RESUMEN
We investigated the association of allergic diseases and epilepsy with risk of brain tumours, in Interphone, a 13-country case-control study. Data were obtained from 2693 glioma cases, 2396 meningioma cases, and 1102 acoustic neuroma cases and their 6321 controls. Conditional logistic regression models were used to estimate pooled odds ratios (ORs) and their respective 95% confidence intervals (CIs), adjusted for education and time at interview. Reduced ORs were observed for glioma in relation to physician-diagnosed asthma (OR = 0.73; CI 0.58-0.92), hay fever (OR 0.72; CI 0.61-0.86), and eczema (OR 0.78, CI 0.64-0.94), but not for meningioma or acoustic neuroma. Previous diagnosis of epilepsy was associated with an increased OR for glioma (2.94; CI 1.87-4.63) and for meningioma (2.12; CI 1.27-3.56), but not for acoustic neuroma. This large-scale case-control study adds to the growing evidence that people with allergies have a lower risk of developing glioma, but not meningioma or acoustic neuroma. It also supports clinical observations of epilepsy prior to the diagnosis of glioma and meningioma.
Asunto(s)
Neoplasias Encefálicas , Epilepsia , Glioma , Hipersensibilidad , Neoplasias Meníngeas , Meningioma , Neuroma Acústico , Neoplasias Encefálicas/epidemiología , Estudios de Casos y Controles , Epilepsia/complicaciones , Glioma/epidemiología , Humanos , Hipersensibilidad/complicaciones , Hipersensibilidad/epidemiología , Neoplasias Meníngeas/complicaciones , Neoplasias Meníngeas/epidemiología , Meningioma/complicaciones , Meningioma/epidemiología , Neuroma Acústico/complicaciones , Neuroma Acústico/epidemiología , Factores de RiesgoRESUMEN
OBJECTIVES: To validate self-reported occupational loud noise exposure against expert evaluation of noise levels in a French case-control study on acoustic neuroma and to estimate the impact of exposure misclassification on risk estimation. METHODS: Noise levels were evaluated in 1006 jobs held by 111 cases and 217 population controls by an expert. Case-control differences in self-reporting were analyzed with logistic models. Sensitivity, specificity, positive and negative predictive values, and observed agreement of the self-reports were computed relative to the expert evaluation. They were used to calibrate the odds ratio (OR) between lifetime ever occupational loud noise exposure and the risk of acoustic neuroma, without adjustment for measurement error of the expert assessments. RESULTS: Cases reported noise levels in individual jobs closer to the expert assessment than controls, but the case-control difference was small for lifetime exposures. For expert-rated exposure of 80 dB(A), reporting of individual jobs by cases was more sensitive (54% in cases, 37% in controls), whereas specificity (91% in cases, 93% in controls) and observed agreement (82% in cases, 81% in controls) were similar. When lifetime exposure was considered, sensitivity increased (76% in cases, 65% in controls), while cases specificity decreased (84%). When these values were used to calibrate self-reports for exposure misclassification compared to expert evaluation at 80 dB(A), the crude OR of 1.7 was reduced to 1.3. CONCLUSIONS: Despite the relatively accurate reporting of loud noise, the impact of the calibration on the OR was non-negligible.
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Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Exposición Profesional/análisis , Autoinforme/normas , Adulto , Estudios de Casos y Controles , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Neuroma Acústico/epidemiología , Exposición Profesional/estadística & datos numéricosRESUMEN
BACKGROUND: Little is known about occupational risk factors for meningioma. OBJECTIVES: To study whether risk of meningioma is associated with several occupational exposures, including selected combustion products, dusts and other chemical agents. METHODS: The INTEROCC study was an international case-control study of brain cancer conducted in seven countries. Data collection by interview included lifetime occupational histories. A job exposure matrix was used to derive estimates of exposure for the 12 agents. ORs for ever versus never exposed and for exposure-response using duration of exposure and cumulative exposure were derived using conditional logistic regression stratified by sex, age group, country/region, adjusted for education. RESULTS: These analyses included 1906 cases and 5565 controls. For 11 of the 12 agents, no excess risk was found for ever exposed. For ever exposure to oil mists, an elevated OR of 1.57 (95% CI 1.10 to 2.22, 51 exposed cases) was found. Statistically significant exposure-response relationships were observed with cumulative exposure (p=0.01) and duration of exposure (p=0.04). Among women, there were also significant trends for cumulative and duration of exposure to asbestos and excesses in the highest exposure categories for formaldehyde. CONCLUSIONS: Most agents examined did not provoke excess risks of meningioma. The main finding from this study is that it is the first study to identify a statistical association between exposure to oil mists and meningioma. This may be a chance finding or could be due to confounding with iron exposure and further research is required to understand whether the relationship is causal.
