95% confidence interval: 1.04, 1.35) after adjustment for the matching variables and potential confounders. This association was also present among children who did not have a high birth weight, suggesting that accelerated growth, rather than high birth weight per se, is associated with risk of acute lymphoblastic leukemia. Similar associations between proportion of optimal birth weight and acute lymphoblastic leukemia were observed for both sexes and across age groups and leukemia subtypes. Results of this study confirm earlier findings of a positive association between rapidity of fetal growth and subsequent risk of acute lymphoblastic leukemia in childhood, and they are consistent with a role for insulin-like growth factors in the causal pathway.
Overview of recent studies on childhood leukaemia, intra-uterine growth and diet
Publisher: Oxford University Press (OUP)
Date: 15-10-2008
DOI: 10.1093/RPD/NCN303
Abstract: Many studies have looked at the association between birth weight and risk of acute lymphoblastic leukaemia in children, but few have been able to examine the growth by incorporating estimates of gestational age. Recent results suggest that increased growth is associated with increased risk of childhood leukaemia. Evidence is also gathering that certain dietary intakes, possibly folate, in mothers, are also related to leukaemia occurrence. If these associations are real, they may be operating through growth factor pathways.
Fractional Polynomials and Model Selection in Generalized Estimating Equations Analysis, With an Application to a Longitudinal Epidemiologic Study in Australia
Publisher: Oxford University Press (OUP)
Date: 08-10-2008
DOI: 10.1093/AJE/KWN292
Abstract: In epidemiologic studies, researchers often need to establish a nonlinear exposure-response relation between a continuous risk factor and a health outcome. Furthermore, periodic interviews are often conducted to take repeated measurements from an in idual. The authors proposed to use fractional polynomial models to jointly analyze the effects of 2 continuous risk factors on a health outcome. This method was applied to an analysis of the effects of age and cumulative fluoride exposure on forced vital capacity in a longitudinal study of lung function carried out among aluminum workers in Australia (1995-2003). Generalized estimating equations and the quasi-likelihood under the independence model criterion were used. The authors found that the second-degree fractional polynomial models for age and fluoride fitted the data best. The best model for age was robust across different models for fluoride, and the best model for fluoride was also robust. No evidence was found to suggest that the effects of smoking and cumulative fluoride exposure on change in forced vital capacity over time were significant. The trend 1 model, which included the unexposed persons in the analysis of trend in forced vital capacity over tertiles of fluoride exposure, did not fit the data well, and caution should be exercised when this method is used.
Plasma retinol, carotene and vitamin E concentrations and lung function in a crocidolite-exposed cohort from Wittenoom, Western Australia: A cohort study
Publisher: Springer Science and Business Media LLC
Date: 11-05-2005
Abstract: Increased rates of death from asbestos related diseases have been reported for people previously employed in the mining and milling operations at Wittenoom (Western Australia), and people who lived in the nearby town, where they were environmentally exposed to crocidolite. Annual measurements of forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) and plasma concentrations of retinol, carotene and vitamin E have been made since 1992. Mixed effects models were used to examine the associations between lung function and the plasma vitamin levels of retinol, carotene and vitamin E. After adjusting for potential confounders, higher plasma retinol and carotene concentrations were significantly associated with higher levels of lung function at entry into the study, while vitamin E concentrations were associated with lower entry lung function. Retinol was associated with a less steep decline of lung function over time, while carotene concentrations were associated with an increased decline of lung function over time and vitamin E levels were not associated with changes of lung function over time. These results support a beneficial relationship between plasma concentrations of retinol on the levels and rates of change of lung function, while showing no such consistent beneficial effect for plasma levels of beta-carotene or vitamin E.
Association between diesel engine exhaust exposure and lung function in Australian gold miners
Publisher: Elsevier BV
Date: 05-2020
Epidemiology of malignant mesothelioma in Australia
Publisher: Elsevier BV
Date: 08-2004
Tumor Suppressor microRNAs Contribute to the Regulation of PD-L1 Expression in Malignant Pleural Mesothelioma
Publisher: Elsevier BV
Date: 08-0088
DOI: 10.1016/J.JTHO.2017.05.024
Abstract: The upregulation of programmed death ligand 1 (PD-L1) is found in many cancers and contributes to evasion of the host's immune defense. In malignant pleural mesothelioma (MPM), PD-L1 expression is associated with the nonepithelioid histological subtype and poor prognosis, but the pathways involved in control of PD-L1 expression in MPM are poorly understood. To address one possible means of PD-L1 regulation we investigated the relationship between dysregulated microRNA levels and PD-L1 expression. PD-L1 expression was analyzed by immunohistochemistry in tissue microarrays prepared from s les from patients undergoing an operation (pleurectomy with or without decortication). MicroRNA expression was analyzed by reverse-transcriptase quantitative polymerase chain reaction. Regulation of PD-L1 expression in cell lines was assessed after transfection with microRNA mimics and small interfering RNAs. Interaction between microRNAs and PD-L1 was analyzed by using argonaute-2 immunoprecipitation and a luciferase reporter assay. In a series of 72 patients with MPM, 18 (25%) had positive PD-L1 staining, and this was more common in patients with the nonepithelioid subtype (p = 0.01). PD-L1 expression was associated with poor survival (median overall survival 4.0 versus 9.2 months with positive versus negative PD-L1 expression [p < 0.001]), and in multivariate analyses, PD-L1 expression remained a significant adverse prognostic indicator (hazard ratio = 2.2, 95% confidence interval: 1.2-4.1, p < 0.01). In the same patient series, PD-L1 expression was also associated with downregulation of microRNAs previously shown to have tumor suppressor activity in MPM. The median microRNA expression levels of miR-15b, miR-16, miR-193a-3p, miR-195, and miR-200c were significantly lower in the PD-L1-positive s les. Transfecting MPM cell lines with mimics corresponding to miR-15a and miR-16, both of which are predicted to target PD-L1, led to downregulation of PD-L1 mRNA and protein. In addition, miR-193a-3p, with an alternative G-U-containing target site, also caused PD-L1 downregulation. Together, these data suggest that tumor suppressor microRNAs contribute to the regulation of PD-L1 expression in MPM.
Infant, maternal and demographic predictors of delayed vaccination
Publisher: Elsevier BV
Date: 08-2020
DOI: 10.1016/J.VACCINE.2019.09.091
Abstract: Receiving vaccines at or close to their due date (vaccination timeliness) is a now key measure of program performance. However, studies comprehensively examining predictors of delayed infant vaccination are lacking. We aimed to identify predictors of short and longer-term delays in diphtheria-tetanus-pertussis (DTP) vaccination by dose number and ethnicity. Perinatal, notification, death and immunisation databases were linked for 1.3 million births in 2000-11 from two Australian states (Western Australia and New South Wales), with follow-up data until 2013. Ordinal logistic regression was used to estimate adjusted relative risks (RR) by degree of delay. Separate models were constructed for each vaccine dose and for Aboriginal and non-Aboriginal children. Each dose-specific cohort included at least 49,000 Aboriginal and 1.1 million non-Aboriginal children. Delayed receipt was more common among Aboriginal than non-Aboriginal children (eg for the first dose of DTP [DTP1] 19.4 v 8.1%). Risk factors for delayed vaccination were strongest for DTP1, and delayed receipt of DTP1 was a key driver of subsequent delays every week DTP1 was delayed was associated with a 1.6 to 2-fold increased risk of delayed DTP2 receipt. For DTP1, ≥3 previous pregnancies (the only factor more strongly associated with longer than shorter delays RR ≥5 compared to no previous pregnancies), and children born to mothers <20 years of age (RR ≥2 compared to ≥35 years) were at highest risk of delay. Other independent predictors were prematurity, maternal smoking during pregnancy, and being born in Western Australia (if Aboriginal) or another country in the Oceania region. The sub-populations at risk for delayed vaccination we have identified are likely generalisable to other high-income settings. Measures to improve their dose 1 timeliness, particularly for children with older siblings, are likely to have significant flow-on benefits for timeliness of later doses.
Correlations of siblings’ and mothers’ utilisation of primary and hospital health care: A record linkage study in Western Australia
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.SOCSCIMED.2005.08.027
Abstract: A relationship between maternal and child use of general practitioners (GPs) has been shown to exist for some time, however, the reasons for this relationship are not clear and the extent to which this relationship extends to tertiary care is unknown. The aim of this study was to examine the relationships between the utilisation of health care by siblings and mothers over a 14 year period. A retrospective cohort study of 756 mothers and their 1494 children up to age 14 years was conducted in three general practices in Western Australia. Medicare claims and hospital morbidity records for 1984-1997 were linked using deterministic and probabilistic matching. Generalised Estimating Equations and correlations were used to examine the relationships between the utilisation of primary and hospital health care by family members. Significant correlations were found between hospital admissions of all participants and their GP visits, specialist visits, pathology and diagnostic imaging combined and hospital length of stay. There was a strong association between siblings' use of GPs. A child's rate of GP attendance increased with that of its mother. There was a weak but significant relationship between siblings' use of hospitals, and a child's hospital admission rate increased with that of its mother. It is concluded that there is a strong relationship between siblings' use of GPs and a weaker but still significant association between the hospital admissions of siblings. As expected, there were strong associations between mother and child visits to GPs. There was also an association between a mother's use of hospital and that of her children. This finding reduces the plausibility that the relationships found between utilisation of health care by siblings and mothers can be explained entirely by behavioural factors, and suggests the presence of intergenerational correlation of morbidity.
Aerodigestive and gastrointestinal tract cancers and exposure to Crocidolite (Blue asbestos): Incidence and mortality among former Crocidolite workers
Publisher: Wiley
Date: 2004
DOI: 10.1002/IJC.20313
Abstract: The objective of this article was to assess the association between the incidence and mortality from aerodigestive cancers and exposure to crocidolite (blue asbestos). Our study is a cohort study of former workers of the now-defunct crocidolite mining and milling operation at Wittenoom, Western Australia, who have been followed up since 1979 and on whom asbestos exposure and smoking information was known. Standardised mortality and incidence rates were used to compare former workers with the Western Australian male population. Cases were matched with up to 10 randomly assigned controls, and conditional logistic regression was used to examine the relationship between asbestos exposure, smoking status and cancer incidence. There were 129 incident cases from all cancers of interest and 57 deaths. Former workers had a significantly higher risk of mortality from upper aerodigestive cancers than the Western Australian male population. The incidence of upper and lower aerodigestive cancers was higher in the Wittenoom cohort but not significantly so. Cumulative exposure to asbestos did not appear to be associated with the incidence of stomach cancer, colorectal cancer or upper aerodigestive cancers. Smoking status was strongly associated with the incidence of upper aerodigestive cancers, with current smokers experiencing the greatest risk. Our study with longer and more complete follow-up, smoking information and a stronger study design does not show an association between cumulative asbestos exposure and stomach cancer or other gastrointestinal cancers. The excess mortality from upper aerodigestive cancers seen in this cohort of former asbestos workers compared to the Western Australian male population does not appear to be associated with exposure to crocidolite.
Dietary intake of omega-3 fatty acids and risk of depressive symptoms in adolescents
Publisher: Hindawi Limited
Date: 27-04-2011
DOI: 10.1002/DA.20822
Abstract: Previous randomized controlled trials have demonstrated that omega-3 polyunsaturated fatty acids (n-3 PUFA) are beneficial in reducing symptoms of depression. However, there is limited evidence regarding the influence of dietary n-3 PUFA intake on mood in adolescents drawn from population studies. In the present investigation, we examined the relationship between dietary n-3 PUFA intake on depression symptomatology in a large prospective pregnancy cohort followed for 17 years. Adolescents enrolled in the Western Australian Pregnancy Cohort (Raine) Study completed a Food Frequency Questionnaire to assess dietary fatty acid intake, as well as other dietary factors at age 14 and a fasting blood s le was taken. Participants also completed the Beck Depression Inventory for Youth (BDI-Y) at age 14 (N = 1,407) and at age 17 (N = 995). An inverse relationship was observed between intake of both saturated fat and of n-3 PUFA at age 14 and BDI-Y scores at both 14 and 17 years of age. However, after adjusting for energy (kJ) intake and other lifestyle confounders, the relationships were no longer significant. Associations previously reported between n3 PUFA and depressive symptoms may be due to collinearity with other dietary and lifestyle factors.
The diagnosis of autism in a female: could it be Rett syndrome?
Publisher: Springer Science and Business Media LLC
Date: 08-08-2007
DOI: 10.1007/S00431-007-0569-X
Abstract: The overlap between autism and Rett syndrome clinical features has led to many cases of Rett syndrome being initially diagnosed with infantile autism or as having some autistic features. Both conditions seriously disrupt social and language development and are often accompanied by repetitive, nonpurposeful stereotypic hand movements. The aims of this study were to compare the early and subsequent clinical courses of female subjects with Rett syndrome categorised by whether or not a diagnosis of autism had been proposed before Rett syndrome had been diagnosed and compare the spectrum of methyl-CpG binding protein 2 (MECP2) mutations identified among the two groups. This study made use of a total of 313 cases recorded in two databases: the Australian Rett Syndrome Database (ARSD) and the International Rett Syndrome Phenotype Database (InterRett). Cases with an initial diagnosis of autism had significantly milder Rett syndrome symptoms and were more likely to remain ambulant, to have some functional hand use and not to have developed a scoliosis. Females with the p.R306C or p.T158M mutations in the MECP2 gene were more likely to have an initial diagnosis of autism, and the specific Rett syndrome symptoms were noted at a later age. We recommend that females who are initially considered to have autism be carefully monitored for the evolution of the signs and symptoms of Rett syndrome.
Functional haplotypes in the PTGDR gene fail to associate with asthma in two Australian populations
Publisher: Wiley
Date: 27-01-2011
DOI: 10.1111/J.1440-1843.2010.01917.X
Abstract: Haplotypes in the promoter region of the prostanoid DP receptor (PTGDR) gene have been shown to functionally influence gene transcription and to be associated with asthma in two previous case-control studies in Caucasians. This study tested the association of PTGDR haplotypes with asthma phenotypes in two large Caucasian-Australian populations. These results were incorporated in a meta-analysis with previously published data to determine the overall role for these haplotypes in the risk of asthma. Three PTGDR promoter-region single nucleotide polymorphisms (SNP) were genotyped in 368 in iduals from the Western Australian Twin Child Health study and 2988 in iduals from the Busselton Health Study. Logistic regression and transition disequilibrium tests were used to assess whether SNP genotypes and three SNP haplotypes were associated with doctor-diagnosed asthma or intermediate quantitative traits. Longitudinal data from the Busselton Health Study were used to examine whether PTGDR influences changes in lung function over time. Meta-analysis incorporated the findings of this study with those of two previous studies in Caucasian populations. Cross-sectional associations between PTGDR haplotypes and asthma phenotypes were non-significant (P > 0.05) in both populations. Longitudinal analyses of PTGDR and lung function were also non-significant. Meta-analysis, however, suggested that haplotype TCT was significantly associated with decreased risk of asthma (OR = 0.76 P = 0.02) while haplotype CCC was not significantly associated with asthma (OR = 1.30 P = 0.07). These results suggest that despite the non-significant findings in the present study populations, PTGDR promoter haplotypes may account for a small but significant proportion of the risk of asthma in Caucasian populations.
Exposure to pesticides and the risk of childhood brain tumors
Publisher: Springer Science and Business Media LLC
Date: 05-04-2013
DOI: 10.1007/S10552-013-0205-1
Abstract: Previous research has suggested positive associations between parental or childhood exposure to pesticides and risk of childhood brain tumors (CBT). This Australian case-control study of CBT investigated whether exposures to pesticides before pregnancy, during pregnancy and during childhood, were associated with an increased risk. Cases were recruited from 10 pediatric oncology centers, and controls by random-digit dialing, frequency matched on age, sex, and State of residence. Exposure data were collected by written questionnaires and telephone interviews. Data were analyzed by unconditional logistic regression. The odds ratios (ORs) for professional pest control treatments in the home in the year before the index pregnancy, during the pregnancy, and after the child's birth were 1.54 (95% confidence interval (CI): 1.07, 2.22), 1.52 (95% CI: 0.99, 2.34) and 1.04 (95% CI: 0.75, 1.43), respectively. ORs for treatments exclusively before pregnancy and during pregnancy were 1.90 (95% CI: 1.08, 3.36) and 1.02 (95% CI: 0.35, 3.00), respectively. The OR for the father being home during the treatment was 1.79 (95% CI: 0.85, 3.80). The OR for paternal occupational exposure in the year before the child's conception was 1.36 (95% CI: 0.66, 2.80). ORs for prenatal home pesticide exposure were elevated for low- and high-grade gliomas effect estimates for other CBT subtypes varied and lacked precision. These results suggest that preconception pesticide exposure, and possibly exposure during pregnancy, is associated with an increased CBT risk. It may be advisable for both parents to avoid pesticide exposure during this time.
Record linkage study of the pathogen-specific burden of respiratory viruses in children
Publisher: Wiley
Date: 30-10-2017
DOI: 10.1111/IRV.12508
RSV prophylaxis use in high-risk infants in Western Australia, 2002-2013
Publisher: Springer Science and Business Media LLC
Date: 22-10-2020
DOI: 10.1186/S12887-020-02390-5
Abstract: The monoclonal antibody, palivizumab is licensed for use in high-risk infants to prevent severe illness caused by respiratory syncytial virus (RSV). The level of its use and compliance with current jurisdictional guidelines which were amended in 2010, is unknown. We determined the level of palivizumab use in a cohort of high-risk infants in Western Australia. Using probabilistically linked administrative data, we conducted a birth cohort study within tertiary neonatal intensive care units (NICUs) born between 2002 and 2013. We described palivizumab use by patient characteristics, eligibility criteria according to guidelines over the period of study and identified predictors of its use. Of 24,329 infants admitted to tertiary NICUs, 271 (1.1%) were dispensed 744 palivizumab doses with 62.5% being dispensed to infants born 2010–2013. The median number of doses received was 2. A total of 2679 infants met at least one of three criteria for palivizumab (criteria 1: gestational age at birth 28 weeks and chronic lung disease criteria 2: gestational age 28 weeks and Aboriginal criteria 3: congenital heart disease not otherwise in criteria 1 or 2). The extent of palivizumab use differed across the 3 groups. Of 803 infants meeting criteria 1, 21.8% received at least 1 dose of palivizumab 52.8% from 2010 onwards. From 174 infants meeting criteria 2, 14.4% received at least 1 dose 43.1% from 2010 onwards and from 1804 births meeting criteria 3, only 3.7% received at least 1 dose 5.4% from year of birth 2010 onwards). In adjusted analyses, being born after 2010, being extreme preterm, chronic lung disease, congenital lung disease and being born in autumn or winter were independent predictors of palivizumab use. In this high-risk setting and notwithstanding the limitations of our data sources, the level of compliance of palivizumab use against current guidelines was low. Most doses were dispensed to infants meeting at least one high-risk criterion. Evidence of incomplete dosing is an important finding in light of recent developments of single dose monoclonal antibodies offering longer protection.
Folate pathway gene polymorphisms and risk of childhood brain tumors: Results from an Australian case-control study
Publisher: American Association for Cancer Research (AACR)
Date: 31-05-2015
DOI: 10.1158/1055-9965.EPI-14-1248
Abstract: Background: Recent research suggests that maternal folic acid supplementation is associated with a reduced risk of childhood brain tumors (CBT) polymorphisms in folate pathway genes could modify this association or directly influence CBT risk. Methods: Associations between risk of CBT and folate pathway polymorphisms were investigated in a population-based case–control study in Australia (2005–2010). Cases were recruited through all Australian pediatric oncology centers and controls by national random digit dialing. Data were available from 321 cases and 552 controls. Six polymorphisms were genotyped in children and parents (MTHFR 677C& T, MTHFR 1298A& C, MTRR 66A& G, MTR 2756A& G, MTR 5049C& A, and CBS 2199 T& C). Maternal folic acid use was ascertained via questionnaire. ORs were estimated using unconditional logistic regression. Case–parent trio analyses were also undertaken. Results: There was weak evidence of a reduced risk of CBT for the MTRR 66GG genotype in the child or father: ORs 0.71 [95% confidence interval (CI), 0.48–1.07] 0.54 (95% CI, 0.34–0.87), respectively. Maternal prepregnancy folic acid supplementation showed a stronger negative association with CBT risk where the child, mother, or father had the MTRR 66GG genotype (Pinteraction = 0.07, 0.10, and 0.18, respectively). Conclusions: Evidence for an association between folate pathway genotypes and CBT is limited in this study. There was possible protection by the MTRR 66GG genotype, particularly when combined with maternal prepregnancy folic acid supplementation these results are novel and require replication. Impact: The possible interaction between folic acid supplementation and MTRR 66A& G, if confirmed, would strengthen evidence for prepregnancy folate protection against CBT. Cancer Epidemiol Biomarkers Prev 24(6) 931–7. ©2015 AACR.
Representativeness of child controls recruited by random digit dialling
Publisher: Wiley
Date: 02-03-2010
DOI: 10.1111/J.1365-3016.2010.01099.X
Abstract: Recruiting control subjects who are representative of the population from which the cases are drawn is a challenge in case-control studies. This paper examines the performance of random digit dialling (RDD) in obtaining a control s le, and the s le's representativeness of the population with respect to socio-economic status. The study subjects were recruited from 2003 to 2006 for a national, population-based case-control study investigating causes of acute lymphoblastic leukaemia (ALL) in children <15 years of age in Australia. Control families' addresses were linked to Australian Bureau of Statistics Census 2006 Collection Districts and thus to Socio-Economic Indexes for Area scores, which are area-based measures of socio-economic status. These scores were compared with those of all collection districts where families lived. We estimate that 55% of eligible families in the RDD s le agreed to participate in the study. Participation was directly related to socio-economic status with those of highest economic status most likely to participate. Completeness of participation in the components of data collection was similarly related to socio-economic status. This evidence of selection according to socio-economic status indicates that there may also be selection with respect to other factors potentially important in the aetiology of ALL.
Serum mesothelin for early detection of asbestos-induced cancer malignant mesothelioma
Publisher: American Association for Cancer Research (AACR)
Date: 09-2010
DOI: 10.1158/1055-9965.EPI-10-0346
Abstract: Background: Malignant mesothelioma is an aggressive, almost uniformly fatal tumor, primarily caused by exposure to asbestos. Since the recent discovery that serum mesothelin is a sensitive and highly specific biomarker for mesothelioma, one of the key issues raised is whether mesothelin levels represent a useful screening test for asbestos-exposed at-risk in iduals. In this study, soluble mesothelin was determined in sequential serum s les collected from asbestos-exposed in iduals before the development of mesothelioma. Methods: Archival serum s les from 106 in iduals who developed mesothelioma, 99 asbestos-exposed in iduals from the Wittenoom Cancer Surveillance Program, and 109 non–asbestos-exposed in iduals from the Busselton Health Survey were identified. Serum mesothelin concentrations were determined using the MESOMARK assay. Results: Longitudinal mesothelin levels determined in healthy asbestos-exposed in iduals over a period of 4 years were stable (Pearson's r = 0.96 P & 0.0001). There was no correlation between mesothelin concentration and cumulative asbestos exposure. Mesothelin concentrations were greater than the threshold value of 2.5 nmol/L in the penultimate serum s le before the diagnosis of mesothelioma in 17 of 106 people. Using an increase above the 95% confidence interval of the mean of a given in idual's longitudinal mesothelin results, 33 of 82 in iduals had increasing mesothelin levels before diagnosis. Conclusion: In a population with a high pretest probability of developing mesothelioma, the serum biomarker mesothelin is elevated in absolute terms in 15% and in relative terms in 40% of the group. Impact: Future studies examining a combination of biomarkers could improve sensitivity of screening. Cancer Epidemiol Biomarkers Prev 19(9) 2238–46. ©2010 AACR.
Development of quantitative exposure data for a pooled exposure-response analysis of 10 silica cohorts
Publisher: Wiley
Date: 16-07-2002
DOI: 10.1002/AJIM.10097
Abstract: Comprehensive quantitative silica exposure estimates over time, measured in the same units across a number of cohorts, would make possible a pooled exposure-response analysis for lung cancer. Such an analysis would help clarify the continuing controversy regarding whether silica causes lung cancer. Existing quantitative exposure data for 10 silica-exposed cohorts were retrieved from the original investigators. Occupation- and time-specific exposure estimates were either adopted/adapted or developed for each cohort, and converted to milligram per cubic meter (mg/m(3)) respirable crystalline silica. Quantitative exposure assignments were typically based on a large number (thousands) of raw measurements, or otherwise consisted of exposure estimates by experts (for two cohorts). Median exposure level of the cohorts ranged between 0.04 and 0.59 mg/m(3) respirable crystalline silica. Exposure estimates were partially validated via their successful prediction of silicosis in these cohorts. Existing data were successfully adopted or modified to create comparable quantitative exposure estimates over time for 10 silica-exposed cohorts, permitting a pooled exposure-response analysis. The difficulties encountered in deriving common exposure estimates across cohorts are discussed.
Genetic variants associated with increased risk of malignant pleural mesothelioma: a genome-wide association study.
Publisher: Public Library of Science (PLoS)
Date: 23-04-2013
A study and review of developmental dysgraphia in relation to acquired dysgraphia
Publisher: Elsevier BV
Date: 1995
DOI: 10.1016/0387-7604(94)00110-J
Abstract: A survey of developmental dysgraphia in a population of 259 normal 13- and 14-year-old schoolchildren has been carried out. The neurological characteristics of handwriting impairments in the 25 children with the poorest handwriting skills are described. These data form the basis of a clinical classification of developmental dysgraphia. A group of simple clinical tests of handwriting and associated functions are offered for routine use. Because they are based on neurological principles relating to acquired dysgraphia, the classification and testing format may be used for correlation with neuro-imaging in research studies. More importantly, they may also facilitate both counselling and remediation for a particular child. The test battery could be modified for use in epidemiological surveys of neurodevelopmental disorders.
Detecting genotyping error using measures of degree of hardy-weinberg disequilibrium
Publisher: Walter de Gruyter GmbH
Date: 06-01-2010
Abstract: Tests for Hardy-Weinberg equilibrium (HWE) have been used to detect genotyping error, but those tests have low power unless the s le size is very large. We assessed the performance of measures of departure from HWE as an alternative way of screening for genotyping error. Three measures of the degree of disequilibrium (alpha, ,D, and F) were tested for their ability to detect genotyping error of 5% or more using simulations and a real dataset of 184 children with leukemia genotyped at 28 single nucleotide polymorphisms. The simulations indicate that all three disequilibrium coefficients can usefully detect genotyping error as judged by the area under the Receiver Operator Characteristic (ROC) curve. Their discriminative ability increases as the error rate increases, and is greater if the genotyping error is in the direction of the minor allele. Optimal thresholds for detecting genotyping error vary for different allele frequencies and patterns of genotyping error but allele frequency-specific thresholds can be nominated. Applying these thresholds would have picked up about 90% of genotyping errors in our actual dataset. Measures of departure from HWE may be useful for detecting genotyping error, but this needs to be confirmed in other real datasets.
Asbestos exposure: challenges for Australian clinicians
Publisher: AMPCo
Date: 02-2016
DOI: 10.5694/MJA15.01072
Gynecologic and breast cancers in women after exposure to blue Asbestos at Wittenoom
Publisher: American Association for Cancer Research (AACR)
Date: 2009
DOI: 10.1158/1055-9965.EPI-08-0746
Abstract: Introduction: Animal studies have suggested an association between asbestos and ovarian cancer, and asbestos fibers have been detected in human ovaries. Sexual intercourse may introduce asbestos fibers into the vagina and to the cervix and ovaries. Occupational cohorts have reported excess mortality from reproductive cancers, but exposure-response relationships are inconsistent. We examine the incidence and exposure-response relationships of these cancers among 2,968 women and girls exposed to blue asbestos at Wittenoom, Western Australia. Methods: 2,552 women were residents of the town and 416 worked for the asbestos company (Australian Blue Asbestos). Standardized incidence ratios compared the Wittenoom women with the Western Australian population. A nested case-control design and conditional logistic regression examined exposure-response relationships. Results: Ovarian (standardized incidence ratio, 1.27), cervical (standardized incidence ratio, 1.44), and uterine cancer (standardized incidence ratio, 1.23) increased but not statistically significantly among the Wittenoom women compared with the Western Australian population. Among the Australian Blue Asbestos workers, cervical cancer was twice that of the Western Australian population (standardized incidence ratio, 2.38), but ovarian cancer was less (standardized incidence ratio, 0.65). Women who first arrived at Wittenoom aged ≥40 years had an odds ratio of 13.9 (95% confidence interval, 2.2-90.2) for cervical cancer compared with those aged & years at first arrival. Women who lived with or washed the clothes of an Australian Blue Asbestos worker did not have an increased risk for any of the gynecologic or breast cancers. Discussion: There is no consistent evidence of an increased risk for gynecologic and breast cancers among the women from Wittenoom. Ovarian cancers and peritoneal mesotheliomas were not misclassified in this cohort. (Cancer Epidemiol Biomarkers Prev 2009 (1):OF140–8)
Breastfeeding, body mass index, and asthma and atopy in children
Publisher: Springer US
Date: 2004
Fetal Growth and Acute Childhood Leukemia: Looking Beyond Birth Weight
Publisher: Oxford University Press (OUP)
Date: 07-06-2007
DOI: 10.1093/AJE/KWM065
Abstract: The authors examined the relation between birth weight, intrauterine growth, and risk of childhood leukemia using population-based linked health data from Western Australia. A cohort of 576,593 infants born in 1980-2004 were followed from birth to diagnosis of acute lymphoblastic leukemia (ALL) (n = 243) or acute myeloid leukemia (AML) (n = 36) before their 15th birthday, death, or the end of follow-up (December 31, 2005). Data were analyzed using Cox regression. Risk of ALL was positively associated with the proportion of optimal birth weight--a measure of the appropriateness of fetal growth--particularly among children younger than 5 years the hazard ratio for a 1-standard-deviation increase in proportion of optimal birth weight was 1.25 (95% confidence interval: 1.07, 1.47). Among children younger than 5 years not classified as having high birth weight (defined as >3,500 g, >3,800 g, and >4,000 g), a 1-unit increase in proportion of optimal birth weight was associated with an approximately 40% increase in ALL risk. This suggests that accelerated growth, rather than high birth weight per se, is involved in the etiology of ALL. These findings are consistent with a role for insulin-like growth factor I in the causal pathway. Findings for AML were inconclusive, probably because of small numbers.
Respiratory symptoms and lung function in bauxite miners
Publisher: Springer Science and Business Media LLC
Date: 10-2001
Abstract: To determine whether cumulative bauxite exposure is associated with respiratory symptoms or changes in lung function in a group of bauxite miners. Current employees at three bauxite mines in Australia were invited to participate in a survey comprising: questionnaire on demographic details, respiratory symptoms, and work history skin prick tests for four common aeroallergens and spirometry. A task exposure matrix was constructed for bauxite exposure in all tasks in all jobs based on monitoring data. Data were examined for associations between cumulative bauxite exposure, and respiratory symptoms and lung function, by regression analyses. The participation rate was 86%. Self-reported work-related respiratory symptoms were reported by relatively few subjects (1.5%-11.8%). After adjustment for age and smoking no significant differences in the prevalence of respiratory symptoms were identified between subjects, in the quartiles of cumulative bauxite exposure distribution. The forced expiratory volume in I s (FEV1) of the exposed group was found to be significantly lower than that for the unexposed group. After adjustment for age, height, and smoking there were no statistically significant differences between quartiles in FEVI, forced vital capacity (FVC) and FEVl/FVC ratio. These data provide little evidence of a serious adverse effect on respiratory health associated with exposure to bauxite in an open-cut bauxite mine in present day conditions.
The relationship between maternal psychiatric disorder, autism spectrum disorder and intellectual disability in the child: a composite picture
Publisher: Herbert Publications PVT LTD
Date: 2015
In vitro cytotoxicity of nelarabine, clofarabine and flavopiridol in paediatric acute lymphoblastic leukaemia
Publisher: Wiley
Date: 23-03-2007
DOI: 10.1111/J.1365-2141.2007.06527.X
Abstract: The in vitro efficacies of three new drugs--clofarabine (CLOF), nelarabine (NEL) and flavopiridol (FP) - were assessed in a panel of acute lymphoblastic leukaemia (ALL) cell lines. The 50% inhibitory concentration (IC50) for CLOF across all lines was 188-fold lower than that of NEL. B-lineage, but not T-lineage lines, were >7-fold more sensitive to CLOF than cytosine arabinoside (ARAC). NEL IC50 was 25-fold and 113-fold higher than ARAC in T- and B-lineage, respectively. T-ALL cells were eightfold more sensitive to NEL than B-lineage but there was considerable overlap. FP was more potent in vitro than glucocorticoids and thiopurines and at doses that recent phase I experience predicts will translate into clinical efficacy. Potential cross-resistance of CLOF, NEL and FP was observed with many front-line ALL therapeutics but not methotrexate or thiopurines. Methotrexate sensitivity was inversely related to that of NEL and FP. Whilst NEL was particularly effective in T-ALL, a subset of patients with B-lineage ALL might also be sensitive. CLOF appeared to be marginally more effective in B-lineage than T-ALL and has a distinct resistance profile that may prove useful in combination with other compounds. FP should be widely effective in ALL if sufficient plasma levels can be achieved clinically.
Perinatal Risk Factors Associated With Gastroenteritis Hospitalizations in Aboriginal and Non-Aboriginal Children in Western Australia (2000-2012)
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2019
Development and validation of the Curtin Bach Screening Questionnaire (CBSQ): a discriminative disability measure
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 1995
Bronchiectasis in Infants and Preschool Children Diagnosed with Cystic Fibrosis after Newborn Screening
Publisher: Elsevier BV
Date: 11-2009
DOI: 10.1016/J.JPEDS.2009.05.005
Abstract: To determine the prevalence of bronchiectasis in young children with cystic fibrosis (CF) diagnosed after newborn screening (NBS) and the relationship of bronchiectasis to pulmonary inflammation and infection. Children were diagnosed with CF after NBS. Computed tomography and bronchoalveolar lavage were performed with anesthesia (n = 96). Scans were analyzed for the presence and extent of abnormalities. The prevalence of bronchiectasis was 22% and increased with age (P = .001). Factors associated with bronchiectasis included absolute neutrophil count (P = .03), neutrophil elastase concentration (P = .001), and Pseudomonas aeruginosa infection (P = .03). Pulmonary abnormalities are common in infants and young children with CF and relate to neutrophilic inflammation and infection with P. aeruginosa. Current models of care for infants with CF fail to prevent respiratory sequelae. Bronchiectasis is a clinically relevant endpoint that could be used for intervention trials that commence soon after CF is diagnosed after NBS.
The association between behavior and genotype in Rett Syndrome using the Australian Rett Syndrome database
Publisher: Wiley
Date: 02-01-2006
DOI: 10.1002/AJMG.B.30270
Maternal Health in Pregnancy and Intellectual Disability in the Offspring: A Population-Based Study
Publisher: Elsevier BV
Date: 06-2006
DOI: 10.1016/J.ANNEPIDEM.2005.05.002
Abstract: The aim of the study is to investigate the relationship between common maternal conditions and intellectual disability (ID) of unknown cause in the offspring. Information about the maternal health of children with and without ID was obtained by using record linkage. For mothers with specific medical conditions, proportions of children with mild to moderate ID, severe ID, and autism spectrum disorder (ASD) with ID were compared with those who did not have ID. There was an increased risk for mild to moderate ID in children of mothers with asthma (odds ratio [OR], 1.52 confidence interval [CI], 1.26-1.83]), diabetes (OR, 1.69 CI, 1.26-2.27), a renal or urinary condition (OR, 2.09 CI, 1.39-3.14), and epilepsy (OR, 3.53 CI, 2.56-4.84). ASD risk was increased for children of women with diabetes (OR, 2.89 CI, 1.28-6.51) and epilepsy (OR, 4.57 CI, 1.69-12.31). For anemia (n = 1101), there was an increased risk for severe ID (OR, 5.26 CI, 2.16-12.80). The increased risk for ID in offspring of mothers with such conditions as asthma and diabetes is particularly important for disadvantaged or ethnic populations, for whom these conditions are more prevalent and may be less well managed.
Plenty of evidence on mandatory folate fortification
Publisher: Elsevier BV
Date: 04-2006
Links2HealthierBubs' cohort study: Protocol for a record linkage study on the safety, uptake and effectiveness of influenza and pertussis vaccines among pregnant Australian women
Publisher: BMJ
Date: 06-2019
DOI: 10.1136/BMJOPEN-2019-030277
Abstract: Pregnant women and infants are at risk of severe influenza and pertussis infection. Inactivated influenza vaccine (IIV) and diphtheria-tetanus-acellular pertussis vaccine (dTpa) are recommended during pregnancy to protect both mothers and infants. In Australia, uptake is not routinely monitored but coverage appears sub-optimal. Evidence on the safety of combined antenatal IIV and dTpa is fragmented or deficient, and there remain knowledge gaps of population-level vaccine effectiveness. We aim to establish a large, population-based, multi-jurisdictional cohort of mother-infant pairs to measure the uptake, safety and effectiveness of antenatal IIV and dTpa vaccines in three Australian jurisdictions. This is a first step toward assessing the impact of antenatal vaccination programmes in Australia, which can then inform government policy with respect to future strategies in national vaccination programmes. ‘Links2HealthierBubs’ is an observational, population-based, retrospective cohort study established through probabilistic record linkage of administrative health data. The cohort includes births between 2012 and 2017 (~607 605 mother-infant pairs) in jurisdictions with population-level antenatal vaccination and health outcome data (Western Australia, Queensland and the Northern Territory). Perinatal data will be the reference frame to identify the cohort. Jurisdictional vaccination registers will identify antenatal vaccination status and the gestational timing of vaccination. Information on maternal, fetal and child health outcomes will be obtained from hospitalisation and emergency department records, notifiable diseases databases, developmental anomalies databases, birth and mortality registers. Ethical approval was obtained from the Western Australian Department of Health, Curtin University, the Menzies School of Health Research, the Royal Brisbane and Women’s Hospital, and the West Australian Aboriginal Health Ethics Committees. Research findings will be disseminated in peer-reviewed journals, at scientific meetings, and may be incorporated into communication materials for public health agencies and the public.
Neighbourhood socioeconomic status and maternal factors at birth as moderators of the association between birth characteristics and school attainment: A population study of children attending government schools in Western Australia
Publisher: BMJ
Date: 18-05-2009
Abstract: This article investigates whether reading and writing skills among children of equivalent perinatal characteristics differ by neighbourhood socioeconomic status and maternal factors. Notifications of births for all non-Aboriginal singletons born in 1990-7 in Western Australia subsequently attending government primary schools were linked to the State literacy tests in grade three and with information on socioeconomic status of the school and the residential area. Using multilevel modelling, the associations between birth characteristics (gestational age, intrauterine growth, birth order and Apgar score at 5 minutes) and literacy attainment in grade three were examined in models that included socioeconomic and demographic factors of the child, mother and community. Higher percentages of optimal head circumference and birth length and term birth were positively and independently associated with literacy scores. A higher percentage of optimal birth weight was associated with higher reading scores especially for children born to mothers residing in educationally advantaged areas. First birth was positively associated with reading and writing attainment: this association was stronger for children born to single mothers and additional advantage in writing was also associated with first birth in children living in disadvantaged areas. These findings suggest that having suboptimal growth in utero or an older sibling at birth increases vulnerability to poor literacy attainment especially among children born to single mothers or those in disadvantaged neighbourhoods. These data provide evidence for advocating lifestyles compatible with optimum fetal growth and socioeconomic conditions conducive to healthy lifestyles, particularly during pregnancy.
Does Exposure to Asbestos Cause Ovarian Cancer? A Systematic Literature Review and Meta-analysis
Publisher: American Association for Cancer Research (AACR)
Date: 07-2011
DOI: 10.1158/1055-9965.EPI-10-1302
Abstract: Introduction: The asbestos and ovarian cancer relationship is not well understood because of small numbers of women exposed to asbestos, small numbers of cases, and misclassification of peritoneal mesothelioma as ovarian cancer on death certificates. The aim of this study was to conduct a meta-analysis to quantify the evidence that exposure to asbestos causes ovarian cancer. Methods: Fourteen cohort and two case-control studies were identified in Medline searches from 1950 to 2008. Results: Statistically significant excess mortality was reported in four of the cohort studies, all of which determined their outcomes from the death certificate. Peritoneal mesotheliomas were reported in these studies, two of which reexamined pathology specimens and reported disease misclassification. Exposure-response relationships were inconsistent. When all studies were included in a meta-analysis, the effect size was 1.75 (95% CI, 1.45–2.10) attenuating to 1.29 (95% CI, 0.97–1.73) in studies with confirmed ovarian cancers. Conclusion: Taken without further analysis, women thought to have ovarian cancer had an increased rate in the meta-analysis if reporting having been exposed to asbestos, compared with reference populations. This result may have occurred because of disease misclassification. Cancer Epidemiol Biomarkers Prev 20(7) 1287–95. ©2011 AACR.
Maternal dietary intake of folate and vitamins B6 and B12 during pregnancy and risk of childhood brain tumors
Publisher: Informa UK Limited
Date: 04-06-2014
DOI: 10.1080/01635581.2014.916326
Abstract: Childhood brain tumors (CBT) are the second most common childhood cancers, yet their etiology is largely unknown. We investigated whether maternal gestational intake of folate and vitamins B6 and B12 was associated with CBT risk in a nationwide case-control study conducted 2005-2010. Case children 0-14 years were recruited from all 10 Australian pediatric oncology centers. Control children were recruited by national random digit dialing, frequency matched to cases on age, sex, and state of residence. Dietary intake was ascertained using food frequency questionnaires and adjusted for total energy intake. Data from 293 case and 726 control mothers were analyzed using unconditional logistic regression. The odds ratio (OR) for the highest versus lowest tertile of folate intake was 0.70 [95% confidence interval (CI): 0.48, 1.02]. The ORs appeared lower in mothers who drank alcohol during pregnancy (OR = 0.45, 95% CI: 0.22, 0.93), mothers who took folic acid (OR = 0.67, 95% CI: 0.42, 1.06) or B6/B12 supplements (OR = 0.51, 95% CI: 0.25, 1.06) and in children younger than 5 years (OR = 0.50, 95% CI: 0.27, 0.93). These findings are consistent with folate's crucial role in maintenance of genomic integrity and DNA methylation. Dietary intake of B6 and B12 was not associated with risk of CBT.
How accurate are international classification of diseases-10 diagnosis codes in detecting influenza and pertussis hospitalizations in Children?
Publisher: Oxford University Press (OUP)
Date: 04-07-2014
DOI: 10.1093/JPIDS/PIT036
Abstract: Influenza and pertussis are major causes of pediatric morbidity. We measured the accuracy of their International Classification of Diseases (ICD-10-AM) diagnosis codes using linked population-based laboratory and hospital data in 245,249 children. Influenza diagnosis codes had high specificity (98.6%) and modest positive predictive value (PPV 84.1%) and sensitivity (86.1%, 95% CI: 83.4%-88.6%) for a laboratory-confirmed episode. For pertussis diagnosis codes, PPV (86.8%) and specificity (98.9%) were high, but sensitivity was poor (27.8%, 95% CI: 23.5%-32.4%). Measures varied according to age, remoteness, Aboriginality, severity, and detection method. Both laboratory and hospitalization data are needed to accurately determine the burden of pediatric influenza and pertussis.
Seizure variables and their relationship to genotype and functional abilities in the CDKL5 disorder
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 21-10-2016
DOI: 10.1212/WNL.0000000000003352
Abstract: To investigate seizure outcomes and their relationships to genotype and functional abilities in in iduals with the cyclin-dependent kinase-like-5 (CDKL5) disorder. Using the International CDKL5 Disorder Database, we identified 172 cases with a pathogenic CDKL5 mutation. We categorized in idual mutations into 4 groups based on predicted structural and functional consequences. Negative binomial regression was used to model the linear association between current seizure rate and mutation group, current level of assistance required to walk 10 steps, and the highest level of expressive communication used to convey refusal or request. All but 3 (169/172) patients had a history of epilepsy. The median age at seizure onset was 6 weeks (range 1 week–1.5 years) and the median seizure rate at ascertainment was 2 per day (range 0–20 per day). After adjusting for walking ability and confounders including use or otherwise of polytherapy, seizure rate was lower in those with truncating mutations between aa172 and aa781 compared to those with no functional protein (incidence rate ratio [IRR] 0.57 95% confidence interval [CI] 0.35–0.93). Ability to walk and use of spoken language were associated with lower rates of current seizures when compared to those with the least ability after adjusting for genotype (walking: IRR 0.62 95% CI 0.39–0.99, communication: IRR 0.48 95% CI 0.23–1.02). At a median age at questionnaire completion of 5 years, those previously treated with corticosteroids had more frequent seizures than those who have never been treated, whether or not there was a history of infantile spasms. Epilepsy is pervasive but not mandatory for the CDKL5 disorder. Genotype and functional abilities were related to seizure frequency, which appears refractory to antiepileptic drugs.
A retrospective population-based cohort study identifying target areas for prevention of acute lower respiratory infections in children
Publisher: Springer Science and Business Media LLC
Date: 12-2010
Increasing incidence of malignant mesothelioma after exposure to asbestos during home maintenance and renovation
Publisher: AMPCo
Date: 09-2011
DOI: 10.5694/MJA11.10125
Abstract: To determine trends in incidence of malignant mesothelioma (MM) caused by exposure to asbestos during home maintenance and renovation. Using the Western Australian Mesothelioma Register, we reviewed all cases of MM diagnosed in WA from 1960 to the end of 2008, and determined the primary source of exposure to asbestos. Categories of exposure were collapsed into seven groups: asbestos miners and millers from Wittenoom all other asbestos workers residents from Wittenoom home maintenance/renovators other people exposed but not through their occupation and people with unknown asbestos exposure or no known asbestos exposure. Latency periods and age at diagnosis for each group were calculated and compared. In WA, 1631 people (1408 men, 223 women) were diagnosed with MM between 1960 and 2008. Since 1981, there have been 87 cases (55 in men) of MM attributed to asbestos exposure during home maintenance and renovation, and an increasing trend in such cases, in both men and women. In the last 4 years of the study (2005-2008), home renovators accounted for 8.4% of all men and 35.7% of all women diagnosed with MM. After controlling for sex and both year and age at diagnosis, the latency period for people exposed to asbestos during home renovation was significantly shorter than that for all other exposure groups, but the shorter follow-up and difficulty recalling when exposure first occurred in this group may partly explain this. MM after exposure to asbestos during home renovation is an increasing problem in WA, and these cases seem to have a shorter latency period than other types of exposure. MM cases related to renovation will probably continue to increase because of the many homes that have contained, and still contain, asbestos building products.
Caustic Mist Exposure and Respiratory Outcomes in a Cohort Study of Alumina Refinery Workers
Publisher: Oxford University Press (OUP)
Date: 18-03-2021
Abstract: A common chemical exposure in alumina refining is caustic mist. Although recognized as a strong airways irritant, little is known of the chronic respiratory effects of caustic mist in alumina refining. A suitable metric for caustic mist exposure assessment in alumina refining for epidemiological purposes has not been identified. Peak exposure is likely to be important, but is difficult to assess in epidemiological studies. In this study, we investigate the respiratory effects of caustic mist in an inception cohort (n = 416) of alumina refinery workers and describe the development and use of a peak exposure metric for caustic mist. We then compare the results with a metric based on duration of exposure. Participants were interviewed annually about respiratory symptoms and had a lung function test. Job history data were collected from each interview and levels of caustic mist were measured periodically by air monitoring. We found a weak association between the caustic mist peak exposure metric and reported cough (P for linear trend = 0.079) with the highest peak exposure group odds ratio = 2.32 (95% confidence interval: 1.27, 4.22). For lung function, we found declines in the forced expiratory volume in 1 second and forced vital capacity for changes in annual and absolute lung function for both metrics of exposure, but only the ratio of absolute lung function was statistically associated with an increasing duration of caustic exposure (P for linear trend = 0.011). In this cohort, we did not observe an association with respiratory symptoms or consistent decrements in lung function. There was little difference between the exposure metrics used for investigation of the chronic effects from caustic mist.
