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E Sweeney, Y Cui, V DeClercq, P Devichand, C Forbes, S Grandy, J M T Hicks, M Keats, L Parker, D Thompson, M Volodarsky, Z M Yu, T J B Dummer, Cohort Profile: The Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) Study, International Journal of Epidemiology, Volume 46, Issue 6, December 2017, Pages 1762–1763i, https://doi.org/10.1093/ije/dyx124
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Why was the cohort set up?
The Atlantic Partnership for Tomorrow’s Health (Atlantic PATH) study is a regional cohort of the Canadian Partnership for Tomorrow Project (CPTP) which is a multi-centred prospective cohort study.1 Prospective cohort studies that follow participants over time provide an opportunity to better understand how genetics, environment and lifestyle factors interact to affect the development of chronic health outcomes. The CPTP involves five regional cohorts in eight provinces, including Atlantic PATH, Alberta’s Tomorrow Project, the Ontario Health Study, the British Columbia Generations Project and CARTaGENE (Quebec). The CPTP was established in 2008 with a goal of recruiting 300 000 participants from across Canada in order to examine the complex interplay of factors that lead to the development of cancer and other chronic diseases.2 CPTP participants will be followed actively and passively over a period of 30 years – actively with requests for additional questionnaire data, biological samples or physical measurements, and passively by linking to provincial health records in order to determine future health outcomes.
Atlantic PATH has two primary objectives: (i) to develop a databank containing health and health-related measures, as well as biological samples; and (ii) to encourage and facilitate the use of the databank by researchers, with an emphasis on cancer aetiology and other chronic disease. Atlantic PATH created and developed a data and biological samples repository located in Halifax, Nova Scotia, as a resource to support health-based research and analysis. Atlantic PATH is funded by the Canadian Partnership Against Cancer, and includes all four Atlantic Canadian Provinces (Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador).
Who is in the cohort?
Atlantic PATH’s study population includes residents of Atlantic Canada. Atlantic PATH sought to recruit at least 30 000 participants, and the only inclusion criteria for interested individuals was residence in one of the Atlantic Canada Provinces and age 30–74 years. Data was collected between 2009 and 2015, with participants providing informed consent as part of their participation in the study. Recruitment used a range of outreach activities, including invitations from the Provincial Health Insurance provider (Nova Scotia only), advertising, media coverage, community and workplace events, incentive programmes (e.g. Airmiles) and community champions who encouraged their friends and families to participate. Participants provided data in person at assessment centres, via online questionnaires or by mail (paper questionnaires and ‘PATH Packs’). Participants also provided physical measurements (height, weight, waist and hip circumference, body composition and blood pressure) and biological samples (blood, urine, saliva and toenails).
A total of 35 935 participants were recruited and completed the core questionnaire. The dataset was then harmonized to ensure consistency with the other CPTP regions. The harmonized dataset for Atlantic PATH includes 31 173 participants in the CPTP age range of 35–69 (9 445 men and 21 728 women). Based on the provincial population estimates from Statistics Canada, a representative cohort in this region would ideally include 40% of participants from Nova Scotia, 32% from New Brunswick, 22% from Newfoundland and Labrador and 6% from Prince Edward Island.3 The actual percentage of participants in the Atlantic PATH cohort include 53% from Nova Scotia, 28% from New Brunswick, 15% from Newfoundland and Labrador and 4% from Prince Edward Island. The majority of participants are females (70%) over 50 years of age (63%).
All participants completed the core questionnaire, with 68% also completing a secondary questionnaire specific to Atlantic Canada, which included detailed questions on diet and physical activity, mental health and depression, home environment, and residential and occupational history. At least one biological sample was provided by 91% of participants; venous blood samples were provided by 84% (Table 1).
. | In-person/assessment centres (n = 7145) . | Online questionnaires (n = 10 657) . | PATH Packs/paper questionnaires (n = 13 371) . | Total (n = 31 173) . |
---|---|---|---|---|
Completed core questionnaire | 7 145 | 10 657 | 13 371 | 31 173 |
Completed Atlantic Provinces questionnaire | 6 956 | 1 810 | 12 523 | 21 289 |
Completed a minimum of one physical measure | 7 095 | 7 743 | 7 572 | 22 410 |
Provided a dried blood spot | 3 | 1 126 | 8 662 | 9 791 |
Provided a venous blood sample | 7 051 | 7 197 | 7 070 | 21 318 |
Provided a saliva sample | 6 168 | 1 577 | 309 | 8 054 |
Provided a urine sample | 6 932 | 2 994 | 1 799 | 11 725 |
Provided toenail samples | 6 989 | 8 258 | 11 301 | 26 548 |
. | In-person/assessment centres (n = 7145) . | Online questionnaires (n = 10 657) . | PATH Packs/paper questionnaires (n = 13 371) . | Total (n = 31 173) . |
---|---|---|---|---|
Completed core questionnaire | 7 145 | 10 657 | 13 371 | 31 173 |
Completed Atlantic Provinces questionnaire | 6 956 | 1 810 | 12 523 | 21 289 |
Completed a minimum of one physical measure | 7 095 | 7 743 | 7 572 | 22 410 |
Provided a dried blood spot | 3 | 1 126 | 8 662 | 9 791 |
Provided a venous blood sample | 7 051 | 7 197 | 7 070 | 21 318 |
Provided a saliva sample | 6 168 | 1 577 | 309 | 8 054 |
Provided a urine sample | 6 932 | 2 994 | 1 799 | 11 725 |
Provided toenail samples | 6 989 | 8 258 | 11 301 | 26 548 |
Without the age restriction requirement for the harmonized data, Atlantic PATH collected 35 676 core questionnaires and 25 404 Atlantic Provinces questionnaires. Of these, at least one physical measure was collected from 21 309 individuals, as well as 12 025 dried blood spots, 23 897 venous blood samples, 9169 saliva samples, 12 990 urine samples, and 33 011 toenail samples. Participants who completed a self-assessment questionnaire (online questionnaire or PATH Pack) were subsequently invited to a mobile clinic to obtain physical measures and biological samples. Of these 24 028 participants, 5086 provided both a dried blood spot sample and a venous blood sample.
. | In-person/assessment centres (n = 7145) . | Online questionnaires (n = 10 657) . | PATH Packs/paper questionnaires (n = 13 371) . | Total (n = 31 173) . |
---|---|---|---|---|
Completed core questionnaire | 7 145 | 10 657 | 13 371 | 31 173 |
Completed Atlantic Provinces questionnaire | 6 956 | 1 810 | 12 523 | 21 289 |
Completed a minimum of one physical measure | 7 095 | 7 743 | 7 572 | 22 410 |
Provided a dried blood spot | 3 | 1 126 | 8 662 | 9 791 |
Provided a venous blood sample | 7 051 | 7 197 | 7 070 | 21 318 |
Provided a saliva sample | 6 168 | 1 577 | 309 | 8 054 |
Provided a urine sample | 6 932 | 2 994 | 1 799 | 11 725 |
Provided toenail samples | 6 989 | 8 258 | 11 301 | 26 548 |
. | In-person/assessment centres (n = 7145) . | Online questionnaires (n = 10 657) . | PATH Packs/paper questionnaires (n = 13 371) . | Total (n = 31 173) . |
---|---|---|---|---|
Completed core questionnaire | 7 145 | 10 657 | 13 371 | 31 173 |
Completed Atlantic Provinces questionnaire | 6 956 | 1 810 | 12 523 | 21 289 |
Completed a minimum of one physical measure | 7 095 | 7 743 | 7 572 | 22 410 |
Provided a dried blood spot | 3 | 1 126 | 8 662 | 9 791 |
Provided a venous blood sample | 7 051 | 7 197 | 7 070 | 21 318 |
Provided a saliva sample | 6 168 | 1 577 | 309 | 8 054 |
Provided a urine sample | 6 932 | 2 994 | 1 799 | 11 725 |
Provided toenail samples | 6 989 | 8 258 | 11 301 | 26 548 |
Without the age restriction requirement for the harmonized data, Atlantic PATH collected 35 676 core questionnaires and 25 404 Atlantic Provinces questionnaires. Of these, at least one physical measure was collected from 21 309 individuals, as well as 12 025 dried blood spots, 23 897 venous blood samples, 9169 saliva samples, 12 990 urine samples, and 33 011 toenail samples. Participants who completed a self-assessment questionnaire (online questionnaire or PATH Pack) were subsequently invited to a mobile clinic to obtain physical measures and biological samples. Of these 24 028 participants, 5086 provided both a dried blood spot sample and a venous blood sample.
How often have they been followed up?
The data collected from 2009 to 2015 represents the first stage of the Atlantic PATH study. Participants have consented to be followed over a 30-year period as part of the long-term study. Data will be collected actively and passively at regular intervals to obtain additional information on lifestyle behaviours, health outcomes, biological samples and physical measurements. The first online follow-up questionnaire was implemented in the fall of 2016.
What has been measured?
The Atlantic PATH study includes a varied collection of data to provide researchers with a wealth of information to examine the interplay of genetic, lifestyle and environmental factors that contribute to the development of chronic disease.
Questionnaire content
A standardized core questionnaire was developed in concert with the four other regional CPTP cohorts and implemented across the CPTP. A secondary questionnaire was developed for Atlantic PATH in order to collect additional data with questions unique to the Atlantic Provinces (Supplementary Material Tables 1 and 2, available as Supplementary data at IJE online).
Core questionnaire
The core questionnaire includes information about participants’ health and well-being, including demographics, health status, family health history, medical history, cancer diagnoses, medication use, sleep patterns, sunlight exposure, diet, alcohol consumption, tobacco use, second-hand smoke exposure, physical activity levels [short form of the International Physical Activity Questionnaire (IPAQ)],4 employment status and anthropometric measurements.
Questions unique to the Atlantic Provinces
A secondary questionnaire was developed with questions unique to the Atlantic Canada component of CPTP. It provides additional data about cooking and water sources, allergies, diet, depression, weight, physical activity levels (long-form IPAQ), residential history and occupational and environmental exposures.
Physical measures
Non-invasive physical measures were provided by 20 492 participants, including height, weight, hip and waist circumference, body composition and blood pressure. A Seca stadiometer was used to measure height and a Tanita bioelectrical impedance device was used to measure body weight and body fat percentage. Body mass index (BMI) was calculated by dividing weight in kilograms by height in metres squared. An additional 6587 participants provided self-reported height, weight, and hip and waist circumference measurements.
Biological samples
Participants provided biological samples including blood, saliva, urine and toenails. Samples were collected at assessment centres, but in the case of participants completing a self-assessment package, toenails and blood spot cards were collected by the participant and then mailed to the Atlantic PATH office. Venous blood samples (23 ml/participant) were collected from participants at an assessment centre. Once processed, plasma, buffy coat, red blood cells, serum, saliva and urine were transferred to 2-ml cryovials and stored in -80°C freezers. Toenail samples were collected in ziplock bags and stored in cabinets at room temperature.
Data linkage
A research platform is being developed which will add health data from administrative health databases, vital statistics and cancer registries to the existing data bank. The de-identified data and biological samples from Atlantic PATH are available to the academic research community for research purposes. Researchers are required to apply to Atlantic PATH for data and sample access, and all approved projects require approval from an institutional research ethics board. Details about the data and sample application process can be found at [www.atlanticpath.ca].
What has been found? Key findings and publications
Sociodemographic characteristics
Population representativeness was assessed by comparing sociodemographic characteristics of cohort participants with the general population aged 35–69 in Atlantic Canada, using self-reported data from the 2011 Canadian Census.5 There was overall concordance in the distribution of characteristics between the cohort and the general population (Table 2). The most notable differences between Atlantic PATH participants and the general population in Atlantic Canada include higher socioeconomic status, and higher representations of women (70% vs 51%), of people born in countries other than Canada (9% vs 4%) and of people with undergraduate and graduate degrees (30% vs 16% and 15% vs 5%, respectively).
Sociodemographic Characteristics . | . | Atlantic PATH Cohort (n = 31 173) n (%) . | Canadian Census data (n = 1 148 538) n (%) . |
---|---|---|---|
Sex | Male | 9438 (30.3) | 558 970 (48.7) |
Female | 21 735 (69.7) | 589 568 (51.3) | |
Age | 35–39 | 3095 (9.9) | 142 016 (12.4) |
40–44 | 3728 (12.0) | 159 278 (13.9) | |
45–49 | 4566 (14.7) | 191 889 (16.7) | |
50–54 | 5421 (17.4) | 186 898 (16.3) | |
55–59 | 5657 (18.2) | 183 696 (16.0) | |
60–64 | 5326 (17.1) | 165 920 (14.5) | |
65–69 | 3380 (10.8) | 118 841 (10.4) | |
Province | Nova Scotia | 16 577 (53.2) | 452 155 (39.4) |
New Brunswick | 8826 (28.3) | 368 319 (32.1) | |
Prince Edward Island | 1167 (3.7) | 66 214 (5.8) | |
Newfoundland and Labrador | 4513 (14.5) | 261 851 (22.8) | |
Not reported | 90 (0.3) | –a | |
Country of birth | Canada | 24 006 (77.0) | 1 091 037 (95.0) |
Other | 2864 (9.2) | 42 815 (3.7) | |
Unknown | 4303 (13.8) | 14 686 (1.3) | |
First language learned | English only | 26 726 (85.7) | 1 001 442 (87.2) |
French only | 1598 (5.1) | 144 916 (12.6) | |
Other | 271 (0.9) | 1228 (0.1) | |
Unknown | 2578 (8.3) | – | |
Education (completed) | < High school | 452 (1.5) | 226 966 (19.8) |
High school | 5461 (17.5) | 256 723 (22.4) | |
College | 11 270 (36.2) | 412 877 (36.0) | |
University | 9260 (29.7) | 189 163 (16.5) | |
Graduate degree | 4604 (14.8) | 55 005 (4.8) | |
Unknown | 126 (0.4) | 7805 (0.7) | |
Working status | Employed | 21 727 (69.7) | – |
Retired | 6202 (19.9) | ||
Unable to work | 966 (3.1) | ||
Unemployed | 1874 (6.0) | ||
Unknown | 404 (1.3) | ||
Shift work | Regular, daytime schedule | 16 966 (79.1) | – |
Irregular schedule, or on call/other | 2642 (12.3) | ||
Evening shift/occasional night shift | 350 (1.6) | ||
Regular night shift/rotation | 1481 (6.9) | ||
Marital status | Married and/or living with a partner | 24 714 (79.3) | 864 105 (75.2) |
Single, never married | 2115 (6.8) | 117 989 (10.3) | |
Divorced/separated | 3277 (10.5) | 130 559 (11.4) | |
Widowed | 946 (3.0) | 35 884 (3.1) | |
Unknown | 121 (0.4) | – | |
Annual household income | < $25 000 | 1500 (4.8) | 163 990 (14.3) |
$25 000–$49 000 | 5171 (16.6) | 259 407 (22.6) | |
$50 000–$74 999 | 6275 (20.1) | 240 313 (20.9) | |
$75 000–$149 999 | 12 454 (40.0) | 380 218 (33.1) | |
> $150 000 | 3643 (11.7) | 102 693 (8.9) | |
Unknown | 2130 (6.8) | 1918 (0.2) | |
Ethnicity | Aboriginal | 902 (2.9) | 33 842 (3.0) |
Arab | 111 (0.4) | 1798 (0.2) | |
Black (African or Caribbean descent) | 158 (0.5) | 6856 (0.6) | |
East Asian/Filipino/South Asian/ Southeast Asian/West Asian | 120 (0.4) | 8683 (0.8) | |
Latin American/Hispanic | 53 (0.2) | 550 691 (0.1) | |
Other and/or multiple ethnicities | 692 (2.2) | 1878 (0.7) | |
White | 27 333 (87.7) | 1 087 990 (95.3) | |
Not reported | 1804 (5.8) | 6940 (0.6) |
Sociodemographic Characteristics . | . | Atlantic PATH Cohort (n = 31 173) n (%) . | Canadian Census data (n = 1 148 538) n (%) . |
---|---|---|---|
Sex | Male | 9438 (30.3) | 558 970 (48.7) |
Female | 21 735 (69.7) | 589 568 (51.3) | |
Age | 35–39 | 3095 (9.9) | 142 016 (12.4) |
40–44 | 3728 (12.0) | 159 278 (13.9) | |
45–49 | 4566 (14.7) | 191 889 (16.7) | |
50–54 | 5421 (17.4) | 186 898 (16.3) | |
55–59 | 5657 (18.2) | 183 696 (16.0) | |
60–64 | 5326 (17.1) | 165 920 (14.5) | |
65–69 | 3380 (10.8) | 118 841 (10.4) | |
Province | Nova Scotia | 16 577 (53.2) | 452 155 (39.4) |
New Brunswick | 8826 (28.3) | 368 319 (32.1) | |
Prince Edward Island | 1167 (3.7) | 66 214 (5.8) | |
Newfoundland and Labrador | 4513 (14.5) | 261 851 (22.8) | |
Not reported | 90 (0.3) | –a | |
Country of birth | Canada | 24 006 (77.0) | 1 091 037 (95.0) |
Other | 2864 (9.2) | 42 815 (3.7) | |
Unknown | 4303 (13.8) | 14 686 (1.3) | |
First language learned | English only | 26 726 (85.7) | 1 001 442 (87.2) |
French only | 1598 (5.1) | 144 916 (12.6) | |
Other | 271 (0.9) | 1228 (0.1) | |
Unknown | 2578 (8.3) | – | |
Education (completed) | < High school | 452 (1.5) | 226 966 (19.8) |
High school | 5461 (17.5) | 256 723 (22.4) | |
College | 11 270 (36.2) | 412 877 (36.0) | |
University | 9260 (29.7) | 189 163 (16.5) | |
Graduate degree | 4604 (14.8) | 55 005 (4.8) | |
Unknown | 126 (0.4) | 7805 (0.7) | |
Working status | Employed | 21 727 (69.7) | – |
Retired | 6202 (19.9) | ||
Unable to work | 966 (3.1) | ||
Unemployed | 1874 (6.0) | ||
Unknown | 404 (1.3) | ||
Shift work | Regular, daytime schedule | 16 966 (79.1) | – |
Irregular schedule, or on call/other | 2642 (12.3) | ||
Evening shift/occasional night shift | 350 (1.6) | ||
Regular night shift/rotation | 1481 (6.9) | ||
Marital status | Married and/or living with a partner | 24 714 (79.3) | 864 105 (75.2) |
Single, never married | 2115 (6.8) | 117 989 (10.3) | |
Divorced/separated | 3277 (10.5) | 130 559 (11.4) | |
Widowed | 946 (3.0) | 35 884 (3.1) | |
Unknown | 121 (0.4) | – | |
Annual household income | < $25 000 | 1500 (4.8) | 163 990 (14.3) |
$25 000–$49 000 | 5171 (16.6) | 259 407 (22.6) | |
$50 000–$74 999 | 6275 (20.1) | 240 313 (20.9) | |
$75 000–$149 999 | 12 454 (40.0) | 380 218 (33.1) | |
> $150 000 | 3643 (11.7) | 102 693 (8.9) | |
Unknown | 2130 (6.8) | 1918 (0.2) | |
Ethnicity | Aboriginal | 902 (2.9) | 33 842 (3.0) |
Arab | 111 (0.4) | 1798 (0.2) | |
Black (African or Caribbean descent) | 158 (0.5) | 6856 (0.6) | |
East Asian/Filipino/South Asian/ Southeast Asian/West Asian | 120 (0.4) | 8683 (0.8) | |
Latin American/Hispanic | 53 (0.2) | 550 691 (0.1) | |
Other and/or multiple ethnicities | 692 (2.2) | 1878 (0.7) | |
White | 27 333 (87.7) | 1 087 990 (95.3) | |
Not reported | 1804 (5.8) | 6940 (0.6) |
aData unavailable from Statistics Canada.