Asunto(s)
Neoplasias Encefálicas/etiología , Polvo , Meningioma/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Aceites/efectos adversos , Humo , Adulto , Anciano , Amianto/efectos adversos , Estudios de Casos y Controles , Femenino , Formaldehído/efectos adversos , Humanos , Modelos Logísticos , Masculino , Neoplasias Meníngeas , Persona de Mediana Edad , Oportunidad Relativa , Factores de Riesgo , Factores Sexuales , Encuestas y CuestionariosRESUMEN
BACKGROUND: The aetiology of glioma remains largely unknown. Occupational solvent exposure has been suggested as a putative cause of glioma, but past studies have been inconsistent. We examined the association between a range of solvents and glioma risk within the INTEROCC project, a study of brain tumours and occupational exposures based on data from seven national case-control studies conducted in the framework of the INTERPHONE study. We also investigated associations according to tumour grade. METHODS: Data from the seven countries were standardised and then combined into one aggregate data set. Pooled odds ratios (ORs) were estimated for adjusted models that included sex, age, country-region of residence and level of educational attainment. Exposures to any solvent or 11 specific solvents or subgroups were assessed using a modified version of the FINJEM job exposure matrix (JEM) specifically developed for the study, called INTEROCC-JEM. RESULTS: Analysis included 2000 glioma cases and 5565 controls. For glioma and ever/never exposure to any solvent, the OR was 0.91 (95% confidence interval: 0.74-1.11). All ORs were <1.0 for specific solvents/subgroups. There were no increases in risk according to high or low grade of tumour. CONCLUSIONS: The results of this study show no consistent associations for any solvent exposures overall or by grade of tumour.
Asunto(s)
Neoplasias Encefálicas/epidemiología , Glioma/epidemiología , Exposición Profesional/estadística & datos numéricos , Solventes , Adolescente , Adulto , Factores de Edad , Anciano , Australia/epidemiología , Neoplasias Encefálicas/patología , Canadá/epidemiología , Estudios de Casos y Controles , Femenino , Francia/epidemiología , Alemania/epidemiología , Glioma/patología , Humanos , Israel/epidemiología , Masculino , Persona de Mediana Edad , Clasificación del Tumor , Nueva Zelanda/epidemiología , Oportunidad Relativa , Factores de Riesgo , Factores Sexuales , Reino Unido/epidemiología , Adulto JovenRESUMEN
OBJECTIVES: In absence of clear evidence regarding possible effects of occupational chemical exposures on brain tumour aetiology, it is worthwhile to explore the hypothesis that such exposures might act on brain tumour risk in interaction with occupational exposure to extremely low frequency magnetic fields (ELF). METHODS: INTEROCC is a seven-country (Australia, Canada, France, Germany, Israel, New Zealand and UK), population-based, case-control study, based on the larger INTERPHONE study. Incident cases of primary glioma and meningioma were ascertained from 2000 to 2004. Job titles were coded into standard international occupational classifications and estimates of ELF and chemical exposures were assigned based on job-exposure matrices. Dichotomous indicators of cumulative ELF (≥50th vs <50th percentile, 1-4 year exposure time window) and chemical exposures (ever vs never, 5-year lag) were created. Interaction was assessed on both the additive and multiplicative scales. RESULTS: A total of 1939 glioma cases, 1822 meningioma cases and 5404 controls were included in the analysis, using conditional logistic regression. There was no clear evidence for interactions between ELF and any of the chemical exposures assessed for either glioma or meningioma risk. For glioma, subjects in the low ELF/metal exposed group had a lower risk than would be predicted from marginal effects. Results were similar according to different exposure time windows, to cut-points of exposure or in exposed-only analyses. CONCLUSIONS: There was no clear evidence for interactions between occupational ELF and chemical exposures in relation to glioma or meningioma risk observed. Further research with more refined estimates of occupational exposures is recommended.
