- Email: [email protected]
Airflow Obstruction in a Population Exposed to Occupational Lung Carcinogens
668
Abstracts / Annals of Epidemiology 22 (2012) 661e680
meets (abnormal) criteria for metabolic syndrome. Mean LDL cholesterol and insulin values were abnormal in all DU categories. Those who reported DU OL were significantly more likely to have abnormal CMDR versus non-DU (OR¼1.3, 95% CI: 1.10-1.45) and females were 1.6 times more likely than nonDU to have a cluster of >3 CMDRF (p < 0.0001). Conclusion: Results show that DU is associated with elevated BMI, WC, LDL cholesterol and insulin in young adults, and among women in particular. These findings suggest there are significant proportions of the US young adult population in poor cardiometabolic health.
Environment or Occupation P31. Potential Life Expectancy Gains Related to HealthHarmless Tobacco Products M.H. Brenner. Department of Epidemiology, Berlin University of Technology, Berlin, Germany Purpose: Given the importance of tobacco as a risk factor in CVD, lung cancer (LC) and COPD mortality, 21st century tobacco research includes efforts to design products that require minimal or less harm to health. But if such health-harmless products were successfully marketed, how great a reduction in smoking-related deaths could be achieved? An empirical answer to this question would involve the determination of how much tobacco actually contributes to CVD, LC and COPD mortality, holding constant other risk factors that normally influence these causes of death. Methods: We used data for 43 industrialized countries on smoking prevalence and age-adjusted mortality for major smoking-related illnesses, to determine the basic relation between smoking and mortality in different industrialized countries. Multi-decrement life-table analysis was used to derive the gains in life expectancy. Results: Remarkably, in standard cross-sectional regression analysis, very few significant relations could be found between these variables. However, the inclusion of national level socio-economic variables e e.g, GDP per capita, labor force participation e allowed the basic relations between smoking and mortality to be observed. Nevertheless, the dominant factors influencing mortality, in multi-variable regression, related to the national economy. Conclusion: Absent “traditional” patterns of economic growth, the beneficial effect of health-harmless tobacco products might only be minimal.
P32-S. Using National Injury Surveillance Systems to Assess Law Enforcement-Related Injury and Fatality Rates A.T. Holloway-Beth, L. Friedman. Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, IL Purpose: Assaults by police go under-reported and are poorly described in America. Methods: The Criminal Justice system (Bureau of Justice Statistics- BJS) along with the Public Health system (Centers of Disease Control and PreventionCDC) collects and store information on injuries and fatalities that are caused by police officers. These two systems were compared using epidemiological methods. The BJS uses surveys to assess injury rates and sampling of police departments for fatality rates. Results: The BJS found the average injury rate to be 34.4 per 100,000 for 2002, 2005, and 2008, while the CDC reports 23.2 per 100,000 for the same period. The BJS was 1.48 times more likely to report injuries than the CDC but this is not surprising because according to the 1999 BJS report only 34% of those injured used emergency services, 20% treated themselves, and 43% received no treatment at all. The CDC data shows that Black males were 5.35 times more likely to be injured by the police than White males; the BJS does not breakdown rates racially. Fatality rates from both the BJS and the CDC were essentially the same, averaging 0.14 per 100,000 from 2003 to 2007. The CDC has been collecting fatality data since 1981 while the BJS began in 2003. Conclusion: Fatal injuries seem to be captured well by the BJS and the CDC but there is a large discrepancy in the capturing of non-fatal injuries. The BJS provides injury rates in 3 year reports and fatality rates annually whereas the CDC does not report injury or fatality rates.
