Whole-body MR vascular screening detects unsuspected concomitant vascular disease in coronary heart disease patients.

Coronary heart disease (CHD) patients often show atherosclerotic vascular disease in other vascular territories. We evaluated how often whole-body MR imaging detects concomitant arterial pathologies in CHD patients, and how often these pathologies were not known to the patients previously. Of 4,814 participants in the population-based Heinz Nixdorf Recall Study, 327 reported CHD (i.e., previous coronary bypass surgery, angioplasty); of those, 160 patients (mean age 66.4 years) were examined using MR of the brain, the heart (excluding the coronary arteries), and whole-body MR angiography. The prevalence of each vascular pathology was assessed, correlated to the others and compared to patients' histories. Of the 160 CHD patients, 16 (10%) showed MR signs of stroke, and 77 (48.1%) had a stenosis >50% in at least one extracerebral peripheral artery (other than the coronaries), including 28 (17.5%) with relevant renal artery stenoses, and 20 (12.5%) with relevant extracerebral internal carotid artery stenoses. False negative histories were reported in 12 of 81 cases with myocardial infarctions, and in 11 of 16 cases with cerebrovascular infarctions. This whole-body atherosclerosis MR screening program allows previously unknown concomitant vascular disease to be detected in coronary heart disease patients. Its prospective value should be assessed in further studies.

Assessing contamination paths of the German adult population with gold and platinum. The German Environmental Survey 1998 (GerES III).

BACKGROUND: Even though increased environmental platinum levels were found since the introduction of automobile catalytic converters, little is known about the pathways of corporal uptake and the bioavailability of platinum in the general adult population. The aim of this study is to identify and quantify the main exposure pathways of gold and platinum in the general adult population. METHODS: The German Environmental Survey 1998 (GerES III) collected population-based data on the corporal gold and platinum burden from a large sample of 1080 persons, 18-69 years of age. Urinary metal concentration was analysed by SF-ICP-MS. Exposure data were assessed by standardized questionnaires. Data were log transformed and analysed using multiple linear regression analysis with respect to exposure variables. RESULTS: The R2 of the linear regression model of urinary gold and platinum (ng/l) burden is 0.349 and 0.235, respectively. In both models, the number of teeth with noble metal dental alloy restorations (NMDAR) is the most important exposure pathway. One versus no tooth with NMDAR is associated with an increase of 23.7% in urinary gold and 35.6% in platinum concentration. Chewing gum intensifies the release of gold and platinum from NMDAR: every additional day per week when gum is chewed is associated with an increased gold (5.6%) and platinum (6.9%) burden. Furthermore, elevated urinary gold and platinum concentrations were found for higher creatinine concentrations, more frequent coffee consumption and for people from the upper social class. Gold burden is also increased in people with arthritis. Platinum burden is also increased in people living in western or northern Germany. Traffic-related variables had no significant effect on platinum burden.

Carpenters, cabinetmakers, and risk of testicular germ cell cancer.

OBJECTIVE: A recent cohort study showed an increased risk of testicular cancer among members of the United Brotherhood of Carpenters and Joiners of America. We explored our data of a German population-based case-control study on the etiology of testicular cancer with regard to this association. METHODS: The case-control study included 269 testicular cancer cases and 797 controls. We applied conditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95% CIs). RESULTS: People who worked as cabinetmakers or carpenters had an OR of 0.84 (95% CI = 0.45-1.56). Risks were increased among cabinetmakers who worked at least 15 years ago (OR = 5.81, 95% CI = 1.20-28.09). Ever being employed as a carpenter was associated with a reduced OR of 0.59 (95% CI = 0.24-1.46). CONCLUSIONS: Cabinetmakers may be at an increased risk of testicular cancer.

Residential exposure to overhead high-voltage lines and the risk of testicular cancer: results of a population-based case-control study in Hamburg (Germany).

BACKGROUND: In a population-based case-control study we examined the association between residential exposure to overhead high-voltage lines and testicular cancer. METHODS: We recorded the residential biography of cases with testicular cancer identified by the Hamburg Cancer Registry and of controls that were randomly selected from the mandatory registry of residents in Hamburg. The study included 145 incident cases between 15 and 69 years of age, diagnosed between 1995 and 1997, and 313 controls, matched for age in 5-year strata. In model A, exposure was defined by distance (ever vs never). Model B took into account residence time and the inverse distance from the nearest high-voltage line. It distinguished between low and high exposure, the never exposed persons serving as a reference group. Odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were calculated by unconditional logistic regression. For men below the age of 40 years and men aged 40 years and over separate analyses were carried out. RESULTS: Within a corridor of 100 m the prevalence of exposure to high-voltage lines in Hamburg was 6.9% in cases and 5.8% in controls (OR=1.3; 95% CI=0.56-2.80). In the more complex model B we found an OR of 1.2 (95% CI=0.60-2.47) for low exposure and 1.7 (95% CI=0.91-3.32) for high exposure. Younger men show slightly increased risks in both models. CONCLUSIONS: In all, residential exposure to high-voltage lines did not seem to be a major risk factor for testicular cancer in our study. Yet, the fact that risks for men below the age of 40 years were slightly increased in both exposure models deserves further attention.

Testicular, other genital, and breast cancers in first-degree relatives of testicular cancer patients and controls.