Sociodemographic Characteristics . | . | Atlantic PATH Cohort (n = 31 173) n (%) . | Canadian Census data (n = 1 148 538) n (%) . |
---|---|---|---|
Sex | Male | 9438 (30.3) | 558 970 (48.7) |
Female | 21 735 (69.7) | 589 568 (51.3) | |
Age | 35–39 | 3095 (9.9) | 142 016 (12.4) |
40–44 | 3728 (12.0) | 159 278 (13.9) | |
45–49 | 4566 (14.7) | 191 889 (16.7) | |
50–54 | 5421 (17.4) | 186 898 (16.3) | |
55–59 | 5657 (18.2) | 183 696 (16.0) | |
60–64 | 5326 (17.1) | 165 920 (14.5) | |
65–69 | 3380 (10.8) | 118 841 (10.4) | |
Province | Nova Scotia | 16 577 (53.2) | 452 155 (39.4) |
New Brunswick | 8826 (28.3) | 368 319 (32.1) | |
Prince Edward Island | 1167 (3.7) | 66 214 (5.8) | |
Newfoundland and Labrador | 4513 (14.5) | 261 851 (22.8) | |
Not reported | 90 (0.3) | –a | |
Country of birth | Canada | 24 006 (77.0) | 1 091 037 (95.0) |
Other | 2864 (9.2) | 42 815 (3.7) | |
Unknown | 4303 (13.8) | 14 686 (1.3) | |
First language learned | English only | 26 726 (85.7) | 1 001 442 (87.2) |
French only | 1598 (5.1) | 144 916 (12.6) | |
Other | 271 (0.9) | 1228 (0.1) | |
Unknown | 2578 (8.3) | – | |
Education (completed) | < High school | 452 (1.5) | 226 966 (19.8) |
High school | 5461 (17.5) | 256 723 (22.4) | |
College | 11 270 (36.2) | 412 877 (36.0) | |
University | 9260 (29.7) | 189 163 (16.5) | |
Graduate degree | 4604 (14.8) | 55 005 (4.8) | |
Unknown | 126 (0.4) | 7805 (0.7) | |
Working status | Employed | 21 727 (69.7) | – |
Retired | 6202 (19.9) | ||
Unable to work | 966 (3.1) | ||
Unemployed | 1874 (6.0) | ||
Unknown | 404 (1.3) | ||
Shift work | Regular, daytime schedule | 16 966 (79.1) | – |
Irregular schedule, or on call/other | 2642 (12.3) | ||
Evening shift/occasional night shift | 350 (1.6) | ||
Regular night shift/rotation | 1481 (6.9) | ||
Marital status | Married and/or living with a partner | 24 714 (79.3) | 864 105 (75.2) |
Single, never married | 2115 (6.8) | 117 989 (10.3) | |
Divorced/separated | 3277 (10.5) | 130 559 (11.4) | |
Widowed | 946 (3.0) | 35 884 (3.1) | |
Unknown | 121 (0.4) | – | |
Annual household income | < $25 000 | 1500 (4.8) | 163 990 (14.3) |
$25 000–$49 000 | 5171 (16.6) | 259 407 (22.6) | |
$50 000–$74 999 | 6275 (20.1) | 240 313 (20.9) | |
$75 000–$149 999 | 12 454 (40.0) | 380 218 (33.1) | |
> $150 000 | 3643 (11.7) | 102 693 (8.9) | |
Unknown | 2130 (6.8) | 1918 (0.2) | |
Ethnicity | Aboriginal | 902 (2.9) | 33 842 (3.0) |
Arab | 111 (0.4) | 1798 (0.2) | |
Black (African or Caribbean descent) | 158 (0.5) | 6856 (0.6) | |
East Asian/Filipino/South Asian/ Southeast Asian/West Asian | 120 (0.4) | 8683 (0.8) | |
Latin American/Hispanic | 53 (0.2) | 550 691 (0.1) | |
Other and/or multiple ethnicities | 692 (2.2) | 1878 (0.7) | |
White | 27 333 (87.7) | 1 087 990 (95.3) | |
Not reported | 1804 (5.8) | 6940 (0.6) |
Sociodemographic Characteristics . | . | Atlantic PATH Cohort (n = 31 173) n (%) . | Canadian Census data (n = 1 148 538) n (%) . |
---|---|---|---|
Sex | Male | 9438 (30.3) | 558 970 (48.7) |
Female | 21 735 (69.7) | 589 568 (51.3) | |
Age | 35–39 | 3095 (9.9) | 142 016 (12.4) |
40–44 | 3728 (12.0) | 159 278 (13.9) | |
45–49 | 4566 (14.7) | 191 889 (16.7) | |
50–54 | 5421 (17.4) | 186 898 (16.3) | |
55–59 | 5657 (18.2) | 183 696 (16.0) | |
60–64 | 5326 (17.1) | 165 920 (14.5) | |
65–69 | 3380 (10.8) | 118 841 (10.4) | |
Province | Nova Scotia | 16 577 (53.2) | 452 155 (39.4) |
New Brunswick | 8826 (28.3) | 368 319 (32.1) | |
Prince Edward Island | 1167 (3.7) | 66 214 (5.8) | |
Newfoundland and Labrador | 4513 (14.5) | 261 851 (22.8) | |
Not reported | 90 (0.3) | –a | |
Country of birth | Canada | 24 006 (77.0) | 1 091 037 (95.0) |
Other | 2864 (9.2) | 42 815 (3.7) | |
Unknown | 4303 (13.8) | 14 686 (1.3) | |
First language learned | English only | 26 726 (85.7) | 1 001 442 (87.2) |
French only | 1598 (5.1) | 144 916 (12.6) | |
Other | 271 (0.9) | 1228 (0.1) | |
Unknown | 2578 (8.3) | – | |
Education (completed) | < High school | 452 (1.5) | 226 966 (19.8) |
High school | 5461 (17.5) | 256 723 (22.4) | |
College | 11 270 (36.2) | 412 877 (36.0) | |
University | 9260 (29.7) | 189 163 (16.5) | |
Graduate degree | 4604 (14.8) | 55 005 (4.8) | |
Unknown | 126 (0.4) | 7805 (0.7) | |
Working status | Employed | 21 727 (69.7) | – |
Retired | 6202 (19.9) | ||
Unable to work | 966 (3.1) | ||
Unemployed | 1874 (6.0) | ||
Unknown | 404 (1.3) | ||
Shift work | Regular, daytime schedule | 16 966 (79.1) | – |
Irregular schedule, or on call/other | 2642 (12.3) | ||
Evening shift/occasional night shift | 350 (1.6) | ||
Regular night shift/rotation | 1481 (6.9) | ||
Marital status | Married and/or living with a partner | 24 714 (79.3) | 864 105 (75.2) |
Single, never married | 2115 (6.8) | 117 989 (10.3) | |
Divorced/separated | 3277 (10.5) | 130 559 (11.4) | |
Widowed | 946 (3.0) | 35 884 (3.1) | |
Unknown | 121 (0.4) | – | |
Annual household income | < $25 000 | 1500 (4.8) | 163 990 (14.3) |
$25 000–$49 000 | 5171 (16.6) | 259 407 (22.6) | |
$50 000–$74 999 | 6275 (20.1) | 240 313 (20.9) | |
$75 000–$149 999 | 12 454 (40.0) | 380 218 (33.1) | |
> $150 000 | 3643 (11.7) | 102 693 (8.9) | |
Unknown | 2130 (6.8) | 1918 (0.2) | |
Ethnicity | Aboriginal | 902 (2.9) | 33 842 (3.0) |
Arab | 111 (0.4) | 1798 (0.2) | |
Black (African or Caribbean descent) | 158 (0.5) | 6856 (0.6) | |
East Asian/Filipino/South Asian/ Southeast Asian/West Asian | 120 (0.4) | 8683 (0.8) | |
Latin American/Hispanic | 53 (0.2) | 550 691 (0.1) | |
Other and/or multiple ethnicities | 692 (2.2) | 1878 (0.7) | |
White | 27 333 (87.7) | 1 087 990 (95.3) | |
Not reported | 1804 (5.8) | 6940 (0.6) |
aData unavailable from Statistics Canada.
Body composition
Based on BMI, 71% of participants were overweight or obese, and the majority of participants had an increased accumulation of abdominal fat as indicated by a waist circumference (abdominal obesity) or waist-to-hip ratio above recommended guidelines (Table 3). These individuals are at an increased risk of developing chronic disease (Table 3).6–9 The mean waist measurement for participants was 94 cm with a mean hip measurement of 105 cm. The mean weight of participants was 79 kg with a mean fat mass of 34%.
Body composition . | Total n (%) . |
---|---|
Measured BMI (kg/m2) | |
Underweight | 206 (0.8) |
Normal weight | 6973 (27.7) |
Overweight | 9318 (37.2) |
Obese | 8533 (34.1) |
Waist-to-hip ratio | 16 591 (62.2) |
Abdominal obesity | 13 830 (51.8) |
Mean (SD) | |
Height (cm) | 162.2 (20.5) |
Weight (kg) | 78.9 (18.2) |
Waist (cm) | 93.5 (16.0) |
Hips (cm) | 105.3 (13.3) |
BMI (kg/m2) | 28.3 (6.0) |
Waist-to-hip ratio | 0.89 (0.1) |
Fat mass (%) | 33.5 (9.13) |
Body composition . | Total n (%) . |
---|---|
Measured BMI (kg/m2) | |
Underweight | 206 (0.8) |
Normal weight | 6973 (27.7) |
Overweight | 9318 (37.2) |
Obese | 8533 (34.1) |
Waist-to-hip ratio | 16 591 (62.2) |
Abdominal obesity | 13 830 (51.8) |
Mean (SD) | |
Height (cm) | 162.2 (20.5) |
Weight (kg) | 78.9 (18.2) |
Waist (cm) | 93.5 (16.0) |
Hips (cm) | 105.3 (13.3) |
BMI (kg/m2) | 28.3 (6.0) |
Waist-to-hip ratio | 0.89 (0.1) |
Fat mass (%) | 33.5 (9.13) |
Underweight, <18.5; normal weight, 18.5–24.9; overweight, 25.0–29.9; obese (≥30.0). Waist-to-hip ratio > 0.90 for men and >0.85 for women. Waist circumference ≥ 102 cm for men and ≥88 cm for women.
Body composition . | Total n (%) . |
---|---|
Measured BMI (kg/m2) | |
Underweight | 206 (0.8) |
Normal weight | 6973 (27.7) |
Overweight | 9318 (37.2) |
Obese | 8533 (34.1) |
Waist-to-hip ratio | 16 591 (62.2) |
Abdominal obesity | 13 830 (51.8) |
Mean (SD) | |
Height (cm) | 162.2 (20.5) |
Weight (kg) | 78.9 (18.2) |
Waist (cm) | 93.5 (16.0) |
Hips (cm) | 105.3 (13.3) |
BMI (kg/m2) | 28.3 (6.0) |
Waist-to-hip ratio | 0.89 (0.1) |
Fat mass (%) | 33.5 (9.13) |
Body composition . | Total n (%) . |
---|---|
Measured BMI (kg/m2) | |
Underweight | 206 (0.8) |
Normal weight | 6973 (27.7) |
Overweight | 9318 (37.2) |
Obese | 8533 (34.1) |
Waist-to-hip ratio | 16 591 (62.2) |
Abdominal obesity | 13 830 (51.8) |
Mean (SD) | |
Height (cm) | 162.2 (20.5) |
Weight (kg) | 78.9 (18.2) |
Waist (cm) | 93.5 (16.0) |
Hips (cm) | 105.3 (13.3) |
BMI (kg/m2) | 28.3 (6.0) |
Waist-to-hip ratio | 0.89 (0.1) |
Fat mass (%) | 33.5 (9.13) |
Underweight, <18.5; normal weight, 18.5–24.9; overweight, 25.0–29.9; obese (≥30.0). Waist-to-hip ratio > 0.90 for men and >0.85 for women. Waist circumference ≥ 102 cm for men and ≥88 cm for women.
Behaviours and chronic conditions
The health and lifestyle behaviours and self-reported chronic health conditions of participants are detailed in Table 4. Only 28% of participants reported meeting the 7–10 daily-recommended servings of fruit and vegetables.10 Overall, participants scored a 38 on a Healthy Eating Index which measures food quality intake and the potential to prevent chronic disease (minimum 0, maximum 60).11 There was fairly even distribution between low (31%), moderate (36%) and high (33%) levels of physical activity among participants. The majority of physical activity takes place at the household level (42%), 26% occurs in the workplace, 22% in leisure time, and 11% as part of active transportation. Approximately 71% of participants engage in one unhealthy habit, including smoking, alcohol drinking, low levels of physical activity or low fruit and vegetable consumption. There were 23% of participants with two unhealthy habits, 3.5% of participants with three unhealthy habits and less than 1% have four or more (Table 5).
