Health problems account for a small part of the association between socioeconomic status and disability pension award. Results from the Hordaland Health Study

<p>Abstract</p> <p>Background</p> <p>Low socioeconomic status is a known risk factor for disability pension, and is also associated with health problems. To what degree health problems can explain the increased risk of disability pension award associated with low socioeconomic status is not known.</p> <p>Methods</p> <p>Information on 15,067 participants in the Hordaland Health Study was linked to a comprehensive national registry on disability pension awards. Level of education was used as a proxy for socioeconomic status. Logistic regression analyses were employed to examine the association between socioeconomic status and rates of disability pension award, before and after adjusting for a wide range of somatic and mental health factors. The proportion of the difference in disability pension between socioeconomic groups explained by health was then calculated.</p> <p>Results</p> <p>Unadjusted odds ratios for disability pension was 4.60 (95% CI: 3.34-6.33) for the group with elementary school only (9 years of education) and 2.03 (95% CI 1.49-2.77) for the group with high school (12 years of education) when compared to the group with higher education (more than 12 years). When adjusting for somatic and mental health, odds ratios were reduced to 3.87 (2.73-5.47) and 1.81 (1.31-2.52). This corresponds to health explaining only a marginal proportion of the increased level of disability pension in the groups with lower socioeconomic status.</p> <p>Conclusion</p> <p>There is a socioeconomic gradient in disability pension similar to the well known socioeconomic gradient in health. However, health accounts for little of the socioeconomic gradient in disability pension. Future studies of socioeconomic gradients in disability pension should focus on explanatory factors beyond health.</p

Advantages of linking national registries with twin registries for epidemiological research

Linking national registries with twin data represents an opportunity to produce epidemiological research of high quality. National registries contain information on a broad array of variables, some of which cannot be measured reliably in regular health surveys. By taking kinship into consideration, twin studies have the benefit of being able to identify confounding stemming from genetic or shared environmental sources. In this paper, we use examples from our own interview and questionnaire-based twin studies from the Norwegian Twin Registry (NTR) on mental disorders, alcohol use and socioeconomic status linked to registry data on medical benefits to demonstrate the value. In the first example, we examined to what extent genetic and environmental factors contributed to sick leave and disability pension and the association between these two types of benefits. In the second example, we explored the genetic and environmental relationship between personality disorders and sick leave. In the third example, a co-twin control design was applied to explore whether there is a true protective relationship between moderate alcohol consumption and health. The fourth example shows to what degree anxiety and depression are associated with later sick leave granted for not only mental disorders, but also somatic disorders, adjusted for confounding by genetic and shared environmental factors. In the fifth example, we address the socioeconomic gradient in sick leave, adjusting for non-observed confounders associated with the family in a co-twin control design. Our examples illustrate some of the potentials obtainable by linking national registries with twin data. The efforts that have been made to create the NTR in Norway and the International Network of Twin Studies (INTR) internationally make these types of linkage studies easier to conduct and available to more researchers. As there are still many areas to explore, we encourage epidemiological researchers to make use of this possibility

Dishwashing Water Recycling System And Related Water Quality Standards For Military Use

As the demand for reliable and safe water supplies increases, both water quality and available quantity are being challenged by population growth and climate change. Greywater reuse is becoming a common practice worldwide; however, in remote locations of limited water supply, such as those encountered in military installations, it is desirable to expand its classification to include dishwashing water to maximize the conservation of fresh water. Given that no standards for dishwashing greywater reuse by the military are currently available, the current study determined a specific set of water quality standards for dishwater recycling systems for U.S. military field operations. A tentative water reuse standard for dishwashing water was developed based on federal and state regulations and guidelines for non-potable water, and the developed standard was cross-evaluated by monitoring water quality data from a full-scale dishwashing water recycling system using an innovative electrocoagulation and ultrafiltration process. Quantitative microbial risk assessment (QMRA) was also performed based on exposure scenarios derived from literature data. As a result, a specific set of dishwashing water reuse standards for field analysis (simple, but accurate) was finalized as follows: turbidity (\u3c1NTU), Escherichia coli (\u3c50cfumL-1), and pH (6-9). UV254 was recommended as a surrogate for organic contaminants (e.g., BOD5), but requires further calibration steps for validation. The developed specific water standard is the first for dishwashing water reuse and will be expected to ensure that water quality is safe for field operations, but not so stringent that design complexity, cost, and operational and maintenance requirements will not be feasible for field use. In addition the parameters can be monitored using simple equipment in a field setting with only modest training requirements and real-time or rapid sample turn-around. This standard may prove useful in future development of civilian guidelines

