OBJECTIVE: To examine the validity of self-reported information on obesity and high blood pressure (HBP) in relation to gender and age, and to explore the impacts of their misclassi®cation on the association between obesity and HBP. DESIGN: Community based cross-sectional study. SUBJECTS: 1791 adult subjects living in Humboldt, Saskatchewan, Canada. MEASUREMENTS: Objectively measured HBP was positive if systolic blood pressure (BP) was !140 mm Hg, diastolic BP was !90 mm Hg or the subject was currently using antihypertensive medication. Self-reported HBP was positive if the subjects gave an af®rmative response to the question:`Has a doctor ever said you had high blood pressure?' Body mass index (BMI) was calculated as weight (kg)aheight (m) 2 . Obesity was de®ned as a BMI b 27 kgam 2 . Measured obesity and reported obesity were based on measured and self-reported information on height and weight, respectively. RESULTS: The sensitivity of self-reported HBP was low, and was lower for men than for women, and for younger subjects than for older subjects. The speci®city was similar for both genders. Obese individuals had higher sensitivity and lower speci®city than non-obese individuals. The differential misclassi®cation of self-reported HBP caused a bias away from the null when the relative risk for HBP in relation to obesity was estimated. CONCLUSIONS: As a result of the gender-and age-related misclassi®cation of self-reported HBP, the modi®cation role of gender and age on the association between obesity and HBP could be altered. The bias caused by self-reported obesity was relatively small and was either toward or away from the null.
We examined the possible impact of tonsillectomy or adenoidectomy (T/A) on the relationship between environmental tobacco smoke (ETS) exposure and respiratory outcomes. This study was conducted in Humboldt, Saskatchewan, in 1993. The target population included all residents aged 6-17 yrs. Of the 1,019 eligible subjects, 892 participated (88%). Estimates of ETS exposure were based on the reported smoking habits of the children's household members. We defined current cough as a positive response to the question: "Does this child usually have a cough?". Information also included morning cough, night cough and a history of T/A. For children with no history of T/A, the prevalence of current cough was 8.9%, 12.2% and 14.5% for those living in families with 0, 1, and 2+ smokers respectively. The corresponding prevalence was 7.0%, 30.2% and 36.8% for children with history of T/A. Similar effects of ETS exposure were observed on morning cough and night cough. The results did not change significantly when we used various ETS measures and controlled for confounding factors. Compared to children living in nonsmoking families and without history of T/A, the adjusted odds ratio for children with a history of T/A was 7.19 (p<0.001) if they were living in families smoking >20 cigarettes x day(-1) at home. The corresponding odds ratio was only 1.64 (p=0.11) for children without a history of T/A. We concluded that children living in smoking family were more likely to cough than those living in nonsmoking families and tonsillectomy or adenoidectomy increased the apparent influence of environmental tobacco exposure on cough.
Introduction: Few studies of children have considered the effects of asthma on health−related quality of life (HRQL). We compared HRQL between children (6−18 years) with and without asthma or wheeze, and differences in the associations between personal and environmental characteristics with HRQL. Methods: We conducted a case−control study in Humboldt, Canada and the surrounding area. Cases comprised subjects reporting wheeze in the past 12 months or doctor−diagnosed asthma. Two controls per case were selected randomly. Data was collected by questionnaire, dust collection (play area floor and mattress) for endotoxin, and saliva collection for cotinine, a measure of tobacco smoke exposure. Body mass index was calculated from measured height and weight to classify children as obese or not. HRQL was assessed by the Child Health Questionnaire PF−50. Two summary scores were calculated: the physical summary score (PHS) and the psychosocial summary score (PSS). Results: Among those contacted and eligible, 43% took part (102 cases, 207 controls). Cases had lower PHS [mean=53.3 (SD=2.4) vs 55.8 (SD=4.7), p<0.01] and PSS [mean=51.0 (SD=9.9) vs 55.2 (SD=5.7), p<0.01] than controls indicating worse HRQL. Being obese was associated with lower PHS among cases but not controls. Higher activity levels were associated with higher PSS. Higher levels of mattress endotoxin were associated with worse PHS among cases with low tobacco smoke exposure, but with better PHS among cases with high tobacco smoke exposure. Conclusions: Children with asthma or wheeze experience lower HRQL than controls. Being obese and with asthma or wheeze may compound these effects while being active, regardless of disease status, may improve HRQL. Interaction between environmental factors can result in differences in HRQL with stronger effects being present among children with asthma or wheeze. This abstract is funded by: CIHR MOP−57907. Am J Respir Crit Care Med 179;2009:A4805 Internet address: www.atsjournals.org Online Abstracts Issue
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