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Laustsen BH, Omland Ø, Würtz ET, Jørgensen L, Bønløkke JH. Serum selenium levels and asthma among seafood processing workers in Greenland. Int J Circumpolar Health 2021; 80:1972525. [PMID: 34455939 PMCID: PMC8409947 DOI: 10.1080/22423982.2021.1972525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Selenium levels in the Inuit population of Greenland have been declining during the last decades. The association between Selenium and asthma has been investigated previously, but with conflicting results. The objective was to measure human serum Se (s-Se) in Greenlandic seafood processing workers, to compare with levels recorded in previous decades and to establish if s-Se is associated with asthma or lung function. Data, including questionnaire answers, spirometry, skin-prick test and s-Se from 324 seafood processing workers in Greenland were collected during 2016-2017. Mean s-Se values were compared by t-test and one-way ANOVA. Associations between s-Se and asthma, symptoms from the lower airways at work and lung function were assessed using linear regression. The mean s-Se was 96.2 µg/L. S-Se was higher among non-smokers and workers living in settlements. Workers with asthma did not have s-Se levels significantly different from those of non-asthmatics. We found a positive association between s-Se levels and FEV1 values. Selenium levels appear to continue declining in Greenland, presumably because of a more Westernised lifestyle. The health effects of declining Selenium levels remain unclear. We did not establish an association between s-Se and asthma, but we did record a positive association between s-Se and FEV1.
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Affiliation(s)
- Birgitte Hamann Laustsen
- Department of Clinical Medicine, the Faculty of Medicine, Danish Ramazzini Centre, Aalborg University, Aalborg, Denmark.,Institute of Nursing & Health Science, Ilisimatusarfik, University of Greenland, Greenland
| | - Øyvind Omland
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Else Toft Würtz
- Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
| | - Louise Jørgensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - Jakob Hjort Bønløkke
- Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aalborg University Hospital, Denmark
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At Thobari J, Satria CD, Ridora Y, Watts E, Handley A, Standish J, Bachtiar NS, Buttery JP, Soenarto Y, Bines JE. Non-antibiotic medication use in an Indonesian community cohort 0-18 months of age. PLoS One 2020; 15:e0242410. [PMID: 33206684 PMCID: PMC7673523 DOI: 10.1371/journal.pone.0242410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 10/30/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Rational medication use for treatment is mandatory, particularly in children as they are vulnerable to possible hazards of drugs. Understanding the medication use pattern is of importance to identify the problems of drug therapy and to improve the appropriate use of medication among this population. METHODS A post-hoc study of the RV3-BB Phase IIb trial to children aged 0-18 months which was conducted in Indonesia during January 2013 to July 2016. Any concomitant medication use and health events among 1621 trial participants during the 18 months of follow-up were documented. Information on medication use included the frequency, formulation, indication, duration of usage, number of regimens, medication types, and therapeutic classes. RESULTS The majority of participants (N = 1333/1621; 82.2%) used at least one non-antibiotic medication for treatment during the 18-month observation period. A total of 7586 medication uses were recorded, mostly in oral formulation (90.5%). Of all illnesses recorded, 24.7% were treated with a single drug regimen of non-antibiotic medication. The most common therapeutic classes used were analgesics/antipyretics (30.1%), antihistamines for systemic use (17.4%), cough and cold preparations (13.5%), vitamins (8.6%), and antidiarrheals (6.6%). The main medication types used were paracetamol (29.9%), chlorpheniramine (16.8%), guaifenesin (8.9%), zinc (4.6%), and ambroxol (4.1%). Respiratory system disorder was the most common reason for medication use (51.9%), followed by gastrointestinal disorders (19.2%), pyrexia (16.9%), and skin disorders (7.0%). CONCLUSION A large number of children were exposed to at least one medication during their early life, including those where evidence of efficacy and safety in a pediatric population is lacking. This supports the need for further research on pediatric drug therapy to improve the appropriate use of medication in this population.
