The Alaska Department of Health and Social Services implemented the Behavioral Risk Factor Surveillance System (BRFSS) in 1990 incooperation with the federal Centers for Disease Control and Prevention. The system gathers information about the health-related lifestyle choices of Alaskan adults related to leading causes of death such as heart disease, cancer and injury. The program is part of an ongoing national data collection system. Results are analyzed each year to improve our understanding of Alaskanhealth habits and to measure progress toward national and state health objectives. This report summarizes survey findings from1991 to 1996 and compares the results to selected national health objectives presented in the Healthy People 2000 publication.
In April 1988, an outbreak of gastroenteritis occurred among employees in a large company in Helsinki, Finland. A retrospective cohort study, using a self-administered questionnaire, was carried out to ascertain the cause and extent of the outbreak. To meet the case definition, employees had to have had diarrhoea and/or vomiting since 2 April, 1998. A subanalysis was made in the biggest office, consisting of 360 employees, of whom 204 (57%) completed the questionnaire. Of these 108 (53%) met the case definition. Employees who had eaten raspberry dressing were more likely to meet the case definition than those who had not (Attack Rate (AR) 65% versus AR 18% Relative Risk, (RR) 3.7, 95%, Confidence Intervals (CI) 2.0-6.7). Four stool specimens obtained from affected kitchen staff who had all eaten the raspberry dressing and who had all become ill simultaneously with the employees were positive by polymerase chain reaction (PCR) for calicivirus. The data suggest that the primary source of the outbreak was imported frozen raspberries contaminated by calicivirus.
Escherichia coli O157:H7 infections have traditionally been associated with animal products, but outbreaks associated with produce have been reported with increasing frequency. In fall 1996, a small cluster of E. coli O157:H7 infections was epidemiologically linked to a particular brand (brand A) of unpasteurized apple juice.
To define the extent of the outbreak, confirm the source, and determine how the apple juice became contaminated.
Descriptive epidemiologic study and traceback investigation.
Western United States and British Columbia, Canada.
Patients with E. coli O157:H7 infection who were exposed to brand A apple juice.
Clinical outcome and juice exposure histories of case-patients, pulsed-field gel electrophoresis of case and juice isolates, and juice production practices.
Seventy persons with E. coli O157:H7 infection and exposure to brand A unpasteurized apple juice were identified. Of these persons, 25 (36%) were hospitalized, 14 (20%) developed the hemolytic uremic syndrome, and 1 (1%) died. Recalled apple juice that was produced on 7 October 1996 grew E. coli O157:H7 with a pulsed-field gel electrophoresis pattern indistinguishable from that of case isolates. Apple juice produced on 7 October 1996 accounted for almost all of the cases, and the source of contamination was suspected to be incoming apples. Three lots of apples could explain contamination of the juice: Two lots originated from an orchard frequented by deer that were subsequently shown to carry E. coli O157:H7, and one lot contained decayed apples that had been waxed.
Standard procedures at a state-of-the-art plant that produced unpasteurized juices were inadequate to eliminate contamination with E. coli O157:H7. This outbreak demonstrated that unpasteurized juices must be considered a potentially hazardous food and led to widespread changes in the fresh juice industry.
Exposure to polychlorinated biphenyls and organochlorine pesticides through traditional food resources was examined for Arctic Indigenous women living in two cultural and environmental areas of the Canadian Arctic--one community representing Baffin Island Inuit in eastern Arctic and two communities representing Sahtú Dene/Métis in western Arctic. Polychlorinated biphenyls, toxaphene, chlorobenzenes, hexachlorocyclohexanes, dichlorodiphenyltrichloroethane, chlordane-related compounds and dieldrin were determined in local food resources as normally prepared and eaten. Quantified dietary recalls taken seasonally reflected normal consumption patterns of these food resources by women in three age groups: 20-40 y, 41-60 y and > or = 61 y. There was wide variation of intake of all organochlorine contaminants in both areas and among age groups for the Sahtú. Fifty percent of the intake recalls collected from the Baffin Inuit exceeded the acceptable daily intake for chlordane-related compounds and toxaphene, and a substantial percentage of the intake records for dieldrin and polychlorinated biphenyls exceeded the acceptable or tolerable daily intake levels. Primary contributing foods to organochlorine contaminants intake for the Baffin Inuit were meat and blubber of ringed seal, blubber of walrus and mattak and blubber of narwal. Important foods contributing organochlorine contaminant to the Sahtú Dene/Métis were caribou, whitefish, inconnu, trout and duck. The superior nutritional benefits and potential health risks of traditional food items are reviewed, as are implications for monitoring organochlorine contaminant contents of food, clinical symptoms and food use.