Behaviours and chronic conditionsa . | . | Nova Scotia n (%) . | New Brunswick n (%) . | Prince Edward Island n (%) . | Newfoundland and Labrador n (%) . | Atlantic PATH cohort n (%) . |
---|---|---|---|---|---|---|
Smoking status | Never smoked | 8227 (50) | 4547 (52.1) | 545 (47.1) | 2072 (46.3) | 15 439 (50.0) |
Past smoker | 6599 (40.1) | 3299 (37.8) | 503 (43.5) | 1827 (40.9) | 12 260 (39.7) | |
Occasional smoker | 412 (2.5) | 197 (2.3) | 32 (2.8) | 135 (3.0) | 778 (2.5) | |
Daily smoker | 1216 (7.4) | 693 (7.9) | 77 (6.7) | 437 (9.8) | 2430 (7.9) | |
Passive exposure to smoke at home | Never | 11 904 (88.6) | 7889 (89.2) | 1060 (90.7) | 3988 (91.0) | 24 919 (89.2) |
Once a month | 344 (2.6) | 291 (3.3) | 31 (2.7) | 160 (3.6) | 829 (3.0) | |
Once a week | 250 (1.9) | 99 (1.1) | 7 (0.6) | 52 (1.2) | 408 (1.5) | |
Almost daily | 247 (1.8) | 134 (1.5) | 20 (1.7) | 77 (1.7) | 479 (1.7) | |
Daily | 688 (5.1) | 370 (4.2) | 47 (4.0) | 193 (4.3) | 1302 (4.0) | |
Alcohol intake (past 12 months) | Never | 1599 (9.9) | 988 (11.3) | 128 (11.1) | 629 (14.2) | 3355 (11.0) |
< once a month | 4670 (29.0) | 2595 (29.8) | 339 (29.4) | 1239 (27.9) | 8869 (29.1) | |
2–3 times a month | 2183 (13.6) | 1155 (13.3) | 148 (12.9) | 572 (12.9) | 4068 (13.3) | |
Once a week | 1822 (11.3) | 1103 (12.7) | 140 (12.2) | 549 (12.4) | 3636 (11.9) | |
2–3 times a week | 2989 (18.6) | 1598 (18.3) | 197 (17.1) | 866 (19.5) | 5662 (18.6) | |
Almost every day | 2829 (17.6) | 1281 (14.7) | 200 (17.4) | 589 (13.3) | 4918 (16.1) | |
Sleep (per night) | <4 h | 203 (1.2) | 59 (0.7) | 7 (0.6) | 40 (0.9) | 311 (1.0) |
4–<7 h | 4175 (25.6) | 2221 (25.6) | 324 (28.4) | 1307 (29.8) | 8054 (26.3) | |
7–<9 h | 10756 (66.1) | 5763 (66.5) | 722 (63.2) | 2725 (62.1) | 20 016 (65.5) | |
9–<11 h | 1069 (6.6) | 588 (6.8) | 79 (6.9) | 293 (6.7) | 2037 (6.7) | |
≥11 h | 78 (0.5) | 39 (0.4) | 10 (0.9) | 26 (0.6) | 155 (0.5) | |
Weekday exposure to UV radiation in summer months | <30 min | 3500 (33.0) | —b | — | — | 3500 (33.0) |
30–59 min | 2328 (22.0) | — | — | — | 2328 (22.0) | |
1–<2 h | 2056 (19.4) | — | — | — | 2056 (19.4) | |
2–<3 h | 1500 (14.1) | — | — | — | 1500 (14.1) | |
3–<4 h | 653 (6.2) | — | — | — | 653 (6.2) | |
≥4 h | 564 (5.3) | — | — | — | 564 (5.3) | |
Weekend exposure to UV radiation in summer months | <30 min | 1186 (11.2) | — | — | — | 1186 (11.2) |
30–59 min | 1596 (15.0) | — | — | — | 1596 (15.0) | |
1–<2 h | 2263 (21.3) | — | — | — | 2263 (21.3) | |
2–<3 h | 2634 (24.8) | — | — | — | 2634 (24.8) | |
3–<4 h | 1560 (14.7) | — | — | — | 1560 (14.7) | |
≥4 h | 1368 (12.9) | — | — | — | 1368 (12.9) | |
Physical activity (IPAQ Short) | Low | 1860 (29.2) | 2689 (30.6) | 359 (30.9) | 1496 (33.4) | 6428 (30.8) |
Moderate | 2296 (36.1) | 3256 (37.1) | 436 (31.5) | 1471 (32.8) | 7485 (35.9) | |
High | 2205 (34.7) | 2837 (32.3) | 366 (31.5) | 1513 (33.8) | 6948 (33.3) | |
Types of daily physical activity | Occupational | 83 | 121 | 108 | 132 | 99 min (26)c |
Active transport | 42 | 38 | 36 | 39 | 41 min (11) | |
Household | 166 | 145 | 126 | 158 | 159 min (42) | |
Leisure time | 86 | 78 | 72 | 75 | 83 min (22) | |
Sedentary time | <3 h | 2152 (14.2) | 796 (10.4) | 129 (13.2) | 460 (12.2) | 3550 (12.8) |
3–<6 h | 6679 (44.1) | 3148 (41.0) | 405 (41.4) | 1620 (42.9) | 1182 (43.0) | |
6–<9 h | 4321 (28.5) | 2575 (33.6) | 284 (29.0) | 1158 (30.7) | 8364 (30.2) | |
9–<11 h | 1184 (7.8) | 726 (9.5) | 101 (10.3) | 334 (8.9) | 2349 (8.5) | |
≥11 h | 822 (5.4) | 429 (5.6) | 60 (7.6) | 200 (5.3) | 1517 (5.5) | |
Daily fruit, vegetable and juice consumption | None | 389 (2.4) | 116 (1.3) | 16 (1.4) | 76 (1.7) | 598 (2.0) |
1 | 663 (4.1) | 265 (3.0) | 35 (3) | 194 (4.4) | 1158 (3.8) | |
2–3 | 3261 (20.1) | 1777 (20.3) | 211 (18.1) | 1135 (25.5) | 6411 (20.9) | |
4–6 | 7517 (46.3) | 3928 (44.9) | 523 (45) | 1965 (44.1) | 13 964 (45.5) | |
7–10 | 3819 (23.5) | 2344 (26.8) | 337 (29) | 965 (21.7) | 7489 (24.4) | |
>11 | 582 (3.6) | 329 (3.8) | 41 (3.5) | 120 (2.7) | 1077 (3.5) | |
Healthy Eating Indexd | Mean (SD) | 38.1 (9.8) | 39.7 (8.0) | 39.2 (7.8) | 37.7 (9.1) | 38.4 (9.3) |
Range | 1.0–60.0 | 3.7–59.0 | 9.1–54.1 | 2.0–57.0 | 1–60 | |
Depression score | None/minimal | 10 301 (76.4) | 3646 (76.7) | 318 (79.9) | 1968 (74.7) | 16 275 (76.3) |
Mild | 2280 (16.9) | 804 (16.9) | 60 (15.1) | 482 (18.3) | 3637 (17.1) | |
Moderate | 588 (4.4) | 216 (4.5) | 13 (3.3) | 115 (4.4) | 932 (4.4) | |
Moderately severe | 218 (1.6) | 69 (1.5) | 4 (1.0) | 41 (1.6) | 336 (1.6) | |
Severe | 96 (0.7) | 20 (0.4) | 3 (0.8) | 27 (1.0) | 146 (0.7) | |
Anxiety score | None/minimal | 11 076 (82.5) | 3908 (82.6) | 328 (82.8) | 2144 (82.0) | 17 503 (82.5) |
Mild | 1719 (12.8) | 606 (12.8) | 50 (12.6) | 332 (12.7) | 2714 (12.8) | |
Moderate | 421 (3.1) | 152 (3.2) | 10 (2.5) | 91 (3.5) | 675 (3.2) | |
Severe | 203 (1.5) | 68 (1.4) | 8 (2.0) | 47 (1.8) | 327 (1.5) | |
Endocrine/metabolic diseases | Diabetes | 1179 (7.1) | 619 (7.0) | 83 (7.1) | 341 (7.6) | 2222 (7.2) |
Type I diabetes | 95 (0.6) | 68 (0.8) | 5 (0.4) | 28 (0.6) | 196 (0.6) | |
Type II diabetes | 847 (5.1) | 453 (5.1) | 69 (5.9) | 261 (5.8) | 1630 (5.2) | |
Gestational | 237 (1.4) | 98 (1.1) | 9 (0.8) | 52 (1.2) | 396 (1.3) | |
Circulatory system disease | Hypertension | 4026 (24.3) | 2279 (25.8) | 297 (25.5) | 1236 (27.4) | 7857 (25.2) |
Stroke | 170 (1.0) | 97 (1.1) | 16 (1.4) | 29 (0.6) | 315 (1.01) | |
Myocardial infarction | 286 (1.7) | 142 (1.6) | 21 (1.8) | 88 (2) | 540 (1.73) | |
Angina | 203 (1.9) | 4 (0.6) | 0 (0) | 1 (2.8) | 209 (1.8) | |
Respiratory system disease | COPD | 241 (1.5) | 113 (1.3) | 21 (1.4) | 61 (1.9) | 438 (1.4) |
Asthma | 1864 (11.3) | 1044 (12.1) | 139 (12.2) | 434 (9.9) | 3490 (11.2) | |
Chronic bronchitis | 372 (3.7) | 1 (7.7) | 0 (0) | 0 (0) | 373 (1.2) | |
Emphysema | 46 (0.5) | 0 (0) | 0 (0) | 0 (0) | 46 (0.2) | |
Musculoskeletal system and connective tissue disease | Arthritis | 4456 (27.2) | 2025 (23.7) | 291 (25.8) | 1303 (29.7) | 8097 (26.5) |
Rheumatoid arthritis | 571 | 241 | 40 | 163 | 1019 | |
Osteoarthritis | 2418 | 1034 | 154 | 626 | 4242 | |
Other arthritis | 444 | 209 | 18 | 114 | 785 | |
Osteoporosis | 914 (5.6) | 387 (4.5) | 52 (4.6) | 268 (6.1) | 1628 (5.3) | |
Eye disease | Glaucoma | 202 (1.9) | 8 (1.1) | 1 (10.0) | 1 (6.3) | 213 (1.8) |
Cataracts | 632 (5.9) | 21 (2.9) | 0 (0) | 1 (2.8) | 657 (5.7) | |
Macular degeneration | 127 (1.2) | 4 (0.6) | 0 (0) | 0 (0) | 131 (1.1) | |
Liver disorders | Cirrhosis | 37 (0.2) | 17 (0.2) | 2 (0.2) | 15 (0.3) | 71 (0.23) |
Chronic hepatitis | 73 (0.4) | 23 (0.3) | 3 (0.3) | 18 (0.4) | 118 (0.38) | |
Digestive system disease | Irritable bowel syndrome | 1411 (8.6) | 817 (9.5) | 109 (9.6) | 482 (10.9) | 2823 (9.2) |
Inflammatory bowel disease | 326 (2.0) | 160 (1.8) | 31 (2.7) | 95 (2.1) | 614 (1.97) | |
Crohn’s disease | 189 (1.1) | 78 (0.9) | 10 (0.9) | 38 (0.9) | 316 (1.0) | |
Ulcerative colitis | 181 (1.1) | 91 (1.0) | 21 (1.8) | 59 (1.3) | 353 (1.1) | |
Gastro-oesophageal reflux disease | 1506 (14.0) | 66 (9.2) | 0 (0) | 3 (8.3) | 1577 (13.7) | |
Gallbladder disease | 1245 (11.6) | 78 (10.9) | 0 (0) | 4 (11.1) | 13 127 (11.5) | |
Skin disease | Eczema | 1650 (10.0) | 1065 (12.3) | 144 (12.6) | 541 (12.2) | 3408 (11.1) |
Psoriasis | 725 (4.4) | 447 (5.2) | 59 (5.2) | 276 (6.2) | 1512 (4.9) | |
Allergies and food intolerances | Allergies | 1851 (45.1) | 2799 (49.1) | 195 (45.2) | 1268 (38.8) | 6113 (45.3) |
Animals | 664 (35.8) | 988 (35.3) | 64 (32.5) | 449 (35.4) | 2165 (35.4) | |
Foods | 386 (20.9) | 688 (24.6) | 41 (21.0) | 238 (18.8) | 1353 (22.1) | |
Insect bites | 241 (13.0) | 305 (10.9) | 20 (10.3) | 103 (8.1) | 669 (10.9) | |
Latex | 106 (5.7) | 185 (6.6) | 10 (5.1) | 59 (4.7) | 360 (5.9) | |
Medications | 629 (34.0) | 1091 (39.0) | 68 (34.9) | 470 (37.0) | 2258 (36.9) | |
Metal | 180 (9.7) | 249 (8.9) | 19 (9.7) | 140 (11.0) | 588 (9.6) | |
Mould or dust | 722 (39.0) | 1159 (41.4) | 75 (38.1) | 482 (38.0) | 2438 (39.8) | |
Pollen | 926 (50.0) | 1412 (50.4) | 95 (48.5) | 534 (42.1) | 2967 (48.5) | |
Autoimmune diseases | Systemic lupus erythematosus | 55 (0.3) | 27 (0.3) | 3 (0.3) | 15 (0.3) | 100 (0.3) |
Diseases of the nervous system | Multiple sclerosis | 106 (0.6) | 45 (0.5) | 13 (1.1) | 21 (0.5) | 185 (0.6) |
Migraines | 1727 (16.1) | 101 (14.1) | 1 (10.0) | 6 (16.7) | 1835 (15.9) | |
Parkinson’s disease | 15 (0.1) | 1 (0.1) | 0 (0) | 0 (0) | 16 (0.1) |
Behaviours and chronic conditionsa . | . | Nova Scotia n (%) . | New Brunswick n (%) . | Prince Edward Island n (%) . | Newfoundland and Labrador n (%) . | Atlantic PATH cohort n (%) . |
---|---|---|---|---|---|---|
Smoking status | Never smoked | 8227 (50) | 4547 (52.1) | 545 (47.1) | 2072 (46.3) | 15 439 (50.0) |
Past smoker | 6599 (40.1) | 3299 (37.8) | 503 (43.5) | 1827 (40.9) | 12 260 (39.7) | |
Occasional smoker | 412 (2.5) | 197 (2.3) | 32 (2.8) | 135 (3.0) | 778 (2.5) | |
Daily smoker | 1216 (7.4) | 693 (7.9) | 77 (6.7) | 437 (9.8) | 2430 (7.9) | |
Passive exposure to smoke at home | Never | 11 904 (88.6) | 7889 (89.2) | 1060 (90.7) | 3988 (91.0) | 24 919 (89.2) |
Once a month | 344 (2.6) | 291 (3.3) | 31 (2.7) | 160 (3.6) | 829 (3.0) | |
Once a week | 250 (1.9) | 99 (1.1) | 7 (0.6) | 52 (1.2) | 408 (1.5) | |
Almost daily | 247 (1.8) | 134 (1.5) | 20 (1.7) | 77 (1.7) | 479 (1.7) | |
Daily | 688 (5.1) | 370 (4.2) | 47 (4.0) | 193 (4.3) | 1302 (4.0) | |
Alcohol intake (past 12 months) | Never | 1599 (9.9) | 988 (11.3) | 128 (11.1) | 629 (14.2) | 3355 (11.0) |
< once a month | 4670 (29.0) | 2595 (29.8) | 339 (29.4) | 1239 (27.9) | 8869 (29.1) | |
2–3 times a month | 2183 (13.6) | 1155 (13.3) | 148 (12.9) | 572 (12.9) | 4068 (13.3) | |
Once a week | 1822 (11.3) | 1103 (12.7) | 140 (12.2) | 549 (12.4) | 3636 (11.9) | |
2–3 times a week | 2989 (18.6) | 1598 (18.3) | 197 (17.1) | 866 (19.5) | 5662 (18.6) | |
Almost every day | 2829 (17.6) | 1281 (14.7) | 200 (17.4) | 589 (13.3) | 4918 (16.1) | |
Sleep (per night) | <4 h | 203 (1.2) | 59 (0.7) | 7 (0.6) | 40 (0.9) | 311 (1.0) |
4–<7 h | 4175 (25.6) | 2221 (25.6) | 324 (28.4) | 1307 (29.8) | 8054 (26.3) | |
7–<9 h | 10756 (66.1) | 5763 (66.5) | 722 (63.2) | 2725 (62.1) | 20 016 (65.5) | |
9–<11 h | 1069 (6.6) | 588 (6.8) | 79 (6.9) | 293 (6.7) | 2037 (6.7) | |
≥11 h | 78 (0.5) | 39 (0.4) | 10 (0.9) | 26 (0.6) | 155 (0.5) | |
Weekday exposure to UV radiation in summer months | <30 min | 3500 (33.0) | —b | — | — | 3500 (33.0) |
30–59 min | 2328 (22.0) | — | — | — | 2328 (22.0) | |
1–<2 h | 2056 (19.4) | — | — | — | 2056 (19.4) | |
2–<3 h | 1500 (14.1) | — | — | — | 1500 (14.1) | |
3–<4 h | 653 (6.2) | — | — | — | 653 (6.2) | |
≥4 h | 564 (5.3) | — | — | — | 564 (5.3) | |
Weekend exposure to UV radiation in summer months | <30 min | 1186 (11.2) | — | — | — | 1186 (11.2) |
30–59 min | 1596 (15.0) | — | — | — | 1596 (15.0) | |
1–<2 h | 2263 (21.3) | — | — | — | 2263 (21.3) | |
2–<3 h | 2634 (24.8) | — | — | — | 2634 (24.8) | |
3–<4 h | 1560 (14.7) | — | — | — | 1560 (14.7) | |
≥4 h | 1368 (12.9) | — | — | — | 1368 (12.9) | |
Physical activity (IPAQ Short) | Low | 1860 (29.2) | 2689 (30.6) | 359 (30.9) | 1496 (33.4) | 6428 (30.8) |
Moderate | 2296 (36.1) | 3256 (37.1) | 436 (31.5) | 1471 (32.8) | 7485 (35.9) | |
High | 2205 (34.7) | 2837 (32.3) | 366 (31.5) | 1513 (33.8) | 6948 (33.3) | |
Types of daily physical activity | Occupational | 83 | 121 | 108 | 132 | 99 min (26)c |
Active transport | 42 | 38 | 36 | 39 | 41 min (11) | |
Household | 166 | 145 | 126 | 158 | 159 min (42) | |
Leisure time | 86 | 78 | 72 | 75 | 83 min (22) | |
Sedentary time | <3 h | 2152 (14.2) | 796 (10.4) | 129 (13.2) | 460 (12.2) | 3550 (12.8) |
3–<6 h | 6679 (44.1) | 3148 (41.0) | 405 (41.4) | 1620 (42.9) | 1182 (43.0) | |
6–<9 h | 4321 (28.5) | 2575 (33.6) | 284 (29.0) | 1158 (30.7) | 8364 (30.2) | |
9–<11 h | 1184 (7.8) | 726 (9.5) | 101 (10.3) | 334 (8.9) | 2349 (8.5) | |
≥11 h | 822 (5.4) | 429 (5.6) | 60 (7.6) | 200 (5.3) | 1517 (5.5) | |
Daily fruit, vegetable and juice consumption | None | 389 (2.4) | 116 (1.3) | 16 (1.4) | 76 (1.7) | 598 (2.0) |