A psychometric experiment in causal inference to estimate evidential weights used by epidemiologists
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2001
DOI: 10.1097/00001648-200103000-00019
Abstract: A psychometric experiment in causal inference was performed on 159 Australian and New Zealand epidemiologists. Subjects each decided whether to attribute causality to 12 summaries of evidence concerning a disease and a chemical exposure. The 1,748 unique summaries embodied predetermined distributions of 19 characteristics generated by computerized evidence simulation. Effects of characteristics of evidence on causal attribution were estimated from logistic regression, and interactions were identified from a regression tree analysis. Factors with the strongest influence on the odds of causal attribution were statistical significance (odds ratio = 4.5 if 0.001 < or = P < 0.05 and 7.2 if P or = 0.05) refutation of alternative explanations (odds ratio = 8.1 for no known confounder vs none adjusted) strength of association (odds ratio = 2.0 if 1.5 < relative risk 2.0, vs relative risk < or = 1.5) and adjunct information concerning biological, factual, and theoretical coherence. The refutation of confounding reduced the cutpoint in the regression tree for decision-making based on strength of association. The effect of the number of supportive studies reached saturation after it exceeded 12 studies. There was evidence of flawed logic in the responses concerning specificity of effects of exposure and a tendency to discount evidence if the P-value was a "near miss" (0.050 < P < 0.065). Evidential weights based on regression coefficients for causal criteria can be applied to actual scientific evidence.
Mothers of Children with Autism have Different Rates of Cancer According to the Presence of Intellectual Disability in Their Child
Publisher: Springer Science and Business Media LLC
Date: 06-07-2016
DOI: 10.1007/S10803-016-2847-9
Abstract: Autism spectrum disorder (ASD) and intellectual disability (ID) are neurodevelopmental disorders with strong genetic components. Increasingly, research attention has focused on whether genetic factors conveying susceptibility for these conditions, also influence the risk of other health conditions, such as cancer. We examined the occurrence of hospital admissions and treatment/services for cancer in mothers of children with ASD with or without ID compared with other mothers. After linking Western Australian administrative health databases, we used Cox regression to estimate the hazard ratios (HRs) of any hospitalisations and treatment/services for cancer in these groups of mothers. Mothers of children with ASD without ID had greater risk of admissions for cancer (HR 1.29 [95 % CI 1.1, 1.7]), and for treatment/services in particular (HR 1.41 [95 % CI 1.0, 2.0]), than mothers of children with no ASD/ID, while mothers of children with ASD with ID were no more likely to have a cancer-related hospital admission than other mothers. Mothers of children with autism without ID had increased risk of cancer, which may relate to common genetic pathways.
Lung Function, Bronchial Responsiveness, and Asthma in a Community Cohort of 6-Year-Old Children
Publisher: American Thoracic Society
Date: 04-2004
Chest MRI in patients with cystic fibrosis: a radiation-free method Response
Publisher: BMJ
Date: 16-10-2013
Vitamin A and cancer prevention I: observations in workers previously exposed to asbestos at Wittenoom, Western Australia
Publisher: Wiley
Date: 30-01-1998
DOI: 10.1002/(SICI)1097-0215(19980130)75:3<355::AID-IJC5>3.0.CO;2-1
Abstract: Our aim was to describe a vitamin A-based cancer prevention program for former asbestos workers and to check for possible harmful effects by comparing rates of disease and death in study subjects with subjects who chose not to join. All subjects had been occupationally exposed to crocidolite at Wittenoom Gorge between 1943 and 1966 1,677 subjects indicated interest in the program and 1,203 joined between June 1990 and May 1995. Comparison subjects consisted of 996 former workers known to be alive in Western Australia in 1990 who did not join the program. Program subjects were provided with annual supplies of vitamin A (either synthetic beta-carotene or retinol), help in quitting smoking and dietary advice. The comparison group received only mail contact. Both groups were followed up to December 1994 for vital status and cancer information, and rates of cancer and death from various causes were compared. Mortality in both groups was higher than expected (standardised mortality ratio 1.23 in program subjects and 1.67 in comparison subjects). After adjustment for age, smoking and asbestos exposure, the relative rates in participants compared with non-participants was below I for all examined cancers and causes of death. For mesothelioma and lung cancer, group differences increased with time from entry, whereas other differences dissipated with time. No significant side effects were reported. In conclusion, program participants had significantly lower mortality than non-participants, but the rates of the 2 groups converged with time.
Low-moderate prenatal alcohol exposure and risk to child behavioral development: A prospective cohort study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2010
Parental smoking and risk of childhood brain tumors
Publisher: Wiley
Date: 13-02-2013
DOI: 10.1002/IJC.28004
Abstract: Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their etiology remains largely unknown. Tobacco smoke contains 61 known carcinogens and increases the risk of several adult cancers. This study investigated associations between parental smoking and risk of CBT in a population-based case-control study conducted between 2005 and 2010. Cases were identified through all ten Australian pediatric oncology centers, controls via nationwide random-digit dialing, frequency matched to cases on age, sex and state of residence. Parental smoking information was obtained for 302 cases and 941 controls through mailed questionnaires that requested average daily cigarette use in each calendar year from age 15 to the child's birth, linked to residential and occupational histories. Data were analyzed using unconditional logistic regression, adjusting for frequency matching variables and potential confounders. Overall, parental smoking before or during pregnancy showed no association with CBT risk. The odds ratios for maternal smoking before and during pregnancy were 0.99 (95% CI: 0.70, 1.40) and 0.89 (95% CI: 0.61, 1.21), respectively, and those for paternal smoking before and during pregnancy were 0.99 (95% CI: 0.71, 1.38) and 1.04 (95% CI: 0.74, 1.46), respectively. In children under 24 months of age, the odds ratios for maternal smoking preconception and during pregnancy were 5.06 (95% CI 1.35-19.00) and 4.61 (95% CI: 1.08, 19.63), although these results were based on modest numbers. Future studies should investigate the associations between maternal smoking and risk of CBT by the child's age of diagnosis.
Erratum to: Exposure to pesticides and the risk of childhood brain tumors
Publisher: Springer Science and Business Media LLC
Date: 07-2014
Trends in infant/child mortality and life expectancy in Indigenous populations in Yunnan Province, China
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1111/J.1753-6405.2008.00219.X
Abstract: The 2000 Census in China registered 55 groups of Indigenous population, including 104.49 million people, making up 8.1% of China's total population. Yunnan Province, located in Southwest China, is the only province where all 55 Indigenous nationalities are represented (14.15 million), making up 33.4% of Yunnan's total population. This study aimed to examine trends in infant and child mortality and life expectancy at birth of the 22 largest Indigenous nationalities and compared these trends with those of the majority Han Chinese in Yunnan and China as a whole. Data sources of mortality and socioeconomic status came from the population censuses of China (1953, 1964, 1982, 1990, and 2000) and Yunnan (1990-2000) and from the Provincial Health Department (1990, 1995, 1996 and 2000). Weighted linear regression analysis was used to examine the associations between infant/child mortality and life expectancy at birth, socioeconomic indicators and the use of preventive health services. In 2000, the infant mortality rate was 26.90 for China and 53.64 for Han Chinese in Yunnan per 1,000 live birth versus 77.75 for the 22 largest minority nationalities in Yunnan, despite improvements in health status indicators since 1990. The inequalities in life expectancy at birth between China as a whole and some minority nationalities remained striking in 2000 (57.18 versus 71.40). Literacy, prenatal examination, hospital deliveries, economic development were important predictors of these health indicators. Efforts to continue to improve these intermediate proximate determinants and to target the most disadvantaged Indigenous groups are likely to further reduce health disparities between the Chinese and Indigenous populations.
Migration and work in postwar Australia: mortality profile comparisons between Australian and Italian workers exposed to blue asbestos at Wittenoom
Publisher: BMJ
Date: 29-07-2018
DOI: 10.1136/OEMED-2017-104322
Abstract: Three hundred and thirty thousand Italians arrived in Australia between 1945 and 1966, many on assisted passage schemes where the worker agreed to a 2-year unskilled employment contract. Italians were the largest of 52 migrant groups employed at the Wittenoom blue asbestos mining and milling operation. We compare mortality from asbestos-related diseases among Italian and Australian workers employed at Wittenoom. A cohort of 6500 male workers was established from employment records and followed up at state and national mortality and cancer registries. SMRs were calculated to compare mortality with the Western Australian male population. Time-varying Cox proportional hazards models compared the risk of mesothelioma between Australian and Italian workers. 1031 Italians and 3465 Australians worked at Wittenoom between 1943 and 1966. Duration of employment was longer for the Italian workers, although the concentration of exposure was similar. The mesothelioma mortality rate per 100 000 was higher in Italians (184, 95% CI 148 to 229) than Australians (128, 95% CI 111 to 149). The risk of mesothelioma was greater than twofold (HR 2.27, 95% CI 1.43 to 3.60) in Italians at the lowest asbestos exposure category ( fibre years er mL). A hierarchy in migration, isolation and a shortage of workers led to Italians at Wittenoom incurring higher cumulative exposure to blue asbestos and subsequently a greater rate of malignant mesothelioma than Australian workers. Poor working conditions and disparities between native and foreign-born workers has had a detrimental and differential impact on the long-term health of the workforce.
Dietary Patterns Identified Using Factor Analysis and Prostate Cancer Risk: A Case Control Study in Western Australia
Publisher: Elsevier BV
Date: 05-2008
DOI: 10.1016/J.ANNEPIDEM.2007.11.010
Abstract: Dietary patterns offer an alternative method for analyzing dietary intakes that take into account the whole diet. We investigated empirical dietary patterns and prostate cancer risk in Western Australia (WA) using a population-based case-control study. Incident prostate cancer cases were identified via the WA Cancer Registry. Controls were sourced from the WA electoral roll, frequency matched on age. A food frequency questionnaire (FFQ) estimated usual dietary intake from 10 years earlier. Factor analysis identified dietary patterns in FFQ data. Effects of independent dietary patterns on prostate cancer risk were examined using unconditional logistic regression, adjusting for potential confounders. A total of 546 cases and 447 controls provided data. Three distinct dietary patterns were identified, which we labeled vegetable, Western, and health-conscious. An increased risk for prostate cancer was observed with the Western pattern, which consisted of high intakes of red and processed meats, fried fish, hamburgers, chips, high-fat milk, and white bread. Men in the highest quartile for Western pattern score had an odds ratio of 1.82 (95% confidence interval 1.15-2.87, trend p = 0.02). Results were similar for aggressive cases and attenuated for non-aggressive cancers. A western style diet may lead to increased risks for prostate cancer, especially aggressive prostate cancer.
Alcoholic drinks: Important triggers for asthma
Publisher: Elsevier BV
Date: 03-2000
Abstract: Although anecdotally alcoholic drinks seem to be common triggers for asthma, little is known of the prevalence, the characteristics, or the mechanisms underlying these reactions. The primary aim of this study was to determine the frequency and characteristics of asthmatic reactions triggered by alcoholic drinks in a community-based cohort of asthmatic subjects. Investigations of other food sensitivities were also completed to explore some of the possible components of alcoholic drinks that may be responsible for these asthmatic responses. A validated food allergy questionnaire was used to assess the characteristics of alcoholic drink-induced asthma in 366 adult patients recruited from the Asthma Foundation of Western Australia. The food allergy questionnaire was sent out by mail and self-administered by recipients. Thirty-three percent of respondents indicated that alcoholic drinks had been associated with the triggering of asthma on at least 2 occasions. Wines were the most frequent triggers, with responses being rapid in onset (<1 hour) and of mild to moderate severity. Logistic regression analysis indicated that wine-induced asthmatic reactions were reported more often by women (P =.032), by those taking oral steroids (P =.021), by in iduals who had reported their first asthma attack at a younger age (P <. 001), and by those who had previously visited an alternative health practitioner for asthma (P =.041). A significant association between wine-induced asthma and asthma triggered by sulfite-containing foods (P <.001) and by aspirin and nonsteroidal anti-inflammatory medicines (P =.01) was also observed. Alcoholic drinks, and particularly wines, appear to be important triggers for asthmatic responses. Sensitivity to the sulfite additives in wines seems likely to play an important role in many of these reactions. Sensitivities of in iduals to salicylates present in wines may also play a role.
Measurement of urinary 1-aminopyrene and 1-hydroxypyrene as biomarkers of exposure to diesel particulate matter in gold miners
Publisher: Elsevier BV
Date: 10-2019
DOI: 10.1016/J.SCITOTENV.2019.06.242
Abstract: Metabolites of polycyclic aromatic hydrocarbons measured in human s les are often used as biomarkers of exposure to diesel engine exhaust (DEE). The aim of this study was to assess the changes in urinary levels of 1-aminopyrene (1-AP) and 1-hydroxypyrene (1-OHP) and their relationship with Elemental Carbon (EC), as a component of diesel engine exhaust exposure, among a hard-rock gold-mining population. Urine s les were collected at the beginning and end of a 12-hour work shift from 100 underground and above ground gold miners. Miners were fitted with personal exposure monitoring equipment to quantify exposure to DEE, measured as Elemental Carbon (EC), across their 12-hour work shift. General linear regression assessed associations of the post-shift urinary 1-AP and 1-OHP concentrations with EC, controlling for age, gender, the pre-shift biomarker level, Body Mass Index (BMI), days on current shift, time in mining, smoking status and second-hand smoke exposure. The concentrations of 1-AP and 1-OHP increased significantly across a 12-hour mining work shift. Moreover, consistent with the sensitivity analysis, the concentration of 1-AP was significantly associated with EC after adjustments. Urinary 1-OHP, but not 1-AP was significantly associated with current smoking. Urinary 1-AP may be a more robust and specific biomarker of DEE than 1-OHP.
Prognostic significance of an early rise to peak creatine kinase after acute myocardial infarction
Publisher: Elsevier BV
Date: 06-1988
DOI: 10.1016/0002-9149(88)91150-2
Abstract: Because an early rise to peak creatine kinase (CK) is regarded as a noninvasive marker of early coronary reperfusion, the short- and long-term significance of this phenomenon was studied. In a series of consecutive patients admitted between 1974 and 1976 with acute myocardial infarction (AMI), 2 hourly CK estimations were performed. Complete CK curves were obtained in 102 patients, all of whom have been followed for 10 years. Without reference to their clinical course or follow-up, patients were ided into those with CK curves peaking less than or equal to 15 hours (mean 11 hours n = 41) and those with curves peaking greater than 15 hours (mean 21 hours n = 61). There were no differences in age, Norris index, location of AMI or past history of coronary artery disease between the groups however, the mean peak CK was higher in the late peak group (p less than 0.05) and there were more non-Q-wave infarcts in the early peak group (p less than 0.01). In the first 9 months of follow-up there were fewer cardiac deaths in the early peak group (5 vs 13%), but this difference was not significant, and at 12 months the survival curves crossed. At 10 years, survival was 42% in the early peak group and 65% in the late peak group (p less than 0.05). Cox regression analysis showed that early peaking of the CK curve was an independent marker for cardiac death overall (relative risk 2.3, p less than 0.02). In 1-year survivors the relative risk increased to 3.8 (p less than 0.008).(ABSTRACT TRUNCATED AT 250 WORDS)
Trends in childhood acute lymphoblastic leukemia in Western Australia, 1960-2006
Publisher: Wiley
Date: 24-12-2008
DOI: 10.1002/IJC.23226
Abstract: Increases in the incidence of childhood acute lymphoblastic leukemia (ALL) have been reported in some countries, while other reports from similar geographical regions have indicated stable rates. The reasons for the discrepancies have been debated in the literature, with the focus on whether the observed increases are "real" or an artifact resulting from improvements in diagnosis, case ascertainment and population coverage over time. We used population-based data from Western Australia to investigate trends in the incidence of childhood ALL between 1960 and 2006. Age-standardized incidence rates (ASRs) and rate ratios (indicating annual percent change) were estimated using Poisson regression. Between 1960 and 2006, the ASR was 3.7 per 100,000 person-years, with an annual percent increase of 0.40% (95% CI: -0.20, 1.00). Between 1982 and 2006, the ASR was 3.8, with an annual percent increase of 0.80% (95% CI = -0.70 to 2.30). This increased to 1.42% (95% CI: -0.30, 3.0) when a sensitivity analysis was undertaken to assess the effect of excluding the final 2 years of data. Annual increases of 3.7% (95% CI: -0.50, 8.00) among children aged 5-14 years, and of 3.10% (95% CI: 0.50, 5.70) in girls, were observed for this latter period. These results were supported by national Australian incidence data available for 1982-2003. There may have been a small increase in the incidence of ALL since 1982 among girls and older children, but an overall increase appears unlikely. No impact of folate supplementation or fortification is apparent.
Association of gestational age and growth measures at birth with infection-related admissions to hospital throughout childhood: a population-based, data-linkage study from Western Australia
Publisher: Elsevier BV
Date: 08-2016
Prediction of relapse in paediatric pre‐B acute lymphoblastic leukaemia using a three‐gene risk index
Publisher: Wiley
Date: 21-02-2008
DOI: 10.1111/J.1365-2141.2008.06981.X
Abstract: Despite high cure rates 25% of children with acute lymphoblastic leukaemia (ALL) relapse and have dismal outcome. Crucially, many are currently stratified as standard risk (SR) and additional markers to improve patient stratification are required. Here we have used diagnostic bone marrow specimens from 101 children with pre-B ALL to examine the use of gene expression profiles (GEP) as predictors of long-term clinical outcome. Patients were ided into two cohorts for model development and validation based on availability of specimen material. Initially, GEP from 55 patients with sufficient material were analysed using HG-U133A microarrays, identifying an 18-gene classifier (GC) that was more predictive of outcome than conventional prognostic parameters. After feature selection and validation of expression levels by quantitative reverse transcription polymerase chain reaction (qRT-PCR), a three-gene qRT-PCR risk index [glutamine synthetase (GLUL), ornithine decarboxylase antizyme inhibitor (AZIN), immunoglobulin J chain (IGJ)] was developed that predicted outcome with an accuracy of 89% in the array cohort and 87% in the independent validation cohort. The data demonstrate the feasibility of using GEP to improve risk stratification in childhood ALL. This is particularly important for the identification of patients destined to relapse despite their current stratification as SR, as more intensive front-line treatment options for these in iduals are already available.
Exposure to professional pest control treatments and the risk of childhood acute lymphoblastic leukemia
Publisher: Wiley
Date: 11-02-2011
DOI: 10.1002/IJC.25769
Abstract: Previous studies suggest that exposure to pesticides increases the risk of childhood acute lymphoblastic leukemia (ALL). The aim of this analysis was to investigate whether professional pest treatments in or around the home before birth or during childhood increased the risk of childhood ALL. Data from 388 cases and 870 frequency-matched controls were analyzed using unconditional logistic regression, adjusting for study matching variables and potential confounders, to calculate odds ratios (ORs). A meta-analysis of our findings with the published findings of previous studies was also conducted. The ORs for any professional pest control treatments were 1.19 (95% CI 0.83, 1.69) in the year before pregnancy, 1.30 (95% CI 0.86, 1.97) during pregnancy and 1.24 (95% CI 0.93, 1.65) for those done after the child's birth. The ORs for exposure after birth were highest when it occurred between the ages of two and three years. ORs were elevated for termite treatments before birth. ORs were higher for pre-B than T cell ALL and for t(12 ) (ETV6-Runx-1) than other cytogenetic sub-types. The pooled OR from a meta-analysis of our study with three previous studies of professional pest control treatments during pregnancy was 1.37 (95% CI 1.00, 1.88). Our results, and those of our meta-analysis, provide some evidence of a modestly increased risk of ALL for professional pest control treatments done during the index pregnancy and possibly in the child's early years. The analysis of pooled data from international collaborations may provide more certainty regarding these potentially important associations.
Pooled exposure-response analyses and risk assessment for lung cancer in 10 cohorts of silica-exposed workers: An IARC multicentre study
Publisher: Springer Science and Business Media LLC
Date: 2001
Abstract: Silica is one of the most common occupational exposures worldwide. In 1997 the International Agency for Research on Cancer (IARC) classified inhaled crystalline silica as a human carcinogen (group 1), but acknowledged limitations in the epidemiologic data, including inconsistencies across studies and the lack of extensive exposure-response data. We have conducted a pooled exposure-response analysis of 10 silica-exposed cohorts to investigate lung cancer. The pooled cohort included 65,980 workers (44,160 miners, 21,820 nominees), and 1,072 lung cancer deaths (663 miners, 409 nonminers). Follow-up has been extended for five of these cohorts beyond published data. Quantitative exposure estimates by job and calendar time were adopted, modified, or developed to permit common analyses by respirable silica (mg/m3) across cohorts. The log of cumulative exposure, with a 15-year lag, was a strong predictor of lung cancer (p = 0.0001), with consistency across studies (test for heterogeneity, p = 0.34). Results for the log of cumulative exposure were consistent between underground mines and other facilities. Categorical analyses by quintile of cumulative exposure resulted in a monotonic trend with odds ratios of 1.0. 1.0, 1.3, 1.5, 1.6. Analyses using a spline curve also showed a monotonic increase in risk with increasing exposure. The estimated excess lifetime risk (through age 75) of lung cancer for a worker exposed from age 20 to 65 at 0.1 mg/m3 respirable crystalline silica (the permissible level in many countries) was 1.1-1.7%, above background risks of 3-6%. Our results support the decision by the IARC to classify inhaled silica in occupational settings as a carcinogen, and suggest that the current exposure limits in many countries may be inadequate. These data represent the first quantitative exposure-response analysis and risk assessment for silica using data from multiple studies.
Statistical adjustment of genotyping error in a case–control study of childhood leukaemia
Publisher: Springer Science and Business Media LLC
Date: 13-09-2012
Respiratory symptoms and lung function in alumina refinery employees
Publisher: BMJ
Date: 04-2000
DOI: 10.1136/OEM.57.4.279
Abstract: Employees in alumina refineries are known to be exposed to a number of potential respiratory irritants, particularly caustic mist and bauxite and alumina dusts. To examine the prevalence of work related respiratory symptoms and lung function in alumina refinery employees and relate these to their jobs. 2964 current employees of three alumina refineries in Western Australia were invited to participate in a cross sectional study, and 89% responded. Subjects were given a questionnaire on respiratory symptoms, smoking, and occupations with additional questions on temporal relations between respiratory symptoms and work. Forced expiratory volume in 1 second (FEV(1)) and forced vital capacity (FVC) were measured with a rolling seal spirometer. Atopy was assessed with prick skin tests for common allergens. Associations between work and symptoms were assessed with Cox's regression to estimate prevalence ratios, and between work and lung function with linear regression. Work related wheeze, chest tightness, shortness of breath, and rhinitis were reported by 5.0%, 3.5%, 2.5%, and 9.5% of participants respectively. After adjustment for age, smoking, and atopy, most groups of production employees reported a greater prevalence of work related symptoms than did office employees. After adjustment for age, smoking, height, and atopy, subjects reporting work related wheeze, chest tightness, and shortness of breath had significantly lower mean levels of FEV(1) (186, 162, and 272 ml respectively) than subjects without these symptoms. Prevalence of most work related symptoms was higher at refinery 2 than at the other two refineries, but subjects at this refinery had an adjusted mean FEV(1) >60 ml higher than the others. Significant differences in FVC and FEV(1)/FVC ratio, but not FEV(1), were found between different process groups. There were significant differences in work related symptoms and lung function between process groups and refineries, but these were mostly not consistent. Undefined selection factors and underlying population differences may account for some of these findings but workplace exposures may also contribute. The differences identified between groups were unlikely to be clinically of note.
Radiographic (ILO) readings predict arterial oxygen desaturation during exercise in subjects with asbestosis
Publisher: BMJ
Date: 03-2003
DOI: 10.1136/OEM.60.3.201
Abstract: Exercise impairment is common in subjects with asbestosis. Arterial oxygen desaturation during exercise is an important contributor to exercise limitation. The International Labour Office (ILO) classification of plain chest radiographs correlates with resting pulmonary function, but its value in predicting abnormal ventilatory responses to exercise, including desaturation, has not been explored. To determine in subjects with asbestosis (1) if radiographic profusion scores and the extent of small irregular shadows on plain chest radiographs correlate with resting lung function and abnormal ventilatory responses to exercise and (2) if radiographic scores add value to resting lung function tests in predicting abnormal ventilatory responses to exercise. Thirty eight male subjects with asbestosis were included. Plain chest radiographs were read according to the ILO classification independently by three observers. All subjects underwent assessment of lung function and an incremental exercise test. Profusion scores and number of affected zones correlated significantly with the percentage predicted values of single breath diffusing capacity (DLCO), forced vital capacity (FVC), and total lung capacity (TLC). Arterial oxygen desaturation occurred in 29% of the subjects. The severity of desaturation correlated significantly with profusion and the number of affected zones. The combined use of number of affected zones, FEV(1)/FVC ratio and DLCO predicted desaturation during exercise with an explained variance of 41%. VO(2)max was significantly related only to DLCO but was not predicted by the ILO score. Arterial oxygen desaturation correlated with the profusion and extent of parenchymal abnormality on chest radiographs. The addition of morphological indices to physiological measurements is valuable for predicting oxygen desaturation during exercise but not for VO(2)max. Refinement of the radiographic scoring system and the addition of more sophisticated imaging techniques may further improve the predictive power.
Environmental enrichment intervention for Rett syndrome: An individually randomised stepped wedge trial
Publisher: Springer Science and Business Media LLC
Date: 10-01-0015
Risk of Developmental Disorders in Children of Immigrant Mothers: A Population-Based Data Linkage Evaluation
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JPEDS.2018.08.047
Abstract: To evaluate the prevalence and risks of developmental disability (autism spectrum disorder, intellectual disability, and cerebral palsy) in Western Australian children of different groups of foreign-born women. Western Australian population-based linked data of 764 749 singleton live births from 1980 to 2010 were used to compare disability outcomes among children of foreign-born, Australian-born non-Indigenous, and Indigenous women. The risk of disability was assessed using multinomial logistic regression. Overall, the prevalence of any disability was lowest for the children of foreign-born mothers. From 1980 to 1996 but not from 1997 to 2010, children born to mothers from foreign-born low-income countries had an increased relative risk of autism spectrum disorder with intellectual disability, and children born to foreign-born mothers from upper-middle-income countries had an increased risk of cerebral palsy with intellectual disability. After adjusting for smoking, the relative risks of intellectual disability and cerebral palsy with intellectual disability were markedly decreased in children of Australian-born Indigenous mothers. Although we did not find among children born to foreign-born women an increased prevalence across all the measured developmental outcomes, we did observe an increased risk of autism spectrum disorder with intellectual disability and cerebral palsy with intellectual disability for mothers of some foreign-born groups. Our findings related to smoking in the Indigenous population underscore its possible role on the causal pathway to intellectual disability. Maternal migration is considered a factor on the causal pathway to intellectual disability. Maternal migration may be either a risk or a protective factor on the causal pathway to developmental disabilities and the direct role of migration is inconclusive in our study.
Mesothelioma in Australia: a review
Publisher: AMPCo
Date: 11-2017
DOI: 10.5694/MJA17.00397
Abstract: The incidence of malignant mesothelioma in Australia is among the highest in the world as a result of widespread use of asbestos by industry and in construction throughout the 20th century. The risk of developing malignant mesothelioma after asbestos exposure is dose-related a transient, low dose exposure confers a correspondingly very low risk of disease. Malignant mesothelioma is a heterogeneous disease, partly explaining the limited role of biomarkers in screening and diagnosis. The prognosis remains poor, and early advice on medico-legal compensation and a collaborative team approach to managing malignant mesothelioma are both essential. Chemotherapy can have a modest treatment effect in some people. New therapies, such as immunotherapy, do not yet have a defined role in the treatment of malignant mesothelioma. As treatment options for malignant mesothelioma are limited and no cure is available, there is no established role for early detection or screening of at risk populations. A multidisciplinary approach to caring for patients with malignant mesothelioma and their carers is vital.
Emergency department overcrowding, mortality and the 4‐hour rule in Western Australia
Publisher: AMPCo
Date: 02-2012
DOI: 10.5694/MJA11.11159
Abstract: To assess whether emergency department (ED) overcrowding was reduced after the introduction of the 4-hour rule in Western Australia and whether any changes in overcrowding were associated with significant changes in patient mortality rates. Quasi-experimental intervention study using dependent pretest and post-test s les. Hospital and patient data were obtained for three tertiary hospitals and three secondary hospitals in Perth, WA, for 2007-08 to 2010-11. Mortality rates overcrowding rates. No change was shown in mortality from 2007-08 to 2010-11 for the secondary hospitals and from 2007-08 to 2009-10 for the tertiary hospitals. ED overcrowding (as measured by 8-hour access block) at the tertiary hospitals improved dramatically, falling from above 40% in July 2009 to around 10% by early 2011, and presentations increased by 10%, while the mortality rate fell significantly (by 13% 95% CI, 7%-18% P < 0.001) from 1.12% to 0.98% between 2009-10 and 2010-11. Monthly mortality rates decreased significantly in two of the three tertiary hospitals concurrently with decreased access block and an increased proportion of patients admitted in under 4 hours. Introduction of the 4-hour rule in WA led to a reversal of overcrowding in three tertiary hospital EDs that coincided with a significant fall in the overall mortality rate in tertiary hospital data combined and in two of the three in idual hospitals. No reduction in adjusted mortality rates was shown in three secondary hospitals where the improvement in overcrowding was minimal.
Curtin industrial safety trial: Methods and safe practice and housekeeping outcomes
Publisher: Elsevier BV
Date: 12-1996
Relationships between alumina and bauxite dust exposure and cancer, respiratory and circulatory disease
Publisher: BMJ
Date: 19-03-2009
Abstract: To examine the associations between alumina and bauxite dust exposure and cancer incidence and circulatory and respiratory disease mortality among bauxite miners and alumina refinery workers. This cohort of 5770 males has previously been linked to national mortality and national and state cancer incidence registries (1983-2002). In this paper, Poisson regression was used to undertake internal comparisons within the cohort based on subgroups of cumulative exposure to inhalable bauxite and alumina dust. Exposure was estimated using job histories and historical air monitoring data. There was no association between ever bauxite exposure and any of the outcomes. There was a borderline significant association between ever alumina exposure and cerebrovascular disease mortality (10 deaths, RR 3.8, 95% CI 1.1 to 13). There was some evidence of an exposure-response relationship between cumulative bauxite exposure and non-malignant respiratory disease mortality (seven deaths, trend p value: 0.01) and between cumulative alumina exposure and cerebrovascular disease mortality (trend p value: 0.04). These associations were based on very few cases and for non-malignant respiratory disease the deaths represented a heterogeneous mixture of causes. There was no evidence of an excess risk for any cancer type with bauxite or alumina exposure. These preliminary findings, based on very few cases, suggest that cumulative inhalable bauxite exposure may be associated with an excess risk of death from non-malignant respiratory disease and that cumulative inhalable alumina dust exposure may be associated with an excess risk of death from cerebrovascular disease. Neither exposure appears to increase the risk of incident cancers.
Benefits of routine immunizations on childhood survival in Tari, Southern Highlands Province, Papua New Guinea
Publisher: Oxford University Press (OUP)
Date: 27-08-2004
DOI: 10.1093/IJE/DYH262
Abstract: Non-specific beneficial as well as deleterious effects of childhood immunizations have been reported in areas of high mortality. This study aimed to determine the effects of diphtheria-tetanus-whole-cell-pertussis (DTP), BCG, hepatitis B, and measles vaccines on mortality in the highlands of Papua New Guinea (PNG). Demographic events for children born in 1989-1994 who were under monthly demographic surveillance in Tari were recorded from birth until age 2 years, out-migration, death, or the end of the study period. Data on BCG, hepatitis B, DTP, measles and pneumococcal polysaccharide vaccination were collected monthly from clinic records. To allow for different characteristics of immunized and non-immunized children, analysis included conditioning on a propensity score for vaccination, adjusting for differences in children's background characteristics. In all, 101/3502 children (3%) who had at least one vaccine died between ages 29 days and 24 months were compared to 112/546 (21%) who had none. BCG was associated with lower mortality in the 1-5 month age group (hazard ratio [HR] = 0.17, 95% CI: 0.09, 0.34), measles vaccine with lower mortality at age 6-11 months (HR = 0.42, 95% CI: 0.17, 1.01), and pneumococcal polysaccharide vaccine with lower mortality at age 12-23 months (HR = 0.42, 95% CI: 0.19, 0.93). One or more doses of DTP was associated with lower overall mortality (HR = 0.27, 95% CI: 0.16, 0.44), particularly in the 1-5 month age group (HR = 0.19, 95% CI: 0.10, 0.34), and also in those who had had prior BCG (HR = 0.45, 95% CI: 0.22, 0.91). Routine immunizations are effective in reducing overall mortality in young children in an area of high mortality. In particular, DTP, whether considered separately or in addition to BCG, was associated with a lowering of overall mortality, in contrast to findings reported from Guinea-Bissau.
Exposure to Diagnostic Radiological Procedures and the Risk of Childhood Acute Lymphoblastic Leukemia
Publisher: American Association for Cancer Research (AACR)
Date: 11-2010
DOI: 10.1158/1055-9965.EPI-10-0542
Abstract: Background: Diagnostic irradiation of the mother during pregnancy increases the risk of childhood acute lymphoblastic leukemia (ALL). There is inconsistent evidence on associations between ALL and other parental or childhood diagnostic irradiation. The aim of this analysis is to investigate whether diagnostic X-rays of the mother before birth, of the father before conception, or of the child increased the risk of childhood ALL. Methods: Data from 389 cases and 876 frequency-matched controls were analyzed using unconditional logistic regression, adjusting for study matching factors and potential confounders. A meta-analysis of our findings in relation to paternal X-rays before conception with the published findings of previous studies was also conducted. Results: There was no evidence of an increased risk with maternal abdominal X-rays before the birth of the index child or with the child having any X-rays more than 6 months before the censoring date. The odds ratio (OR) for any paternal abdominal X-ray before conception was 1.17 [95% confidence interval (95% CI), 0.88-1.55], and 1.47 (95% CI, 0.98-2.21) for more than one X-ray. The OR for any paternal intravenous pyelogram before conception was 3.56 (95% CI, 1.59-7.98). The pooled OR for this study with previous studies of any paternal abdominal X-rays before conception was 1.17 (95% CI, 0.92-1.48). Conclusions: There was some evidence of an increased risk of ALL in the offspring if the father had more than one abdominal X-ray before conception or had ever had an intravenous pyelogram. Impact: We plan to repeat this analysis by using pooled data to improve precision. Cancer Epidemiol Biomarkers Prev 19(11) 2897–909. ©2010 AACR.
Maternal Psychiatric Disorder and the Risk of Autism Spectrum Disorder or Intellectual Disability in Subsequent Offspring
Publisher: Springer Science and Business Media LLC
Date: 15-09-2015
DOI: 10.1007/S10803-015-2594-3
Abstract: Psychiatric disorders are more common in the mothers of children with autism spectrum disorder (ASD) or intellectual disability (ID) after the birth of their child. We aimed to assess the relationship between women's psychiatric contacts and subsequent offspring with ASD/ID. We linked three Western Australian registers to investigate pre-existing maternal outpatient psychiatric contacts and the odds of ASD/ID in a subsequent child. Women with a previous outpatient psychiatric contact were more than twice as likely to have a child with ASD [OR 2.07 (95 % CI 1.7, 2.6)] or ID [OR 2.31 (2.1, 2.6)]. Further research exploring the effect on pregnancy outcomes of medications prescribed to women with psychiatric disorders is implicated.
Autoimmune antibodies and asbestos exposure: Evidence from Wittenoom, Western Australia
Publisher: Wiley
Date: 24-05-2018
DOI: 10.1002/AJIM.22863
Abstract: Studies comparing different forms of asbestos are rare, and limited by the failure to compare results with unexposed populations. We compare autoimmune responses among former workers and residents of the crocidolite mining and milling town of Wittenoom, Western Australia, with an unexposed population. ANA testing using indirect immunofluorescence was performed on randomly selected serum s les from Wittenoom workers or residents and compared with those from participants of another unexposed cohort study. ANA scores were higher in the Wittenoom participants compared with Busselton and the odds of being ANA positive was fivefold greater among Wittenoom participants than Busselton (OR 5.5, 95%CI 2.3-13.0). This study is the first to report increased ANA positivity among persons exposed exclusively to crocidolite. This finding of a high frequency of positive ANA tests among crocidolite-exposed subjects may be an indicator for an increased risk of systemic autoimmune diseases and needs further scrutiny.
The PHF11 gene is not associated with asthma or asthma phenotypes in two independent populations
Publisher: BMJ
Date: 21-04-2009
Abstract: Numerous areas of the human genome have previously been associated with asthma and asthma-related phenotypes, but few positive findings have been successfully replicated in independent populations. Initial studies have reported strong associations of variants in the plant homeodomain zinc finger protein 11 (PHF11) gene with serum IgE levels, asthma, airway hyper-responsiveness and childhood atopic dermatitis. To investigate the association of variants in the PHF11 gene with asthma and associated intermediate phenotypes in two independent Western Australian population-based s les. A linkage-disequilibrium (LD)-tagging set of 20 single nucleotide polymorphisms (SNPs) was genotyped in PHF11 in two separate populations (total n = 2315), a family-based twin study consisting of 230 families (n = 992 subjects) and a population-based nested case-control study consisting of 617 asthma cases and 706 controls. Information regarding asthma, respiratory physiology, atopy and environmental exposures was collected. Transmission disequilibrium tests, variance components models and generalised linear models were used to test for association between PHF11 SNPs and selected asthma outcomes (including longitudinal change in lung function). After correction for multiple testing, no statistically significant (p < 0.05) associations were found between PHF11 and either asthma or total serum IgE levels in either population. No statistically significant associations were found with any other asthma-associated phenotypes in either population. Previously reported associations of PHF11 with asthma outcomes were not replicated in this study. This study suggests that PHF11 is unlikely to contain polymorphic loci that have a major impact on asthma susceptibility in our populations.
InterRett - the application of bioinformatics to international Rett syndrome research
Publisher: Informa UK Limited
Date: 03-2005
DOI: 10.1080/03014460500075068
Abstract: InterRett, International Rett Syndrome Association (IRSA) Rett Phenotype Database, is a unique international project funded by the IRSA, which brings together child neurologists, geneticists, paediatricians, epidemiologists, researchers and families of affected children. The principal aim of InterRett is to increase the clinical understanding of Rett syndrome throughout the world and with the statistical power of large case numbers, determine any correlations between genotype and the phenotypic characteristics. Since establishment of the database in January 2003, InterRett has registered 286 cases from 24 countries, with family questionnaire data submitted on 242 cases and clinician data on 116 cases. Collated de-identified data gathered from families and clinicians have been incorporated into a searchable online database allowing simple and complex interrogation of the clinical phenotype information. InterRett will also serve as a clearing house for data to encourage inter-country collaboration between researchers and negotiations are in place with several countries for data contributions in excess of 1000 cases. The resulting online database will be an invaluable resource for understanding the nature and management of Rett syndrome, as well as providing a model for other rare childhood disorders.
Trends in exposure to respirable crystalline silica (1986‐2014) in Australian mining
Publisher: Wiley
Date: 10-07-2017
DOI: 10.1002/AJIM.22740
Abstract: Respirable crystalline silica (RCS) has been associated with severe health risks. Exposures in Western Australia (WA) have been typically high in hard-rock mining and have reduced substantially since the mid-1900s. We described trends in RCS exposure in WA miners over the past 30 years. A total of 79 445 reported personal RCS exposure measurements, covering the years 1986-2014, were examined. Mixed-effects models were applied to estimate RCS exposure levels, including spline terms to estimate a time trend. An overall downward trend of about -8% per year was observed for RCS exposures in WA mining. Highest RCS exposure levels were modeled for base metal mining and exploration settings. Drilling occupations were among the highest exposed jobs. RCS exposure levels have fallen considerably in the last three decades. However, there are still mining occupations that may need further attention to avoid adverse health effects in these workers.
Exposure-response analysis and risk assessment for silica and silicosis mortality in a pooled analysis of six cohorts
Publisher: BMJ
Date: 11-2002
Abstract: To study the relation between exposure to crystalline silica and silicosis mortality. Although mortality is an important endpoint for regulators, there have been no exposure-response studies for silicosis mortality, because of the relative rareness of silicosis as an underlying cause of death, and the limited availability of quantitative exposure estimates. Data from six occupational cohorts were pooled with good retrospective exposure data in which 170 deaths from silicosis were reported. Standard life table analyses, nested case-control analyses, and risk assessment were performed. The rate of silicosis mortality in the combined data was 28/100 000 py, increasing in nearly monotonic fashion from 4.7/100 000 for exposure of 0-0.99 mg/m(3)-years to 233/100 000 for exposure of >28.1 mg/m(3)-years. The estimated risk of death up to age 65 from silicosis after 45 years of exposure at 0.1 mg/m(3) silica (the current standard in many countries) was 13 per 1000, while the estimated risk at an exposure of 0.05 mg/m(3) was 6 per 1000. Both of these risks are above the risk of 1 per 1000 typically deemed acceptable by the US OSHA. The findings from this pooled analysis add further support to the need to control silica exposure and to lower the occupational standards. Our estimates of lifetime silicosis mortality risk are probably underestimates as, in addition to exposure misclassification, our study might have suffered from outcome misclassification in that silicosis deaths might have been coded to other related causes, such as tuberculosis or chronic obstructive pulmonary disease.
Cancer incidence among women and girls environmentally and occupationally exposed to blue asbestos at Wittenoom, Western Australia
Publisher: Wiley
Date: 20-12-2007
DOI: 10.1002/IJC.23331
Abstract: The impact of crocidolite exposure on the health of former Wittenoom miners and millers (largely male) has been well documented. Less is known about the health outcomes of the 2,968 women and girls who lived (N = 2,552) and worked (N = 416) in the blue asbestos milling and mining town of Wittenoom between 1943 and 1992. Quantitative exposure measurements were derived from dust studies undertaken over the lifetime of the mine and mill and the township. Incident cancers were obtained from the Western Australian (WA) Cancer Registry and the National Cancer Clearing House. Standardized incidence ratios (SIRS) compared Wittenoom females with the WA female population. Exposure-response relationships were examined using a matched case-control study design. There were (47) mesothelioma and (55) lung cancer cases among the 437 cancers in the Wittenoom females over the period 1960-2005. When compared to the WA female population, Wittenoom women and girls had higher rates of mesothelioma and possibly lung cancer. Mesothelioma incidence rates are increasing with the incidence rate of 193 per 100,000 in the period 2000-2005 being more than double that for the period 1995-1999 at 84 per 100,000. A significant exposure-response relationship was present for mesothelioma, but not for lung cancer. Forty years after the asbestos mine and mill at Wittenoom were closed, there is a high toll from cancer among the former female residents of the town and company workers.
Relationship of asthma, atopy, and bronchial responsiveness to serum eosinophil cationic proteins in early childhood
Publisher: Elsevier BV
Date: 11-2004
DOI: 10.1016/J.JACI.2004.07.051
Abstract: The relationship between atopy, asthma, and eosinophilic inflammation is less clear in early childhood than later in life. We sought to determine the relationships between asthma, atopy, and serum eosinophil cationic protein (ECP), a biomarker of eosinophil activation, in 6-year-old children. Serum ECP levels were available from 968 six-year-old children who were part of a longitudinal birth cohort being assessed for asthma and atopy. Detailed clinical history and examination, lung function testing, methacholine challenge, and skin prick testing to 4 common allergens were undertaken. Subgroups of the children were compared by using t tests, ANOVA, chi 2 tests, and regression analysis. One hundred ninety-one (19.7%) children had current asthma, with 114 (59.7%) of these being atopic. The mean serum ECP level for the entire group was 18.0 mug/L (range, 2.0-146.0 mug/L), with no difference between male and female patients. Serum ECP was higher in atopic children (20.5 +/- 18.4), those with asthma (22.4 +/- 19.6), and those with asthma and atopy (26.6 +/- 22.4 all P < .001 compared with children with no asthma or atopy [16.1 +/- 15.9]). Serum ECP levels were highest in children with severe asthma ( P < .001), especially in those with concurrent atopy. Severity of atopy, judged on the basis of wheal size or derived variables combining wheal size and the number of positive skin tests, was a major determinant of serum ECP. Heightened methacholine responsiveness was not associated with increased serum ECP levels. The higher serum ECP levels seen in 6-year-old children with current asthma and more severe atopy suggest that atopy and eosinophilic inflammation are important in driving this clinical phenotype and that this might represent asthma that persists.
Pertussis burden and acellular pertussis vaccine effectiveness in high risk children
Publisher: Elsevier BV
Date: 02-2022
DOI: 10.1016/J.VACCINE.2021.10.013
Abstract: Pertussis hospitalisation is more common among infants born prematurely, who have significant comorbidities, or are Indigenous, but acellular pertussis (aP) vaccine effectiveness (VE) estimates in these sub-groups are lacking. We measured aP VE by Indigenous status, and policy-relevant categories of prematurity and comorbidity, in a population-based Australian cohort. Perinatal, disease notification, hospitalisation, mortality, and vaccination data were linked to birth records in two Australian states (Western Australia and New South Wales) 2001-2012, with follow-up to the end of 2013. Children followed to 18 months of age were stratified by Aboriginality, prematurity (<32 vs 32- 1,300,000 children, 63,867 (4·9%) were Aboriginal, 47,721 (3·6%) had at least one comorbidity and 3,771 first episodes of notified pertussis occurred <18 months of age of these, 1,207 (32.0%) had an associated pertussis-coded hospitalisation. For hospitalised pertussis in Aboriginal and non-Aboriginal children, there was significant protection post dose 1 (VE 51% v 25%), 2 (VE 69% v 74%) and 3 (VE 76% v 80%). For children with co-morbidities, VE for hospitalised pertussis was low and non-significant post dose 1 (0%) and 2 (30%). Post dose 3, VE was significant for hospitalised pertussis (70% 95% CI 29-87) but not for non-hospitalised pertussis (24% 95% CI -49 to 61). For most Aboriginal and non-Aboriginal children, improved timeliness of current infant doses and higher antenatal coverage should further improve protection against pertussis of any severity. For children at highest risk of severe pertussis (born <32 weeks gestation or with significant medical comorbidities), our data suggest that additional measures-such as extra doses of pertussis-containing vaccines and/or vaccines with improved immunogenicity-are needed for protection.
