To determine whether elevated rates of mortality from systemic sclerosis (SSc) in the Southeastern United States result from local, multicounty clusters of the disease.
Detection of spatial clusters of SSc mortality by applying the method of Kulldorff and Nagarwalla to death certificate data from 955 counties in 12 southeastern states.
From 1981 to 1990, significant excess mortality from SSc in the Southeastern US occurred among white males [standardized mortality ratio (SMR)=1.2 ; p=0.0004] and black males (SMR=1.2 ; p=0.04), but not among white females (SMR=0.98 ; p=0.55) or black females (SMR=1.1 ; p=0.06).
When the cluster detection algorithm was applied to data for white males, 3 significant clusters were identified.
The primary cluster (p=0.001) was centered around Coffee, Tennessee.
Two smaller clusters overlapped the primary cluster - one centered at Calhoun, Alabama, (p=0.008) and another centered at Chattooga, Georgia, (p=0.04).
Analysis of data for black males resulted in a single significant cluster (p=0.02) centered at Northampton.
When data for white or black females were analyzed, no clusters reached statistical significance.
In combination, excess SSc mortality in the detected clusters accounted for 79.0 and 66.2%, respectively, of the excess deaths among white and black males across the whole Southeast. (...)
Mots-clés Pascal : Sclérodermie, Etiologie, Homme, Epidémiologie, Mortalité, Environnement, Facteur risque, Amas local, Ethnie, Peau pathologie, Tissu conjonctif pathologie, Maladie système, Maladie autoimmune, Immunopathologie
Mots-clés Pascal anglais : Scleroderma, Etiology, Human, Epidemiology, Mortality, Environment, Risk factor, Local cluster, Ethnic group, Skin disease, Connective tissue disease, Systemic disease, Autoimmune disease, Immunopathology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0049700
Code Inist : 002B07. Création : 14/05/1998.