International Journal of Circumpolar Health

Published by Co-Action Publishing
Online ISSN: 2242-3982
Print ISSN: 1239-9736
This paper describes the life control and its development, concentrating on relationship between life control and health. The main goal is to review the life control and health among Northern Finnish women and men. Life control and its connections with health and life situation make up the theoretical basis of the work. The definition of life control is based on Antonovsky's theory of a sense of coherence. The concept of life control here includes the following subconcepts: comprehensibility (how understandable are the internal and external environments), manageability (ability to influence one's life course at work and in one's whole life), meaningfulness (one's experiences of the meaning of the present or future events) and life satisfaction and human relationships. Future studies need to explain factors affecting the abilities of individuals to control their lives and reach sensible decisions regarding their health and lives overall. New ways of strengthening life control among those who have become marginalized in relation to society need to be identified. A model of factors relating to life control and relationships between such factors could be constructed.
The objective of this study was to refine the understanding of cognitive troubles in autism and to clarify the modes of information processing mobilized by the subjects. Eight children were examined, aged 4;9-9;1, with a diagnosis of moderate autism. The Kaufman Assessment Battery for Children (K-ABC) was presented to each child. The results support an executive functioning deficit interpretation and a weak drive for central coherence in autism. Practical implications of this study in terms of follow up are also discussed.
In a case-control study we compared men who had suffered a myocardial infarction with age-matched controls free from clinically apparent ischemic heart disease. Our main interest were differences in serum lipid and apolipoprotein concentrations. We found no significant differences between these two populations. The fatty acid composition of the serum cholesterol esters was studied as an indirect measure of the dietary fat quality. There were rather small differences with regard to the fatty acid composition between the survivor cases and the controls suggesting that the quality of the dietary fat was not better among the cases after the myocardial infarction than among the average male in Kiruna. The cases had a significantly higher proportion of palmitoleic acid (16:1 n-7, p < 0.004) than the controls, also after controlling for other biomedical risk factors. A high content of palmitoleic acid may be a marker of increased risk for coronary heart disease.
Chronic otitis media (COM) and associated hearing loss is a frequent problem for many Inuit children in Canada. In this study, we evaluated individuals aged 12-16 years living in Inukjuak, to determine the prevalence of middle ear disease and hearing loss, and the effect of hearing loss on academic performance. Otological examination, hearing test, medical and school file review were performed in November 1997. 88 individuals were seen. Otological examination revealed maximal scarring in 1.8%, minimal scarring in 34.9%, normal eardrums in 49.1% and chronic otitis media in 16.9%. There were 62 individuals whose ear exams could be directly compared with a previous exam done in 1987. Of those, there were three ears that had developed COM and 4/13 ears with COM in 1987 that had healed. Hearing tests found bilateral normal hearing in 80% (PTA <20dB), unilateral loss in 15% and bilateral loss in 5%. Hearing loss was associated with poorer academic performance in Language (p<.05). A similar trend was found in Mathematics but not in Inuttitut. Chronic otitis media remains a significant problem among the Inuit, with a prevalence of 16.9% in individuals aged 12-16 years. One in five in this age group has hearing loss, and this hearing loss impacts on academic performance.
Recent studies showed that depression was an independent predictor of mortality from cardio-vascular disease in healthy women. To explore the effect of depression (D) on relative risk (RR) of myocardial infarction (MI) and stroke for 16 years (1995-2010) in the female population aged 25-64 years from Novosibirsk, Russia. Under the third screening of the WHO "MONICA-psychosocial" (MOPSY) programme, a cohort of women aged 25-64 years (N=560) was surveyed. Women were followed for 16 years for the incidence of MI and stroke (1995-2010). D was measured at the baseline examination by means of test "MOPSY". Participants having stroke, MI, arterial hypertension, coronary artery diseases and diabetes in their medical history at the baseline were excluded from this analysis. The prevalence of D in women aged 25-64 years was 55.2%. With the growth of D levels, positive self-rated health reduced and almost 100% of those women have complaints about their health, but considered the care of their health insufficient. Women with major D significantly extended negative behavioral habits: smoking and unsuccessful attempts to give up, low physical activity, and less likely to follow a diet (healthy food). Major D associated with high job strain and family stress. Relative risk (RR) of MI development in women with D during 16 years of study was higher in 2.53 cases (p<0.05) and risk of stroke was higher in 4.63 cases (p<0.05). The prevalence of D in women aged 25-64 years was >50%. Women with D had a 2.53-fold risk of MI and 4.63-fold risk of stroke during the 16 years of follow-up.
Information is presented on human remains from Antarctica and the circumstances under which they were found at Cape Shirreff (62 degrees 27' S., 60 degrees 47' W.), Livingston Island, South Shetlands. Support is given to the hypothesis that all the recovered bones belonged to the same person. A thorough anthropometric analysis revealed that the skull belonged to a mestizo female, 21 years of age, who may have hailed from the Chilean southern channels and whose arrival to Antarctica was possible aboard a sealer boat. Death appears to have occurred in the Antarctic during the sealing period (1819-1825). Signs of nutritional stress, anaemia, and an external otitis were identified. It is intended to use DNA analyses to prove that the femurs recovered in 1988 and 1993 belonged to the same person whose skull was found at Cape Shirreff in 1985.
The aim of the Consequence of Colonization project is to study population development and mortality in Swedish Sápmi. This article, the first to be drawn from our research, compares these changes between Sami and non-Sami, South and North Sami. Study design. Longitudinal individual based data from computerized records ofthe Glillivare, Undersåker and Frostviken parishes, divided into 2 40-year periods: 1776-1815 and 1856-1895. The main source material used for the present study was a set of data files from the Demographic Data Base (DDB) at Umeå University, the largest historical database in Europe. A Sami cohort was created by indicators of ethnicity in the parish registers, and was later extended with automatic linkages to children and parents. Sami mortality rates show great fluctuations during the period 1776-1815, almost always peaking at a higher rate than in the rest of Sweden. The non-Sami group had lower mortality rates compared with both Sweden as a whole and the Sami in the parish. Between 1856 and 1895, the non-Sami experienced a very small reduction in their mortality rates and the Sami experienced overall improvement in their health status. Significant differences in age-specific mortality appear when the South and North Sami are compared, showing that the South Sami had far lower child mortality rates. The Sami population's health status improved during the nineteenth century. This indicates that they had advanced in the epidemiologic transition model. A corresponding change is not found for the non-Sami group.
In East Greenland (Tasiilaq) a common recessive disease, Cholestasis Familiaris Groenlandica (CFG)/Byler-like disease, occurs in Eskimo children. Samples from 123 persons, from a large consanguineous pedigree in East Greenland including 7 affected and 3 small families from West Greenland with a total of 4 affected children, have been collected for linkage and homozygosity studies. An earlier hint of linkage to chromosome 18q (lod score of 1.5 to blood group JK) is now raised to a multipoint lod score of Z = 3.25 in the area of the DNA markers D18S851 and D18S858. Different haplotypes follow the disease gene among Inuits in West Greenland and a possibility of locus heterogeneity of CFG between East and West Greenland exist.