1 | 663 (4.1) | 265 (3.0) | 35 (3) | 194 (4.4) | 1158 (3.8) | |
2–3 | 3261 (20.1) | 1777 (20.3) | 211 (18.1) | 1135 (25.5) | 6411 (20.9) | |
4–6 | 7517 (46.3) | 3928 (44.9) | 523 (45) | 1965 (44.1) | 13 964 (45.5) | |
7–10 | 3819 (23.5) | 2344 (26.8) | 337 (29) | 965 (21.7) | 7489 (24.4) | |
>11 | 582 (3.6) | 329 (3.8) | 41 (3.5) | 120 (2.7) | 1077 (3.5) | |
Healthy Eating Indexd | Mean (SD) | 38.1 (9.8) | 39.7 (8.0) | 39.2 (7.8) | 37.7 (9.1) | 38.4 (9.3) |
Range | 1.0–60.0 | 3.7–59.0 | 9.1–54.1 | 2.0–57.0 | 1–60 | |
Depression score | None/minimal | 10 301 (76.4) | 3646 (76.7) | 318 (79.9) | 1968 (74.7) | 16 275 (76.3) |
Mild | 2280 (16.9) | 804 (16.9) | 60 (15.1) | 482 (18.3) | 3637 (17.1) | |
Moderate | 588 (4.4) | 216 (4.5) | 13 (3.3) | 115 (4.4) | 932 (4.4) | |
Moderately severe | 218 (1.6) | 69 (1.5) | 4 (1.0) | 41 (1.6) | 336 (1.6) | |
Severe | 96 (0.7) | 20 (0.4) | 3 (0.8) | 27 (1.0) | 146 (0.7) | |
Anxiety score | None/minimal | 11 076 (82.5) | 3908 (82.6) | 328 (82.8) | 2144 (82.0) | 17 503 (82.5) |
Mild | 1719 (12.8) | 606 (12.8) | 50 (12.6) | 332 (12.7) | 2714 (12.8) | |
Moderate | 421 (3.1) | 152 (3.2) | 10 (2.5) | 91 (3.5) | 675 (3.2) | |
Severe | 203 (1.5) | 68 (1.4) | 8 (2.0) | 47 (1.8) | 327 (1.5) | |
Endocrine/metabolic diseases | Diabetes | 1179 (7.1) | 619 (7.0) | 83 (7.1) | 341 (7.6) | 2222 (7.2) |
Type I diabetes | 95 (0.6) | 68 (0.8) | 5 (0.4) | 28 (0.6) | 196 (0.6) | |
Type II diabetes | 847 (5.1) | 453 (5.1) | 69 (5.9) | 261 (5.8) | 1630 (5.2) | |
Gestational | 237 (1.4) | 98 (1.1) | 9 (0.8) | 52 (1.2) | 396 (1.3) | |
Circulatory system disease | Hypertension | 4026 (24.3) | 2279 (25.8) | 297 (25.5) | 1236 (27.4) | 7857 (25.2) |
Stroke | 170 (1.0) | 97 (1.1) | 16 (1.4) | 29 (0.6) | 315 (1.01) | |
Myocardial infarction | 286 (1.7) | 142 (1.6) | 21 (1.8) | 88 (2) | 540 (1.73) | |
Angina | 203 (1.9) | 4 (0.6) | 0 (0) | 1 (2.8) | 209 (1.8) | |
Respiratory system disease | COPD | 241 (1.5) | 113 (1.3) | 21 (1.4) | 61 (1.9) | 438 (1.4) |
Asthma | 1864 (11.3) | 1044 (12.1) | 139 (12.2) | 434 (9.9) | 3490 (11.2) | |
Chronic bronchitis | 372 (3.7) | 1 (7.7) | 0 (0) | 0 (0) | 373 (1.2) | |
Emphysema | 46 (0.5) | 0 (0) | 0 (0) | 0 (0) | 46 (0.2) | |
Musculoskeletal system and connective tissue disease | Arthritis | 4456 (27.2) | 2025 (23.7) | 291 (25.8) | 1303 (29.7) | 8097 (26.5) |
Rheumatoid arthritis | 571 | 241 | 40 | 163 | 1019 | |
Osteoarthritis | 2418 | 1034 | 154 | 626 | 4242 | |
Other arthritis | 444 | 209 | 18 | 114 | 785 | |
Osteoporosis | 914 (5.6) | 387 (4.5) | 52 (4.6) | 268 (6.1) | 1628 (5.3) | |
Eye disease | Glaucoma | 202 (1.9) | 8 (1.1) | 1 (10.0) | 1 (6.3) | 213 (1.8) |
Cataracts | 632 (5.9) | 21 (2.9) | 0 (0) | 1 (2.8) | 657 (5.7) | |
Macular degeneration | 127 (1.2) | 4 (0.6) | 0 (0) | 0 (0) | 131 (1.1) | |
Liver disorders | Cirrhosis | 37 (0.2) | 17 (0.2) | 2 (0.2) | 15 (0.3) | 71 (0.23) |
Chronic hepatitis | 73 (0.4) | 23 (0.3) | 3 (0.3) | 18 (0.4) | 118 (0.38) | |
Digestive system disease | Irritable bowel syndrome | 1411 (8.6) | 817 (9.5) | 109 (9.6) | 482 (10.9) | 2823 (9.2) |
Inflammatory bowel disease | 326 (2.0) | 160 (1.8) | 31 (2.7) | 95 (2.1) | 614 (1.97) | |
Crohn’s disease | 189 (1.1) | 78 (0.9) | 10 (0.9) | 38 (0.9) | 316 (1.0) | |
Ulcerative colitis | 181 (1.1) | 91 (1.0) | 21 (1.8) | 59 (1.3) | 353 (1.1) | |
Gastro-oesophageal reflux disease | 1506 (14.0) | 66 (9.2) | 0 (0) | 3 (8.3) | 1577 (13.7) | |
Gallbladder disease | 1245 (11.6) | 78 (10.9) | 0 (0) | 4 (11.1) | 13 127 (11.5) | |
Skin disease | Eczema | 1650 (10.0) | 1065 (12.3) | 144 (12.6) | 541 (12.2) | 3408 (11.1) |
Psoriasis | 725 (4.4) | 447 (5.2) | 59 (5.2) | 276 (6.2) | 1512 (4.9) | |
Allergies and food intolerances | Allergies | 1851 (45.1) | 2799 (49.1) | 195 (45.2) | 1268 (38.8) | 6113 (45.3) |
Animals | 664 (35.8) | 988 (35.3) | 64 (32.5) | 449 (35.4) | 2165 (35.4) | |
Foods | 386 (20.9) | 688 (24.6) | 41 (21.0) | 238 (18.8) | 1353 (22.1) | |
Insect bites | 241 (13.0) | 305 (10.9) | 20 (10.3) | 103 (8.1) | 669 (10.9) | |
Latex | 106 (5.7) | 185 (6.6) | 10 (5.1) | 59 (4.7) | 360 (5.9) | |
Medications | 629 (34.0) | 1091 (39.0) | 68 (34.9) | 470 (37.0) | 2258 (36.9) | |
Metal | 180 (9.7) | 249 (8.9) | 19 (9.7) | 140 (11.0) | 588 (9.6) | |
Mould or dust | 722 (39.0) | 1159 (41.4) | 75 (38.1) | 482 (38.0) | 2438 (39.8) | |
Pollen | 926 (50.0) | 1412 (50.4) | 95 (48.5) | 534 (42.1) | 2967 (48.5) | |
Autoimmune diseases | Systemic lupus erythematosus | 55 (0.3) | 27 (0.3) | 3 (0.3) | 15 (0.3) | 100 (0.3) |
Diseases of the nervous system | Multiple sclerosis | 106 (0.6) | 45 (0.5) | 13 (1.1) | 21 (0.5) | 185 (0.6) |
Migraines | 1727 (16.1) | 101 (14.1) | 1 (10.0) | 6 (16.7) | 1835 (15.9) | |
Parkinson’s disease | 15 (0.1) | 1 (0.1) | 0 (0) | 0 (0) | 16 (0.1) |
aAll behaviours and chronic conditions are based on the harmonized data set or supplementary Atlantic Canada questionnaire with the following exceptions which are based on earlier datasets with smaller populations: angina, eye disease, skin disease, migraines, UV exposure, Parkinson’s disease, gastro-oesophageal reflux disease, and gallbladder disease. bSome data unavailable for New Brunswick, Prince Edward Island and Newfoundland and Labrador. cThe types of physical activity were calculated using the domains from the long-form IPAQ. The data presented include the total daily minutes of physical activity and the percentage of daily activity for occupational physical activity, active transport physical activity, household physical activity and leisure time physical activity. dA Healthy Eating Index (HEI) was developed for 21 504 participants who responded to comprehensive questions on food intake. The HEI was derived according to the methods recommended for Americans and Canadians in terms of food quality and prevention of chronic disease. The HEI is a continuous variable with a perfect score of 60 and a minimum score of 0.11 See Supplementary Material Table 3 (available as Supplementary data at IJE online).
Behaviours and chronic conditionsa . | . | Nova Scotia n (%) . | New Brunswick n (%) . | Prince Edward Island n (%) . | Newfoundland and Labrador n (%) . | Atlantic PATH cohort n (%) . |
---|---|---|---|---|---|---|
Smoking status | Never smoked | 8227 (50) | 4547 (52.1) | 545 (47.1) | 2072 (46.3) | 15 439 (50.0) |
Past smoker | 6599 (40.1) | 3299 (37.8) | 503 (43.5) | 1827 (40.9) | 12 260 (39.7) | |
Occasional smoker | 412 (2.5) | 197 (2.3) | 32 (2.8) | 135 (3.0) | 778 (2.5) | |
Daily smoker | 1216 (7.4) | 693 (7.9) | 77 (6.7) | 437 (9.8) | 2430 (7.9) | |
Passive exposure to smoke at home | Never | 11 904 (88.6) | 7889 (89.2) | 1060 (90.7) | 3988 (91.0) | 24 919 (89.2) |
Once a month | 344 (2.6) | 291 (3.3) | 31 (2.7) | 160 (3.6) | 829 (3.0) | |
Once a week | 250 (1.9) | 99 (1.1) | 7 (0.6) | 52 (1.2) | 408 (1.5) | |
Almost daily | 247 (1.8) | 134 (1.5) | 20 (1.7) | 77 (1.7) | 479 (1.7) | |
Daily | 688 (5.1) | 370 (4.2) | 47 (4.0) | 193 (4.3) | 1302 (4.0) | |
Alcohol intake (past 12 months) | Never | 1599 (9.9) | 988 (11.3) | 128 (11.1) | 629 (14.2) | 3355 (11.0) |
< once a month | 4670 (29.0) | 2595 (29.8) | 339 (29.4) | 1239 (27.9) | 8869 (29.1) | |
2–3 times a month | 2183 (13.6) | 1155 (13.3) | 148 (12.9) | 572 (12.9) | 4068 (13.3) | |
Once a week | 1822 (11.3) | 1103 (12.7) | 140 (12.2) | 549 (12.4) | 3636 (11.9) | |
2–3 times a week | 2989 (18.6) | 1598 (18.3) | 197 (17.1) | 866 (19.5) | 5662 (18.6) | |
Almost every day | 2829 (17.6) | 1281 (14.7) | 200 (17.4) | 589 (13.3) | 4918 (16.1) | |
Sleep (per night) | <4 h | 203 (1.2) | 59 (0.7) | 7 (0.6) | 40 (0.9) | 311 (1.0) |
4–<7 h | 4175 (25.6) | 2221 (25.6) | 324 (28.4) | 1307 (29.8) | 8054 (26.3) | |
7–<9 h | 10756 (66.1) | 5763 (66.5) | 722 (63.2) | 2725 (62.1) | 20 016 (65.5) | |
9–<11 h | 1069 (6.6) | 588 (6.8) | 79 (6.9) | 293 (6.7) | 2037 (6.7) | |
≥11 h | 78 (0.5) | 39 (0.4) | 10 (0.9) | 26 (0.6) | 155 (0.5) | |
Weekday exposure to UV radiation in summer months | <30 min | 3500 (33.0) | —b | — | — | 3500 (33.0) |
30–59 min | 2328 (22.0) | — | — | — | 2328 (22.0) | |
1–<2 h | 2056 (19.4) | — | — | — | 2056 (19.4) | |
2–<3 h | 1500 (14.1) | — | — | — | 1500 (14.1) | |
3–<4 h | 653 (6.2) | — | — | — | 653 (6.2) | |
≥4 h | 564 (5.3) | — | — | — | 564 (5.3) | |
Weekend exposure to UV radiation in summer months | <30 min | 1186 (11.2) | — | — | — | 1186 (11.2) |
30–59 min | 1596 (15.0) | — | — | — | 1596 (15.0) | |
1–<2 h | 2263 (21.3) | — | — | — | 2263 (21.3) | |
2–<3 h | 2634 (24.8) | — | — | — | 2634 (24.8) | |
3–<4 h | 1560 (14.7) | — | — | — | 1560 (14.7) | |
≥4 h | 1368 (12.9) | — | — | — | 1368 (12.9) | |
Physical activity (IPAQ Short) | Low | 1860 (29.2) | 2689 (30.6) | 359 (30.9) | 1496 (33.4) | 6428 (30.8) |
Moderate | 2296 (36.1) | 3256 (37.1) | 436 (31.5) | 1471 (32.8) | 7485 (35.9) | |
High | 2205 (34.7) | 2837 (32.3) | 366 (31.5) | 1513 (33.8) | 6948 (33.3) | |
Types of daily physical activity | Occupational | 83 | 121 | 108 | 132 | 99 min (26)c |
Active transport | 42 | 38 | 36 | 39 | 41 min (11) | |
Household | 166 | 145 | 126 | 158 | 159 min (42) | |
Leisure time | 86 | 78 | 72 | 75 | 83 min (22) | |
Sedentary time | <3 h | 2152 (14.2) | 796 (10.4) | 129 (13.2) | 460 (12.2) | 3550 (12.8) |
3–<6 h | 6679 (44.1) | 3148 (41.0) | 405 (41.4) | 1620 (42.9) | 1182 (43.0) | |
6–<9 h | 4321 (28.5) | 2575 (33.6) | 284 (29.0) | 1158 (30.7) | 8364 (30.2) | |
9–<11 h | 1184 (7.8) | 726 (9.5) | 101 (10.3) | 334 (8.9) | 2349 (8.5) | |
≥11 h | 822 (5.4) | 429 (5.6) | 60 (7.6) | 200 (5.3) | 1517 (5.5) | |
Daily fruit, vegetable and juice consumption | None | 389 (2.4) | 116 (1.3) | 16 (1.4) | 76 (1.7) | 598 (2.0) |
1 | 663 (4.1) | 265 (3.0) | 35 (3) | 194 (4.4) | 1158 (3.8) | |
2–3 | 3261 (20.1) | 1777 (20.3) | 211 (18.1) | 1135 (25.5) | 6411 (20.9) | |
4–6 | 7517 (46.3) | 3928 (44.9) | 523 (45) | 1965 (44.1) | 13 964 (45.5) | |
7–10 | 3819 (23.5) | 2344 (26.8) | 337 (29) | 965 (21.7) | 7489 (24.4) | |
>11 | 582 (3.6) | 329 (3.8) | 41 (3.5) | 120 (2.7) | 1077 (3.5) | |
Healthy Eating Indexd | Mean (SD) | 38.1 (9.8) | 39.7 (8.0) | 39.2 (7.8) | 37.7 (9.1) | 38.4 (9.3) |
Range | 1.0–60.0 | 3.7–59.0 | 9.1–54.1 | 2.0–57.0 | 1–60 | |
Depression score | None/minimal | 10 301 (76.4) | 3646 (76.7) | 318 (79.9) | 1968 (74.7) | 16 275 (76.3) |
Mild | 2280 (16.9) | 804 (16.9) | 60 (15.1) | 482 (18.3) | 3637 (17.1) | |
Moderate | 588 (4.4) | 216 (4.5) | 13 (3.3) | 115 (4.4) | 932 (4.4) | |
Moderately severe | 218 (1.6) | 69 (1.5) | 4 (1.0) | 41 (1.6) | 336 (1.6) | |
Severe | 96 (0.7) | 20 (0.4) | 3 (0.8) | 27 (1.0) | 146 (0.7) | |
Anxiety score | None/minimal | 11 076 (82.5) | 3908 (82.6) | 328 (82.8) | 2144 (82.0) | 17 503 (82.5) |
Mild | 1719 (12.8) | 606 (12.8) | 50 (12.6) | 332 (12.7) | 2714 (12.8) | |
Moderate | 421 (3.1) | 152 (3.2) | 10 (2.5) | 91 (3.5) | 675 (3.2) | |
Severe | 203 (1.5) | 68 (1.4) | 8 (2.0) | 47 (1.8) | 327 (1.5) | |
Endocrine/metabolic diseases | Diabetes | 1179 (7.1) | 619 (7.0) | 83 (7.1) | 341 (7.6) | 2222 (7.2) |
Type I diabetes | 95 (0.6) | 68 (0.8) | 5 (0.4) | 28 (0.6) | 196 (0.6) | |
Type II diabetes | 847 (5.1) | 453 (5.1) | 69 (5.9) | 261 (5.8) | 1630 (5.2) | |
Gestational | 237 (1.4) | 98 (1.1) | 9 (0.8) | 52 (1.2) | 396 (1.3) | |
Circulatory system disease | Hypertension | 4026 (24.3) | 2279 (25.8) | 297 (25.5) | 1236 (27.4) | 7857 (25.2) |
Stroke | 170 (1.0) | 97 (1.1) | 16 (1.4) | 29 (0.6) | 315 (1.01) | |
Myocardial infarction | 286 (1.7) | 142 (1.6) | 21 (1.8) | 88 (2) | 540 (1.73) | |
Angina | 203 (1.9) | 4 (0.6) | 0 (0) | 1 (2.8) | 209 (1.8) | |
Respiratory system disease | COPD | 241 (1.5) | 113 (1.3) | 21 (1.4) | 61 (1.9) | 438 (1.4) |
Asthma | 1864 (11.3) | 1044 (12.1) | 139 (12.2) | 434 (9.9) | 3490 (11.2) | |
Chronic bronchitis | 372 (3.7) | 1 (7.7) | 0 (0) | 0 (0) | 373 (1.2) | |
Emphysema | 46 (0.5) | 0 (0) | 0 (0) | 0 (0) | 46 (0.2) | |
Musculoskeletal system and connective tissue disease | Arthritis | 4456 (27.2) | 2025 (23.7) | 291 (25.8) | 1303 (29.7) | 8097 (26.5) |
Rheumatoid arthritis | 571 | 241 | 40 | 163 | 1019 | |