Lung cancer screening an asbestos exposed population: Existing lung cancer risk criteria are not sufficient
Publisher: Wiley
Date: 08-03-2023
DOI: 10.1111/RESP.14487
Abstract: Asbestos is a major risk factor for lung cancer, with or without tobacco smoke exposure. Low dose computed tomography (LDCT) screening for early lung cancer is effective but only when targeting high risk populations. This study aimed to analyse the effectiveness of LDCT screening in an asbestos exposed population and to compare lung cancer screening program (LCSP) eligibility criteria. Participants in an asbestos health surveillance program, the Western Australia Asbestos Review Program, underwent at least one LDCT scan and lung function assessment as part of annual review between 2012 and 2017. Lung cancer cases were confirmed through linkage to the WA cancer registry. Theoretical eligibility for different screening programs was calculated. Five thousand seven hundred and two LDCT scans were performed on 1743 in iduals. The median age was 69.8 years, 1481 (85.0%) were male and 1147 (65.8%) were ever‐smokers (median pack‐year exposure of 20.0). Overall, 26 lung cancers were detected (1.5% of the population 3.5 cases per 1000 person‐years of observation). Lung cancer was early stage in 86.4% and four (15.4%) cases were never smokers. Based on current lung screening program criteria, 1299 (74.5%) of this population, including the majority (17, 65.4%) of lung cancer cases, would not have been eligible for any LCSP. This population is at raised risk despite modest tobacco exposure. LDCT screening is effective at identifying early‐stage lung cancer in this population and existing lung cancer risk criteria do not capture this population adequately.
Psychiatric disorders during early adulthood in those with childhood onset type 1 diabetes
Publisher: Hindawi Limited
Date: 23-11-2017
DOI: 10.1111/PEDI.12469
Abstract: To determine the incidence of and risk factors for psychiatric disorders in early adulthood in patients with childhood onset type 1 diabetes (T1D). In this retrospective-cohort study, we identified a population-based childhood onset T1D cohort and an age and sex matched (5:1) non-diabetic comparison cohort. Data linkage was used to access inpatient hospitalization data, mental health support service data, and mortality data to follow-up both cohorts into early adulthood. The mean age of T1D diagnosis was 9.5 years (SD 4.1), with a mean age at end of follow-up of 26.4 years (SD 5.2, max 37.7). The diagnosis of any psychiatric disorder was observed for 187 of 1302 (14.3%) in the T1D cohort and 400 of 6422 (6.2%) in the comparison cohort [adjusted hazard ratio (HR) 2.3 95% CI 1.9, 2.7]. Anxiety, eating, mood, and personality and behaviour disorders were observed at higher rates within the T1D cohort. Comorbid psychiatric disorders were more frequent, at the cohort level, within the T1D cohort (2-3 disorders 3.76% vs 1.56%) and service utilization was higher (15+ contacts 6.8% vs 2.8%) though these differences did not remain when restricted to only those in iduals diagnosed during follow-up. A history of poor glycaemic control was associated with an increased risk of anxiety, mood, and 'any' disorder (HR ranging from 1.35 to 1.42 for each 1% increase in mean paediatric HbA1c). Our findings highlight the need for access to mental health support services as part of routine patient care for young adults with T1D, and for better predictive tools to facilitate targeting at-risk patients with early intervention programs.
Asbestos-related diseases
Publisher: International Union Against Tuberculosis and Lung Disease
Date: 06-2020
Abstract: Knowledge of asbestos-related diseases has been accumulating for over one hundred years as the industrial value of asbestos was recognised for the strength of its fibres and their resistance to destruction, resulting in increasing production and use until the multiple health effects have become apparent. Deposition in the lung parenchyma results in an inflammatory rogressively fibrotic response, with impaired gas exchange and reduced lung compliance (‘asbestosis'), causing progressive dyspnoea and respiratory failure for which only palliation is indicated, although anti-fibrotic agents used for idiopathic usual interstitial pneumonitis remain to be evaluated. Benign pleural effusion, diffuse pleural fibrosis (occasionally with associated rolled atelectasis) and pleural plaques are the non-malignant pleural diseases that result from fibres reaching the pleura. But the main issues that led to the ban on asbestos in industry are those of malignancy: lung cancer, malignant mesothelioma (MM) of the pleura and MM of the peritoneum. Bronchogenic carcinoma risk from asbestos exposure is dose-dependent and multiplies the risk attributable to tobacco smoking. The principles of treatment are as for all cases of lung cancer. Low-dose computed tomography screening of exposed people can detect early-stage, non-small cell cancers, with improved survival. The hibole varieties of asbestos are much more potent causes of MM than chrysotile, and the risk increases exponentially for 40–50 years following first exposure. As MM is non-resectable and poorly responsive to chemotherapy and radiotherapy, curative treatment is not possible and screening not justified.
Development and Evaluation of a Prediction Model for Ascertaining Rheumatic Heart Disease Status in Administrative Data
Publisher: Informa UK Limited
Date: 07-2020
DOI: 10.2147/CLEP.S241588
Cross-sectional and longitudinal association of the secretoglobin 1A1 gene A38G polymorphism with asthma phenotype in the Perth Infant Asthma Follow-up cohort
Publisher: Wiley
Date: 2009
DOI: 10.1111/J.1365-2222.2008.03102.X
Abstract: Associations between Clara cell secretory protein gene variants (SCGB1A1, also known as CC16, CC10, CCSP and uteroglobin) and the asthma phenotype have been found in five out of eight studies world-wide. No study has investigated the contribution of SCGB1A1 polymorphisms to the development and/or persistence of the asthma phenotype in a birth cohort followed over time. The aim of this study was to determine the role of the SCGB1A1 gene in the development of the asthma phenotype. The Perth Infant Asthma Follow-up (PIAF) cohort (n=231 unrelated infants, unselected for asthma and recruited at birth) were seen at 1 month, 6 and 11 years of age, and had a questionnaire, lung function, airway responsiveness (AR) and skin prick tests (SPTs) completed. Blood was taken at 6 and 11 years for total and specific immunoglobulin E (sIgE) and DNA extraction. SPT positivity had at least one positive SPT. SIgE>4 kU/L had at least one sIgE above 4 kU/L. SCGB1A1 A38G (rs3741240), that alters gene transcription, was genotyped using Sau96I restriction digestion of exon 1 PCR products. At 6 and 11 years of age, 33.0% and 29.7% of those genotyped had doctor-diagnosed asthma, and 35.8% and 52.1% had SPT positivity. In cross-sectional analyses, children with 38G/38A or 38A/38A had increased AR at 1 month (1.72-fold, P=0.013) sIgE>4 kU/L [odds ratio (OR)=6.95, 95% confidence interval (CI)=1.35-35.91, P=0.021] house dust mite (HDM) SPT positivity (OR=7.21, 95% CI=1.09-47.78, P=0.041) and sIgE (4.57-fold, P=0.045) at 6 years and doctor-diagnosed asthma (OR=3.93, 95% CI=1.24-12.47, P=0.02) and cat SPT positivity (OR=4.34, 95% CI=1.01-18.77, P=0.049) at 11 years. Longitudinal analyses of 6 and 11 years paired data showed that children with 38A/38A had increased persistent sIgE>4 kU/L (OR=11.87, 95% CI=1.97-71.53, P=0.007) and persistent HDM SPT positivity (OR=7.84, 95% CI=1.04-58.92, P=0.045). SCGB1A1 A38G may play a role in the development and persistence of the asthma phenotype in childhood.
Interpretation of recent sudden infant death syndrome rates in Western Australia
Publisher: Wiley
Date: 25-11-2005
DOI: 10.1111/J.1440-1754.2005.00756.X
Abstract: The diagnosis of sudden infant death syndrome (SIDS) has undergone several changes in definition since first being recognised as a cause of death. Linked total population data from Western Australia enable investigations to determine changes in classifications of mortality for the infants of Aboriginal and non-Aboriginal mothers (Aboriginal and Torres Strait Islander people are referred to throughout this report as 'Aboriginal'). Data for recent years show a shift away from a classification of 'SIDS' towards a classification of 'unascertainable', particularly for Aboriginal infants. This has implications for the accurate translation of data into policy and practice.
Adolescent dietary patterns are associated with lifestyle and family psycho-social factors
Publisher: Cambridge University Press (CUP)
Date: 10-2009
DOI: 10.1017/S1368980008004618
Abstract: Dietary intake during adolescence contributes to lifelong eating habits and the development of early risk factors for disease in adulthood. Few studies have examined the dietary patterns of adolescents and the social and environmental factors that may affect them during this life stage. The present study describes dietary patterns in a cohort of adolescents and examines their associations with socio-economic factors, as well as parental and adolescent risk factor behaviours. A semi-quantitative FFQ was used to assess study adolescents’ usual dietary intake over the previous year. Information was collected on family functioning and various socio-economic and risk factor variables via questionnaire. Adolescents visited the study clinic for anthropometric measurements. The Western Australian Pregnancy Cohort Study (Raine Study), Perth, Western Australia. Adolescents ( n 1631) aged 14 years from a pregnancy cohort study. Factor analysis identified two distinct dietary patterns that differed predominantly in fat and sugar intakes. The ‘Western’ pattern consisted of high intakes of take-away foods, soft drinks, confectionery, French fries, refined grains, full-fat dairy products and processed meats. The ‘healthy’ pattern included high intakes of whole grains, fruit, vegetables, legumes and fish. ANOVA showed that the ‘Western’ dietary pattern was positively associated with greater television viewing and having a parent who smoked, and was inversely associated with family income. The ‘healthy’ pattern was positively associated with female gender, greater maternal education, better family functioning and being in a two-parent family, and was inversely associated with television viewing. The study suggests that both lifestyle factors and family psycho-social environment are related to dietary patterns in Australian adolescents.
The quantitative risks of mesothelioma and lung cancer in relation to asbestos exposure: The wittenoom data (multiple letters)
Publisher: Oxford University Press (OUP)
Date: 2002
Morphology of bronchogenic carcinoma in workers formerly exposed to crocidolite at wittenoom gorge in Western Australia
Publisher: Wiley
Date: 15-04-1986
Abstract: Cytology and histology material from 46 bronchogenic carcinomas occurring in ex-workers from the Wittenoom crocidolite mine and mill in Western Australia and a matched random s le of 234 other bronchogenic carcinomas occurring in Western Australia over the same period were reviewed by a single histopathologist without knowledge of asbestos exposure status. Squamous-cell carcinomas formed 45.7% of the cancers in the asbestos-exposed group but only 32.5% of the cancers in the comparison group. This difference could not be explained by differences in smoking history between the two groups of lung cancer patients or in the type of histopathological material available for review. The excess of squamous-cell cancers was observed in subjects both with and without parenchymal asbestosis.
Respiratory symptoms and lung-function changes with exposure to five substances in aluminium smelters
Publisher: Springer Science and Business Media LLC
Date: 02-2003
DOI: 10.1007/S00420-002-0398-1
Abstract: To determine whether exposure to five different occupational substances contributes to respiratory symptoms in aluminium smelter workers. A cross-sectional survey of 1,615 male employees of two Australian aluminium smelters was conducted in 1995. Subjects underwent spirometry and were asked about respiratory symptoms and the relationship of those symptoms to work. Their job histories were combined with a task exposure matrix to produce in idual quantitative measures of cumulative exposure to fluoride, sulphur dioxide, inspirable dust, the benzene-soluble fraction of coal tar pitch volatiles (BSF), and oil mist. After adjusting for smoking and age, we found that subjects with the highest cumulative exposure to fluoride (>0.16 mg/m(3) years) and inspirable dust (>2.9 mg/m(3) years) were two to four times more likely to report work-related wheeze and chest tightness than were unexposed subjects. Lower prevalence ratios for the same symptoms were seen with sulphur dioxide and BSF. Levels of lung function decreased slightly with exposure to oil mist, but not with cumulative exposure to other substances. This study suggests that the relevant causative agents for respiratory symptoms in aluminium smelters are fluoride and inspirable dust.
Histological grading in breast cancer: Interobserver agreement, and relation to other prognostic factors including ploidy
Publisher: Elsevier BV
Date: 1992
DOI: 10.3109/00313029209063625
Abstract: Sections of neoplasms from 76 female patients with primary operable carcinoma of the breast were independently assessed by 2 pathologists for histological features and assigned a grade score. Relative disagreement rates between pathologists were estimated by use of a log-linear model and found to be similar to those reported by many other groups, but higher than that reported by acknowledged experts. Tumor grade was related to nuclear DNA content as measured by static cytometry, inversely related to oestrogen receptor status and provided some additional prognostic information but, in this small series of patients, did not correlate with short-term survival as closely as other prognostic indicators such as ploidy, tumor size or the extent of lymph node involvement. Patients with Grade III tumors had a particularly poor prognosis, however, there were few patients allotted to Grade III (poorly differentiated tumors), and survival differences between Grades I and II were small in short-term followup, used alone, grading separated out only a small proportion of patients into useful prognostic groups. This preliminary study emphasizes the need for a careful approach to the use of grading of breast carcinomas in the routine histopathology laboratory. Demonstration of higher levels of interobserver agreement, or concordance with experts in the field, will be necessary before our grading can be incorporated into a prognostic index useful for patient management.
Timeliness and factors associated with rotavirus vaccine uptake among Australian Aboriginal and non-Aboriginal children: A record linkage cohort study
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.VACCINE.2019.08.013
Abstract: Rotavirus vaccines (RV), included in Australia's National Immunisation Program from mid-July 2007, are unique in strict time limits for administration. Here, we report on timeliness of RV uptake, compare cumulative RV coverage to age 12 months with DTPa, and assess factors associated with receipt of RV among Aboriginal and non-Aboriginal children. Birth records for 681,456 children born in two Australian states in 2007-2012 were probabilistically linked to national immunisation records. We assessed on-time coverage (defined as receipt of vaccine dose between 4 days prior to scheduled date and the recommended upper limit) for RV and compared this to diphtheria-tetanus-pertussis (DTPa) vaccine. Logistic regression modelling was used to assess independent determinants of receipt of RV. Compared to non-Aboriginal infants, on-time RV coverage was lower for all doses among Aboriginal infants. Post the upper age limit of RV dose2, DTPa dose2 coverage increased by 9-16% to ≥90%, whereas RV coverage remained around 77% (Aboriginal) and 85% (non-Aboriginal). Compared to first-born children, the adjusted odds of receiving ≥1 RV dose if born to a mother with ≥3 previous births was 0.30 (95%CI: 0.27-0.34) among Aboriginal, and 0.53 (95%CI: 0.51-0.55) among non-Aboriginal children. Prematurity (<33 weeks), low birthweight (<1500 g), maternal age <20 years, maternal smoking during pregnancy and living in a disadvantaged area were independently associated with decreased vaccine uptake. Aboriginal children are at greater risk of rotavirus disease than non-Aboriginal children and delayed vaccine receipt is substantially higher. Although specific programs targeting groups at risk of delayed vaccination might improve RV coverage, relaxation of upper age restrictions is most readily implementable, and its overall risk-benefit should be evaluated.
Predictors of seizure onset in Rett syndrome
Publisher: Elsevier BV
Date: 10-2006
DOI: 10.1016/J.JPEDS.2006.06.015
Abstract: To investigate risk factors for seizure onset in Rett syndrome. Information on presence and age at onset of seizures, perinatal and developmental history, and genetic status was abstracted on 275 cases in the Australian Rett Syndrome Database. Cox and Weibull regression were used to investigate and provide a model for predicting the effects of genetic and developmental factors on age at seizure onset. Seizures were reported in 81% of 275 cases the median age of onset was 48 months. Not having gained the ability to walk (P = .003) and developmental problems in the first 10 months of age (P = .04) were associated with an almost 2-fold increased risk of seizures. Cases without a detectable MECP2 mutation had a higher risk of seizure onset up to 4 years of age (P < .001) but a lower risk after 4 years (P = .08). Seizure onset in Rett syndrome is associated with early developmental factors and with genotype. Information on these factors can be used to predict age at seizure onset after diagnosis.
Early-life respiratory viral infections, atopic sensitization, and risk of subsequent development of persistent asthma
Publisher: Elsevier BV
Date: 05-2007
Exposure to inorganic arsenic in soil increases urinary inorganic arsenic concentrations of residents living in old mining areas
Publisher: Springer Science and Business Media LLC
Date: 03-2004
DOI: 10.1023/B:EGAH.0000020897.15564.93
Abstract: The short term human exposure studies conducted on populations exposed to high concentrations of inorganic arsenic in soil have been inconsistent in demonstrating a relationship between environmental concentrations and exposure measures. In Australia there are many areas with very high arsenic concentrations in residential soil most typically associated with gold mining activities in rural areas. This study aimed to investigate the relationship between environmental arsenic and urinary inorganic arsenic concentrations in a population living in a gold mining area (soil arsenic concentrations between 9 and 9900 mg kg(-1)), and a control population with low arsenic levels in soil (between 1 and 80 mg kg(-1)). Risk factors for increased urinary arsenic concentrations were also explored. There was a weak but significant relationship between soil arsenic concentrations and inorganic urinary arsenic concentration with a Spearman correlation coefficient of 0.39. When participants with greater than 100 mg kg(-1) arsenic in residential soil were selected, the coefficient increased to 0.64. The geometric mean urinary inorganic arsenic concentration for the exposed group was 1.64 microg L(-1) (<detection limit -28.4 microg L(-1)) and for the control group was 1.18 microg L(-1) (<detection limit -4.69 microg L(-1)). Participants with residential soil in excess of 1000 mg kg(-1) recorded a geometric mean urinary inorganic arsenic concentration of 2.46 microg L(-1). In a random effects linear regression model, soil arsenic concentration was the significant predictor of increased urinary arsenic concentrations. Season was shown to have a significant influence on urinary inorganic arsenic concentrations. Other factors such as age, gender and hours of contact with soil may also be important risk factors. These results show that high concentrations of arsenic in soil can make a contribution to urinary inorganic arsenic concentrations.
There is variability in the attainment of developmental milestones in the CDKL5 disorder
Publisher: Springer Science and Business Media LLC
Date: 05-01-2015
Low positive predictive value of International Classification of Diseases, 10th Revision codes in relation to rheumatic heart disease: a challenge for global surveillance
Publisher: Wiley
Date: 03-2019
DOI: 10.1111/IMJ.14221
Abstract: International Classification of Diseases, 10th Revision codes for rheumatic heart disease (RHD) include valvular heart disease of unspecified origin, limiting their usefulness for estimating RHD burden. A cross-disciplinary national consultation developed an algorithm to improve RHD identification in hospital data. The algorithm has been operationalised and piloted. The algorithm developed categorised 32% of RHD-coded patients as probable ossible RHD. We outline a series of research initiatives to improve identification of RHD in administrative data thereby contributing to monitoring the RHD burden globally.
Sense of control and wellbeing decades after exposure to blue asbestos at Wittenoom, Western Australia
Publisher: Informa UK Limited
Date: 06-2012
All cause mortality and incidence of cancer in workers in bauxite mines and alumina refineries
Publisher: Wiley
Date: 13-05-2008
DOI: 10.1002/IJC.23554
Abstract: Bauxite is a reddish clay that is refined to produce alumina, which is then reduced to aluminium. There have been studies examining the health of workers in aluminium smelters, but not workers in bauxite mining and alumina refining. A cohort of employees of 1 large aluminium company since 1983 was assembled (n = 6,485, 5,828 men). Deaths and incident cancers to 2002 were ascertained by linkage to national and state cancer and death registries. SIRs and SMRs were calculated compared to national rates standardizing for calendar year, sex and 5-year age group. The mortality from all causes (SMR 0.68, 95% CI: 0.60-0.77), and from circulatory and respiratory diseases, all cancers combined and injury in the male cohort were lower than in the Australian male population and were similar across work groups and with duration of employment. The only significant increased mortality risk was from pleural mesothelioma. The incidence of all cancers combined was similar to the Australian rate. The cohort had a lower risk of incident lymphohaematopoietic cancer (SIR 0.50, 95% CI: 0.31-0.88) and a higher risk of melanoma (SIR 1.30, 95% CI: 1.00-1.69) although no dose-responses were seen. There was also an increased risk of mesothelioma (SIR 3.49, 95% CI: 1.82-6.71), which was associated with exposures outside the aluminium industry. This study is the first to examine cancer and mortality amongst workers in bauxite mines and alumina refineries and found little evidence for increased cancer incidence or mortality in these workers.
Pleurodesis outcome in malignant pleural mesothelioma: Table 1
Publisher: BMJ
Date: 07-01-2013
DOI: 10.1136/THORAXJNL-2012-203043
Abstract: Few data exist on the pleurodesis outcome in patients with malignant pleural mesothelioma (MPM). A retrospective review of the Western Australian Mesothelioma Registry over 5 years revealed 390 evaluable patients. Only a subset of patients (42.3%) underwent pleurodesis, surgically (n=78) or by bedside instillation of sclerosants (n=87). Surgical pleurodesis showed no advantages over bedside pleurodesis in efficacy (32% vs 31% failures requiring further drainage, p=0.98), patient survival (p=0.52) or total time spent in hospital from procedure till death (p=0.36). No clinical, biochemical or radiographic parameters tested adequately predict pleurodesis outcome.
Role of Respiratory Viruses in Acute Upper and Lower Respiratory Tract Illness in the First Year of Life
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2006
Authenticity and drug resistance in a panel of acute lymphoblastic leukaemia cell lines
Publisher: Springer Science and Business Media LLC
Date: 21-11-2006
Seasonality of respiratory viral identification varies with age and aboriginality in metropolitan Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2009
The Risk of Neurodevelopmental Disabilities in Children of Immigrant and Refugee Parents: Current Knowledge and Directions for Future Research
Publisher: Springer Science and Business Media LLC
Date: 31-10-2017
Optimization is required when using linked hospital and laboratory data to investigate respiratory infections
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.JCLINEPI.2015.08.003
Abstract: Despite a recommendation for microbiological testing, only 45% of children hospitalized for respiratory infections in our previous data linkage study linked to a microbiological record. We conducted a chart review to validate linked microbiological data. The chart review consisted of children aged <5 years admitted to seven selected hospitals for respiratory infections in Western Australia, 2000-2011. We calculated the proportion of admissions where testing was performed and any pathogens detected. We compared these proportions between the chart review and our previous data linkage study. Poisson regression was used to identify factors predicting the likelihood of microbiological tests in the chart review cohort. From the chart review, 77% of 746 records had a microbiological test performed compared with 46% of 18,687 records from our previous data linkage study. Of those undergoing testing, 66% of the chart review and 64% of data linkage records had ≥1 respiratory pathogen(s) detected. In the chart review cohort, frequency of testing was highest in children admitted to metropolitan hospitals. Validation studies are essential to ensure the quality of linked data. Our previous data linkage study failed to capture all relevant microbiological records. Findings will be used to optimize extraction protocols for future linkage studies.
Sleep problems in Rett syndrome
Publisher: Elsevier BV
Date: 11-2007
Hair and toenail arsenic concentrations of residents living in areas with high environmental arsenic concentrations.
Publisher: Environmental Health Perspectives
Date: 02-2003
DOI: 10.1289/EHP.5455
Abstract: Surface soil and groundwater in Australia have been found to contain high concentrations of arsenic. The relative importance of long-term human exposure to these sources has not been established. Several studies have investigated long-term exposure to environmental arsenic concentrations using hair and toenails as the measure of exposure. Few have compared the difference in these measures of environmental sources of exposure. In this study we aimed to investigate risk factors for elevated hair and toenail arsenic concentrations in populations exposed to a range of environmental arsenic concentrations in both drinking water and soil as well as in a control population with low arsenic concentrations in both drinking water and soil. In this study, we recruited 153 participants from areas with elevated arsenic concentrations in drinking water and residential soil, as well as a control population with no anticipated arsenic exposures. The median drinking water arsenic concentrations in the exposed population were 43.8 micro g/L (range, 16.0-73 micro g/L) and median soil arsenic concentrations were 92.0 mg/kg (range, 9.1-9,900 mg/kg). In the control group, the median drinking water arsenic concentration was below the limit of detection, and the median soil arsenic concentration was 3.3 mg/kg. Participants were categorized based on household drinking water and residential soil arsenic concentrations. The geometric mean hair arsenic concentrations were 5.52 mg/kg for the drinking water exposure group and 3.31 mg/kg for the soil exposure group. The geometric mean toenail arsenic concentrations were 21.7 mg/kg for the drinking water exposure group and 32.1 mg/kg for the high-soil exposure group. Toenail arsenic concentrations were more strongly correlated with both drinking water and soil arsenic concentrations however, there is a strong likelihood of significant external contamination. Measures of residential exposure were better predictors of hair and toenail arsenic concentrations than were local environmental concentrations.
Predicting survival in malignant mesothelioma
Publisher: European Respiratory Society (ERS)
Date: 07-07-2011
DOI: 10.1183/09031936.00000811
Abstract: Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Australian Mesothelioma Registry to December 2005 were examined. Sex, age, date and method of diagnosis, site of disease and histological type were recorded. Date of onset of symptoms and performance status were obtained from clinical notes for a s le of cases. Cox regression was used to examine the association of the clinical variables and the 10-yr periods of disease onset with survival after diagnosis. Survival was inversely related to age, being worse for males (hazard ratio (HR) 1.4, 95% CI 1.2-1.6), and those with peritoneal mesothelioma (HR 1.4, 95% CI 1.1-1.7). Patients with sarcomatoid histology had worse prognosis than patients with epithelioid and biphasic histological subtypes. Survival improved after the 1970s and has made incremental improvements since then. Median (interquartile range) survival by decade, from 1960 until 2005, was 64 (0-198), 177 (48-350), 221 (97-504), 238 (108-502) and 301 (134-611) days ~4 weeks of this apparent improvement can be attributed to earlier diagnosis. With increasing resources and treatment costs for MM over the past 40 yrs, there have been modest improvements in survival but no complete remissions.
Relation between Intrauterine Growth and Subsequent Intellectual Disability in a Ten-year Population Cohort of Children in Western Australia
Publisher: Oxford University Press (OUP)
Date: 15-11-2007
DOI: 10.1093/AJE/KWM245
Abstract: The authors investigated the association between intrauterine growth and intellectual disability (ID). The appropriateness of intrauterine growth was assessed using percentage of optimal birth weight, a measure that accounts for gestational age, maternal height, parity, and infant sex. Using population-based record linkage, singleton Caucasian and Aboriginal children born in Western Australia in 1983-1992 and alive in 2002 with ID of unknown cause (n = 2,625) were compared with children without ID (n = 217,252). The odds of ID increased with less-than-optimal intrauterine growth. In Caucasian children, after adjustment for sociodemographic factors, severe growth restriction was associated with development of mild-moderate ID among preterm births ( or =37 weeks) (OR = 2.42, 95% CI: 1.88, 3.12) and with severe ID (OR = 4.79, 95% CI: 2.59, 8.83) among term births. Effects were similar among Aboriginal children. Severe growth restriction (OR = 3.2, 95% CI: 1.3, 7.9) and poor head growth (OR = 3.6, 95% CI: 1.4, 9.0) were independently associated with severe ID. Infants with excess intrauterine growth were more likely to be diagnosed with ID associated with autism spectrum disorder (OR = 2.36, 95% CI: 0.93, 6.03). These findings suggest that inappropriate intrauterine growth, less than or greater than optimal birth weight, is associated with development of ID.
Comparison of outcomes following a cytological or histological diagnosis of malignant mesothelioma
Publisher: Springer Science and Business Media LLC
Date: 14-02-2017
DOI: 10.1038/BJC.2017.20
Infant mortality among Australian Aboriginals – Authors' reply
Publisher: Elsevier BV
Date: 09-2006
History of tobacco and health
Publisher: Wiley
Date: 07-08-2003
DOI: 10.1046/J.1440-1843.2003.00483.X
Abstract: Tobacco comes from plants that are native to the Americas around Peru and Ecuador,where it has been found since prehistoric times. It was brought back to Europe by early explorers where it was adopted by society and re-exported to the rest of the world as European colonization took place. Smoking tobacco in pipes of one sort or other gave way to handmade and then manufactured cigarettes, especially during the First World War. Smoking rates increased dramatically during the 20th century in developed countries until recently and rates are still increasing in underdeveloped countries. An epidemic of smoking-related diseases has followed the prevalence of smoking. Scientific knowledge of the harmful effects of active tobacco smoking has accumulated during the past 60 years since early descriptions of the increasing prevalence of lung cancer. The first epidemiological studies showing an association between smoking and lung cancer were published in 1950. In 1990 the US Surgeon General concluded that smoking was the most extensively documented cause of disease ever investigated but governments worldwide have been ambivalent and slow in taking action to reduce smoking. Tobacco smoking is now agreed to be a major cause of a vast number of diseases and other adverse effects. Since the 1980s passive smoking including exposure in utero has also been implicated as a significant cause of numerous diseases. In response, the tobacco industry has managed to forestall and prevent efforts to control this major health problem.
Relative validity of adolescent dietary patterns: a comparison of a FFQ and 3 d food record
Publisher: Cambridge University Press (CUP)
Date: 27-01-2011
DOI: 10.1017/S0007114510004137
Abstract: Interest in empirically derived dietary patterns has increased over the past decade. However, relatively few studies have evaluated dietary patterns using different dietary methods, or in young populations. We quantitatively compared dietary patterns from a FFQ with those from a 3 d food record (FR) in a cohort of adolescents. Subjects from the Western Australian Pregnancy Cohort (Raine) Study completed a semi-quantitative FFQ and a 3 d FR at 14 years of age ( n 783). Major dietary patterns were identified using exploratory factor analysis on thirty-eight food groups. Dietary pattern z -scores were compared using 95 % limits of agreement (LOA) and Spearman's r . Two major dietary patterns were identified in the FFQ and FR: a ‘Healthy’ pattern, which was high in fresh fruit, vegetables, whole grains and grilled or canned fish, and a ‘Western’ pattern, which was high in take-away foods, confectionery, soft drinks, crisps and fried potato. The nutrient profiles of these dietary patterns were similar when estimated by the FFQ and FR. The LOA between dietary pattern scores from the FFQ and FR were − 1·69 to 1·75 (‘Healthy’) and − 1·89 to 1·82 (‘Western’). Minor differences in agreement were observed when boys and girls were analysed separately. Spearman's correlation coefficients between the FFQ and the FR were r 0·45 (‘Healthy’) and r 0·36 (‘Western’). Comparable dietary patterns may be obtained from the FFQ and FR using exploratory factor analysis. This supports the use of major dietary patterns identified using the FFQ in this adolescent cohort.
Earlier study on asbestos workers, ILO scores, and oxygenation more comprehensive (multiple letters)
Publisher: BMJ
Date: 08-2003
DOI: 10.1136/OEM.60.8.611
Progression of early structural lung disease in young children with cystic fibrosis assessed using CT
Publisher: BMJ
Date: 26-12-2012
DOI: 10.1136/THORAXJNL-2011-200912
Abstract: Cross-sectional studies implicate neutrophilic inflammation and pulmonary infection as risk factors for early structural lung disease in infants and young children with cystic fibrosis (CF). However, the longitudinal progression in a newborn screened population has not been investigated. To determine whether early CF structural lung disease persists and progresses over 1 year and to identify factors associated with radiological persistence and progression. 143 children aged 0.2-6.5 years with CF from a newborn screened population contributed 444 limited slice annual chest CT scans for analysis that were scored for bronchiectasis and air trapping and analysed as paired scans 1 year apart. Logistic and linear regression models, using generalised estimating equations to account for multiple measures, determined associations between persistence and progression over 1 year and age, sex, severe cystic fibrosis transmembrane regulator (CFTR) genotype, pancreatic sufficiency, current respiratory symptoms, and neutrophilic inflammation and infection measured by bronchoalveolar lavage. Once detected, bronchiectasis persisted in 98/133 paired scans (74%) and air trapping in 178/220 (81%). The extent of bronchiectasis increased in 139/227 (63%) of paired scans and air trapping in 121/264 (47%). Radiological progression of bronchiectasis and air trapping was associated with severe CFTR genotype, worsening neutrophilic inflammation and pulmonary infection. CT-detected structural lung disease identified in infants and young children with CF persists and progresses over 1 year in most cases, with deteriorating structural lung disease associated with worsening inflammation and pulmonary infection. Early intervention is required to prevent or arrest the progression of structural lung disease in young children with CF.
Respiratory Morbidity and Exposure to Bauxite, Alumina and Caustic Mist in Alumina Refineries
Publisher: Wiley
Date: 09-2001
DOI: 10.1539/JOH.43.231
Fetal growth and the risk of childhood non-CNS solid tumours in Western Australia
Publisher: Springer Science and Business Media LLC
Date: 17-06-2008
Epidemiologists' Characteristics Had Little Influence on Causal Inference
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-2001
Onset of maternal psychiatric disorders after the birth of a child with intellectual disability: A retrospective cohort study
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.JPSYCHIRES.2014.11.011
Abstract: Mothers of a child with intellectual disability (ID) have more psychiatric disorders after the birth of their child than other mothers. However, it is unclear if this is because they have more psychiatric disorders before the birth or if the increase is related to the burden of caring for the child. We aimed to calculate the rate of new psychiatric disorders in mothers after the birth of their eldest child with ID born between 1983 and 2005 and to compare these with rates in women with a child with no ID or autism spectrum disorder (ASD) born during the same period. By linking data from Western Australian population-based registries, we selected women with no psychiatric history who survived the birth of their live-born child (N = 277,559) and compared rates of psychiatric disorders for women with a child with ID and women without a child with or ASD. Negative binomial regression with STATA 12 was used for all analyses. Mothers of children with mild-moderate ID of unknown cause had around two to three and a half times the rate of psychiatric disorders of mothers of children without ID or ASD. Mothers of children with Down syndrome and no pre-existing psychiatric disorder showed resilience and had no impairments in their mental health. Interventions and services are needed for mothers of other children with ID to improve their mental health. Further research is implicated to explore the mental health of mothers of children with ID and a pre-existing psychiatric disorder.
The Western Australian Register of Childhood Multiples: Effects of Questionnaire Design and Follow-up Protocol on Response Rates and Representativeness
Publisher: Cambridge University Press (CUP)
Date: 04-2004
ART, birth defects and subfertility—what should prospective patients be told?
Publisher: Springer Science and Business Media LLC
Date: 09-2011
Chest pain in asbestos-exposed individuals with benign pleural and parenchymal disease
Publisher: American Thoracic Society
Date: 11-2000
DOI: 10.1164/AJRCCM.162.5.9912012
Abstract: Many asbestos-exposed in iduals complain of chest pain for which there is no clear explanation. To determine whether chest pain is associated with the presence of benign pleural or parenchymal disease on chest radiograph, we studied 1,280 subjects undergoing surveillance because of prior asbestos exposure at Wittenoom, Western Australia. All subjects completed the Rose questionnaire on chest pain and this revealed 556 subjects (43%) who experienced some chest pain. A posterior-anterior chest radiograph was performed at the same clinic visit and was subsequently graded independently by two experienced readers for diffuse parenchymal disease and pleural disease. Logistic regression models adjusted for sex, age, and cumulative asbestos exposure indicated that the presence of chest pain was significantly associated with the presence of both benign pleural disease and diffuse parenchymal disease. Further analysis after stratification of chest pain into nonanginal and anginal pain showed that there was a significant association between anginal pain and the presence of pleural and parenchymal asbestos-induced radiologic abnormalities and an association of nonanginal pain with parenchymal disease. We conclude that radiographic evidence of either parenchymal or pleural disease in subjects exposed to asbestos is significantly related to the presence of chest pain, particularly anginal pain.
Respiratory infections and lung function in an Australian Aboriginal community
Publisher: Wiley
Date: 05-02-2008
Comparison of measures of exposure to asbestos in former crocidolite workers from Wittenoom Gorge, W. Australia
Publisher: Wiley
Date: 11-1996
DOI: 10.1002/(SICI)1097-0274(199611)30:5<579::AID-AJIM5>3.0.CO;2-O
Abstract: Cytochrome
Maternal use of folic acid and other supplements and risk of childhood brain tumors
Publisher: American Association for Cancer Research (AACR)
Date: 11-2012
DOI: 10.1158/1055-9965.EPI-12-0803
Abstract: Background: Interest in a possible protective effect of maternal vitamin use before or during pregnancy against childhood brain tumors (CBT) and other childhood cancers has grown over the past decade. Our Australian study of CBTs, conducted between 2005 and 2011, investigated whether maternal use folic acid and other supplements was protective. Methods: Case children were identified through the 10 Australian pediatric oncology centers and controls were recruited by national random digit dialing. Mothers of 327 cases and 867 control children provided information on supplement use before and during the index pregnancy, including brand name, dose, and timing. Data were analyzed using multivariable unconditional logistic regression. Results: The OR for any maternal use of folic acid, use of folic acid without iron or vitamins B6, B12, C, or A, and any vitamin use before pregnancy, were: 0.68 [95% confidence interval (CI), 0.46–1.00 0.55 (95% CI, 0.32–0.93) and 0.68 (95% CI, 0.46–1.01), respectively. The ORs for use of these supplements during pregnancy were also below unity, but generally closer to the null than those for the prepregnancy period. There was some evidence of an inverse dose–response during each time period. Conclusions: These results suggest that folic acid supplements before and possibly during pregnancy may protect against CBT. Such associations are biologically plausible through established mechanisms. Impact: This study provides evidence of a specific protective effect of prenatal folic acid supplementation against the risk of CBT that is not attributable to the actions of the other micronutrients investigated. Cancer Epidemiol Biomarkers Prev 21(11) 1933–41. ©2012 AACR.
Trajectories of childhood body mass index are associated with adolescent sagittal standing posture
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.3109/17477166.2010.530664
Abstract: To identify distinct age-related trajectory classes of body mass index (BMI) z-scores from childhood to adolescence, and to examine the association of these trajectories with measures of standing sagittal spinal alignment at 14 years of age. Adolescents participating in the Western Australian Pregnancy Cohort (Raine) Study contributed data to the study (n=1 373). Age- and gender-specific z-scores for BMI were obtained from height and weight at the ages of 3, 5, 10 and 14 years. Latent class group analysis was used to identify six distinct trajectory classes of BMI z-score. At the age of 14 years, adolescents were categorised into one of four subgroups of sagittal spinal posture using k-means cluster analysis of photographic measures of lumbar lordosis, thoracic kyphosis and trunk sway. Regression modeling was used to assess the relationship between postural angles and subgroups, and different BMI trajectory classes, adjusting for gender. Six trajectory classes of BMI z-score were estimated: Very Low (4%), Low (24%), Average (34%), Ascending (6%), Moderate High (26%) and Very High (6%). The proportions of postural subgroups at age 14 were Neutral (29%), Flat (22%), Sway (27%) and Hyperlordotic (22%). BMI trajectory class was strongly associated with postural subgroup, with significantly higher proportions of adolescents in the Very High, High and Ascending BMI trajectory classes displaying a Hyperlordotic or Sway posture than a Neutral posture at age 14. This prospective study provides evidence that childhood obesity, and how it develops, is associated with standing sagittal postural alignment in adolescence.
Lower Airway Infection in Preschool Children with Cystic Fibrosis: An International Comparison Reply
Publisher: American Thoracic Society
Date: 15-03-2020
Associations of the IL12B promoter polymorphism in longitudinal data from asthmatic patients 7 to 42 years of age
Publisher: Elsevier BV
Date: 03-2004
Impact of standardised feeding regimens on incidence of neonatal necrotising enterocolitis: a systematic review and meta-analysis of observational studies
Publisher: BMJ
Date: 03-2005
Refuelling of vehicles, the use of wood burners and the risk of acute lymphoblastic leukaemia in childhood
Publisher: Wiley
Date: 16-08-2011
DOI: 10.1111/J.1365-3016.2011.01224.X
Abstract: It is plausible that exposure of the parents before birth or of the child to sources of benzene increases the risk of childhood acute lymphoblastic leukaemia (ALL). The aim of this analysis was to investigate whether refuelling a vehicle with petrol before birth or burning wood to heat the home before or after the child's birth increased the risk of childhood ALL. Data from 389 cases and 876 frequency-matched controls were analysed using unconditional logistic regression, adjusting for study matching factors and potential confounders. The odds ratio (OR) for the mother ever refuelling a vehicle with petrol for non-occupational purposes before or during the pregnancy was 0.97 [95% confidence interval (CI) 0.69, 1.38]. The OR for the father for this exposure in the year before conception was 0.88 [95% CI 0.52, 1.48]. The OR for use of a closed wood burner to heat the home in the year before or during pregnancy was 1.41 [95% CI 1.02, 1.94] and 1.25 [95% CI 0.92, 1.70] after birth. We found no evidence that non-occupational refuelling a vehicle with petrol in the year before or during pregnancy increased the risk of ALL in the offspring. There was weak evidence that burning wood in a closed burner to heat the home increased the risk, but there was no dose-response relationship and chance could explain the finding.
A Comparison of Autism Prevalence Trends in Denmark and Western Australia
Publisher: Springer Science and Business Media LLC
Date: 11-02-2011
DOI: 10.1007/S10803-011-1186-0
Abstract: Prevalence statistics for autism spectrum disorders (ASD) vary widely across geographical boundaries. Some variation can be explained by diagnostic methods, case ascertainment and age at diagnosis. This study compared prevalence statistics for two distinct geographical regions, Denmark and Western Australia, both of which have had population-based registers and consistent classification systems operating over the past decade. Overall ASD prevalence rates were higher in Denmark (68.5 per 10,000 children) compared with Western Australia (51.0 per 10,000 children), while the diagnosis of childhood autism was more prevalent in Western Australia (39.3 per 10,000 children) compared with Denmark (21.8 per 10,000 children). These differences are probably caused by local phenomena affecting case ascertainment but influence from biological or geographical factors may exist.
The association between dietary patterns and mental health in early adolescence
Publisher: Elsevier BV
Date: 07-2009
DOI: 10.1016/J.YPMED.2009.05.009
Abstract: To investigate the associations between dietary patterns and mental health in early adolescence. The Western Australian Pregnancy Cohort (Raine) Study is a prospective study of 2900 pregnancies recruited from 1989-1992. At 14 years of age (2003-2006 n=1324), the Child Behaviour Checklist (CBCL) was used to assess behaviour (characterising mental health status), with higher scores representing poorer behaviour. Two dietary patterns (Western and Healthy) were identified using factor analysis and food group intakes estimated by a 212-item food frequency questionnaire. Relationships between dietary patterns, food group intakes and behaviour were examined using general linear modelling following adjustment for potential confounding factors at age 14: total energy intake, body mass index, physical activity, screen use, family structure, income and functioning, gender and maternal education at pregnancy. Higher total (b=2.20, 95% CI=1.06, 3.35), internalizing (withdrawn/depressed) (b=1.25, 95% CI=0.15, 2.35) and externalizing (delinquent/aggressive) (b=2.60, 95% CI=1.51, 3.68) CBCL scores were significantly associated with the Western dietary pattern, with increased intakes of takeaway foods, confectionary and red meat. Improved behavioural scores were significantly associated with higher intakes of leafy green vegetables and fresh fruit (components of the Healthy pattern). These findings implicate a Western dietary pattern in poorer behavioural outcomes for adolescents. Better behavioural outcomes were associated with a higher intake of fresh fruit and leafy green vegetables.
Effect of N ‐acetylcysteine supplementation on oxidative stress status and alveolar inflammation in people exposed to asbestos: A double‐blind, randomized clinical trial
Publisher: Wiley
Date: 14-07-2015
DOI: 10.1111/RESP.12592
Abstract: Many of the pathological consequences in the lung following inhalation of asbestos fibres arise as a consequence of persistent oxidative stress and inflammation. Inflammatory responses can be observed in asymptomatic asbestos-exposed in iduals. There are currently no interventions to reduce inflammatory or oxidative responses to asbestos before disease develops. We investigated the effects of oral N-acetylcysteine (NAC) on indicators of inflammation or oxidative stress in asymptomatic people previously exposed to asbestos. A double-blind, randomized, placebo-controlled study was conducted to assess the effectiveness and safety of 1800 mg of NAC given orally over a period of 4 months. This was a proof of principle study. Effectiveness was assessed using indicators of inflammation or oxidation as primary end-points. Serum levels of total combined thiols (cysteine, cysteinylglycine, glutathione and homocysteine) were used to monitor the NAC supplementation. Thirty-four subjects were randomly allocated to NAC and 32 to placebo. Serum levels of total combined thiols were similar between the groups after intervention. There were no differences in levels of inflammatory or oxidative stress end-points between the groups. No adverse effects were identified. No evidence was found that NAC supplementation replenishes total combined thiols in the blood of healthy subjects with a history of asbestos exposure. There was also no evidence of reduced indicators of inflammation or oxidative stress. Further studies should determine the conditions required to increase levels of total anti-oxidant capacity in the blood and in the lungs of subjects with either asbestos-related diseases or subclinical lung inflammation.
Translating microarray data for diagnostic testing in childhood leukaemia
Publisher: Springer Science and Business Media LLC
Date: 26-09-2006
Association between asthma-related phenotypes and the CC16 A38G polymorphism in an unselected population of young adult Danes
Publisher: Springer Science and Business Media LLC
Date: 14-01-0003
DOI: 10.1007/S00251-005-0778-2
Abstract: The gene for Clara cell 16-kDa (CC16) protein is a promising candidate for asthma susceptibility. The CC16 38A allele has been associated with decreased CC16 plasma levels and increased incidence of asthma in Australian children. To date these results have not been replicated in adults. Therefore, potential links between CC16 A38G, asthma and atopy were investigated in an unselected population of young adult Danes. Four hundred sixty-four Danes, aged 19-29 years, from Copenhagen participated in an asthma and allergy phenotype-genotype study. Genotyping was done by Sau96I restriction digestion of PCR products spanning the A38G polymorphism. Potential A38G genotype and asthma-related phenotype associations were investigated using regression analysis, adjusting for potential confounders where appropriate. Adults with the 38AA genotype had higher odds of current asthma (OR 3.2, P=0.013) and ever asthma (OR 2.2, P=0.045) compared with those with the 38GG genotype. Adjusting for atopy had minimal effect on this relationship. A positive linear trend was evident between the 38A allele and atopic dermatitis (OR 1.67, P=0.02). No associations were found between the A38G polymorphism and rhinitis, atopy, forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), airway responsiveness (AR) to histamine or peripheral blood eosinophil level (PBEL). An atopy-independent association between CC16 38AA and asthma prevalence was identified, suggesting the CC16 38A allele predisposes to adult asthma independent of Th1/Th2 processes. This finding is consistent with previous studies in children, but is the first reported association between CC16 A38G and asthma in adults. CC16 38A also displayed a positive linear trend with atopic dermatitis.
Brief Report: Burden of Care in Mothers of Children with Autism Spectrum Disorder or Intellectual Disability
Publisher: Springer Science and Business Media LLC
Date: 19-10-2015
DOI: 10.1007/S10803-015-2629-9
Abstract: Compared to other mothers, mothers of children with autism spectrum disorder (ASD) or intellectual disability (ID) have higher rates of treatment episodes for psychiatric disorders. We aimed to estimate the maternal burden of care by comparing the length of hospitalisations for psychiatric disorders and the treatment rates for psychiatric disorders after the birth in mothers of children with ASD/ID and no psychiatric history to that of other mothers with no psychiatric history. Mothers of children with ID of known cause (not Down syndrome) and mothers of children ASD without ID emerged as particularly vulnerable. Mothers of children with Down syndrome were resilient. The development of specialised organisations to provide support to mothers of children with ID of known cause (not Down syndrome) and mothers of children with ASD without ID could assist them to maintain their mental health.