P33-S. Incidence and Mortality of Pesticide Poisoning in South Korea, 2006-2010 Won Jin Lee,1 Eun Shil Cha,1 Yousun Ko,1 Jaeyoung Kim2. 1 Department of Preventive Medicine, College of Medicine, Korea University, 2 Department of Preventive Medicine, College of Medicine, Keimyung University Purpose: Pesticide poisoning has been recognized as an important public health issue worldwide. The objective of this study is to identify the magnitude of mortality and incidence of pesticide poisoning and to describe their epidemiologic characteristics in South Korea. Methods: We calculated the age-standardized rates of mortality and incidence of pesticide poisoning in South Korea from 2006 through 2010, using the registered death data and National Health Insurance claims data. Pesticide-related deaths and illnesses were defined by ICD-10 with the code for toxic effect of pesticides (T60.0-T60.9). Results: During the study period 2006-2010, a total of 16,161 deaths and 45,290 patients related to pesticide poisoning were identified, with mortality and incidence rates of 6.5 and 18.3 per 100,000, respectively. The proportion of pesticide poisoning among total incident cases with poisoning and total poisoning deaths were 7.5% and 66.9%, respectively. Intentional selfpoisoning was the majority cause of death from pesticides (85.9% of total pesticide poisoning deaths). The rate of pesticide poisoning was higher in men than in women and the highest in the rural area. Age-specific pesticide poisoning rates increased with age, with the highest rate among those aged 80 or over. Pesticide poisoning mainly occurred from May to August and main causative agents were herbicides and fungicides. Conclusion: Pesticide-related incidence and mortality are prevalent and demonstrated demographic, seasonal and regional variations.
P34. Agricultural Activites Related to Pesticide Exposure Among Male Farmers in South Korea Won Jin Lee,1 Yousun Ko,1 Yun Keun Lee,2 Eun Shil Cha1. 1 Department of Preventive Medicine, College of Medicine, Korea University, 2 Wonjin Institute for Occupational and Environmental Health, Seoul, Korea Purpose: The objective of this study was to examine the agricultural characteristics related to pesticide exposure among male Korean farmers. Methods: A nationwide sampling survey of male farmers was conducted in South Korea. This survey used a stratified multistage probability sampling design and adopted the face-to-face interview method. A total of 1,958 male farmers were interviewed in order to investigate the agricultural activities which represent pesticide exposure in 2010. Farming characteristics were analyzed by type of farming and cumulative days or hours of pesticide application were calculated as the sum of exposure to pesticides by each type of farming. Results: Rice was the most frequent farming type followed by vegetable, fruit, and greenhouse. Greenhouse (11.9 days) and fruit (9.1 days) farmers had the higher annual days of pesticide application than those of other farming type, whereas an application hour per day was the lowest at greenhouse farmers (1.8 hour). Overall, cumulative annual pesticide application hours were the highest in fruit farmers (37.0 hours), and were lowest in rice farmers (8.8 hours). The proportion of personal protective equipment used was similar by type of farming. Conclusion: Our nationwide sampling survey demonstrated that fruit farmers have the highest risk of occupational pesticide exposure in South Korea. Analyzing the agricultural activities provides important information to estimate pesticide exposure for future epidemiologic study.
P35-S. Airflow Obstruction in Occupational Lung Carcinogens
a
Population
Exposed
to
N. Fauziah,1 R. Booton,2 P.V. Barber,2 T. Frank,2 F. de Vocht,1 A.C. Povey1. 1 Centre for Occupational & Environmental Health, The University of Manchester, UK, 2 University Hospital of South Manchester, UK Purpose: Morbidity and mortality from obstructive respiratory diseases has increased. Occupational risk factors can be important determinants of disease development. In this study we are investigating the association between exposure to occupational lung carcinogens and recorded airflow obstruction in high risk populations.
Abstracts / Annals of Epidemiology 22 (2012) 661e680
Methods: This is a population-based cohort study, with subjects aged 40-75 and registered with GP practices in the Wythenshawe District of Manchester. At baseline, participants completed a questionnaire on occupational exposures, smoking status, family history, respiratory symptoms and undertook spirometry. Results: 2700 subjects were invited to participate of which 389 (14.4% responded). So far 255 (9.4%) have completed the baseline assessment and 245 (96.1%) spirometry. 158 participants (64.5%) had a history of occupational exposure to lung carcinogens and 138 (56.3%) of them have been exposed to dust. After adjusting for smoking, age and gender, occupational exposure to asbestos and cement were strongly associated with airflow obstruction compared with no exposure (p < 0.05) with an OR 5.70 (95% CI 1.08 e 29.9) and OR 3.96 (95% CI 1.74 e 9.04), respectively. Conclusion: The population-based study reaffirms that those workers exposed to occupational carcinogens are at a higher risk of having airflow obstruction, a marker of lung cancer risk.