Figure1. Categories of antimicrobials prescribed annually among AI/AN persons <18 years of age in Anchorage, Alaska.  
Visit-based prescribing rate for AI/AN persons <18 years of age by antibiotic class, Achorage, Alaska.  
Visit-based prescribing rate among AI/AN children in Anchorage, Alaska.  
In the U.S., the total number of antimicrobials prescribed in ambulatory care declined between 1989 and 2000; however, antimicrobial resistance increased among many pathogens. We evaluated antimicrobial prescribing patterns from 1992 to 2004 in Alaska Native/American Indian (AI/AN) persons Retrospective study based on medical records. Medical records were used to obtain data on oral antibiotics prescribed for ambulatory and emergency-room visits. Antimicrobial prescribing rates were calculated per population and per ambulatory-clinic visit. The total number of antimicrobial courses prescribed increased 94% from 4,929 (1992) to 9,561 (2004). However, the total number of ambulatory-clinic visits also increased (79%) from 49,008 (1992) to 87,486 (2004), while the population of AI/AN persons <18 in Anchorage region rose 14%. The population-based rate of antimicrobial prescriptions (per 1,000 persons) rose from 309 (1992) to 524 (2004 (p<0.001). The visit-based annual rate (per 1,000 visits) remained stable from 101 (1992) to 109 (2004) (=0.651). Overall, visit-based prescriptions rates in AI/AN persons were lower than previously reported among children in the U.S. (range 250-340). Penicillins comprised >50% of antimicrobials presribed from 1992 to 2004. Visit-based prescribing rates from 1992 to 2004 changed: penicillin, +27% (p=0.210): cephalosporins, +33% (p=0.23); trimethoprim-sulfamethexazole, -48% (p<0.001). Visit -based antimicrobial prescribing rates in the Anchorage region for AI/AN children receiving care in the AI/AN health system have been stable over a 13-year period. Although a trend in decreased antibiotic prescribing has been seen in the general U.S. population, visit-based prescribing rates in the Anchorage region for AI/AN children have remained below those in previous studies in the U.S.
Participating in a community with other retired individuals to increase life quaøity can be possible for the older persons. Cultural and ethnical background is important for their social identity. To identify what the informants think is important in their surroundings in order to extend their healthy life period. A structured questionnaire developed by the OCIN network. Nineteen elderly women aged 75 years or more were interviewed. This regional survey is a pilot study in Norway. The data were collected during 2 periods, in 2009 and 2010. The data are analyzed using a result scheme prepared by the network OCIN. Our findings show that this is a group of elderly women that are concerned with promoting their own health. The participants wish to take care of themselves, so they do not become a burden for society and the local authorities. The findings of this study suggest that participation in the local context is important for promoting health and well-being among elderly in all ethnicities. For the Sami elderly, this is particularly important because meeting equal-minded people helps them maintain their Sami identity. In the Sami culture and among the Sami elderly, it is important to be "strong" and "healthy". Due to these norms, the elderly Sami women try to live with their illnesses and are less eager to go to the doctor when they are seriously ill.
This paper considers the spread of the 1918 influenza virus as it occurred among Inupiat communities on Alaska's Seward Peninsula. Documented historical sources concerning the epidemic among the Native communities are scarce and contain limited information. In contrast, oral histories of the event provide not only information about community mortality rates, but they also corroborate the few written documents that discuss the epidemic. Additionally, it has been found that the dispersal of the virus on the peninsula can only be accurately reconstructed with the aid of oral testimony. Data useful to both anthropologists and epidemiologists can be derived from this approach to historical analysis.
To describe the lifestyle of the Sami of southern Lapland 50 to 70 years ago in relation to the present-day Sami and non-Sami populations and, thereby, to provide a basis for future studies of culturally related determinants of health and illness. A qualitative analysis, and a quantitative comparison of Sami and non-Sami groups. Semi-structured interviews were conducted with 20 elderly Sami concerning their parents' lifestyle and diet 50 to 70 years ago. Questionnaire data from 81 reindeer-herding Sami, 226 non-reindeer-herding Sami and 1,842 sex-, age- and geographically matched non-Sami from the population-based Västerbotten Intervention Project were analysed by non-parametric tests and partial least squares methodology. Surprisingly, fatty fish may have been more important than reindeer meat for the Sami of southern Lapland in the 1930s to 1950s, and it is still consumed more frequently by reindeer-herding Sami than nonreindeer-herding Sami and non-Sami. Other dietary characteristics of the historical Sami and present-day reindeer-herding Sami were higher intakes of fat, blood and boiled coffee, and lower intakes of bread, fibre and cultivated vegetables, compared with present-day non-Sami. Physical activity was also a part of the daily life of the Sami to a greater extent in the 1930s to 1950s than today. Sami men often worked far from home, while the women were responsible for fishing, farming, gardening (which was introduced in the 1930-1950 period), as well as housework and childcare. For studies investigating characteristic lifestyle elements of specific ethnic groups, the elements of greatest acknowledged cultural importance today (in this case reindeer meat) may not be of the most objective importance traditionally.
Fluctuations in alcohol consumption in Greenland have been extreme since alcohol became available to the Greenland Inuit in the 1950s, increasing from low levels in the 1950s to very high levels in the 1980s - about twice as high as alcohol consumption in Denmark. Since then, consumption has declined, and current consumption is slightly below alcohol consumption in Denmark, while alcohol prices are far above Danish prices. Description of historical trends and possible causal connections of alcohol prices, alcohol consumption and alcohol-related mortality in Greenland 1951-2010 as a background for the evaluation of the impact of various types of policy. Time series for Greenland 1951-2010 for alcohol prices, consumption and mortality are compiled, and variation and correlations are discussed in relation to various policies aimed at limiting alcohol consumption. Corresponding time series for Denmark 1906-2010 are presented for comparison. The trends in alcohol prices and consumption followed each other rather closely until the 1990s in Greenland and the 1980s in Denmark. At this time, consumption stabilised while prices decreased further, but the effect of prices upon consumption is strong, also in recent years. A trend in Greenlandic mortality similar to consumption is discernible, but not significant. Among alcohol-related deaths cirrhosis of the liver is less prevalent whilst accidents are more prevalent than in Denmark. The effect of alcohol excise taxes and rationing upon consumption is evident. The stabilisation and subsequent decline in consumption since the mid-1990s, while alcohol prices decreased persistently, does not preclude continued effects of prices. On the contrary, price effects have been neutralised by other stronger causes. Whether these are government anti-alcohol campaigns or a cultural change is not clear.