Asunto(s)
Neoplasias Encefálicas/etiología , Campos Electromagnéticos/efectos adversos , Glioma/etiología , Meningioma/etiología , Enfermedades Profesionales/etiología , Exposición Profesional/efectos adversos , Adulto , Anciano , Australasia , Neoplasias Encefálicas/inducido químicamente , Canadá , Estudios de Casos y Controles , Europa (Continente) , Femenino , Glioma/inducido químicamente , Humanos , Israel , Modelos Logísticos , Campos Magnéticos , Masculino , Neoplasias Meníngeas/inducido químicamente , Neoplasias Meníngeas/etiología , Meningioma/inducido químicamente , Persona de Mediana Edad , Enfermedades Profesionales/inducido químicamente , Factores de RiesgoRESUMEN
BACKGROUND: Brain tumor etiology is poorly understood. Based on their ability to pass through the blood-brain barrier, it has been hypothesized that exposure to metals may increase the risk of brain cancer. Results from the few epidemiological studies on this issue are limited and inconsistent. METHODS: We investigated the relationship between glioma risk and occupational exposure to five metals - lead, cadmium, nickel, chromium and iron- as well as to welding fumes, using data from the seven-country INTEROCC study. A total of 1800 incident glioma cases and 5160 controls aged 30-69 years were included in the analysis. Lifetime occupational exposure to the agents was assessed using the INTEROCC JEM, a modified version of the Finnish job exposure matrix FINJEM. RESULTS: In general, cases had a slightly higher prevalence of exposure to the various metals and welding fumes than did controls, with the prevalence among ever exposed ranging between 1.7 and 2.2% for cadmium to 10.2 and 13.6% for iron among controls and cases, respectively. However, in multivariable logistic regression analyses, there was no association between ever exposure to any of the agents and risk of glioma with odds ratios (95% confidence intervals) ranging from 0.8 (0.7-1.0) for lead to 1.1 (0.7-1.6) for cadmium. Results were consistent across models considering cumulative exposure or duration, as well as in all sensitivity analyses conducted. CONCLUSIONS: Findings from this large-scale international study provide no evidence for an association between occupational exposure to any of the metals under scrutiny or welding fumes, and risk of glioma.
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Contaminantes Ocupacionales del Aire/toxicidad , Gases/toxicidad , Glioma/epidemiología , Metales Pesados/toxicidad , Enfermedades Profesionales/epidemiología , Exposición Profesional , Soldadura , Glioma/inducido químicamente , Enfermedades Profesionales/inducido químicamente , RiesgoRESUMEN
The aim of the study was to examine associations between occupational exposure to metals and meningioma risk in the international INTEROCC study. INTEROCC is a seven-country population-based case-control study including 1906 adult meningioma cases and 5565 population controls. Incident cases were recruited between 2000 and 2004. A detailed occupational history was completed and job titles were coded into standard international occupational classifications. Estimates of mean workday exposure to individual metals and to welding fumes were assigned based on a job-exposure-matrix. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated using conditional logistic regression. Although more controls than cases were ever exposed to metals (14 vs. 11 %, respectively), cases had higher median cumulative exposure levels. The ORs for ever vs. never exposure to any metal and to individual metals were mostly greater than 1.0, with the strongest association for exposure to iron (OR 1.26, 95 % CI 1.0-1.58). In women, an increased OR of 1.70 (95 % CI 1.0-2.89) was seen for ever vs never exposure to iron (OR in men 1.19, 95 % CI 0.91-1.54), with positive trends in relation with both cumulative and duration of exposure. These results remained after consideration of other occupational metal or chemical co-exposures. In conclusion, an apparent positive association between occupational exposure to iron and meningioma risk was observed, particularly among women. Considering the fact that meningioma is a hormone dependent tumor, the hypothesis that an interaction between iron and estrogen metabolism may be a potential mechanism for a carcinogenic effect of iron should be further investigated.