Catalytic Hydrothermal Liquefaction of Food Waste Using CeZrOx

Approximately 15 million dry tons of food waste is produced annually in the United States (USA), and 92% of this waste is disposed of in landfills where it decomposes to produce greenhouse gases and water pollution. Hydrothermal liquefaction (HTL) is an attractive technology capable of converting a broad range of organic compounds, especially those with substantial water content, into energy products. The HTL process produces a bio-oil precursor that can be further upgraded to transportation fuels and an aqueous phase containing water-soluble organic impurities. Converting small oxygenated compounds that partition into the water phase into larger, hydrophobic compounds can reduce aqueous phase remediation costs and improve energy yields. HTL was investigated at 300 °C and a reaction time of 1 h for conversion of an institutional food waste to bio-oil, using either homogeneous Na2CO3 or heterogeneous CeZrOx to promote in situ conversion of water-soluble organic compounds into less oxygenated, oil-soluble products. Results with food waste indicate that CeZrOx improves both bio-oil higher heating value (HHV) and energy recovery when compared both to non-catalytic and Na2CO3-catalyzed HTL. The aqueous phase obtained using CeZrOx as an HTL catalyst contained approximately half the total organic carbon compared to that obtained using Na2CO3—suggesting reduced water treatment costs using the heterogeneous catalyst. Experiments with model compounds indicated that the primary mechanism of action was condensation of aldehydes, a reaction which simultaneously increases molecular weight and oxygen-to-carbon ratio—consistent with the improvements in bio-oil yield and HHV observed with institutional food waste. The catalyst was stable under hydrothermal conditions (≥16 h at 300 °C) and could be reused at least three times for conversion of model aldehydes to water insoluble products. Energy and economic analysis suggested favorable performance for the heterogeneous catalyst compared either to non-catalytic HTL or Na2CO3-catalyzed HTL, especially once catalyst lifetime differences were considered. The results of this study establish the potential of heterogeneous catalysts to improve HTL economics and energetics

Mood, anxiety, and alcohol use disorders and later cause-specific sick leave in young adult employees

Background Mental disorders strongly influence work capability in young adults, but it is not clear which disorders that are most strongly associated with sick leave, and which diagnoses that are stated on the sick leave certificates. Better knowledge of the impairments associated with different mental disorders is needed for optimal planning of interventions and prioritization of health services. In the current study, we investigate the prospective associations between eight mood, anxiety, and alcohol use disorders, and later sick leave granted for mental, somatic, or any disorder. Methods Lifetime mental disorders were assessed by structured diagnostic interviews in 2,178 young adults followed for eight years with registry data on sick leave. Relative risk ratios were estimated for the associations between each mental disorder and the different forms of sick leave. Results All included diagnoses were associated with later sick leave. In adjusted analyses, major depressive disorder and generalized anxiety disorder were the strongest predictors of sick leave granted for mental disorders, whereas social anxiety disorder and specific phobia were the strongest predictors of sick leave granted for somatic disorders. Specific phobia and major depressive disorder had the highest attributable fractions for all-cause sick leave. Conclusions Mood and anxiety disorders constituted independent risk factors for all cause sick leave, whereas alcohol use disorders seemed to be of less importance in young adulthood. Disorders characterised by distress were most strongly associated with sick leave granted for mental disorders, whereas disorders characterised by fear primarily predicted sick leave granted for somatic conditions. A large part of all sick leave is related to specific phobia, due to the high prevalence of this disorder. The impairment associated with this common disorder may be under-acknowledged, and it could decrease work capacity among individuals with somatic disorders. This disorder has good treatment response and may be overlooked as a target for interventions aimed at prevention of sick leave