Donald T Wigle

• MD, PhD, MPH
• University of Ottawa

Health surveillance is the ongoing, systematic use of routinely collected health data to guide public health action in a timely fashion. This paper describes the creation and growth of national surveillance systems in Canada and their impact on chronic disease and injury prevention. In 2008, the authors started a review process to retrace the histo...

La surveillance de la santé consiste en l’utilisation systématique et continue de données sur la santé recueillies régulièrement en vue d’orienter les mesures de santé publique en temps opportun. Ce document décrit la création et l’essor des systèmes nationaux de surveillance au Canada et les répercussions de ces systèmes sur la prévention des mala...

It is a systematic review and meta-analysis of previous observational epidemiologic studies examining the relationship between residential pesticide exposures during critical exposure time windows (preconception, pregnancy, and childhood) and childhood leukemia. Searches of Medline and other electronic databases were performed (1950-2009). Study se...

It is a systematic review and meta-analysis of previous observational epidemiologic studies examining the relationship between residential pesticide exposures during critical exposure time windows (preconception, pregnancy, and childhood) and childhood leukemia. Searches of Medline and other electronic databases were performed (1950-2009). Study se...

We conducted a systematic review and meta-analysis of previous observational epidemiologic studies examining the relationship between residential pesticide exposures during critical exposure time windows (preconception, pregnancy, and childhood) and childhood leukemia. Searches of MEDLINE and other electronic databases were performed (1950-2009). R...

We conducted a systematic review and meta-analysis of childhood leukemia and parental occupational pesticide exposure. Searches of MEDLINE (1950-2009) and other electronic databases yielded 31 included studies. Two authors independently abstracted data and assessed the quality of each study. Random effects models were used to obtain summary odds ra...

The use of pesticides has enhanced the health and economies of nations around the world by improving crop production. However, pesticides may pose health risks, particularly to the fetus and young children. In a secondary analysis of the Ontario Farm Family Health Study, we explored the relationship between birth defects and parental pesticide expo...

This review summarizes the level of epidemiologic evidence for relationships between prenatal and/or early life exposure to environmental chemical contaminants and fetal, child, and adult health. Discussion focuses on fetal loss, intrauterine growth restriction, preterm birth, birth defects, respiratory and other childhood diseases, neuropsychologi...

American men have a lifetime risk of about 18% for prostate cancer diagnosis. Large international variations in prostate cancer risks and increased risks among migrants from low- to high-risk countries indicate important roles for environmental factors. Major known risk factors include age, family history, and country/ethnicity. Type 2 diabetes app...

Breast cancer is the most frequently diagnosed cancer among Canadian women, accounting for about 30% of all new cancer cases each year. Although the incidence of breast cancer has increased over the past 50 years, the cause of this rise is unknown. Risk factors for breast cancer may be classified into four broad categories: (1) genetic/familial, (2...

In humans, immune development begins early in embryonic life and continues throughout the early postnatal period. Although a number of pesticides have been observed to induce developmental immunotoxicity in mice, few human studies have examined the long term effects of in utero pesticide exposure on childhood morbidity. Empirical evidence suggests...

An invaluable desk reference for busy public health practitioners. A Dictionary of Public Health is an alphabetical listing of almost 5000 words and phrases used in public health science and practice. It offers definitions, discussions and an occasional brief commentary on the relevance of each term to people and their health. This volume is a trus...

The human fetus, child, and adult may experience adverse health outcomes from parental or childhood exposures to environmental toxicants. The fetus and infant are especially vulnerable to toxicants that disrupt developmental processes during relatively narrow time windows. This review summarizes knowledge of associations between child health and de...

Wigle and Lanphear argue that for many toxins widely dispersed in the environment, even very low levels pose health risks.

Disinfection of drinking water through processes including filtration and chlorination was one of the major achievements of public health, beginning in the late 1800s and the early 1900s. Chloroform and other chlorination disinfection by-products (CBPs) in drinking water were first reported in 1974. Chloroform and several other CBPs are known to ca...