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Affiliation(s)
- Jarir At Thobari
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
- Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
- Department of Paediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Cahya Dewi Satria
- Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
- Department of Paediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Yohanes Ridora
- Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Emma Watts
- RV3 Rotavirus Vaccine Program, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Amanda Handley
- RV3 Rotavirus Vaccine Program, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Medicines Development for Global Health, Melbourne, Victoria, Australia
| | - Jane Standish
- RV3 Rotavirus Vaccine Program, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of General Medicine, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
| | | | - Jim P. Buttery
- RV3 Rotavirus Vaccine Program, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Paediatrics, Monash University, Clayton, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia
- Department of Infection and Immunity, Monash Children’s Hospital, Clayton, Victoria, Australia
| | - Yati Soenarto
- Pediatric Research Office, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
- Department of Paediatrics, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Special Region of Yogyakarta, Indonesia
| | - Julie E. Bines
- RV3 Rotavirus Vaccine Program, Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Department of Pediatrics, University of Melbourne, Melbourne, Victoria, Australia
- Department of Gastroenterology and Clinical Nutrition, Royal Children’s Hospital Melbourne, Parkville, Victoria, Australia
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Bénard-Laribière A, Jové J, Lassalle R, Robinson P, Droz-Perroteau C, Noize P. Drug use in French children: a population-based study. Arch Dis Child 2015; 100:960-5. [PMID: 25977563 DOI: 10.1136/archdischild-2014-307224] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 04/21/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVE To provide an overview of drug use in outpatient children in France, a population-based study using a national reimbursement claims database representative of 90% of the French population was conducted. DESIGN Cross-sectional study performed between January and December 2011 using the EGB database (Echantillon Généraliste de Bénéficiaires), a 1/97th sample of the national healthcare insurance system beneficiaries. Drug use in children <18 years old was estimated through reimbursements for prescribed drugs excluding vaccines. Prevalences of use were calculated for different levels of the Anatomical Therapeutic Chemical classification by considering as users children who had at least one reimbursement during the study period. RESULTS In 2011, 133,800 children were included in the study. The overall prevalence of drug use was 84% and the median number of different drugs per child was 5. Drug use was greatest in children aged <2 years. The most widely used drugs were paracetamol, systemic anti-infectives, nasal corticosteroids and decongestants, and anti-histamines. 21% children <2 years received domperidone. CONCLUSIONS There is widespread use of medicines that are unlikely to be effective and may have significant toxicity in French children. Irrational use of medicines appears to be greatest in children aged 5 years and under.
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Affiliation(s)
| | - Jérémy Jové
- CIC Bordeaux CIC1401, Bordeaux, France ADERA, Pessac, France
| | - Régis Lassalle
- CIC Bordeaux CIC1401, Bordeaux, France ADERA, Pessac, France
| | - Philip Robinson
- CIC Bordeaux CIC1401, Bordeaux, France ADERA, Pessac, France
| | | | - Pernelle Noize
- Service de pharmacologie médicale, CHU Bordeaux, Bordeaux, France CIC Bordeaux CIC1401, Bordeaux, France INSERM, U657, Bordeaux, France
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Moraes CG, Mengue SS, Tavares NUL, Dal Pizzol TDS. [Drug use among children between zero and six years old: a population baseline study in the south of Brazil]. CIENCIA & SAUDE COLETIVA 2015; 18:3585-93. [PMID: 24263875 DOI: 10.1590/s1413-81232013001200015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/19/2012] [Indexed: 11/22/2022] Open
Abstract
The scope of this article was to estimate the prevalence of medication use in children between zero and six years old, analyzing the associated socio-demographic characteristics, and evaluating the adequacy of the medication with respect to pediatric recommendations and restrictions per age group. A cross-sectional study was conducted by means of cluster sampling on a sample comprised of children aged six or under, residents of a city in the south of Brazil. A standardized questionnaire about medication use 15 days prior to the interview was applied. A descriptive analysis was carried out, and the association between medication use and socio-demographic factors was evaluated, as well as the analysis of the pediatric adequacy of the most prevalent medication. Of the 687 children evaluated, 52% used at least one drug in the period. Associations between medication use and socio-demographic characteristics were not found, with the exception of per capita monthly income. The most prevalent medication was paracetamol (17.1%), followed by amoxicillin (9.5%) and dipyrone (8.4%). Among the ten drugs most used in children, six had pediatric restrictions for the age group. The results indicate significant use of medication, including medication with age restrictions, particularly for children under two years of age.
