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Urolithiasis in Tennessee: An occupational window into a regional problem

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  • Thun, M.J.
  • Schober, S.

Abstract

Background: Urinary tract stones (stones) are believed to be unusually common in the southeastern United States but neither the incidence of nor the risk factors for stones are known. Methods: In three well-defined occupational populations in eastern Tennessee, we assessed the prevalence, incidence, and cumulative incidence of stones and measured biochemical risk factors for lithogenesis. Results: The age-adjusted prevalence of stones was 18.5 percent in Tennessee compared to 7.7 percent among White males in US NHANES (prevalence ratio 2.4, 95% CI 1.7, 3.3). The cumulative incidence (risk) was 27.8 percent by age 65, higher than in any other reported population. Risk factors were age, a family history, and urinary saturation with calcium-oxalate (COAX). Persons with a positive family history and the highest measured CAOX index had a predicted lifetime risk of 88.8 percent. Biochemical factors affecting lithogenesis were hypercalcuria, hyperoxaluria, and low urine volume. Conclusion: Future research should characterize the geographic boundaries of a southeastern ''stone-belt'' and explore genetic and dietary hypotheses that might explain it.

Suggested Citation

  • Thun, M.J. & Schober, S., 1991. "Urolithiasis in Tennessee: An occupational window into a regional problem," American Journal of Public Health, American Public Health Association, vol. 81(5), pages 587-591.
    • Handle: RePEc:aph:ajpbhl:1991:81:5:587-591_0
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    Cited by:

    1. Zorn, R. & Richter, D. & Frick, B. & Farago, B., 1993. "Neutron scattering experiments on the glass transition of polymers," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 201(1), pages 52-66.
    2. Oligschleger, C. & Schober, H.R., 1993. "Dynamics of Se glasses," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 201(1), pages 391-394.
    3. Dzugutov, M., 1993. "Phonons in a simple monatomic model of metallic glass," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 201(1), pages 430-433.
    4. Schober, H.R., 1993. "Soft phonons in glasses," Physica A: Statistical Mechanics and its Applications, Elsevier, vol. 201(1), pages 14-24.

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