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Lina J. Leurs, (1) Leo J. Schouten, (1) Margreet N. Mons, (2) Roentgen. Alexandra Goldbohm, (3) and you may PietA. van den Brandt (1)
Wanting a simple yet effective construction to own evaluating publicity-condition dating in an assembled cohort
(1) Maastricht College, GROW-School to own Oncology and you will Developmental Biology, Service out of Epidemiology, Maastricht, the netherlands; (2) KWR, Watercycle Search Institute, Nieuwegein, holland; (3) TNO Total well being, Department off Prevention and you can Fitness, Leiden, holland
Address interaction to help you L.J. Leurs, Maastricht University, GROW-College having Oncology and you can Developmental Biology, Agencies out of Epidemiology, P.O. Box 616, 6200 MD Maastricht, the netherlands. Telephone: 30 0 43 3882392. Fax: 31 0 43 3884128. E-mail:
The audience is in financial trouble on the players of the study and want to thank the brand new Dutch Main Agency out-of Family history and you may Analytics Netherlands to have bringing study. I together with give thanks to A great. Volovics and you may An effective. Kester having analytical suggestions; S. van de- Crommert, H. Brants, J. Nelissen, C. de Zwart, M. Moll, W. van Dijk, and you can A good. Pisters to have direction; and you can H. van Montfort, T. van Moergasiel, L. van den Bosch, Roentgen. Schmeitz, and you will J. Berben to own coding recommendations.
So it enterprise is conducted into the Joint Browse System of your own Dutch liquids people of the boffins off Maastricht College and you may KWR, Watercycle Lookup Institute. This study is actually financed by the KWR, Watercycle Search Institute.
R.An effective.G. and you may Yards.Letter.M. benefit asking organizations (TNO Standard of living and you will KWR, respectively); but not, neither has previously did any earlier search into newest question described in the manuscript. Additionally, external article on the shape and efficiency is conducted because of the a good Scientific Consultative Committee consisting of P. Huntsman (University regarding East Anglia), R. Rylander (emeritus teacher), and you may M.I. Sinclair (Drinking water High quality Look Australian continent Limited, Monash University).
Really degree you to definitely reported an enthusiastic inverse connection ranging from liquids stiffness and IHD or stroke death was in fact ecologic education (Kousa ainsi que al. 2004, 2006, 2008; Maheswaran et al. 1999; ; Sauvant and Pepin 2000). The fresh new accuracy of them brand of degree is often expected as of your own possible ecologic fallacy. A handful of circumstances-control and you will cohort studies with little to no or no modifications to have confounding products including ideal a prospective protective effect of water hardness, calcium otherwise magnesium levels when you look at the liquid, into the death due to IHD or coronary arrest (Luoma mais aussi al. 1983; Punsar and you can Karvonen 1979; Rubenowitz et al. 1996, 1999; Yang 1998; Yang et al. 2006). Additionally, extremely circumstances-handle and cohort knowledge one adjusted having a great deal of prospective confounders, such as for instance cardio risk affairs and you can h2o attributes, receive zero relationship ranging from liquids hardness and you will IHD or coronary arrest mortality (Comstock ainsi que al. 1980; Morris et al. 2001; Rosenlund mais aussi al. 2005). The brand new exception to this rule try happening-handle data conducted from the Rubenowitz mais aussi al. (2000) you to definitely reported down mortality out of serious myocardial infarction ( not into the full frequency) and you will magnesium into the liquid immediately after changing to have a standard range of possible confounders.
Nutrient consumption try modified to possess energy consumption by the residual means (Willett and you can Stampfer 1986). The fresh questionnaire data have been secret-inserted double and canned during the a standardized trend dazzled in respect in order to situation/subcohort condition to attenuate observer bias within the coding and you will research interpretation.
The analyzed exposure variables were total tap water hardness, tap water magnesium, and calcium concentration. In the multivariate analysis, we corrected for potential confounding of other known IHD risk factors: age at baseline (years), cigarette smoking (coded as current vs. never/former smoker and number of cigarettes smoked per day, and years of active smoking), hypertension (yes/no), diabetes (yes/no), body mass index (BMI) (coded as < 18.5 kg/[m.sup.2], 18.5-25 kg/[m.sup.2], 25-30 kg/[m.sup.2], [greater than or equal to] 30 kg/[m.sup.2]), nonoccupational physical activity (coded in tour categories: very little, average, active, or very active), educational level [coded as primary school, lower vocational, high school (junior and senior), and higher vocational/university], total energy intake (kilocalories per day), alcohol consumption (coded in five categories: 0 g/day, 0.1-5 g/day, 5-15 g/day, 15-30 g/day, 2 30 g/day). energy-adjusted saturated/monounsaturated/ polyunsaturated fat consumption (grams per day), and fruit and vegetable consumption (grams per day). We included additional factors that influence the amount of calcium or magnesium absorption from tap water: use of diuretics (yes/no), multivitamin intake (yes/no), calcium supplement intake (yes/no), energy-adjusted dietary calcium and magnesium consumption (milligrams per clay), and total volume of tap water consumption (milliliters per day) (Elin 1988; Greenland et al. 2003; Hornstra et al. 1998; Wilson 1999). When tap water calcium concentration (milligrams per liter) was analyzed, additional adjustment for tap water magnesium concentration (milligrams per liter) occurred and vice versa.
Gillies Myself, Paulin HV. 1983. Variability of mineral consumption away from water: a prospective explanation toward conflict along the relationships off liquid quality to help you cardiovascular illnesses. Int J Epidemiol several(1):45-fifty.