In Reply. —Dr Braun is correct in indicating the RR for coronary heart disease for the lowest folate level studied was statistically significant (P=.04) for women, but not for men. However, the test for trend was statistically significant for both men and women. Although stratum-specific RRs were higher for women compared with men, the 95% CIs aro...

To assess the relationship between serum folate level and the risk of fatal coronary heart disease (CHD) among men and women. Retrospective cohort study with serum folate levels measured from September 1970 to December 1972, with follow-up through 1985. Participants in the Nutrition Canada Survey. A total of 5056 Canadian men and women aged 35 to 7...

To identify factors that may contribute to asthma mortality, 108 acute asthma deaths were reviewed. Information was obtained from medical records, next-of-kin, and autopsy records. The fatal asthmatic was characterized by early-onset asthma, severe disease requiring systemic corticosteroids, and prior hospitalization. Risk factors associated with g...

Health status assessment and disease surveillance are essential to identify and priorize health issues, to evaluate intervention programs and to plan to meet future needs for health services. Canadians currently benefit by having among the highest life expectancies at birth in the world (81 for females, 74 for males). Disability-free life expectanc...

We assessed the relation of serum iron, dietary iron, and the use of iron supplements to the risk of fatal acute myocardial infarction in the Nutrition Canada Survey cohort. We found an association between serum iron and risk of fatal acute myocardial infarction, with rate ratios for males and females in the highest category of serum iron (> or = 1...

The aim of this study was to provide an update of a cohort study (1971-1985) that previously reported a significant trend in the risk of non-Hodgkin's lymphoma among male Saskatchewan farm operators according to fuel-oil expenditures and herbicide spraying for farms less than 1000 acres (2570 hectares) by including two additional Canadian prairie p...

Although farmers appear to be at an increased risk of prostate cancer, the specific exposures which produce the excess risk remain unexplained. This study was based on a retrospectively assembled cohort of male Manitoba, Saskatchewan, and Alberta, Canada, farmers age 45 years or older identified in the 1971 Canadian censuses of population and agric...

Herbicides are a heterogeneous class of chemicals used in agriculture, forestry, and urban settings to kill weeds, shrubs, and broad-leaved trees. The role of herbicides in the etiology of cancer is controversial. Potential studies for review were identified through a MEDLINE1 search and from a check of references in related review articles. This r...

To examine recent trends in mortality and morbidity rates from aortic aneurysms among Canadian seniors. Retrospective study. Men and women age 65 years or older who were hospitalized in Canada with a primary diagnosis of aortic aneurysm or whose underlying cause of death was aortic aneurysm. Unlike other circulatory diseases which have shown marked...

The effect of physical fitness and physical activity on all-cause mortality and mortality due to cardiovascular disease (CVD), cancer and other causes was examined using a population-based representative sample of the Canadian population. A total of 691 deaths occurred among persons age 30-69 during the 7-year follow-up period. Of these, 37, 33 and...

To analyse brain cancer patterns in Canada, particularly according to age and sex distributions, temporal patterns and regional variations. Changes in diagnostic techniques, survival rates and trends by tumour type were also examined. Descriptive epidemiologic study based on Canada-wide population data for 1959-88. Rates of death, incidence and adm...

The correlates of suicide rates were determined by conducting a multivariate study of sociodemographic indicators and suicide rates of 261 Canadian census divisions. Twenty-one sociodemographic variables were entered into a stepwise multiple linear regression to develop a model for suicide rates. The important variables were mortality rate for all...

We calculated relative survival rates from 5 to 15 years after diagnosis for cancer cases diagnosed in Saskatchewan, Canada, between 1967 and 1986. Cancers with high 15-year relative survival (greater than 60%) included lip, melanoma among women, other male genital sites, and corpus uteri. As anticipated, relative survival rates declined with incre...

The present investigation involved an analysis of approximately 70,000 male Saskatchewan farm operators, a subset of the 365,000 Canadian farm operators to be investigated in the Canadian Farm Operator Mortality Study. The results of the Saskatchewan analysis indicate that during the interval studied, overall mortality among Saskatchewan farmers wa...

The effects of residential exposure to environmental tobacco smoke were studied in a sample of 6,529 Canadian children under 15 years of age. Univariate analysis indicated an elevated risk of bronchitis among children whose mothers were single, or under age 25, or whose income or educational level was low. Multivariate analysis indicated that the r...