Age-standardized mortality rates (ASMR per 100,000), all cancer sites, among men and women in Chukotsky district and Russia, 1961–1990.
Age-standardized mortality rates (ASMR per 100,000) for oesophageal cancer among men and women in Chukotsky district and Russia, 1961–1990.
Age-standardized mortality rates (ASMR per 100,000) for cancer of the lungs, trachea and bronchi among men and women in Chukotsky district and Russia, 1961–1990.
The general aim was to assess the pattern and trend in cancer mortality among the indigenous people of coastal Chukotka during the period 1961-1990. All cases of cancer deaths of indigenous residents of the Chukotsky district in the north-easternmost coast of Chukotka Autonomous Okrug were copied from personal death certificates. There were a total of 219 cancer deaths during the study period. The average annual number of cases, percent, crude, and age-standardized cancer mortality rates (ASMR) per 100,000 among men and women for all sites combined and selected sites were calculated. Data were aggregated into six 5-year periods to assess temporal trends. Direct age-standardization was performed with the Segi-Doll world standard population used by the International Agency for Research on Cancer. The indigenous Chukchi and Eskimo people living in Chukotsky district were at higher risk of death from cancer during the 30-year period between 1961 and 1990, with ASMR among men twice that of Russia, and among women 3.5 times higher. The excess can be attributed to the extremely high mortality from oesophageal cancer and lung cancer. The indigenous people of coastal Chukotka were at very high risk of death from cancer relative to the Russian population nationally. The mortality data from this study correspond to the pattern of incidence reported among other indigenous people of the Russian Arctic. Little information is available since 1990, and the feasibility of ethnic-specific health data is now severely limited.
Unnatural deaths among Indigenous populations, including the Swedish Sami, occur more often than among the general population. To find prevention strategies, we explored the circumstances of the unnatural deaths of members of reindeer-herding Sami families. The number of deaths from among a cohort of 7,482 members of reindeer-herding Sami families were retrieved from the National Board of Health and Welfare for the years 1961- 2001. An evaluation of the information from autopsy records at the National Board of Forensic Medicine, police reports, and available medical records identified 158 unnatural deaths. These were then analysed in detail. Transport-related deaths and suicides were the most common unnatural deaths among Swedish reindeer-herding Sami family members. Suicides contributed to 23% of all deaths, road traffic accidents to 16%, and snowmobile fatalities to 11%. The accidents generally reflected an "outdoor lifestyle" and the working conditions were characterized by the use of off-road vehicles such as snowmobiles. Half of the number of victims tested positive for alcohol and alcohol abuse was documented in 15% of all victims. The results indicate that alcohol is an important factor in preventing unnatural deaths among reindeer-herding Sami, together with increased safety of both on-road and off-road transportation.
Age distribution of participants of the epidemiological investigation carried out in East Greenland in 1963 (9, 10). 
It is important to know the starting point when describing changes in Inuit in transition. The original charts of 1,852 individuals from the epidemiological investigation in East Greenland around 1963 performed by Littauer and colleagues were recovered recently. They included height, weight and a physical investigation. The focus of this paper was adult Inuit body proportions in 1963 by ten-year age groups excluding participants with disabilities affecting body build. Relatively stable values were seen in both genders with age. Median values in men/women aged 20 years and above were: height 164/153.5 cm, weight 64/54 kg and BMI 23.7/23.1. Men aged 50 years and above had a little lower height and weight than young men. Women aged 40-49 years had a higher weight and BMI, but this evened out in the older age groups. Median BMI was relatively high compared to WHO definition. The data from 1963 gives a starting point for evaluating changes in Inuit body build and the prevalence of overweight. Furthermore, they indicate a need for Inuit-specific normal BMI delineation.
As the 1996 Canadian recipient of the J.A.Hildes Medal in Circumpolar Health, I wouldlike to document for this journal an overviewof the contributions of McGill Universityduring the second half of the 20th century tothe delivery of health care to the Inuit living inthe Eastern Canadian Arctic – the Baffin Zone,Northwest Territories (NWT). McGill Universityis the oldest university in Canada. It wasestablished as a college in 1819 and conferredits first degree as a university, a medical degree,in 1833. The university is a leader in Canada formedical education and research and is recognizedregionally, nationally and internationallyas a center of excellence. Its contributions toCanadian northern studies over the years arevaried, extensive and significant. International Journal of Circumpolar Health 65:1 2006
Association between hair colour and age. The association is explained with a logarithmic model and is similar for males and females.
Colour distribution of hair among Skolt Sami of aged 20–59 years. The colour groups defined in the Fisher-Saller scale are used. In this scale, the hair colours are classified with increasing darkness into the codes A to Y. The classes are commonly grouped in larger groups A–E, F–L, M–O, P–T and U–Y. Note that the combined colour group U–Y is dominant and that the darkest colour, Y, is missing.
Proportion of darkest hair colours (U–Y) among Skolt Sami and their neighbouring populations.
The population is increasingly lighter pigmented moving in a northward direction in Europe until reaching the Arctic Circle, where the Samis (Lapps) are clearly more pigmented. In 1966-1970, we investigated a total of 689 subjects in the villages of Sevettijärvi and Nellim, including persons with mixed Sami and Finnish heritage; of these, 487 (242 males, 245 females) had both parents classified as Skolt Sami. For estimation of the colour of the iris and hair, international scales were used. For translucency of the iris, pigmentation of the fundus was estimated in 3 different shades. The length and type of eyelashes were classified into 3 categories. To our knowledge, a simultaneous study of the pigmentation of eyebrows, eyelashes and eye fundus at different ages has not previously been published. The age differences of iris colour were highly significant. Iris colour in children varied markedly, and they generally had lighter colours than later in life. Age and sex effects on the translucency of irises were found. Male irises were more translucent. Fundus pigmentation was scanty in the youngest age groups, with full pigmentation being reached at 20 years. Among young individuals hair colour darkens with increasing age. Eyebrow colour was slightly lighter for both sexes in the youngest age groups that in older cohorts. Women had longer eyelashes than males. The main factor of the lighter skin is a higher ability to synthesize vitamin D, providing superior protection against rickets. The Skolt Samis are more pigmented than other Nordic people. In earlier times they had problems with rickets but our studies did not show any essential symptoms of rickets today. Visual acuity among Skolt Samis was good. They had lower prevalence of myopia compared to Finns. The stronger pigmentation of Skolt Samis is probably due to their origin from darker Eastern populations. Since our investigations were made, the Skolt Samis have been to a great part mixed with neighbouring populations and scattered throughout Finland. Even their old language is nowadays used mainly for traditional purposes. Therefore similar studies could not be performed anymore.