Asunto(s)
Neoplasias Meníngeas/epidemiología , Neoplasias Meníngeas/etiología , Meningioma/epidemiología , Meningioma/etiología , Metales/toxicidad , Exposición Profesional/efectos adversos , Adolescente , Adulto , Distribución por Edad , Anciano , Estudios de Casos y Controles , Femenino , Humanos , Cooperación Internacional , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
OBJECTIVE: To examine associations between occupational exposure to selected organic solvents and meningioma. METHODOLOGY: A multicentre case-control study conducted in seven countries, including 1906 cases and 5565 controls. Occupational exposure to selected classes of organic solvents (aliphatic and alicyclic hydrocarbons, aromatic hydrocarbons, chlorinated hydrocarbons and 'other' organic solvents) or seven specific solvents (benzene, toluene, trichloroethylene, perchloroethylene, 1,1,1-trichloroethylene, methylene chloride and gasoline) was assessed using lifetime occupational histories and a modified version of the FINJEM job-exposure matrix (INTEROCC-JEM). Study participants were classified as 'exposed' when they had worked in an occupation for at least 1 year, with a 5-year lag, in which the estimated prevalence of exposure was 25% or greater in the INTEROCC-JEM. Associations between meningioma and each of the solvent exposures were estimated using conditional logistic regression, adjusting for potential confounders. RESULTS: A total of 6.5% of study participants were ever exposed to 'any' solvent, with a somewhat greater proportion of controls (7%) ever exposed compared with cases (5%), but only one case was ever exposed to any chlorinated hydrocarbon (1,1,1-trichloroethane). No association was observed between any of the organic solvents and meningioma, in either men or women, and no dose-response relationships were observed in internal analyses using either exposure duration or cumulative exposure. DISCUSSION: We found no evidence that occupational exposure to these organic solvents is associated with meningioma.
Asunto(s)
Neoplasias Meníngeas , Meningioma , Enfermedades Profesionales , Exposición Profesional , Solventes , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Modelos Logísticos , Masculino , Neoplasias Meníngeas/inducido químicamente , Meningioma/inducido químicamente , Persona de Mediana Edad , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Solventes/efectos adversos , Adulto JovenRESUMEN
BACKGROUND: Good sleep quality is essential for recovery. The risk factors of sleep disorders have been extensively investigated, but there is sparse information on the association of socioeconomic factors with a person's sleep quality. The aim of the present analysis is to investigate this association, taking particularly the effect of health confounders into consideration. METHODS: The data were extracted from the cross-sectional QUEBEB Study. In total, the study sample consisted of 3281 participants (1817 women and 1464 men, aged 16-72 years). Here socioeconomic status (SES) was collected from the baseline survey taken in 2004. Sleep quality for the same participants was measured with in-depth personal interviews in 2006 using the Pittsburgh Sleep Quality Index, together with other relevant characteristics (e.g. anxiety, depression and health status). Multiple logistic regression analyses were performed. RESULTS: People living in an urban environment with a high or medium SES have a greater probability of good sleep quality (odds ratio 1.65, 95% confidence interval 1.27-2.14; odds ratio 1.40, 95% confidence interval 1.16-1.69) than persons with a low SES. Anxiety and depression, but also health status, are also associated with sleep quality and can influence in part the socioeconomic levels seen in sleep quality. CONCLUSION: SES and sleep quality are associated. However, there are important additional determinants that influence the level of association between SES and sleep quality. Several factors, such as anxiety, depression and health status, are associated with poorer sleep quality, but at the same time, these factors occur more often within lower social classes.
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Trastornos del Sueño-Vigilia/epidemiología , Clase Social , Adolescente , Adulto , Anciano , Estudios Transversales , Femenino , Alemania/epidemiología , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Socioeconómicos , Encuestas y Cuestionarios , Población UrbanaRESUMEN
BACKGROUND: The aim was to investigate possible associations between glioma (an aggressive type of brain cancer) and occupational exposure to selected agents: combustion products (diesel and gasoline exhaust emissions, benzo(a)pyrene), dusts (animal dust, asbestos, crystalline silica, wood dust) and some other chemical agents (formaldehyde, oil mist, sulphur dioxide). METHODS: The INTEROCC study included cases diagnosed with glioma during 2000-2004 in sub-regions of seven countries. Population controls, selected from various sampling frames in different centers, were frequency or individually matched to cases by sex, age and center. Face-to-face interviews with the subject or a proxy respondent were conducted by trained interviewers. Detailed information was collected on socio-economic and lifestyle characteristics, medical history and work history. Occupational exposure to the 10 selected agents was assessed by a job exposure matrix (JEM) which provides estimates of the probability and level of exposure for different occupations. Using a 25% probability of exposure in a given occupation in the JEM as the threshold for considering a worker exposed, the lifetime prevalence of exposure varied from about 1% to about 15% for the different agents. Associations between glioma and each of the 10 agents were estimated by conditional logistic regression, and using three separate exposure indices: i) ever vs. never; ii) lifetime cumulative exposure; iii) total duration of exposure. RESULTS: The study sample consisted of 1,800 glioma cases and 5,160 controls. Most odds ratio estimates were close to the null value. None of the ten agents displayed a significantly increased odds ratio nor any indication of dose-response relationships with cumulative exposure or with duration of exposure. CONCLUSION: Thus, there was no evidence that these exposures influence risk of glioma.