The impact, time trends and potential for prevention of premature deaths in Canada were assessed. There were almost 100,000 deaths before age 75 in Canada during 1986 resulting in over 1.7 million potential years of life lost (PYLL). The three leading broad disease categories responsible for PYLL were cancer, injuries/violence and cardiovascular di...

From 1985 to 1988, 10 Canadian community health units, in conjunction with Health and Welfare Canada, conducted a standardized telephone survey to assess the prevalence of health risk factors among persons aged 15 and over. Seatbelt use, hypertension awareness, physical activity, smoking, alcohol use, cancer screening status and sociodemographic va...

Suicide rates in Canada rapidly increased during the 1960s and 1970s. More recent analysis of these trends indicates that in males suicide rates have stabilized and in females a notable decrease has been identified. The greatest changes in suicide rates have occurred among the youngest age groups (15 to 19), while little change has occurred in suic...

Monthly trends in mortality and hospital admission rates attributed to asthma for those aged 15 to 34 for the province of Ontario were examined for the period 1979 to 1986. Graphs showing the monthly variation after the elimination of trend are presented. Time series models were constructed to evaluate the statistical significance. Asthma hospital...

A cohort study of the mortality experience (1971–1985) of male Saskatchewan farmers has been conducted. This study involved linkage of records of the almost 70,000 male farmers identified on the 1971 Census of Agriculture and the corresponding Census of Population to mortality records. Pesticide exposure indices for individual farm operators for th...

The process of health risk assessment has been the subject of systematic study in recent years. For example, interdisciplinary groups established by the U.S. National Research Council (NRC 1983) and the World Health Organization (WHO 1985) have developed models for risk assessment and risk management. These investigations have provided clear framew...

We assessed the mortality rates by age, sex, race, blood type, primary diagnosis, treatment and transplantation history of 8432 patients in Canada for whom end-stage renal disease (ESRD) was diagnosed between 1981 and 1986. Significant differences in the probability of dying were found between those with and without diabetes mellitus, between those...

The recent decline in coronary heart disease (CHD) mortality has been attributed to reduction in risk factors, improved management and the possibility of statistical artifacts. The purpose of this study is to assess the impact of geographic and time variation in the coding of cause of death from death certificates into ICD codes upon CHD mortality...

Morrison, H. I. (Laboratory Centre for Disease Control, Ottawa, Ontario, Canada K1A 0L2), R. M. Semenciw, Y. Mao, and D. T. Wigle. Cancer mortality among a group of fluorspar miners exposed to radon progeny. Am J Epidemiol 1988; 128:1266–75. A cohort study of the mortality experience (1950–1984) of 1,772 Newfoundland underground fluorspar miners oc...

RÉSUMÉ Ce texte porte sur l'évolution du suicide au Québec et dans l'ensemble du Canada de 1951 à 1986. Au cours des dernières années, les taux comparatifs de suicide du Québec ont surpassé ceux du Canada. L'augmentation la plus marquante a été observée chez les jeunes adultes. Certains indicateurs sociaux, notamment le pourcentage de chômeurs et l...

The cardiovascular mortality experience of over 7000 Canadians ages 35–79 years free of self-reported heart disease or stroke who participated in the Nutrition Canada survey is presented. The effects of various risk factors on cardiovascular disease mortality were assessed using multlvarlate Poisson regression analyses. Factors associated with a si...

We calculated 5-year crude and relative survival rates, by age and sex, for patients in Alberta in whom cancer was diagnosed between 1974 and 1978. Cancers with low overall 5-year relative survival rates (less than 35%) included stomach cancer, cancer of the pancreas, lung cancer, brain cancer, multiple myeloma and myeloid leukemia. Cancers with hi...

Mortality attributable to tobacco use in Canada is estimated from different data sources. The estimate based on a ten year follow-up of the 1970-72 Nutrition Canada Survey cohort is 34,700 (95% Confidence Limits, CL: 22,300-42,100) tobacco-related deaths among Canadians aged 35-79 in 1983. The corresponding estimate for 1985 is 35,400 (95% CL: 22,8...