The incidence of prostate cancer differs significantly between US race groups. In prior reviews of cancer in Alaska Natives, the incidence of prostate cancer has been observed to occur at a low rate compared to US Whites and Blacks. However, a detailed report of prostate cancer in this population has not been previously published. Incidence of prostate cancer in Alaska Native men was determined for the time period 1969-2003 using data from the Alaska Native Tumor Registry. The registry is a population-based registry which participates in the National Cancer Institute Surveillance, Epidemiology and End Results Program, and has collected cancer information on Alaska Natives since 1969. Incidence rates were calculated for all Alaska Natives and for each of the three major ethnic groups (Aleut, Eskimo, Indian). Comparisons of incidence rates between Alaska Natives and US Whites were performed using odds ratios. Temporal changes were identified by a Chi square analysis for trend. During the 35-year period of review, 332 Alaska Native men were diagnosed with prostate cancer. The age-adjusted incidence rate of 69.5 per 100 000 in Alaska Native men during 1994-2003 was significantly higher than the rate of 45.5 per 100 000 for the earlier period 1969-1983. The US White rate for 1994-2002 of 169.5 per 100 000 was significantly higher than the rate for Alaska Native men for 1994-2003. Results of comparisons between Alaska Native ethnic groups for 1969-2003 showed that prostate cancer was highest in Indians and Aleuts and lowest among Eskimos. Compared to the US White population, the incidence of prostate cancer in Alaska Native men is significantly lower. Prostate cancer rates among Alaska Native ethnic groups differ. The reason for these differences remains undetermined.
The objectives of this study were to determine if the incidence of and mortality from cancer have increased between 1972-1991, and to describe the distribution of cancer sites and survival for Registered Indians living on-reserves. Cancer cases and deaths on-reserve were obtained from the provincial cancer registry, using a postal code match. Treaty Status was verified using a population registry kept by Health Canada. Population figures on-reserve were obtained from the federal Department of Indian Affairs. The average annual number of cases and deaths increased by 64% and 122%, respectively, between 1972-76 and 1987-91 (NS). The age and sex standardized incidence and mortality rates increased by 7% and 50% (NS). Males had a 1.1 times higher incidence and 1.4 times higher death rate than females. The entire excess male incidence and mortality occurs after age 50. Females have 1.1 to 6.2 times the incidence and mortality between ages 20-49. Cancer incidence and mortality appear to be increasing on-reserve. The distribution of leading sites and pattern of survival are similar to that of the rest of the population, with the exception of a higher proportion of cases and mortality caused by cervical and gallbladder cancer in females and kidney cancer in both sexes. The lung cancer rate is increasing in women and is the leading cause of cancer mortality for both sexes. It is likely that these trends will continue for some time unless there is reduction in the high rate of smoking, dietary change, and implementation of more widespread and effective Pap screening on-reserves.
Sampling frame. 
Prevalence of maternal anemia registered in the KBR from 1973 through 2002, by time periods. 
The purpose of this study was to determine the prevalence of anemia in pregnancy in Monchegorsk, north-west Russia, and to analyse its association with birth weight and the risk of stillbirth and preterm birth. A registry study based on the Kola Birth Registry. A total of 24,525 women who gave birth in Monchegorsk between 1973 and 2002 and who had data on anemia in pregnancy in the Kola Birth Registry (KBR) were included in the study. For these women, data on maternal anemia, age, occupation, marital status, parity, smoking, alcohol, gestational age, birth weight, stillbirth and year of delivery were obtained from the KBR. Linear regression was used to study the effect of maternal anemia on birth weight. Logistic regression was used to estimate the effect of anemia on the risks of stillbirth and preterm birth, with adjustment for the above-mentioned characteristics. Crude and adjusted odds ratios (OR) were calculated. The prevalence of anemia increased from 43.7% in the 1970s to 89.8% in the beginning of the 2000s. Infants born to women with anemia were 48 grams (95% CI 36, 59) heavier than infants of non-anemic women. Women with anemia in pregnancy were less likely to have stillbirths (OR=0.68; 95% CI 0.52, 0.89) and preterm births (OR=0.66; 95% CI 0.58, 0.75) after adjustment for potential confounders. The prevalence of anemia in pregnant women as defined by the KBR more than doubled during the 30-year period. Positive associations with birth weight and negative associations with the risk of stillbirth and live preterm birth were observed.
To describe the occurrence of pancreatic, biliary tract, and gallbladder cancers within the Alaska Native (AN) population. Study design: Population-based analysis utilizing a tumor registry and comparative population data. Pancreaticobiliary cancers rates for AN people during 1973-2007 were determined from the Surveillance, Epidemiology, and End Results (SEER) AN Tumor Registry. Cancer incidence rates were age-adjusted to the World Standard Million and compared over 2 time periods with US white and black rates. During 1973-2007, 213 AN people developed pancreatic cancer, 73 gallbladder cancer and 61 biliary tract cancer. Pancreatic cancer occurs at similar rates in AN men and women, but data for 1993-2007 indicate that the rates among AN men may be increasing. The incidence rate in AN women (9.5/100,000) was statistically higher than in US white women (5.8/100,000). The incidence for biliary tract cancer in AN men and gallbladder cancer in AN men and women is statistically higher than that for US whites and blacks. Pancreaticobiliary cancers, particularly biliary tract and gallbladder cancers, in both AN men and women and pancreatic cancer in women occur at an increased rate in AN people. Risk factors relating to the elevated rate are discussed. Certain factors are potentially modifiable, such as the use of tobacco and obesity.
During the second half of the 20th century living conditions of the Inuit populations in the Arctic have undergone major transitions. The objective was to investigate how the cancer pattern was affected by these changes, using data from the Danish Cancer Registry and the Civil Registration System. In the period 1973-1997 total cancer incidence increased by 4% per 5 years for men and 6% per 5 years for women. The incidence of lung, stomach, breast and colon cancer increased in both sexes, whereas the incidence of cervical cancer decreased. Thus, the overall cancer incidence among Greenlandic Inuit is increasing as a result of increases in several cancers that are common in Western populations. In contrast to global trends, a significant increase in the incidence of stomach cancer in both sexes was observed.