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Neoplasias Encefálicas/etiología , Glioma/etiología , Exposición Profesional/estadística & datos numéricos , Adulto , Anciano , Neoplasias Encefálicas/epidemiología , Estudios de Casos y Controles , Femenino , Glioma/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Factores de Riesgo , Encuestas y CuestionariosRESUMEN
The energy absorbed from the radio-frequency fields of mobile telephones depends strongly on distance from the source. The authors' objective in this study was to evaluate whether gliomas occur preferentially in the areas of the brain having the highest radio-frequency exposure. The authors used 2 approaches: In a case-case analysis, tumor locations were compared with varying exposure levels; in a case-specular analysis, a hypothetical reference location was assigned for each glioma, and the distances from the actual and specular locations to the handset were compared. The study included 888 gliomas from 7 European countries (2000-2004), with tumor midpoints defined on a 3-dimensional grid based on radiologic images. The case-case analyses were carried out using unconditional logistic regression, whereas in the case-specular analysis, conditional logistic regression was used. In the case-case analyses, tumors were located closest to the source of exposure among never-regular and contralateral users, but not statistically significantly. In the case-specular analysis, the mean distances between exposure source and location were similar for cases and speculars. These results do not suggest that gliomas in mobile phone users are preferentially located in the parts of the brain with the highest radio-frequency fields from mobile phones.
Asunto(s)
Neoplasias Encefálicas/patología , Teléfono Celular , Glioma/patología , Ondas de Radio/efectos adversos , Adolescente , Adulto , Anciano , Neoplasias Encefálicas/epidemiología , Neoplasias Encefálicas/etiología , Europa (Continente)/epidemiología , Femenino , Lóbulo Frontal/patología , Glioma/epidemiología , Glioma/etiología , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Lóbulo Occipital/patología , Lóbulo Parietal/patología , Proyectos de Investigación , Estudios Retrospectivos , Factores de Riesgo , Lóbulo Temporal/patología , Factores de TiempoRESUMEN
Mental disorders in the elderly often influence their social and physical wellbeing. Depression and anxiety disorders may frequently be found in elderly patients with chronic diseases; however, we now know that this patient group may benefit from psychotherapy. The psychotherapeutic group "40 plus" provides a supportive group intervention for physically and psychically impaired patients in their second half of life. The group intervention allows them to recognize and to activate their resources, as well as the interaction between physical disorders and psychosocial burdens and possible influential aspects to be perceived. An evaluation of 64 patients who participated in this group intervention showed a significant improvement of depression, psychosocial burdens and somatization. The concept of the group "40 plus" presented here may therefore be seen as to effectively bridge a gap in the health care of the elderly.