No available dietary assessment method is without error in measuring dietary intake. This has led to an increased interest in biological markers of dietary intake. This article is a review of the literature investigating whether the concentration of carotenoids in blood can serve as biological markers for the intake of fruit and vegetables. The literature indicates an association between intake of fruit and vegetables and the concentration of total carotenoids, alfa-carotene, beta-carotene, lutein and beta-cryptoxanthin in plasma. The same association was not observed for plasma lycopene. Results from several studies also indicate that plasma alfa-carotene and plasma total carotenoids are more suitable as biological markers of the intake of fruit and vegetables than the other carotenoids. As there are large individual variations in the plasma carotenoid response after intake, carotenoids in blood will be a better marker of intake at group level than individual level. Furthermore, the average value from several measurements of carotenoids in blood will be a better marker of long-term intake than a single measurement. Several factors in addition to fruit and vegetables influence the concentration of carotenoids in blood. It is important to assess these factors when carotenoids in blood are used as biological markers of the intake of fruit and vegetables.
The average dietary intake of coenzyme Q10 and coenzyme Q9 of the Danish population was determined, based on food consumption data from a national dietary survey. Selected food items in edible form were analyzed for the coenzyme Q content by HPCL with UV-detection, and their contribution to the total intake calculated. The effect of cooking was a 14-32% destruction of coenzyme Q10 by frying, and no detectable destruction by boiling. The average coenzyme Q10 intake of the Danish population was estimated to 3-5 mg/day, primarily derived from meat and poultry (64% of the daily intake), while cereals, fruit, edible fats, and vegetables only make minor contributions. The intake of coenzyme Q10 is approximately 1 mg/day, primarily derived from vegetable fats and cereals. The alpha-tocopherol content of the selected food samples was analyzed by HPLC with fluorescence detection, and the calculated average intake of alpha-tocopherol was comparable to the estimate from the dietary survey (7-8 vs. 7.4 mg alpha-tocopherol/day, respectively). The commercially available dietary supplements (capsules) provide 10-30 mg CoQ10/day, thus the average diet. The optimal dietary intake of coenzyme Q10 is unknown.
The purpose of the study was to investigate the consumption of fruit and vegetables among boys and girls in a teenage cohort with respect to changes, gender differences and stability of consumption over time. In 1990, a representative sample of 13-year-olds from Hordaland county was recruited (n = 924) and surveyed regularly until the age of 19. The frequency of consumption decreased dramatically from the age of 13 to the age of 19. At the age of 13, 57% reported eating fruit daily, whereas only 21% of the boys and 37% of the girls reported eating fruit daily at the age of 19. Corresponding results for the consumption of vegetables showed that 42% reported eating vegetables daily at the age of 13, compared to 29% at the age of 19. No clear gender differences were found. The consumption frequency at group level at the age of 13 was a good indicator of the consumption frequency at a later age during adolescence. While younger adolescents until now have been at the focus of campaigns aimed at increasing fruit and vegetable consumption, our results point to the importance of focusing also on the older adolescents.
Micronuclei in peripheral blood lymphocytes from British Columbia seasonal farmworkers and controls were evaluated using the cytokinesis-block technique. The farmworkers harvested berry crops and were likely occupationally exposed to pesticides. Subjects were 39 female subjects of South Asian descent; 18 farmworkers employed during 1993 and 21 age-matched controls. The mean age was 55.9 years. Micronuceli were also scored for the presence of kinetochores. No significant difference was found between the frequency of micronucleated binucleates in the farmworkers group (19.20/1000 binucleates), and the control group (21.76/1000 binucleates). However, among the farmworkers employed in 1993, there was a positive, but not statistically significant, association between micronucleated cell frequency and weeks worked: 16.44/1000 binucleates in those working less than 20 weeks; 23.78/1000 binucleates in those working 20 to 23 weeks; and 25.43/1000 binucleates in those working more than 23 weeks. In those who had ever been employed as farmworkers, there was an elevated frequency of micronucleated cells in the group with the longest history of employment as a farmworker (25.28/1000 binucleates) compared to those with the shortest employment history (16.48/1000 binucleates). This trend remained evident after adjusting for age, red blood cell folate, meat consumption, coffee consumption and recent vaccination. A positive association between the consumption of meat and micronucleus frequency was also observed. Non-meat eaters were likely life-long vegetarians. Micronuclei in farmworkers had a lower frequency of kinetochore positive micronuclei than controls. This study indicates that South Asian berry pickers in British Columbia may be at risk for genetic damage. More studies in other ethnic groups and in males are needed to generalize the findings of this study. More direct measures of exposure are needed to elucidate the sources of genotoxicity.
The occurrence of dental erosion and the relative importance of some related factors were explored in a cross-sectional study, using blind dental examinations. A sample of 186 workers from four factories was drawn. Among the 157 dentate participants 76 were working in departments containing acid fumes and 81 controls had never worked under such conditions. Out of the dentate participants, 20 (12.7% had erosion). Anterior teeth were affected more often than posterior ones. Exposure to acid fumes, increasing age and frequency of intake of fruits increased the probability of dental erosion. It can be concluded that exposure to acid fumes in the work environment is associated with dental erosion especially on anterior teeth.