Previous studies showed an increased prevalence of testicular cancer among fathers and brothers of testicular cancer patients. We examined whether testicular, other genital, and breast cancers aggregate in parents and siblings of testicular cancer patients in a population-based case-control study, including males, ages 15 to 69 years at diagnosis, with primary malignant tumors of the testes or extragonadal germ cell tumors. Controls were ascertained through the mandatory registries of residents and frequency matched to the cases by age and region of residence. In a face-to-face interview, 269 cases and 797 controls provided health-related information on parents and siblings. We calculated odds ratios (OR) and corresponding 95% confidence intervals (95% CI) based on the generalized estimating equations technique, adjusting for the matching variables and relatives' age. Three (1.1%) fathers and eight (3.2%) brothers of cases were affected with testicular cancer compared with four (0.5%) fathers and two (0.2%) brothers of controls. The OR (95% CI) of familial testicular cancer was 6.6 (2.35-18.77). Only nonseminoma patients had fathers with testicular cancer, whereas the affected brothers were all related to seminoma patients. Overall, we found an increased risk for genital other than testicular cancers (OR 2.5, 95% CI 1.43-4.43). For breast cancer, we detected an increased risk in sisters (OR 9.5, 95% CI 2.01-45.16, adjusted for age of study participant and age of sister) but not in mothers. Our findings support the hypothesis that testicular and other genital cancers have a common familial component that may be due to genetic and shared exogenous factors such as estrogen exposure during fetal development.

Occupation as a risk factor for uveal melanoma in Germany.

OBJECTIVE: This study explored occupational risks linked to uveal melanoma. METHODS: The analysis pooled data from two case-referent studies (hospital- and population-based) conducted in Germany between 1995 and 1998, with incident cases matched with several referents by age, gender, and region of residence. The subjects were contacted through personal or telephone interviews. Their exposure status was based on their occupational history. Dichotomous coding for the main task and categorization into different occupational classification systems was performed. Altogether of 118 cases and 475 referents were included. Adjusted odds ratios were calculated by conditional logistic regression. RESULTS: Relevant occupations included food, beverage, and tobacco processors [odds ratio (OR) 4.7, 95% confidence interval (95% CI) 0.99-22.0] and miners (OR 2.3, 95% CI 0.92-5.99) among the men and station, engine and heavy equipment operators and freight handlers (OR 2.5, 95% CI 0.94-6.58) and medical, dental, pharmaceutical and veterinary workers (OR 2.1, 95% CI 0.71-6.02) among the women according to the International Standard Classification of Occupations, whereas, according to the European Industrial Classification, the relevant occupations were the food industry (OR 3.4, 95% CI 1.08-10.5) and the chemical and pharmaceutical industry (OR 2.8, 95% CI 1.01-7.78) among the men and machine production (OR 3.2, 95% CI 0.96-10.7) and health and veterinary sector (OR 2.4, 95% CI 0.97-5.71) among the women. CONCLUSIONS: These analyses support the potential role of occupational exposure as a risk factor for uveal melanoma. The findings must be interpreted carefully since the exposure was assessed indirectly.

Pet birds and risk of lung cancer in North-Western Germany.

In a case-control study on lung cancer and occupational exposures, a subgroup of 144 cases and 253 population-based controls interviewed in the last 16 months of the study, were additionally asked about their exposure to pet birds and other pets. We used the same questionnaire as a previous German study that found a positive association between pet bird keeping and lung cancer. Odds ratios were calculated for lifetime and adulthood exposure respectively. The adjusted odds ratio for ever keeping pet birds was 0.85 (95% CI: 0.53-1.35), and 0.87 (95% CI: 0.56-1.36) for adulthood exposure. There was no evidence of a trend for increasing lung cancer risk with duration of pet bird keeping. With decreasing age at diagnosis, an apparent risk emerged, yielding an odds ratio of 7.62 (95% CI: 2.15-26.95) for ever versus never in the youngest age group (< or =55 years). This odds ratio was reduced to 3.82 (95% CI: 0.98-14.92) after adjustment for smoking and was only 1.39 (95% CI: 0.49-3.95) for adulthood exposure. In general, our results indicate that pet bird keeping does not seem to increase the risk of lung cancer. The divergent findings at younger ages may be explained by age-related recall bias, but should be investigated in future studies.

Testicular cancer and electromagnetic fields (EMF) in the workplace: results of a population-based case-control study in Germany.

OBJECTIVES: In a population-based case-control study, we examined the association of testicular cancer and electromagnetic fields (EMF) in the workplace. METHODS: Incident cases (n = 269) were recruited between 1995 and 1997. A total of 797 controls matched on age and region were randomly selected from mandatory registries of residents. EMF exposure was assessed for five categories in standardized face-to-face interviews using closed questions. For each exposure category, odds ratios (OR) were calculated, stratified by age and region, and in a more complex model weighted by duration and distance using conditional logistic regression. Subgroup analyses were conducted for seminoma and non-seminoma and for blue- and white-collar workers. Additionally, potential radar exposure was individually assessed by experts based on all available information including free text. RESULTS: There was no excess risk for cases who reported to have ever worked near the following: radar units (OR = 1.0; 95% CI = 0.60-1.75); radiofrequency emitters (OR = 0.9; 95% CI = 0.60-1.24); electrical machines (OR = 1.0; 95% CI = 0.72-1.33): high-voltage lines or high-voltage electrical transmission installations (OR = 0.7; 95% CI = 0.38-1.18); or visual display units or complex electrical environments (OR = 0.9; 95% CI = 0.67-1.21). The results for the weighted exposure and subgroup analyses did not differ substantially. For radar exposure as assessed by the experts, the OR was 0.4 (95% CI = 0.13-1.16). CONCLUSIONS: EMF exposure in the workplace does not seem to be a relevant risk factor for testicular cancer in our study.