The Long-Term Effects of Breastfeeding on Child and Adolescent Mental Health: A Pregnancy Cohort Study Followed for 14 Years
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.1016/J.JPEDS.2009.10.020
Abstract: To determine whether there was an independent effect of breastfeeding on child and adolescent mental health. The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnant women and followed the live births for 14 years. Mental health status was assessed by the Child Behaviour Checklist (CBCL) at 2, 6, 8, 10, and 14 years. Maternal pregnancy, postnatal, and infant factors were tested in multivariable random effects models and generalized estimating equations to examine the effects of breastfeeding duration on mental health morbidity. Breastfeeding for less than 6 months compared with 6 months or longer was an independent predictor of mental health problems through childhood and into adolescence. This relationship was supported by the random effects models (increase in total CBCL score: 1.45 95% confidence interval 0.59, 2.30) and generalized estimating equation models (odds ratio for CBCL morbidity: 1.33 95% confidence interval 1.09, 1.62) showing increased behavioral problems with shorter breastfeeding duration. A shorter duration of breastfeeding may be a predictor of adverse mental health outcomes throughout the developmental trajectory of childhood and early adolescence.
P049 Cancer incidence in western australian miners (1996–2013)
Publisher: BMJ Publishing Group Ltd
Date: 09-2016
Parental smoking impairs vaccine responses in children with atopic genotypes
Publisher: Elsevier BV
Date: 02-2007
DOI: 10.1016/J.JACI.2006.09.018
Abstract: Gene-environment interactions play central roles in controlling postnatal maturation of immune function, but their effects on infant vaccine responses are unknown. Genetic variants associated with atopy and the environmental factor of exposure to parental smoking (PS) of tobacco independently alter immune responses. We sought to investigate the hypothesis that genetic variants associated with atopy and their interaction with PS influence infant vaccine responsiveness. In 200 infants with parental atopic history, relationships were sought between polymorphisms in the IL-4, IL-4 receptor alpha (IL-4Ralpha), and IL-13 genes PS and immune responses to diphtheria/tetanus vaccination. Analyses stratified by PS unmasked negative associations between atopic alleles of these genes and vaccine outcomes. The most consistent involved the IL-4Ralpha 551 QR/QQ genotypes, which were associated with reduced IgG levels (P = .02) and T-cell responses (IFN-gamma, P = .002 IL-10, P = .01 1L-13, P = .01 IL-5, P = .06) to tetanus toxoid and parallel reductions in polyclonal T-cell responses and innate immune responses in PS-exposed infants. PS potentiates suppressive effects of variants in immune response genes in children. These effects are not observed in the absence of this exposure. Ultimately, this finding might have implications for infant vaccination in countries with high smoking rates. It might also have broader implications in relation to environmental toxicology because it demonstrates specific mechanisms through which the developing immune system might be differentially sensitive to low-level toxicant exposures. PS interacts with genes associated with atopy to impair vaccine responses. These interactions might have vaccine design and public health implications.
Early mortality from external causes in Aboriginal mothers: A retrospective cohort study
Publisher: Springer Science and Business Media LLC
Date: 06-2016
Antibiotic use in the first year of life and risk of atopic disease in early childhood
Publisher: Wiley
Date: 19-11-2023
DOI: 10.1111/J.1365-2222.2008.03138.X
Abstract: Reduced post-natal microbial stimulation resulting from improvements in public health measures, smaller family size, and through increased antibiotic use has been postulated to account for the increasing prevalence of atopic diseases seen predominantly in developed countries. To investigate use of antibiotics in the first year of life and subsequent development of atopic disease in early childhood. A prospective birth cohort of 198 children at high atopic risk was recruited prenatally and followed for 5 years. Illnesses and antibiotic use were ascertained through daily diaries, and diagnoses of asthma and hayfever were collected by questionnaire interviews. The children were examined regularly for eczema, and atopic status was defined by skin prick tests and serum total IgE. The effect of antibiotic use on subsequent atopic disease was examined using logistic regression with propensity score adjustment. 54.0% (107/198) of children received at least one course of antibiotics, mainly for acute respiratory illnesses (ARI). Thirty-three percent (329/984) of the ARI involved the lower respiratory tract (LRI). Twenty-three percent (222/984) of ARI were treated with antibiotics, with LRI significantly more likely to receive antibiotics. Antibiotic use was associated with asthma (unadjusted odds ratio 2.3 95% confidence interval 1.2-4.5 P=0.01) but this association was reduced after propensity score adjustment. No associations were found between antibiotic use and eczema, current wheeze, current asthma, atopic asthma, allergic rhinoconjunctivitis or atopy. Although this was a small study, systematic and careful monitoring of ARI, antibiotic use, and asthma and atopic diseases did not indicate that receipt of antibiotics early in life led to subsequent asthma or atopy at 5 years.
Health service utilisation for acute respiratory infections in infants graduating from the neonatal intensive care unit
Publisher: Springer Science and Business Media LLC
Date: 07-2023
DOI: 10.1186/S12887-023-04152-5
Abstract: Despite advances in neonatal intensive care, babies admitted to Neonatal Intensive Care Units (NICU) suffer from adverse outcomes. We aim to describe the longer-term respiratory infectious morbidity of infants discharged from NICU using state-wide population-based linked data in Western Australia. We used probabilistically linked population-based administrative data to analyse respiratory infection morbidity in a cohort of 23,784 infants admitted to the sole tertiary NICU, born 2002–2013 with follow up to 2015. We analysed incidence rates of secondary care episodes (emergency department presentations and hospitalisations) by acute respiratory infection (ARI) diagnosis, age, gestational age and presence of chronic lung disease (CLD). Poisson regression was used to investigate the differences in rates of ARI hospital admission between gestational age groups and those with CLD, after adjusting for age at hospital admission. From 177,367 child-years at risk (i.e., time that a child could experience an ARI outcome), the overall ARI hospitalisation rate for infants and children aged 0–8 years was 71.4/1000 (95% confidence interval, CI: 70.1, 72.6), with the highest rates in infants aged 0–5 months (242.9/1000). For ARI presentations to emergency departments, equivalent rates were 114/1000 (95% CI: 112.4, 115.5) and 337.6/1000, respectively. Bronchiolitis was the most common diagnosis among both types of secondary care, followed by upper respiratory tract infections. Extremely preterm infants ( 28 weeks gestation at birth) were 6.5 (95% CI: 6.0, 7.0) times more likely and those with CLD were 5.0 (95% CI: 4.7, 5.4) times more likely to be subsequently admitted for ARI than those in NICU who were not preterm or had CLD after adjusting for age at hospital admission. There is an ongoing burden of ARI in children who graduate from the NICU, especially those born extremely preterm, that persists into early childhood. Early life interventions to prevent respiratory infections in these children and understanding the lifelong impact of early ARI on later lung health are urgent priorities.
Incidence of and risk factors for hospitalisations due to vascular complications: A population-based type 1 diabetes cohort (n = 1316) followed into early adulthood
Publisher: Elsevier BV
Date: 05-2017
DOI: 10.1016/J.JDIACOMP.2016.11.022
Abstract: To determine the incidence of hospitalisations and risk factors for vascular complications experienced during early adulthood in patients with childhood onset type 1 diabetes. A population-based childhood onset type 1 diabetes cohort was identified from a statewide register (1992-2012). Data linkage was used to identify a matched comparison cohort. Hospital admissions data were extracted to follow up both cohorts into early adulthood (1975-2012). The type 1 diabetes cohort (n=1316) had a mean age of diagnosis of 9.5years, 49.5% were women and mean age at the end of follow-up was 26.3years (range 18-38). Within the type 1 diabetes cohort 32 (2.4%) were hospitalised with a vascular complication during early adulthood. Poor glycaemic control during paediatric management was associated with a significant increase in risk for ophthalmic complication with 19.4% (n=12/62) of those with a mean HbA1c >12% (108mmol/mol) diagnosed compared to 0.72% (n=5/696) of those with mean HbA1c <9% (75mmol/mol), adjusted hazard ratio 8.4 (95% CI 2.0, 34.7). Severe vascular complications requiring hospital admission continue to be observed during early adulthood. Both women and those with poor glycaemic control are at increased risk of requiring a hospital admission for these complications during early adulthood.
Western Australian children with acute lymphoblastic leukemia are taller at diagnosis than unaffected children of the same age and sex
Publisher: Wiley
Date: 18-01-2011
DOI: 10.1002/PBC.22832
Abstract: Acute lymphoblastic leukemia (ALL) is the commonest childhood malignancy in Australian children. Recently published data from Western Australia suggest a link between proportion of optimal birth weight and the risk of ALL, but few studies have investigated the relationship between growth during infancy and early childhood and risk of leukemia. The aim of this study was to determine whether children diagnosed with ALL in Western Australia were taller at the time of diagnosis than children of the same age and sex in the general population. Records of children diagnosed with ALL between January 1984 and June 2008 were accessed. Height before the commencement of chemotherapy was recorded and compared to the height of population norms derived from the Longitudinal Study of Australian Children. On average, male cases were 0.67 cm (95% CI -0.21, 1.54 cm) taller and female cases were 0.30 cm (95% CI -0.68, 1.28 cm) taller than population controls. Our results suggest that children diagnosed with ALL in Western Australia are slightly taller than their counterparts in the general population. These findings are consistent with at least one previous study. While this increase in height may be too small to be recognizable clinically, it is consistent with the notion that growth factors play a role in the pathogenesis of ALL beyond infancy.
Transiently increased IgE responses in infants and pre-schoolers receiving only acellular Diphtheria–Pertussis–Tetanus (DTaP) vaccines compared to those initially receiving at least one dose of cellul
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.VACCINE.2016.05.048
Abstract: Several previous studies have highlighted the strong Th2-polarising and IgE-promoting activity of the DTaP vaccine, but there is no evidence that this has pathological consequences and accordingly there is no current interest amongst vaccine developers in reformulating DTaP to attenuate these properties. In light of an apparent resurgence in pertussis in many countries, and emerging evidence from other areas of paediatric immunology of IgE-mediated interference with host defence mechanisms, this issue requires more detailed clarification. We have re-evaluated the impact of DTaP-only versus mixed DTwP/DTaP vaccination on Th2-dependent "bystander" IgE responses in three cohorts of children under different priming conditions, encompassing both vaccine-targeted and unrelated antigens including food allergens. We confirm the generalised IgE-trophic activity of the DTaP vaccine in pre-schoolers and demonstrate similar (albeit transient) effects in infants. We additionally demonstrate that use of an alternative mixed infant priming schedule encompassing an initial dose of DTwP significantly attenuates this property. Central to our interpretation of these findings are studies demonstrating: (i) mixed DTwP/DTaP priming improves resistance to pertussis disease and attenuates the IgE-stimulatory component of long term vaccine-specific memory (ii) IgE-mediated mechanisms can interfere with innate antiviral immunity and accordingly exacerbate airway symptoms in infected children. These observations, taken together with the data presented here, suggest a plausible mechanistic link between baseline pertussis-specific IgE titres in DTaP vaccinees and susceptibility to pertussis disease, which merits testing. Retrospective IgE analyses on sera collected from children at the time of presentation with pertussis could resolve this issue.
Maternal folate and other vitamin supplementation during pregnancy and risk of acute lymphoblastic leukemia in the offspring
Publisher: Wiley
Date: 23-03-2010
DOI: 10.1002/IJC.24969
Abstract: The Australian Study of Causes of Acute Lymphoblastic Leukemia in Children (Aus-ALL) was designed to test the hypothesis, raised by a previous Western Australian study, that maternal folic acid supplementation during pregnancy might reduce the risk of childhood acute lymphoblastic leukemia (ALL). Aus-ALL was a national, population-based, multicenter case-control study that prospectively recruited 416 cases and 1,361 controls between 2003 and 2007. Detailed information was collected about maternal use of folic acid and other vitamin supplements before and during the index pregnancy. Data were analyzed using logistic regression, adjusting for matching factors and potential confounders. A meta-analysis with the results of previous studies of folic acid supplementation was also conducted. We found weak evidence of a protective effect of maternal folate supplementation before pregnancy against risk of childhood ALL, but no evidence for a protective effect of its use during pregnancy. A meta-analysis including this and 2 other studies, but not the study that raised the hypothesis, also found little evidence that folate supplementation during pregnancy protects against ALL: the summary odds ratios (ORs) for folate supplementation were 1.06 [95% confidence interval (CI): 0.77-1.48] with reference to no folate supplementation and 1.02 (95% CI: 0.86-1.20) with reference to no vitamin supplementation. For vitamin supplementation in general, the summary OR from a meta-analysis of 5 studies-including Aus-ALL-was 0.83 (95% CI: 0.73-0.94). Vitamin supplementation in pregnancy may protect against childhood ALL, but this effect is unlikely to be large or, if real, specifically due to folate.
Combined CA125 and Mesothelin Levels for the Diagnosis of Malignant Mesothelioma
Publisher: Elsevier BV
Date: 10-2007
Abstract: Malignant mesothelioma is an aggressive, uniformly fatal tumor. Serum markers would be useful for the diagnosis of this disease. One potential marker is mesothelin. The purpose of this study was to study the mesothelin biomarker in a large patient cohort and to determine if another biomarker, CA125, improves on the sensitivity of mesothelin in the diagnosis of mesothelioma. Serum levels of mesothelin and CA125 were determined by commercially available assays in 117 s les obtained at diagnosis from patients with pleural malignant mesothelioma, 33 healthy, asbestos-exposed in iduals, 53 patients with asbestos-related lung or pleural disease, and 30 patients presenting with benign pleural effusions. Cross-validated sensitivities were determined, and receiver operator characteristic curves were generated to compare the diagnostic accuracy of the biomarkers. CA125 had a cross-validated sensitivity of 27% for mesothelioma patients at a specificity of 95% relative to asbestos-exposed in iduals, or 50% relative to in iduals with benign pleural effusions. Mesothelin had a cross-validated sensitivity of 52% for mesothelioma patients, at a sensitivity of 95% relative to in iduals with benign lung or pleural disease. CA125 and mesothelin levels were discordant in > 50% of mesothelioma patients. Combining the data from the two biomarkers using a logistic regression model did not improve sensitivity for detecting mesothelioma above that of the mesothelin marker alone. Combining mesothelin and CA125 data does not improve the sensitivity of mesothelioma diagnosis over mesothelin alone. The use of both markers potentially increases the number of patients who can be monitored.
Maternal antibiotic exposure during pregnancy and hospitalization with infection in offspring: authors’ reply
Publisher: Oxford University Press (OUP)
Date: 30-05-2018
DOI: 10.1093/IJE/DYY097
Cancer incidence in the Western Australian mining industry (1996–2013)
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.CANEP.2017.05.001
Abstract: Miners are frequently exposed to established and potential carcinogens. We aimed to assess cancer incidence in miners relative to the general population and identify high-risk subgroups. Incident cancers in Western Australian miners (n=153,922 86% male) during 1996-2013 were identified. Indirectly standardised incidence ratios (SIRs) were calculated and mixed-effects Poisson models were used to calculate Incidence Rate Ratios (IRRs) to identify high-risk within-cohort subgroups. Compared with the general population, the overall cancer incidence in miners (n=4194 cases) was lower for both females (SIR:0.83, 95%CI:0.74-0.92) and males (SIR:0.96, 95%CI:0.93-0.99). Overall, cancer incidence did not differ by employment duration or employment commencement time. Ever-underground work was associated with lung cancer (IRR:1.81, 95%CI:1.11-2.93). Relative to multi-ore miners, IRRs for specific cancers were significantly different when exclusively mining: iron (prostate:0.73, 95%CI:0.56-0.94) gold (lung:1.77, 95%CI:1.04-3.01 and colorectum:1.70, 95%CI:1.16-2.51) and other metals (urinary tract:1.85, 95%CI:1.03-3.31 and leukaemia:0.36, 95%CI:0.14-0.96). Working underground emerged as a significant determinant of lung cancer risk in our contemporary mining cohort. Increased risks of lung, prostate, colorectal and urinary tract cancers and leukaemia were identified in miners of specific ores. These findings underline the importance of continued surveillance of the health and exposures of this relatively young cohort of miners.
Absent otoacoustic emissions predict otitis media in young Aboriginal children: a birth cohort study in Aboriginal and non-Aboriginal children in an arid zone of Western Australia.
Publisher: Springer Science and Business Media LLC
Date: 28-08-2008
Autism spectrum disorders in young children: Effect of changes in diagnostic practices
Publisher: Oxford University Press (OUP)
Date: 07-09-2009
DOI: 10.1093/IJE/DYP260
Abstract: It is unclear whether the increase in autism over the past two decades is a real increase or due to changes in diagnosis and ascertainment of autism spectrum disorders (ASDs), which include autism, Asperger syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). The aim of this study was to examine the trends in ASD over time in Western Australia (WA) and the possible effects and contribution of changes in diagnostic criteria, age at diagnosis, eligibility for service provision based on ASD diagnoses and changes in diagnostic practices. A population-based study was conducted among the cohort of children born in WA between 1983 and 1999 and diagnosed with ASD between the age of 2 and 8 years up to December 31, 2004. The trend in ASD diagnosis over the study period was assessed by investigating birth cohort and period effects, and examining whether these were modified by age of diagnosis. ASD diagnosis corresponding with changes in diagnostic criteria, funding and service provision over time were also investigated. A subgroup analysis of children aged <or=5 years was also conducted to examine trends in the incidence and age of diagnosis of ASD and intellectual disability (ID) and to investigate the role of changes in diagnostic practices. The overall prevalence of ASD among children born between 1983 and 1999 and diagnosed by age 8 was 30 per 10,000 births with the prevalence of autism comprising 21 per 10,000 births. The prevalence of ASD increased by 11.9% per annum, from 8 cases per 10,000 births in 1983 to 46 cases per 10,000 births in 1999. The annual incidence of ASD, based on newly diagnosed ASD cases in each year from 1985 to 2002, increased over the study period. The increase in incidence of ASD appeared to coincide with changes in diagnostic criteria and availability of funding and services in WA, particularly for children aged <5 years. The age-specific rates of autism and PDD-NOS increased over time and the median age of diagnosis for autism decreased from 4 to 3 years of age throughout the 1990s. For children aged <or=5 years the incidence of ASD diagnosis increased significantly from 1992, with an average annual increase of 22%. Similar findings were found for autism. In the corresponding years the incidence of diagnosis of severe ID fell by 10% per annum and mild-moderate ID increased by 3% per annum. The rise in incidence of all types of ASDs by year of diagnosis appears to be related to changes in diagnostic and service provision practices in WA. In children aged <or=5 years, diagnosis of severe ID decreased, but mild-moderate ID increased during the study period. A true increase in ASD cannot be ruled out.
Retinol supplementation and mesothelioma incidence in workers earlier exposed to blue asbestos (Crocidolite) at Wittenoom, Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2010
Hospitalisation for bronchiolitis in infants is more common after elective caesarean delivery
Publisher: BMJ
Date: 28-10-2012
DOI: 10.1136/ARCHDISCHILD-2011-300607
Abstract: The authors previously reported an increased risk of hospitalisation for acute lower respiratory infection up to age 2 years in children delivered by elective caesarean section. In view of increasing rates of elective caesarean delivery, this association warranted further investigation. To examine associations between the number of hospital admissions for bronchiolitis and pneumonia and elective caesarean delivery. Retrospective population-based data linkage cohort study of 212 068 non-Aboriginal singleton births of 37-42 weeks gestation. Negative binomial regression was used to examine associations between mode of delivery and hospitalisations for both bronchiolitis and pneumonia in children aged <12 months and 12-23 months. Models were adjusted for obstetric and known risk factors. 16% of children were delivered by elective caesarean section (n=33 421). In adjusted analysis, compared with spontaneous vaginal delivery, these children had increased risk of admissions for bronchiolitis at age <12 months (incidence rate ratio (IRR) 1.11 95% CI 1.01 to 1.23) and 12-23 months (IRR 1.20 95% CI 0.94 to 1.53) independent of other fetal and maternal factors. There was no association between elective caesarean delivery and number of pneumonia admissions aged <12 months (IRR 1.03 95% CI 0.80 to 1.33) and 12-23 months (IRR 1.09 95% CI 0.88 to 1.34). Delivery by elective caesarean was independently associated with infant admissions for bronchiolitis but not pneumonia. Elective caesareans or delivery without labour may result in impaired immunity in the newborn leading to increased risk of early viral lower respiratory infections.
Nuclear DNA content and prognosis in human breast cancer: A static cytophotometric study
Publisher: Springer Science and Business Media LLC
Date: 06-1987
DOI: 10.1007/BF01807362
Abstract: Emotional processing is influenced by cognitive processes and vice versa, indicating a profound interaction of these domains. The investigation of the neural mechanisms underlying this interaction is not only highly relevant for understanding the organization of human brain function. Rather, it may also help in understanding dysregulated emotions in affective disorders and in elucidating the neurobiology of cognitive behavioural therapy (e.g. in borderline personality disorder), which aims at modulating dysfunctional emotion processes by cognitive techniques, such as restructuring. In the majority of earlier studies investigating the interaction of emotions and cognition, the main focus has been on the investigation of the effects of emotional stimuli or, more general, emotional processing, e.g. instituted by emotional material that needed to be processed, on cognitive performance and neural activation patterns. Here we pursued the opposite approach and investigated the modulation of implicit processing of emotional stimuli by cognitive demands using an event-related functional magnetic resonance imaging--study on a motor short-term memory paradigm with emotional interferences. Subjects were visually presented a finger-sequence consisting either of four (easy condition) or six (difficult condition) items, which they had to memorize. After a short pause positive, negative or neutral International affective picture system pictures or a green dot (as control condition) were presented. Subjects were instructed to reproduce the memorized sequence manually as soon as the picture disappeared. Analysis showed that with increasing cognitive demand (long relative to short sequences), neural responses to emotional pictures were significantly reduced in amygdala and orbitofrontal cortex. In contrast, the more difficult task evoked stronger activation in a widespread frontoparietal network. As stimuli were task-relevant go-cues and hence had to be processed perceptually, we would interpret this as a specific attenuation of affective responses by concurrent cognitive processing--potentially reflecting a relocation of resources mediated by the frontoparietal network.
Exposure to crocidolite and the incidence of different histological types of lung cancer
Publisher: BMJ
Date: 03-1996
DOI: 10.1136/OEM.53.3.157
Abstract: To estimate the relations between exposure to both tobacco smoke and crocidolite and the incidence of various histological types of lung cancer. In 1979 all former workers from the Wittenoom asbestos industry who could be traced were sent a questionnaire on smoking history. Of 2928 questionnaires sent, satisfactory replies were received from 2400 men and 149 women. Of the men, 80% had smoked at some time and 50% still smoked. Occupational exposure to crocidolite was known from employment records and follow up was maintained through death and cancer registries in Australia with histological diagnoses obtained from the relevant State Cancer Registry. Conditional logistic regression was used to estimate the effects of tobacco and asbestos exposure on incidence of different cell types of lung cancer in a nested case-control design. Between 1979 and 1990, 71 cases of lung cancer occurred among men in this cohort: 27% squamous cell carcinoma, 31% adenocarcinoma, 18% small cell carcinoma, 11% large cell carcinoma, and 13% unclassified or indeterminate. Two of the classified cases and one unclassified case had never smoked. The incidence of both squamous and adenocarcinoma types of lung cancer were greatest in ex-smokers and in those subjects with the highest levels of exposure to crocidolite. After adjustment for smoking habit, the increase in incidence of lung cancer with increasing exposure to crocidolite was greater for squamous cell carcinoma than for adenocarcinoma. The results from this study have shown significant exposure-response effects for exposure to crocidolite, and both adenocarcinoma and squamous cell carcinoma of the lung. They also provide some further evidence against the theory that parenchymal fibrosis induced by asbestos is a necessary precursor to asbestos induced lung cancer.
Asbestos exposure and gestational trophoblastic disease: A hypothesis
Publisher: American Association for Cancer Research (AACR)
Date: 11-2009
DOI: 10.1158/1055-9965.EPI-09-0731
Abstract: Among 2,968 women and girls exposed to crocidolite (blue asbestos) at Wittenoom, three cases of choriocarcinoma and three cases of hydatidiform mole have been identified (crude incidence rate of 9.9 per 1000 women and 1.7 per 1000 deliveries for choriocarcinoma and hydatidiform mole, respectively). The women with choriocarcinoma were resident at Wittenoom at the time of disease development, whereas hydatidiform mole occurred much later in women who had first been exposed to asbestos as young girls. Four of the six cases were known to have lived with asbestos company workers who brought their dusty work-clothes home for washing. Asbestos fibers have been reported in the lung, the pleural and peritoneal mesothelium, and the human ovary. They have also been detected in placental digests of live and stillborn infants. This cluster of gestational trophoblastic diseases has some biological plausibility for asbestos causation. Taking an occupational and residential history and examining pathologic specimens for asbestos fibers or bodies may prove useful in patients with gestational trophoblastic disease. (Cancer Epidemiol Biomarkers Prev 2009 (11):2895–8)
InterRett and RettBASE : International Rett syndrome association databases for Rett syndrome
Publisher: SAGE Publications
Date: 10-2003
DOI: 10.1177/08830738030180100301
Abstract: In 2001, the International Rett Syndrome Association funded the establishment of a World Wide Web—based database to collect and display the genetic data of children and adults with Rett syndrome from around the world. RettBASE ( mecp2.chw.edu.au ) encompasses both published and unpublished data includes pathogenic mutations, benign polymorphisms, and sequence variations of uncertain significance and has a range of query capabilities, allowing for simple or complex interrogation of the database. To undertake genotype—phenotype correlations and to identify the likely subtle differences in phenotype, detailed phenotype data on large s les will be provided by the International Rett Syndrome Association International Phenotype database InterRett. InterRett is under development by the Australian Rett syndrome study group at the Telethon Institute for Child Health Research in Perth, Western Australia. It will collect data from clinicians and families and provide deidentified, collated data on the Internet ( www.ichr.uwa.edu.au/rett/irsa ). Data records will be linked with RettBASE through a common unique identifier. An international reference panel is advising on the development of the database. Data collection procedures from families and clinicians are currently being piloted. Full data collection from both groups began in the second half of 2003. Concurrently, the output database will be developed to provide deidentified in idual records and collated data for clinicians and researchers and collated data for families and the general public. This Web-based database will be an invaluable resource for understanding the nature of the disorder and managing children and adults with Rett syndrome. ( J Child Neurol 2003 :709—713).
Effectiveness of seasonal trivalent influenza vaccination against hospital-attended acute respiratory infections in pregnant women: A retrospective cohort study
Publisher: Elsevier BV
Date: 07-2016
DOI: 10.1016/J.VACCINE.2016.05.032
Abstract: Pregnant women are at risk of serious influenza infection. Although previous studies indicate maternal influenza vaccination can prevent hospitalisation in young infants, there is limited evidence of the effect in mothers. A cohort of 34,701 pregnant women delivering between 1 April 2012 and 31 December 2013 was created using birth records. Principal diagnosis codes from hospital emergency department (ED) and inpatient records were used to identify episodes of acute respiratory illness (ARI) during the 2012 and 2013 southern hemisphere influenza seasons. Cox regression models were used to calculate adjusted hazard ratios (aHRs) by maternal vaccination status, controlling for Indigenous status, socioeconomic level, medical conditions, and week of delivery. 3,007 (8.7%) women received a seasonal influenza vaccine during pregnancy. Vaccinated women were less likely to visit an ED during pregnancy for an ARI (9.7 visits per 10,000 person-days vs. 35.5 visits per 10,000 person-days aHR: 0.19, 95% CI: 0.05-0.68). Vaccinated women were also less likely to be hospitalised with an ARI compared to unvaccinated women (16.2 hospitalisations per 10,000 person-days vs. 34.0 hospitalisations per 10,000 person-days aHR: 0.35, 95% CI: 0.13-0.97). Influenza vaccination during pregnancy was associated with significantly fewer hospital attendances for ARI in pregnant women.
Sex differences between parental pregnancy characteristics and nonalcoholic fatty liver disease in adolescents
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 13-11-2018
DOI: 10.1002/HEP.29347
Abstract: Nonalcoholic fatty liver disease (NAFLD) is a complex chronic liver disorder. Examination of parental pregnancy‐related characteristics may provide insights into the origins of risk of NAFLD in offspring. We examined relationships between parental pregnancy‐related characteristics and NAFLD in 1,170 adolescent offspring aged 17 years participating in the Western Australian Pregnancy (Raine) Cohort Study. Fatty liver was diagnosed using liver ultrasound. NAFLD was diagnosed in 15.2% of adolescents at age 17 years. In univariate analysis, maternal factors associated with NAFLD in female offspring were younger maternal age ( P = 0.02), higher maternal prepregnancy BMI ( P 0.001), higher maternal weight gain by 18 weeks' gestation ( P 0.001), and maternal smoking during pregnancy ( P = 0.04). Paternal age or body mass index (BMI) were not associated with NAFLD in female offspring. In contrast, higher paternal BMI ( P 0.001), maternal prepregnancy BMI ( P 0.001), and lower family socioeconomic status (SES) at time of birth ( P = 0.001), but not parental age nor maternal gestational weight gain, were associated with NAFLD in male offspring. Using multivariate logistic regression, factors independently associated with NAFLD after adjusting for obesity in adolescent females included maternal obesity (odds ratio [OR], 3.46 95% confidence interval [CI], 1.49‐8.05 P = 0.004) and maternal weight gain ≥6.0 kg by the 18th week of gestation (OR, 1.10 95% CI, 1.04‐1.15 P 0.001). In adolescent males, family SES at the time of birth (OR, 9.07 95% CI, 1.54‐53.29 P = 0.02) remained significantly associated with NAFLD after multivariate modeling adjusted for adolescent obesity. Conclusion: Early‐life contributors to NAFLD show considerable sexual dimorphism. Maternal obesity and higher early‐mid gestational weight gain were associated with NAFLD in female offspring, whereas lower family SES at birth was associated with NAFLD in male offspring independent of adolescent obesity. (H epatology 2018 :108‐122).
The gene expression signature of relapse in paediatric acute lymphoblastic leukaemia: Implications for mechanisms of therapy failure
Publisher: Wiley
Date: 31-10-2005
DOI: 10.1111/J.1365-2141.2005.05785.X
Abstract: Despite significant improvements in the treatment of childhood acute lymphoblastic leukaemia (ALL), the prognosis for relapsing patients remains poor. The aim of this study was to generate a transcriptional profile of relapsed ALL to increase our understanding of the mechanisms involved in therapy failure. RNA was extracted from 11 pairs of cryopreserved pre-B ALL bone marrow specimens taken from the same patients at diagnosis and relapse, and analysed using HG-U133A microarrays. Relapse specimens overexpressed genes that are involved with cell growth and proliferation, in keeping with their aggressive phenotype. When tested in 72 independent specimens of pre-B ALL and T-ALL, the identified genes could successfully differentiate between diagnosis and relapse in either lineage, indicating the existence of relapse mechanisms common to both. These genes have functions relevant for oncogenesis, drug resistance and metastasis, but are not related to classical multidrug-resistance pathways. Increased expression of the top-ranked gene (BSG) at diagnosis was significantly associated with adverse outcome. Several chromosomal loci, including 19p13, were identified as potential hotspots for aberrant gene expression in relapsed ALL. Our results provide evidence for a link between drug resistance and the microenvironment that has previously only been considered in the context of solid tumour biology.
Risk factors for malignant mesothelioma in people with no known exposure to asbestos
Publisher: Wiley
Date: 28-02-2017
DOI: 10.1002/AJIM.22695
Abstract: Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5-10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. Cases with no known asbestos exposure were selected from the WA Mesothelioma Register (WAMR). Matched controls were selected from hospital patients admitted for conditions unrelated to asbestos. Occupational histories were coded by an industrial hygienist. Data were analyzed using conditional logistic regression. Thirty-eight MM participants and 134 controls were recruited. Risk of MM was increased (OR = 3.1, 95%CI 1.0-9.6) after no known, but likely, exposure to asbestos at work. Because of its extensive use, few people in WA have never been exposed to asbestos. Unrecognized exposure may cause most MM cases initially regarded as "no exposure." Am. J. Ind. Med. 60:432-436, 2017. © 2017 Wiley Periodicals, Inc.
Assisted Reproductive Technology and Major Birth Defects in Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2013
Prenatal Alcohol Exposure and Risk of Birth Defects
Publisher: American Academy of Pediatrics (AAP)
Date: 10-2010
Abstract: The goal was to examine the associations between dose, pattern, and timing of prenatal alcohol exposure (PAE) and birth defects. Data from a randomly selected, population-based cohort of nonindigenous women who gave birth to a live infant in Western Australia (WA) between 1995 and 1997 (N = 4714) were linked to WA Midwives Notification System and WA Birth Defects Registry data. We assessed the associations of PAE before pregnancy, in the first trimester, and in late pregnancy with any birth defect and with birth defects classified as alcohol-related birth defects (ARBDs) by the Institute of Medicine (IOM), by using logistic regression. The prevalence of birth defects classified as ARBDs by the IOM was low. Compared with abstinence, heavy PAE in the first trimester was associated with increased odds of birth defects classified as ARBDs (adjusted odds ratio: 4.6 [95% confidence interval: 1.5–14.3]), with similar findings after validation through bootstrap analysis. There was no association between low or moderate PAE and birth defects. A fourfold increased risk of birth defects classified as ARBDs was observed after heavy PAE in the first trimester. Many in idual birth defects included in the IOM classification for ARBDs either were not present in this cohort or were not associated with PAE. Large, population-based studies are needed to strengthen the evidence base for ARBDs.
Validation of an Asbestos Job-Exposure Matrix (AsbJEM) in Australia: Exposure-Response Relationships for Malignant Mesothelioma
Publisher: Oxford University Press (OUP)
Date: 23-05-2019
Abstract: An asbestos job-exposure matrix (AsbJEM) has been developed to systematically and cost-effectively evaluate occupational exposures in population-based studies. The primary aim of this study was to examine the accuracy of the AsbJEM in determining exposure–response relationships between asbestos exposure estimates and malignant mesothelioma (MM) incidence (indirect validation). The secondary aim was to investigate whether the assumptions used in the development of the original AsbJEM provided accurate asbestos exposure estimates. The study population consisted of participants in an annual health surveillance program, who had at least 3-month occupational asbestos exposure. Calculated asbestos exposure indices included cumulative asbestos exposure and the average exposure intensity, estimated using the AsbJEM and duration of employment. Asbestos and MM exposure–response relationships were compared between the original AsbJEM and its variations based on manipulations of the intensity, duration and frequency of exposure. Twenty-four exposure estimates were calculated for both cumulative asbestos exposure and the average exposure intensity using three exposure intensities (50th, 75th and 90th percentile of the range of mode exposure), four peak durations (15, 30, 60 and 120 min) and two patterns of peak frequency (original and doubled). Cox proportional hazards models were used to describe the associations between MM incidence and each of the cumulative and average intensity estimates. Data were collected from 1602 male participants. Of these, 40 developed MM during the study period. There were significant associations between MM incidence and both cumulative and average exposure intensity for all estimates. The strongest association, based on the regression-coefficient from the models, was found for the 50th percentile of mode exposure, 15-min peak duration and the doubled frequency of peak exposure. Using these assumptions, the hazard ratios for mesothelioma were 1 (reference), 1.91, 3.24 and 5.37 for the quartiles of cumulative asbestos exposure and 1 (reference), 1.84, 2.31 and 4.40 for the quartiles of the average exposure intensity, respectively. The well-known positive exposure–response relationship between MM incidence and both estimated cumulative asbestos exposure and average exposure intensity was confirmed. The strongest relationship was found when the frequency of peak exposure in the AsbJEM was doubled from the originally published estimates.
Neck/shoulder pain, habitual spinal posture and computer use in adolescents: The importance of gender
Publisher: Informa UK Limited
Date: 06-2011
Infant respiratory infections and later respiratory hospitalisation in childhood
Publisher: European Respiratory Society (ERS)
Date: 20-08-2015
DOI: 10.1183/13993003.00587-2015
Abstract: Acute respiratory infections (ARI) cause significant morbidity in infancy. We sought to quantify the relationship between ARI and development of respiratory morbidity in early childhood. Population-based longitudinal hospitalisation data were linked to perinatal, birth and death records for 145 580 Western Australian children from 1997 to 2002. We conducted Cox regression with sensitivity analyses to quantify the risk of recurrent ARI in infancy for respiratory hospitalisation after the age of 3 years. ARI in infancy was significantly related to respiratory hospitalisation before (hazard ratio (HR) 3.5, 95% CI 3.1–3.8) and after (HR 3.0, 95% CI 2.6–3.4) adjusting for known risk factors including maternal smoking during pregnancy, season of birth, delivery mode and gestational age. We noted a dose response with the number and length of infant ARI hospitalisations and increasing risk with no effect modification by gestational age. Results were similar when later respiratory hospitalisations were restricted to asthma hospitalisations only. Recurrent hospitalisations for ARI in infancy significantly increase the risk of respiratory morbidity and asthma requiring hospitalisation after the age of 3 years in a dose-response fashion. The increase in relative risk is not modified by gestational age. Efforts to reduce the occurrence of infant ARI are likely to have significant public health benefits.
Differential relationships between anthropometry measures and cardiovascular risk factors in boys and girls
Publisher: Informa UK Limited
Date: 06-2011
DOI: 10.3109/17477166.2010.512388
Abstract: The aim of the study was to compare commonly used anthropometry for cardiovascular risk factors in 14-year-olds. A total of 1 149 children of an Australian pregnancy (Raine) cohort with recruitment 1989-1991 were assessed for anthropometry and fasting lipids, insulin, and blood pressure. There were significant distinctions in the associations between anthropometry and groups of cardiovascular risk factors. These distinctions differed by gender. Insulin resistance, triglycerides, C-reactive protein levels, low density lipoprotein (LDH)/high density lipoprotein (HDL) and total/HDL cholesterol ratios had the strongest association with waist, waist/height ratio and body mass index. By contrast, in boys, height was the strongest independent predictor (in a negative direction) of total and LDL-cholesterol. Blood pressure and uric acid was most strongly correlated with body weight and height (heavier and taller boys). Taller male adolescents had highest blood pressures and lowest cholesterol levels. No single adolescent anthropometric measure best predicted all cardiovascular risk factors. Each measure showed distinct relationships with specific groups of risk factors. Contrasting associations may reflect different pathogenesis by which gender, puberty, and adiposity affect metabolic risk. No single anthropometric measurement in childhood would appear to be superior or sufficient when investigating the developmental origins of cardiovascular health and related metabolic disease.
Plasma concentrations of retinol, carotene, and vitamin E and mortality in subjects with asbestosis in a cohort exposed to crocidolite in Wittenoom, Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2005
DOI: 10.1097/01.JOM.0000165750.54747.27
Abstract: We sought to examine the relationships between plasma concentrations of retinol, carotene, and vitamin E and mortality associated with asbestosis in people previously exposed to crocidolite. Cox regression modeling was applied to examine these relationships at the first measurement of each vitamin, at the measurement at each visit, and with the rate of change of each vitamin during the follow-up. There were 76 deaths of people with asbestosis during the follow-up period and 1885 subjects censored. Mortality in subjects with asbestosis was inversely related to plasma levels of retinol and Vitamin E concentrations and to their rate of increase during the follow-up. Carotene concentrations at first visit were associated with lower mortality but not during the follow up period. Chronically low levels of these vitamins are associated with an increased risk of dying with asbestosis.
Trends in the Diagnosis of Rett Syndrome in Australia
Publisher: Springer Science and Business Media LLC
Date: 09-2011
The influence of estrogen and progesterone receptors on survival in patients with carcinoma of the uterine cervix
Publisher: Elsevier BV
Date: 03-1986
DOI: 10.1016/0090-8258(86)90134-4
Abstract: The prognostic value of estrogen receptors (ER) and progesterone receptors (PR) was studied in 246 women with primary carcinoma of the uterine cervix. In addition to the receptor status information on tumor stage, histological type, age at operation, and menopausal status was recorded and analyzed. If the patient died the cause of death was ascertained. The median survival time for the 97 patients who died was 15 months and the survivors were followed for an average of 34 months. The survival curve was compared with an age, sex, and year of death matched West-Australian population. The survival curves for patients with ER+ or ER- and PR+ or PR- tumors were virtually indistinguishable. Overall survival in patients with cervical carcinoma is not influenced by the receptor status or the receptor concentration of the carcinoma.
Trends in mode of delivery during 1984-2003: Can they be explained by pregnancy and delivery complications?
Publisher: Wiley
Date: 07-2007
DOI: 10.1111/J.1471-0528.2007.01307.X
Abstract: To describe trends in mode of delivery, to identify significant factors which affected mode of delivery, and to describe how these factors and their impact have changed over time. Total population birth cohort. Western Australia 1984-2003. The analysis was restricted to all singleton infants delivered at 37-42 weeks of gestation with a cephalic presentation (n = 432,327). Logistic regression analyses were undertaken to estimate significant independent risk factors separately for elective and emergency caesarean sections compared with vaginal delivery (spontaneous and instrumental), adjusting for potential confounding variables. Trends in mode of delivery, demographic factors, and pregnancy and delivery complications. Estimated likelihood of elective caesarean section compared with vaginal delivery and emergency caesarean section compared with vaginal delivery. Between 1984-88 and 1999-2003, the likelihood of women having an elective caesarean section increased by a factor of 2.35 times (95% CI 2.28-2.42) and the likelihood of an emergency caesarean section increased 1.89 times (95% CI 1.83-1.96). These caesarean section rate increases remained even after adjustment for their strong associations with many sociodemographic factors, obstetric risk factors, and obstetric complications. Rates of caesarean section were higher in older mothers, especially those older than 40 years of age (elective caesarean section, OR 5.42 [95% CI 4.88-6.01] emergency caesarean section, OR 2.67 [95% CI 2.39-2.97]), and in nulliparous women (elective caesarean section, OR 1.54 [95% CI 1.47-1.61] emergency caesarean section, OR 3.61 [95% CI 3.47-3.76]). Our data show significant changes in mode of delivery in Western Australia from 1984-2003, with an increasing trend in both elective and emergency caesarean section rates that do not appear to be explained by increased risk or indication.
All‐cause mortality and cancer incidence among adults exposed to blue asbestos during childhood
Publisher: Wiley
Date: 09-08-2012
DOI: 10.1002/AJIM.22103
Abstract: There are few data on the long-term health outcomes of exposure to asbestos in childhood. This study investigated cancer and mortality of adults exposed to blue asbestos as children. Data linkage to relevant health registries was used to identify cancers and mortality in a cohort of adults (n = 2,460) that had lived in an asbestos mining town during their childhood (<15 years). There were 217 (93 female) incident cancers and 218 (70 female) deaths among the cohort. Compared with the Western Australian population females had elevated mesothelioma, ovarian and brain cancers, and increased "all cause" and "all cancer" mortality. Males had elevated mesothelioma, leukemia, prostate, brain, and colorectal cancers, and excess mortality from "all causes," "all cancers," circulatory disease, diseases of the nervous system, and accidents. Exposure to blue asbestos in childhood is associated with an increased risk of cancer and mortality in adults.
Onset of maternal psychiatric disorders after the birth of a child with autism spectrum disorder: A retrospective cohort study
Publisher: SAGE Publications
Date: 04-02-2015
Abstract: Mothers of a child with autism spectrum disorder have more psychiatric disorders after the birth of their child. This might be because they have more psychiatric disorders before the birth, or the increase could be related to the burden of caring for their child. We aimed to calculate the incidence of a psychiatric diagnosis in women with no psychiatric history after the birth of their eldest child with autism spectrum disorder compared to women with no child with autism spectrum disorder or intellectual disability and no psychiatric history. By linking datasets from Western Australian population-based registries, we calculated the incidence of a psychiatric disorder in mothers of children with autism spectrum disorder and compared to mothers of children with no autism spectrum disorder or intellectual disability. Negative binomial regression using STATA 13 was used for all analyses. Apart from alcohol and substance abuse, mothers of children with autism spectrum disorder had higher incidences of all categories of psychiatric disorders than other mothers. The increase of psychiatric disorders in mothers of children with autism spectrum disorder and no psychiatric history compared to similar mothers with no child with autism spectrum disorder or intellectual disability might be due to a pre-existing genetic disposition coupled with an environmental trigger provided by the challenges of raising their children with autism spectrum disorder. In addition, the increased burden borne by the mothers of children with autism spectrum disorder might result in a higher incidence of psychiatric disorders in mothers who are not genetically disposed.
Plenty of evidence on mandatory folate fortification
Publisher: Elsevier BV
Date: 02-2006
Infant mortality and family welfare: policy implications for Indonesia
Publisher: BMJ
Date: 07-2003
Abstract: To examine the effect of family welfare index (FWI) and maternal education on the probability of infant death. A population based multistage stratified clustered survey. Women of reproductive age in Indonesia between 1983-1997. The 1997 Indonesian Demographic and Health Survey. Infant mortality was associated with FWI and maternal education. Relative to families of high FWI, the risk of infant death was almost twice among families of low FWI (aOR=1.7, 95%CI=0.9 to 3.3), and three times for families of medium FWI (aOR=3.3,95%CI=1.7 to 6.5). Also, the risk of infant death was threefold higher (aOR=3.4, 95% CI=1.6 to 7.1) among mothers who had fewer than seven years of formal education compared with mothers with more than seven years of education. Fertility related indicators such as young maternal age, absence from contraception, birth intervals, and prenatal care, seem to exert significant effect on the increased probability of infant death. The increased probability of infant mortality attributable to family income inequality and low maternal education seems to work through pathways of material deprivation and chronic psychological stress that affect a person's health damaging behaviours. The policies that are likely to significantly reduce the family's socioeconomic inequality in infant mortality are implicated.
Demographic and clinical predictors of vitamin D status in pregnant women tested for deficiency in Western Australia
Publisher: Elsevier BV
Date: 10-2021
Confirmation of childhood acute lymphoblastic leukemia variants, ARID5B and IKZF1, and interaction with parental environmental exposures.
Publisher: Public Library of Science (PLoS)
Date: 13-10-2014
Mesothelin-family proteins and diagnosis of mesothelioma
Publisher: Elsevier BV
Date: 11-2003
Erratum: Plasma concentrations of retinol, carotene, and vitamin E and mortality in subjects with asbestosis in a cohort exposed to crocidolite in Wittenoom, Western Australia (Journal of Occupational and Environmental Medicine (June 2005) 47, 6 (573))
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2005
Parental prenatal smoking and risk of childhood acute lymphoblastic leukemia
Publisher: Oxford University Press (OUP)
Date: 05-12-2012
DOI: 10.1093/AJE/KWR275
Abstract: The association between parental smoking and risk of childhood acute lymphoblastic leukemia (ALL) was investigated in an Australian population-based case-control study that included 388 cases and 868 controls aged <15 years, recruited from 2003 to 2006. Both of the child's parents provided information about their smoking habits for each year from age 15 years to the child's birth. Data were analyzed by logistic regression. Maternal smoking was not associated with risk of childhood ALL, but the odds ratio for paternal smoking of ≥15 cigarettes per day around the time of the child's conception was 1.35 (95% confidence interval: 0.98, 1.86). The associations between parental smoking risk of childhood ALL did not differ substantially by immunophenotypic or cytogenetic subtype. Meta-analyses of paternal smoking, including results from the Australian Study of Causes of Acute Lymphoblastic Leukemia in Children and those of previous studies, produced summary odds ratios of 1.15 (95% confidence interval: 1.06, 1.24) for any paternal smoking around the time of the child's conception and 1.44 (95% confidence interval: 1.24, 1.68) for smoking ≥20 cigarettes per day at that time. Study results suggest that heavier paternal smoking around the time of conception is a risk factor for childhood ALL. Men should be strongly encouraged to cease smoking, particularly when planning to start a family.