Alaska Native (AN) women have exhibited some of the highest incidence rates of cancer overall, and different patterns of site-specific incidence compared to other U.S. populations. This study compares incidence rates between AN and U.S. white women (USW) for cancers of the breast, uterus, ovary and cervix, and examines effects of time period and birth cohort as determinants of incidence trends among AN women. Observational, population-based study. Cancer incidence data from the Alaska Native Tumor Registry and SEERStat, 1974-2003. Age-adjusted World Standard Population rates were calculated for a current 5-year period and over time (30 years), and compared to other populations using rate ratios with 95% confidence intervals. Log-linear regression models used to assess impact on trend of age, time period and birth cohort. Compared to U.S. white women, current cancer rates among AN women are not significantly different for cancer of the breast and cervix, and significantly lower for cancers of the ovary and uterus. Trends over time over a 30-year time period also differ for these cancer sites. There were significant increases in breast and uterine cancer, and in contrast, a marked decline in cervical cancer. There was no significant change for cancer of the ovary. Changes appear to be due largely to period, not birth cohort effects. Increases in breast cancer may be due to a combination of modifiable behaviours; increased BMI and a shift to a non-traditional diet. Increases in uterine cancer could be associated with increased BMI and diabetes. Cervical cancer rates have declined to USW levels. The marked decline is likely due to enhanced screening and control efforts within the Alaska Native Women's cancers among Alaska Natives Tribal Health System (formerly Alaska Area USPHS, Indian Health Service utilizing resources available from the Centers for Disease Control tribal and state Breast and Cervical Cancer Early Detection Programs).
To describe the mortality of the Finnish Sami population. Study design. A cohort study. The Sami population living in northern Finland represents a specific genetic background and a way of life that has been different from other Finns. A cohort of all 2091 Sami and 4,161 non-Sami people from the 2 northernmost municipalities of Finland on 31 December 1978 was identified from the National Population Register and followed up for their mortality during 1979-2005. Altogether 625 Sami died during 1979-2005, while the expected number based on the average mortality rates in the entire Finnish population was 633. The standardized mortality ratio (SMR) of the Sami population was 0.99 (95% confidence interval 0.91-1.06), and for the non-Sami 1.07 (1.00-1.14). The mortality from accidents and violence was elevated both among the Sami, SMR 1.67 (1.32-2.08), and among the non-Sami, 1.28 (1.04-1.53). Snowmobile and water transport accidents were especially common. SMR for disease mortality among the Sami men was 0.88 (0.78-0.98). Half of the decrease was attributable to the low mortality from cancer, SMR 0.69 (0.52-0.90). SMR for circulatory diseases was very similar. The SMRs for dementia and Alzheimer's disease were elevated among the Sami men. The Sami men had a lower disease mortality as compared with the Finnish population generally and their non-Sami neighbours, although their life habits would suggest a higher mortality rate. Reasons for their lower mortality may be related to their diet that is rich in reindeer meat and fish, their physically active way of life or their genetic background.
Distribution of patients with diagnosis ''OD'' among enterprises of Murmansk Oblast in 1980Á2010.
Rate of new cases of occupational diseases (including poisonings) per 10,000 workers in Murmansk Oblast compared to Russia, 1980Á2009.
Official statistics tend to underestimate the incidence of occupational disease (OD) nationally and regionally in Russia. The general aim was to obtain an accurate estimate of ODs in Murmansk Oblast in 1980-2010 and to determine the rate of specific types of ODs among cohorts of workers who had been exposed to the hazardous factors causing the disease. Data were retrieved from the Murmansk Oblast ODs database for the oblast and 2 enterprises - Apatite JSC and Kolskaya MSC - which contributed to more than half of the ODs in the oblast in 1980-2010. The total number of ODs and 5 specific categories (musculoskeletal, respiratory, nervous diseases, hearing loss and vibration disease) were analysed. THE TOTAL RATE OF ODS AMONG WORKERS OF MAIN SHOPS IN BOTH ENTERPRISES WHO WERE ACTUALLY EXPOSED TO HARMFUL FACTORS WERE EXTREMELY HIGH: the rate for Apatite JSC was 25 times higher than in Russia and 15 times higher than in Murmansk Oblast, while the rate for Kolskaya MSC was about 30 and 20 times greater than in Russia and in Murmansk Oblast, respectively; in the 2000s the difference reached 100-150 times. The rise in reported ODs in both enterprises corresponded to the time when intensive medical examinations were conducted by the Kola Research Laboratory for Occupational Health (KRLOH) in Kirovsk. A similar pattern was also observed for the sub-categories of musculoskeletal, respiratory, nervous diseases, hearing loss and vibration disease. It is likely that the true burden of OD is even higher due to misdiagnosis, reluctance of workers concerned about job security to present for care and the lack of reliable information on working conditions needed to establish a causal link between disease and occupational exposure. As with many other regions across Russia, ODs in Murmansk Oblast are grossly underestimated. Serious problems exist in the Russian occupational health care system and the collection of occupational health statistics that require urgent, fundamental reform.
Map of northern regions of the Russian Federation. (Reproduced by permission from Young TK, ed. Circumpolar Health Atlas. Toronto: University of Toronto Press, 2012)
Rate of new cases of occupational diseases, including poisonings (per 10,000 workers), in Russia and selected Arctic regions.
There is a paradox in Russia and its Arctic regions which reports extremely low rates of occupational diseases (ODs), far below those of other socially and economically advanced circumpolar countries. Yet, there is widespread disregard for occupational health regulations and neglect of basic occupational health services across many industrial enterprises. This review article presents official statistics and summarises the results of a search of peer-reviewed scientific literature published in Russia on ODs and occupational health care in Russia and the Russian Arctic, within the period 1980-2010. Worsening of the economic situation, layoff of workers, threat of unemployment and increased work load happened during the "wild market" industrial restructuring in 1990-2000, when the health and safety of workers were of little concern. Russian employers are not legally held accountable for neglecting safety rules and for underreporting of ODs. Almost 80% of all Russian industrial enterprises are considered dangerous or hazardous for health. Hygienic control of working conditions was minimised or excluded in the majority of enterprises, and the health status of workers remains largely unknown. There is direct evidence of general degradation of the occupational health care system in Russia. The real levels of ODs in Russia are estimated to be at least 10-100 times higher than reported by official statistics. The low official rates are the result of deliberate hiding of ODs, lack of coverage of working personnel by properly conducted medical examinations, incompetent management and the poor quality of staff, facilities and equipment. Reform of the Russian occupational health care system is urgently needed, including the passing of strong occupational health legislation and their enforcement, the maintenance of credible health monitoring and effective health services for workers, improved training of occupational health personnel, protection of sanitary-hygienic laboratories in industrial enterprises, and support for research assessing occupational risk and the effectiveness of interventions.
Map of the Euro-Arctic Barents region ( 
To describe secular trends in selected pregnancy outcomes in the Komi Republic, Russia, in 1980-1999. A descriptive study. Data on all single infants born in Syktyvkar and Vorkuta during the period 1980-1999 were abstracted from the birth journals at maternity homes (n = 69,340). Proportions of stillbirths, preterm and post-term births as well as the mean values for birth weight and length of term infants were estimated in each of the locations over time and summarized in 5-year periods. Multiple logistic and linear regression analyses were used to study independent effects of the time periods on the outcomes, adjusted for maternal age in Syktyvkar and for maternal age, parity and infant gender in Vorkuta. Considerable variations over time were observed for all studied outcomes except for stillbirths. The lowest prevalence of both preterm and post-term births was observed in 1985-1989 in both Syktyvkar (4.3% and 3.2%) and Vorkuta (3.5% and 3.1%). Average birth weight in term infants was significantly lower in 1995-1999 in both Syktyvkar (-33 g, 95% CI: -46,-21) and Vorkuta (-81 g, 95% CI: -100, -62) than in 1980-1984. The proportions of preterm and post-term births increased while the average birth weight in term infants decreased over the 20-year period of observation. Further research should address those factors that could explain the observed pattern of pregnancy outcomes in the Komi Republic.