P36. Air Ions and Mood Outcomes: a Review and Metaanalysis V. Perez, D.D. Alexander, W.H. Bailey. Health Sciences, Exponent, Inc., Chicago, IL Purpose: Psychological effects of air ions have been reported for more than 80 years in the media and scientific literature. This study summarizes a qualitative literature review and quantitative meta-analysis, where applicable, that examines the potential effects of exposure to negative and positive air ions on psychological measures of mood and emotional state. Methods: A structured literature review was conducted to identify human experimental studies published through July 1, 2011. Thirty studies (19572010) evaluating the effects of air ionization on depression, anxiety, mood states, and subjective feelings of mental well-being in humans were included. Five studies on negative ionization and depression (measured using a structured interview guide) were evaluated using meta-analysis. Results: Consistent ionization effects were not observed for anxiety, mood, relaxation/sleep, and personal comfort. Negative ionization, however, was significantly associated with lower depression ratings (mean summary effect and 95% confidence interval [CI] following high- and low-density exposure: 14.28 (95% CI: 12.93-15.62) and 7.23 (95% CI: 2.62- 11.83), respectively). However, no relationship between the duration or frequency of ionization treatment on depression ratings was evident. Conclusion: No consistent influence of air ionization on anxiety, mood, relaxation, sleep, and personal comfort measures was observed. In contrast, negative air ionization was associated with lower depression scores at the highest exposure level. Future research should determine the biological plausibility of this association.
P37-S. Use of Uncertainty Analysis to Quantify the Impact of Measurement Error on an Estimate of Effect for Occupational Exposure to Tcdd-Contaminated Chemicals and Ischemic Heart Disease L.L.F. Scott. Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN Purpose: Over the last decade advances in epidemiologic methods have refocused attention on causal relationships, renouncing simple associations that often lack quantitative adjustment for study imperfections. Here, the impact of exposure and disease misclassification on the odds ratio (OR) for ischemic heart disease (IHD) mortality in a cohort of workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were quantified. Methods: Uncertainty methods were used to calculate ORs corrected for misclassification due to inaccurate disease reporting on death certificates and the use of surrogate exposure metrics measured in a fraction of the workers 20 years post-exposure. Probability distributions identified for each misclassification parameter using external validation data and expert judgment were then sampled using Monte Carlo simulation techniques. Results: Correction for exposure and disease misclassification produced a lognormal probability distribution of ORs for IHD with a wider range of possible values than the traditional epidemiological analysis. Conclusion: The application of uncertainty analysis to studies of workers occupationally exposed to TCDD-contaminated chemicals is useful for quantifying systematic error and will be valuable in determining whether a true causal relationship exists between exposure and IHD in these workers.
669
Health Services P38-S. Are Physicians the Worst Patients? A Study of Physician Adherence to International Adult Health Guidelines Among Themselves N.A. AlAnazi, A.I. AlSharidi, M.A. AlGhamdi, M.A. AlMeshal, R. AlJaser, R. AlAnazi, A.O. AlSuwaida. Department of Medicine, KSU, Riyadh, KSA Purpose: Physician's attitude towards disease prevention is important and level of their acceptance of these preventive strategies is much significant. Their adherence to the screening guidelines in applying it on the patients depends on how much they are implementing it on themselves. Yet few studies tackled the adherence of physicians to preventive medicine guidelines through applying it on themselves. Methods: An online and paper format survey was completed by a sample of 635 physicians from Saudi Arabia and some of the gulf countries including Bahrain, Kuwait and Emirates. The study included 495 males and 140 females. The collected data included the main components of screening program which has been recommended by the international guidelines. Results: A significant percentage of physicians were not adherent to the preventive screen measures recommended by the international guidelines. Rates of Self-reported adherence to guidelines were low for colonoscopy and stool occult blood test (12% and 18%, respectively). Of male physician, 13% had PSA tests and less than 1% had digital rectal exams. Sixty percent of female physician do not get annual mammograms. Among participants, 40% do not participate in physical activity, 17% are active smokers and 89% use their cell phone when they drive. Conclusion: Most of the physicians are not applying the recommended international preventive guidelines on themselves. This may also negatively influence the adoption and implementation of screening guidelines among their patients.