Estimation of quantitative levels of diesel exhaust exposure and the health impact in the contemporary Australian mining industry
Publisher: BMJ
Date: 15-11-2017
DOI: 10.1136/OEMED-2016-103808
Abstract: To estimate quantitative levels of exposure to diesel exhaust expressed by elemental carbon (EC) in the contemporary mining industry and to describe the excess risk of lung cancer that may result from those levels. EC exposure has been monitored in Western Australian miners since 2003. Mixed-effects models were used to estimate EC levels for five surface and five underground occupation groups (as a fixed effect) and specific jobs within each group (as a random effect). Further fixed effects included s ling year and duration, and mineral mined. On the basis of published risk functions, we estimated excess lifetime risk of lung cancer mortality for several employment scenarios. Personal EC measurements (n=8614) were available for 146 different jobs at 124 mine sites. The mean estimated EC exposure level for surface occupations in 2011 was 14 µg/m EC exposure levels in the contemporary Australian mining industry are still substantial, particularly for underground workers. The estimated excess numbers of lung cancer deaths associated with these exposures support the need for implementation of stringent occupational exposure limits for diesel exhaust.
Silicosis compensation in Western Australian gold miners since the introduction of an occupational exposure standard for crystalline silica
Publisher: Oxford University Press (OUP)
Date: 11-2002
Abstract: Occupational exposure limits for crystalline silica are under review worldwide because of the large numbers of exposed people and, especially, because of the recent International Agency for Research on Cancer classification of silica as a human carcinogen. The aims of this study were to (i) re-examine the incidence of silicosis in Western Australian gold miners and, using estimates of the total population at risk, (ii) estimate the upper confidence limit for the risk of silicosis in Western Australian gold miners since 1974, when the current exposure standard for crystalline silica was implemented. Work histories of cases compensated for pneumoconiosis after 1974 were examined. Numbers of workers in the total workforce likely to be exposed to crystalline silica in Western Australia were estimated as the population at risk. There were no cases of compensated silicosis in Western Australian miners whose first dust exposure began during or after 1974. The upper 95% confidence interval for this zero rate was estimated to be 4.8 per 100,000 person-yr. There have been no compensated cases of silicosis in Western Australia among miners first exposed to crystalline silica after introduction of the current exposure standard. A rate of compensated silicosis higher than five cases per 100,000 person-yr is unlikely.
Correlation of lung function with ultra-low-dose CT-detected lung parenchymal abnormalities: a cohort study of 1344 asbestos exposed individuals
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJRESP-2022-001366
Abstract: Deliberate exposure to medical ionising radiation should be as low as reasonably practicable but the reduction of radiation from CT should be balanced against diagnostic image quality. The ability of ultra-low-dose CT (uLDCT: similar radiation to chest X-ray) to demonstrate low contrast abnormalities (emphysema and interstitial lung abnormality (ILA)) is unclear. The aim of this cross-sectional study was to analyse the lung parenchymal findings from uLDCT scans against physiological measures of respiratory function. WA Asbestos Review Programme participants were eligible if they had an uLDCT scan and lung function assessment between Janary and December 2018. All scans were performed using a single CT machine and reported using a standardised, semiquantitative synoptic report which includes emphysema and linear fibrosis (ILA) scores. Of 1344 participants, median (IQR) age was 72.0 (65.0–78.0) years, the majority were males (84.9%) with mixed occupational asbestos exposure (68.1%). There were 721 (53.6%) with no abnormality, 158 (11.8%) with emphysema, 465 (34.6%) with ILA. Mean radiation dose was 0.12 mSv. There was statistically significant between group differences for all physiological parameters of lung function compared with controls. For instance, the emphysema score significantly correlated with obstructive forced expiratory volume in 1 s (FEV 1 )/forced vital capacity ratio (r=0.512), per cent predicted FEV 1 (r=0.24) and lower diffusion of carbon monoxide (DLCO) (r=0.337). Multivariate modelling demonstrated that increasing age, emphysema and fibrosis scores predicted reduced DLCO (adjusted R 2 =0.30). uLDCT-detected parenchymal lung abnormalities correlate strongly with significant changes on lung function testing suggesting the observed CT abnormalities are of physiological and clinical significance.
Erratum: Parental occupational exposure to engine exhausts and childhood brain tumors. Int J Cancer. 2013 Jun 15;132(12):2975-9. doi: 10.1002/ijc.27972. Epub 2012 Dec 19.
Publisher: Wiley
Date: 15-07-2014
DOI: 10.1002/IJC.28977
Exposure to household paintyng and floor treatments, and parental occupational paint exposure and risk of childhood brain tumors: Results from an Australia case-control study
Publisher: Springer Science and Business Media LLC
Date: 12-12-2014
DOI: 10.1007/S10552-013-0330-X
Abstract: Childhood brain tumors (CBT) are the leading cause of cancer death in children, yet their etiology remains largely unknown. This study investigated whether household exposure to paints and floor treatments and parental occupational painting were associated with CBT risk in a population-based case-control study conducted between 2005 and 2010. Cases were identified through all ten Australian pediatric oncology centers, and controls via nationwide random-digit dialing, frequency matched to cases on age, sex, and state of residence. Data were obtained from parents in mailed questionnaires and telephone interviews. Information on domestic painting and floor treatments, and parental occupational exposure to paint, in key periods relating to the index pregnancy and childhood was obtained for 306 cases and 950 controls. Data were analyzed using unconditional logistic regression, adjusting for frequency matching variables and potential confounders. Overall, we found little evidence that parental, fetal, or childhood exposure to home painting or floor treatments was associated with risk of CBT. There was, though, some evidence of a positive association between childhood exposure to indoor painting and risk of high-grade glioma [odds ratio (OR) 3.31, 95 % confidence interval (CI) 1.29, 8.52] based on very small numbers. The OR for the association between CBT and paternal occupational exposure to paint any time before the pregnancy was 1.32 (95 % CI 0.90, 1.92), which is consistent with the results of other studies. Overall, we found little evidence of associations between household exposure to paint and the risk of CBT in any of the time periods investigated.
Optimal fetal growth for the Caucasian singleton and assessment of appropriateness of fetal growth: An analysis of a total population perinatal database
Publisher: Springer Science and Business Media LLC
Date: 24-05-2005
Higher ultraviolet radiation during early life is associated with lower risk of childhood type 1 diabetes among boys
Publisher: Springer Science and Business Media LLC
Date: 20-09-2021
DOI: 10.1038/S41598-021-97469-Z
Abstract: Population-level ecological studies show type 1 diabetes incidence is inversely correlated with ambient ultraviolet radiation (UVR) levels. We conducted a nested case–control study using administrative datasets to test this association at the in idual level. Cases ( n = 1819) were children born in Western Australia (WA) from 1980–2014, diagnosed with type 1 diabetes at ≤ 16 years. Controls ( n = 27,259) were randomly selected from all live births in WA, matched to cases by sex and date of birth. Total ambient erythemal ultraviolet radiation (UVR) doses for each trimester of pregnancy and first year of life were estimated for each in idual, using daily NASA satellite data that were date- and geographically-specific. Conditional logistic regression tested the association between UVR dose and case–control status. Type 1 diabetes risk was 42% lower in boys of mothers with third-trimester UVR dose in the highest (compared to the lowest) quartile (p = 0.04). Higher UVR in the first year of life was associated with lower type 1 diabetes risk among boys (p = 0.01). UVR dose was not associated with type 1 diabetes risk in girls. Higher UVR in late pregnancy and early life appear to interact with sex-specific factors to lower type 1 diabetes risk among boys in Western Australia.
A comparison of measures of access to child health clinics and the implications for modelling the location of new clinics
Publisher: Elsevier BV
Date: 04-1999
DOI: 10.1111/J.1467-842X.1999.TB01233.X
Abstract: To determine whether measurement of access to existing child health clinics, and modelled location of new clinics, was affected by the spatial definitions of the target population. Populations requiring childhood screening services were defined as located at in idual households, and at geographic and population-weighted centroids of small and large areas. Straight-line and network distances were measured and compared from these origins to varying numbers of existing clinics. The same origins were used to model sets of locations for new clinics, and access levels were again compared. Travel distances for 82,499 annual baby-visits to 140 existing clinics were between 136,000 km and 84,000 km, depending on origin definition. An analysis based on small area centroid data was as accurate as one based on household data. Planning solutions for new clinics located on the basis of few large areas, with populations centred at spatially defined centroids, resulted in poorer access for the population (231,000 km of travel) than one based on many small areas with populations centred at population weighted centroids (194,000 km of travel). Public access to health facilities will be improved if decisions about their locations are aided by the application of spatial analysis techniques based on small area definitions.
Interleukin-10/Interleukin-5 responses at birth predict risk for respiratory infections in children with atopic family history
Publisher: American Thoracic Society
Date: 02-2009
The effects of respiratory infections, atopy, and breastfeeding on childhood asthma
Publisher: European Respiratory Society (ERS)
Date: 05-2002
DOI: 10.1183/09031936.02.00103602
Abstract: The objectives of the present study were to quantify the association of atopy and respiratory infections with asthma, and exclusive breastfeeding with respiratory illness, atopy and asthma in children. A cohort study of 2,602 children enrolled prior to birth and followed prospectively, provided data on respiratory illness, the method of feeding in the first year of life, as reported on a prospective diary card, and current asthma at the age of 6 yrs (defined as doctor-diagnosed asthma with wheeze in the last year or cough without a cold, and currently taking either preventer or reliever asthma medication), as reported by parental questionnaire. Atopy was defined by a positive skin-prick test assessed at the age of 6 yrs. Wheezing lower respiratory illness (LRI) in the first year of life, particularly multiple episodes of wheezing LRI, increased the risk for current asthma in both nonatopic (odds ratio (OR) 4.10, p< or =0.0005) and atopic children (OR 9.00, p< or =0.0005), but did not increase the risk for atopy. In contrast, up to three upper respiratory tract infections demonstrated a negative association and four or more a positive risk for current asthma in unadjusted (p=0.006) and adjusted (p=0.057) analysis. Following adjustment, exclusive breastfeeding for <4 months was associated with an increased risk for current asthma (OR 1.36, 95% confidence interval 1.00-1.85, p=0.047). Wheezing lower respiratory illness in the first year of life and atopy are independently associated with increased risk for current asthma at the age of 6 yrs, suggesting that their effects are mediated via different causal pathways and that these risk factors are multiplicative when they operate concomitantly within in idual children. Exclusive breastfeeding protects against asthma via effects on both these pathways, as well as through other as yet undefined mechanisms.
Emergency department overcrowding and mortality after the introduction of the 4‐hour rule in Western Australia
Publisher: AMPCo
Date: 05-2012
DOI: 10.5694/MJA12.10548
Is potroom asthma due more to sulphur dioxide than fluoride? An inception cohort study in the Australian aluminium industry
Publisher: BMJ
Date: 26-08-2010
Abstract: Although an asthma-like syndrome has been recognised in aluminium smelter workers for over 70 years, the causal agent has been difficult to identify. An inception cohort study was conducted at two Australian aluminium smelters where 446 employees participated over a period of 9 years. Cumulative exposures between interviews were estimated from job histories using a task exposure matrix based on measurements in the smelters. Participants completed an MRC respiratory questionnaire, spirometry and methacholine challenge test. Data were analysed with generalised estimating equations to allow for repeated measurements of each participant. Wheeze and chest tightness, the two symptoms most closely related to asthma, showed associations with occupational exposures. SO(2) exposure was significantly associated with these symptoms, bronchial hyper-responsiveness (BHR) to methacholine (a feature of asthma), airflow limitation (reduced forced expiratory volume in 1 second/forced vital capacity ratio) and longitudinal decline in lung function. Fluoride exposure was associated with the same outcomes, but less strongly. Inhalable dust and the benzene soluble fraction (BSF) were associated with symptoms of asthma and BHR. Although many of the exposures were highly correlated, further modelling suggested that of the known respiratory irritants, SO(2) was more likely than fluoride to be primarily responsible for the symptoms observed. Fluoride, inhalable dust and SO(2) were the most important airborne contaminants associated with effects on lung function. The observed effects were detected at contaminant levels within occupational exposure standards, so further reductions are required, particularly in SO(2) exposures.
Soluble mesothelin-related protein - A blood test for mesothelioma
Publisher: Elsevier BV
Date: 07-2005
DOI: 10.1016/J.LUNGCAN.2005.03.020
Abstract: Identification of tumor marker for mesothelioma (MM) might prove useful in diagnosis as well as for monitoring tumor in response to therapy and for screening at-risk in iduals. We tested the hypothesis that soluble mesothelin-related protein (SMRP), a mesothelin family member, in the serum would be such a marker. Our data show that determination of SMRP in serum is a marker of MM with a sensitivity of sensitivity 83% and specificity 95% in the first 48 MM patients tested. Changes in serum SMRP levels parallel clinical course/tumor size and SMRP is elevated in 75% of patients at diagnosis. SMRP should also be useful for monitoring disease progression, and importantly, may prove useful for screening asbestos-exposed in iduals for early MM.
ASSESSMENT OF FOLATE STATUS
Publisher: Elsevier BV
Date: 11-1982
Commentary: Spearman's 'The proof and measurement of association between two things'
Publisher: Oxford University Press (OUP)
Date: 10-2010
DOI: 10.1093/IJE/DYQ200
Preventing falls in older people: Outcome evaluation of a randomized controlled trial
Publisher: Wiley
Date: 11-2001
DOI: 10.1046/J.1532-5415.2001.4911236.X
Abstract: To evaluate the outcome of an intervention to reduce hazards in the home on the rate of falls in seniors. Randomized controlled trial, with follow-up of subjects for 1 year. Community-based study in Perth, Western Australia. People age 70 and older. One thousand eight hundred seventy-nine subjects were recruited and randomly allocated by household to the intervention and control groups in the ratio 1:2. Because of early withdrawals, 1,737 subjects commenced the study. All members of both groups received a single home visit from a research nurse. Intervention subjects (n = 570) were offered a home hazard assessment, information on hazard reduction, and the installation of safety devices, whereas control subjects (n = 1,167) received no safety devices or information on home hazard reduction. Both groups recorded falls on a daily calendar. Reported falls were confirmed by a semistructured telephone interview and were assigned to one of three overlapping categories: all falls, falls inside the home, and falls involving environmental hazards in the home. Analysis was by multivariate modelling of rate ratios and odds ratios for falls, corrected for household clustering, using Poisson regression and logistic regression with robust variance estimation. Overall, 86% of study subjects completed the 1 year of follow-up. The intervention was not associated with any significant reduction in falls or fall-related injuries. There was no significant reduction in the intervention group in the incidence rate of falls involving environmental hazards inside the home (adjusted rate ratio, 1.11 95% CI = 0.82-1.50), or the proportion of the intervention group who fell because of hazards inside the home (adjusted odds ratio, 0.97 95% CI = 0.74-1.28). No reduction was seen in the rate of all falls (adjusted rate ratio, 1.02 95% CI = 0.83-1.27) or the rate of falls inside the home (adjusted rate ratio, 1.17 95% CI = 0.85-1.60). There was no significant reduction in the rate of injurious falls in intervention subjects (adjusted rate ratio, 0.92 95% CI = 0.73-1.14). The intervention failed to achieve a reduction in the occurrence of falls. This was most likely because the intervention strategies had a limited effect on the number of hazards in the homes of intervention subjects. The study provides evidence that a one-time intervention program of education, hazard assessment, and home modification to reduce fall hazards in the homes of healthy older people is not an effective strategy for the prevention of falls in seniors.
Gender-specific differences in adipose distribution and adipocytokines influence adolescent nonalcoholic fatty liver disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2011
DOI: 10.1002/HEP.24097
Abstract: Nonalcoholic fatty liver disease (NAFLD) is a predominantly adult-diagnosed disorder. Knowledge regarding the epidemiology, phenotype, and metabolic risk factors, during adolescence is limited. We sought to determine the prevalence, phenotype, and predictors of NAFLD in 1170 community-based adolescents in the Western Australian Pregnancy Cohort (Raine) Study (the Raine Cohort) who underwent a cross-sectional assessment that included questionnaires, anthropometry, cardiovascular examinations, blood tests, and abdominal ultrasound examinations. Among the 1170 adolescents assessed, the prevalence of NAFLD was 12.8%. Females compared with males had a significantly higher prevalence of NAFLD (16.3% versus 10.1%, P = 0.004) and central obesity (33.2% versus 9.9%, P < 0.05). The severity of hepatic steatosis was associated with the body mass index, waist circumference, subcutaneous adipose tissue thickness (SAT), serum leptin level, homeostasis model assessment for insulin resistance score (P < 0.001 for all), and serum alanine aminotransferase level (P < 0.005) in both genders, but it was associated with increasing visceral adipose tissue thickness (VAT P < 0.001) and decreasing serum adiponectin levels (P 0.05) however, in comparison with females with NAFLD, males with NAFLD had greater VAT, a more severe metabolic phenotype with higher glucose levels and systolic blood pressure and lower adiponectin and high-density lipoprotein cholesterol levels (P < 0.001 for all), and greater measures of liver injury (alanine aminotransferase and aspartate aminotransferase, P < 0.001 for all). Similarly, metabolic syndrome was more common in males than females with NAFLD (24% versus 8%, P = 0.01). Suprailiac skinfold thickness predicted NAFLD independently of the body mass index, insulin resistance, and VAT. Gender differences in adolescent NAFLD are related to differences in adipose distribution and adipocytokines. The male phenotype of NAFLD is associated with more adverse metabolic features and greater visceral adiposity than the female phenotype despite the lower prevalence of NAFLD.
Changes in risk factors for preterm birth in Western Australia 1984-2006
Publisher: Wiley
Date: 02-05-2013
Abstract: To characterise changing risk factors of preterm birth in Western Australia between 1984 and 2006. Population-based study. Western Australia. All non-Aboriginal women giving birth to live singleton infants between 1984 and 2006. Multinomial, multivariable regression models were used to assess antecedent profiles by preterm status and labour onset types (spontaneous, medically indicated, prelabour rupture of membranes [PROM]). Population attributable fraction (PAF) estimates characterized the contribution of in idual antecedents as well as the overall contribution of two antecedent groups: pre-existing medical conditions (including previous obstetric history) and pregnancy complications. Antecedent relationships with preterm birth, stratified by labour onset type. Marked increases in maternal age and primiparous births were observed. A four-fold increase in the rates of pre-existing medical complications over time was observed. Rates of pregnancy complications remained stable. Multinomial regression showed differences in antecedent profiles across labour onset types. PAF estimates indicated that 50% of medically indicated preterm deliveries could be eliminated after removing six antecedents from the population estimates for PROM and spontaneous preterm reduction were between 10 and 20%. Variables pertaining to previous and current obstetric complications (previous preterm birth, previous caesarean section, pre-ecl sia and antepartum haemorrhage) were the most influential predictors of preterm birth and adverse labour onset (PROM and medically indicated). Preterm antecedent profiles have changed markedly over the 23 years studied. Some changes may be attributable to true change, others to advances in surveillance and detection. Still others may signify change in clinical practice.
Influenza Vaccination and Stillbirth Prevention in High-Income Countries
Publisher: Oxford University Press (OUP)
Date: 09-03-2017
DOI: 10.1093/CID/CIX108
Familial aggregation of malignant mesothelioma in former workers and residents of Wittenoom, Western Australia
Publisher: Wiley
Date: 16-08-2012
DOI: 10.1002/IJC.27758
Abstract: Clustering of cases of malignant mesothelioma within families has often been observed, but disentangling genetic and exposure effects has not been done. Former workers and residents exposed to crocidolite at Wittenoom, Western Australia, where many families shared exposure to asbestos, have had high rates of mesothelioma. Our study aimed to estimate the additional risk of mesothelioma in relatives, after allowance for common exposure to crocidolite. More than 11,000 former asbestos workers and residents from Wittenoom have been followed up in cancer and death registries. Levels of exposure for all members of the Wittenoom cohorts have been estimated previously. Relationships between family members of all mesothelioma cases were established from questionnaires, birth and death certificates. Expected numbers of cases of mesothelioma were estimated by fitting a Weibull survival model to all data, based on time from first asbestos exposure, duration and intensity of exposure and age. For each family group, the earliest case was considered the index case. Predicted risk was estimated for each subject from the time of diagnosis of the index case. Familial risk ratios were estimated by iding observed cases by the sum of risks of all same degree relatives of index cases. There were 369 family groups with at least one case of mesothelioma and a further 25 cases of mesothelioma among relatives in the same families, with 12.9 expected. The risk ratio for blood relatives was 1.9 (95% confidence interval [CI] = 1.3-2.9, p = 0.002). These findings suggest an important, but not large, genetic component in mesothelioma, similar to many other cancers.
Investigating genotype-phenotype relationships in Rett syndrome using an international data set
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-03-2008
DOI: 10.1212/01.WNL.0000304752.50773.EC
Abstract: Rett syndrome is an uncommon neurodevelopmental disorder with an incidence of 1:9,000 live female births. The principal genetic cause was first reported in 1999 when the association with mutations in the methyl-CpG-binding protein 2 (or MECP2) gene was identified. This study uses data from a large international database, InterRett, to examine genotype-phenotype relationships and compares these with previous findings in a population-based cohort. The data set for these analyses was derived from a subset of InterRett cases with subject information collected from the family, the clinician, or both. In idual phenotypic characteristics and clinical severity using three scales were compared among those with eight known recurrent pathogenic MECP2 mutations as well as those with C-terminal deletions (n = 272). Overall, p.R270X and p.R255X were the most severe and p.R133C and p.R294X were the mildest mutations. Significant differences by mutation were seen for in idual phenotypic characteristics such as hand use, ambulation, and language. This multicenter investigation into the phenotypic correlates of MECP2 mutations in Rett syndrome has provided a greater depth of understanding than hitherto available about the specific phenotypic characteristics associated with commonly occurring mutations. Although the modifying influence of X inactivation on clinical severity could not be included in the analysis, the findings confirm clear genotype-phenotype relationships in Rett syndrome and show the benefits of collaboration crucial to effective research in rare disorders.
Age and sex differences in malignant mesothelioma after residential exposure to blue asbestos (crocidolite)
Publisher: Elsevier BV
Date: 02-2007
Abstract: Blue asbestos was mined and milled at Wittenoom, Western Australia, from 1943 until 1966. Various public records were used to establish a cohort of residents of the nearby township. Mine tailings were distributed throughout the town. To report the incident number of malignant mesotheliomas that have occurred in residents of the town who did not work at the mine or mill and to determine if female subjects are more susceptible to asbestos exposure than male subjects, and if children are more susceptible than adults. A total of 4,768 residents of the town of Wittenoom have been followed up in cancer and death registries. There were 67 cases of mesothelioma, and 64 deaths with mesothelioma to the end of 2002. The mortality rate with mesothelioma increased with increasing residence duration, time since first exposure, and estimated cumulative exposure. The mesothelioma mortality rate was consistently lower for female subjects when compared with male subjects, but the dose-response curve was steeper for female subjects. The rate was lower in those first exposed as children compared with those first exposed at > or = 15 years of age. The dose-response slope for asbestos exposure and mortality from mesothelioma was not different between those who were first exposed as children than those who were first exposed at > or = 15 years of age. Former residents of a crocidolite mining town have a high rate of mesothelioma. The rate is higher in male subjects and those > or = 15 years of age at first exposure, but women have a steeper dose-response curve.
Exposure to house painting and the use of floor treatments and the risk of childhood acute lymphoblastic leukemia
Publisher: Wiley
Date: 23-07-2011
DOI: 10.1002/IJC.25572
Abstract: Painting in the home has been identified as a potential risk factor for childhood acute lymphoblastic leukemia (ALL). The aim of this analysis was to investigate whether exposure to house painting or floor treatments before birth or during childhood increased the risk of childhood ALL. Data from 389 cases and 876 frequency‐matched controls were analyzed using unconditional logistic regression, adjusting for study matching variables and potential confounders. Overall, there was little evidence of an increased risk with painting inside the house in the year before the pregnancy, during the pregnancy, or after the child's birth however, the risk appeared to be increased in certain circumstances. The odds ratio (OR) for more than three rooms being painted during pregnancy was 1.68 [95% confidence interval (CI) 1.01, 2.80]. The OR for someone other than the parents painting inside the house in the year before the pregnancy was 2.37 (95% CI 1.30, 4.30) and 3.07 (95% CI 1.46, 6.46) when more than three rooms were painted. The OR for the mother painting the outside of the house with oil‐based paint in the year before the pregnancy was 2.97 (95% CI 1.06, 8.33). No association was found with having floor treatments in any time period. We found some evidence of an increased risk of ALL associated with house painting. An apparently increased risk associated with someone other than the parents painting inside the house may be related to the amount of paint used and the intensity of the dose received.
Prediction modelling using routine clinical parameters to stratify survival in Malignant Pleural Mesothelioma patients undergoing cytoreductive surgery
Publisher: Elsevier BV
Date: 02-2019
DOI: 10.1016/J.JTHO.2018.10.005
Abstract: Malignant pleural mesothelioma (MPM) is an uncommon cancer with a poor prognosis and heterogeneous survival. Surgery for MPM is offered in some specialist centers to highly selected patients. A previously described classification and regression tree (CART) model stratified survival in unselected MPM patients using routinely collected clinical data. This study aimed to examine the performance of this CART model on a highly selected surgical population. Data were collected from subjects undergoing cytoreductive surgery for MPM from specialist centers in Hyõgo, Japan, and Sydney, Australia, between 1991 and 2016. The CART model was applied using the combination of clinical variables to stratify subjects into risk groups (1 through 4) survival characteristics were then compared. Two hundred eighty-nine cases were included (205 from Australia, 84 from Japan). Overall median survival was 34.6 (interquartile range: 17.5-56.1) months median age was 63.0 (interquartile range: 57.0-67.8) years, and 83.0% (n = 240) were male. There were no clinically meaningful differences between the two cohorts. Survival across the four risk groups was significantly different (p 153 g/L and serum albumin > 43 g/L at time of referral to the surgical center. Using routinely available clinical variables, the CART model was able to stratify surgical patients into risk groups with statistically different survival characteristics with fair to good performance. Presence of weight loss, anemia, and low albumin should confer caution when considering surgical therapy for MPM.
Reduction in disparity for pneumonia hospitalisations between Australian Indigenous and non-Indigenous children
Publisher: BMJ
Date: 22-01-2012
Abstract: In the 1990s pneumonia hospitalisation rates in Western Australia (WA) were 13 times higher in Indigenous children than in non-Indigenous children. Rates of invasive pneumococcal disease in Indigenous children declined following the introduction in 2001 of 7-valent pneumococcal conjugate vaccine (7vPCV) in a 2-4-6 month schedule with an 18-month pneumococcal polysaccharide booster (PPV). We investigated population trends for pneumonia hospitalisations between 1996 and 2005. Population-based retrospective data linkage cohort study of singleton live births from 1996-2005. Hospitalisations for acute lower respiratory infections in Indigenous and non-Indigenous children less than 5 years of age were extracted and trends in age-specific incidence rates were examined using log-linear modelling. From 245 249 births (7.1% Indigenous), there were 7727 pneumonia episodes. Between 1996 and 2000 and 2001 and 2005 all-cause pneumonia hospitalisations fell by 28-44% in Indigenous children aged 6-35 months with no equivalent decline in non-Indigenous children or for other acute lower respiratory infections. Incidence rate ratios for pneumonia comparing Indigenous with non-Indigenous children aged 6-11 months fell from 14.6 (95% CI 12.3 to 17.2) in 1996-2000 to 9.9 (8.4 to 11.6) in 2001-2005. Log-linear modelling showed a steady decline in Indigenous children of 9%/annum (5-12%) at age 12-23 months for all-cause pneumonia and 37%/annum (20-50%) at age 6-11 months for pneumococcal pneumonia from 1996 to 2005, including the years prior to introduction of pneumococcal vaccines. Pneumonia hospitalisations and the disparity between Indigenous and non-Indigenous children has declined by a third. The unique Australian pneumococcal vaccine programme is likely to have had a significant effect but changes in socioeconomic factors have also contributed to the declines.
Effectiveness of pneumococcal conjugate vaccine against hospital admissions for pneumonia in Australian children
Publisher: Elsevier BV
Date: 10-2019
Longitudinal analysis of respiratory outcomes among bauxite exposed workers in western Australia
Publisher: Wiley
Date: 15-06-2015
DOI: 10.1002/AJIM.22492
Abstract: Occupational exposure to bauxite is common in the aluminium industry but little is known about the associated health effects. This study investigates respiratory health in relation to respirable bauxite dust exposure longitudinally over a 13 year period. An inception cohort study recruited 91 male bauxite miners and 363 male alumina refinery workers. Annual measurements of respiratory symptoms and lung function were made. Cumulative exposure to bauxite was derived from job histories and air monitoring data. Mixed-effects modeling was used. No associations were found between cumulative bauxite exposure and respiratory symptoms or lung function. However, when analysis was restricted to the first three rounds, FEV1 was significantly lower in all exposure groups than in those unexposed but with no significant trend. Increasing exposure to bauxite dust in the aluminum industry was not associated with respiratory symptoms or consistent decrements in lung function.
Seasonal trivalent influenza vaccination during pregnancy and the incidence of stillbirth: Population-based retrospective cohort study
Publisher: Oxford University Press (OUP)
Date: 30-03-2016
DOI: 10.1093/CID/CIW082
Abstract: Although antenatal influenza vaccination is an important public health intervention for preventing serious infection in pregnant women and newborns, reported vaccine coverage is often <50%. Concern for the safety to the fetus is a commonly cited reason for vaccine hesitancy and refusal. The incidence of stillbirth following pandemic vaccination has been previously studied however, no population-based study has evaluated the incidence of stillbirth following seasonal trivalent influenza vaccination. We used probabilistic linking of perinatal and maternal vaccination records to establish a cohort of 58 008 births occurring between April 2012 and December 2013. Stillbirth was defined as birth ≥20 weeks' gestation with an Apgar score of zero at 1 and 5 minutes following delivery. Cox regression models adjusted for maternal smoking, Indigenous status, and propensity for vaccination were used to calculate adjusted hazard ratios (aHRs) in vaccinated and unvaccinated mothers. A total of 5076 (8.8%) pregnant women received trivalent influenza vaccine and 377 stillbirths occurred. There were 5.0 and 3.0 stillbirths per 100 000 pregnancy-days among unvaccinated and vaccinated women, respectively. After adjustment, stillbirth was 51% less likely among vaccinated vs unvaccinated mothers (aHR, 0.49 95% confidence interval [CI], .29-.84). The largest relative reduction in stillbirths was observed for births occurring just after influenza season (aHR, 0.33 95% CI, .12-.88). Mothers who received seasonal TIV during pregnancy were significantly less likely to experience stillbirth compared with unvaccinated mothers. These results support the safety of seasonal influenza immunization during pregnancy and suggest a protective effect.
Curtin industrial safety trial: Managerial behavior and program effectiveness
Publisher: Elsevier BV
Date: 12-1996
Changes in caesarean delivery rates in Western Australia from 1995 to 2010 by gestational age at birth
Publisher: Wiley
Date: 25-06-2015
DOI: 10.1111/PPE.12202
Abstract: The caesarean delivery rate in the developed world has been increasing. It is not well understood how caesarean delivery rates have changed by gestational age at birth in Western Australia, particularly in relation to the introduction of the early-term delivery guidelines in Australia in 2006. Data from the Western Australian Midwives Notification System were used to identify 193,136 singletons born to primiparous women at 34-42 weeks' gestation during 1995-2010. Caesarean delivery rates were calculated by gestational age group (34-36 weeks, 37-38 weeks, and 39-42 weeks) and stratified into pre-labour and in-labour caesarean delivery. The average annual percent change (AAPC) for the caesarean delivery rates was calculated using joinpoint regression. Log-binomial regression was used to estimate the risk of having a caesarean delivery while adjusting for maternal and antenatal factors. Caesarean delivery rates rose steadily from 1995 to 2005 (AAPC = 5.9%, [95% confidence interval (CI) 4.9, 6.9]), but stabilised since then (AAPC = 0.9%, [95% CI -1.9, 3.8]). The rate of in-labour caesarean deliveries rose consistently from 1995 to 2010 across all gestational age groups. The pre-labour caesarean delivery rate rise was most dominant at 37-38 weeks' gestation from 1995 to 2005 (AAPC = 6.8%, [95% CI 5.4, 8.2]), but declined during 2006-10 (AAPC = -4.5, [95% CI -6.7, -2.3]), while at the same time the rate at 39-42 weeks rose slightly. The rise in pre-labour caesarean deliveries during 1995-2005 occurred predominantly at 37-38 weeks' gestation, but declined again from 2006 to 2010. This suggests that the recently developed Australian early-term delivery guidelines may have had some success in reducing early-term deliveries in Western Australia.
Diagnosis of Autism Spectrum Disorder According to Maternal-Race Ethnicity and Country of Birth: A Register-Based Study
Publisher: Springer Science and Business Media LLC
Date: 23-05-2019
DOI: 10.1007/S10803-019-04068-Z
Abstract: An increased prevalence of autism spectrum disorder (ASD) among children of immigrant backgrounds has been observed but clinical profiles are rarely compared. Diagnostic data from children with ASD notified to the Western Australian Register for Autism Spectrum Disorders were analysed according to maternal-race ethnicity and country of birth. A total of 4776 children aged between 0 and 18 years diagnosed with ASD from 1999 to 2017 were included. Those born to immigrant mothers from lower income countries were younger at the time of diagnosis, had an increased risk of intellectual disability and poorer presentations in the social and communication domains. Further work is required to understand environmental influences that may affect children born to immigrant mothers and to improve monitoring and assessments.
Breast feeding and respiratory morbidity in infancy: a birth cohort study
Publisher: BMJ
Date: 03-2003
DOI: 10.1136/ADC.88.3.224
Abstract: To examine the relation between the duration of breast feeding and morbidity as a result of respiratory illness and infection in the first year of life. Prospective birth cohort study of 2602 live born children ascertained through antenatal clinics at the major tertiary obstetric hospital in Perth, Western Australia. Main outcome measures were hospital, doctor, or clinic visits, and hospital admissions for respiratory illness and infection in the first year of life. Main exposure measures were the duration of predominant breast feeding (defined as the age other milk was introduced) and partial (any) breast feeding (defined as the age breast feeding was stopped). Main confounders were gender, gestational age less than 37 weeks, smoking in pregnancy, older siblings, maternal education, and maternal age. Hospital, doctor, or clinic visits for four or more upper respiratory tract infections were significantly greater if predominant breast feeding was stopped before 2 months or partial breast feeding was stopped before 6 months. Predominant breast feeding for less than six months was associated with an increased risk for two or more hospital, doctor, or clinic visits and hospital admission for wheezing lower respiratory illness. Breast feeding for less than eight months was associated with a significantly increased risk for two or more hospital, doctor, or clinic visits or hospital admissions because of wheezing lower respiratory illnesses. Predominant breast feeding for at least six months and partial breast feeding for up to one year may reduce the prevalence and subsequent morbidity of respiratory illness and infection in infancy.
Gene Expression Levels in Small Specimens From Patients Detected Using Oligonucleotide Arrays
Publisher: Springer Science and Business Media LLC
Date: 2005
DOI: 10.1385/MB:29:1:31
Population based ascertainment of twins and their siblings, born in Western Australia 1980 to 1992, through the construction and validation of a maternally linked database of siblings
Publisher: Cambridge University Press (CUP)
Date: 10-2002
Can linked emergency department data help assess the out-of-hospital burden of acute lower respiratory infections? A population-based cohort study
Publisher: Springer Science and Business Media LLC
Date: 28-08-2012
Occurrence and management of acute respiratory illnesses in early childhood
Publisher: Wiley
Date: 16-02-2007
DOI: 10.1111/J.1440-1754.2007.01033.X
Abstract: Acute respiratory illnesses (ARI) impose massive economic burden on health services. The growing costs, limited benefits of pharmacotherapeutic agents, and alarming rise in antibiotic resistance poses a major health challenge. Analysis of the nature and burden of ARI through well-designed epidemiologic studies will help in the development of a uniform public health approach to identify methods to reduce disease transmission and maximise prevention strategies. The aim of this study was to analyse the nature and magnitude of the burden of ARI encountered by a cohort of children in the first 5 years of life. This community-based prospective study of ARI followed a cohort of children from birth until 5 years of age. Information on all episodes of ARI encountered, and their management, was collected through daily symptom diary and fortnightly telephone calls. Four episodes of ARI/year were reported in the first 2 years and 2-3 episodes/year between 2 and 5 years. The majority were upper respiratory infections. 53% had at least one lower respiratory infection in the first year. For the majority, symptoms lasted 1-2 weeks. 53% were treated with antitussives or cough mixtures, 44% with paracetamol and 23% with antibiotics. A total of 46% of the episodes presented to a family physician, with younger children and those with lower respiratory infection more likely to seek attention. ARI are common in childhood and although symptoms may last for 4 weeks, the majority resolve spontaneously. Use of medication does not appear to significantly alter the course or duration of symptoms of ARI.
A Novel Clinical Prediction Model for Prognosis in Malignant Pleural Mesothelioma Using Decision Tree Analysis
Publisher: Elsevier BV
Date: 04-2016
DOI: 10.1016/J.JTHO.2015.12.108
Abstract: Malignant pleural mesothelioma (MPM) is a rare cancer with a heterogeneous prognosis. Prognostic models are not widely utilized clinically. Classification and regression tree (CART) analysis examines the interaction of multiple variables with a given outcome. Between 2005 and 2014, all cases with pathologically confirmed MPM had routinely available histological, clinical, and laboratory characteristics recorded. Classification and regression tree analysis was performed using 29 variables with 18-month survival as the dependent variable. Risk groups were refined according to survival and clinical characteristics. The model was then tested on an external international cohort. A total of 482 cases were included in the derivation cohort the median survival was 12.6 months, and the median age was 69 years. The model defined four risk groups with clear survival differences (p < 0.0001). The strongest predictive variable was the presence of weight loss. The group with the best survival at 18 months (86.7% alive, median survival 34.0 months, termed risk group 1) had no weight loss, a hemoglobin level greater than 153 g/L, and a serum albumin level greater than 43 g/L. The group with the worst survival (0% alive, median survival 7.5 months, termed risk group 4d) had weight loss, a performance score of 0 or 1, and sarcomatoid histological characteristics. The C-statistic for the model was 0.761, and the sensitivity was 94.5%. Validation on 174 external cases confirmed the model's ability to discriminate between risk groups in an alternative data set with fair performance (C-statistic 0.68). We have developed and validated a simple, clinically relevant model to reliably discriminate patients at high and lower risk of death using routinely available variables from the time of diagnosis in unselected populations of patients with MPM.
No dose-dependent increase in fracture risk after long-term exposure to high doses of retinol or beta-carotene
Publisher: Springer Science and Business Media LLC
Date: 18-09-2012
DOI: 10.1007/S00198-012-2131-6
Abstract: Uncertainty remains over whether or not high intakes of retinol or vitamin A consumed through food or supplements may increase fracture risk. This intervention study found no increase in fracture risk among 2,322 adults who took a controlled, high-dose retinol supplement (25,000 IU retinyl palmitate/day) for as long as 16 years. There was some evidence that beta-carotene supplementation decreased fracture risk in men. There is conflicting epidemiological evidence regarding high intakes of dietary or supplemental retinol and an increased risk for bone fracture. We examined fracture risk in a study administering high doses of retinol and beta-carotene (BC) between 1990 and 2007. The Vitamin A Program was designed to test the efficacy of retinol and BC supplements in preventing malignancies in persons previously exposed to blue asbestos. Participants were initially randomised to 7.5 mg retinol equivalents (RE)/day as retinyl palmitate, 30 mg/day BC or 0.75 mg/day BC from 1990 to 1996 after which, all participants received 7.5 mg RE/day. Fractures were identified by questionnaire and hospital admission data up until 2006. Risk of any fracture or osteoporotic fracture according to cumulative dose of retinol and BC supplementation was examined using conditional logistic regression models adjusting for age, sex, smoking, body mass index, medication use and previous fracture. Supplementation periods ranged from 1 to 16 years. Of the 2,322 (664 females and 1,658 males) participants, 187 experienced 237 fractures. No associations were observed between cumulative dose of retinol and risk for any fracture (OR per 10 g RE=0.83 95% CI, 0.63-1.08) or osteoporotic fracture (OR per 10 g RE=0.95 95% CI 0.64-1.40). Among men, cumulative dose of BC was associated with a slightly reduced risk of any fracture (OR per 10 g=0.89 95% CI 0.81-0.98) and osteoporotic fracture (OR per 10 g=0.84 95% CI 0.72-0.97). This study observed no increases in fracture risk after long-term supplementation with high doses of retinol and/or beta-carotene.
The association between Staphylococcus aureus and subsequent bronchiectasis in children with cystic fibrosis
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.JCF.2017.12.002
Abstract: Staphylococcus aureus (S. aureus) may be related to more rapid progression of cystic fibrosis (CF) lung disease. In the AREST CF cohort study, children diagnosed with CF undergo annual bronchoscopies with bronchoalveolar lavage and ultra-low-dose, chest computed tomography (CT) up to 6-years-old. Spirometry was assessed 3-monthly from the age of 4years. Associations between de novo S. aureus acquisition before school age and CT and lung function at ages 5-7years were investigated. Models were adjusted for multiple markers of disease severity at baseline. De novo S. aureus acquisition at 3-years-old (n/N=12/122) was associated with increased bronchiectasis score at age 5-6years. This association decreased but remained significant after adjustment for confounders. S. aureus at 3 was associated with significantly reduced FEF De novo S. aureus acquisition at age 3 is associated with later bronchiectasis and FEF
Altered glucose metabolism in childhood pre-B acute lymphoblastic leukaemia
Publisher: Springer Science and Business Media LLC
Date: 31-08-2006
Abstract: The cells of solid tumours are known to have an altered metabolism, with high rates of glucose uptake and glycolysis, which results in the excessive production of lactate. To date there has been no definitive research documenting metabolic changes in acute lymphoblastic leukaemia (ALL) cells. In order to investigate whether ALL cells have an altered metabolism, we initially compared the transcriptional profiles of 22 specimens from paediatric patients diagnosed with ALL to five CD34+ specimens isolated from bone marrow, which was verified in an independent cohort of 101 specimens. Profiling revealed the upregulation of genes facilitating glycolysis in the ALL specimens compared to the CD34+ specimens, while those involved in the tricarboxylic acid cycle were downregulated. Functional studies supported the microarray findings threefold: (1) higher expression of the glucose transport protein glucose transporter 1 in ALL compared to CD34+ specimens, (2) the excessive production of lactate in ALL cell lines and (3) sensitivity of ALL cell lines to the glycolysis inhibitor 2-deoxy-D-glucose. While metabolic alterations have been well documented in solid tumours, this is the first study to provide direct evidence for the existence of metabolic changes in the leukaemic cells of ALL patients. The finding offers new options for targeted therapy for ALL patients.
The creatine kinase ratio: A useful means of detecting early peaking of the creatine kinase curve after acute myocardial infarction
Publisher: Elsevier BV
Date: 11-1988
DOI: 10.1016/0002-9149(88)90902-2
Abstract: In the title compound, [Mn(C(8)H(4)NO(6))(2)(C(18)H(11)N(5))(2)], the Mn(II) atom is six-coordinated by two N,N'-bidentate 6-(pyridin-4-yl)-5H-cyclo-penta-[f][1,10]phenanthroline (pcp) ligands and two carboxyl-ate O atoms from two monodentate 3-carb-oxy-5-nitro-benzoate anions in a distorted cis-MnO(2)N(4) octa-hedral arrangement. Within the pcp ligands, the dihedral angles between the polycyclic skeletons and pendant pyridine rings are 6.2 (2) and 8.3 (2)°. In the crystal, mol-ecules are linked by O-H⋯N and N-H⋯O hydrogen bonds. Several aromatic π-π stacking inter-actions [shortest centroid-centroid separation = 3.516 (3) Å] are also observed.
Response to letter by Farioli et al
Publisher: BMJ
Date: 30-03-2019
Soluble Mesothelin Related Protein in Mesothelioma
Publisher: Elsevier BV
Date: 02-2006
High IFN-γ production by CD8+ T cells and early sensitization among infants at high risk of atopy
Publisher: Elsevier BV
Date: 04-2004
How many doses make a difference? An analysis of secondary prevention of rheumatic fever and rheumatic heart disease
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 18-12-2018
Abstract: Acute rheumatic fever ( ARF ) and rheumatic heart disease cause substantial burdens worldwide. Long‐term antibiotic secondary prophylaxis is used to prevent disease progression, but evidence for benefits of different adherence levels is limited. Using data from northern Australia, we identified factors associated with adherence, and the association between adherence and ARF recurrence, progression to rheumatic heart disease, worsening or improvement of rheumatic heart disease, and mortality. Factors associated with adherence (percent of doses administered) were analyzed using logistic regression. Nested case–control and case–crossover designs were used to investigate associations with clinical outcomes conditional logistic regression was used to estimate odds ratios ( OR ) with 95% CIs Adherence estimates (7728) were analyzed. Being female, younger, having more‐severe disease, and living remotely were associated with higher adherence. Alcohol misuse was associated with lower adherence. The risk of ARF recurrence did not decrease until ≈40% of doses had been administered. Receiving % was associated with a 4‐fold increase in the odds of ARF recurrence (case–control OR : 4.00 [95% CI : 1.7–9.29], case–crossover OR : 3.31 [95% CI : 1.09–10.07]) and appeared to be associated with increased all‐cause mortality (case–control OR : 1.90 [95% CI : 0.89–4.06] case–crossover OR 1.91 [95% CI : 0.51–7.12]). We show for the first time that increased adherence to penicillin prophylaxis is associated with reduced ARF recurrence, and a likely reduction in mortality, in our setting. These findings can motivate patients to receive doses since even relatively low adherence can be beneficial, and additional doses further reduce adverse clinical outcomes.
Dietary patterns and surgically treated benign prostatic hyperplasia: A case control study in Western Australia
Publisher: Wiley
Date: 04-2008
Time trends in prevalence of cervical cytological abnormality in women attending a sexually transmitted diseases clinic and their relationship to trends in sexual activity and specific infections
Publisher: Springer Science and Business Media LLC
Date: 10-1986
DOI: 10.1038/BJC.1986.225
Abstract: Trends in prevalence of cytological evidence of cervical intraepithelial neoplasia (CIN) and cervical infection with human papilloma virus (HPV), as indicated by HPV infection and dyskeratosis, were studied in 2,992 new attenders at a sexually transmitted diseases (STD) clinic between 1978 and 1982. Crude prevalence of CIN increased from 1.3% to 4.3% (P less than 0.001) and crude prevalence of HPV infection increased from 2.8% to 9.3% (P less than 0.001). Age adjustment had little effect on these trends. Review, in 1984-85, of s les of smears taken in 1978 and 1982 showed that recognition of koilocytosis by the laboratory had increased substantially over time while a tendency had developed to downgrade nuclear changes in the presence of koilocytosis. Correction of the 1978 and 1982 smear results to the 1984-85 classifications suggested that prevalence of koilocytosis had increased little (from 13.4% to 16.1%, P = 0.20) while there had been a substantial real increase in CIN (0.8% to 2.4%, P less than 0.001). To try to explain the trend in CIN, other characteristics of a s le of attenders at the STD clinic were studied. There were no appreciable trends in prevalence of past STD, number of sexual partners in the last 3 months, method of contraception, genital warts and culture of N. gonorrhoea, T. vaginalis, C. albicans and Chlamydia sp. from the vagina. There was an increase in the proportions in socioeconomic group I, as classified by postcode of residence (17.0% to 26.9%, P = 0.04), referred as contacts rather than with symptoms (24.0% to 41.6%, P less than 0.001), with a clinical diagnosis of genital herpes (5.0% to 8.6%, P = 0.08) and with herpes virus cultured from the cervix (2.1% to 6.3%, P = 0.03). The trend in prevalence of herpes virus infection was not explained by the other trends. It may explain the trend in prevalence of CIN.
