Nature of socioeconomic inequalities in neonatal mortality: population based study

Objective To investigate time trends in socioeconomic inequalities in cause specific neonatal mortality in order to assess changing patterns in mortality due to different causes, particularly prematurity, and identify key areas of focus for future intervention strategies

Occupational Exposure to Hydrazine and Subsequent Risk of Lung Cancer: 50-Year Follow-Up

Hydrazine is carcinogenic in animals, but there is inadequate evidence to determine if it is carcinogenic in humans. This study aimed to evaluate the association between hydrazine exposure and the risk of lung cancer.The cause specific mortality rates of a cohort of 427 men who were employed at an English factory that produced hydrazine between 1945 and 1971 were compared with national mortality rates.By the end of December 2012 205 deaths had occurred. For men in the highest exposure category with greater than two years exposure and after more than ten years since first exposure the relative risks compared with national rates were: 0.85 (95% CI: 0.18-2.48) for lung cancer, 0.61 (95% CI: 0.07-2.21) for cancers of the digestive system, and 0.44 (95% CI: 0.05-1.57) for other cancers.After 50 years of follow up, the results provide no evidence of an increased risk of death from lung cancer or death from any other cause

Socioeconomic inequalities in the rate of stillbirths by cause: a population-based study.

OBJECTIVE: To assess time trends in socioeconomic inequalities in overall and cause-specific stillbirth rates in England. DESIGN: Population-based retrospective study. SETTING: England. PARTICIPANTS: Stillbirths occurring among singleton infants born between 1 January 2000 and 31 December 2007. MAIN OUTCOME MEASURE: Cause-specific stillbirth rate per 10 000 births by deprivation tenth and year of birth. Deprivation measured using the UK index of multiple deprivation at Super Output Area level. METHODS: Poisson regression models were used to estimate the relative deprivation gap (comparing the most and least deprived tenths) in rates of stillbirths (overall and cause-specific). Excess mortality was calculated by applying the rates seen in the least deprived tenth to the entire population at risk. Discussions with our local NHS multicentre ethics committee deemed that this analysis of national non-identifiable data did not require separate ethics approval. RESULTS: There were 44 stillbirths per 10 000 births, with no evidence of a change in rates over time. Rates were twice as high in the most deprived tenth compared with the least (rate ratio (RR) 2.1, 95% CI 2.0 to 2.2) with no evidence of a change over time. There was a significant deprivation gap for all specific causes except mechanical events (RR 1.2, 95% CI 0.9 to 1.5). The widest gap was seen for stillbirths due to antepartum haemorrhages (RR 3.1, 95% CI 2.8 to 3.5). No evidence of a change in the rate of stillbirth or deprivation gap over time was seen for any specific cause. CONCLUSION: A wide deprivation gap exists in stillbirth rates for most causes and is not diminishing. Unexplained antepartum stillbirths accounted for 50% of the deprivation gap, and a better understanding of these stillbirths is necessary to reduce socioeconomic inequalities

Number of deaths observed (O) and expected (E) by category of exposure, duration of exposure, years since first exposure, and cause.

<p>* All men were exposed for ≥ 6 months.</p><p>For category and duration of exposure see footnotes to <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0138884#pone.0138884.t001" target="_blank">Table 1</a>. IHD = ischaemic heart disease.</p><p>Number of deaths observed (O) and expected (E) by category of exposure, duration of exposure, years since first exposure, and cause.</p

Number of men exposed and man-years at risk by category of exposure, duration of exposure, and years since first exposure.

<p>* All men were exposed for ≥ 6 months.</p><p>† Men who at first had low or moderate exposures and who were subsequently highly exposed contributed man-years at risk in the low or moderate categories initially and to the high category after their first exposure in that category. The numbers of men in each category, therefore, add up to more than 427 in all, as some men contributed to more than one category. Similarly, all men who contributed man-years at risk ≥ 10 y after first exposure and for durations of exposure of ≥ 2 y also contributed to man-years at risk <10 y after first exposure and to < 2 y duration of exposure.</p><p>‡ High = men who may have been exposed to about 1–10 ppm hydrazine vapour in the ambient air; moderate = men unlikely to have been exposed to ≥ 1 ppm and probably < 0.5 ppm hydrazine vapour in the ambient air; low = men unlikely to have been exposed to hydrazine vapour.</p><p>Number of men exposed and man-years at risk by category of exposure, duration of exposure, and years since first exposure.</p

Congenital anomalies associated with trisomy 18 or trisomy 13: a registry-based study in 16 european countries, 2000-2011

The aim of this study was to examine the prevalence of trisomies 18 and 13 in Europe and the prevalence of associated anomalies. Twenty-five population-based registries in 16 European countries provided data from 2000–2011. Cases included live births, fetal deaths (20+ weeks’ gestation), and terminations of pregnancy for fetal anomaly (TOPFAs). The prevalence of associated anomalies was reported in live births. The prevalence of trisomy 18 and trisomy 13 were 4.8 (95%CI: 4.7–5.0) and 1.9 (95%CI: 1.8–2.0) per 10,000 total births. Seventy three percent of cases with trisomy 18 or trisomy 13 resulted in a TOPFA. Amongst 468 live born babies with trisomy 18, 80% (76–83%) had a cardiac anomaly, 21% (17–25%) had a nervous system anomaly, 8% (6–11%) had esophageal atresia and 10% (8–13%) had an orofacial cleft. Amongst 240 Live born babies with trisomy 13, 57% (51–64%) had a cardiac anomaly, 39% (33–46%) had a nervous system anomaly, 30% (24–36%) had an eye anomaly, 44% (37–50%) had polydactyly and 45% (39–52%) had an orofacial cleft. For babies with trisomy 18 boys were less likely to have a cardiac anomaly compared with girls (OR?=?0.48 (0.30–0.77) and with trisomy 13 were less likely to have a nervous system anomaly [OR?=?0.46 (0.27–0.77)]. Babies with trisomy 18 or trisomy 13 do have a high proportion of associated anomalies with the distribution of anomalies being different in boys and girl