Obesity was associated to the risk of adult onset asthma, while short height and low leisure time physical activity can be considered as other potential risk factors.

BackgroundYersinia enterocolitica (YE) is the causative agent of yersiniosis. YE encompass strains of diverse pathogenicity: YE biotypes 1B and 2-5 are considered pathogenic, whereas biotype 1A is in general considered nonvirulent. Also YE-like species, which can sometimes be misidentified as YE, are considered nonvirulent.MethodsIn order to study differences in clinical picture caused by different YE types and their possible sources a case-control study was conducted in 2006. In this case-control study, 295 case-patients with YE or YE-like finding and their 758 controls responded to the questionnaire about symptoms and possible sources of infection.ResultsStrains of pathogenic YE bio/serotypes 3-4/O:3 or 2/O:9 were found in 18%, YE biotype 1A in 65% and YE -like strains of 17% of the patients. Patients infected with the strains of pathogenic YE bio/serotypes were younger and had fever more often than those with BT 1A who suffered more from vomiting. Symptoms of reactive arthritis were reported by 10% of pathogenic YE infections, 3% of YE BT 1A, and 0.3% of the controls. Eating or tasting raw or medium done pork was a significant risk factor for pathogenic YE bio/serotype infection (OR 6.6; 95% CI 1.7-24.9) as well as eating in a canteen (OR 3.5; 95% CI 1.6-7.9). Imported fruits and berries were associated with increased risk of YE BT 1A finding.ConclusionsThe symptoms of the patients with YE BT 1A differed from yersiniosis caused by the classic pathogenic YE bio/serotypes. In addition, the patients with YE BT 1A had more protracted gastrointestinal disorders and unspecific complaints. Small children were overrepresented in classic pathogenic bio/serotypes while in BT 1A or YE-like species were not found among children younger than two years. This suggests the lacking virulence of the BT 1A strains. We can not, however, rule out the possibility that some strains of genetically heterogeneous group of BT 1A may cause an illness.

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An inappropriate cross-connection between sewage- and drinking-water pipelines contaminated tap water in a Finnish town, resulting in an extensive waterborne gastroenteritis outbreak in this developed country. According to a database and a line-list, altogether 1222 subjects sought medical care as a result of this exposure. Seven pathogens were found in patient samples of those who sought treatment. To establish the true disease burden from this exposure, we undertook a population-based questionnaire investigation with a control population, infrequently used to study waterborne outbreaks. The study covered three areas, contaminated and uncontaminated parts of the town and a control town. An estimated 8453 residents fell ill during the outbreak, the excess number of illnesses being 6501. Attack rates were 53% [95% confidence interval (CI) 49.5-56.4] in the contaminated area, 15.6% (95% CI 13.1-18.5) in the uncontaminated area and 6.5% (95% CI 4.8-8.8) in the control population. Using a control population allowed us to differentiate baseline morbidity from the observed morbidity caused by the water contamination, thus enabling a more accurate estimate of the disease burden of this outbreak.

Some of the inconsistency may have arisen from confounding since, although many studies Background -Few studies have been published on the overall survival of adult have controlled for the effect of age, sex and smoking, 2 5 15 the effects of occupation 15 and patients with asthma. A cohort study was performed to assess the mortality from all other lung diseases 2 may also be important. We have studied mortality from all causes among causes, from chronic obstructive pulmonary disease, and from lung cancer persons with asthma in Finland in a population based cohort study, in addition to the specific among adult asthmatic subjects. Methods -A population of 31 110 Finnish risk of death due to asthma, chronic obstructive pulmonary disease, and lung cancer. Possible adult women and men, mostly twins, was studied to compare the 16 year mortality confounding due to smoking, social class, domestic animals and pets, other respiratory morrates among asthmatic (n=471) and nonasthmatic persons. A further 293 twin bidity, and atopy have been taken into account. pairs, discordant for asthma, were also studied to determine whether the mortality of patients with asthma differs from Methods that of their age matched siblings.  Results -Mortality from all causes was The study population was based on the Finnish increased among asthmatic adults (age twin cohort which consists primarily of adult adjusted hazard ratios 1.49, 95% CI 1.09 twin pairs, with both members alive in 1967 to 2.05 for men and 1.53, 95% CI 1.10 and born before 1958, as well as some unrelated to 2.13 for women), and mortality due to individuals included because of the selection chronic obstructive pulmonary diseases criteria used to form the cohort. 16 Pairs of was also significantly increased in asth-persons with the same date of birth, same matic subjects. The risk of death due to surname at birth, same local community of lung cancer was increased in men with birth, and same sex were identified from the asthma (hazard ratio adjusted for smoking Central Population Registry of Finland. A 3.19, 95% CI 1.39 to 7.31). The risk ratios postal questionnaire was mailed in the autumn found among twins discordant for asthma of 1975 with questions that covered twinship, corresponded to those found in the whole medical history, symptoms, state of health, socohort.cial factors, and psychological traits. The reConclusions -Survival in adults with sponse rate of the questionnaire study was 89%, asthma is worse than in those without yielding 31 110 responses, 26 533 from twins asthma. The excess deaths due to chronic and 4577 from singletons. Twinship was deobstructive pulmonary disease may ex-termined from questionnaire responses and plain some part of the increased mortality confirmed, when necessary, from birth records rates, but not all of it.in local parish registers. Zygosity was de- (Thorax 1997;52:49-54) termined by a validated questionnaire method. 17 Department of Public Health, FIN-00014Keywords: asthma, mortality, cohort study. The medic...