P39-S. Depression as a Determinant of Preventive Healthcare Practices Among Women B. Brewer, V.K. Cheruvu. College of Public Health, Kent State University, Kent, OH Purpose: The purpose of this research study is to examine the association between depression and screening for breast and cervical cancers in a national, multiethnic sample. Methods: Cross-sectional data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of current depression, using the PHQ-8 scale, among women who have had lifetime diagnosis of depression. Data were available from 21 states. Logistic regression models were used to model the likelihood of screening for breast and cervical cancers in relation to current depression adjusting for all potential confounders. Data were analyzed in 2012 and accounted for the complex sampling design of the BRFSS to generalize the findings to the non-institutionalized US population of women. Results: The prevalence of current depression among women who are eligible for screening for cervical and breast cancers is 28.4% and 27.2%. Women with current depression were less likely to have a screening test for breast and cervical cancers [Odds Ratio (OR): 0.54, 95% CI: 0.44 e 0.66; Odds Ratio (OR): 0.56, 95% CI: 0.47 e0.64] when compared to women without current depression. Conclusion: This study provides evidence for the effect of depression on different cancer-screening tests in a national sample. Consideration of targeted preventive healthcare services is necessary for women with mental disorders.
P40. Humourous Fobt Video: Accelerating Use of Focus Group Findings to Benefit Cancer Screening Among the Under and Never Screened Dionne Gesink,1 Levni Yilmaz,2 Brooke Filsinger,3 Sarai Racey,1 Alanna Mihic,1 Joan Antal,3 Susan Bondy1. 1 University of Toronto, Toronto, Ontario, 2 Tales of Mere Existence, San Francisco, CA, 3 Cancer Care Ontario, Toronto, Ontario
Abstracts / Annals of Epidemiology 22 (2012) 661e680
meets (abnormal) criteria for metabolic syndrome. Mean LDL cholesterol and insulin values were abnormal in all DU categories. Those who reported DU OL were significantly more likely to have abnormal CMDR versus non-DU (OR¼1.3, 95% CI: 1.10-1.45) and females were 1.6 times more likely than nonDU to have a cluster of >3 CMDRF (p < 0.0001). Conclusion: Results show that DU is associated with elevated BMI, WC, LDL cholesterol and insulin in young adults, and among women in particular. These findings suggest there are significant proportions of the US young adult population in poor cardiometabolic health.
Environment or Occupation P31. Potential Life Expectancy Gains Related to HealthHarmless Tobacco Products M.H. Brenner. Department of Epidemiology, Berlin University of Technology, Berlin, Germany Purpose: Given the importance of tobacco as a risk factor in CVD, lung cancer (LC) and COPD mortality, 21st century tobacco research includes efforts to design products that require minimal or less harm to health. But if such health-harmless products were successfully marketed, how great a reduction in smoking-related deaths could be achieved? An empirical answer to this question would involve the determination of how much tobacco actually contributes to CVD, LC and COPD mortality, holding constant other risk factors that normally influence these causes of death. Methods: We used data for 43 industrialized countries on smoking prevalence and age-adjusted mortality for major smoking-related illnesses, to determine the basic relation between smoking and mortality in different industrialized countries. Multi-decrement life-table analysis was used to derive the gains in life expectancy. Results: Remarkably, in standard cross-sectional regression analysis, very few significant relations could be found between these variables. However, the inclusion of national level socio-economic variables e e.g, GDP per capita, labor force participation e allowed the basic relations between smoking and mortality to be observed. Nevertheless, the dominant factors influencing mortality, in multi-variable regression, related to the national economy. Conclusion: Absent “traditional” patterns of economic growth, the beneficial effect of health-harmless tobacco products might only be minimal.