Osteoarthritis | 2418 | 1034 | 154 | 626 | 4242 | |
Other arthritis | 444 | 209 | 18 | 114 | 785 | |
Osteoporosis | 914 (5.6) | 387 (4.5) | 52 (4.6) | 268 (6.1) | 1628 (5.3) | |
Eye disease | Glaucoma | 202 (1.9) | 8 (1.1) | 1 (10.0) | 1 (6.3) | 213 (1.8) |
Cataracts | 632 (5.9) | 21 (2.9) | 0 (0) | 1 (2.8) | 657 (5.7) | |
Macular degeneration | 127 (1.2) | 4 (0.6) | 0 (0) | 0 (0) | 131 (1.1) | |
Liver disorders | Cirrhosis | 37 (0.2) | 17 (0.2) | 2 (0.2) | 15 (0.3) | 71 (0.23) |
Chronic hepatitis | 73 (0.4) | 23 (0.3) | 3 (0.3) | 18 (0.4) | 118 (0.38) | |
Digestive system disease | Irritable bowel syndrome | 1411 (8.6) | 817 (9.5) | 109 (9.6) | 482 (10.9) | 2823 (9.2) |
Inflammatory bowel disease | 326 (2.0) | 160 (1.8) | 31 (2.7) | 95 (2.1) | 614 (1.97) | |
Crohn’s disease | 189 (1.1) | 78 (0.9) | 10 (0.9) | 38 (0.9) | 316 (1.0) | |
Ulcerative colitis | 181 (1.1) | 91 (1.0) | 21 (1.8) | 59 (1.3) | 353 (1.1) | |
Gastro-oesophageal reflux disease | 1506 (14.0) | 66 (9.2) | 0 (0) | 3 (8.3) | 1577 (13.7) | |
Gallbladder disease | 1245 (11.6) | 78 (10.9) | 0 (0) | 4 (11.1) | 13 127 (11.5) | |
Skin disease | Eczema | 1650 (10.0) | 1065 (12.3) | 144 (12.6) | 541 (12.2) | 3408 (11.1) |
Psoriasis | 725 (4.4) | 447 (5.2) | 59 (5.2) | 276 (6.2) | 1512 (4.9) | |
Allergies and food intolerances | Allergies | 1851 (45.1) | 2799 (49.1) | 195 (45.2) | 1268 (38.8) | 6113 (45.3) |
Animals | 664 (35.8) | 988 (35.3) | 64 (32.5) | 449 (35.4) | 2165 (35.4) | |
Foods | 386 (20.9) | 688 (24.6) | 41 (21.0) | 238 (18.8) | 1353 (22.1) | |
Insect bites | 241 (13.0) | 305 (10.9) | 20 (10.3) | 103 (8.1) | 669 (10.9) | |
Latex | 106 (5.7) | 185 (6.6) | 10 (5.1) | 59 (4.7) | 360 (5.9) | |
Medications | 629 (34.0) | 1091 (39.0) | 68 (34.9) | 470 (37.0) | 2258 (36.9) | |
Metal | 180 (9.7) | 249 (8.9) | 19 (9.7) | 140 (11.0) | 588 (9.6) | |
Mould or dust | 722 (39.0) | 1159 (41.4) | 75 (38.1) | 482 (38.0) | 2438 (39.8) | |
Pollen | 926 (50.0) | 1412 (50.4) | 95 (48.5) | 534 (42.1) | 2967 (48.5) | |
Autoimmune diseases | Systemic lupus erythematosus | 55 (0.3) | 27 (0.3) | 3 (0.3) | 15 (0.3) | 100 (0.3) |
Diseases of the nervous system | Multiple sclerosis | 106 (0.6) | 45 (0.5) | 13 (1.1) | 21 (0.5) | 185 (0.6) |
Migraines | 1727 (16.1) | 101 (14.1) | 1 (10.0) | 6 (16.7) | 1835 (15.9) | |
Parkinson’s disease | 15 (0.1) | 1 (0.1) | 0 (0) | 0 (0) | 16 (0.1) |
Behaviours and chronic conditionsa . | . | Nova Scotia n (%) . | New Brunswick n (%) . | Prince Edward Island n (%) . | Newfoundland and Labrador n (%) . | Atlantic PATH cohort n (%) . |
---|---|---|---|---|---|---|
Smoking status | Never smoked | 8227 (50) | 4547 (52.1) | 545 (47.1) | 2072 (46.3) | 15 439 (50.0) |
Past smoker | 6599 (40.1) | 3299 (37.8) | 503 (43.5) | 1827 (40.9) | 12 260 (39.7) | |
Occasional smoker | 412 (2.5) | 197 (2.3) | 32 (2.8) | 135 (3.0) | 778 (2.5) | |
Daily smoker | 1216 (7.4) | 693 (7.9) | 77 (6.7) | 437 (9.8) | 2430 (7.9) | |
Passive exposure to smoke at home | Never | 11 904 (88.6) | 7889 (89.2) | 1060 (90.7) | 3988 (91.0) | 24 919 (89.2) |
Once a month | 344 (2.6) | 291 (3.3) | 31 (2.7) | 160 (3.6) | 829 (3.0) | |
Once a week | 250 (1.9) | 99 (1.1) | 7 (0.6) | 52 (1.2) | 408 (1.5) | |
Almost daily | 247 (1.8) | 134 (1.5) | 20 (1.7) | 77 (1.7) | 479 (1.7) | |
Daily | 688 (5.1) | 370 (4.2) | 47 (4.0) | 193 (4.3) | 1302 (4.0) | |
Alcohol intake (past 12 months) | Never | 1599 (9.9) | 988 (11.3) | 128 (11.1) | 629 (14.2) | 3355 (11.0) |
< once a month | 4670 (29.0) | 2595 (29.8) | 339 (29.4) | 1239 (27.9) | 8869 (29.1) | |
2–3 times a month | 2183 (13.6) | 1155 (13.3) | 148 (12.9) | 572 (12.9) | 4068 (13.3) | |
Once a week | 1822 (11.3) | 1103 (12.7) | 140 (12.2) | 549 (12.4) | 3636 (11.9) | |
2–3 times a week | 2989 (18.6) | 1598 (18.3) | 197 (17.1) | 866 (19.5) | 5662 (18.6) | |
Almost every day | 2829 (17.6) | 1281 (14.7) | 200 (17.4) | 589 (13.3) | 4918 (16.1) | |
Sleep (per night) | <4 h | 203 (1.2) | 59 (0.7) | 7 (0.6) | 40 (0.9) | 311 (1.0) |
4–<7 h | 4175 (25.6) | 2221 (25.6) | 324 (28.4) | 1307 (29.8) | 8054 (26.3) | |
7–<9 h | 10756 (66.1) | 5763 (66.5) | 722 (63.2) | 2725 (62.1) | 20 016 (65.5) | |
9–<11 h | 1069 (6.6) | 588 (6.8) | 79 (6.9) | 293 (6.7) | 2037 (6.7) | |
≥11 h | 78 (0.5) | 39 (0.4) | 10 (0.9) | 26 (0.6) | 155 (0.5) | |
Weekday exposure to UV radiation in summer months | <30 min | 3500 (33.0) | —b | — | — | 3500 (33.0) |
30–59 min | 2328 (22.0) | — | — | — | 2328 (22.0) | |
1–<2 h | 2056 (19.4) | — | — | — | 2056 (19.4) | |
2–<3 h | 1500 (14.1) | — | — | — | 1500 (14.1) | |
3–<4 h | 653 (6.2) | — | — | — | 653 (6.2) | |
≥4 h | 564 (5.3) | — | — | — | 564 (5.3) | |
Weekend exposure to UV radiation in summer months | <30 min | 1186 (11.2) | — | — | — | 1186 (11.2) |
30–59 min | 1596 (15.0) | — | — | — | 1596 (15.0) | |
1–<2 h | 2263 (21.3) | — | — | — | 2263 (21.3) | |
2–<3 h | 2634 (24.8) | — | — | — | 2634 (24.8) | |
3–<4 h | 1560 (14.7) | — | — | — | 1560 (14.7) | |
≥4 h | 1368 (12.9) | — | — | — | 1368 (12.9) | |
Physical activity (IPAQ Short) | Low | 1860 (29.2) | 2689 (30.6) | 359 (30.9) | 1496 (33.4) | 6428 (30.8) |
Moderate | 2296 (36.1) | 3256 (37.1) | 436 (31.5) | 1471 (32.8) | 7485 (35.9) | |
High | 2205 (34.7) | 2837 (32.3) | 366 (31.5) | 1513 (33.8) | 6948 (33.3) | |
Types of daily physical activity | Occupational | 83 | 121 | 108 | 132 | 99 min (26)c |
Active transport | 42 | 38 | 36 | 39 | 41 min (11) | |
Household | 166 | 145 | 126 | 158 | 159 min (42) | |
Leisure time | 86 | 78 | 72 | 75 | 83 min (22) | |
Sedentary time | <3 h | 2152 (14.2) | 796 (10.4) | 129 (13.2) | 460 (12.2) | 3550 (12.8) |
3–<6 h | 6679 (44.1) | 3148 (41.0) | 405 (41.4) | 1620 (42.9) | 1182 (43.0) | |
6–<9 h | 4321 (28.5) | 2575 (33.6) | 284 (29.0) | 1158 (30.7) | 8364 (30.2) | |
9–<11 h | 1184 (7.8) | 726 (9.5) | 101 (10.3) | 334 (8.9) | 2349 (8.5) | |
≥11 h | 822 (5.4) | 429 (5.6) | 60 (7.6) | 200 (5.3) | 1517 (5.5) | |
Daily fruit, vegetable and juice consumption | None | 389 (2.4) | 116 (1.3) | 16 (1.4) | 76 (1.7) | 598 (2.0) |
1 | 663 (4.1) | 265 (3.0) | 35 (3) | 194 (4.4) | 1158 (3.8) | |
2–3 | 3261 (20.1) | 1777 (20.3) | 211 (18.1) | 1135 (25.5) | 6411 (20.9) | |
4–6 | 7517 (46.3) | 3928 (44.9) | 523 (45) | 1965 (44.1) | 13 964 (45.5) | |
7–10 | 3819 (23.5) | 2344 (26.8) | 337 (29) | 965 (21.7) | 7489 (24.4) | |
>11 | 582 (3.6) | 329 (3.8) | 41 (3.5) | 120 (2.7) | 1077 (3.5) | |
Healthy Eating Indexd | Mean (SD) | 38.1 (9.8) | 39.7 (8.0) | 39.2 (7.8) | 37.7 (9.1) | 38.4 (9.3) |
Range | 1.0–60.0 | 3.7–59.0 | 9.1–54.1 | 2.0–57.0 | 1–60 | |
Depression score | None/minimal | 10 301 (76.4) | 3646 (76.7) | 318 (79.9) | 1968 (74.7) | 16 275 (76.3) |
Mild | 2280 (16.9) | 804 (16.9) | 60 (15.1) | 482 (18.3) | 3637 (17.1) | |
Moderate | 588 (4.4) | 216 (4.5) | 13 (3.3) | 115 (4.4) | 932 (4.4) | |
Moderately severe | 218 (1.6) | 69 (1.5) | 4 (1.0) | 41 (1.6) | 336 (1.6) | |
Severe | 96 (0.7) | 20 (0.4) | 3 (0.8) | 27 (1.0) | 146 (0.7) | |
Anxiety score | None/minimal | 11 076 (82.5) | 3908 (82.6) | 328 (82.8) | 2144 (82.0) | 17 503 (82.5) |
Mild | 1719 (12.8) | 606 (12.8) | 50 (12.6) | 332 (12.7) | 2714 (12.8) | |
Moderate | 421 (3.1) | 152 (3.2) | 10 (2.5) | 91 (3.5) | 675 (3.2) | |
Severe | 203 (1.5) | 68 (1.4) | 8 (2.0) | 47 (1.8) | 327 (1.5) | |
Endocrine/metabolic diseases | Diabetes | 1179 (7.1) | 619 (7.0) | 83 (7.1) | 341 (7.6) | 2222 (7.2) |
Type I diabetes | 95 (0.6) | 68 (0.8) | 5 (0.4) | 28 (0.6) | 196 (0.6) | |
Type II diabetes | 847 (5.1) | 453 (5.1) | 69 (5.9) | 261 (5.8) | 1630 (5.2) | |
Gestational | 237 (1.4) | 98 (1.1) | 9 (0.8) | 52 (1.2) | 396 (1.3) | |
Circulatory system disease | Hypertension | 4026 (24.3) | 2279 (25.8) | 297 (25.5) | 1236 (27.4) | 7857 (25.2) |
Stroke | 170 (1.0) | 97 (1.1) | 16 (1.4) | 29 (0.6) | 315 (1.01) | |
Myocardial infarction | 286 (1.7) | 142 (1.6) | 21 (1.8) | 88 (2) | 540 (1.73) | |
Angina | 203 (1.9) | 4 (0.6) | 0 (0) | 1 (2.8) | 209 (1.8) | |
Respiratory system disease | COPD | 241 (1.5) | 113 (1.3) | 21 (1.4) | 61 (1.9) | 438 (1.4) |
Asthma | 1864 (11.3) | 1044 (12.1) | 139 (12.2) | 434 (9.9) | 3490 (11.2) | |
Chronic bronchitis | 372 (3.7) | 1 (7.7) | 0 (0) | 0 (0) | 373 (1.2) | |
Emphysema | 46 (0.5) | 0 (0) | 0 (0) | 0 (0) | 46 (0.2) | |
Musculoskeletal system and connective tissue disease | Arthritis | 4456 (27.2) | 2025 (23.7) | 291 (25.8) | 1303 (29.7) | 8097 (26.5) |
Rheumatoid arthritis | 571 | 241 | 40 | 163 | 1019 | |
Osteoarthritis | 2418 | 1034 | 154 | 626 | 4242 | |
Other arthritis | 444 | 209 | 18 | 114 | 785 | |
Osteoporosis | 914 (5.6) | 387 (4.5) | 52 (4.6) | 268 (6.1) | 1628 (5.3) | |
Eye disease | Glaucoma | 202 (1.9) | 8 (1.1) | 1 (10.0) | 1 (6.3) | 213 (1.8) |
Cataracts | 632 (5.9) | 21 (2.9) | 0 (0) | 1 (2.8) | 657 (5.7) | |
Macular degeneration | 127 (1.2) | 4 (0.6) | 0 (0) | 0 (0) | 131 (1.1) | |
Liver disorders | Cirrhosis | 37 (0.2) | 17 (0.2) | 2 (0.2) | 15 (0.3) | 71 (0.23) |
Chronic hepatitis | 73 (0.4) | 23 (0.3) | 3 (0.3) | 18 (0.4) | 118 (0.38) | |
Digestive system disease | Irritable bowel syndrome | 1411 (8.6) | 817 (9.5) | 109 (9.6) | 482 (10.9) | 2823 (9.2) |
Inflammatory bowel disease | 326 (2.0) | 160 (1.8) | 31 (2.7) | 95 (2.1) | 614 (1.97) | |
Crohn’s disease | 189 (1.1) | 78 (0.9) | 10 (0.9) | 38 (0.9) | 316 (1.0) | |
Ulcerative colitis | 181 (1.1) | 91 (1.0) | 21 (1.8) | 59 (1.3) | 353 (1.1) | |
Gastro-oesophageal reflux disease | 1506 (14.0) | 66 (9.2) | 0 (0) | 3 (8.3) | 1577 (13.7) | |
Gallbladder disease | 1245 (11.6) | 78 (10.9) | 0 (0) | 4 (11.1) | 13 127 (11.5) | |
Skin disease | Eczema | 1650 (10.0) | 1065 (12.3) | 144 (12.6) | 541 (12.2) | 3408 (11.1) |
Psoriasis | 725 (4.4) | 447 (5.2) | 59 (5.2) | 276 (6.2) | 1512 (4.9) | |
Allergies and food intolerances | Allergies | 1851 (45.1) | 2799 (49.1) | 195 (45.2) | 1268 (38.8) | 6113 (45.3) |
Animals | 664 (35.8) | 988 (35.3) | 64 (32.5) | 449 (35.4) | 2165 (35.4) | |
Foods | 386 (20.9) | 688 (24.6) | 41 (21.0) | 238 (18.8) | 1353 (22.1) | |
Insect bites | 241 (13.0) | 305 (10.9) | 20 (10.3) | 103 (8.1) | 669 (10.9) | |
Latex | 106 (5.7) | 185 (6.6) | 10 (5.1) | 59 (4.7) | 360 (5.9) | |
Medications | 629 (34.0) | 1091 (39.0) | 68 (34.9) | 470 (37.0) | 2258 (36.9) | |
Metal | 180 (9.7) | 249 (8.9) | 19 (9.7) | 140 (11.0) | 588 (9.6) | |
Mould or dust | 722 (39.0) | 1159 (41.4) | 75 (38.1) | 482 (38.0) | 2438 (39.8) | |
Pollen | 926 (50.0) | 1412 (50.4) | 95 (48.5) | 534 (42.1) | 2967 (48.5) | |
Autoimmune diseases | Systemic lupus erythematosus | 55 (0.3) | 27 (0.3) | 3 (0.3) | 15 (0.3) | 100 (0.3) |
Diseases of the nervous system | Multiple sclerosis | 106 (0.6) | 45 (0.5) | 13 (1.1) | 21 (0.5) | 185 (0.6) |
Migraines | 1727 (16.1) | 101 (14.1) | 1 (10.0) | 6 (16.7) | 1835 (15.9) | |
Parkinson’s disease | 15 (0.1) | 1 (0.1) | 0 (0) | 0 (0) | 16 (0.1) |
aAll behaviours and chronic conditions are based on the harmonized data set or supplementary Atlantic Canada questionnaire with the following exceptions which are based on earlier datasets with smaller populations: angina, eye disease, skin disease, migraines, UV exposure, Parkinson’s disease, gastro-oesophageal reflux disease, and gallbladder disease. bSome data unavailable for New Brunswick, Prince Edward Island and Newfoundland and Labrador. cThe types of physical activity were calculated using the domains from the long-form IPAQ. The data presented include the total daily minutes of physical activity and the percentage of daily activity for occupational physical activity, active transport physical activity, household physical activity and leisure time physical activity. dA Healthy Eating Index (HEI) was developed for 21 504 participants who responded to comprehensive questions on food intake. The HEI was derived according to the methods recommended for Americans and Canadians in terms of food quality and prevention of chronic disease. The HEI is a continuous variable with a perfect score of 60 and a minimum score of 0.11 See Supplementary Material Table 3 (available as Supplementary data at IJE online).
