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Impaired lung function is a major clinical indicator of mortality risk in men and women for a wide range of diseases. The use of FEV1 as part of any health assessment of middle aged patients should be considered. Smokers with reduced FEV1 should form a priority group for targeted advice to stop smoking.

Background: The prognostic impact of heart failure relative to that of 'high-profile' disease states such as cancer, within the whole population, is unknown. Methods: All patients with a first admission to any Scottish hospital in 1991 for heart failure, myocardial infarction or the four most common types of cancer specific to men and women were identified. Five-year survival rates and associated loss of expected life-years were then compared. Results: In 1991, 16 224 men had an initial hospitalisation Ž . Ž . for heart failure n s 3241 , myocardial infarction n s 6932 or cancer of the lung, large bowel, prostate or bladder Ž . Ž . Ž . n s 6051 . Similarly, 14 842 women were admitted for heart failure n s 3606 , myocardial infarction n s 4916 , or cancer of Ž . the breast, lung, large bowel or ovary n s 6320 . With the exception of lung cancer, heart failure was associated with the Ž . poorest 5-year survival rate approximately 25% for both sexes . On an adjusted basis, heart failure was associated with worse Ž . long-term survival than bowel cancer in men adjusted odds ratio, 0.89; 95% CI, 0.82᎐0.97; P-0.01 and breast cancer in Ž . women odds ratio, 0.59; 95% CI, 0.55᎐0.64; P-0.001 . The overall population rate of expected life-years lost due to heart failure in men was 6.7 yearsr1000 and for women 5.1 yearsr1000. Conclusion: With the notable exception of lung cancer, heart failure is as 'malignant' as many common types of cancer and is associated with a comparable number of expected life-years lost. ᮊ

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Objective: To investigate the association between social circumstances in childhood and mortality from various causes of death in adulthood. Design: Prospective observational study. Setting: 27 workplaces in the west of Scotland. Subjects: 5645 men aged 35-64 years at the time of examination.