Early respiratory infection is associated with reduced spirometry in children with cystic fibrosis
Publisher: American Thoracic Society
Date: 15-11-2014
Incidence of NUT carcinoma in Western Australia from 1989 to 2014: a review of pediatric and adolescent cases from Perth Children’s Hospital
Publisher: Springer Science and Business Media LLC
Date: 27-06-2021
DOI: 10.1186/S12885-021-08432-0
Abstract: NUT carcinoma (NC), previously known as NUT midline carcinoma, is a rare and very aggressive cancer that occurs in both children and adults. NC is largely chemoresistant, with an overall survival of less than 7 months. Because the carcinoma is not restricted to a particular organ, diagnosis is often a challenge. In the absence of a clearly determined incidence for NC, we sought to study the diagnosis of patients in a well-defined population. We systematically reviewed records of all patients that presented to the Oncology Department of the Princess Margaret Hospital for Children from 1989 to 2014. This institution in the geographically isolated state of Western Australia has a catchment population of around 2 million. We then identified all high grade undifferentiated sarcomas or carcinomas in the 0–16 year age group. Over 26 years, we found 14 patients of 16 years or younger with undifferentiated malignant tumors. Of these, five tumors were positive by immunohistochemistry for the NUT/NUTM1 (Nuclear Protein in Testis) protein and/or the translocation t(15 ). Three patients presented with thoracic tumors, one with a para-spinal tumor, and one had an upper airway nasopharyngeal carcinoma. In all five cases, there was an initial response to therapy and then progression. This 26-year survey was conducted in a geographically isolated state with a well-defined population, and we determined an estimated incidence of NC of around 0.41 per million child years (0–16 yrs. of age) at risk. From three patients it was feasible to derive cell lines for further genetic analyses and drug screening. For the first time, the incidence of NC could be determined in a well-defined geographic area. The calculated rate of NC incidence is consistent with a history of under-recognition for this malignancy. These findings indicate that improved diagnostic detection of NC would enable better management and counselling of patients. Our findings emphasize the heterogeneity of NC, and they highlight the need to develop personalised therapy options, and to consider a diagnosis of NC in undifferentiated malignant tumors.
Genotype and early development in Rett syndrome : the value of international data
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.BRAINDEV.2005.03.023
Abstract: Rett syndrome is a neurodevelopmental disorder mostly affecting females and caused by mutations in the MECP2 gene. Originally the syndrome was characterised as having a normal prenatal and perinatal period with later regression. Previous work has speculated that the girl with Rett syndrome may not be normal at birth. to examine whether early development between birth and ten months varies by genotype in Rett syndrome. cases were sourced from two databases, the Australian Rett Syndrome Database (est. 1993) and the newly formed InterRett - IRSA Rett Phenotype Database. Data available on 320 cases included information provided by parents on perinatal problems, early developmental behaviour and mobility. Problem scores, mobility scores and a total composite score for each mutation were generated and compared. overall, 58% of respondents noted unusual behaviour during the first six months and 70.6% from the period between 6 and 10 months of life. Statistically significant differences were detected between some of the common mutations. Infants with R294X (P=0.05) and R133C (P=0.03) were less likely than those with R255X to have problems in the perinatal period. The most severe profile overall for early development was associated with mutations R255X and R270X. This is the largest study to date examining the effects of in idual mutations in Rett syndrome. With the ongoing case ascertainment and expansion of InterRett, s le size will increase rapidly and provide improved statistical power for future analyses. Results from this study will contribute to understanding the mechanism of early development in Rett syndrome and determining if and at which time(s) early intervention might be feasible.
Prediction models for the development of COPD: a systematic review
Publisher: Informa UK Limited
Date: 06-2018
DOI: 10.2147/COPD.S155675
School performance in children with type 1 diabetes: a contemporary population-based study
Publisher: Hindawi Limited
Date: 25-11-2014
DOI: 10.1111/PEDI.12243
Abstract: Our aim was to examine the school performance of children with type 1 diabetes in comparison to their peers, exploring changes over time, and the impact of clinical factors on school performance. The study included data on 666 children with type 1 diabetes from the Western Australia Children's Diabetes Database. (WACDD), a population-based registry, and 3260 school and school year matched non-diabetic children. Records from the National Assessment Program - Literacy and Numeracy (NAPLAN) (2008-2011), which examines four educational outcome domains and is administered annually to all years 3, 5, 7, and 9 children in Australia, were sourced for both groups. Clinical data were obtained for the children with diabetes from the WACDD. No significant difference was observed between those with type 1 diabetes and their peers, across any of the tested domains and school years analysed. No decline over time was observed, and no decline following diagnosis was observed. Type 1 diabetes was associated with decreased school attendance, 3% fewer days attended per year. Poorer glycaemic control [higher haemoglobin A1c (HbA1c)] was associated with a lower test score [0.2-0.3 SD per 1% (10.9 mmol/mol) increase in HbA1c], and with poorer attendance [1.8% decrease per 1% (10.9 mmol/mol) increase in HbA1c]. No association was observed with history of severe hypoglycaemia, diabetic ketoacidosis or age of onset and school test scores. These results suggest that type 1 diabetes is not associated with a significant decrement in school performance, as assessed by NAPLAN. The association of poorer glycaemic control with poorer school performance serves as further evidence for clinicians to focus on improving glycaemic control.
Cross-sectional study of population-specific streptococcal antibody titres in Uganda
Publisher: BMJ
Date: 29-06-2020
DOI: 10.1136/ARCHDISCHILD-2020-318859
Abstract: Despite substantial variation of streptococcal antibody titres among global populations, there is no data on normal values in sub-Saharan Africa. The objective of this study was to establish normal values for antistreptolysin O (ASO) and antideoxyribonuclease B (ADB) antibodies in Uganda. This was an observational cross-sectional study. This study was conducted at Mulago National Referral Hospital, which is located in the capital city, K ala, and includes the Uganda Heart Institute. Participants (aged 0–50 years) were recruited. Of 428 participants, 22 were excluded from analysis, and 183 (44.4%) of the remaining were children aged 5–15 years. ASO was measured in-country by nephelometric technique. ADB s les were sent to Australia (PathWest) for analysis by enzyme inhibition assay: 80% upper limit values were established. The median ASO titre in this age group was 220 IU/mL, with the 80th percentile value of 389 IU/mL. The median ADB titre in this age group was 375 IU/mL, with the 80th percentile value of 568 IU/mL. The estimated Ugandan paediatric population standardised 80% upper-limit-of-normal ASO and ADB titres is higher than many global populations. Appropriateness of using population-specific antibody cutoffs is yet to be determined and has important implications for the sensitivity and specificity of rheumatic fever diagnosis.
Mortality and cancer incidence in workers in two Australian prebake aluminium smelters
Publisher: BMJ
Date: 12-02-2009
Abstract: Exposures in the aluminium production industry have been declining and this study aimed to investigate cancer and mortality in two Australian prebake aluminium smelters. The cohort included 4396 males who had worked in a prebake smelter for at least 3 months. They were matched against the National Death Index and the National Cancer Statistics Clearing House to obtain cause of death and type of cancer. Standardised Mortality Ratios (SMRs) and Standardised Incidence Ratios (SIRs) were calculated for the whole cohort, for production or maintenance work categories and for duration of employment categories. The SMRs for all causes, circulatory, respiratory and injury deaths were at or below expected. Mesothelioma was the only significantly increased cause of death (SMR 3.52, 95% CI 1.47 to 8.46). Death from prostate cancer in production workers was elevated (SMR 2.39, 95% CI 1.29 to 4.44) and in those who had worked for more than 20 years in production or maintenance jobs (SMR 3.67, 95% CI 1.53 to 8.81). There were statistically significant excesses of incident stomach cancer, mesothelioma, and kidney cancer cases, while the SIR for melanoma was significantly reduced. There was no significant trend for duration of exposure for any type of incident cancer. This study found no overall excess of mortality or cancer, but incident mesothelioma and kidney cancer risks were elevated. The lack of excess risk for lung or bladder cancer or deaths from respiratory disease may be related to the different level and pattern of exposure between Søderberg and prebake smelters.
Parental occupational exposure to engine exhausts and childhood brain tumors
Publisher: Wiley
Date: 19-12-2013
DOI: 10.1002/IJC.27972
Abstract: Childhood brain tumors (CBT) are the leading cause of cancer death in children their risk factors are still largely unknown. Since most CBTs are diagnosed before five years of age, prenatal exposure and early postnatal factors may be involved in their etiology. We investigated the association between CBT and parental occupational exposure to engine exhausts in an Australian population-based case-control study. Parents of 306 cases and 950 controls completed detailed occupational histories. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for both maternal and paternal exposure in key time periods. Increased risks were observed for maternal exposure to diesel exhaust any time before the child's birth (OR 2.03, 95% CI 1.09-3.81) and paternal exposure around the time of the child's conception (OR 1.62, 95% CI 1.12-2.34). No clear associations with other engine exhausts were found. Our results suggest that parental occupational exposure to diesel exhaust may increase the risk of CBT.
MicroRNA Signatures in Malignant Pleural Mesothelioma Effusions
Publisher: Hindawi Limited
Date: 31-07-2019
DOI: 10.1155/2019/8628612
Abstract: Malignant pleural mesothelioma (MPM) is an incurable cancer of the pleura that can be difficult to diagnose. Biomarkers for an easier and/or earlier diagnosis are needed. Approximately 90% of MPM patients develop a pleural effusion (PE). PEs are ideal sources of biomarkers as the fluid would almost always require drainage for diagnostic and/or therapeutic reasons. However, differentiating MPM PE from PE caused by other diseases can be challenging. MicroRNAs are popular biomarkers given their stable expression in tissue and fluid. MicroRNAs have been analysed in PE cytology s les for the diagnosis of MPM but have not been measured in frozen/fresh PE. We hypothesise that microRNAs expressed in PE are biomarkers for MPM. TaqMan OpenArray was used to analyse over 700 microRNAs in PE cells and supernatants from 26 MPMs and 21 other PE-causing diseases. In PE cells, combining miR-143, miR-210, and miR-200c could differentiate MPM with an area under the curve (AUC) of 0.92. The three-microRNA signature could also discriminate MPM from a further 40 adenocarcinomas with an AUC of 0.9887. These results suggest that the expression of miR-143, miR-210, and miR-200c in PE cells might provide a signature for diagnosing MPM.
Risk factors for increased urinary inorganic arsenic concentrations from low arsenic concentrations in drinking water.
Publisher: Informa UK Limited
Date: 09-2003
The additional risk of malignant mesothelioma in former workers and residents of Wittenoom with benign pleural disease or asbestosis
Publisher: BMJ
Date: 10-2005
Silica, compensated silicosis, and lung cancer in Western Australian goldminers
Publisher: BMJ
Date: 04-1998
DOI: 10.1136/OEM.55.4.243
Abstract: Silica has recently been reclassified as carcinogenic to humans based largely on the observed increase in rates of lung cancer in subjects with silicosis. Other recent reviews have arrived at different conclusions as to whether silicosis or silica itself is carcinogenic. This study aims to examine exposure-response relations between exposure to silica and subsequent silicosis and lung cancer in a cohort of goldminers. 2,297 goldminers from Kalgoorlie in Western Australia were examined in 1961, 1974, and 1975. Data were collected on respiratory symptoms, smoking habits, and employment history. Subjects were followed up to the end of 1993. Survival analyses for lung cancer mortality and incidence of compensated silicosis were performed with age and year matched conditional logistic regression analyses. 89% of the cohort were traced to the end of 1993. 84% of the men had smoked at some time and 66% were current smokers. 1386 deaths occurred during the follow up period, 138 from lung cancer, and 631 subjects were compensated for silicosis. A strong effect of smoking on mortality from lung cancer, and a smaller effect on the incidence of compensated silicosis was found. There was a strong effect of duration and intensity of exposure on the incidence of silicosis. The risk of mortality from lung cancer increased after compensation for silicosis. Of all direct measures of exposure to silica, only log cumulative exposure was significantly related to incidence of lung cancer, but this effect disappeared once the onset of silicosis was taken into account. The incidence of silicosis was clearly related to exposure to silica and the onset of silicosis conferred a significant increase in risk for subsequent lung cancer, but there was no evidence that exposure to silica caused lung cancer in the absence of silicosis.
Detection of hemizygous deletions in genomic DNA from leukaemia specimens for the diagnosis of patients
Publisher: Elsevier BV
Date: 02-2005
DOI: 10.1016/J.LEUKRES.2004.05.021
Abstract: Hemizygous deletions in genomic DNA appear to play an important role in tumorigenesis. The loss or inactivation of tumour suppressor genes (TSGs) is of critical importance in most malignancies, and has been shown to affect response to therapy. Here, we report a quantitative real-time polymerase chain reaction (qPCR) designed to detect two TSGs at the CDKN2A locus, p16(INK4A) and p14(ARF) that allows the detection of hemizygous deletions. Testing by qPCR of 18 bone marrow specimens from paediatric acute lymphoblastic leukaemia (ALL) patients at diagnosis revealed nine to be GG, six to be GD and three to be DD for exon 2 of p14(ARF) 16(INK4A), concordant with Southern blotting analysis. A panel of 13 ALL cell lines was investigated for deletions at the CDKN2A locus and one of the lines, typed as GD for all exons, was further assessed by fluorescence in situ hybridisation, confirming the qPCR findings. The expression levels of p16(INK4A) and p14(ARF) were measured in all cell lines and these quantitative reverse transcriptase PCR results also agreed with the typing by qPCR. The qPCR method described is suitable for detection of hemizygous loss in primary patient material and the accuracy of the method was verified by three independent techniques.
Fruit, vegetable, vitamin A intakes, and prostate cancer risk
Publisher: Springer Science and Business Media LLC
Date: 22-05-2008
Abstract: Prostate cancer risk was examined in relation to intakes of fruit, vegetables, beta-carotene and retinol. Subjects were a cohort of 1985 men previously to asbestos who participated in a cancer prevention programme of beta-carotene and retinol supplements that commenced in July 1990. Diet was assessed at entry to the programme. Ninety-seven cases of prostate cancer were identified during follow-up until the end of 2004. A decreased prostate cancer risk was observed with increasing intakes of vitamin C-rich vegetables, including bell peppers and broccoli. Fruit, other vegetables and vitamin A intakes did not appear to be strong factors in the development of prostate cancer in this study.
Clinical and demographic risk factors associated with mortality during early adulthood in a population‐based cohort of childhood‐onset Type 1 diabetes
Publisher: Wiley
Date: 16-07-2014
DOI: 10.1111/DME.12522
Abstract: To calculate standardized mortality ratios and to assess the association between paediatric clinical factors and higher risk of mortality during early adulthood in a population-based cohort of subjects with Type 1 diabetes. Subjects with Type 1 diabetes were identified through the Western Australian Children's Diabetes Database and clinical data for those who reached 18 years of age (n = 1309) were extracted. An age- and sex-matched (without diabetes) comparison cohort (n = 6451) was obtained from the birth registry. Mortality records were obtained from the death registry. Participants were followed up until 31 January 2012. Associations of clinical factors (from clinic visits before 18 years of age) with mortality were assessed using Cox proportional hazard models. The standardized mortality ratio for all-cause mortality was 1.7 (95% CI 0.7-3.3) for male and 10.1 (95% CI 5.2-17.7) for female subjects with Type 1 diabetes (median age at end of study 25.6 years). The adjusted hazard ratio was 1.5 (95% CI 1.1-2.1) for a 1% increase in mean paediatric HbA1c level, 3.8 (95% CI 0.9-15.3) for four episodes of severe hypoglycaemia relative to zero episodes, and 6.21 (95% CI 1.4-28.4) for a low-level socio-economic background relative to a high-level background. People with childhood-onset Type 1 diabetes have higher mortality rates in early adulthood. At particularly high risk are women, those with a history of poor HbA1c levels, those with recurrent severe hypoglycaemia during paediatric management, and those from a low socio-economic background. These groups may benefit from intensified management during transition from paediatric to adult care facilities.
Associations between interpregnancy interval and preterm birth by previous preterm birth status in four high‐income countries: a cohort study
Publisher: Wiley
Date: 14-12-2020
Abstract: To investigate the effect of interpregnancy interval (IPI) on preterm birth (PTB) according to whether the previous birth was preterm or term. Cohort study. USA (California), Australia, Finland, Norway (1980–2017). Women who gave birth to first and second ( n = 3 213 855) singleton livebirths. Odds ratios (ORs) for PTB according to IPIs were modelled using logistic regression with prognostic score stratification for potential confounders. Within‐site ORs were pooled by random effects meta‐analysis. PTB (gestational age weeks). Absolute risk of PTB for each IPI was 3–6% after a previous term birth and 17–22% after previous PTB. ORs for PTB differed between previous term and preterm births in all countries ( P‐for‐interaction ≤ 0.001). For women with a previous term birth, pooled ORs were increased for IPI months (OR 1.50, 95% CI 1.43–1.58) 6–11 months (OR 1.10, 95% CI 1.04–1.16) 24–59 months (OR 1.16, 95% CI 1.13–1.18) and ≥ 60 months (OR 1.72, 95%CI 1.60–1.86), compared with 18–23 months. For previous PTB, ORs were increased for months (OR 1.30, 95% CI 1.18–1.42) and ≥60 months (OR 1.29, 95% CI 1.17–1.42), but were less than ORs among women with a previous term birth ( P 0.05). Associations between IPI and PTB are modified by whether or not the previous pregnancy was preterm. ORs for short and long IPIs were higher among women with a previous term birth than a previous PTB, which for short IPI is consistent with the maternal depletion hypothesis. Given the high risk of recurrence and assuming a causal association between IPI and PTB, IPI remains a potentially modifiable risk factor for women with previous PTB. Short versus long interpregnancy intervals associated with higher ORs for preterm birth (PTB) after a previous PTB.
Aetiology of stillbirth: unexplored is not unexplained
Publisher: Elsevier BV
Date: 10-2007
DOI: 10.1111/J.1753-6405.2007.00116.X
Abstract: To describe the rate of and demographic factors associated with fetal postmortem investigation and to classify the cause of all fetal deaths that underwent postmortem investigation. To compare the proportion of deaths remaining unexplained after postmortem investigation with estimates derived from death certificates. All fetal deaths in Western Australia (WA) from 1990 to 1999 were identified. These data were used to calculate postmortem rates and describe the characteristics of women consenting to postmortems. A multidisciplinary team classified the cause of all deaths that underwent postmortem investigation using the Perinatal Society of Australia and New Zealand Perinatal Death Classification System. The proportion of deaths that were unexplained was compared with estimates based on death certificates. Of the 1,619 fetal deaths recorded for 1990 to 1999, 49% (n=789) underwent complete postmortem investigation. Based on investigations, 22% of the 789 fetal deaths were unexplained and a further 18% were identified as having fetal growth restriction. Based on death certificates, 42% were unexplained and 65% were later explained by postmortem investigation. Postmortem investigation rates are low. They reveal a cause of death for the majority of cases that are unexplained clinically. Epidemiological investigations of unexplained fetal death based on cases not subject to complete postmortem investigation may lead to inaccurate conclusions. A standardised definition for unexplained fetal deaths that distinguishes between cases with detailed investigation and those with limited or no investigation is needed.
Lifecourse Childhood Adiposity Trajectories Associated With Adolescent Insulin Resistance
Publisher: American Diabetes Association
Date: 21-03-2011
DOI: 10.2337/DC10-1809
Abstract: In light of the obesity epidemic, we aimed to characterize novel childhood adiposity trajectories from birth to age 14 years and to determine their relation to adolescent insulin resistance. A total of 1,197 Australian children with cardiovascular/metabolic profiling at age 14 years were studied serially from birth to age 14 years. Semiparametric mixture modeling was applied to anthropometric data over eight time points to generate adiposity trajectories of z scores (weight-for-height and BMI). Fasting insulin and homeostasis model assessment of insulin resistance (HOMA-IR) were compared at age 14 years between adiposity trajectories. Seven adiposity trajectories were identified. Three (two rising and one chronic high adiposity) trajectories comprised 32% of the population and were associated with significantly higher fasting insulin and HOMA-IR compared with a reference trajectory group (with longitudinal adiposity z scores of approximately zero). There was a significant sex by trajectory group interaction (P & 0.001). Girls within a rising trajectory from low to moderate adiposity did not show increased insulin resistance. Maternal obesity, excessive weight gain during pregnancy, and gestational diabetes were more prevalent in the chronic high adiposity trajectory. A range of childhood adiposity trajectories exist. The greatest insulin resistance at age 14 years is seen in those with increasing trajectories regardless of birth weight and in high birth weight infants whose adiposity remains high. Public health professionals should urgently target both excessive weight gain in early childhood across all birth weights and maternal obesity and excessive weight gain during pregnancy.
Fetal growth and the risk of childhood CNS tumors and lymphomas in Western Australia
Publisher: Wiley
Date: 15-04-2008
DOI: 10.1002/IJC.23486
Abstract: The etiology of childhood cancers is largely unknown, although the early age at diagnosis has led to particular interest in in utero and perinatal factors. Birth weight is the most frequently studied perinatal factor in relation to risk of childhood cancers, and results have been inconsistent. We investigated whether the risk of CNS tumors and lymphomas in children was associated with three measures of the appropriateness of intra-uterine growth: proportion of optimal birth weight (POBW), birth length (POBL) and weight for length (POWFL). A cohort of 576,633 infants born in Western Australia in 1980-2004 were followed from birth to diagnosis of a CNS tumor (n = 183) or lymphoma (n = 84) before age 15, death, or December 31, 2005, and analyzed with Cox regression. Overall, there was little evidence of any association between fetal growth and risk of CNS tumors, although risk of ependymoma/choroid plexus tumors was positively associated with POBL and negatively associated with POWFL. The risk of Hodgkin and Burkitt lymphoma increased with increasing fetal growth among boys only, whereas the increased risk observed with non-Hodgkin lymphoma was only in girls. These associations between fetal growth and disease risk were also observed among children not classified as high birth weight, suggesting that accelerated growth is more important than birth weight per se. Results were similar when cases were compared with their unaffected siblings, suggesting that the increased growth associated with cancer risk was not general to the family. The associations we observed are consistent with causal pathways involving fetal growth factors.
Rett syndrome in Australia: A review of the epidemiology
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.JPEDS.2005.10.037
Abstract: To examine the prevalence, cumulative incidence, and survival in an Australian cohort with Rett syndrome (RTT). The Australian Rett Syndrome Database is a longitudinal data collection that included 276 verified female cases at the end of 2004. Survival was calculated using the Kaplan-Meier product limit method, and cumulative incidence was determined using the complement of the Kaplan-Meier method. Most cases (88.4%) have had MECP2 mutation testing, with positive results in 73%. The prevalence of RTT was .88 per 10,000 females in 5- to 18-year-olds, and the cumulative incidence was 1.09 per 10,000 females by 12 years of age. The cumulative incidence by the age of 5 years increased from .39 per 10,000 in the 1980 to 1984 cohort to .76 per 10,000 in birth cohorts beyond 1984. Survival was 77.8% at 25 years, compared with 99.96% survival in the Australian female population. Pneumonia (10/25) was the most common cause of death. The availability of genetic testing has contributed to the changing pattern and timing of RTT diagnosis in Australia. Girls with RTT have worse survival compared with the general female population. When more data are available, it will be possible to evaluate the relationship between survival and specific MECP2 mutations.
Re-evaluation of link between interpregnancy interval and adverse birth outcomes: retrospective cohort study matching two intervals per mother
Publisher: BMJ
Date: 23-07-2014
DOI: 10.1136/BMJ.G4333
Non-specific benefit of seasonal influenza vaccine on respiratory syncytial virus-hospitalisations in children
Publisher: Elsevier BV
Date: 07-2023
Maternal asthma, infant feeding, and the risk of asthma in childhood
Publisher: Elsevier BV
Date: 07-2002
Abstract: Controversy surrounds the issue of whether children with asthmatic mothers should be breast-fed. The aim of this study was to investigate whether maternal asthma status alters the association between asthma and breast-feeding. In a cohort study of 2602 West Australian children enrolled before birth and followed prospectively, we collected data on method of infant feeding, maternal asthma (as reported by parental questionnaire), atopy (as measured by skin prick test), and current asthma (defined as a physician's diagnosis of asthma and wheeze in the last year) at 6 years of age. The risk of childhood asthma increased if exclusive breast-feeding was stopped (other milk was introduced) before 4 months (odds ratio, 1.28 95% CI, 1.01-1.62 P =.038), and this risk was not altered by atopy or maternal asthma status. After adjusting for covariates, exclusive breast-feeding for less than 4 months was a significant risk factor for current asthma (odds ratio, 1.35 95% CI, 1.00-1.82 P =.049). There was no formal statistical interaction between breast-feeding and maternal asthma status (P =.970). In this study maternal asthma status did not modify the association between asthma and breast-feeding duration. We recommend that infants with or without a maternal history of asthma be exclusively breast-fed for 4 months and beyond.
Hazards of residential exposure to household asbestos
Publisher: Elsevier BV
Date: 11-2017
Assessment of Early Bronchiectasis in Young Children With Cystic Fibrosis Is Dependent on Lung Volume
Publisher: Elsevier BV
Date: 10-2013
Abstract: The aim of this study was to determine whether assessment of early CT scan-detected bronchiectasis in young children with cystic fibrosis (CF) depends on lung volume. This study, approved by the hospital ethics committee, included 40 young children with CF from a newborn screened population contributing paired volume-controlled inspiratory and expiratory volumetric chest CT scans acquired under general anesthesia while clinically stable. Bronchiectasis was assessed with a semiquantitative CT scan score in inspiration and expiration, and the sensitivity of the expiratory CT scan to detect bronchiectasis was compared with the inspiratory CT scan by sensitivity and intraclass correlation coefficient analysis and Bland-Altman plots. Matched inspiratory and expiratory airway-vessel measurements were obtained in a subset of 10 children, and the relationship between lung volume and airway:vessel ratio after adjusting for age and vessel size was examined with the use of a linear regression model with generalized estimating equations. The number of visible airways in inspiration and expiration was compared in all 40 children by Wilcoxon signed rank test. Expiratory scans had poor sensitivity (0.46) to detect bronchiectasis, underestimating disease extent (P .001). Airway:vessel ratios were consistently higher in inspiration, independent of age and vessel size (P .001), with significantly more airways visible in inspiration than in expiration, independent of age (median, 71 vs 28, respectively P .001). In young children with CF, radiologic assessment of early bronchiectasis with chest CT scan depends on lung volume thus, expiratory scans may not be appropriate for evaluating bronchiectasis in this population. Lung volume during CT image acquisition should be standardized to evaluate airway dimensions in young children.
Plasma micronutrient levels and telomere length in children
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.NUT.2014.08.005
Abstract: Telomeres are long hexamer (TTAGGG) repeats at the ends of chromosomes, and contribute to maintenance of chromosomal stability. Telomere shortening has been linked to cancers and other chronic diseases in adults, although evidence for causal associations is limited. The aim of this study was to determine whether nutritional factors are associated with telomere length (TL) in children. We conducted a cross-sectional study of nutritional factors and TL in 437 children between 2009 and 2011. Healthy children ages 3, 6, and 9 y provided blood s les, and their parents completed a food frequency questionnaire and a telephone interview about relevant environmental exposures. TL and blood micronutrient levels were measured, and genotyping at 10 loci was undertaken. Associations between the micronutrients and other variables were assessed using linear regression. No significant main or interactive effects of age or sex were seen. After adjustment for age, sex, parental education, and month of blood collection, TL was inversely associated with plasma zinc, and shorter in children with the homozygous mutant genotype of the RFC G80A (rs1051266) polymorphism. To the best of our knowledge, this is the first investigation of the association between telomere length and micronutrients in healthy children. The reason for the inverse relationship of TL with zinc is unknown but could be the result of an increase in telomere sequence deletions caused by labile zinc induction of oxidative stress. These findings should be corroborated in other studies before nutritional recommendations might be considered.
Low dose CT detected interstitial lung abnormalities in a population with low asbestos exposure
Publisher: Wiley
Date: 03-05-2021
DOI: 10.1002/AJIM.23251
Abstract: The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT‐detected interstitial lung abnormalities (ILA). The Asbestos Review Program offers annual LDCT, health assessments, and pulmonary function tests to an asbestos‐exposed cohort. Asbestosis was defined using the Helsinki Consensus statement and the presence of ILA defined using a protocol for occupational CT reports. At least two of three pulmonary function tests: forced expiratory volume in 1 s (FEV 1 ) forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLco) were required for analysis of physiological decline. From 1513 cases, radiological ILA was present in 485 (32%). The cohort was 83.5% male with a median age of 68.3 years and a median (IQR) asbestos exposure of 0.7 (0.09–2.32) fiber/ml‐year. A mixed occupation, mixed asbestos fiber cohort comprised the majority of the cohort (65.8%). Of those with ILA, 40 (8.2%) had an FVC decline of ≥10% and 30 (6.2%) had a DLco decline of ≥15% per year. Time since first exposure, increasing tobacco exposure and reported dyspnea were independently associated with the presence of ILA. In this population with relatively low asbestos exposure, LDCT‐detected ILA that fits criteria for asbestosis is common, but physiological decline is not. This mild chronic stable phenotype of asbestos‐associated ILA contrasts with the traditionally accepted views that asbestosis requires high exposures.
Perinatal risk factors associated with skin infection hospitalisation in Western Australian Aboriginal and Non-Aboriginal children
Publisher: Wiley
Date: 09-2019
DOI: 10.1111/PPE.12573
Abstract: Hospitalisation with skin infection in Western Australian (WA) Aboriginal children is common, with the highest rates in infants and children from remote WA. We aimed to quantify infant, maternal, and sociodemographic risk factors for skin infection hospitalisation in WA children, focussing on Aboriginal children aged <17 years. We conducted a retrospective population-based cohort study with linked perinatal and hospitalisation data on WA-born children (1996-2012), of whom 31 348 (6.7%) were Aboriginal. We used Cox regression to calculate adjusted hazard ratios and associated population attributable fractions (PAFs) for perinatal factors attributed to first hospitalisation with skin infection. To identify specific risk factors for early-onset infection, we further restricted the cohort to infants aged <1 year. Overall, 5439 (17.4%) Aboriginal and 6750 (1.5%) non-Aboriginal children were hospitalised at least once with a skin infection. Aboriginal infants aged <1 year had the highest skin infection hospitalisation rate (63.2 per 1000 child-years). The strongest risk factors in Aboriginal children aged <17 years were socio-economic disadvantage, very remote location at birth, and multi-parity (≥3 previous pregnancies) accounting for 24%, 23%, and 15% of skin infection hospitalisations, respectively. Other risk factors included maternal age <20 years, maternal smoking during pregnancy, and low birthweight. We have quantified the relative influence of perinatal risk factors associated with skin infection hospitalisations in WA children, providing measures indicating which factors have the potential to reduce the most hospitalisations. Our evidence not only supports existing calls for substantial government investment in addressing underlying social and environmental barriers to healthy skin in WA Aboriginal children but also identifies potential areas to target health promotion messaging at in iduals/families on maternal smoking during pregnancy and skin hygiene for families.
Follow‐up phone calls increase nutrient intake estimated by three‐day food diaries in 13‐year‐old participants of the Raine study
Publisher: Wiley
Date: 06-08-2007
Are preterm birth and intra-uterine growth restriction more common in Western Australian children of immigrant backgrounds? A population based data linkage study
Publisher: Springer Science and Business Media LLC
Date: 09-08-2019
Agreement between a brief food frequency questionnaire and diet records using two statistical methods
Publisher: Cambridge University Press (CUP)
Date: 04-2001
DOI: 10.1079/PHN200062
Abstract: To compare intra- and inter-method reliability of a semi-quantitative food frequency questionnaire (FFQ) designed specifically to measure beta carotene (BC) and retinol intake, using two methods – the limits of agreement (LOA) and the correlation coefficient. A cross-sectional study of dietary intake. A randomized trial of vitamin A supplements in 2769 subjects with past asbestos exposure. Data from 57 men and 26 women, aged 28–72 years, living in Western Australia. The FFQ was administered at baseline (FFQ1) and repeated 1 year later (FFQ2). Four 1-week diet records (DRs) were completed during the year. Mean agreement between FFQ2 and FFQ1 was 120% for BC and 98% for retinol. LOA were 47–306% and 21–459%, respectively. Mean agreement between FFQ2 and the DR was 149% for BC and 63% for retinol LOA were 50–447% and 11–349%, respectively. Mean agreement and LOA varied across energy intakes. Between the DR and FFQ2, correlation coefficients were 0.36 for BC and 0.51 for retinol. These varied considerably across age, gender and energy intakes and were not in accordance with limits of agreement findings. Although correlation coefficients were positive and significant, there was less than ideal intra-method and inter-method reliability shown by the limits of agreement method. Bias was uneven across the range of intakes, the LOA were wide and, compared with the DR, the FFQ significantly over-estimated BC and under-estimated retinol. This shows the limitations of calculating correlation coefficients alone, for assessing reliability and validity.
Changing Prevalence of Lower Airway Infections in Young Children with Cystic Fibrosis
Publisher: American Thoracic Society
Date: 09-2019
nm23-H1 metastasis suppressor gene expression in primary breast cancer: associations with axillary lymph node status, tumour size, type and grade
Publisher: Elsevier BV
Date: 12-1993
Plasma versus serum levels of osteopontin and mesothelin in patients with malignant mesothelioma—Which is best?
Publisher: Elsevier BV
Date: 10-2011
DOI: 10.1016/J.LUNGCAN.2011.02.007
Abstract: Blood-based markers for malignant mesothelioma (MM), particularly soluble mesothelin and osteopontin, are currently of great clinical interest. As there is some concern about the sensitivity of osteopontin in serum versus plasma, we compared them in the same patient population to mesothelin. Soluble mesothelin and osteopontin concentrations were determined by commercial assays in blood s les from 66 patients with pleural MM, 47 patients with non-malignant asbestos-related lung or pleural disease, 42 patients with other benign pleural and lung diseases and 21 patients with lung cancer. Soluble mesothelin and osteopontin in serum and plasma were significantly elevated in MM patients compared to patients with benign lung and pleural disease. At a level of specificity of 95% relative to patients with benign disease, the sensitivity of mesothelin in serum and plasma at presentation with symptoms was 67%, and for osteopontin in the plasma was 40% and in the serum was 20% for MM patients. Combining the serum mesothelin and plasma osteopontin markers using a logistic regression model did not significantly increase the area under the receiver operator curve. Plasma osteopontin has a superior diagnostic accuracy to serum. As the choice of blood s le type has limit effect on soluble mesothelin sensitivity, plasma should be collected for biomarker evaluation in patients suspected of having mesothelioma.
Ratio of omega-6 to omega-3 fatty acids and childhood asthma.
Publisher: Informa UK Limited
Date: 2004
Abstract: Asthma is a leading cause of morbidity for children and is a major public health problem in Australia. Ecological and temporal data suggest that dietary factors may have a role in recent increases in the prevalence of asthma. The aim of conducting this study was to investigate whether childhood asthma was associated with the ratio of omega 6 (n-6) to omega 3 (n-3) fatty acids in the diet (n-6:n-3). The Western Australian Pregnancy Cohort Study is a prospective birth cohort of 2602 children. Using a nested case-control cross-sectional study design within this cohort, a group of children were identified as cases with current asthma at 6 or at 8 years of age or as controls with no asthma at 6 or at 8 years. Dietary details including n-6 and n-3 fatty acid intake data were collected by parent response to a questionnaire when the children were 8 years old. Logistical regression was used to compare quartiles of n-6:n-3 intake in cases and controls. Adjustment was made for covariates: gender, gestational age, breastfeeding, older siblings, maternal smoking during pregnancy, maternal age, maternal asthma, child's current age in months, body mass index, total energy intake, and antioxidant intake (vitamins A, C, E, and zinc). A response rate of 83% was achieved by providing complete data from 335 children [49% cases with current asthma (n = 166), 51% controls (n = 169)]. Following adjustment for covariates the association between the ratio of n-6:n-3 fatty acids and risk for current asthma was statistically significant (p = 0.022). We found evidence for a modulatory effect of the dietary n-6:n-3 fatty acid ratio on the presence of asthma in children. Our results provide evidence that promotion of a diet with increased n-3 fatty acids and reduced n-6 fatty acids to protect children against symptoms of asthma is warranted.
The common BDNF polymorphism may be a modifier of disease severity in Rett syndrome
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-04-2009
Ultraviolet radiation exposure and serum vitamin D levels in young children
Publisher: Wiley
Date: 18-06-2014
DOI: 10.1111/JPC.12657
Abstract: Health benefits of adequate vitamin D levels in the blood include better bone health and a reduced incidence of a range of chronic diseases and infections. Ultraviolet (UV) radiation exposure from the sun is the main source of vitamin D however, such exposure, especially from a young age, is also a potential risk factor for skin cancer. The current study examined the association of UV exposure with vitamin D production in young children to determine the period of weekly exposure prior to blood testing that affected serum 25-hydroxyvitamin D (25(OH)D) levels. Between 2009 and 2011, healthy children aged 3, 6 and 9 years were recruited from the community for a cross-sectional study of nutritional factors and DNA damage. Parents of 464 children provided information on the children's average weekly sun exposure and level of sun protection during each of the 16 weeks before blood s le collection by a domiciliary phlebotomist. Serum 25(OH)D levels were best predicted from UV exposure during the week before blood collection for s les drawn in autumn, summer or spring. For s les drawn in winter, serum 25(OH)D levels were best predicted by UV exposure during the 2 weeks before blood collection. Consistent weekly sun exposure may be beneficial for young children, especially in winter, to maintain healthy vitamin D levels in the blood. However, confirmation of these results is needed before their public health significance can be fully evaluated.
Establishing a process for conducting cross-jurisdictional record linkage in Australia
Publisher: Elsevier BV
Date: 04-2016
Abstract: To describe the realities of conducting a cross-jurisdictional data linkage project involving state and Australian Government-based data collections to inform future national data linkage programs of work. We outline the processes involved in conducting a Proof of Concept data linkage project including the implementation of national data integration principles, data custodian and ethical approval requirements, and establishment of data flows. The approval process involved nine approval and regulatory bodies and took more than two years. Data will be linked across 12 datasets involving three data linkage centres. A framework was established to allow data to flow between these centres while maintaining the separation principle that serves to protect the privacy of the in idual. This will be the first project to link child immunisation records from an Australian Government dataset to other administrative health datasets for a population cohort covering 2 million births in two Australian states. Although the project experienced some delays, positive outcomes were realised, primarily the development of strong collaborations across key stakeholder groups including community engagement. We have identified several recommendations and enhancements to this now established framework to further streamline the process for data linkage studies involving Australian Government data.
Low-moderate prenatal alcohol exposure and risk to child behavioural development: A prospective cohort study
Publisher: Wiley
Date: 28-05-2010
DOI: 10.1111/J.1471-0528.2010.02596.X
Abstract: To examine the association of fetal alcohol exposure during pregnancy with child and adolescent behavioural development. The Western Australian Pregnancy Cohort (Raine) Study recruited 2900 pregnancies (1989-91) and the 14-year follow up was conducted between 2003 and 2006. Tertiary obstetric hospital in Perth, Western Australia. The women in the study provided data at 18 and 34 weeks of gestation on weekly alcohol intake: no drinking, occasional drinking (up to one standard drink per week), light drinking (2-6 standard drinks per week), moderate drinking (7-10 standard drinks per week), and heavy drinking (11 or more standard drinks per week). Methods Longitudinal regression models were used to analyse the effect of prenatal alcohol exposure on Child Behaviour Checklist (CBCL) scores over 14 years, assessed by continuous z-scores and clinical cutoff points, after adjusting for confounders. Their children were followed up at ages 2, 5, 8, 10 and 14 years. The CBCL was used to measure child behaviour. Light drinking and moderate drinking in the first 3 months of pregnancy were associated with child CBCL z-scores indicative of positive behaviour over 14 years after adjusting for maternal and sociodemographic characteristics. These changes in z-score indicated a clinically meaningful reduction in total, internalising and externalising behavioural problems across the 14 years of follow up. Our findings do not implicate light-moderate consumption of alcohol in pregnancy as a risk factor in the epidemiology of child behavioural problems.
Neonatal complications in public and private patients: a retrospective cohort study
Publisher: BMJ
Date: 2013
Participation in population-based case-control studies: does the observed decline vary by socio-economic status?
Publisher: Wiley
Date: 23-02-2012
DOI: 10.1111/J.1365-3016.2011.01253.X
Abstract: An Australian study of childhood leukaemia (Aus-ALL) previously reported that control participation was positively associated with socio-economic status (SES). A similar study of childhood brain tumours (Aus-CBT) was carried out 4 years later, and this paper compares control participation and its relationship with SES in the two studies. To assess the representativeness of controls in terms of SES, the addresses of controls were linked to Australian Bureau of Statistics Census 2006 Collection Districts (CDs), and hence to area-based indices of SES. Independent s le t-tests and chi-squared tests were used to compare the SES indices of CDs where Aus-CBT controls lived with those where Aus-ALL controls lived and with those of all CDs where Australian families lived. The overall percentage of eligible families who agreed to participate was lower in Aus-CBT (53.9%) than in Aus-ALL (70.3%). Control families in both studies were of higher SES than the general population, while the distribution of SES among recruited controls was similar in both studies. These findings provide some reassurance that the observed decline in research participation over time may not be associated with an increasingly unrepresentative participant population.
Respiratory symptoms and lung function in two prebake aluminum smelters
Publisher: Wiley
Date: 05-1999
DOI: 10.1002/(SICI)1097-0274(199905)35:5<491::AID-AJIM6>3.0.CO;2-H
Abstract: Respiratory symptoms are known to occur in some aluminum smelter employees working in the potroom department but little is known about the respiratory health of employees in other departments. This cross-sectional study examined the prevalence of work-related respiratory symptoms and levels of lung function in different departments of two aluminum smelters compared to administration employees. Multiple logistic regression was performed with each of four work-related symptoms as outcomes and multiple linear regressions were performed with FEV1 and FVC as outcomes. There were 1,529 male participants in the two smelters representing a response rate of 89.6%. After adjusting for age and smoking, work-related respiratory symptoms were reported significantly more often among the ingot mill, anode, and potroom groups in Smelter A. In Smelter B, ingot employees were more likely to report work-related wheeze and potroom employees were more likely to report work-related rhinitis. Symptoms tended to increase with increasing time in the potrooms but were more likely to occur in new employees in the ingot mill and anode process groups. After adjusting for age, height, and smoking, there were no significant differences between the process groups for either FEV1 or FVC at Smelter A, and at Smelter B potroom employees had slightly greater FEV1 and FVC than the administration employees. Work-related respiratory symptoms among aluminum smelter workers are not reported only by potroom employees but also by ingot mill and anode employees.
Dietary patterns and markers for the metabolic syndrome in Australian adolescents
Publisher: Elsevier BV
Date: 05-2010
DOI: 10.1016/J.NUMECD.2009.03.024
Abstract: Overweight and other risk factors for cardiovascular disease (CVD) as well as their clustering, are increasingly prevalent among adolescents. We examined dietary patterns, CVD risk factors, and the clustering of these risk factors in 1139 14-year-olds living in Western Australia. Usual dietary intake was assessed using a food frequency questionnaire. Two dietary patterns, 'Western' and 'Healthy', were identified using factor analysis. Associations between these dietary patterns and BMI, waist circumference, systolic blood pressure, fasting levels of serum glucose, insulin, total cholesterol, HDL-C, LDL-C, triglycerides and insulin resistance were assessed using ANOVA. Cluster analysis identified a high risk group (the 'high risk metabolic cluster') with features akin to adult metabolic syndrome. Belonging to the 'high risk metabolic cluster' was examined in relation to dietary patterns using logistic regression, adjusting for aerobic fitness and socio-demographic factors. Higher 'Western' dietary pattern scores were associated with greater odds for the 'high risk metabolic cluster' (p for trend=0.02) and greater mean values for total cholesterol (p for trend=0.03), waist circumference (p for trend=0.03) and BMI (p for trend=0.02) in girls, but not boys. Scores for the 'Healthy' dietary pattern were not related to the 'high risk metabolic cluster' but were inversely associated with serum glucose in boys and girls (p for trend=0.01 and 0.04, respectively) and were positively associated with HDL-C in boys (p for trend=0.02). Dietary patterns are associated with CVD risk factors and the clustering of these risk factors in adolescence.
Perinatal factors and the development of autism: a population study.
Publisher: American Medical Association (AMA)
Date: 06-2004
The familial risk of infection-related hospitalization in children: A population-based sibling study
Publisher: Public Library of Science (PLoS)
Date: 28-04-2021
DOI: 10.1371/JOURNAL.PONE.0250181
Abstract: To assess the risk of severe childhood infections within families, we conducted a sibling analysis in a population-based cohort study with genealogical linkage. We investigated the sibling risk of hospitalization with common infections, a marker of severity. We hypothesized that having siblings hospitalized for infection would increase the proband’s risk of admission with infection. We used population data on Western Australian live-born singletons and their siblings between 1980 and 2014. Measures of infection were infection-related hospitalizations from discharge diagnostic codes. Exposure was having a sibling who had an infection-related hospitalization. Outcomes were infection-related hospitalizations in the child roband. Probands were followed until an infection-related hospitalization admission (up to the first three), death, 18th birthday, or end of 2014, whichever occurred first. Infection risks were estimated by adjusted Cox proportional hazard models for multiple events. Of 512,279 probands, 142,915 (27.9%) had infection-related hospitalizations 133,322 (26.0%) had a sibling with a previous infection-related hospitalization (i.e. exposed). Median interval between sibling and proband infection-related hospitalizations was 1.4 years (inter-quartile range 0.5–3.7). Probands had a dose-dependent increase in risk if sibling/s had 1, 2, or 3+ infection-related hospitalizations (adjusted hazard ratio, aHR 1.41, 95% CI 1.39–1.43 aHR 1.65, 1.61–1.69 aHR 1.83, 1.77–1.90, respectively). Among siblings with the same clinical infection type, highest sibling risks were for genitourinary (aHR 2.06, 1.68–2.53), gastrointestinal (aHR 2.07, 1.94–2.19), and skin/soft tissue infections (aHR 2.34, 2.15–2.54). Overall risk of infection-related hospitalization was higher in children with more siblings and with older siblings. In this population-based study, we observed an increased risk of infection-related hospitalization in children whose siblings were previously hospitalized for infection. Public health interventions may be particularly relevant in families of children hospitalized with infection.