The aim of the study was to examine the trends which have occurred during the past generation in body mass index (BMI) and in the prevalence of overweight and obesity among children in public schools in Nuuk, Greenland. The study is a retrospective cohort study of BMI among inschooling children (age 6 or 7 years old). A database was created on the basis of files from school-nurses containing information on height and weight among children having attended school in Nuuk since 1970. The database contained 10,121 measurements in total, whereas 2,801 were on inschooling children. Measurements from these children form the basis of this study. Mean and quartiles of BMI among the inschooling children in 5-year intervals were used to determine the development in BMI since 1980. On the basis of international cut-points for use among children and adolescents, the proportion of overweight and obese children and the trends since 1980 were determined. The mean BMI has risen by a total of a bit more than 6% since 1980, corresponding to a rise of 1.2-3.8% for every 5-year period. Increases are also observed when assessing the proportion of overweight and obese, which were 6.6% and 0.9%, respectively, among the inschooling children during the period 1980-1984. These proportions increased to 16.5% and 5.2%, respectively, in 2000-2004. This study has provided evidence that during the past two decades, children in Nuuk have undergone a development towards a higher prevalence of overweight and obesity.
Human papillomavirus (HPV) vaccine prevents cervical pre-cancers and cancers caused by HPV types 16 and 18. This study provides information on the HPV types detected in cervical cancers of Alaska Native (AN) women. Cases of invasive cervical cancer diagnosed in AN women aged 18 and above between 1980 and 2007 were identified from the Alaska Native Tumor Registry. A representative formalin-fixed, paraffin-embedded archived pathology block was retrieved and serially sectioned to allow histologic confirmation of lesion (first and last sections) and PCR testing of intervening sections. Extracted DNA was tested for HPV using Linear Array HPV Genotyping Test (Roche Diagnostics) with additional INNO-LiPA HPV Genotyping Assay (Innogenetics) testing on negative or inadequate specimens. All specimens were tested for a minimum 37 HPV types. Of 62 cervical cancer specimens evaluated, 57 (91.9%) contained one or more HPV types. Thirty-eight (61.2%) cancers contained HPV types 16 or 18, and 18 (29%) contained an oncogenic type other than type 16 or 18. Overall, almost two-thirds (61.2%) of the archived cervical cancers had detectible HPV types 16 or 18, a finding similar to studies of US women. As expected, a proportion of cancers would not be prevented by the current vaccines. HPV vaccination and cervical cancer screening are important prevention strategies for AN women.
To evaluate preterm birth (PTB) for Inuit and First Nations vs. non-Indigenous populations in the province of Québec, Canada. Study design: Retrospective cohort study. We evaluated singleton live births for Québec residents, 1981-2008 (n = 2,310,466). Municipality of residence (Inuit-inhabited, First Nations-inhabited, rest of Québec) and language (Inuit, First Nations, French/English) were used to identify Inuit and First Nations births. The outcome was PTB (<37 completed weeks). Cox proportional hazards regression was employed to estimate hazard ratios (HR) and 95% confidence intervals (CI) of PTB, adjusting for maternal age, education, marital status, parity and birth year. PTB rates were higher for Inuit language speakers in Inuit-inhabited areas and the rest of Québec compared with French/English speakers in the rest of Québec, and disparities persisted over time. Relative to French/English speakers in the rest of Québec, Inuit language speakers in the rest of Québec had the highest risk of PTB (HR 1.98, 95% CI: 1.62-2.41). The risk was also elevated for Inuit language speakers in Inuit-inhabited areas, though to a lesser extent (HR 1.29, 95% CI: 1.18-1.41). In contrast, First Nations language speakers in First Nations-inhabited areas and the rest of Québec had similar or lower risks of PTB relative to French/English speakers in the rest of Québec. Inuit populations, especially those outside Inuit-inhabited areas, have persistently elevated risks of PTB, indicating a need for strategies to prevent PTB in this population.
The purpose was to examine changes in the numbers of asthma-related hospitalizations among conscripts and possible seasonal fluctuations. Data on treatment periods for asthma among men aged 18-22 years at military hospitals in 1982-1992 were collected from the national hospital discharge register. Monthly numbers of hospitalizations were calculated for each year separately, together with the frequency of such periods per 1000 conscripts. Results. A total of 4894 asthma-related hospitalizations were recorded in 1982-1992, the frequency per 1000 conscripts increasing from 8.5 in 1982 to 27.7 in 1992. Evident seasonal fluctuations were observed in 1982-1989, the peaks being recorded for February (14% above the annual average), July (26%) and November (51%). A change in these seasonal fluctuations was observed in 1990-1992, however. The frequency of asthma-induced hospitalizations among conscripts tripled between 1982 and 1992, evidently indicating a real increase in the number of occurrences. The hospitalization peaks are located at the beginning of military service, a point at which factors tending to aggravate asthma exercise a major impact.
To examine trends in diabetes prevalence, incidence, complications and mortality between 1985 and 2006 among Alaska Native people. We used data from the population-based Alaska Native Diabetes Registry, which includes all people who receive care in the Alaska Tribal Health System. We compared the periods of 1986-1990 and 2002-2006 for diabetes-related amputations, renal replacement and mortality using Poisson regression. Complications and mortality data were examined for trends using Poisson regression. Survival analyses for those diagnosed since 31 December 1985 were performed using the Cox proportional hazard model. Age-adjusted diabetes prevalence increased from 17.3 in 1985 to 47.6/1,000 in 2006. The number of Alaska Native people living in Alaska with diabetes increased from 610 in 1985 to 3,386 in 2006. Diabetes incidence rates have also increased. Comparing age-adjusted rates for the 5-year periods 1986-1990 and 2002-2006, amputations decreased from 5.3 to 2.6/1,000, renal replacement decreased from 3.3 to 1.2/1,000 and mortality decreased from 41.7 to 33.2/1,000. Yearly analyses showed a downward trend for amputations, renal replacement and mortality rates. Survival analyses showed a significantly higher hazard ratio for any amputations, major amputations and renal replacement for the earlier time period compared to the most recent time period. An increase in risk factors, awareness, funding and case-finding may be contributing to the increase in prevalence and incidence of diagnosed diabetes. While diabetes prevalence and incidence are increasing among Alaska Native people, our results suggest that even in remote, rural areas, complications and mortality can be reduced.