Number of unhealthy habitsa . | Unhealthy habit . | Atlantic PATH Cohort n (%) . | |||
---|---|---|---|---|---|
None | 14 963 (48.0) | ||||
One | Low physical activity | 5951 (19.1) | |||
Smoking | 3208 (10.3) | ||||
Drinking | 4918 (15.8) | ||||
Low fruit and vegetable intake | 8167 (26.2) | ||||
Two | Low physical activity | Smoking | 817 (2.62) | ||
Smoking | Low fruit and vegetable intake | 1422 (4.6) | |||
Low physical activity | Low fruit and vegetable intake | 2178 (7.0) | |||
Low physical activity | Drinking | 775 (2.5) | |||
Smoking | Drinking | 524 (1.7) | |||
Drinking | Low fruit and vegetable intake | 1355 (4.4) | |||
Three | Low physical activity | Smoking | Low fruit and vegetable intake | 438 (1.4) | |
Low physical activity | Smoking | Drinking | 112 (0.4) | ||
Smoking | Drinking | Low fruit and vegetable intake | 235 (0.8) | ||
Low physical activity | Drinking | Low fruit and vegetable intake | 308 (1.0) | ||
Four | Low physical activity | Smoking | Drinking | Low fruit and vegetable intake | 56 (0.2) |
Number of unhealthy habitsa . | Unhealthy habit . | Atlantic PATH Cohort n (%) . | |||
---|---|---|---|---|---|
None | 14 963 (48.0) | ||||
One | Low physical activity | 5951 (19.1) | |||
Smoking | 3208 (10.3) | ||||
Drinking | 4918 (15.8) | ||||
Low fruit and vegetable intake | 8167 (26.2) | ||||
Two | Low physical activity | Smoking | 817 (2.62) | ||
Smoking | Low fruit and vegetable intake | 1422 (4.6) | |||
Low physical activity | Low fruit and vegetable intake | 2178 (7.0) | |||
Low physical activity | Drinking | 775 (2.5) | |||
Smoking | Drinking | 524 (1.7) | |||
Drinking | Low fruit and vegetable intake | 1355 (4.4) | |||
Three | Low physical activity | Smoking | Low fruit and vegetable intake | 438 (1.4) | |
Low physical activity | Smoking | Drinking | 112 (0.4) | ||
Smoking | Drinking | Low fruit and vegetable intake | 235 (0.8) | ||
Low physical activity | Drinking | Low fruit and vegetable intake | 308 (1.0) | ||
Four | Low physical activity | Smoking | Drinking | Low fruit and vegetable intake | 56 (0.2) |
aUnhealthy habits were defined as having low physical activity based on an IPAQ score, being a current smoker, drinking almost daily and consuming ≤3 servings of fruit and vegetables per day.
Number of unhealthy habitsa . | Unhealthy habit . | Atlantic PATH Cohort n (%) . | |||
---|---|---|---|---|---|
None | 14 963 (48.0) | ||||
One | Low physical activity | 5951 (19.1) | |||
Smoking | 3208 (10.3) | ||||
Drinking | 4918 (15.8) | ||||
Low fruit and vegetable intake | 8167 (26.2) | ||||
Two | Low physical activity | Smoking | 817 (2.62) | ||
Smoking | Low fruit and vegetable intake | 1422 (4.6) | |||
Low physical activity | Low fruit and vegetable intake | 2178 (7.0) | |||
Low physical activity | Drinking | 775 (2.5) | |||
Smoking | Drinking | 524 (1.7) | |||
Drinking | Low fruit and vegetable intake | 1355 (4.4) | |||
Three | Low physical activity | Smoking | Low fruit and vegetable intake | 438 (1.4) | |
Low physical activity | Smoking | Drinking | 112 (0.4) | ||
Smoking | Drinking | Low fruit and vegetable intake | 235 (0.8) | ||
Low physical activity | Drinking | Low fruit and vegetable intake | 308 (1.0) | ||
Four | Low physical activity | Smoking | Drinking | Low fruit and vegetable intake | 56 (0.2) |
Number of unhealthy habitsa . | Unhealthy habit . | Atlantic PATH Cohort n (%) . | |||
---|---|---|---|---|---|
None | 14 963 (48.0) | ||||
One | Low physical activity | 5951 (19.1) | |||
Smoking | 3208 (10.3) | ||||
Drinking | 4918 (15.8) | ||||
Low fruit and vegetable intake | 8167 (26.2) | ||||
Two | Low physical activity | Smoking | 817 (2.62) | ||
Smoking | Low fruit and vegetable intake | 1422 (4.6) | |||
Low physical activity | Low fruit and vegetable intake | 2178 (7.0) | |||
Low physical activity | Drinking | 775 (2.5) | |||
Smoking | Drinking | 524 (1.7) | |||
Drinking | Low fruit and vegetable intake | 1355 (4.4) | |||
Three | Low physical activity | Smoking | Low fruit and vegetable intake | 438 (1.4) | |
Low physical activity | Smoking | Drinking | 112 (0.4) | ||
Smoking | Drinking | Low fruit and vegetable intake | 235 (0.8) | ||
Low physical activity | Drinking | Low fruit and vegetable intake | 308 (1.0) | ||
Four | Low physical activity | Smoking | Drinking | Low fruit and vegetable intake | 56 (0.2) |
aUnhealthy habits were defined as having low physical activity based on an IPAQ score, being a current smoker, drinking almost daily and consuming ≤3 servings of fruit and vegetables per day.
Pre-existing chronic disease and multi-morbidity is an issue for a proportion of the cohort. One-third of participants have been diagnosed with one chronic condition, 19% have been diagnosed with two conditions, 8% with three conditions and 5% with four or more (Table 6). Common chronic diseases and conditions among participants include arthritis (26.5%), hypertension (25%), asthma (11%), irritable bowel syndrome (9%) and diabetes (7%).
Comorbidities (total number of diseases) . | Atlantic PATH Cohort n (%) . |
---|---|
0 | 11 213 (36.0) |
1 | 10 177 (32.7) |
2 | 5818 (18.7) |
3 | 2529 (8.1) |
4+ | 1436 (4.6) |
Comorbidities (total number of diseases) . | Atlantic PATH Cohort n (%) . |
---|---|
0 | 11 213 (36.0) |
1 | 10 177 (32.7) |
2 | 5818 (18.7) |
3 | 2529 (8.1) |
4+ | 1436 (4.6) |
Comorbidities (total number of diseases) . | Atlantic PATH Cohort n (%) . |
---|---|
0 | 11 213 (36.0) |
1 | 10 177 (32.7) |
2 | 5818 (18.7) |
3 | 2529 (8.1) |
4+ | 1436 (4.6) |
Comorbidities (total number of diseases) . | Atlantic PATH Cohort n (%) . |
---|---|
0 | 11 213 (36.0) |
1 | 10 177 (32.7) |
2 | 5818 (18.7) |
3 | 2529 (8.1) |
4+ | 1436 (4.6) |
Cancer and chronic disease in Atlantic PATH participants
The most commonly diagnosed cancers among women in Canada include breast cancer, colorectal cancer, uterine cancer, thyroid cancer and lung cancer.12 This is largely reflected in the most commonly diagnosed cancers among female Atlantic PATH participants, which include breast cancer (n = 515), cervical cancer (n = 238), thyroid cancer (n = 80), colon cancer (n = 72) and uterine cancer (n = 67) (Table 7). The most commonly diagnosed cancers among men in Canada include prostate cancer, colorectal cancer, bladder cancer, melanoma, and non-Hodgkin lymphoma.12 Similarly, the most commonly diagnosed cancers among male Atlantic PATH participants include prostate cancer (n = 158), colon cancer (n = 61), non-Hodgkin’s lymphoma (n = 38), bladder cancer (n = 27) and kidney cancer (n = 22) (Table 7). It should be noted that skin cancer has been excluded from this analysis because there is uncertainty distinguishing between cases of melanoma and non-melanoma. Participants also reported cancer incidence in biological parents and siblings.
Type of cancer . | First cancer diagnosis (female) . | First cancer diagnosis (male) . | Total . |
---|---|---|---|
Bladder | 15 | 27 | 42 |
Brain | 10 | 4 | 14 |
Breast | 515 | 5 | 520 |
Cervix | 238 | 0 | 238 |
Colon | 72 | 61 | 133 |
Oesophagus | 0 | 8 | 8 |
Kidney | 25 | 22 | 47 |
Larynx | 0 | 4 | 4 |
Leukaemia | 15 | 15 | 30 |
Liver | 4 | 3 | 7 |
Lung and bronchus | 19 | 10 | 29 |
Non-Hodgkin’s lymphoma | 41 | 38 | 79 |
Other | 100 | 64 | 164 |
Ovarian | 50 | 0 | 50 |
Pancreas | 5 | 2 | 7 |
Prostate | 0 | 158 | 158 |
Rectum | 11 | 8 | 19 |
Skin | 408 | 242 | 650 |
Stomach | 5 | 4 | 9 |
Thyroid | 80 | 16 | 96 |
Uterus | 67 | 0 | 67 |
Total | 1680 | 691 | 2371 |
Type of cancer . | First cancer diagnosis (female) . | First cancer diagnosis (male) . | Total . |
---|---|---|---|
Bladder | 15 | 27 | 42 |
Brain | 10 | 4 | 14 |
Breast | 515 | 5 | 520 |
Cervix | 238 | 0 | 238 |
Colon | 72 | 61 | 133 |
Oesophagus | 0 | 8 | 8 |
Kidney | 25 | 22 | 47 |
Larynx | 0 | 4 | 4 |
Leukaemia | 15 | 15 | 30 |
Liver | 4 | 3 | 7 |
Lung and bronchus | 19 | 10 | 29 |
Non-Hodgkin’s lymphoma | 41 | 38 | 79 |
Other | 100 | 64 | 164 |
Ovarian | 50 | 0 | 50 |
Pancreas | 5 | 2 | 7 |
Prostate | 0 | 158 | 158 |
Rectum | 11 | 8 | 19 |
Skin | 408 | 242 | 650 |
Stomach | 5 | 4 | 9 |
Thyroid | 80 | 16 | 96 |
Uterus | 67 | 0 | 67 |
Total | 1680 | 691 | 2371 |
Type of cancer . | First cancer diagnosis (female) . | First cancer diagnosis (male) . | Total . |
---|---|---|---|
Bladder | 15 | 27 | 42 |
Brain | 10 | 4 | 14 |
Breast | 515 | 5 | 520 |
Cervix | 238 | 0 | 238 |
Colon | 72 | 61 | 133 |
Oesophagus | 0 | 8 | 8 |
Kidney | 25 | 22 | 47 |
Larynx | 0 | 4 | 4 |
Leukaemia | 15 | 15 | 30 |
Liver | 4 | 3 | 7 |
Lung and bronchus | 19 | 10 | 29 |
Non-Hodgkin’s lymphoma | 41 | 38 | 79 |
Other | 100 | 64 | 164 |
Ovarian | 50 | 0 | 50 |
Pancreas | 5 | 2 | 7 |
Prostate | 0 | 158 | 158 |
Rectum | 11 | 8 | 19 |
Skin | 408 | 242 | 650 |
Stomach | 5 | 4 | 9 |
Thyroid | 80 | 16 | 96 |
Uterus | 67 | 0 | 67 |
Total | 1680 | 691 | 2371 |
Type of cancer . | First cancer diagnosis (female) . | First cancer diagnosis (male) . | Total . |
---|---|---|---|
Bladder | 15 | 27 | 42 |
Brain | 10 | 4 | 14 |
Breast | 515 | 5 | 520 |
Cervix | 238 | 0 | 238 |
Colon | 72 | 61 | 133 |
Oesophagus | 0 | 8 | 8 |
Kidney | 25 | 22 | 47 |
Larynx | 0 | 4 | 4 |
Leukaemia | 15 | 15 | 30 |
Liver | 4 | 3 | 7 |
Lung and bronchus | 19 | 10 | 29 |
Non-Hodgkin’s lymphoma | 41 | 38 | 79 |
Other | 100 | 64 | 164 |
Ovarian | 50 | 0 | 50 |
Pancreas | 5 | 2 | 7 |
Prostate | 0 | 158 | 158 |
Rectum | 11 | 8 | 19 |
Skin | 408 | 242 | 650 |
Stomach | 5 | 4 | 9 |
Thyroid | 80 | 16 | 96 |
Uterus | 67 | 0 | 67 |
Total | 1680 | 691 | 2371 |
In addition to the highest rates of cancer in the country,13–15 Atlantic Canada has similarly high rates of diabetes and cardiovascular disease. For example, 6.7% of the Canadian population (aged 12+) reported a diagnosis of diabetes, with the majority of cases diagnosed after the age of 35. In this case, the provinces with the highest proportion of diabetes cases include Newfoundland and Labrador, New Brunswick and Nova Scotia.16 The data from the Atlantic PATH cohort mirrors these findings, with 7.2% of participants reporting a history of diabetes.
Moreover, Canadian population data show that approximately 22% of Canadian adults (aged 20–79) have hypertension.17 Slightly more than 25% of Atlantic PATH participants reported a history of high blood pressure. Similarly, the prevalence of stroke (1.0%) in Atlantic Canada reflects the national data (1.1%).18 However, the rate of myocardial infarction among Atlantic PATH participants (1.7%) is higher than the national average of 0.2%.19,20
Unique contributions by Atlantic PATH
This study recognizes that Atlantic Canada is a unique region with some of the poorest health outcomes in Canada. Atlantic PATH provides a wealth of baseline data that will be connected with follow-up data to allow researchers to gain a more in-depth understanding of the causes and consequences of the variation in health of Atlantic Canadian residents.