P32-S. Using National Injury Surveillance Systems to Assess Law Enforcement-Related Injury and Fatality Rates A.T. Holloway-Beth, L. Friedman. Environmental and Occupational Health Sciences, University of Illinois at Chicago, Chicago, IL Purpose: Assaults by police go under-reported and are poorly described in America. Methods: The Criminal Justice system (Bureau of Justice Statistics- BJS) along with the Public Health system (Centers of Disease Control and PreventionCDC) collects and store information on injuries and fatalities that are caused by police officers. These two systems were compared using epidemiological methods. The BJS uses surveys to assess injury rates and sampling of police departments for fatality rates. Results: The BJS found the average injury rate to be 34.4 per 100,000 for 2002, 2005, and 2008, while the CDC reports 23.2 per 100,000 for the same period. The BJS was 1.48 times more likely to report injuries than the CDC but this is not surprising because according to the 1999 BJS report only 34% of those injured used emergency services, 20% treated themselves, and 43% received no treatment at all. The CDC data shows that Black males were 5.35 times more likely to be injured by the police than White males; the BJS does not breakdown rates racially. Fatality rates from both the BJS and the CDC were essentially the same, averaging 0.14 per 100,000 from 2003 to 2007. The CDC has been collecting fatality data since 1981 while the BJS began in 2003. Conclusion: Fatal injuries seem to be captured well by the BJS and the CDC but there is a large discrepancy in the capturing of non-fatal injuries. The BJS provides injury rates in 3 year reports and fatality rates annually whereas the CDC does not report injury or fatality rates.
P33-S. Incidence and Mortality of Pesticide Poisoning in South Korea, 2006-2010 Won Jin Lee,1 Eun Shil Cha,1 Yousun Ko,1 Jaeyoung Kim2. 1 Department of Preventive Medicine, College of Medicine, Korea University, 2 Department of Preventive Medicine, College of Medicine, Keimyung University Purpose: Pesticide poisoning has been recognized as an important public health issue worldwide. The objective of this study is to identify the magnitude of mortality and incidence of pesticide poisoning and to describe their epidemiologic characteristics in South Korea. Methods: We calculated the age-standardized rates of mortality and incidence of pesticide poisoning in South Korea from 2006 through 2010, using the registered death data and National Health Insurance claims data. Pesticide-related deaths and illnesses were defined by ICD-10 with the code for toxic effect of pesticides (T60.0-T60.9). Results: During the study period 2006-2010, a total of 16,161 deaths and 45,290 patients related to pesticide poisoning were identified, with mortality and incidence rates of 6.5 and 18.3 per 100,000, respectively. The proportion of pesticide poisoning among total incident cases with poisoning and total poisoning deaths were 7.5% and 66.9%, respectively. Intentional selfpoisoning was the majority cause of death from pesticides (85.9% of total pesticide poisoning deaths). The rate of pesticide poisoning was higher in men than in women and the highest in the rural area. Age-specific pesticide poisoning rates increased with age, with the highest rate among those aged 80 or over. Pesticide poisoning mainly occurred from May to August and main causative agents were herbicides and fungicides. Conclusion: Pesticide-related incidence and mortality are prevalent and demonstrated demographic, seasonal and regional variations.
P34. Agricultural Activites Related to Pesticide Exposure Among Male Farmers in South Korea Won Jin Lee,1 Yousun Ko,1 Yun Keun Lee,2 Eun Shil Cha1. 1 Department of Preventive Medicine, College of Medicine, Korea University, 2 Wonjin Institute for Occupational and Environmental Health, Seoul, Korea Purpose: The objective of this study was to examine the agricultural characteristics related to pesticide exposure among male Korean farmers. Methods: A nationwide sampling survey of male farmers was conducted in South Korea. This survey used a stratified multistage probability sampling design and adopted the face-to-face interview method. A total of 1,958 male farmers were interviewed in order to investigate the agricultural activities which represent pesticide exposure in 2010. Farming characteristics were analyzed by type of farming and cumulative days or hours of pesticide application were calculated as the sum of exposure to pesticides by each type of farming. Results: Rice was the most frequent farming type followed by vegetable, fruit, and greenhouse. Greenhouse (11.9 days) and fruit (9.1 days) farmers had the higher annual days of pesticide application than those of other farming type, whereas an application hour per day was the lowest at greenhouse farmers (1.8 hour). Overall, cumulative annual pesticide application hours were the highest in fruit farmers (37.0 hours), and were lowest in rice farmers (8.8 hours). The proportion of personal protective equipment used was similar by type of farming. Conclusion: Our nationwide sampling survey demonstrated that fruit farmers have the highest risk of occupational pesticide exposure in South Korea. Analyzing the agricultural activities provides important information to estimate pesticide exposure for future epidemiologic study.