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Envejecimiento/psicología , Trastornos Mentales/psicología , Trastornos Mentales/terapia , Psicoterapia de Grupo , Adulto , Anciano , Ansiedad/psicología , Ansiedad/terapia , Depresión/psicología , Depresión/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estrés Psicológico/psicología , Estrés Psicológico/terapiaRESUMEN
In all epidemiological studies the validity of self-reported questionnaire data is an important issue as the exposure assessment based on such data is a major source of bias in the risk estimation. A validation study was conducted based on a case-control study including 94 acoustic neuroma cases and 191 matched controls from the German Interphone Study to investigate the level of agreement between self-reported occupational noise exposure and a job-exposure-matrix (JEM) on noise exposure derived from a lifetime occupation calendar. The JEM was generated based on measurement data collected in the literature for various occupations. Level of agreement was investigated by using sensitivity, specificity, kappa coefficient and the Youden-Index. The receiver operating characteristics curve yielded an optimal cut point of 80 decibel(Acoustic) (dB(A)) to dichotomize noise exposure, displaying a moderate agreement between self-reported exposure and the JEM-based exposure (kappa of 0.53) that was slightly higher for cases than controls (kappas of 0.62 and 0.48). The agreement was only slightly lower if the longest held job or the last held job were used instead of the loudest job of the lifetime job history. The cut point of 80 dB(A) corresponds with regulations for workers safety with a recommendation to wear noise protection. The good levels of agreement between self-reported high occupational noise exposure compared with JEM-data, together with no substantial differences between cases and controls, suggest that self-reported data on occupational noise exposure is a valid exposure metric. Noise exposure appears to be appropriate if only exposure information on the last or the longest held job is available.
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Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Exposición Profesional/análisis , Autorrevelación , Adulto , Humanos , Entrevistas como Asunto , Persona de Mediana Edad , Exposición Profesional/estadística & datos numéricos , Percepción , Encuestas y Cuestionarios , Trabajo/estadística & datos numéricosRESUMEN
The aim of the present analysis was to examine the association of a medical history of asthma, hay fever, eczema, or epilepsy with the risk of glioma and meningioma. Data of a German population-based case-control study included 381 meningioma cases, 366 glioma cases, and 1,494 controls. Participants' histories of asthma, hay fever, eczema, and epilepsy and the respective ages at onset were asked during a personal interview. A small inverse association between allergic condition and both glioma (odds ratio: 0.92; 95% CI: 0.70-1.22) and meningioma (odd ratio: 0.87; 95% CI: 0.66-1.14) was found. For glioma, this inverse association was more pronounced in persons reporting to have asthma compared to other allergic conditions. The positive association between epilepsy and particularly glioma suggests that epilepsy is an early symptom of the disease. As the association was seen also for epilepsies occurring more than a decade before the diagnosis of glioma, this might indicate either an aetiological role of epilepsy, or a relatively long preclinical phase. In conclusion our study confirms previous findings of case control studies but not those from cohort studies. However, possible selection bias in case control studies might not explain the different results in its entirety.
Asunto(s)
Neoplasias Encefálicas/etiología , Epilepsia/complicaciones , Glioma/etiología , Hipersensibilidad/complicaciones , Neoplasias Meníngeas/etiología , Meningioma/etiología , Adulto , Neoplasias Encefálicas/epidemiología , Estudios de Casos y Controles , Epilepsia/epidemiología , Alemania/epidemiología , Glioma/epidemiología , Humanos , Hipersensibilidad/epidemiología , Masculino , Neoplasias Meníngeas/epidemiología , Meningioma/epidemiología , Persona de Mediana Edad , Factores de RiesgoRESUMEN
BACKGROUND: The aim of this study was to examine the feasibility of performing a cohort study on health risks from occupational exposure to radiofrequency electromagnetic fields (RF-EMF) in Germany. METHODS: A set of criteria was developed to evaluate the feasibility of such a cohort study. The criteria aimed at conditions of exposure and exposure assessment (level, duration, preferably on an individual basis), the possibility to assemble a cohort and the feasibility of ascertaining various disease endpoints. RESULTS: Twenty occupational settings with workers potentially exposed to RF-EMF and, in addition, a cohort of amateur radio operators were considered. Based on expert ratings, literature reviews and our set of predefined criteria, three of the cohorts were identified as promising for further evaluation: the personnel (technicians) of medium/short wave broadcasting stations, amateur radio operators, and workers on dielectric heat sealers. After further analyses, the cohort of workers on dielectric heat sealers seems not to be feasible due to the small number of exposed workers available and to the difficulty of assessing exposure (exposure depends heavily on the respective working process and mixture of exposures, e.g. plastic vapours), although exposure was highest in this occupational setting. The advantage of the cohort of amateur radio operators was the large number of persons it includes, while the advantage of the cohort of personnel working at broadcasting stations was the quality of retrospective exposure assessment. However, in the cohort of amateur radio operators the exposure assessment was limited, and the cohort of technicians was hampered by the small number of persons working in this profession. CONCLUSION: The majority of occupational groups exposed to RF-EMF are not practicable for setting up an occupational cohort study due to the small numbers of exposed subjects or due to exposure levels being only marginally higher than those of the general public.