One of Atlantic PATH’s early contributions includes the investigation of the relationship between diet quality and depression. A recent analysis found there was an association between depressive symptoms and higher levels of obesity, as well as between major depression, poor diet and physical inactivity.11
Atlantic PATH is the only CPTP cohort to collect toenail samples (Table 8), which can be used as an indicator of environmental exposures as they reflect exposure to trace elements for up to 12 months before clipping.21 The collection of toenail clippings is non-invasive, and clippings are a highly stable biosample that can be easily maintained and transported. The study received recognition from the Guinness Book of World Records for the world’s largest toenail collection.22,23 The toenail samples have been used to shed light on the relationship between drinking water arsenic intake and arsenic body burden, identifying a role for body fat in the bioaccumulation of arsenic in toenails.24
Metal . | N . | Mean (µg/g) . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Sodium (Na) | 2351 | 207.843 | 262.716 | 144.818 | 80.140 | 246.693 | 131.310 | 126.008 | 136.772 |
Magnesium (Mg) | 2348 | 102.399 | 62.899 | 91.986 | 71.721 | 115.554 | 90.323 | 88.348 | 92.342 |
Potassium (K) | 2348 | 250.903 | 252.377 | 184.923 | 97.583 | 324.188 | 157.688 | 150.487 | 165.272 |
Calcium (Ca) | 2345 | 673.616 | 392.104 | 594.705 | 449.684 | 807.890 | 591.697 | 578.628 | 605.201 |
Aluminium (Al) | 2346 | 10.858 | 14.823 | 7.360 | 4.420 | 11.986 | 7.006 | 6.740 | 7.282 |
Vanadium (V) | 2352 | 0.075 | 0.060 | 0.072 | 0.072 | 0.072 | 0.071 | 0.070 | 0.072 |
Manganese (Mn) | 2348 | 0.946 | 1.902 | 0.408 | 0.208 | 0.912 | 0.444 | 0.440 | 0.461 |
Cobalt (Co) | 2348 | 0.024 | 0.035 | 0.019 | 0.019 | 0.019 | 0.020 | 0.020 | 0.021 |
Nickel (Ni) | 2348 | 19.332 | 59.069 | 0.704 | 0.203 | 6.342 | 1.260 | 1.146 | 1.386 |
Copper (Cu) | 2348 | 4.095 | 2.993 | 3.426 | 2.801 | 4.446 | 3.411 | 3.324 | 3.500 |
Zinc (Zn) | 2349 | 82.906 | 42.741 | 77.939 | 68.335 | 89.822 | 76.155 | 74.713 | 77.624 |
Silver (Ag) | 2349 | 0.034 | 0.141 | 0.019 | 0.019 | 0.019 | 0.021 | 0.021 | 0.021 |
Cadmium (Cd) | 2349 | 0.021 | 0.021 | 0.017 | 0.017 | 0.017 | 0.018 | 0.018 | 0.019 |
Tin (Sn) | 2347 | 0.114 | 0.207 | 0.059 | 0.031 | 0.122 | 0.063 | 0.060 | 0.065 |
Barium (Ba) | 2254 | 0.417 | 0.402 | 0.278 | 0.146 | 0.548 | 0.263 | 0.252 | 0.274 |
Lead (Pb) | 2350 | 0.267 | 0.608 | 0.129 | 0.068 | 0.244 | 0.133 | 0.127 | 0.129 |
Uranium (U) | 2350 | 0.029 | 0.102 | 0.012 | 0.012 | 0.012 | 0.015 | 0.015 | 0.016 |
Thorium (Th) | 2349 | 0.031 | 0.039 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.025 |
Iron (Fe) | 2348 | 19.193 | 39.112 | 11.109 | 6.972 | 18.134 | 11.186 | 10.757 | 11.633 |
Chromium (Cr) | 2347 | 0.602 | 1.068 | 0.281 | 0.153 | 0.626 | 0.313 | 0.300 | 0.327 |
Selenium (Se) | 2349 | 1.935 | 3.735 | 0.856 | 0.679 | 1.249 | 1.058 | 1.019 | 1.099 |
Arsenic (As) | 2350 | 0.090 | 0.202 | 0.061 | 0.023 | 0.095 | 0.059 | 0.057 | 0.061 |
Beryllium (Be) | 2351 | 0.029 | 0.003 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 |
Molybdenum (Mo) | 2347 | 0.055 | 0.017 | 0.054 | 0.054 | 0.054 | 0.054 | 0.054 | 0.055 |
Thallium (Tl) | 2351 | 0.018 | 0.001 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 |
Antimony (Sb) | 2349 | 0.034 | 0.041 | 0.027 | 0.027 | 0.027 | 0.029 | 0.029 | 0.030 |
Boron (B) | 2345 | 0.286 | 0.536 | 0.127 | 0.127 | 0.209 | 0.182 | 0.177 | 0.188 |
Metal . | N . | Mean (µg/g) . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Sodium (Na) | 2351 | 207.843 | 262.716 | 144.818 | 80.140 | 246.693 | 131.310 | 126.008 | 136.772 |
Magnesium (Mg) | 2348 | 102.399 | 62.899 | 91.986 | 71.721 | 115.554 | 90.323 | 88.348 | 92.342 |
Potassium (K) | 2348 | 250.903 | 252.377 | 184.923 | 97.583 | 324.188 | 157.688 | 150.487 | 165.272 |
Calcium (Ca) | 2345 | 673.616 | 392.104 | 594.705 | 449.684 | 807.890 | 591.697 | 578.628 | 605.201 |
Aluminium (Al) | 2346 | 10.858 | 14.823 | 7.360 | 4.420 | 11.986 | 7.006 | 6.740 | 7.282 |
Vanadium (V) | 2352 | 0.075 | 0.060 | 0.072 | 0.072 | 0.072 | 0.071 | 0.070 | 0.072 |
Manganese (Mn) | 2348 | 0.946 | 1.902 | 0.408 | 0.208 | 0.912 | 0.444 | 0.440 | 0.461 |
Cobalt (Co) | 2348 | 0.024 | 0.035 | 0.019 | 0.019 | 0.019 | 0.020 | 0.020 | 0.021 |
Nickel (Ni) | 2348 | 19.332 | 59.069 | 0.704 | 0.203 | 6.342 | 1.260 | 1.146 | 1.386 |
Copper (Cu) | 2348 | 4.095 | 2.993 | 3.426 | 2.801 | 4.446 | 3.411 | 3.324 | 3.500 |
Zinc (Zn) | 2349 | 82.906 | 42.741 | 77.939 | 68.335 | 89.822 | 76.155 | 74.713 | 77.624 |
Silver (Ag) | 2349 | 0.034 | 0.141 | 0.019 | 0.019 | 0.019 | 0.021 | 0.021 | 0.021 |
Cadmium (Cd) | 2349 | 0.021 | 0.021 | 0.017 | 0.017 | 0.017 | 0.018 | 0.018 | 0.019 |
Tin (Sn) | 2347 | 0.114 | 0.207 | 0.059 | 0.031 | 0.122 | 0.063 | 0.060 | 0.065 |
Barium (Ba) | 2254 | 0.417 | 0.402 | 0.278 | 0.146 | 0.548 | 0.263 | 0.252 | 0.274 |
Lead (Pb) | 2350 | 0.267 | 0.608 | 0.129 | 0.068 | 0.244 | 0.133 | 0.127 | 0.129 |
Uranium (U) | 2350 | 0.029 | 0.102 | 0.012 | 0.012 | 0.012 | 0.015 | 0.015 | 0.016 |
Thorium (Th) | 2349 | 0.031 | 0.039 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.025 |
Iron (Fe) | 2348 | 19.193 | 39.112 | 11.109 | 6.972 | 18.134 | 11.186 | 10.757 | 11.633 |
Chromium (Cr) | 2347 | 0.602 | 1.068 | 0.281 | 0.153 | 0.626 | 0.313 | 0.300 | 0.327 |
Selenium (Se) | 2349 | 1.935 | 3.735 | 0.856 | 0.679 | 1.249 | 1.058 | 1.019 | 1.099 |
Arsenic (As) | 2350 | 0.090 | 0.202 | 0.061 | 0.023 | 0.095 | 0.059 | 0.057 | 0.061 |
Beryllium (Be) | 2351 | 0.029 | 0.003 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 |
Molybdenum (Mo) | 2347 | 0.055 | 0.017 | 0.054 | 0.054 | 0.054 | 0.054 | 0.054 | 0.055 |
Thallium (Tl) | 2351 | 0.018 | 0.001 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 |
Antimony (Sb) | 2349 | 0.034 | 0.041 | 0.027 | 0.027 | 0.027 | 0.029 | 0.029 | 0.030 |
Boron (B) | 2345 | 0.286 | 0.536 | 0.127 | 0.127 | 0.209 | 0.182 | 0.177 | 0.188 |
aSee Supplementary material Table 4 (available as Supplementary data at IJE online).
SD, standard deviation; IQR, interquartile range; GM, geometric mean; CI, confidence interval.
Metal . | N . | Mean (µg/g) . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Sodium (Na) | 2351 | 207.843 | 262.716 | 144.818 | 80.140 | 246.693 | 131.310 | 126.008 | 136.772 |
Magnesium (Mg) | 2348 | 102.399 | 62.899 | 91.986 | 71.721 | 115.554 | 90.323 | 88.348 | 92.342 |
Potassium (K) | 2348 | 250.903 | 252.377 | 184.923 | 97.583 | 324.188 | 157.688 | 150.487 | 165.272 |
Calcium (Ca) | 2345 | 673.616 | 392.104 | 594.705 | 449.684 | 807.890 | 591.697 | 578.628 | 605.201 |
Aluminium (Al) | 2346 | 10.858 | 14.823 | 7.360 | 4.420 | 11.986 | 7.006 | 6.740 | 7.282 |
Vanadium (V) | 2352 | 0.075 | 0.060 | 0.072 | 0.072 | 0.072 | 0.071 | 0.070 | 0.072 |
Manganese (Mn) | 2348 | 0.946 | 1.902 | 0.408 | 0.208 | 0.912 | 0.444 | 0.440 | 0.461 |
Cobalt (Co) | 2348 | 0.024 | 0.035 | 0.019 | 0.019 | 0.019 | 0.020 | 0.020 | 0.021 |
Nickel (Ni) | 2348 | 19.332 | 59.069 | 0.704 | 0.203 | 6.342 | 1.260 | 1.146 | 1.386 |
Copper (Cu) | 2348 | 4.095 | 2.993 | 3.426 | 2.801 | 4.446 | 3.411 | 3.324 | 3.500 |
Zinc (Zn) | 2349 | 82.906 | 42.741 | 77.939 | 68.335 | 89.822 | 76.155 | 74.713 | 77.624 |
Silver (Ag) | 2349 | 0.034 | 0.141 | 0.019 | 0.019 | 0.019 | 0.021 | 0.021 | 0.021 |
Cadmium (Cd) | 2349 | 0.021 | 0.021 | 0.017 | 0.017 | 0.017 | 0.018 | 0.018 | 0.019 |
Tin (Sn) | 2347 | 0.114 | 0.207 | 0.059 | 0.031 | 0.122 | 0.063 | 0.060 | 0.065 |
Barium (Ba) | 2254 | 0.417 | 0.402 | 0.278 | 0.146 | 0.548 | 0.263 | 0.252 | 0.274 |
Lead (Pb) | 2350 | 0.267 | 0.608 | 0.129 | 0.068 | 0.244 | 0.133 | 0.127 | 0.129 |
Uranium (U) | 2350 | 0.029 | 0.102 | 0.012 | 0.012 | 0.012 | 0.015 | 0.015 | 0.016 |
Thorium (Th) | 2349 | 0.031 | 0.039 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.025 |
Iron (Fe) | 2348 | 19.193 | 39.112 | 11.109 | 6.972 | 18.134 | 11.186 | 10.757 | 11.633 |
Chromium (Cr) | 2347 | 0.602 | 1.068 | 0.281 | 0.153 | 0.626 | 0.313 | 0.300 | 0.327 |
Selenium (Se) | 2349 | 1.935 | 3.735 | 0.856 | 0.679 | 1.249 | 1.058 | 1.019 | 1.099 |
Arsenic (As) | 2350 | 0.090 | 0.202 | 0.061 | 0.023 | 0.095 | 0.059 | 0.057 | 0.061 |
Beryllium (Be) | 2351 | 0.029 | 0.003 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 |
Molybdenum (Mo) | 2347 | 0.055 | 0.017 | 0.054 | 0.054 | 0.054 | 0.054 | 0.054 | 0.055 |
Thallium (Tl) | 2351 | 0.018 | 0.001 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 |
Antimony (Sb) | 2349 | 0.034 | 0.041 | 0.027 | 0.027 | 0.027 | 0.029 | 0.029 | 0.030 |
Boron (B) | 2345 | 0.286 | 0.536 | 0.127 | 0.127 | 0.209 | 0.182 | 0.177 | 0.188 |
Metal . | N . | Mean (µg/g) . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Sodium (Na) | 2351 | 207.843 | 262.716 | 144.818 | 80.140 | 246.693 | 131.310 | 126.008 | 136.772 |
Magnesium (Mg) | 2348 | 102.399 | 62.899 | 91.986 | 71.721 | 115.554 | 90.323 | 88.348 | 92.342 |
Potassium (K) | 2348 | 250.903 | 252.377 | 184.923 | 97.583 | 324.188 | 157.688 | 150.487 | 165.272 |
Calcium (Ca) | 2345 | 673.616 | 392.104 | 594.705 | 449.684 | 807.890 | 591.697 | 578.628 | 605.201 |
Aluminium (Al) | 2346 | 10.858 | 14.823 | 7.360 | 4.420 | 11.986 | 7.006 | 6.740 | 7.282 |
Vanadium (V) | 2352 | 0.075 | 0.060 | 0.072 | 0.072 | 0.072 | 0.071 | 0.070 | 0.072 |
Manganese (Mn) | 2348 | 0.946 | 1.902 | 0.408 | 0.208 | 0.912 | 0.444 | 0.440 | 0.461 |
Cobalt (Co) | 2348 | 0.024 | 0.035 | 0.019 | 0.019 | 0.019 | 0.020 | 0.020 | 0.021 |
Nickel (Ni) | 2348 | 19.332 | 59.069 | 0.704 | 0.203 | 6.342 | 1.260 | 1.146 | 1.386 |
Copper (Cu) | 2348 | 4.095 | 2.993 | 3.426 | 2.801 | 4.446 | 3.411 | 3.324 | 3.500 |
Zinc (Zn) | 2349 | 82.906 | 42.741 | 77.939 | 68.335 | 89.822 | 76.155 | 74.713 | 77.624 |
Silver (Ag) | 2349 | 0.034 | 0.141 | 0.019 | 0.019 | 0.019 | 0.021 | 0.021 | 0.021 |
Cadmium (Cd) | 2349 | 0.021 | 0.021 | 0.017 | 0.017 | 0.017 | 0.018 | 0.018 | 0.019 |
Tin (Sn) | 2347 | 0.114 | 0.207 | 0.059 | 0.031 | 0.122 | 0.063 | 0.060 | 0.065 |
Barium (Ba) | 2254 | 0.417 | 0.402 | 0.278 | 0.146 | 0.548 | 0.263 | 0.252 | 0.274 |
Lead (Pb) | 2350 | 0.267 | 0.608 | 0.129 | 0.068 | 0.244 | 0.133 | 0.127 | 0.129 |
Uranium (U) | 2350 | 0.029 | 0.102 | 0.012 | 0.012 | 0.012 | 0.015 | 0.015 | 0.016 |
Thorium (Th) | 2349 | 0.031 | 0.039 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.025 |
Iron (Fe) | 2348 | 19.193 | 39.112 | 11.109 | 6.972 | 18.134 | 11.186 | 10.757 | 11.633 |
Chromium (Cr) | 2347 | 0.602 | 1.068 | 0.281 | 0.153 | 0.626 | 0.313 | 0.300 | 0.327 |
Selenium (Se) | 2349 | 1.935 | 3.735 | 0.856 | 0.679 | 1.249 | 1.058 | 1.019 | 1.099 |
Arsenic (As) | 2350 | 0.090 | 0.202 | 0.061 | 0.023 | 0.095 | 0.059 | 0.057 | 0.061 |
Beryllium (Be) | 2351 | 0.029 | 0.003 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 | 0.029 |
Molybdenum (Mo) | 2347 | 0.055 | 0.017 | 0.054 | 0.054 | 0.054 | 0.054 | 0.054 | 0.055 |
Thallium (Tl) | 2351 | 0.018 | 0.001 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 | 0.018 |
Antimony (Sb) | 2349 | 0.034 | 0.041 | 0.027 | 0.027 | 0.027 | 0.029 | 0.029 | 0.030 |
Boron (B) | 2345 | 0.286 | 0.536 | 0.127 | 0.127 | 0.209 | 0.182 | 0.177 | 0.188 |
aSee Supplementary material Table 4 (available as Supplementary data at IJE online).
SD, standard deviation; IQR, interquartile range; GM, geometric mean; CI, confidence interval.
Atlantic PATH is also the only regional CPTP cohort that collected water samples as part of a sub-study. There were 2929 water samples collected, most of which were obtained from the primary drinking water source of the household. The water samples were analysed to determine the distribution of metal contaminants across the samples (Table 9).