P35-S. Airflow Obstruction in Occupational Lung Carcinogens
a
Population
Exposed
to
N. Fauziah,1 R. Booton,2 P.V. Barber,2 T. Frank,2 F. de Vocht,1 A.C. Povey1. 1 Centre for Occupational & Environmental Health, The University of Manchester, UK, 2 University Hospital of South Manchester, UK Purpose: Morbidity and mortality from obstructive respiratory diseases has increased. Occupational risk factors can be important determinants of disease development. In this study we are investigating the association between exposure to occupational lung carcinogens and recorded airflow obstruction in high risk populations.
Abstracts / Annals of Epidemiology 22 (2012) 661e680
Methods: This is a population-based cohort study, with subjects aged 40-75 and registered with GP practices in the Wythenshawe District of Manchester. At baseline, participants completed a questionnaire on occupational exposures, smoking status, family history, respiratory symptoms and undertook spirometry. Results: 2700 subjects were invited to participate of which 389 (14.4% responded). So far 255 (9.4%) have completed the baseline assessment and 245 (96.1%) spirometry. 158 participants (64.5%) had a history of occupational exposure to lung carcinogens and 138 (56.3%) of them have been exposed to dust. After adjusting for smoking, age and gender, occupational exposure to asbestos and cement were strongly associated with airflow obstruction compared with no exposure (p < 0.05) with an OR 5.70 (95% CI 1.08 e 29.9) and OR 3.96 (95% CI 1.74 e 9.04), respectively. Conclusion: The population-based study reaffirms that those workers exposed to occupational carcinogens are at a higher risk of having airflow obstruction, a marker of lung cancer risk.
P36. Air Ions and Mood Outcomes: a Review and Metaanalysis V. Perez, D.D. Alexander, W.H. Bailey. Health Sciences, Exponent, Inc., Chicago, IL Purpose: Psychological effects of air ions have been reported for more than 80 years in the media and scientific literature. This study summarizes a qualitative literature review and quantitative meta-analysis, where applicable, that examines the potential effects of exposure to negative and positive air ions on psychological measures of mood and emotional state. Methods: A structured literature review was conducted to identify human experimental studies published through July 1, 2011. Thirty studies (19572010) evaluating the effects of air ionization on depression, anxiety, mood states, and subjective feelings of mental well-being in humans were included. Five studies on negative ionization and depression (measured using a structured interview guide) were evaluated using meta-analysis. Results: Consistent ionization effects were not observed for anxiety, mood, relaxation/sleep, and personal comfort. Negative ionization, however, was significantly associated with lower depression ratings (mean summary effect and 95% confidence interval [CI] following high- and low-density exposure: 14.28 (95% CI: 12.93-15.62) and 7.23 (95% CI: 2.62- 11.83), respectively). However, no relationship between the duration or frequency of ionization treatment on depression ratings was evident. Conclusion: No consistent influence of air ionization on anxiety, mood, relaxation, sleep, and personal comfort measures was observed. In contrast, negative air ionization was associated with lower depression scores at the highest exposure level. Future research should determine the biological plausibility of this association.