In obstructive hypertrophic cardiomyopathy (muscular or hypertrophic subaortic stenosis), there is rapid early systolic ejection through an outflow tract that is narrowed by ventricular septal hypertrophy. This results in Venturi forces acting on the mitral leaflets, which cause mitral leaflet systolic anterior motion. Subsequent mitral leaflet-sep...

A case-control study of hypertension was conducted, using as a sampling frame a cross-sectional survey of Canadian Federal civil servants. Three case groups were selected, based on prior knowledge of hypertensive status and measured blood pressure. A 3-to-1 matching scheme was employed. Data was analysed using a logistic regression model. Statistic...

Recent rates of illness and death from asthma in Canada and rates of hospital admission/separation for asthma were examined by age group and region. The death rates were higher in 1982-84 than in 1970-72, especially among those aged 15 to 34 years. Increases were also noted in hospital admission/separation rates, especially among those less than 15...

The Department of National Health and Welfare has developed a telephone administered risk factor survey. This survey contains modules on seatbelt use, hypertension awareness, physical fitness, cigarette smoking, alcohol consumption, socio-demographic information and cancer screening in women. Results are presented from one such survey conducted in...

Recently published evidence indicates that involuntary smoking causes an increased risk of lung cancer among nonsmokers. Information was compiled on the proportion of people who had never smoked among victims of lung cancer, the risk of lung cancer for nonsmokers married to smokers and the prevalence of such exposure. On the basis of these data we...

"The evolution of mortality in Quebec over the past three decades is reviewed. Life expectancies and potential years of life lost from birth to age 75 are calculated. Also, interprovincial comparisons of mortality are included. Quebec's mortality experience, in comparison to the other provinces, is poor. Causes of death that are of particular conce...

Data on mortality among over 8000 Canadians aged 35 to 79 years who participated in the Nutrition Canada survey are presented. The effects of various risk factors on mortality were assessed with a multivariate Poisson regression analysis. Factors associated with a significantly increased risk of death over a 10-year follow-up period ending in 1981...

. Tobacco products are the only widespread source of human exposure to nicotine . The concentrations in urine from involuntary and voluntary smokers of nicotine and cotinine, the main in vivo metabolite of nicotine, were used to assess the relative exposures of such persons to toxic components of tobacco smoke . Estimates for individual components...

RÉSUMÉ L’évolution de la mortalité par cause, au Québec, pour les trois dernières décennies, est étudiée. Les espérances de vie et les années potentielles de vie perdues, de la naissance à 75 ans, sont calculées. De plus, les taux de mortalité des différentes provinces, pour certaines causes de décès, sont comparés. Il en résulte que le Québec conn...

A population-based computer record linkage of infant births and deaths was conducted for 1978 and 1979 covering Canadian provinces. Birthweight was inversely related to risk of postneonatal death for all causes examined, including accidental deaths. Length of gestation was inversely associated with risk, but the strength of the relationship was muc...

The clinical and haemodynamic significance of the subaortic pressure gradient in patients with muscular (hypertrophic) subaortic stenosis (hypertrophic obstructive cardiomyopathy) has long been debated. In this report we summarize the evidence which indicates that true obstruction to left ventricular outflow exists in these patients. Rapid left ven...

Echocardiography has greatly simplified the diagnosis of hypertrophic cardiomyopathy and routine haemodynamic studies are usually only required in patients being considered for myectomy or the assessment of coexistent coronary disease. A complete echo Doppler study should be performed in all patients with hypertrophic cardiomyopathy to define the d...

We computed age specific and adjusted mortality rates for Canadan Indian reserves for available provinces for 1977-1982 and compared to rates for Canada as a whole. Age-specific all-cause mortality rates were two to three times higher up to age 50. Standardized mortality ratios (SMRs) for ages 1-69 indicated elevated risks among both sexes for all...

Infant mortality on Indian reserves in five Canadian provinces was investigated for the period 1976 to 1983. Indian reserve neonatal mortality was over one third higher than that experienced by the comparable nonreserve population, while postneonatal mortality was almost four times higher. Significantly elevated postneonatal causes of death include...