Metal . | n . | Mean µg/l . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Beryllium (Be)a | 2925 | 0.084 | 0.206 | 0.044 | 0.044 | 0.044 | 0.048 | 0.046 | 0.049 |
Boron (B) | 2927 | 33.2 | 92.0 | 11.2 | 6.0 | 24.3 | 11.6 | 10.9 | 12.2 |
Sodium (Na) | 2923 | 24471 | 36711 | 11553 | 6395 | 26480 | 11626 | 11026 | 12247 |
Magnesium (Mg) | 2925 | 3544 | 5523 | 1744 | 435 | 4259 | 848 | 776 | 926 |
Potassium (K) | 2921 | 1616 | 5178 | 848 | 383 | 1752 | 639 | 601 | 679 |
Calcium (Ca) | 2923 | 19261 | 24518 | 9755 | 3672 | 27664 | 4939 | 4510 | 5415 |
Aluminum (Al) | 2924 | 35.437 | 80.412 | 3.482 | 0.877 | 32.721 | 5.355 | 4.963 | 5.783 |
Vanadium (V) | 2924 | 0.647 | 1.799 | 0.190 | 0.142 | 0.414 | 0.242 | 0.231 | 0.254 |
Manganese (Mn) | 2922 | 55.612 | 201.633 | 5.32 | 0.947 | 19.786 | 4.442 | 4.055 | 4.865 |
Cobalt (Co) | 2923 | 1.058 | 3.293 | 0.055 | 0.036 | 0.187 | 0.106 | 0.099 | 0.114 |
Nickel (Ni) | 2927 | 1.228 | 3.303 | 0.594 | 0.271 | 1.246 | 0.475 | 0.449 | 0.503 |
Copper (Cu) | 2923 | 86.0 | 262.4 | 17.0 | 4.3 | 62.7 | 14.0 | 13.0 | 15.2 |
Zinc (Zn) | 2928 | 45.9 | 139.7 | 12.6 | 4.5 | 48.7 | 12.0 | 11.2 | 12.8 |
Molybdenuma (Mo) | 2925 | 1.062 | 3.443 | 0.079 | 0.079 | 0.462 | 0.197 | 0.186 | 0.208 |
Silvera (Ag) | 2921 | 0.056 | 0.066 | 0.048 | 0.048 | 0.048 | 0.044 | 0.043 | 0.045 |
Cadmiuma (Cd) | 2928 | 0.049 | 0.149 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.026 |
Tina (Sn) | 2926 | 0.128 | 0.775 | 0.046 | 0.046 | 0.046 | 0.054 | 0.053 | 0.056 |
Antimonya (Sb) | 2922 | 0.063 | 0.109 | 0.048 | 0.048 | 0.048 | 0.047 | 0.046 | 0.048 |
Barium (Ba) | 2926 | 49.4 | 93.8 | 10.0 | 3.3 | 57.6 | 7.6 | 7.0 | 8.4 |
Thalliuma (Tl) | 2924 | 0.023 | 0.027 | 0.021 | 0.021 | 0.021 | 0.018 | 0.018 | 0.019 |
Lead (Pb) | 2924 | 1.473 | 4.300 | 0.381 | 0.124 | 1.189 | 0.342 | 0.319 | 0.366 |
Uraniuma (U) | 2923 | 1.000 | 5.276 | 0.023 | 0.023 | 0.085 | 0.055 | 0.051 | 0.059 |
Thoriuma (Th) | 2927 | 0.349 | 0.939 | 0.047 | 0.047 | 0.092 | 0.086 | 0.082 | 0.090 |
Iron (Fe) | 2923 | 105.7 | 308.1 | 20.4 | 5.7 | 73.0 | 19.9 | 18.5 | 21.3 |
Chromium (Cr) | 2924 | 0.153 | 0.267 | 0.071 | 0.032 | 0.170 | 0.076 | 0.072 | 0.079 |
Arsenic (As) | 2924 | 2.564 | 9.008 | 0.310 | 0.122 | 1.331 | 0.372 | 0.346 | 0.401 |
Selenium (Se) | 2925 | 0.584 | 0.971 | 0.157 | 0.048 | 0.703 | 0.199 | 0.188 | 0.210 |
Metal . | n . | Mean µg/l . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Beryllium (Be)a | 2925 | 0.084 | 0.206 | 0.044 | 0.044 | 0.044 | 0.048 | 0.046 | 0.049 |
Boron (B) | 2927 | 33.2 | 92.0 | 11.2 | 6.0 | 24.3 | 11.6 | 10.9 | 12.2 |
Sodium (Na) | 2923 | 24471 | 36711 | 11553 | 6395 | 26480 | 11626 | 11026 | 12247 |
Magnesium (Mg) | 2925 | 3544 | 5523 | 1744 | 435 | 4259 | 848 | 776 | 926 |
Potassium (K) | 2921 | 1616 | 5178 | 848 | 383 | 1752 | 639 | 601 | 679 |
Calcium (Ca) | 2923 | 19261 | 24518 | 9755 | 3672 | 27664 | 4939 | 4510 | 5415 |
Aluminum (Al) | 2924 | 35.437 | 80.412 | 3.482 | 0.877 | 32.721 | 5.355 | 4.963 | 5.783 |
Vanadium (V) | 2924 | 0.647 | 1.799 | 0.190 | 0.142 | 0.414 | 0.242 | 0.231 | 0.254 |
Manganese (Mn) | 2922 | 55.612 | 201.633 | 5.32 | 0.947 | 19.786 | 4.442 | 4.055 | 4.865 |
Cobalt (Co) | 2923 | 1.058 | 3.293 | 0.055 | 0.036 | 0.187 | 0.106 | 0.099 | 0.114 |
Nickel (Ni) | 2927 | 1.228 | 3.303 | 0.594 | 0.271 | 1.246 | 0.475 | 0.449 | 0.503 |
Copper (Cu) | 2923 | 86.0 | 262.4 | 17.0 | 4.3 | 62.7 | 14.0 | 13.0 | 15.2 |
Zinc (Zn) | 2928 | 45.9 | 139.7 | 12.6 | 4.5 | 48.7 | 12.0 | 11.2 | 12.8 |
Molybdenuma (Mo) | 2925 | 1.062 | 3.443 | 0.079 | 0.079 | 0.462 | 0.197 | 0.186 | 0.208 |
Silvera (Ag) | 2921 | 0.056 | 0.066 | 0.048 | 0.048 | 0.048 | 0.044 | 0.043 | 0.045 |
Cadmiuma (Cd) | 2928 | 0.049 | 0.149 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.026 |
Tina (Sn) | 2926 | 0.128 | 0.775 | 0.046 | 0.046 | 0.046 | 0.054 | 0.053 | 0.056 |
Antimonya (Sb) | 2922 | 0.063 | 0.109 | 0.048 | 0.048 | 0.048 | 0.047 | 0.046 | 0.048 |
Barium (Ba) | 2926 | 49.4 | 93.8 | 10.0 | 3.3 | 57.6 | 7.6 | 7.0 | 8.4 |
Thalliuma (Tl) | 2924 | 0.023 | 0.027 | 0.021 | 0.021 | 0.021 | 0.018 | 0.018 | 0.019 |
Lead (Pb) | 2924 | 1.473 | 4.300 | 0.381 | 0.124 | 1.189 | 0.342 | 0.319 | 0.366 |
Uraniuma (U) | 2923 | 1.000 | 5.276 | 0.023 | 0.023 | 0.085 | 0.055 | 0.051 | 0.059 |
Thoriuma (Th) | 2927 | 0.349 | 0.939 | 0.047 | 0.047 | 0.092 | 0.086 | 0.082 | 0.090 |
Iron (Fe) | 2923 | 105.7 | 308.1 | 20.4 | 5.7 | 73.0 | 19.9 | 18.5 | 21.3 |
Chromium (Cr) | 2924 | 0.153 | 0.267 | 0.071 | 0.032 | 0.170 | 0.076 | 0.072 | 0.079 |
Arsenic (As) | 2924 | 2.564 | 9.008 | 0.310 | 0.122 | 1.331 | 0.372 | 0.346 | 0.401 |
Selenium (Se) | 2925 | 0.584 | 0.971 | 0.157 | 0.048 | 0.703 | 0.199 | 0.188 | 0.210 |
a > 50% of values are less than the minimum detection limits, respectively.
Metal . | n . | Mean µg/l . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Beryllium (Be)a | 2925 | 0.084 | 0.206 | 0.044 | 0.044 | 0.044 | 0.048 | 0.046 | 0.049 |
Boron (B) | 2927 | 33.2 | 92.0 | 11.2 | 6.0 | 24.3 | 11.6 | 10.9 | 12.2 |
Sodium (Na) | 2923 | 24471 | 36711 | 11553 | 6395 | 26480 | 11626 | 11026 | 12247 |
Magnesium (Mg) | 2925 | 3544 | 5523 | 1744 | 435 | 4259 | 848 | 776 | 926 |
Potassium (K) | 2921 | 1616 | 5178 | 848 | 383 | 1752 | 639 | 601 | 679 |
Calcium (Ca) | 2923 | 19261 | 24518 | 9755 | 3672 | 27664 | 4939 | 4510 | 5415 |
Aluminum (Al) | 2924 | 35.437 | 80.412 | 3.482 | 0.877 | 32.721 | 5.355 | 4.963 | 5.783 |
Vanadium (V) | 2924 | 0.647 | 1.799 | 0.190 | 0.142 | 0.414 | 0.242 | 0.231 | 0.254 |
Manganese (Mn) | 2922 | 55.612 | 201.633 | 5.32 | 0.947 | 19.786 | 4.442 | 4.055 | 4.865 |
Cobalt (Co) | 2923 | 1.058 | 3.293 | 0.055 | 0.036 | 0.187 | 0.106 | 0.099 | 0.114 |
Nickel (Ni) | 2927 | 1.228 | 3.303 | 0.594 | 0.271 | 1.246 | 0.475 | 0.449 | 0.503 |
Copper (Cu) | 2923 | 86.0 | 262.4 | 17.0 | 4.3 | 62.7 | 14.0 | 13.0 | 15.2 |
Zinc (Zn) | 2928 | 45.9 | 139.7 | 12.6 | 4.5 | 48.7 | 12.0 | 11.2 | 12.8 |
Molybdenuma (Mo) | 2925 | 1.062 | 3.443 | 0.079 | 0.079 | 0.462 | 0.197 | 0.186 | 0.208 |
Silvera (Ag) | 2921 | 0.056 | 0.066 | 0.048 | 0.048 | 0.048 | 0.044 | 0.043 | 0.045 |
Cadmiuma (Cd) | 2928 | 0.049 | 0.149 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.026 |
Tina (Sn) | 2926 | 0.128 | 0.775 | 0.046 | 0.046 | 0.046 | 0.054 | 0.053 | 0.056 |
Antimonya (Sb) | 2922 | 0.063 | 0.109 | 0.048 | 0.048 | 0.048 | 0.047 | 0.046 | 0.048 |
Barium (Ba) | 2926 | 49.4 | 93.8 | 10.0 | 3.3 | 57.6 | 7.6 | 7.0 | 8.4 |
Thalliuma (Tl) | 2924 | 0.023 | 0.027 | 0.021 | 0.021 | 0.021 | 0.018 | 0.018 | 0.019 |
Lead (Pb) | 2924 | 1.473 | 4.300 | 0.381 | 0.124 | 1.189 | 0.342 | 0.319 | 0.366 |
Uraniuma (U) | 2923 | 1.000 | 5.276 | 0.023 | 0.023 | 0.085 | 0.055 | 0.051 | 0.059 |
Thoriuma (Th) | 2927 | 0.349 | 0.939 | 0.047 | 0.047 | 0.092 | 0.086 | 0.082 | 0.090 |
Iron (Fe) | 2923 | 105.7 | 308.1 | 20.4 | 5.7 | 73.0 | 19.9 | 18.5 | 21.3 |
Chromium (Cr) | 2924 | 0.153 | 0.267 | 0.071 | 0.032 | 0.170 | 0.076 | 0.072 | 0.079 |
Arsenic (As) | 2924 | 2.564 | 9.008 | 0.310 | 0.122 | 1.331 | 0.372 | 0.346 | 0.401 |
Selenium (Se) | 2925 | 0.584 | 0.971 | 0.157 | 0.048 | 0.703 | 0.199 | 0.188 | 0.210 |
Metal . | n . | Mean µg/l . | SD . | Median . | IQR . | GM . | 95% CI . | ||
---|---|---|---|---|---|---|---|---|---|
Beryllium (Be)a | 2925 | 0.084 | 0.206 | 0.044 | 0.044 | 0.044 | 0.048 | 0.046 | 0.049 |
Boron (B) | 2927 | 33.2 | 92.0 | 11.2 | 6.0 | 24.3 | 11.6 | 10.9 | 12.2 |
Sodium (Na) | 2923 | 24471 | 36711 | 11553 | 6395 | 26480 | 11626 | 11026 | 12247 |
Magnesium (Mg) | 2925 | 3544 | 5523 | 1744 | 435 | 4259 | 848 | 776 | 926 |
Potassium (K) | 2921 | 1616 | 5178 | 848 | 383 | 1752 | 639 | 601 | 679 |
Calcium (Ca) | 2923 | 19261 | 24518 | 9755 | 3672 | 27664 | 4939 | 4510 | 5415 |
Aluminum (Al) | 2924 | 35.437 | 80.412 | 3.482 | 0.877 | 32.721 | 5.355 | 4.963 | 5.783 |
Vanadium (V) | 2924 | 0.647 | 1.799 | 0.190 | 0.142 | 0.414 | 0.242 | 0.231 | 0.254 |
Manganese (Mn) | 2922 | 55.612 | 201.633 | 5.32 | 0.947 | 19.786 | 4.442 | 4.055 | 4.865 |
Cobalt (Co) | 2923 | 1.058 | 3.293 | 0.055 | 0.036 | 0.187 | 0.106 | 0.099 | 0.114 |
Nickel (Ni) | 2927 | 1.228 | 3.303 | 0.594 | 0.271 | 1.246 | 0.475 | 0.449 | 0.503 |
Copper (Cu) | 2923 | 86.0 | 262.4 | 17.0 | 4.3 | 62.7 | 14.0 | 13.0 | 15.2 |
Zinc (Zn) | 2928 | 45.9 | 139.7 | 12.6 | 4.5 | 48.7 | 12.0 | 11.2 | 12.8 |
Molybdenuma (Mo) | 2925 | 1.062 | 3.443 | 0.079 | 0.079 | 0.462 | 0.197 | 0.186 | 0.208 |
Silvera (Ag) | 2921 | 0.056 | 0.066 | 0.048 | 0.048 | 0.048 | 0.044 | 0.043 | 0.045 |
Cadmiuma (Cd) | 2928 | 0.049 | 0.149 | 0.022 | 0.022 | 0.022 | 0.025 | 0.024 | 0.026 |
Tina (Sn) | 2926 | 0.128 | 0.775 | 0.046 | 0.046 | 0.046 | 0.054 | 0.053 | 0.056 |
Antimonya (Sb) | 2922 | 0.063 | 0.109 | 0.048 | 0.048 | 0.048 | 0.047 | 0.046 | 0.048 |
Barium (Ba) | 2926 | 49.4 | 93.8 | 10.0 | 3.3 | 57.6 | 7.6 | 7.0 | 8.4 |
Thalliuma (Tl) | 2924 | 0.023 | 0.027 | 0.021 | 0.021 | 0.021 | 0.018 | 0.018 | 0.019 |
Lead (Pb) | 2924 | 1.473 | 4.300 | 0.381 | 0.124 | 1.189 | 0.342 | 0.319 | 0.366 |
Uraniuma (U) | 2923 | 1.000 | 5.276 | 0.023 | 0.023 | 0.085 | 0.055 | 0.051 | 0.059 |
Thoriuma (Th) | 2927 | 0.349 | 0.939 | 0.047 | 0.047 | 0.092 | 0.086 | 0.082 | 0.090 |
Iron (Fe) | 2923 | 105.7 | 308.1 | 20.4 | 5.7 | 73.0 | 19.9 | 18.5 | 21.3 |
Chromium (Cr) | 2924 | 0.153 | 0.267 | 0.071 | 0.032 | 0.170 | 0.076 | 0.072 | 0.079 |
Arsenic (As) | 2924 | 2.564 | 9.008 | 0.310 | 0.122 | 1.331 | 0.372 | 0.346 | 0.401 |
Selenium (Se) | 2925 | 0.584 | 0.971 | 0.157 | 0.048 | 0.703 | 0.199 | 0.188 | 0.210 |
a > 50% of values are less than the minimum detection limits, respectively.
What are the main strengths and weaknesses?
The harmonization of the five regional cohorts of the CPTP is grounded in the potential to analyse the interaction between genetic, lifestyle and environmental factors that result in the development of cancer and other chronic diseases, in a large and diverse sample of the Canadian population. It offers researchers unprecedented access to data and biological samples from over 300 000 participants across Canada.1 Each of the CPTP cohorts is also encouraged to include data sources that are unique to their region. The Atlantic PATH study included an additional survey with questions relevant to the Atlantic Provinces, as well as being the only region to collect drinking water samples and toenail clippings.
One of the core strengths of the Atlantic PATH study lies in the number of participants, with over 30 000 people recruited across four Canadian provinces. It is also apparent in the commitment of participants to be followed over a 30-year period, to allow data linkage access to their provincial health records and to allow Canadian and international researchers to use their data and biological samples for future health research projects. Atlantic Canada is a diverse and unique region, which frequently reports some of the highest rates of common chronic diseases in Canada, and therefore provides an ideal environment to study the determinants of cancer and other chronic diseases.
Despite efforts to achieve regional representativeness, the participants may not be entirely representative of the general population as the majority are females, aged 50+.
Can I get hold of the data? Where can I find out more?
Atlantic PATH participants consented to the use of their data by Canadian and international researchers, and a research platform has been designed specifically for this purpose. The data and biological samples collected as part of the study are available to the academic research community through a formal application process. Researchers must have ethics approval and complete a data access application which will be reviewed by a Data Access Committee. Complete information about the application process can be found on the study website [www.atlanticpath.ca]. Researchers interested in obtaining data and biological samples from more than one CPTP region can apply through the national CPTP Portal [https://portal.partnershipfortomorrow.ca]. Additional information can be obtained by contacting Atlantic PATH [info@atlanticpath.ca].
The Atlantic PATH study is a 30-year prospective cohort study investigating the genetic, environmental and lifestyle factors that contribute to cancer and other chronic disease outcomes.
Atlantic PATH began in 2009 as part of the Canadian Partnership for Tomorrow Project which involves five cohorts across the country.
Atlantic PATH participants include a total of 31 173 people aged 35–69 from Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland and Labrador.
The data includes questionnaires, physical measures, biological samples and data linkage available via provincial government administrative databases.
A follow-up questionnaire was implemented in the fall of 2016.
Data are available for use by health researchers. Additional information can be obtained by contacting [info@atlanticpath.ca].
Supplementary Data
Supplementary data are available at IJE online.
Funding
Production of this study has been made possible through financial support from the Canadian Partnership Against Cancer and by Health Canada, as well as through support from a grant from the Canadian Cancer Society (grant #19989). The views expressed herein represent the views of the authors and do not necessarily represent the views of Health Canada.
Acknowledgements
We would like to thank the Atlantic PATH participants who donated their time, personal health history and biological samples to this project. We would also like to thank the Atlantic PATH team members for data collection and management.
Conflict of interest: The authors have no conflicts of interest to declare.