Medical consultations recorded by the British Antarctic Survey between 1986-1995 were analysed. A total of 3683 new consultations were recorded, an incidence of 2193.7/1000/year, with a significantly higher incidence on the bases compared to the ships. Injuries comprised 30.2% of consultations, an incidence of 661.7/1000/year. The bases had a significantly higher incidence of injuries. Work accounted for 47.0% and recreation 30.6% of all injuries.
To investigate the psychosocial well-being of adolescents with and without symptoms of attention deficit hyperactive disorder (ADHD). A cross-sectional study. Adolescents who were 15 and 16 years old with (n = 487) and without (n = 5988) ADHD symptoms were drawn from the Northern Finland Birth Cohort 1986 (n = 9432). ADHD symptoms were assessed by the parents on the SWAN scale while the adolescents completed a questionnaire on their current life situation. The adolescents with ADHD symptoms more often attended a special school and had repeated a grade than those without. Over one-third of those with symptoms were uncertain about their educational plans while 44% of them preferred vocational education. They also reported their health as being poorer and they visited a physician or a nurse more often than the others. Most adolescents reported that they were satisfied with their life, but there were a larger proportion of adolescents with ADHD symptoms among the fairly dissatisfied ones. As well, boys with ADHD symptoms reported the lack of close friends. Adverse psychosocial factors accumulated in those adolescents with greater ADHD symptoms. The adolescents with ADHD symptoms considered their psychosocial well-being to be poorer than those without ADHD symptoms. In clinical work, it is essential to recognize the most impaired adolescents who need special attention and support at school as well as in their social interactions with their peers and families. From a public health perspective, this information is necessary in order to focus society's limited resources on those with a higher risk of experiencing complicated outcomes.
Deliberate self-harm (DSH) is an act with a non-fatal outcome in which an individual initiates a behavior, such as self-cutting or burning, with the intention of inflicting harm on his or her self. Interpersonal difficulties have been shown to be a risk factor for DSH, but the association between subjective experience of loneliness and DSH have rarely been examined. To examine the frequency of DSH or its ideation and loneliness among 16-year-olds to determine if associations exist between DSH and loneliness, loneliness-related factors, self-rated health and satisfaction with life. The study population (n=7,014) was taken from Northern Finland Birth Cohort 1986 (N=9,432). Cross-tabulations were used to describe the frequency of DSH by factors selected by gender. Logistic regression analysis was used to describe the association between DSH and loneliness and other selected factors. Nearly 8.7% (n=608) of adolescents reported DSH often/sometimes during the preceding 6 months, with girls (n=488, 13.4%) reporting DSH almost 4 times than that of boys (n=120, 3.6%). Nearly 3.2% of the adolescents (girls: n=149, 4.1%; boys: n=72, 2.2%) expressed that the statement I feel lonely was very/often true, and 26.4% (girls: n=1,265, 34.8%; boys: n=585, 17.4%) expressed that the statement was somewhat/sometimes true. Logistic regression showed that those who reported to be very/often lonely (girls: odds ratio (OR) 4.1; boys: OR 3.2), somewhat/sometimes lonely (girls: OR 2.4; boys: OR 2.4) were dissatisfied with life (girls: OR 3.3; boys: OR 3.3), felt unliked (girls: OR 2.2; boys: OR 6.0) and had moderate self-rated health (girls: OR 2.0; boys: OR 1.7), were more likely to report DSH than those without these feelings. The results show that loneliness is associated with DSH, and that loneliness should be considered as a risk for individual health and well-being.
Population snapshot of serotype 19A isolates in Alaska comparing sequence types (ST) found in 1986Á2000 and 2001Á 2010. Each circle represents a single ST, with the area proportional to the number of isolates of that type. Solid lines between STs represent single-locus variants. STs in black are STs found only in the pre-PCV7 (1986Á2000) era. STs in green are STs found only in the post-PCV7 (2001Á2010) era. STs in pink are STs found in both the pre-PCV7 and post-PCV7 eras. 
After the introduction of the 7-valent pneumococcal conjugate vaccine (PCV7) in Alaska, the incidence of invasive pneumococcal disease (IPD) due to non-vaccine serotypes, particularly serotype 19A, increased. The aim of this study was to describe the molecular epidemiology of IPD due to serotype 19A in Alaska. IPD data were collected from 1986 to 2010 through population-based laboratory surveillance. Isolates were serotyped by the Quellung reaction and MICs determined by broth microdilution. Genotypes were assessed by multilocus sequence typing. Among 3,294 cases of laboratory-confirmed IPD, 2,926 (89%) isolates were available for serotyping, of which 233 (8%) were serotype 19A. Across all ages, the proportion of IPD caused by serotype 19A increased from 3.5% (63/1823) pre-PCV7 (1986-2000) to 15.4% (170/1103) post-PCV7 (2001-2010) (p<0.001); among children <5 years of age, the proportion increased from 5.0% (39/776) to 33.0% (76/230) (p<0.001). The annual incidence rate of IPD due to serotype 19A (all ages) increased from 0.73 cases pre-PCV7 to 2.56 cases/100,000 persons post-PCV7 (p<0.001); rates among children <5 years of age increased from 4.84 cases to 14.1 cases/100,000 persons (p<0.001). Among all IPD isolates with reduced susceptibility to penicillin, 17.8% (32/180) were serotype 19A pre-PCV7 and 64% (121/189) were serotype 19A post-PCV7 (p<0.001). Eighteen different sequence types (STs) were identified; ST199 or single locus variants of ST199 (n=150) and ST172 (n=59) accounted for the majority of isolates. Multidrug-resistant isolates were clustered in ST199 and ST320. While PCV13 should significantly reduce the burden of disease due to 19A, these data highlight the need to continue surveillance for IPD to monitor the effects of vaccination on the expansion and emergence of non-PCV strains.
Regional division of Finland used in the present study. 
Average annual incidence of frostbite per 100,000 inhabitants, by age and sex. 
Average annual incidence of frostbite per 100,000 inhabitants by temperature category and region in Finland. 
Average daily incidence of frostbite requiring hospital treatment per 100,000 inhabitants by temperature and region in Finland. 
The association of frostbite with ambient temperature in Finland is not known. The present study determined the incidence of frostbite and its association with sex, age and ambient temperature in a nationwide sample. The first admissions of all patients (n=1,275) admitted to hospital in Finland during the period 1986-1995 with frostbite as a principal or secondary diagnosis were associated with ambient temperature on the day of admission. The incidence of frostbite was 2.5 per 100,000 inhabitants, it was higher in males than females and increased linearly with age. The annual incidence of frostbite started to rise at below -15 degrees C and was considerable at under -20 degrees C, particularly in northern Finland. However, the daily incidence increased most in the urban area of Helsinki. In the north, the main factor is the large number of cold days in the year. The daily incidence may be affected by urban lifestyle, possibly fashion, and inability to protect oneself against the cold.
