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Ludvigsson JF, Berglind D, Sundquist K, Sundström J, Tynelius P, Neovius M. The Swedish military conscription register: opportunities for its use in medical research. Eur J Epidemiol 2022; 37:767-777. [PMID: 35810240 PMCID: PMC9329412 DOI: 10.1007/s10654-022-00887-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Accepted: 06/01/2022] [Indexed: 11/24/2022]
Abstract
In Sweden, conscription around age 18y was mandatory for young men until June 30, 2010. From July 1, 2017, it became mandatory again for both sexes but the proportion of summoned people for standardised testing has so far been low. This paper describes the history, structure and content of the Swedish Military Conscription Register (SMCR). We retrieved information about the SMCR from written sources and through e-mail interviews with key personnel at the Swedish Defence Conscription and Assessment Agency. We also analysed data from the SMCR between 1969 and 2018. Between 1969 and 2018 the SMCR contains digital data on approximately 2 million individuals (98.6% men). Most conscripts were born between 1951 and 1988 (n = 1,900,000; tested between 1969 and 2006). For the 1951-1987 birth cohorts, the register has a population coverage of approximately 90% for men. Conscripts underwent written tests focusing on verbal, spatial, logical and technical ability, medical, physical, and psychological tests. The medical assessment included hearing, vision, muscle and exercise capacity, height, weight, blood pressure and resting heart rate. The SMCR has been widely used to study, e.g., obesity, cardiovascular disease, mental health, crime, cardiovascular fitness, muscle strength, sick leave and disability pension. Severe disease could qualify for exemption from military service. Thus, the prevalence of such diseases is underestimated in the SMCR population. Between 1990 and 2018, about 25,000 women also volunteered for testing. The SMCR contains population-based data on physical and psychological health in about 90% of all men born between 1951 and 1987 (corresponding to testing between 1969 and 2006), and can be used to address a host of research questions.
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Affiliation(s)
- Jonas F Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Department of Paediatrics, Örebro University Hospital, Örebro, Sweden.,Division of Epidemiology and Public Health, School of Medicine, University of Nottingham, Nottingham, UK.,Department of Medicine, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Daniel Berglind
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Johan Sundström
- Clinical Epidemiology Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.,George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Per Tynelius
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.,Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | - Martin Neovius
- Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, SE-171 76, Stockholm, Sweden.
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Hiyoshi A, Sato Y, Grotta A, Fall K, Montgomery S. Visual Acuity and the Risk of Cycling Injuries: Register-Based Cohort Study From Adolescence to Middle-age. Epidemiology 2022; 33:246-253. [PMID: 34860725 DOI: 10.1097/ede.0000000000001450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Cycling is increasingly encouraged in many countries as an inexpensive and healthy choice of transportation. Operating any vehicle on the road requires high visual acuity, but few studies to our knowledge have examined the association between vision and cycling injuries. METHODS We examined whether poorer visual acuity is associated with increased risk of fatal and nonfatal cycling injuries. We used prospectively recorded register data for 691,402 men born between 1970 and 1992 in Sweden. We followed these men from an average age of 18 years, when visual acuity was assessed during the conscription assessment, to age 45 at the latest. We identified fatal and nonfatal cycling and car injuries using Patient and Cause of Death registers. Cox regression models were used to estimate hazard ratios and 95% confidence intervals. RESULTS Based on visual acuity for the eye with the best vision, moderately impaired acuity 0.9 to 0.6 when wearing refractive correction was associated with increased risk for cycling injuries (hazard ratio = 1.44 [95% confidence interval = 1.16, 1.79]) compared with unimpaired vision (uncorrected visual acuity 1.0) and after adjustment for a wide range of potential confounders. This association remained consistent across various sensitivity analyses. Visual acuity was not associated with car injury risk. CONCLUSIONS In this cohort study, poorer vision was specifically associated with a higher rate of cycling injuries.
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Affiliation(s)
- Ayako Hiyoshi
- From the Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
- Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health, Japan
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
- Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Yuki Sato
- Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health, Japan
| | - Alessandra Grotta
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Katja Fall
- From the Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Scott Montgomery
- From the Clinical Epidemiology and Biostatistics, School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Clinical Epidemiology Division, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
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Doğan G, Şen S, Çavdar E, Mayalı H, Cengiz Özyurt B, Kurt E, Kasırga E. Should we worry about the eyes of celiac patients? Eur J Ophthalmol 2019; 30:886-890. [DOI: 10.1177/1120672119850071] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Purpose: In this article, we evaluate subfoveal choroidal thickness in celiac patients with respect to adherence to the gluten-free diet and nonadherence to the gluten-free diet, comparing with age and sex matched healthy controls using spectral-domain optical coherence tomography. Materials and Methods: A case-control study among 42 celiac patients and 42 healthy participants was conducted in the Department of Pediatric Gastroenterology. Celiac patients of our policlinics compliant with spectral-domain optical coherence tomography examination enrolled in the study. Celiac patients had been asked verbally about their adherence to gluten-free diet, were evaluated according to negative or positive EmA and anti-TG2 for defining adherence, and were divided into two groups (adherence to gluten-free diet and nonadherence to gluten-free diet). Results: Subfoveal choroidal thickness was thinner in EmA (+) or anti-TG2 (+) eyes than EmA(−) or anti-TG2 (−) eyes in celiac patients, but it was not statistically significant. The mean subfoveal choroidal thickness values in eyes with celiac disease, whose diagnosis time was longer than 60 months, were thinner than shorter group. Longer duration of gluten-free diet was associated with adherence difficulty and thinner choroidal thickness (r = −0.15, p = 0.34). Adherence to gluten-free diet was 88.2% for children below the age of 60 months and 57.1% for children older than 60 months. Conclusion: In conclusion, in addition to other extraintestinal manifestations of celiac disease, diagnosis time longer than 60 months in pediatric celiac patients, nonadherence to the gluten-free diet, and antibody positivity should be focused on during ophthalmologic examination and choroid measurement.
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Affiliation(s)
- Güzide Doğan
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Semra Şen
- Department of Pediatric Infection Disease, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Ercüment Çavdar
- Department of Ophthalmology, Akhisar State Hospital, Manisa, Turkey
| | - Hüseyin Mayalı
- Department of Ophthalmology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Beyhan Cengiz Özyurt
- Department of Public Health, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Emin Kurt
- Department of Ophthalmology, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
| | - Erhun Kasırga
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Manisa Celal Bayar University, Manisa, Turkey
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Abstract
Purpose To determine the prevalence of eye disorders in children with celiac disease (CD). Methods A total of 67 patients with CD aged from 1 to 16 years and 38 age- and sex-matched healthy children were screened for decreased visual acuity, cataract, uveitis, and diabetic retinopathy at diagnosis and during follow‐up. Results None of the patients had eye disorders at diagnosis. Only 2 of the patients had accommodative dysfunction and the others had no change in visual function during the follow-up. One of the controls had accommodative dysfunction. Conclusions No significant association was found between CD and eye disorders such as visual acuity, cataract, and uveitis among children.
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