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Methods in pharmacoepidemiology: a review of statistical analyses and data reporting in pediatric drug utilization studies. Eur J Clin Pharmacol 2012; 69:599-604. [PMID: 22832725 DOI: 10.1007/s00228-012-1354-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Accepted: 07/10/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE To evaluate the quality of data reporting and statistical methods performed in drug utilization studies in the pediatric population. METHODS Drug utilization studies evaluating all drug prescriptions to children and adolescents published between January 1994 and December 2011 were retrieved and analyzed. For each study, information on measures of exposure/consumption, the covariates considered, descriptive and inferential analyses, statistical tests, and methods of data reporting was extracted. An overall quality score was created for each study using a 12-item checklist that took into account the presence of outcome measures, covariates of measures, descriptive measures, statistical tests, and graphical representation. RESULTS A total of 22 studies were reviewed and analyzed. Of these, 20 studies reported at least one descriptive measure. The mean was the most commonly used measure (18 studies), but only five of these also reported the standard deviation. Statistical analyses were performed in 12 studies, with the chi-square test being the most commonly performed test. Graphs were presented in 14 papers. Sixteen papers reported the number of drug prescriptions and/or packages, and ten reported the prevalence of the drug prescription. The mean quality score was 8 (median 9). Only seven of the 22 studies received a score of ≥10, while four studies received a score of <6. CONCLUSIONS Our findings document that only a few of the studies reviewed applied statistical methods and reported data in a satisfactory manner. We therefore conclude that the methodology of drug utilization studies needs to be improved.
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Ylinen S, Hämeen-Anttila K, Sepponen K, Lindblad AK, Ahonen R. The use of prescription medicines and self-medication among children--a population-based study in Finland. Pharmacoepidemiol Drug Saf 2011; 19:1000-8. [PMID: 20712023 DOI: 10.1002/pds.1963] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
PURPOSE The aim of this study was to investigate the prevalence and concomitant use of prescription medicines and self-medication, including over-the-counter (OTC) medicines, vitamins, and complementary and alternative medicines (CAMs) among Finnish children aged under 12 years. METHODS We carried out a nationwide postal survey of the use of medicines by a representative sample (n = 6000) of Finnish children aged under 12 years in spring 2007. A response rate of 67% (n = 4032) was achieved. The current use of prescription medicines and the use of OTC medicines, vitamins, and CAMs in the preceding 2 days were the main outcome measures. RESULTS In total, 17% of children had used prescription medicines and 50% some self-medication. The corresponding figures for OTC medicines, vitamins, and CAMs use were 17, 37, and 11%, respectively. Drugs for obstructive airway diseases were the most common prescription medicines, whereas analgesics and antipyretics, including non-steroidal-anti-inflammatory-medicines (NSAID), were the most common OTC medicines reported. Vitamin D was the most common vitamin, while fish oils and fatty acids were the most common CAMs used. Ten percent of the children had used prescription medicines and self-medication concomitantly. CONCLUSIONS Most of the children's medication consists of self-medication, and especially of vitamin use. However, also a considerable proportion had used prescription medicines, and a minority prescription medicines and self-medication concomitantly. In three of the cases, a combination of prescription and OTC medicine with a potential risk for interactions were found. Physicians should be aware of this wide use of self-medication when prescribing medicines.
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Affiliation(s)
- Sanna Ylinen
- School of Pharmacy/Social Pharmacy, Campus of Kuopio, University of Eastern Finland, Finland
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Drug utilisation profile in the Italian paediatric population. Eur J Pediatr 2009; 168:173-80. [PMID: 18446366 DOI: 10.1007/s00431-008-0725-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2008] [Accepted: 03/27/2008] [Indexed: 10/22/2022]
Abstract
OBJECTIVE In order to evaluate the prescribing pattern in the Italian paediatric population, prescriptions involving 923,353 children under 14 years old and dispensed during 2006 by the retail pharmacies of 22 Italian local health units were analysed. MATERIALS AND METHODS A total of 561,237 children (61%) received at least one drug prescription. The prescription prevalence rate was highest in children 3 years of age (78%), decreased with increasing age and was higher in boys than in girls (chi(2)=655; p<<0.001). Each treated child received an average of 3.2 prescriptions and 4.8 boxes. RESULTS Antibiotics and anti-asthmatics were the more prescribed therapeutic classes and represented 80% of prescriptions. Amoxicillin+clavulanic acid was the most prescribed drug (24% of the overall population; 17% of all boxes), followed by inhaled beclometasone and amoxicillin. A total of 620 different drugs were prescribed and the ten leading drugs represented 64% of the prescribed boxes. Six of the ten most prescribed drugs were the same in all age groups. Wide differences were found in the prevalence rate between the different local health units; these ranged between 50.1 and 68.4% (p<<0.001). The prescription prevalence increased in the 2000-2002 period (from 62.2 to 68.3%) and slightly decreased afterwards. CONCLUSION Despite some limitations, the systematic monitoring of prescriptions is a valuable tool for evaluating the appropriateness of the care.
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