Hormones down under: Hormone therapy use after the women's health initiative

Aims: The primary objective was to describe the usage pattern of hormone therapy (HT) in a sample of urban Australian women in 2001 and to assess the characteristics of users vs. non-users. The second objective was to determine whether there had been any change in usage since the publication of the results of the combined oestrogen plus progestagen arm of the Women's Health Initiative (WHI) in 2002. Methods: A cohort of 374 postmenopausal women aged 50-80 years participated in this substudy of the LAW (Longitudinal Assessment of Ageing in Women) project: a 5-year multidisciplinary, observational study. Participants completed an annual medical assessment including details of the use of HT and the reasons for use, as well as demographic and psychosocial data. Results: In December 2001, 30.8% of the participants were using HT, whereas 55.4% were ever users. The management of vasomotor symptoms and mood disturbance were the primary reasons for use. Of those who had been using HT in December 2001 (24.4%) women ceased using HT in the 3 months following publication of the WHI results. The percentage of women using HT in December 2003 (13.9%) was less than half of that of December 2001. Conclusion: The rate of HT use and the reasons for use, in 2001 in Brisbane was similar to that of other Australian regions. Usage of HT decreased since the publication of the WHI results in 2002 which may reflect changing attitudes by patients and practitioners regarding HT.

How does the health and well-being of young Australian vegetarian and semi-vegetarian women compare with non-vegetarians?

Objective: To compare the sociodemographic characteristics, health status and health service use of vegetarians, semi-vegetarians and non-vegetarians. Design: In cross-sectional data analyses of the Australian Longitudinal Study on Women's Health in 2000, 9113 women (aged 22-27 years) were defined as non-vegetarians if they reported including red meat in their diet., as semi-vegetarians if they excluded red meat and as vegetarians if they excluded meat, poultry and fish from their diet. Results: The estimated prevalence was 3% and 10% for vegetarian and semi-vegetarian young women. Compared with non-vegetarians, vegetarians and semi-vegetarians were more likely to live in urban areas and to not be married. Vegetarians and semi-vegetarians had lower body mass index (mean (95% confidence interval): 22.2 (21.7-22.7) and 23.0 (22.7-23.3) kg m(-2)) than non-vegetarians (23.7 (23.6-23.8) kg m(-2)) and tended to exercise more. Semi-vegetarians and vegetarians had poorer mental health, with 21-22% reporting depression compared with 15% of non-vegetarians (P < 0.001). Low iron levels and menstrual symptoms were also more common in both vegetarian groups. Vegetarian and semi-vegetarian women were more likely to consult alternative health practitioners and semi-vegetarians reported taking more prescription and non-prescription medications. Compared with non-vegetarians, semi-vegetarians were less likely and vegetarians much less likely to be taking the oral contraceptive pill. Conclusion: The levels of physical activity and body mass indices of the vegetarian and semi-vegetarian women suggest they are healthier than non-vegetarians. However, the greater reports of menstrual problems and the poorer mental health of these young women may be of clinical significance.

Identification of industrial sources of airborne heavy metal pollution in urban areas

The research examines the deposition of airborne particles which contain heavy metals and investigates the methods that can be used to identify their sources. The research focuses on lead and cadmium because these two metals are of growing public and scientific concern on environmental health grounds. The research consists of three distinct parts. The first is the development and evaluation of a new deposition measurement instrument - the deposit cannister - designed specifically for large-scale surveys in urban areas. The deposit cannister is specifically designed to be cheap, robust, and versatile and therefore to permit comprehensive high-density urban surveys. The siting policy reduces contamination from locally resuspended surface-dust. The second part of the research has involved detailed surveys of heavy metal deposition in Walsall, West Midlands, using the new high-density measurement method. The main survey, conducted over a six-week period in November - December 1982, provided 30-day samples of deposition at 250 different sites. The results have been used to examine the magnitude and spatial variability of deposition rates in the case-study area, and to evaluate the performance of the measurement method. The third part of the research has been to conduct a 'source-identification' exercise. The methods used have been Receptor Models - Factor Analysis and Cluster Analysis - and a predictive source-based deposition model. The results indicate that there are six main source processes contributing to deposition of metals in the Walsall area: coal combustion, vehicle emissions, ironfounding, copper refining and two general industrial/urban processes. |A source-based deposition model has been calibrated using facctorscores for one source factor as the dependent variable, rather than metal deposition rates, thus avoiding problems traditionally encountered in calibrating models in complex multi-source areas. Empirical evidence supports the hypothesised associatlon of this factor with emissions of metals from the ironfoundry industry.

Background levels of urban land contamination

The research work reported in this thesis is concerned with the development and application of an urban scale sampling methodology for measuring and assessing background levels of heavy metal soil contamination in large and varied urban areas. The policy context of the work is broadly the environmental health problems posed by contaminated land and their implications for urban development planning. Within this wider policy context, the emphasis in the research has been placed on issues, related to the determination and application of 'guidelines' for assessing the significance of contaminated land for environmental planning. In concentrating on background levels of land contamination, the research responds to the need for additional techniques which address both the problems of measuring soil contamination at the urban scale and which are also capable of providing detailed information for use in the assessment of contaminated sites. Therefore, a key component of the work has been the development of a land-use based sampling framework for generating spatially comprehensive data on heavy metals in soil. The utility of the information output of the sampling method is demonstrated in two alternative ways. Firstly, it has been used to map the existing pattern of typical levels of heavy metals in urban soils. Secondly, it can be used to generate both generalised data in the form of 'reference levels' from which the overall significance of .background contamination may be assessed and detailed data, termed 'normal limit levels' for use in the assessment of site specific investigation data. The fieldwork was conducted in the West Midlands Metropolitan County and surface soil has been sampled and analysed for a measure of plant-available' and 'total' lead cadmium, copper and zinc. The research contrasts with much of the previous work on contaminated land which has generally concentrated on either the detailed investigation of individual sites suspected of being contaminated or the appraisal of land contamination resulting from specific point sources.