Role of public and private funding in the rising caesarean section rate: A cohort study
Publisher: BMJ
Date: 2013
Maternal antibiotic exposure during pregnancy and hospitalization with infection in offspring: a population-based cohort study
Publisher: Oxford University Press (OUP)
Date: 04-02-2018
DOI: 10.1093/IJE/DYX272
Abstract: The early life microbiome contributes to immune development. Antibiotics during pregnancy alter the microbiome and may influence disease risks in the offspring. We investigated the relationship between maternal antibiotic exposure before and during pregnancy, and risk of childhood hospitalization with infection. We used population-based Danish national databases for pregnancies between 1995 and 2009. Infants were followed from birth until their first infection-related hospitalization, death, 14th birthday, emigration or end-2009. Exposure was maternal antibiotics prescribed before and during pregnancy. Outcome was infection-related hospitalization. 141 359 (18%) mothers had at least one antibiotic prescription during pregnancy, 230 886 (29.4% of those with complete data) in the 18 months before pregnancy. Of 776 657 live-born singletons, 443 546 infection-related hospitalizations occurred in 222 524 (28.6%) children. Pregnancy antibiotic exposure was associated with increased risk of childhood infection-related hospitalization [hazard ratio (HR) 1.18, 95% confidence interval (CI) 1.17-1.19]. In mothers prescribed antibiotics only during pregnancy whose child did not receive pre-hospitalization antibiotics, this association was present only in those born vaginally. Higher risks of infection-related hospitalization occurred when pregnancy antibiotic prescriptions were closer to birth and in mothers receiving more pregnancy antibiotics. Children born to mothers exposed to antibiotics before (but not during) pregnancy also had increased risk of infection-related hospitalization (HR 1.10, 95% CI 1.07-1.12). Antibiotic exposure before or during pregnancy was associated with increased risk of childhood hospitalized infections. Alteration of the maternally derived microbiome and shared heritable and environmental determinants are possible contributory mechanisms.
Relationship between cardiopulmonary mortality and cancer risk and quantitative exposure to polycyclic aromatic hydrocarbons, fluorides, and dust in two prebake aluminum smelters
Publisher: Springer Science and Business Media LLC
Date: 18-03-2009
DOI: 10.1007/S10552-009-9329-8
Abstract: We examined the risk of mortality and cancer incidence with quantitative exposure to benzene-soluble fraction (BSF), benzo(a)pyrene (BaP), fluoride, and inhalable dust in two Australian prebake smelters. A total of 4,316 male smelter workers were linked to mortality and cancer incidence registries and followed from 1983 through 2002 (mean follow-up: 15.9 years, maximum: 20 years). Internal comparisons using Poisson regression were undertaken based on quantitative exposure levels. Smoking-adjusted, monotonic relationships were observed between respiratory cancer and cumulative inhalable dust exposure (trend p = 0.1), cumulative fluoride exposure (p = 0.1), and cumulative BaP exposure (p = 0.2). The exposure-response trends were stronger when examined across the exposed categories (BaP p = 0.1 inhalable dust p = 0.04). A monotonic, but not statistically significant trend was observed between cumulative BaP exposure and stomach cancer (n = 14). Bladder cancer was not associated with BaP or BSF exposure. No other cancer and no mortality outcomes were associated with these smelter exposures. The carcinogenicity of Söderberg smelter exposures is well established in these prebake smelters we observed an association between smelter exposures and respiratory cancer, but not bladder cancer. The exploratory finding for stomach cancer needs confirmation. These results are preliminary due to the young cohort and short follow-up time.
The risk of lung cancer with increasing time since ceasing exposure to asbestos and quitting smoking
Publisher: BMJ
Date: 06-04-2006
La déclaration RECORD (Reporting of Studies Conducted Using Observational Routinely Collected Health Data) : directives pour la communication des études réalisées à partir de données de santé collecté
Publisher: CMA Impact Inc.
Date: 25-02-2019
DOI: 10.1503/CMAJ.181309
Response to Kottek and Kilpatrick, 'Estimating Occupational Exposure to Asbestos in Australia'
Publisher: Oxford University Press (OUP)
Date: 10-03-2016
Sudden infant death syndrome and unascertainable deaths: Trends and disparities among Aboriginal and non‐Aboriginal infants born in Western Australia from 1980 to 2001 inclusive
Publisher: Wiley
Date: 07-2006
DOI: 10.1111/J.1440-1754.2006.00895.X
Abstract: Aim: To analyse patterns and trends in mortality from unknown causes (sudden infant death syndrome and unascertainable deaths) for all Aboriginal and non‐Aboriginal infants born in Western Australia, 1980–2001. Methods: Using total population linked data, we reviewed all post‐mortem reports, including death scene investigations and final causes of death as ascertained by the coroner. Neonatal, post‐neonatal and infant mortality rates attributed to unknown causes were calculated and the latter were analysed according to maternal age, geographical location, gestational age, sex and birthweight. Relative risks (95% confidence interval) for Aboriginal infants (compared with non‐Aboriginal) were calculated. Results: The proportion of deaths considered to be of unascertainable cause has significantly increased in recent years. In contrast to the non‐Aboriginal population, there has been no significant decrease in deaths in the Aboriginal population and the overall relative risk for Aboriginal infants for the most recent years studied was 7.9 (95% confidence interval 5.1–12.2). The relative risk was significantly increased for most categories analysed. Conclusion: Reviewing post‐mortem reports enabled identification of changes in the classification of deaths due to unknown causes. This provided a more accurate picture of the patterns and long‐term trends of such deaths so that programmes can be developed to specifically target those groups most at risk. Adequately funded and evaluated education c aigns aimed at reducing the risk of sudden infant death syndrome among Aboriginal infants are required, as well as sustaining the current efforts that have been so successful for non‐Aboriginal infants.
Assisted Reproductive Technology and Major Birth Defects in Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2012
Pre- and postnatal influences on preschool mental health: A large-scale cohort study
Publisher: Wiley
Date: 10-2008
DOI: 10.1111/J.1469-7610.2008.01955.X
Abstract: Methodological challenges such as confounding have made the study of the early determinants of mental health morbidity problematic. This study aims to address these challenges in investigating antenatal, perinatal and postnatal risk factors for the development of mental health problems in pre-school children in a cohort of Western Australian children. The Raine Study is a prospective cohort study of 2,868 live born children involving 2,979 pregnant women recruited at 18 weeks gestation. Children were followed up at age two and five years. The Child Behaviour Checklist (CBCL) was used to measure child mental health with clinical cut-points, including internalising (withdrawn/depressed) and externalising (aggressive/destructive) behaviours (n = 1707). Multinomial logistic regression analysis showed that the significant risk factors for behaviour problems at age two were the maternal experience of multiple stress events in pregnancy (OR = 1.20, 95% CI = 1.06, 1.37), smoking during pregnancy (OR = 1.30, 95% CI = 1.06, 1.59) and maternal ethnicity (OR = 3.34, 95% CI = 1.61, 6.96). At age five the experience of multiple stress events (OR = 1.17, 95% CI = 1.08, 1.27), cigarette smoking (OR = 1.19, 95% CI = 1.03, 1.37), male gender (OR = 1.43, 95% CI = 1.02, 2.00), breastfeeding for a shorter time (OR = .97, 95% CI = .94, .99) and multiple baby blues symptoms (OR = 1.08, 95% CI = 1.02, 1.14) were significant predictors of mental health problems. Early childhood mental health is significantly affected by prenatal events in addition to the child's later environment. Interventions targeting adverse prenatal, perinatal and postnatal influences can be expected to improve mental health outcomes for children in the early years.
Autoantibodies and cancer among asbestos-exposed cohorts in Western Australia
Publisher: Informa UK Limited
Date: 07-03-2021
Cancer incidence and mortality among underground and surface goldminers in Western Australia
Publisher: Springer Science and Business Media LLC
Date: 11-04-2013
DOI: 10.1038/BJC.2013.154
Hypertensive Diseases of Pregnancy and the Development of Behavioral Problems in Childhood and Adolescence: The Western Australian Pregnancy Cohort Study
Publisher: Elsevier BV
Date: 02-2009
DOI: 10.1016/J.JPEDS.2008.07.061
Abstract: To examine whether maternal gestational hypertension and preecl sia are associated with behavioral problems in offspring throughout childhood and early adolescence. We conducted a prospective cohort study of 2804 women in the Western Australian Pregnancy Cohort Study and their children observed at age 2, 5, 8, 10, and 14 years. The Child Behavior Checklist (CBCL) was used to measure problem child behavior with continuous z-scores and clinical cutoff points. Control variables included known biomedical, sociodemographic, and psychological factors. After adjustment, with general linear model analyses children of women with gestational hypertension were shown to be more likely to have higher CBCL z-scores, indicative of poorer behavior, from 8 years on, with the largest difference seen at 14 years. Children of mothers with preecl sia were more likely to have lower CBCL z-scores, indicative of pro-social behaviors. The multivariable logistic regression analysis showed that gestational hypertension was predictive of clinically significant CBCL T-scores from age 8 to 14 years. This association was significant for externalizing behavior, such as delinquent and aggressive behavior, and for internalizing behavior at age 14 years. Unexpectedly, preecl sia reduced internalizing morbidity at ages 5 and 8 years. The opposing effect on child and adolescent behavior of gestational hypertension and preecl sia warrants further attention.
Association of Birth Outcomes and Maternal, School, and Neighborhood Characteristics with Subsequent Numeracy Achievement
Publisher: Oxford University Press (OUP)
Date: 13-05-2008
DOI: 10.1093/AJE/KWN085
Abstract: This study investigated the relation between birth characteristics and numeracy attainment at age 8 years. Using a multilevel approach, the authors analyzed all non-Aboriginal singletons born in Western Australia who attended government schools and participated in a Western Australia-wide numeracy test in grade 3 between 1999 and 2005. Appropriateness of intrauterine growth was expressed as the proportion of optimal growth parameters for gestational duration, infant sex, and maternal height and parity, which was derived from a total population of births without risk factors for growth restriction. After the authors controlled for sociodemographic factors, term birth and proportion of optimal head circumference at birth were associated with higher numeracy scores. Increasing proportion of optimal birth length and being firstborn were associated with relatively higher numeracy scores among children born to mothers residing in the most educationally deprived area. The relative advantage of being born first was also higher for children born to single mothers. In contrast, higher Apgar scores and greater proportion of optimal birth weight were associated with a lower relative advantage for children born to single mothers. In summary, term birth and increased growth in head circumference and length are key birth characteristics associated with higher numeracy scores, especially among disadvantaged children.
Predicted mortality from malignant mesothelioma among women exposed to blue asbestos at Wittenoom, Western Australia
Publisher: BMJ
Date: 03-2009
Abstract: Nearly 3000 women and girls were documented to have lived at the blue asbestos mining and milling town of Wittenoom in Western Australia between 1943 and 1992. Eight per cent of deaths among these women to the end of 2004 have been from malignant mesothelioma of the pleura. To predict future mortality from mesothelioma to 2030 in this cohort. Mesothelioma mortality rates incorporating parameters for cumulative exposure, a power of time since first exposure and annual rates of fibre clearance from the lung were calculated from maximum likelihood estimates. These rates plus age specific mortality rates for Western Australian females incorporating an excess lung cancer risk were then applied to all Wittenoom cohort women surviving to the end of 2004, in yearly increments, to predict the future numbers of cases of mesothelioma to 2030. There were 40 deaths from mesothelioma among the Wittenoom women to the end of 2004. Using a range of models that incorporate time since first exposure, competing risks from other diseases, latency periods and clearance of mesothelioma from the lungs we predict 66 (lowest estimate) to 87 (highest estimate) deaths from mesothelioma until 2030. This represents one and a half to two and a half times the number of deaths that have already occurred to the end of 2004. The high toll from mesothelioma in this cohort of women and girls will continue well into the future.
Data linkage in an established longitudinal cohort: The Western Australian Pregnancy Cohort (Raine) Study
Publisher: The Sax Institute
Date: 2016
DOI: 10.17061/PHRP2631636
Abstract: The Western Australian Data Linkage System is one of a few comprehensive, population-based data linkage systems worldwide, creating links between information from different sources relating to the same in idual, family, place or event, while maintaining privacy. The Raine Study is an established cohort study with more than 2000 currently active participants. In idual consent was obtained from participants for information in publicly held databases to be linked to their study data. A waiver of consent was granted where it was impracticable to obtain consent. Approvals to link the datasets were obtained from relevant ethics committees and data custodians. The Raine Study dataset was subsequently linked to academic testing data collected by the Western Australian Department of Education. Examination of diet and academic performance showed that children who were predominantly breastfed for at least 6 months scored higher academically at age 10 than children who were breastfed for less than 6 months. A further study found that better diet quality at ages 1, 2 and 3 years was associated with higher academic scores at ages 10 and 12 years. Examination of nutritional intake at 14 years of age found that a better dietary pattern was associated with higher academic performance. The detailed longitudinal data collected in the Raine Study allowed for adjustment for multiple covariates and confounders. Data linkage reduces the burden on cohort participants by providing additional information without the need to contact participants. It can give information on participants who have been lost to follow-up provide or complement missing data give the opportunity for validation studies comparing recall of participants with administrative records increase the population s le of studies by adding control participants from the general population and allow for the adjustment of multiple covariates and confounders. The Raine Study dataset is extensive and detailed, and can be further improved by linking to other external data sources. By linking educational outcomes to the Raine Study database, it was shown across three different age groups that a healthy diet was consistently associated with higher academic performance.
Malignant pleural and peritoneal mesotheliomas in former miners and millers of crocidolite at Wittenoom, Western Australia
Publisher: BMJ
Date: 04-2004
Abstract: To report the number of malignant pleural and peritoneal mesotheliomas that have occurred in former Wittenoom crocidolite workers to the end of 2000, and to compare this with earlier predictions. A group of 6493 men and 415 women who had worked at the former Wittenoom crocidolite mine and mill at some time between 1943 and 1966 have been followed up throughout Australia and Italy to the end of 2000. The cumulative number of mesotheliomas up to 2000 was 235 in men (202 pleural, 33 peritoneal) and seven (all pleural) in women. There had been 231 deaths with mesothelioma (9% of known deaths). The number of deaths in men with mesothelioma between 1987 and 2000 was at the low end of the predictions made earlier based on the number of cases to 1986. If this trend continues, it is predicted that about another 110 deaths with mesothelioma will occur in men by 2020.
Atopy, eczema and breast milk fatty acids in a high‐risk cohort of children followed from birth to 5 yr
Publisher: Wiley
Date: 20-12-2005
DOI: 10.1111/J.1399-3038.2005.00340.X
Abstract: The incidence of atopic diseases such as eczema is increasing in westernized societies. The suggestion that there is a "protective" association between the unique fatty acid composition of breast milk, particularly the omega-3 (n-3) and omega-6 (n-6) essential polyunsaturated fatty acid content, and the development of atopic disease in children was investigated in a cohort study of 263 infants born into families with a history of allergy (one or both parents had asthma, hayfever, eczema). The objectives of this study were to determine the lipid profile [specifically in relation to long-chain polyunsaturated fatty acid (LC-PUFA) composition] in maternal breast milk s les collected at 6 wk and at 6 months following birth, and to investigate the potential role of these fatty acids in modulating the phenotype of children at high genetic risk of developing atopic disease. Breast milk s les were available from 91 atopic mothers at their child's ages of 6 wk and 6 months. These s les were analysed for the fatty acid spectrum. Analysis of variance was used to detect differences between groups of outcomes (no atopy or eczema, non-atopic eczema, atopy, atopic eczema) at ages 6 months and 5 yr, and a multiple comparisons procedure was conducted to isolate the parameters producing the different results (F-test, LSD test). For the exposure variables, n-3 and n-6 fatty acids are expressed as weight percentage and as a ratio (at both time-points). The fatty acid profiles of maternal breast milk at 6 wk and 6 months were similar. An increased ratio of n-6: n-3 fatty acids in both 6 wk and 6 month milk s les was associated with non-atopic eczema (p < 0.005) but not atopy alone or atopic eczema. We found milk fatty acids were a significant modulator of non-atopic eczema but not atopy or atopic eczema in infants at 6 months. In mothers with a history of asthma, hayfever or eczema, their 6-month-old infants were more likely to develop non-atopic eczema if their milk had a higher ratio of n-6: n-3 LC-PUFA.
Identification of novel molecular prognostic markers for paediatric T‐cell acute lymphoblastic leukaemia
Publisher: Wiley
Date: 19-04-2007
DOI: 10.1111/J.1365-2141.2007.06576.X
Abstract: In the last four decades the survival of patients with newly diagnosed childhood T-cell acute lymphoblastic leukaemia (T-ALL) has improved dramatically. In sharp contrast, relapsed T-ALL continues to confer a dismal prognosis. We sought to determine if gene expression profiling could uncover a signature of outcome for children with T-ALL. Using 12 patient specimens obtained before therapy started, we examined the gene expression profile by oligonucleotide microarrays. We identified three genes, CFLAR, NOTCH2 and BTG3, whose expression at the time of diagnosis accurately distinguished the patients according to disease outcome. These genes are involved in the regulation of apoptosis and cellular proliferation. The prognostic value of the three predictive genes was assessed in an independent cohort of 25 paediatric T-ALL patients using quantitative real-time reverse transcription polymerase chain reaction. Patients assigned to the adverse outcome group had a significantly higher cumulative incidence of relapse compared with patients assigned to the favourable outcome group (46% vs. 8%, P = 0.029). Five-year overall survival was also significantly worse in the patients assigned to the adverse outcome group (P = 0.0039). The independent influence of the 3-gene predictor was confirmed by multivariate analysis. Our study provides proof of principle that genome-wide expression profiling can detect novel molecular prognostic markers in paediatric T-ALL.
Distribution of Early Structural Lung Changes due to Cystic Fibrosis Detected with Chest Computed Tomography
Publisher: Elsevier BV
Date: 07-2013
DOI: 10.1016/J.JPEDS.2012.12.042
Abstract: To examine the distribution of early structural lung changes in clinically stable infants and young children with cystic fibrosis using chest computed tomography (CT). This cross-sectional study included 62 children aged 1-6 years with volume-controlled volumetric chest CT scans performed under general anesthesia as part of an early surveillance program. Each lobe was scored for presence and extent of bronchiectasis, mucus plugging, and air trapping using a semiquantitative score. The topographic distribution of structural abnormalities was evaluated by comparing the presence and extent of abnormalities in different lung regions and examining relationships between components. Although bronchiectasis was most common in the right upper lobe, overall changes in lung structure were not more common or more extensive in the upper lobes. Rather, bronchiectasis was more common in the right lung (right lung 0.95, left lung 0.68, P = .003), and mucus plugging (upper 0.41, middle 0.41, lower 0.72, P = .028) and air trapping (upper 0.79, middle 0.48, lower 0.96, P < .001) were more common in the lower lobes. The extents of bronchiectasis (P < .001) and air trapping (P = .011) were greater in the right lung. Scans with bronchiectasis were also more likely to have coexisting mucus plugging (P = .008) and air trapping (P < .001). Early structural lung disease is heterogeneously distributed in the lung. Quantitative scoring tools for studies using chest CT as an end point, and mechanistic studies that seek to better understand the pathogenesis of early cystic fibrosis lung disease, should take account of this differential topographic expression of disease early in life.
Systematic review and meta-analysis of respiratory viral coinfections in children
Publisher: Wiley
Date: 25-02-2016
DOI: 10.1111/RESP.12741
Abstract: Respiratory infections are a common cause of paediatric morbidity. Clinical outcomes in children hospitalized with single respiratory virus infection are compared with those with two or more viral-viral coinfection. Studies were restricted to those reporting on children aged less than 5 years (PROSPERO CRD#42014009133). Published data to calculate risk ratios (RR) comparing children with single viral infections to coinfection using a random effects model were used. Similar analyses by pathogen pairs and by excluding children with comorbidities were performed. Of 4443 articles reviewed, 19 were included. Overall, no differences in the risk of fever, admission to an intensive care unit (ICU), oxygen use, mechanical ventilation and abnormal radiographs between children with single infection and those with coinfection were found. When analysing only children without comorbidities, the risk of fever (RR = 1.16 to RR = 1.24, 95% confidence intervals (CI) = 1.00-1.55) and ICU admission (RR = 1.08 to RR = 1.31, 95% CI = 0.93-1.83) increased but remained non-significant. Point estimates suggested an increased risk of ICU admission in those coinfected with either respiratory syncytial virus or human metapneumovirus compared with those with single infection but was non-significant. Our findings suggest that coinfection is not associated with increased clinical severity, but further investigations by pathogen pairs are warranted.
Contemporary Incidence and Prevalence of Rheumatic Fever and Rheumatic Heart Disease in Australia Using Linked Data: The Case for Policy Change
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-10-2020
Abstract: In 2018, the World Health Organization prioritized control of acute rheumatic fever (ARF) and rheumatic heart disease (RHD), including disease surveillance. We developed strategies for estimating contemporary ARF/RHD incidence and prevalence in Australia (2015–2017) by age group, sex, and region for Indigenous and non‐Indigenous Australians based on innovative, direct methods. This population‐based study used linked administrative data from 5 Australian jurisdictions. A cohort of ARF (age years) and RHD cases ( years) were sourced from jurisdictional ARF/RHD registers, surgical registries, and inpatient data. We developed robust methods for epidemiologic case ascertainment for ARF/RHD. We calculated age‐specific and age‐standardized incidence and prevalence. Age‐standardized rate and prevalence ratios compared disease burden between demographic subgroups. Of 1425 ARF episodes, 72.1% were first‐ever, 88.8% in Indigenous people and 78.6% were aged years. The age‐standardized ARF first‐ever rates were 71.9 and 0.60/100 000 for Indigenous and non‐Indigenous populations, respectively (age‐standardized rate ratio=124.1 95% CI, 105.2–146.3). The 2017 Global Burden of Disease RHD prevalent counts for Australia ( years) underestimate the burden (1518 versus 6156 Australia‐wide extrapolated from our study). The Indigenous age‐standardized RHD prevalence (666.3/100 000) was 61.4 times higher (95% CI, 59.3–63.5) than non‐Indigenous (10.9/100 000). Female RHD prevalence was double that in males. Regions in northern Australia had the highest rates. This study provides the most accurate estimates to date of Australian ARF and RHD rates. The high Indigenous burden necessitates urgent government action. Findings suggest RHD may be underestimated in many high‐resource settings. The linked data methods outlined here have potential for global applicability.
Geographical disparities in emergency department presentations for acute respiratory infections and risk factors for presenting
Publisher: BMJ
Date: 02-2019
DOI: 10.1136/BMJOPEN-2018-025360
Abstract: Studies examining acute respiratory infections (ARIs) in emergency department (EDs), particularly in rural and remote areas, are rare. This study aimed to examine the burden of ARIs among Aboriginal and non-Aboriginal children presenting to Western Australian (WA) EDs from 2002 to 2012. Using a retrospective population-based cohort study linking ED records to birth and perinatal records, we examined presentation rates for metropolitan, rural and remote Aboriginal and non-Aboriginal children from 469 589 births. We used ED diagnosis information to categorise presentations into ARI groups and calculated age-specific rates. Negative binomial regression was used to investigate association between risk factors and frequency of ARI presentation. Overall, 26% of presentations were for ARIs. For Aboriginal children, the highest rates were for those aged months in the Great Southern (1233 per 1000 child-years) and Pilbara regions (1088 per 1000 child-years). Rates for non-Aboriginal children were highest in children months in the Southwest and Kimberley (400 and 375 per 1000 child-years, respectively). Presentation rates for ARI in children from rural and remote WA significantly increased over time in all age groups years. Risk factors for children presenting to ED with ARI were: male, prematurity, caesarean delivery and residence in the Kimberley region and lower socio-economic areas. One in four ED presentations in WA children are for ARIs, representing a significant out-of-hospital burden with some evidence of geographical disparity. Planned linkages with hospital discharge and laboratory detection data will aid in assessing the sensitivity and specificity of ARI diagnoses in ED.
Associations of a novel IL4RA polymorphism, Ala57Thr, in Greenlander Inuit
Publisher: Elsevier BV
Date: 09-2006
DOI: 10.1016/J.JACI.2006.05.009
Abstract: A novel IL4RA polymorphism, Ala57Thr, was identified in Greenlander Inuit. We sought to determine whether the novel Thr57 allele is population specific and to assess the associations of Ala57Thr and Ile50Val with atopy in 2 Inuit populations. Ala57Thr and Ile50Val were genotyped in 651 Inuit living in Denmark, 1295 Inuit living in Greenland, and 1329 in iduals from 7 populations from widely differing global locations. In Inuit the polymorphisms were evaluated for associations with atopy, rhinitis, asthma, and pulmonary function. Thr57 was in linkage disequilibrium with Ile50 (D' = 1, r(2) = 0.13) and was common (33%) in the Inuit but rare (<0.6%) in all other populations. In Inuit living in Denmark, the Thr57 allele (in a dose-dependent manner) and the Ile50/Thr57 haplotype were associated with lower risk of atopy (P(linear) = .003 and P = .034, respectively), with similar trends observed for atopic rhinitis and atopic asthma. In Inuit living in Greenland, Thr57 was not associated with atopy or atopic diseases, but Ile50 was weakly associated with lower risk of atopy. The novel IL4RA Ala57Thr was common in and population specific to Greenlander Inuit, with Thr57 associated with a lower risk of atopy in those living in Denmark. Hence a full investigation of genotype-phenotype relationships in a given population can only be achieved if each gene is screened for novel polymorphisms in that population. Clinical risk attributable to variations in a gene in an ethnic group requires that all variations of the gene are known for that group.
Cohort Profile: The Western Australian Family Connections Genealogical Project
Publisher: Oxford University Press (OUP)
Date: 04-07-2007
DOI: 10.1093/IJE/DYM136
Infection is the major component of the disease burden in aboriginal and non-aboriginal Australian children: A population-based study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2007
DOI: 10.1097/01.INF.0000254148.09831.7F
Abstract: Infection accounts for the majority of pediatric mortality and morbidity in developing countries, but there are limited data on the infectious diseases burden in children from developed countries. We investigated reasons for hospitalization before age 2 years in a birth cohort of Western Australian Aboriginal and non-Aboriginal children. Data on live births between January 1990 and December 2000, and corresponding deaths and hospitalizations in the first 2 years of life, were obtained through linked population-based data. Almost half the cohort of 270,068 children were hospitalized at least once. Aboriginal children had significantly higher admission rates (2196 vs. 779 per 1000 live births), stayed longer and were more likely to die in hospital than non-Aboriginal children. Infections (mainly respiratory and gastrointestinal) were the most common reason for hospitalization, accounting for 34% of all admissions, with higher rates in Aboriginal (1114 per 1000 live births) than non-Aboriginal children (242 per 1000) (P < 0.001). Over time, admission rates for infections declined in Aboriginal children but increased in non-Aboriginal children. Aboriginal children were admitted 14 times more often for pneumonia than non-Aboriginal children. Infections are the leading cause of hospitalization in children under 2 years of age. The continuing heavy burden of serious infections, borne disproportionately by Aboriginal children, needs to be alleviated. Public health interventions such as the development and universal implementation of vaccines for respiratory syncytial virus, rotavirus and influenza are needed, while adequate funding must be committed to Indigenous health services and training.
Randomised controlled trials in cystic fibrosis: What, when and how?
Publisher: European Respiratory Society (ERS)
Date: 30-04-2011
Risk factors for the development of non-response to first-line treatment for tuberculosis in Southern Vietnam
Publisher: Oxford University Press (OUP)
Date: 10-1997
Abstract: Acquired resistance to standard chemotherapy for tuberculosis (TB) is an increasing problem worldwide. Vietnam has one of the highest incidences of TB and also has a large population of potential migrants to other countries. Since 1979 the International Organisation for Migration (IOM) has been running a supervised programme of TB treatment for intending migrants from Vietnam where few facilities for bacteriological culture and sensitivity testing exist. This study aimed to assess the most important factors for predicting non-response to first-line treatment as treatment starts and whether any further indicators occur during the course of treatment which may enable more accurate prediction of non-response. In all, 130 subjects failing to respond to first-line therapy (cases) between 1990 and 1995 were compared with 673 subjects who responded to therapy (controls) on various demographic and clinical characteristics using logistic regression to create a prognostic index. Variables analysed included the patient history of past TB treatment, weight, age, sex and radiological and bacteriological findings. All subjects also tested negative for HIV status. The chief markers of successful response were x-ray signs and degree of sputum smear positivity. These markers provided a prognostic index with an optimal cutoff providing about 70% sensitivity and 80% specificity. Incorporating further measures obtained through the first 3 months of treatment improved the sensitivity to 80%. While this study enabled prediction of the majority of subjects failing to respond to first-line therapy, other factors need to be assessed before recommendations for altering treatment regimens can be made. The prognostic index could be useful in assessing subjects for closer supervision.
p.R270X MECP2 mutation and mortality in Rett syndrome
Publisher: Springer Science and Business Media LLC
Date: 03-08-2005
Abstract: Among cases in the Australian Rett Syndrome Database, the nonsense mutation p.R270X is one of the most commonly occurring single pathogenic MECP2 mutations. In two recent published reports of the MECP2 mutational spectrum the p.R270X appeared to be under represented. We hypothesised that increased mortality arising from this mutation may underlie this apparent discrepancy. We investigated our hypothesis in two independent study groups from Australia and the UK with prospective data collections (total n=524). Only females with Rett syndrome and an identified MECP2 mutation were included. Significant differences in survival were detected among Rett syndrome cases grouped for the eight most frequent mutations (log-rank chi(2) (7)=15.71, P=0.03). Moreover, survival among cases with p.R270X, when compared with survival among cases with all the other mutations was reduced (log-rank chi(2) (2)=6.94, P=0.01). Our observation of a reduced survival associated with the p.R270X mutation offers an explanation for the under representation of p.R270X in older subjects with Rett syndrome.
Erratum: Prenatal stress and risk of behavioral morbidity from age 2 to 14 years: The influence of the number, type, and timing of stressful life events (Development and Psychopathology (2011) 23 (507-520))
Publisher: Cambridge University Press (CUP)
Date: 31-01-2012
Are children more vulnerable to mesothelioma than adults? A comparison of mesothelioma risk among children and adults exposed non-occupationally to blue asbestos at Wittenoom
Publisher: BMJ
Date: 29-08-2018
DOI: 10.1136/OEMED-2018-105108
Abstract: The presence of asbestos in public buildings is a legacy of past asbestos use in many developed countries. Of particular concern is the amount and current condition in schools and the vulnerability of children to mesothelioma. Our aim was to compare the risk of mesothelioma between those exposed to blue asbestos as children and as adults at Wittenoom. Public sources were used to establish the Wittenoom residents’ cohort. Mesothelioma incidence rates per 100 000 person-years at risk were derived for those first exposed to asbestos at Wittenoom as children ( years) or adults separately. Proportional hazards survival models examined the slope of the exposure-response relationship between asbestos exposure and incidence of mesothelioma in different sex and age groups. The mesothelioma rate was lower among those first exposed as children (76.8 per 100 000) than those first exposed as adults (121.3 per 100 000). Adjusting for cumulative exposure to asbestos and sex, those exposed as adults had a greater risk of mesothelioma (adjusted HR 2.5, 95% CI 1.7 to 3.7). The slope of the exposure-response relationship did not differ between those exposed as children and those exposed as adults. We found no greater susceptibility to mesothelioma among those first exposed to asbestos as children than those first exposed as adults. However, given the long latency of mesothelioma, and the greater years of life yet to be lived by the Wittenoom children, it is likely that there will be more cases of mesothelioma in the future among those first exposed as children.
Mortality and airflow obstruction in asthma: a 17‐year follow‐up study
Publisher: Wiley
Date: 09-11-2006
DOI: 10.1111/J.1445-5994.2006.01214.X
Abstract: Asthma is associated with fixed airflow obstruction and an increased risk of death. The aim of this study was to relate asthma mortality and airflow obstruction to severity of asthma in a cohort of patients with chronic asthma studied over a 17-year period. In 1980, asthma severity based on symptoms, asthma duration, treatment and smoking habits were assessed and lung function was measured after maximal therapy in 89 patients. In 1997, mortality was recorded and 44 of 60 patients known to be alive were restudied. Eighteen patients had died: eight deaths were associated with asthma (seven occurred before and one after 1990). The risk of death was higher with decreased forced expiratory volume in 1 s (FEV1), increased FEV1 variability, age and treatment requirements but not symptom severity, at initial study. In the patients restudied, asthma severity and FEV1 variability decreased whereas the dose of inhaled corticosteriods increased 2.8-fold. Highest FEV1 was negatively related to treatment score and smoking history at initial study, but not at follow up and was <80% predicted in 19 (43%) patients, 11 of whom had never smoked. The mean (+/-standard deviation) decrement in FEV1 was 32 +/- 24 mL/year and correlated positively with FEV1 at initial study, smoking history, age of onset of asthma and treatment requirements at follow up. In this cohort study, asthma was associated with chronic airflow obstruction and that with increased risk of mortality. Symptoms and mortality risk improved in association with increased reported use of inhaled corticosteroids however, there was ongoing chronic airflow obstruction.
Maternal dietary intake of folate and vitamins B6 and B12 during pregnancy and the risk of childhood acute lymphoblastic leukemia
Publisher: Informa UK Limited
Date: 11-09-2012
DOI: 10.1080/01635581.2012.707278
Abstract: Our aim was to address the hypothesis that maternal dietary intake of folate during pregnancy is inversely associated with risk of acute lymphoblastic leukemia (ALL) in the offspring. Dietary intake of folate, vitamins B6 and B12 in the last 6 mo of pregnancy from 333 cases and 695 frequency-matched controls were assessed using a food frequency questionnaire. Data were analyzed using unconditional logistic regression, adjusting for study matching variables, total energy, and potentially confounding variables. Higher levels of dietary folate and B12 appeared to be associated with a decreased risk of ALL. Higher levels of vitamin B6 were associated with an increased risk. The strongest associations of ALL with these variables were seen when mothers consumed alcohol in pregnancy. Our findings are consistent with a modest protective effect of higher dietary intake of folate and vitamin B12 against ALL in the offspring, more particularly among women who drank alcohol during pregnancy. These findings are consistent with previous reports of the protective effects of a maternal diet high in fruit, vegetables, and nondairy protein sources. The vitamin B6 findings are not consistent with evidence that it is a protective factor against other cancers, and may be a chance finding.
Hospitalisation rates for children with intellectual disability or autism born in Western Australia 1983–1999: a population-based cohort study
Publisher: BMJ
Date: 2013
Functional abilities in children and adults with the CDKL5 disorder
Publisher: Wiley
Date: 16-08-2016
DOI: 10.1002/AJMG.A.37851
Abstract: Functional abilities in the CDKL5 disorder have been described as severely impaired, yet some in iduals are able to run and use phrases for speech. Our study investigated gross motor, hand function, and expressive communication abilities in in iduals with the CDKL5 disorder. Data for 108 females and 16 males registered with the International CDKL5 disorder database and with a pathogenic CDKL5 mutation were analyzed. Relationships between functional abilities, age, genotype, and gender were analyzed using regression models. Over half of the females could sit on the floor and nearly a quarter could walk 10 steps. Fewer males could complete these tasks although one boy was able to sit, walk, and run. Most females and few males were able to pick up a large object. Females mostly used gestures to communicate while males mostly used other forms of non-verbal communication. Compared to those with no functional CDKL5 protein, in iduals with truncating variants after aa 781 were more likely to be able to stand (OR 5.7, 95%CI 1.2, 26.6) or walk independently (4.3, 95%CI 0.9, 20.5), and use more advanced communication methods such as words (OR 6.1, 95%CI 1.5-24.2). Although abilities were markedly impaired for the majority with the CDKL5 disorder, some females and a few males had better functional abilities. This variability may be related to underlying gene variants, with females with a late truncating variant having better levels of ability than those with no functional protein. © 2016 Wiley Periodicals, Inc.
Effectiveness of a 3 + 0 pneumococcal conjugate vaccine schedule against invasive pneumococcal disease among a birth cohort of 1.4 million children in Australia
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.VACCINE.2018.03.058
Abstract: Most studies use indirect cohort or case-control methods to estimate vaccine effectiveness (VE) of 7- and 13-valent pneumococcal conjugate vaccines (PCV7 and PCV13) against invasive pneumococcal disease (IPD). Neither method can measure the benefit vaccination programs afford the unvaccinated and many studies were unable to estimate dose-specific VE. We linked Australia's national immunisation register with health data from two states to calculate IPD incidence by vaccination status and VE for a 3 + 0 PCV schedule (doses at 2, 4, 6 months, no booster) among a cohort of 1.4 million births. Births records for 2001-2012 were probabilistically linked to IPD notifications, hospitalisations, deaths, and vaccination history (available until December 2013). IPD rates in vaccinated and unvaccinated children 90% coverage in the first year of a universal 3 + 0 PCV program provided high population-level protection, predominantly attributable to strong herd effects. The size of the cohort enabled calculation of robust dose-specific VE estimates for important population sub-groups relevant to vaccination policies internationally.
Effectiveness of Palivizumab against Respiratory Syncytial Virus
Publisher: Elsevier BV
Date: 11-2019
DOI: 10.1016/J.JPEDS.2019.06.058
Abstract: To measure the real-world effectiveness of palivizumab immunoprophylaxis against respiratory syncytial virus (RSV)-confirmed infection before age 2 years in a population-cohort of high-risk infants. Palivizumab is funded for high-risk infants in Western Australia. We used probabilistically linked administrative data encompassing RSV laboratory-confirmed infections, hospital admissions, and palivizumab dispensing records for a cohort of 24 329 high-risk infants admitted to neonatal intensive care units, born 2002-2013 with follow-up to 2015. We used a traditional cohort method with Cox proportional hazards regression and a self-controlled case series analysis to assess effectiveness of palivizumab in reducing RSV-confirmed infection by number of doses. From the cohort of 24 329 infants, 271 (1.1%) received at least 1 dose of palivizumab and 1506 (6.2%) had at least 1 RSV-confirmed infection before age 2 years. Using the traditional cohort approach, we found no protective association of palivizumab receipt with RSV detection (adjusted hazard ratio = 0.99 [95% CI 0.5, 1.9] for 1 dose). However, using a self-controlled case series to eliminate confounding by indication, a protective association was seen with a 74% lower RSV incidence (relative incidence = 0.26 95% CI 0.11, 0.67) following any dose of palivizumab compared with control (nonexposed) periods. After accounting for confounding by indication through a self-controlled analysis, palivizumab appeared effective for reducing virologically confirmed RSV in this high-risk cohort.
Using record linkage to validate notification and laboratory data for a more accurate assessment of notifiable infectious diseases
Publisher: Springer Science and Business Media LLC
Date: 17-06-2017
Asbestos Bodies in Lung Tissue Following Exposure to Crocidolite
Publisher: Wiley
Date: 10-1995
Abstract: A series of 206 necropsies in Western Australia (WA) have had routine counts made of asbestos bodies in s les of lung tissue using conventional light microscopy. Thirty-two cases had worked in the asbestos industry at Wittenoom, WA and (log) counts of asbestos bodies in their lung tissue correlated well with estimates of their (log) cumulative airborne exposure to crocidolite fibers (r = 0.60). There was no association between the number of asbestos bodies and time since exposure to asbestos ceased. In subjects without known exposure to asbestos, there was a weak but nonsignificant increase in number of asbestos bodies with increasing age, with 26% of cases having no asbestos bodies present. It is concluded that the relatively simple technique of light microscopy for counting of asbestos bodies in lung tissue provides a reliable indication of the level of past occupational exposure to crocidolite in subjects whose exposure has been only to crocidolite. This could be extremely useful in follow-up studies of cohorts that lack reliable measures of airborne exposure to crocidolite asbestos.
Hospital admissions in children with developmental disabilities from ethnic minority backgrounds
Publisher: Wiley
Date: 09-09-2019
DOI: 10.1111/DMCN.14348
Abstract: To compare hospital admission patterns after the first year of life in Australian children with developmental disabilities and children with no known disability, according to maternal country of birth and Indigenous status. This was a retrospective cohort study using linked data across health, disability, and hospital admission databases. The study investigated 656 174 children born in Western Australia between 1983 and 2008 with a total of 1 091 834 records of hospital admissions. Children with no known disability born to Indigenous mothers had the highest rate of hospital admissions compared to children of non-Indigenous mothers. Children of foreign-born mothers from low-income countries had the highest rate of hospital admissions if disability was present. Children with cerebral palsy (CP) with or without associated intellectual disability had the highest rate of hospital admissions among children with developmental disability, especially if mothers were foreign-born. Children with CP and intellectual disability, particularly from minority backgrounds (Indigenous Australian and foreign-born mothers), were at higher risk of being admitted to hospital after the first year of life. Hospital admissions in Australian children with and without disabilities differ according to maternal country of birth. Hospital admission rates in children without a developmental disability were greatest for Australian-born Indigenous children. Disabled Australian-born children of foreign-born mothers from low-income countries had the highest hospital admission rates. Hospital admission risk was greatest for Australian-born children with cerebral palsy, especially if mothers were foreign-born.
Regan et al. Reply to Sibling Comparison Design in Birth-Spacing Studies
Publisher: Oxford University Press (OUP)
Date: 05-09-2019
DOI: 10.1093/AJE/KWY187
A Population-Based Matched-Sibling Analysis Estimating the Associations Between First Interpregnancy Interval and Birth Outcomes
Publisher: Oxford University Press (OUP)
Date: 05-09-2019
DOI: 10.1093/AJE/KWY188
Infant nutrition and maternal obesity influence the risk of non-alcoholic fatty liver disease in adolescents
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.JHEP.2017.03.029
Abstract: The pathway to non-alcoholic fatty liver disease (NAFLD) in adolescents may have its origins in adiposity gains, nutrition and sedentary lifestyle established during childhood. There is inadequate knowledge regarding the associations between infant nutrition and subsequent NAFLD. We examined the association of maternal factors and infant nutrition, with the subsequent diagnosis of NAFLD in adolescents. Adolescents aged 17years in the Western Australian Pregnancy (Raine) Cohort study had fatty liver assessment using liver ultrasound. Prospectively recorded data on maternal pregnancy and infant feeding were examined against a NAFLD outcome during late adolescence. NAFLD was diagnosed in 15.2% of the 1,170 adolescents examined. Ninety-four percent had been breastfed as infants. The duration of breastfeeding before starting supplementary milk was ⩾4months in 54.4% and ⩾6months in 40.6%. Breastfeeding without supplementary milk ⩾6months (adjusted odds ratio [OR]: 0.64 95% confidence interval [CI]: 0.43-0.94, p=0.02), maternal pre-pregnancy obesity (adjusted OR: 2.29 95% CI: 1.21-4.32, p=0.01) and adolescent obesity (adjusted OR: 9.08 95% CI: 6.26-13.17, p<0.001) were associated with NAFLD independent of a Western dietary pattern at 17years of age. Adolescents with NAFLD who had been breastfed for ⩾6months had a less adverse metabolic profile compared with adolescents breastfed for <6months. Supplementary milk intake starting before 6months was associated with a higher prevalence and ultrasound severity of NAFLD compared with intake starting after 6months (17.7% vs. 11.2%, p=0.003 and 7.8% vs. 3.4%, p=0.005 respectively). Though NAFLD is generally mediated through adiposity gains, breastfeeding for at least 6months, avoidance of early supplementary formula milk feeding, and normal maternal pre-pregnancy BMI may reduce the odds of a NAFLD diagnosis during adolescence. Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder in which there is too much fat in the liver of people who do not consume excessive amounts of alcohol. In this large study, we found that infants who consumed breast milk for less than 6months before starting infant formula milk, infants who were obese as teenagers or had mothers who were obese at the start of pregnancy, were much more likely to have NAFLD at 17years of age. Based on our findings we consider that reducing the risk of NAFLD in teenagers needs to start before birth, by encouraging normal body mass index before pregnancy, as well as breastfeeding without infant formula milk consumption for the first 6months of life.
Childhood hospitalisation with infection and cardiovascular disease in early-mid adulthood: A longitudinal population-based study
Publisher: Public Library of Science (PLoS)
Date: 04-05-2015
Prenatal Alcohol Exposure and Risk of Birth Defects
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2011
Association of maternal pre-pregnancy weight with birth defects: Evidence from a case-control study in Western Australia
Publisher: Wiley
Date: 02-2009
Population-Based Prevalence of Intellectual Disability and Autism Spectrum Disorders in Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 05-2016
Plasma vitamin concentrations and incidence of mesothelioma and lung cancer in individuals exposed to crocidolite at Wittenoom, Western Australia
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 08-2006
DOI: 10.1097/00008469-200608000-00003
Abstract: Increased rates of death from asbestos-related diseases have been reported in former workers and residents exposed to crocidolite (blue asbestos) at Wittenoom (Western Australia). The relationships between plasma concentrations of retinol, carotene and vitamin E and incidence of mesothelioma and lung cancer in a cohort of people from this town were examined. The relationships were evaluated by survival analyses using data obtained at the first visit, at each visit and with the rate of change of each vitamin during the period of follow-up. Of 1953 study participants, 65 developed mesothelioma during the follow-up, and 47 developed lung cancer. A lower incidence of mesothelioma was related to plasma concentrations of retinol at the first visit [hazard ratio (HR)=0.63, 95% confidence interval=0.41-0.99], and to measurements at each visit (HR=0.71, 95% confidence interval=0.50-1.00). Plasma carotene concentrations at the first measurement, but not during the follow-up period, were associated with lower incidence of lung cancer in men and in workers. No significant associations were found between carotene concentrations and incidence of mesothelioma. Vitamin E concentrations were not significantly associated with mesothelioma or lung cancer incidence. These findings suggest that people with chronically low plasma levels of retinol have increased risk of developing mesothelioma and lung cancer.
Respiratory outcomes among refinery workers exposed to inspirable alumina dust: A longitudinal study in Western Australia
Publisher: Wiley
Date: 17-09-2020
DOI: 10.1002/AJIM.23182
The effect of asbestosis on lung cancer risk beyond the dose related effect of asbestos alone
Publisher: BMJ
Date: 12-2005
Is there a folate‐related gene‐environment interaction in the etiology of childhood acute lymphoblastic leukemia?
Publisher: Wiley
Date: 17-04-2006
DOI: 10.1002/IJC.21803
Abstract: Acute lymphoblastic leukaemia (ALL) is the commonest childhood cancer in developed countries. Little is known about its causes, although its early age at diagnosis has focused interest on maternal and perinatal factors. We have previously observed a protective effect of maternal folate supplementation during pregnancy against ALL, and a number of studies have reported protective effects of some common polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene. One study has suggested that the effect of MTHFR polymorphisms on risk of ALL may depend on folate status. This study aimed to look for evidence of an interaction between maternal folate supplementation and child's genotype among the cases from our previous study. Bone marrow specimens from 82 of 83 case children were available. DNA was extracted and genotyped for MTHFR C677T and A1298C using standard techniques. We used a case-only analysis to estimate the case-only odds ratio (COR) for MTHFR genotype and folate supplementation in association with ALL. None of the CORs indicated a significant departure from a multiplicative model. Adjustment for sex, age or genotype at the other locus had little effect on the results. Other studies of this gene and environment interaction in ALL and other cancers have produced contradictory results, perhaps because of varying definitions of folate exposure. Further research into the interaction of folate intake and genotype in causing ALL and other cancers is needed. We are specifically studying it in an Australian national case-control study of genetic and environmental causes of ALL.
Absence of germline mutations in BAP1 in sporadic cases of malignant mesothelioma
Publisher: Elsevier BV
Date: 05-2015
DOI: 10.1016/J.GENE.2015.03.031
Abstract: Malignant mesothelioma (MM) is a uniformly fatal tumour caused predominantly by exposure to asbestos. It is not known why some exposed in iduals get mesothelioma and others do not. There is some epidemiological evidence of host susceptibility. BAP1 gene somatic mutations and allelic loss are common in mesothelioma and recently a BAP1 cancer syndrome was described in which affected in iduals and families had an increased risk of cancer of multiple types, including MM. To determine if BAP1 mutations could underlie any of the sporadic mesothelioma cases in our cohort of patients, we performed targeted deep sequencing of the BAP1 exome on the IonTorrent Proton sequencer in 115 unrelated MM cases. No exonic germline BAP1 mutations of known functional significance were observed, further supporting the notion that sporadic germline BAP1 mutations are not relevant to the genetic susceptibility of MM.
