A nested case-control study of radiation exposure and brain cancer incidence in the United States Air Force

A nested case-control study design was used to investigate the relationship between radiation exposure and brain cancer risk in the United States Air Force (USAF). The cohort consisted of approximately 880,000 men with at least 1 year of service between 1970 and 1989. Two hundred and thirty cases were identified from hospital discharge records with a diagnosis of primary malignant brain tumor (International Classification of Diseases, 9th revision, code 191). Four controls were exactly matched with each case on year of age and race using incidence density sampling. Potential career summary extremely low frequency (ELF) and microwave-radiofrequency (MWRF) radiation exposures were based upon the duration in each occupation and an intensity score assigned by an expert panel. Ionizing radiation (IR) exposures were obtained from personal dosimetry records.^ Relative to the unexposed, the overall age-race adjusted odds ratio (OR) for ELF exposure was 1.39, 95 percent confidence interval (CI) 1.03-1.88. A dose-response was not evident. The same was true for MWRF, although the OR = 1.59, with 95 percent CI 1.18-2.16. Excess risk was not found for IR exposure (OR = 0.66, 45 percent CI 0.26-1.72).^ Increasing socioeconomic status (SES), as identified by military pay grade, was associated with elevated brain tumor risk (officer vs. enlisted personnel age-race adjusted OR = 2.11, 95 percent CI 1.98-3.01, and senior officers vs. all others age-race adjusted OR = 3.30, 95 percent CI 2.0-5.46). SES proved to be an important confounder of the brain tumor risk associated with ELF and MWRF exposure. For ELF, the age-race-SES adjusted OR = 1.28, 95 percent CI 0.94-1.74, and for MWRF, the age-race-SES adjusted OR = 1.39, 95 percent CI 1.01-1.90.^ These results indicate that employment in Air Force occupations with potential electromagnetic field exposures is weakly, though not significantly, associated with increased risk for brain tumors. SES appeared to be the most consistent brain tumor risk factor in the USAF cohort. Other investigators have suggested that an association between brain tumor risk and SES may arise from differential access to medical care. However, in the USAF cohort health care is universally available. This study suggests that some factor other than access to medical care must underlie the association between SES and brain tumor risk. ^

ECONOMIC ANALYSIS OF THE DEMAND FOR PRESCRIPTION MEDICINE IN THE UNITED STATES

The purpose of this study was to understand the role of principle economic, sociodemographic and health status factors in determining the likelihood and volume of prescription drug use. Econometric demand regression models were developed for this purpose. Ten explanatory variables were examined: family income, coinsurance rate, age, sex, race, household head education level, size of family, health status, number of medical visits, and type of provider seen during medical visits. The economic factors (family income and coinsurance) were given special emphasis in this study.^ The National Medical Care Utilization and Expenditure Survey (NMCUES) was the data source. The sample represented the civilian, noninstitutionalized residents of the United States in 1980. The sample method used in the survey was a stratified four-stage, area probability design. The sample was comprised of 6,600 households (17,123 individuals). The weighted sample provided the population estimates used in the analysis. Five repeated interviews were conducted with each household. The household survey provided detailed information on the United States health status, pattern of health care utilization, charges for services received, and methods of payments for 1980.^ The study provided evidence that economic factors influenced the use of prescription drugs, but the use was not highly responsive to family income and coinsurance for the levels examined. The elasticities for family income ranged from -.0002 to -.013 and coinsurance ranged from -.174 to -.108. Income has a greater influence on the likelihood of prescription drug use, and coinsurance rates had an impact on the amount spent on prescription drugs. The coinsurance effect was not examined for the likelihood of drug use due to limitations in the measurement of coinsurance. Health status appeared to overwhelm any effects which may be attributed to family income or coinsurance. The likelihood of prescription drug use was highly dependent on visits to medical providers. The volume of prescription drug use was highly dependent on the health status, age, and whether or not the individual saw a general practitioner. ^

The diplomatic relations of the United States and Spanish America.

Mode of access: Internet.

General index to the published volumes of the Diplomatic correspondence and Foreign relations of the United States. 1861-1899.

Published in accordance with the Sundry civil act of June 6, 1900.

Foreign relations of the United States, 1955-1957.

Includes bibliographical references and index.

Foreign relations of the United States 1955-1957.

Includes bibliographical references and index.

Japan; suggested outlines for a discussion of Japan, her history, culture, problems, and relations with the United States.

"Professor Latourette, who originally prepared the Syllabus for the Japan Society ... has, in this eighth edition, concerned himself only with the historical and political evolution of Japan and Japan's foreign relations. Mr. Harold Gould Henderson ... has revised and expanded the sections on Japanese art and literature. Professor Douglas G. Haring ... has done the same for the sections on population, family and social life, and manners and customs."--p. 3.

Assessing travel behavior by blacks in the United States: a new perspective. Final report.

Transportation Department, Washington, D.C.

Records of the Department of State relating to political relations between the United States and Japan, 1910-29 [guide].

Cover title.

The five republics of Central America; their political and economic development and their relations with the United States,

Reprint of the 1918 ed.

History of the labor movement in the United States,

Mode of access: Internet.

Papers Relating to the Foreign Relations of the United States, 1918-1919, Russia

Mode of access: Internet.

Foreign relations of the United States.

Some vols. in this ed. are exact reprints (including House document nos.)--of v. from: Foreign relations of the United States, Document ed.

Records of the Department of State relating to political relations between the United States and Argentina, 1910-1929 [microform].

Accompanying guide has date: 1973.

Records of the Department of State relating to political relations between the United States and Central America, 1911-1929 [microform].

Accompanying guide has date: 1969.