The Kivalliq region of Nunavut, Canada, had a 1996 population of 7,131, of which 87% were Inuit. An attempt was made to characterize patterns of mortality in the region. Descriptive regional mortality study, based on 10-year retrospective review of health records data. All deaths and stillbirths of Kivalliq residents during the study period were identified. Available health records data were reviewed for each death, including medical charts, death certificates and coroner's reports where applicable. Age-standardized mortality rates, both overall and cause-specific, were calculated and compared to both Canadian national rates and territorial rates from the same time period. The infant mortality rate was 32.3/1,000 live births, five times Canada's rate. Leading causes of infant deaths were prematurity and Sudden Infant Death Syndrome (SIDS). The overall mortality rate was 1.8 times that of Canada, with leading causes of death being cancers (especially lung cancer), circulatory disease, respiratory disease, unintentional injury and suicide. Identified areas of concern included mortality due to premature birth, SIDS, unintentional injuries, suicides, respiratory disease and lung cancer. It is hoped that this study's results will assist territorial leaders, health workers and citizens in health planning activities.
The prevalence of middle ear disease in 2-6 year old children in 1997 was compared with that observed in 1987 in the same Inuit community in northern Quebec. Risk and protective factors associated with middle ear disease were also assessed. A total of 122 children participated. The assessments included: otological examination, cerumen sampling for analysis of organochlorine compounds, medical file review, and parent questionnaire regarding environmental and lifestyle factors. Comparison of ear examination results in 1997 and 1987 showed that there had been no change in the prevalence of chronic otitis media [9.4% to 10.8%] and proportion of ear drums with minimal scarring [45.6% to 45.4%], an increase in the proportion of normal ear drums [23.9% to 39.0%], a decrease the proportion with maximal scarring [17.8% to 2.0%] and little difference in the rate of serous otitis media [3.3% to 2.8%]. Factors found to be significantly associated with middle ear disease included: number of persons/bedroom, number of siblings with a history of ear disease, age at first, second and third visit to the nursing station for ear problems, and type of milk (formula vs. non-formula) in bottle fed children.
Little information is available on the incidence and mortality of cancer among the Aboriginal population in the Province of Québec, Canada. Cancer was likely rare in this population historically, but recent life-style changes suggest that this may no longer be the case. The purpose of this study was to estimate incidence and mortality rates among Aboriginal people living on reserves and in northern villages in Québec during the period 1988-2004, and to compare these estimates with those of the general population. Incidence and mortality data were extracted respectively from the provincial tumour registry and death file. Aboriginal people were identified based on geographic residence codes. Population data were taken from the Canadian census of 1991, 1996 and 2001. Incidence and mortality rates were calculated and age-standardized according to the World Standard Population. The Aboriginal incidence and mortality rates for cancer, all sites combined, was 321.8 per 100,000 (95% confidence interval 304.5-339.2) and 160.3 per 100,000 (95% CI 147.8-172.8), respectively. These rates are not significantly different from those of the general population of Québec. However, there are differences according to cancer site and sex. Aboriginal men had a higher risk for liver, lung and kidney cancers and a lower risk for prostate, bladder, leukemia and non-Hodgkin's lymphoma cancers, whereas Aboriginal women had a higher risk for colorectal, lung, cervix and kidney cancers, and a lower risk for breast, uterus, bladder, brain, leukemia, stomach and pancreas cancers. Aboriginal people in Québec now experience an overall cancer risk comparable to the general population. The observed differences in specific sites suggest exposure to unique environmental risk factors. Basic surveillance specific to this population is necessary for the planning and evaluation of cancer preventive and curative services.
Trend in incidence of cervical cancer among Inuit women, 1969-1973 to 1999-2003. 
Regional variation in cancer incidence among Inuit men, 1989-2003. 
Regional variation in cancer incidence among Inuit women, 1989-2003. 
This is the second of 2 papers reporting on the result of the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland. Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries. Cancer in general is increasing among Inuit, in all regions, and among both men and women. Inuit continue to be at extreme high risk, relative to non-Inuit and to comparisons of global populations, for the historically recognized so-called traditional cancers (such as cancer of the nasopharynx and salivary glands). Among the so-called modern cancers prevalent in developed societies, lung cancer is rapidly increasing in incidence (especially in Canada), such that the rate in both Inuit men and women is the highest in the world; other cancers, such as colorectal cancer, are also on the rise (especially in Alaska), while breast and prostate cancer remain low relative to the non-Inuit population. The decline in cervical cancer is a positive development; in the 3 regions, the rate in Greenland is the highest. Data such as these can form the basis of interventions directed towards known risk factors such as smoking, diet, obesity, viral and bacterial infections, and low screening prevalence. Cancer surveillance is a basic task of the public health system; in the Arctic, it is particularly important as Inuit continue to undergo further changes in their life-styles and social environments.
Distribution of regional and linguistic groups of Inuit in the circumpolar countries. 
This is first of 2 papers on the Circumpolar Inuit Cancer Review, an international collaborative effort involving researchers and health officials from Alaska, Canada and Greenland. It covers the period 1989-2003, updating the last review (1969-1988) and together provides an overview of the trends and patterns of cancer among the Inuit in 3 countries and over a 35-year period. Inuit cancer cases by age-sex group and anatomic site were obtained from the regional cancer registries. The sources of the age-sex distribution of various Inuit populations include the population registry (Greenland), and annual estimates and periodic censuses (Alaska and Canada). Incidence rates were age-standardization by the direct method to the standard world population of the International Agency for Research on Cancer. This project demonstrates the feasibility of international partnerships in cancer surveillance, and when these partnerships are extended to other diseases and health conditions, they can contribute to the development of a Circumpolar Health Observatory.
A retrospective analysis of accidents involving snowmobiles experienced by members of the British Antarctic Survey between 1989 and 1996 revealed 37 injured individuals (or 1.9% of new consultations). The mean incidence was 26.5/1000 population/year, with the incidence rising over the study period. The commonest injury (35%) was a lower limb sprain. Head injuries accounted for 22% of cases. Both fractures and radiological investigations were recorded significantly (chi 2 p < 0.025) more frequently than for injuries of all causes, although no significant difference was found in Injury Severity Scores (1) between the two groups. Alcohol was implicated in 5.4% of cases.
Top-cited authors
Gert Mulvad
  • University of Greenland
Alexey A Dudarev
  • Northwest Public Health Research Center, St-Petersburg, Russia
Michael Lynge Pedersen
  • University of Greenland
Kue Young
  • University of Alberta
Eva Cecilie Bonefeld-Jørgensen