Association between antenatal cytokine production and the development of atopy and asthma at age 6 years
Publisher: Elsevier BV
Date: 10-2003
DOI: 10.1016/S0140-6736(03)14542-4
Abstract: Various lines of evidence suggest that antenatal factors are important in determining susceptibility to atopy and asthma. One possible mechanism is cytokines, production of which in the placenta is high throughout gestation and which protect placental integrity via control of local immunological homoeostasis. We investigated antenatal cytokine concentrations in a prospective birth cohort, intensively monitored for atopy and asthma outcomes at age 6 years. Cryopreserved cord-blood serum s les from 407 children were assayed for interleukins 4, 5, 6, 10, 12, and 13, interferon gamma, and tumour necrosis factor alpha (TNFalpha). Associations between family, antenatal, and perinatal factors, cord-blood cytokine concentrations, and atopy or asthma outcomes were analysed by logistic regression. Causal effects of cytokines on outcomes were estimated by propensity scores based on family, antenatal, and perinatal factors. Detectable cord-blood concentrations of interleukin 4 and interferon gamma were each associated with lower risk of physician-diagnosed asthma (adjusted odds ratios 0.60 [95% CI 0.37-0.99] and 0.60 [0.37-0.97] respectively), current asthma (0.59 [0.33-1.00] and 0.39 [0.22-0.71]), and current wheeze (0.55 [0.32-0.93] and 0.52 [0.31-0.90]) and atopy (sensitisation to some inhalant allergens) outcomes at 6 years. High concentrations of TNFalpha were associated with lower risk of atopy but not with asthma risk. These associations were broadly unaltered by propensity-score adjustment. Maternal smoking was associated with higher risk of both wheeze at 6 years and lower concentrations of interleukin 4 and interferon gamma in cord blood. The mechanism underlying attenuated T-helper-1/T-helper-2 cytokine production in high-risk children also apparently operates in control of cytokine production in the fetoplacental unit. The finding that this mechanism is dysregulated by maternal smoking suggests it is a target for antenatal environmental factors relevant to asthma aetiology.
Fine particulate matter and risk of preterm birth and pre-labor rupture of membranes in Perth, Western Australia 1997-2007: A longitudinal study
Publisher: Elsevier BV
Date: 12-2014
Assisted reproductive technologies and the risk of birth defects—a systematic review
Publisher: Oxford University Press (OUP)
Date: 02-2005
Abstract: The risk of birth defects in infants born following assisted reproductive technology (ART) treatment is a controversial question. Most publications examining the prevalence of birth defects in ICSI and IVF infants compared to spontaneously conceived infants have serious methodological limitations despite this, most researchers have concluded that there is no increased risk. We carried out a systematic review to identify all papers published by March 2003 with data relating to the prevalence of birth defects in infants conceived following IVF and/or ICSI compared with spontaneously conceived infants. Independent expert reviewers used criteria defined a priori to determine whether studies were suitable for inclusion in a meta-analysis. Fixed effects meta-analysis was performed for all studies and reviewer-selected studies. Twenty-five studies were identified for review. Two-thirds of these showed a 25% or greater increased risk of birth defects in ART infants. The results of meta-analyses of the seven reviewer-selected studies and of all 25 studies suggest a statistically significant 30-40% increased risk of birth defects associated with ART. Pooled results from all suitable published studies suggest that children born following ART are at increased risk of birth defects compared with spontaneous conceptions. This information should be made available to couples seeking ART treatment.
Predictions of mortality from mesothelioma [1]
Publisher: BMJ
Date: 06-2003
DOI: 10.1136/OEM.60.6.458
Child behaviour following low to moderate maternal drinking in pregnancy
Publisher: Wiley
Date: 11-10-2010
Pregnancy and birth outcomes of mothers with intellectual disability and their infants: Advocacy needed to improve well-being
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.DHJO.2019.100871
Abstract: Pregnancy in women with intellectual disability (ID) is increasingly recognised, along with their increased likelihood of experiencing risk factors for adverse pregnancy and infant outcomes. We aimed to compare risks of socio-demographic, pregnancy and infant outcomes of women with ID to other women. All mothers with children born in Western Australia from 1983 to 2012 were linked to the population-based Intellectual Disability Exploring Answers database. Mothers with ID were matched by age and Aboriginality to a population s le of mothers without ID. Pregnancy and birth outcomes were compared for both groups and logistic regression was used to compare outcome risks. Compared to non-Aboriginal mothers without ID, non-Aboriginal mothers with ID were more likely to be of low socio-economic status, be without partner, smoke antenatally and have pre-existing asthma. They had a 1.5 times increased risk of pregnancy complications, specifically pre-ecl sia, urinary tract infection, threatened preterm labour and post-partum haemorrhage. After adjustment for maternal medical conditions and pregnancy complications, infants of Aboriginal mothers with ID had twice the risk of preterm birth and 1.6 times the risk of having percentage of optimal head circumference <95% compared to infants of Aboriginal mothers without ID. Infants of both Aboriginal and non-Aboriginal mothers with ID were more likely to have percentage of optimal birth weight <85% compared to those without ID. For mothers with ID, modifiable risk factors for adverse outcomes need addressing. They may require additional assistance during pregnancy, including more frequent consultations and support to assist with pregnancy management.
Mortality of former crocidolite (blue asbestos) miners and millers at Wittenoom
Publisher: BMJ
Date: 21-11-2008
Abstract: Blue asbestos was mined and milled at Wittenoom in Western Australia between 1943 and 1966. Nearly 7000 male workers who worked at the Wittenoom mine and mill have been followed up using death and cancer registries throughout Australia and Italy to the end of 2000. Person-years at risk were derived using two censoring dates in order to produce minimum and maximum estimates of asbestos effect. Standardised mortality ratios (SMRs) compare the mortality of the former Wittenoom workers with the Western Australian male population. There have been 190 cases of pleural and 32 cases of peritoneal mesothelioma in this cohort of former workers at Wittenoom. Mortality from lung cancer (SMR = 1.52), pneumoconiosis (SMR = 15.5), respiratory diseases (SMR = 1.58), tuberculosis (SMR = 3.06), digestive diseases (SMR = 1.47), alcoholism (SMR = 2.24) and symptoms, signs and ill defined conditions (SMR = 2.00) were greater in this cohort compared to the Western Australian male population. Asbestos related diseases, particularly malignant mesothelioma, lung cancer and pneumoconiosis, continue to be the main causes of excess mortality in the former blue asbestos miners and millers of Wittenoom.
Correlation of ultra-low dose chest CT findings with physiologic measures of asbestosis
Publisher: Springer Science and Business Media LLC
Date: 12-01-2017
DOI: 10.1007/S00330-016-4722-7
Abstract: The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Two thoracic radiologists independently categorised prone ULDCT scans from 143 participants for ILD appearances as absent (score 0), probable (1) or definite (2) without knowledge of asbestos exposure or lung function. Pulmonary function measures included spirometry and diffusing capacity to carbon monoxide (DLCO). Participants were 92% male with a median age of 73.0 years. CT dose index volume was between 0.6 and 1.8 mGy. Probable or definite ILD was reported in 63 (44.1%) participants. Inter-observer agreement was good (k = 0.613, p < 0.001). There was a statistically significant correlation between the ILD score and both forced expiratory volume in 1 second (FEV Changes consistent with ILD on ULDCT correlate well with corresponding reductions in gas transfer, similar to standard CT. In asbestos-exposed populations, ULDCT may be adequate to detect radiological changes consistent with asbestosis. • Interobserver agreement for the ILD score using prone ULDCT is good. • Prone ULDCT appearances of ILD correlate with changes in spirometric observations. • Prone ULDCT appearances of ILD correlate strongly with changes in gas transfer. • Prone ULDCT may provide sufficient radiological evidence to inform the diagnosis of asbestosis.
Assessing the Burden of Laboratory-Confirmed Respiratory Syncytial Virus Infection in a Population Cohort of Australian Children Through Record Linkage
Publisher: Oxford University Press (OUP)
Date: 07-02-2020
Abstract: Significant progress has been made towards an effective respiratory syncytial virus (RSV) vaccine. Age-stratified estimates of RSV burden are urgently needed for vaccine implementation. Current estimates are limited to small cohorts or clinical coding data only. We present estimates of laboratory-confirmed RSV across multiple severity levels. We linked laboratory, perinatal, and hospital data of 469 589 children born in Western Australia in 1996–2012. Respiratory syncytial virus tests and detections were classified into community, emergency department (ED), and hospital levels to estimate infection rates. Clinical diagnoses given to children with RSV infection presenting to ED or hospitalized were identified. In 2000–2012, 10% (n = 45 699) of children were tested for RSV and 16% (n = 11 461) of these tested positive. Respiratory syncytial virus was detected in community, ED (both 0.3 per 1000 child-years), and hospital (2.4 per 1000 child-years) settings. Respiratory syncytial virus-confirmed rates were highest among children aged & months (31 per 1000 child-years). At least one third of children with RSV infection presenting to ED were diagnosed as other infection, other respiratory, or other (eg, agranulocytosis). Respiratory syncytial virus is pervasive across multiple severity levels and diagnoses. Vaccines targeting children & months must be prioritized. Given that most children are never tested, estimating the under-ascertainment of RSV infection is imperative.
Mesothelioma risk after 40 years since first exposure to asbestos: a pooled analysis
Publisher: BMJ
Date: 19-05-2014
DOI: 10.1136/THORAXJNL-2013-204161
Abstract: The risk of malignant mesothelioma (MM) increases proportionally to the cumulative exposure, and to the 3rd or 4th power of time since first exposed, to asbestos. However, little is known about the risk of MM after more than 40 years since first exposure because most epidemiological studies do not have follow-up for sufficient periods of time. The data from six cohort studies of exposed workers and two cohorts with residential exposure have been pooled. A nested case control design matched cases and controls on calendar period and age. Conditional logistic regression modelled the relationship between time since first exposure and risk of MM. The combined data consisted of 22,048 people with asbestos exposure (5769 women), 707 cases of pleural MM (165 in women) and 155 cases of peritoneal MM (32 in women). Median time since first exposure for pleural MM cases was 38.4 years (IQR 31.3-45.3). Median duration of exposure for pleural MM cases was 3.75 years (IQR 0.7-18.2). The rate and risk of pleural MM increased until 45 years following first exposure and then appeared to increase at a slower power of time since first exposure. The rate of increase in peritoneal MM over the 10-50 years since first exposure continued to increase. Exposure to asbestos confers a long-term risk of developing pleural and peritoneal mesothelioma which increases following cessation of exposure. While the rate of increase appears to start to level out after 40-50 years no one survives long enough for the excess risk to disappear.
Vitamin A and cancer prevention II: Comparison of the effects of retinol and β-carotene
Publisher: Wiley
Date: 30-01-1998
DOI: 10.1002/(SICI)1097-0215(19980130)75:3<362::AID-IJC6>3.0.CO;2-0
Abstract: Former blue asbestos workers known to be at high risk of asbestos-related diseases, particularly malignant mesothelioma and lung cancer, were enrolled in a chemo-prevention program using vitamin A. Our aims were to compare rates of disease and death in subjects randomly assigned to beta-carotene or retinol. Subjects were assigned randomly to take 30 mg/day beta-carotene (512 subjects) or 25,000 IU/day retinol (512 subjects) and followed up through death and cancer registries from the start of the study in June 1990 till May 1995. Comparison between groups was by Cox regression in both intention-to-treat analyses and efficacy analyses based on treatment actually taken. Median follow-up time was 232 weeks. Four cases of lung cancer and 3 cases of mesothelioma were observed in subjects randomised to retinol and 6 cases of lung cancer and 12 cases of mesothelioma in subjects randomised to beta-carotene. The relative rate of mesothelioma (the most common single cause of death in our study) for those on retinol compared with those on beta-carotene was 0.24 (95% CI 0.07-0.86). In the retinol group, there was also a significantly lower rate for death from all causes but a higher rate of ischaemic heart disease mortality. Similar results were found with efficacy analyses. Our results confirm other findings of a lack of any benefit from administration of large doses of synthetic beta-carotene. The finding of significantly lower rates of mesothelioma among subjects assigned to retinol requires further investigation.
Increased body mass index is related to apparent circumscribed pleural thickening on plain chest radiographs
Publisher: Wiley
Date: 2001
DOI: 10.1002/1097-0274(200101)39:1<112::AID-AJIM11>3.0.CO;2-G
Abstract: Diffuse pleural thickening and pleural plaques are the commonest radiological manifestations of asbestos exposure. Differentiation between subpleural fat and non-calcified pleural plaques is important clinically and medico-legally. This study aims to determine if apparent circumscribed pleural thickening on chest radiographs is related with obesity. Surveillance chest x-rays of 693 former asbestos workers were read with the ILO classification. Subjects with costophrenic angle obliteration (n = 57) were analyzed separately. The remaining subjects were sub ided according to their body mass index (BMI): Group 1 30 kg/m(2). Baseline characteristics, asbestos exposure, and profusion scores were evenly distributed. BMI of > 30 kg/m(2) was associated with a higher prevalence of pleural thickening on CXR (Gp1 = 8.5% Gp2 = 9.3% Gp3 = 18.3%). This relationship was strongest in the subgroups with 25-50% of the lateral chest wall involved and pleural thickness of 30 kg/m(2)) is related to apparent circumscribed pleural thickening on CXR, especially thin (< 1 cm) shadows covering 25-50% of the lateral chest wall.
Non-equilibrium transport of positron and electron swarms in gases and liquids
Publisher: IOP Publishing
Date: 21-05-2010
Correlation of forced oscillation technique in preschool children with cystic fibrosis with pulmonary inflammation
Publisher: BMJ
Date: 02-2005
Progressive increase of FcεRI expression across several PBMC subsets is associated with atopy and atopic asthma within school-aged children
Publisher: Wiley
Date: 22-05-2019
DOI: 10.1111/PAI.13063
Abstract: Antigen‐specific IgE binds the Fcε receptor I (FcεRI) expressed on several types of immune cells, including dendritic cells (DCs). Activation of FcεRI on DCs in atopics has been shown to modulate immune responses that potentially contribute to asthma development. However, the extent to which DC subsets differ in FcεRI expression between atopic children with or without asthma is currently not clear. This study aimed to analyse the expression of FcεRI on peripheral blood mononuclear cells (PBMCs) from atopic children with and without asthma, and non‐atopic/non‐asthmatic age‐matched healthy controls. We performed multiparameter flow cytometry on PBMC from 391 children across three community cohorts and one clinical cohort based in Western Australia. We confirmed expression of FcεRI on basophils, monocytes, plasmacytoid and conventional DCs, with higher proportions of all cell populations expressing FcεRI in atopic compared to non‐atopic children. Further, we observed that levels of FcεRI expression were elevated across plasmacytoid and conventional DC as well as basophils in atopic asthmatic compared to atopic non‐asthmatic children also after adjusting for serum IgE levels. Our data suggest that the expression pattern of FcεRI on DC and basophils differentiates asthmatic from non‐asthmatic atopic children. Given the significant immune modulatory effects observed as a consequence of FcεRI expression, this altered expression pattern is likely to contribute to asthma pathology in children.
Patterns, trends, and increasing disparities in mortality for Aboriginal and non-Aboriginal infants born in Western Australia, 1980–2001: population database study
Publisher: Elsevier BV
Date: 05-2006
High expression of connective tissue growth factor in pre‐B acute lymphoblastic leukaemia
Publisher: Wiley
Date: 23-08-2007
DOI: 10.1111/J.1365-2141.2007.06739.X
Abstract: In recent years microarrays have been used extensively to characterize gene expression in acute lymphoblastic leukaemia (ALL). Few studies, however, have analysed normal haematopoietic cell populations to identify altered gene expression in ALL. We used oligonucleotide microarrays to compare the gene expression profile of paediatric precursor-B (pre-B) ALL specimens with two control cell populations, normal CD34(+) and CD19(+)IgM(-) cells, to focus on genes linked to leukemogenesis. A set of eight genes was identified with a ninefold higher average expression in ALL specimens compared with control cells. All of these genes were significantly deregulated in an independent cohort of 101 ALL specimens. One gene, connective tissue growth factor (CTGF, also known as CCN2), had exceptionally high expression, which was confirmed in three independent leukaemia studies. Further analysis of CTGF expression in ALL revealed exclusive expression in B-lineage, not T-lineage, ALL. Within B-lineage ALL approximately 75% of specimens were consistently positive for CTGF expression, however, specimens containing the E2A-PBX1 translocation showed low or no expression. Protein studies using Western blot analysis demonstrated the presence of CTGF in ALL cell-conditioned media. These findings indicate that CTGF is secreted by pre-B ALL cells and may play a role in the pathophysiology of this disease.
Viral etiology and the impact of codetection in young children presenting with influenza-like illness
Publisher: Oxford University Press (OUP)
Date: 20-07-2017
DOI: 10.1093/JPIDS/PIW042
Maternal mortality in Yunnan, China: recent trends and associated factors
Publisher: Wiley
Date: 16-05-2007
DOI: 10.1111/J.1471-0528.2007.01362.X
Abstract: Yunnan Province, located in southwest China, is one of the poorest province in China. The maternal mortality ratio (MMR) is about twice the national average (56.2/100,000 live births), and in remote mountainous regions, the rate is five times higher. This study aimed to examine the progress in reduction of maternal mortality in the 1990s and early 2000s and the factors associated with this reduction in Yunnan. A population-based, longitudinal, ecological correlation study. A remote province of China with a proportionately large indigenous population. Populations at county, prefecture and provincial level. Using maternal mortality data collected at the province, prefecture/region and county levels, trend and time series analyses and multivariate linear regression analyses were performed using SPSS (Version 13). MMR and its change over time. MMR declined substantially in the 1990s at a rate of 3.0% per year. Utilisation of prenatal and obstetric care increased and was significantly correlated with the declining trend in MMR. Hospital delivery was a strong predictor of MMR, independent of social and economic development. Both low income and illiteracy were significantly associated with increased MMR. Declines in maternal mortality in Yunnan over the past 14 years appear to reflect health, social and economic interventions implemented in the 1990s. The association of hospital delivery with maternal mortality may be due to the effective management of severe pregnancy and birth complications. Low income and illiteracy were associated with MMR but primarily through their impact on the use of prenatal and obstetric care.
Folate pathway gene polymorphisms, maternal folic acid use, and risk of childhood acute lymphoblastic leukemia
Publisher: American Association for Cancer Research (AACR)
Date: 2015
DOI: 10.1158/1055-9965.EPI-14-0680
Abstract: Background: Several studies suggest that maternal folic acid supplementation before or during pregnancy protects against childhood acute lymphoblastic leukemia (ALL). We investigated associations between ALL risk and folate pathway gene polymorphisms, and their modification by maternal folic acid supplements, in a population-based case–control study (2003–2007). Methods: All Australian pediatric oncology centers provided cases controls were recruited by national random digit dialing. Data from 392 cases and 535 controls were included. Seven folate pathway gene polymorphisms (MTHFR 677C& T, MTHFR 1298A& C, MTRR 66A& G, MTR 2756 A& G, MTR 5049 C& A, CBS 844 Ins68, and CBS 2199 T& C) were genotyped in children and their parents. Information on prepregnancy maternal folic acid supplement use was collected. ORs were estimated with unconditional logistic regression adjusted for frequency-matched variables and potential confounders. Case–parent trios were also analyzed. Results: There was some evidence of a reduced risk of ALL among children who had, or whose father had, the MTRR 66GG genotype: ORs 0.60 [95% confidence interval (CI) 0.39–0.91] and 0.64 (95% CI, 0.40–1.03), respectively. The ORs for paternal MTHFR 677CT and TT genotypes were 1.41 (95% CI, 1.02–1.93) and 1.81 (95% CI, 1.06–3.07). ORs varied little by maternal folic acid supplementation. Conclusions: Some folate pathway gene polymorphisms in the child or a parent may influence ALL risk. While biologically plausible, underlying mechanisms for these associations need further elucidation. Impact: Folate pathway polymorphisms may be related to risk of childhood ALL, but larger studies are needed for conclusive results. Cancer Epidemiol Biomarkers Prev 24(1) 48–56. ©2014 AACR.
Linking pharmacy dispensing data to other administrative health datasets to measure the compliance and effectiveness of RSV immunoprophylaxis.
Publisher: Swansea University
Date: 21-08-2018
Abstract: IntroductionRespiratory Syncytial Virus (RSV) causes considerable morbidity in children. RSV vaccines are in development, but the only current preventive measure is immunoprophylaxis with monoclonal antibody, palivizumab. Australia has no uniform palivizumab guidelines. In Western Australia palivizumab is licensed for use in high risk children but compliance and effectiveness is unknown. Objectives and ApproachWe conducted a retrospective cohort study using palivizumab data from multiple pharmacy dispensing datasets which had been linked with routine laboratory, hospital morbidity, emergency department presentations, deaths and perinatal data for a cohort of infants admitted to Level 3 Neonatal Intensive Care Units (NICU) between 2002 and 2013. We identified palivizumab eligible infants as those who were extremely premature ( weeks gestation) with bronchopulmonary dysplasia and/or who identified as Indigenous and were NICU inpatients during the annual winter RSV season (May-October). We describe the use of palivizumab in infants that did and did not fit the eligibility criteria. ResultsThe NICU cohort included 24,367 infants, of which 1754 had at least 1 RSV-confirmed infection before age 5 years. A total of 686 (2.8%) cohort infants were eligible for palivizumab. Palivizumab dispensing data were amalgamated from 5 pharmacy datasets. Overall, 173 of the palivizumab eligible infants (25.2%) had at least 1 palivizumab dose (27% 1 dose, 34% 2 doses, 28% 3 doses and 11% 4 or more doses). From 2011 when palivizumab guidelines were formalised, 143 (75%) had at least 1 dose. Compliance with at least 1 palivizumab dose was highest in 2011 (84.9%). From 2002-2013, 98 infants were given palivizumab outside eligibility criteria (33% 1 dose, 33% 2 doses, 34% 3 or more doses) with annual use increasing since 2008. Conclusion/ImplicationsThis is the first time pharmacy dispensing data have been linked to other datasets to measure use and effectiveness. Compliance with palivizumab guidelines was high from 2011. These data will be used to measure the effectiveness of palivizumab against RSV-confirmed infections and respiratory infection-related hospitalisations up to age 5 years.
Plasma retinol and total carotenes and fracture risk after long-term supplementation with high doses of retinol
Publisher: Elsevier BV
Date: 05-2014
DOI: 10.1016/J.NUT.2013.10.007
Abstract: Observational studies suggest that moderate intakes of retinol and increased circulating retinol levels may increase fracture risk. Easy access to supplements, combined with an aging population, makes this a potentially important association. The aim of this study was to investigate plasma retinol and total carotene concentrations in relation to fracture risk after long-term supplementation with retinol and/or beta-carotene in 998 adults between 1990 and 2007. Participants were 663 men and 335 women in a cancer prevention program who were initially randomized to a retinol (7.5 mg RE/d) or beta-carotene (30 mg/d) supplement between 1990 and 1996. After 1996, all participants received the retinol supplement only. Plasma retinol and total carotene, medication use and various lifestyle factors were measured at annual clinic visits. Fractures were identified by self-report in 2007. The risk for any fracture or osteoporotic fracture was modeled using Cox proportional hazard models. Over a median follow-up of 7.8 y, 123 participants with plasma s les reported an incident fracture. Although plasma retinol concentrations were markedly higher than those reported in observational studies, no association was observed between plasma retinol and risk for any fracture (hazard ratio [HR], 0.86 μmol/L 95% confidence interval [CI], 0.65-1.14) or osteoporotic fracture (HR, 0.97 μmol/L 95% CI, 0.66-1.43). A lower risk for any fracture was suggested with increasing plasma total carotenes (HR, 0.85 μmol/L 95% CI, 0.71-1.01). This study does not support earlier reports of an increased fracture risk associated with increased plasma retinol concentration. The potential for carotenes to prevent fractures deserves further investigation.
p53 autoantibodies in patients with malignant mesothelioma: stability through disease progression
Publisher: Springer Science and Business Media LLC
Date: 2001
Parental alcohol consumption and risk of childhood acute lymphoblastic leukemia and brain tumors
Publisher: Springer Science and Business Media LLC
Date: 15-02-2013
DOI: 10.1007/S10552-012-0125-5
Abstract: Childhood acute lymphoblastic leukemia (ALL) is the most common childhood malignancy and brain tumors (CBTs) are the leading cause of cancer death in children. In our Australian case-control studies of these cancers, we investigated whether parental alcohol consumption before or during pregnancy was associated with risk. Cases were identified through the ten Australian pediatric oncology centers, and controls were recruited through national random-digit dialling. Detailed information on alcohol consumption, including beverage type, amount, and timing, was collected from 690 case families (388 ALL and 302 CBT) and 1,396 control families. Data were analyzed using unconditional logistic regression. We found no evidence that maternal alcohol use before or during pregnancy was associated with an increased risk of either cancer rather, there was evidence of inverse associations, particularly with wine. For both cancers, we observed U-shaped associations with paternal alcohol consumption in the year before the pregnancy, possibly driven by reduced risk at moderate levels of beer and wine intake and increased risk associated with high levels of beer intake. Moderate intake of spirits by fathers was associated with an increased risk of CBT but not ALL. These findings would be strengthened by corroboration in other studies. While the inverse associations with wine may be interesting mechanistically, the public health message remains that maternal alcohol use during pregnancy causes serious disorders in the offspring and should be avoided. Our findings suggest that men, as well as women, should limit their alcohol intake when planning a pregnancy.
The relationship between outdoor air quality and respiratory symptoms in young children
Publisher: Informa UK Limited
Date: 10-2007
DOI: 10.1080/09603120701628669
Abstract: The aim of this study was to investigate the relationship between air pollution and respiratory symptoms in young children. A total of 263 children at high risk of developing asthma or atopy were recruited antenatally and all respiratory symptoms experienced by the children were recorded by their parents for five years. Daily pollutant concentrations and meteorological data (ambient temperature and humidity) were collected from network monitoring sites. Logistic regression models investigating relationships between in idual air pollutants and respiratory symptoms showed significant associations between Ozone (O3) (1 h and 8 h) concentrations and raised body temperature (lag 0) Carbon monoxide (CO) (8 h) and wheeze/rattle and runny/blocked nose (lag 5 and additive exposure over 5 days) Nitrogen dioxide (NO2) (24 h) concentrations and cough (lag 0 and additive exposure over 5 days) and PM2.5 and visibility (BSP) (1 h) with cough (lag 0). These associations were observed even though air pollutant concentrations were below national standards throughout the study period.
Seizures in Rett syndrome: An overview from a one-year calendar study
Publisher: Elsevier BV
Date: 09-2007
Effect of maternal influenza vaccination on hospitalization for respiratory infections in newborns:a retrospective cohort study
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2016
Ultra low dose CT screen‐detected non‐malignant incidental findings in the Western Australian Asbestos Review Programme
Publisher: Wiley
Date: 16-06-2016
DOI: 10.1111/RESP.12826
Abstract: Computed tomography (CT)-based studies of asbestos-exposed in iduals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of asbestos-exposed subjects in Western Australia. A total of 906 subjects from the Western Australian Asbestos Review Programme underwent LDCT of the chest as part of regular annual review. An indeterminate (solid) nodule was defined as >50 mm Subjects were mostly (81%) men with a median age of 70 years. Fifty-eight (6.5%) participants were current smokers, 511 (56.4%) ex-smokers and 325 (36.4%) never-smokers. One hundred and four indeterminate nodules were detected in 77 subjects (8.5%) of these, eight cases had confirmed lung cancer (0.88%). Eighty-seven subjects (9.6%) had incidental findings that required further investigation, 42 (4.6%) from lower airways inflammation. The majority of nodules were solid, 4-6 mm and more common with age. Five hundred and eighty (64%) subjects had pleural plaques, and 364 (40.2%) had evidence of interstitial lung disease. The prevalence of LDCT-detected indeterminate lung nodules in 906 in iduals with significant asbestos exposure was 8.5%, lower than many other CT studies. Clinically important incidental findings were found in 9.4%, predominantly related to lower respiratory tract inflammation. LDCT appears to effectively describe asbestos-related diseases and is likely to be an acceptable modality to monitor asbestos-exposed in iduals.
Development of a job-exposure matrix (AsbJEM) to estimate occupational exposure to asbestos in Australia
Publisher: Oxford University Press (OUP)
Date: 03-04-2015
Abstract: Occupational exposure data on asbestos are limited and poorly integrated in Australia so that estimates of disease risk and attribution of disease causation are usually calculated from data that are not specific for local conditions. To develop a job-exposure matrix (AsbJEM) to estimate occupational asbestos exposure levels in Australia, making optimal use of the available exposure data. A dossier of all available exposure data in Australia and information on industry practices and controls was provided to an expert panel consisting of three local industrial hygienists with thorough knowledge of local and international work practices. The expert panel estimated asbestos exposures for combinations of occupation, industry, and time period. Intensity and frequency grades were estimated to enable the calculation of annual exposure levels for each occupation-industry combination for each time period. Two indicators of asbestos exposure intensity (mode and peak) were used to account for different patterns of exposure between occupations. Additionally, the probable type of asbestos fibre was determined for each situation. Asbestos exposures were estimated for 537 combinations of 224 occupations and 60 industries for four time periods (1943-1966 1967-1986 1987-2003 ≥2004). Workers in the asbestos manufacturing, shipyard, and insulation industries were estimated to have had the highest average exposures. Up until 1986, 46 occupation-industry combinations were estimated to have had exposures exceeding the current Australian exposure standard of 0.1 f ml(-1). Over 90% of exposed occupations were considered to have had exposure to a mixture of asbestos varieties including crocidolite. The AsbJEM provides empirically based quantified estimates of asbestos exposure levels for Australian jobs since 1943. This exposure assessment application will contribute to improved understanding and prediction of asbestos-related diseases and attribution of disease causation.
Temporal trends and socioeconomic differences in acute respiratory infection hospitalisations in children
Publisher: BMJ
Date: 05-2019
DOI: 10.1136/BMJOPEN-2018-028710
Abstract: Acute respiratory infections (ARIs) are a global cause of childhood morbidity. We compared temporal trends and socioeconomic disparities for ARI hospitalisations in young children across Western Australia, England and Scotland. Retrospective population-based cohort studies using linked birth, death and hospitalisation data. Population birth cohorts spanning 2000–2012 (Western Australia and Scotland) and 2003–2012 (England). ARI hospitalisations in infants ( months) and children (1–4 years) were identified through International Classification of Diseases, 10th edition diagnosis codes. We calculated admission rates per 1000 child-years by diagnosis and jurisdiction-specific socioeconomic deprivation and used negative binomial regression to assess temporal trends. The overall infant ARI admission rate was 44.3/1000 child-years in Western Australia, 40.7/1000 in Scotland and 40.1/1000 in England. Equivalent rates in children aged 1–4 years were 9.0, 7.6 and 7.6. Bronchiolitis was the most common diagnosis. Compared with the least socioeconomically deprived, those most deprived had higher ARI hospitalisation risk (incidence rate ratio 3.9 (95% CI 3.5 to 4.2) for Western Australia 1.9 (1.7 to 2.1) for England 1.3 (1.1 to 1.4) for Scotland. ARI admissions in infants were stable in Western Australia but increased annually in England (5%) and Scotland (3%) after adjusting for non-ARI admissions, sex and deprivation. Admissions for ARI were higher in Western Australia and displayed greater socioeconomic disparities than England and Scotland, where ARI rates are increasing. Prevention programmes focusing on disadvantaged populations in all three countries are likely to translate into real improvements in the burden of ARI in children.
Comparison of an Australian food-frequency questionnaire with diet records: Implications for nutrition surveillance
Publisher: Cambridge University Press (CUP)
Date: 06-2003
DOI: 10.1079/PHN2002434
Abstract: To compare a widely used Australian food-frequency questionnaire (FFQ) with diet records and consider the results in relation to its use in nutrition surveillance. Inter-method reliability study. A randomised trial in subjects with past asbestos exposure. Seventy-two adults living in Western Australia. A semi-quantitative FFQ developed by the Commonwealth Scientific Industrial Research Organisation in South Australia was administered after the completion of four 7-day diet records (DRs). Mean agreement between methods was not significantly different from 100% for many nutrients, but the limits of agreement indicated that, at the in idual level, the FFQ over- or underestimated the DR by at least 50%. Mean agreement between methods decreased significantly with increasing intakes for the majority of nutrients. Pearson's correlation coefficients were less informative indicators of agreement compared with the limits of agreement. These results indicate poor agreement between the FFQ and DR when estimating absolute intakes. Therefore, comparing intakes collected using this FFQ with specific cut-off points such as Recommended Dietary Intakes for nutrition surveillance may lead to seriously flawed conclusions about population intakes.
0402 Does lung cancer incidence and mortality differ with the type of asbestos fibre? : evidence from western australia
Publisher: BMJ Publishing Group Ltd
Date: 08-2017
Incidence of malignant mesothelioma in Aboriginal people in Western Australia
Publisher: Elsevier BV
Date: 08-2016
Abstract: To describe the incidence of malignant mesothelioma (MM) in Aboriginal people in Western Australia (WA) and determine the main routes of exposure to asbestos in this population. All MM cases in Western Australia, as well as the primary source of asbestos exposure, are recorded in the WA Mesothelioma Register. Aboriginal cases up to the end of 2013 were extracted from the register and compared with non-Aboriginal cases with respect to the primary means/source of exposure. Age-standardised incidence rates for each decade from 1980 were calculated for both Aboriginals and non-Aboriginals. Age-standardised mortality rates were calculated for the period 1994-2008 and compared with international rates. There were 39 cases (77% male) of MM among WA Aboriginal people. Twenty-six (67%) were a direct result of the mining of crocidolite at Wittenoom and the subsequent contamination of the surrounding lands. Of the non-Aboriginal MM cases (n = 2070, 86.3% male), fewer than 25% can be attributed to Wittenoom. Aboriginals had consistently higher 10-year incidence rates than non-Aboriginals and, when compared to world populations, the highest mortality rate internationally. When incidence rates in Aboriginal people are compared with non-Aboriginal people, the Wittenoom mining operation has had a disproportionate effect on MM incidence in the local Aboriginal population.
Malignant mesotheliomas in former miners and millers of crocidolite at Wittenoom (Western Australia) after more than 50 years follow-up
Publisher: Springer Science and Business Media LLC
Date: 02-2012
DOI: 10.1038/BJC.2012.23
Mesothelioma: the Wittenoom experience
Publisher: Elsevier BV
Date: 03-1993
Use of data linkage to investigate the aetiology of acute lower respiratory infection hospitalisations in children
Publisher: Wiley
Date: 14-11-2012
Asthma induced by alcoholic drinks: a new food allergy questionnaire
Publisher: Elsevier BV
Date: 12-1999
DOI: 10.1111/J.1467-842X.1999.TB01542.X
Abstract: Asthmatic reactions to foods and drinks are a significant health problem in the community, however, the true extent of this problem is unclear. In this study, a new food allergy questionnaire (FAQ) was designed to specifically investigate the prevalence and characteristics of asthmatic reactions triggered by alcoholic drinks, as well as other foods and chemicals. The questionnaire's validity and reliability were assessed by comparing respondents' answers with data from clinical interview and repeat application. Twenty consecutive outpatients attending a Hospital Asthma Clinic completed the FAQ and subsequently were interviewed independently by their respiratory physician. The FAQ's ability to classify the asthma severity and atopic status of respondents, and to identify those asthmatics sensitive to alcoholic drinks, sulphite-containing foods and aspirin was assessed by comparison with clinical interview. The questionnaire's reliability was assessed in a separate and erse community group of 20 asthmatic volunteers using the test-retest method. Responses to the FAQ were found to correlate highly with assessment by clinical interview for all of the parameters assessed. Specifically, the FAQ identified reactions to alcoholic drinks with a coefficient of agreement of 88.9%, a sensitivity of 100%, and a specificity of 83.3%. Responses to the FAQ were also found to be reproducible for all of the parameters assessed. The FAQ is a useful and reliable tool for assessing the sensitivity of asthmatics to alcoholic drinks and various foods and chemicals, and provides a means to collect data relating to the prevalence and characteristics of these responses in community-based populations.
Survival with Rett syndrome: Comparing Rett's original sample with data from the Australian Rett Syndrome Database
Publisher: Wiley
Date: 06-09-2010
DOI: 10.1111/J.1469-8749.2010.03716.X
Abstract: rett syndrome is a severe neurodevelopmental disorder that typically affects females. Little is known about the natural history and survival time of these females. we compared the survival of all Austrian female participants from Rett's historical cohort (1966) with that of affected females registered in the Australian Rett Syndrome Database. The analysis included both Kaplan-Meier analysis and a log-rank test for equality of survivor functions. of females in the original Austrian group, three are still alive. The median age at death was 13 years 4.8 months. The probability of survival up to the age of 25 years was 21%, compared with 71% in the Australian cohort (p<0.001). We found no practical or statistically significant differences in survival between the various birth year groups within the Australian cohort. our data indicate that survival of females with Rett syndrome has improved since the late 1960s but that there has been shown no change in survival over the last 30 years, possibly because the follow-up time has been too short.
Asbestos exposure and histological subtype of malignant mesothelioma
Publisher: BMJ
Date: 19-08-2016
DOI: 10.1136/OEMED-2016-103721
Abstract: Malignant mesothelioma (MM) has distinct histological subtypes (epithelioid, sarcomatoid and biphasic) with variable behaviour and prognoses. It is well recognised that survival time varies with the histological subtype of MM. It is not known, however, if asbestos exposure characteristics (type of asbestos, degree of exposure) are associated with different histological subtypes. To determine if the pathological MM subtype is associated with the type of asbestos or the attributes of asbestos exposure. Cases of MM for the period 1962 until 2012, their main histological subtype and their most significant source of asbestos exposure were collected from the Western Australian Mesothelioma Registry. Exposure characteristics included, degree of asbestos exposure (including total days exposed, years since first exposure and, for crocidolite only, calculated cumulative exposure), source of exposure (occupational or environmental), form of asbestos handled (raw or processed) and type of asbestos (crocidolite only or mixed fibres). Patients with the biphasic subtype were more likely to have occupational exposure (OR 1.83, 1.12 to 2.85) and exposure to raw fibres (OR 1.58, 1.19 to 2.10). However, differences between subtypes in the proportions with these different exposure characteristics were small and unlikely to be biologically relevant. Other indicators of asbestos exposure were not associated with the histological subtype of mesothelioma. There was no strong evidence of a consistent role of asbestos exposure indicators in determining the histological subtype of MM.
Diagnosis of asbestos-related lung diseases
Publisher: Informa UK Limited
Date: 25-01-2019
DOI: 10.1080/17476348.2019.1568875
Abstract: The diagnosis of lung disease in asbestos-exposed in iduals is a process that not only requires a detailed occupational and tobacco smoking history, but the correlation with physical signs, appropriate imaging, detailed lung function assessment and histology/cytology when required. Worldwide, the total quantity of asbestos mined is static, having decreased dramatically in developed countries but increased in countries where there is no restriction on mining: for ex le, Russia, China, Brazil, and Kazakhstan. The predominant diagnostic challenge in most cases of possible asbestos-related disease is the significant interval between exposure and development of the disease. Also challenging is the estimation of an in idual's risk of disease, not least because asbestos-induced malignancy can be rapidly fatal, and, in the case of lung cancer, early detection can lead to treatment with curative intent. Areas covered: Discussion of quantitative asbestos exposure estimation and risk assessment, selection of the most appropriate imaging modality and frequency of imaging. Expert commentary: Consideration of the future for asbestos-related lung disease includes screening those at highest risk particularly in relation to ongoing mining operations and the management of in-situ asbestos. In the future, screening programs designed with estimation of risk of malignancy, based on quantitative estimates of asbestos exposure, and smoking history are indicated.
Are low sun exposure and/or vitamin D risk factors for type 1 diabetes?
Publisher: Springer Science and Business Media LLC
Date: 03-2017
DOI: 10.1039/C6PP00294C
Abstract: The global variation in type 1 diabetes (T1D) incidence rates is one of the most significant observed for any non-communicable disease. Geographical patterns in incidence suggest that low sun exposure may contribute to the wide disparity, with incidence rates generally increasing with distance from the Equator. T1D development is associated with hyperactivity of the adaptive immune system leading to autoimmune destruction of insulin-secreting pancreatic β cells. Both exposure to ultraviolet radiation (UVR) and vitamin D, with their known immunosuppressive effects, have the potential to delay or inhibit the disease. Efforts to confirm the role of UVR by vitamin D dependent and independent pathways in the pathogenesis of T1D have been challenged by inconsistent results among studies. Human observational studies and animal and in vitro experiments indicate that at least some of the benefits of sun exposure come from improved vitamin D status. There is no evidence of benefit for T1D risk of vitamin D supplementation during pregnancy at current recommended levels (400 IU per day) but some evidence supports that higher sun exposure and/or vitamin D sufficiency in pregnancy, or supplementation in early life, decreases T1D risk. Further research is required to confirm an association between UVR exposure and T1D and clarify the mechanisms involved.
Assisted reproductive technology and birth defects: a systematic review and meta-analysis
Publisher: Oxford University Press (OUP)
Date: 28-02-2013
Abstract: It has been 10 years since we carried out a systematic search of the literature on birth defect risk in infants born following assisted reproductive technology (ART) compared with non-ART infants. Because of changes to ART practice since that review and the publication of more studies the objective of this review was to include these more recent studies to estimate birth defect risk after ART and to examine birth defect risk separately in ART singletons and multiples. We searched Medline, Embase and Current Contents databases (1978-2012). We used the same data extraction sheet and questionnaire we had used previously with the addition of a quality score to the questionnaire. Pooled relative risk (RR) estimates were calculated using a random effects model. All data were analysed using Comprehensive Meta-Analysis V2. There were 45 cohort studies included in this review. ART infants (n = 92 671) had a higher risk of birth defects [RR 1.32, 95% confidence interval (CI) 1.24-1.42] compared with naturally conceived infants (n = 3 870 760). The risk further increased when data were restricted to major birth defects (RR 1.42, 95% CI 1.29-1.56) or singletons only (RR 1.36, 95% CI 1.30-1.43). The results for ART multiples were less clear. When all data for multiples were pooled the RR estimate was 1.11 (95% CI 0.98-1.26) but this increased to 1.26 (0.99-1.60) when the analysis was restricted to studies of ART twins where some adjustment was made for differences in zygosity distribution between ART and non-ART multiples. Birth defects remain more common in ART infants. Further research is required to examine risks for important subgroups of ART exposure.
Association of sociodemographic characteristics of children with intellectual disability in Western Australia
Publisher: Elsevier BV
Date: 04-2005
DOI: 10.1016/J.SOCSCIMED.2004.08.014
Abstract: The social determinants of intellectual disability (ID) are poorly understood, particularly in Australia. This study has investigated sociodemographic correlates of ID of unknown cause in Western Australian born children. Using record linkage to the Western Australian Maternal & Child Health Research Database, maternal sociodemographic characteristics of children with ID (of unknown cause) born between 1983 and 1992 (n = 2871) were compared with those of children without ID (n = 236,964). Socioeconomic indices for areas based on the census district of mother's residence were also included in the analysis. Aboriginal mothers (OR = 2.83 [CI: 2.52, 3.18]), teenagers (OR = 2.09 [CI: 1.82, 2.40]) and single mothers (OR = 2.18 [CI: 1.97, 2.42]) were all at increased risk of having a child with mild or moderate ID. Children of mothers in the most socioeconomically disadvantaged 10% had more than five times the risk of mild and moderate ID compared with those in the least disadvantaged 10% (OR = 5.61 [CI: 4.42, 7.12]). Fourth or later born children were also at increased risk (OR = 1.82 [CI: 1.63, 2.02]). The results of the study have implications both for further aetiological investigation as well as service provision for children with ID. Furthermore, many of the sociodemographic correlates identified in this study, particularly in the mild/moderate category of ID, are potentially modifiable, opening up opportunities for primary prevention.
Assessment of on-time vaccination coverage in population subgroups: A record linkage cohort study
Publisher: Elsevier BV
Date: 06-2018
DOI: 10.1016/J.VACCINE.2018.05.084
Abstract: Reported infant vaccination coverage at age 12 months in Australia is >90%. On-time coverage of the 2-4-6 month schedule and coverage in specific populations is rarely reported. We conducted a population-based cohort study of 1.9 million Australian births, 1996-2012, combining in idual birth and perinatal records with immunisation records through probabilistic linkage. We assessed on-time coverage across 13 demographic and perinatal characteristics of diphtheria-tetanus-pertussis vaccines (DTP) defined as vaccination 14 days prior to the scheduled due date, to 30 days afterwards. On-time DTP vaccination coverage in non-Aboriginal infants was 88.1% for the 2-month dose, 82.0% for 4-month dose, and 76.7% for 6-month dose 3-dose coverage was 91.3% when assessed at 12 months. On-time DTP coverage for Aboriginal infants was 77.0%, 66.5%, and 61.0% for the 2-4-6 month dose 3-dose coverage at 12 months was 79.3%. Appreciable differences in on-time coverage were observed across population subgroups. On-time coverage in non-Aboriginal infants born to mothers with ≥3 previous pregnancies was 62.5% for the 6-month dose (47.9% for Aboriginal infants) up to 23.5 percentage points lower than for first-borns. Infants born to mothers who smoked during pregnancy had coverage 8.7-10.3 percentage points lower than infants born to non-smoking mothers for the 4- and 6-month dose. A linear relationship was apparent between increasing socio-economic disadvantage and decreasing on-time coverage. On-time coverage of the 2-4-6 month schedule is only 50-60% across specific population subgroups representing a significant avoidable public health risk. Aboriginal infants, multiparous mothers, and those who are socio-economically disadvantaged are key groups most likely to benefit from targeted programs addressing vaccine timeliness.
Breast feeding and cognitive development in childhood: A prospective birth cohort study
Publisher: Wiley
Date: 2003
DOI: 10.1046/J.1365-3016.2003.00464.X
Abstract: The aim of this study was to examine prospectively the relation between duration of breast feeding and cognitive outcomes. A cohort study of 2860 children enrolled before birth provided data from 2393 term infants of English-speaking mothers. Of these, complete infant feeding data in the first year of life and verbal cognitive IQ (Peabody Picture Vocabulary Test - PPVT-R) were available for 1450 children at 6 years, and a performance subtest (Perceptual organisation WISC - Block Design) for 1375 children at 8 years. Full breast feeding was categorised as none,> 0 to 6 months. Associations between breast-feeding duration and PPVT-R at 6 years and Block Design at 8 years were estimated before and after adjustment for gender, gestational age, maternal age, maternal education, parental smoking and the presence of older siblings. The early cessation of full breast feeding was associated with reduced verbal IQ and the performance subtest. In unadjusted analysis, mean standardised PPVT-R scores were 6.44 points greater (P 6 months compared with those never breast fed. After adjustment, mean PPVT-R scores were 3.56 points higher in children fully breast fed for> 6 months compared with those children never breast fed (P = 0.003). Similarly, Block Design scores were higher in those fully breast fed for> 6 months compared with those never breast fed in unadjusted (P = 0.001) but not adjusted analyses (P = 0.223). Interactions between maternal education (four levels) and breast feeding demonstrated a positive association of maternal education on verbal IQ (F = 2.64 P = 0.005) in children breast fed for longer but not on performance (F = 0.74 P = 0.67). The early introduction of milk other than breast milk was associated with reduced verbal IQ after adjustment for social and perinatal confounders. Although these effects were interacting with maternal education, they may act through undefined mechanisms in human milk.
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