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Campos Electromagnéticos/efectos adversos , Exposición Profesional/efectos adversos , Adulto , Estudios de Cohortes , Estudios de Factibilidad , Femenino , Alemania , Humanos , Masculino , Persona de Mediana Edad , Medición de Riesgo , Factores de Riesgo , Factores de TiempoRESUMEN
Objective Studies of loud noise exposure and vestibular schwannomas (VS) have shown conflicting results. The population-based INTERPHONE caseâcontrol study was conducted in 13 countries during 2000-2004. In this paper, we report the results of analyses on the association between VS and self-reported loud noise exposure. Methods Self-reported noise exposure was analyzed in 1024 VS cases and 1984 matched controls. Life-long noise exposure was estimated through detailed questions. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using adjusted conditional logistic regression for matched sets. Results The OR for total work and leisure noise exposure was 1.6 (95% CI 1.4-1.9). OR were 1.5 (95% CI 1.3-1.9) for only occupational noise, 1.9 (95% CI 1.4-2.6) for only leisure noise and 1.7 (95% CI 1.2-2.2) for exposure in both contexts. OR increased slightly with increasing lag-time. For occupational exposures, duration, time since exposure start and a metric combining lifetime duration and weekly exposure showed significant trends of increasing risk with increasing exposure. OR did not differ markedly by source or other characteristics of noise. Conclusion The consistent associations seen are likely to reflect either recall bias or a causal association, or potentially indicate a mixture of both.
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Neuroma Acústico/epidemiología , Ruido en el Ambiente de Trabajo/estadística & datos numéricos , Exposición Profesional/estadística & datos numéricos , Adulto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: In 2011, the International Agency for Research on Cancer classified radiofrequency (RF) electromagnetic fields (EMF) as possibly carcinogenic to humans (group 2B), although the epidemiological evidence for the association between occupational exposure to RF-EMF and cancer was judged to be inadequate, due in part to limitations in exposure assessment. This study examines the relation between occupational RF and intermediate frequency (IF) EMF exposure and brain tumor (glioma and meningioma) risk in the INTEROCC multinational population-based case-control study (with nearly 4000 cases and over 5000 controls), using a novel exposure assessment approach. METHODS: Individual indices of cumulative exposure to RF and IF-EMF (overall and in specific exposure time windows) were assigned to study participants using a source-exposure matrix and detailed interview data on work with or nearby EMF sources. Conditional logistic regression was used to investigate associations with glioma and meningioma risk. RESULTS: Overall, around 10% of study participants were exposed to RF while only 1% were exposed to IF-EMF. There was no clear evidence for a positive association between RF or IF-EMF and the brain tumors studied, with most results showing either no association or odds ratios (ORs) below 1.0. The largest adjusted ORs were obtained for cumulative exposure to RF magnetic fields (as A/m-years) in the highest exposed category (≥90th percentile) for the most recent exposure time window (1-4â¯years before the diagnosis or reference date) for both glioma, ORâ¯=â¯1.62 (95% confidence interval (CI): 0.86, 3.01) and meningioma (ORâ¯=â¯1.52, 95% CI: 0.65, 3.55). CONCLUSION: Despite the improved exposure assessment approach used in this study, no clear associations were identified. However, the results obtained for recent exposure to RF electric and magnetic fields are suggestive of a potential role in brain tumor promotion/progression and should be further investigated.
Asunto(s)
Neoplasias Encefálicas/epidemiología , Campos Electromagnéticos/efectos adversos , Exposición Profesional/estadística & datos numéricos , Estudios de Casos y Controles , Humanos , Oportunidad RelativaRESUMEN
BACKGROUND: The role of exposure to low doses of ionising radiation in the aetiology of brain tumours has yet to be clarified. The objective of this study was to investigate the association between medically or occupationally related exposure to ionising radiation and brain tumours. METHODS: We used self-reported medical and occupational data collected during the German part of a multinational case-control study on mobile phone use and the risk of brain tumours (Interphone study) for the analyses. RESULTS: For any exposure to medical ionising radiation we found odds ratios (ORs) of 0.63 (95% confidence interval (CI)=0.48-0.83), 1.08 (95% CI=0.80-1.45) and 0.97 (95% CI=0.54-1.75) for glioma, meningioma and acoustic neuroma, respectively. Elevated ORs were found for meningioma (OR 2.32, 95% CI: 0.90-5.96) and acoustic neuroma (OR 6.45, 95% CI: 0.62-67.16) for radiotherapy to the head and neck regions. CONCLUSION: We did not find any significant increased risk of brain tumours for exposure to medical ionising radiation.
