The purpose of this study was to describe the relative frequency, pattern, and mechanism of surfing injuries. Descriptive data of surfing injuries was collected by using a Web site-based interactive multiple choice survey. Data was collected from May 1998 to August 1999. Completed surveys were obtained from 1,348 individuals reporting 1,237 acute injuries and 477 chronic injuries. Lacerations accounted for 42% of all acute injuries, contusions 13%, sprains/strains 12%, and fractures 8%. Thirty-seven percent of acute injuries were to the lower extremity, and 37% to the head and neck. Fifty-five percent of injuries resulted from contact with ones own board, 12% from another surfer's board, and 17% from the sea floor. Sixty-seven percent of acute surfing injuries are caused by board contact. Older surfers, more expert surfers, and those surfing large waves have a higher relative risk for significant injury. Equipment modifications are suggested that may decrease the risk for injury.

Background We report on the associations between the intake of certain foods and beverages and the incidence of gastric cancer in a cohort of 11 907 randomly selected Japanese residents of Hawaii (6297 women and 5610 men). MethodsThe daily intake of six beverages, cigarettes and alcohol and the weekly frequency of intake of 13 foods and food groups was estimated with a short food frequency questionniare. Over an average follow-up period of 14.8 years, 108 cases of gastric cancer (44 women, 64 men) were identified via linkage to the Hawaii Tumor Registry. ResultsIn gender-combined proportional hazards analyses, the consumption of fresh fruit seven or more times per week was associated with a significantly reduced risk of gastric cancer, compared to lower levels of consumption (relative hazard (RH): 0.6, 95% confidence interval (CI) : 0.4-1.0, P = 0.03). The combined intake of fresh fruit and raw vegetables was inversely associated with the risk of gastric cancer in the total cohort, and among the men (P < 0.05). No significant relationships were found between gastric cancer incidence and the intake of pickled vegetables, miso soup, dried or salted fish, or processed meats among either gender. Compared to non-drinkers, men who drank one cup of coffee per day had a significantly elevated risk of gastric cancer (RH: 2.5, 95% CI: 1.0-6.1, P= 0.05), but there was no evidence of a dose-response relationship. Cigarette smoking and consumption of alcohol were not related to gastric cancer, in analyses restricted to the men. Conclusions The results related to fruit and vegetable intake are consistent with an antinitrosating effect of these foods, while the unexpected association between coffee consumption and gastric cancer is difficult to explain and may represent a chance finding.

The associations between cigarette smoking history and later cognitive performance were examined among 3,429 Japanese-American participants of the Honolulu Heart Program (HHP) and its extension, the Honolulu-Asia Aging Study (HAAS). Cognitive performance was measured by the Cognitive Abilities Screening Instrument (CASI), administered as part of HAAS (mean age at HAAS exam (standard deviation (SD)): 77.7 (4.6) years). Information on smoking history was collected during the first and third HHP exams (mean age (SD) at Exam III: 58.6 (4.7) years). Compared with never-smokers, those who had smoked continuously between Exams I-III and those who had quit smoking during that period had significantly lower CASI scores, after adjustment for age, education, Japanese acculturation, and Exam III alcohol intake. In multiple logistic regression controlling for the above covariates, a significantly higher risk of cognitive impairment (CASI score < 82) was associated with continuous smoking (odds ratio (OR) = 1.36, 95% confidence interval (CI) 1.10-1.69) and quitting between Exams I-III (OR = 1.36, 95% CI 1.03-1.80) compared with never smoking. This excess risk of cognitive impairment among continuous smokers and Exam I-III quitters was slightly diminished by further adjustment for body mass index and several vascular covariates. Additional analyses suggested a reduced risk of cognitive impairment among the longer-term quitters. This study suggests a positive association between smoking during middle age and later risk of cognitive impairment.

Risk of coronary heart disease (CHD) among the Honolulu Heart Program participants was examined in relation to body mass index (BMI) at age 25 and two subsequent periods of weight change: age 25 to examination I (1965-1968) and examination I to examination III (1971-1974). During a maximum follow-up period of 17 years after examination III, there were 479 incident cases of CHD among the study sample of 6,176 Japanese-American men. Levels of BMI at age 25 were positively related to CHD incidence after statistical control for age, smoking, and subsequent weight change. Relative risk between the lowest and highest BMI categories was 2.44 (95% confidence interval (CI) 1.61-3.69). Compared with a weight change of less than 2.5 kg between age 25 and examination I, relative risks were 1.41 (95% CI 1.00-1.97) for a weight gain between 2.6 and 5 kg, 1.60 (95% CI 1.22-2.11) for a weight gain between 5.1 and 10 kg, and 1.75 (95% CI 1.32-2.33) for a weight gain of more than 10 kg. During the examination I-III period, in contrast, the highest risk of CHD was found in men who lost the greatest amount of weight; the relative risk of CHD for men who lost more than 2.5 kg was 1.25 (95% CI 0.98-1.60). The authors conclude that levels of relative weight in early adulthood were positively related to risk of CHD occurring much later in the lives of these men. The association between CHD incidence and weight change appeared to be modified by age, with higher risks for earlier weight gain and later weight loss in the lives of these men.

Obesity in American Samoan adults in 1990 was compared to that in 1976-1978 to evaluate population changes concomitant with modernization. Body weight, stature, the body mass index (BMI), and two skinfolds were measured in 1990 in 830 males and females 25-74 years old, and were compared to corresponding data from 1976 and 1978 for 1,621 adults. Mean BMI and skinfold thicknesses increased markedly from 1976-1978 to 1990 in males at all ages. Mean BMI for 45-54 year old males was approximately 3.6 kg/m higher (P < 0.0001) in 1990 than in 1976-1978, but was only 0.6 kg/m higher in females of the same age. The prevalence of overweight increased significantly from 66% in 1976-1978 to 85% in 1990 (P < 0.001) in 35-44 year old males, but remained about the same, 91%, in females of that age. Similar sex differences in temporal change were found in skinfolds. Fasting serum total and high density lipoprotein (HDL) cholesterol and triglycerides were obtained for a random subsample of 67 males 40-49 years old and were compared to lipid levels in a 1978 sample of American Samoan males of similar age and residence. Both total and HDL cholesterol were significantly different between 1978 and 1990, 178 vs. 205 mg/dl (P < 0.02), and 43 vs. 37 mg/dl (P < 0.01), respectively. Triglycerides were higher in 1990 than in 1978, 169 vs. 128 mg/dl. The results suggest that obesity and adiposity increased more over 12-14 years among adult males than among females, who in 1976-1978 were already massively overweight. © 1993 Wiley-Liss, Inc.

Prognostic, level III.

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