Cancer is diagnosed in about 70 000 Canadians each year and is the leading cause of the loss of potential years of life before age 75 among women. Life-threatening forms of cancer will develop in at least one of every three Canadian newborns during their lifetimes if current cancer risks are not reduced. Lung and breast cancers are, respectively, t...

Despite a general decline in mortality rates in recent decades, these rates are substantially higher among lower socioeconomic groups. To determine target groups for preventive health promotion programs, the prevalence of risk factors for cardiovascular disease by socioeconomic group in Canadian adults aged 20 to 69 years was examined through compa...

A population-based computer record-linkage study of infant births and deaths in 1978 and 1979 in eight Canadian provinces (Quebec and Newfoundland were excluded) was undertaken to permit analysis of perinatal mortality in relation to maternal and infant characteristics. Perinatal mortality rates were significantly higher in nonurban than in urban a...

Associations between mortality rates in 66 Canadian cities and selected drinking water characteristics were analyzed with adjustment for socio-demographic factors. The concentrations of chloroform and total trihalomethanes were significantly associated with chlorine dose. Age-standardized mortality rates for overall mortality (males), all cancers c...

The presence of intracavitary left ventricular (LV) pressure gradients in patients without intraoperative or postmortem evidence of obstruction led Brock1’2 to the concept of a ‘functional obstruction of the left ventricle’. Although the precise site of the functional obstruction was initially thought to be a muscular bar, sphincter or ‘contraction...

Tobacco smoke, which contains over 50 known carcinogens and many other toxic agents, is a health hazard for nonsmokers who are regularly exposed to it while at work. Involuntary exposure to tobacco smoke annoys and irritates many healthy nonsmokers. Serious acute health effects are probably limited to the one fifth of the population with pre-existi...

A total of 64 cases of pleural mesothelioma were reported in British Columbia between 1973 and 1980, 54 in males and 10 in females. There was a significant (p less than 0.05) increase in the incidence among males. The overall incidence rates were 4.9 and 0.9 per million person-years for males and females respectively. The age distribution of the ca...

Preliminary results from Volume 3 of the Mortality Atlas of Canada showed elevated standardized mortality ratios (SMR) for the town of Maniwaki, Quebec of 1.80 for males and 1.67 for females for the period 1973-1979. Before assessing whether further action was required, community health officials validated the data for place of residence as well as...

The review will discuss the occurrence and sources of asbestos fibers in drinking water supplies, methods of analysis, fiber characteristics and effects of water treatment practices on fiber concentration. Drinking water as a source of asbestos for man will be reviewed in the context of other sources of exposure. The biological effects of ingested...

Death certificates were reviewed for the 543 Alberta women who died during the period 1969 through 1978 and for whom the underlying cause of death was coded as uterine cancer. To evaluate the recorded cause of death Alberta Cancer Registry records, which existed for 97% of the women, were examined. Calculations from the revised information showed a...

Samples of raw, treated and distributed tap water were collected from 71 municipalities across Canada and analyzed for asbestos content by transmission electron microscopy. Chrysotile asbestos was identified as the major asbestos type present in drinking water with some 5% of public water supplies containing asbestos at concentrations greater than...

Although two 19th century French pathologists and an early twentieth century German pathologist described cardiac pathological findings compatible with what we know today as 'asymmetrical hypertrophy of the heart', it remained for Donald Teare to bring attention to this entity in 1958. In nine cases of sudden death, Teare described a marked hypertr...

The case group in this Alberta, Canada, study consisted of 202 interviewed women (55-74 years old) with histologically confirmed cancer of the uterine corpus; comparison group was 1243 women with other than urogenital or breast cancer. The women had been interviewed to determine estrogen usage. Estrogen use (current or past) was reported by 47.2% o...

Cancer mortality in Canada during 1931 to 1974 was reviewed. Recently, cancer ranked first as a cause of loss of life expectancy for women and third for men. For Canada, probability of cancer death before age 75 was 12.0% for men and 10.1% for women; by province, Quebec had the highest probabilities both for men (13.8%) and women (11.1%) while Sask...