Asunto(s)
Neoplasias Encefálicas/etiología , Teléfono Celular , Neoplasias Inducidas por Radiación/etiología , Exposición Profesional/efectos adversos , Adulto , Anciano , Neoplasias Encefálicas/epidemiología , Estudios de Casos y Controles , Campos Electromagnéticos/efectos adversos , Femenino , Alemania/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/epidemiología , Radiación Ionizante , Factores de RiesgoRESUMEN
The objective of this study was to test the hypothesis that exposure to continuous low-level radiofrequency electromagnetic fields (RF EMFs) increases the risk of glioma and meningioma. Participants in a population-based case-control study in Germany on the risk of brain tumors in relation to cellular phone use were 747 incident brain tumor cases between the ages of 30 and 69 years and 1494 matched controls. The exposure measure of this analysis was the location of a base station of a DECT (Digital Enhanced Cordless Telecommunications) cordless phone close to the bed, which was used as a proxy for continuous low-level exposure to RF EMFs during the night. Estimated odds ratios were 0.82 (95% confidence interval: 0.29-2.33) for glioma and 0.83 (0.29-2.36) for meningioma. There was also no increasing risk observed with duration of exposure to DECT cordless phone base stations. Although the study was limited due to the small number of exposed subjects, it is still a first indication that residential low-level exposure to RF EMFs may not pose a higher risk of brain tumors.
Asunto(s)
Neoplasias Encefálicas/epidemiología , Teléfono Celular/estadística & datos numéricos , Campos Electromagnéticos , Exposición a Riesgos Ambientales/estadística & datos numéricos , Glioma/epidemiología , Meningioma/epidemiología , Neoplasias Inducidas por Radiación/epidemiología , Adulto , Anciano , Estudios de Casos y Controles , Femenino , Alemania/epidemiología , Humanos , Incidencia , Masculino , Microondas , Persona de Mediana Edad , Modelos de Riesgos Proporcionales , Medición de Riesgo/métodos , Factores de RiesgoRESUMEN
BACKGROUND: Occupational exposure to extremely low-frequency magnetic fields (ELF) is a suspected risk factor for brain tumors, however the literature is inconsistent. Few studies have assessed whether ELF in different time windows of exposure may be associated with specific histologic types of brain tumors. This study examines the association between ELF and brain tumors in the large-scale INTEROCC study. METHODS: Cases of adult primary glioma and meningioma were recruited in seven countries (Australia, Canada, France, Germany, Israel, New Zealand, and the United Kingdom) between 2000 and 2004. Estimates of mean workday ELF exposure based on a job exposure matrix were assigned. Estimates of cumulative exposure, average exposure, maximum exposure, and exposure duration were calculated for the lifetime, and 1 to 4, 5 to 9, and 10+ years before the diagnosis/reference date. RESULTS: There were 3,761 included brain tumor cases (1,939 glioma and 1,822 meningioma) and 5,404 population controls. There was no association between lifetime cumulative ELF exposure and glioma or meningioma risk. However, there were positive associations between cumulative ELF 1 to 4 years before the diagnosis/reference date and glioma [odds ratio (OR) ≥ 90th percentile vs. < 25th percentile, 1.67; 95% confidence interval (CI), 1.36-2.07; PLinear trend < 0.0001], and, somewhat weaker associations with meningioma (OR ≥ 90th percentile vs. < 25th percentile, 1.23; 95% CI, 0.97-1.57; PLinear trend = 0.02). CONCLUSIONS: Results showed positive associations between ELF in the recent past and glioma. IMPACT: Occupational ELF exposure may play a role in the later stages (promotion and progression) of brain tumorigenesis.