P37-S. Use of Uncertainty Analysis to Quantify the Impact of Measurement Error on an Estimate of Effect for Occupational Exposure to Tcdd-Contaminated Chemicals and Ischemic Heart Disease L.L.F. Scott. Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN Purpose: Over the last decade advances in epidemiologic methods have refocused attention on causal relationships, renouncing simple associations that often lack quantitative adjustment for study imperfections. Here, the impact of exposure and disease misclassification on the odds ratio (OR) for ischemic heart disease (IHD) mortality in a cohort of workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were quantified. Methods: Uncertainty methods were used to calculate ORs corrected for misclassification due to inaccurate disease reporting on death certificates and the use of surrogate exposure metrics measured in a fraction of the workers 20 years post-exposure. Probability distributions identified for each misclassification parameter using external validation data and expert judgment were then sampled using Monte Carlo simulation techniques. Results: Correction for exposure and disease misclassification produced a lognormal probability distribution of ORs for IHD with a wider range of possible values than the traditional epidemiological analysis. Conclusion: The application of uncertainty analysis to studies of workers occupationally exposed to TCDD-contaminated chemicals is useful for quantifying systematic error and will be valuable in determining whether a true causal relationship exists between exposure and IHD in these workers.
669
Health Services P38-S. Are Physicians the Worst Patients? A Study of Physician Adherence to International Adult Health Guidelines Among Themselves N.A. AlAnazi, A.I. AlSharidi, M.A. AlGhamdi, M.A. AlMeshal, R. AlJaser, R. AlAnazi, A.O. AlSuwaida. Department of Medicine, KSU, Riyadh, KSA Purpose: Physician's attitude towards disease prevention is important and level of their acceptance of these preventive strategies is much significant. Their adherence to the screening guidelines in applying it on the patients depends on how much they are implementing it on themselves. Yet few studies tackled the adherence of physicians to preventive medicine guidelines through applying it on themselves. Methods: An online and paper format survey was completed by a sample of 635 physicians from Saudi Arabia and some of the gulf countries including Bahrain, Kuwait and Emirates. The study included 495 males and 140 females. The collected data included the main components of screening program which has been recommended by the international guidelines. Results: A significant percentage of physicians were not adherent to the preventive screen measures recommended by the international guidelines. Rates of Self-reported adherence to guidelines were low for colonoscopy and stool occult blood test (12% and 18%, respectively). Of male physician, 13% had PSA tests and less than 1% had digital rectal exams. Sixty percent of female physician do not get annual mammograms. Among participants, 40% do not participate in physical activity, 17% are active smokers and 89% use their cell phone when they drive. Conclusion: Most of the physicians are not applying the recommended international preventive guidelines on themselves. This may also negatively influence the adoption and implementation of screening guidelines among their patients.
P39-S. Depression as a Determinant of Preventive Healthcare Practices Among Women B. Brewer, V.K. Cheruvu. College of Public Health, Kent State University, Kent, OH Purpose: The purpose of this research study is to examine the association between depression and screening for breast and cervical cancers in a national, multiethnic sample. Methods: Cross-sectional data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were used to estimate the prevalence of current depression, using the PHQ-8 scale, among women who have had lifetime diagnosis of depression. Data were available from 21 states. Logistic regression models were used to model the likelihood of screening for breast and cervical cancers in relation to current depression adjusting for all potential confounders. Data were analyzed in 2012 and accounted for the complex sampling design of the BRFSS to generalize the findings to the non-institutionalized US population of women. Results: The prevalence of current depression among women who are eligible for screening for cervical and breast cancers is 28.4% and 27.2%. Women with current depression were less likely to have a screening test for breast and cervical cancers [Odds Ratio (OR): 0.54, 95% CI: 0.44 e 0.66; Odds Ratio (OR): 0.56, 95% CI: 0.47 e0.64] when compared to women without current depression. Conclusion: This study provides evidence for the effect of depression on different cancer-screening tests in a national sample. Consideration of targeted preventive healthcare services is necessary for women with mental disorders.
P40. Humourous Fobt Video: Accelerating Use of Focus Group Findings to Benefit Cancer Screening Among the Under and Never Screened Dionne Gesink,1 Levni Yilmaz,2 Brooke Filsinger,3 Sarai Racey,1 Alanna Mihic,1 Joan Antal,3 Susan Bondy1. 1 University of Toronto, Toronto, Ontario, 2 Tales of Mere Existence, San Francisco, CA, 3 Cancer Care Ontario, Toronto, Ontario