Breast cancer, alcohol, and phosphate toxicity.

Alcohol consumption is associated with an increased risk of breast cancer, even at low alcohol intake levels, but public awareness of the breast cancer risk associated with alcohol intake is low. Furthermore, the causative mechanisms underlying alcohol's association with breast cancer are unknown. The present theoretical paper uses a modified grounded theory method to review the research literature and propose that alcohol's association with breast cancer is mediated by phosphate toxicity, the accumulation of excess inorganic phosphate in body tissue. Serum levels of inorganic phosphate are regulated through a network of hormones released from the bone, kidneys, parathyroid glands, and intestines. Alcohol burdens renal function, which may disturb the regulation of inorganic phosphate, impair phosphate excretion, and increase phosphate toxicity. In addition to causing cellular dehydration, alcohol is an etiologic factor in nontraumatic rhabdomyolysis, which ruptures cell membranes and releases inorganic phosphate into the serum, leading to hyperphosphatemia. Phosphate toxicity is also associated with tumorigenesis, as high levels of inorganic phosphate within the tumor microenvironment activate cell signaling pathways and promote cancer cell growth. Furthermore, phosphate toxicity potentially links cancer and kidney disease in onco-nephrology. Insights into the mediating role of phosphate toxicity may lead to future research and interventions that raise public health awareness of breast cancer risk and alcohol consumption.

Examining the Association Between Alcohol Consumption and Health Conditions in Community Dwelling Older Adults.

The Canadian low-risk drinking guidelines were developed for adults, however, the applicability to older adults was not considered in the development of the guidelines. The objectives of this study were to: (1) to examine alcohol use in community dwelling older males and females using the current Canadian guidelines; (2) to test lower limits of alcohol use on various health factors; and (3) to determine health factors associated with high-risk drinking in older males and females. Data on community dwelling older adults (aged 65 +) was used from the Canadian Injury Prevention Survey (n = 2274). Descriptive statistics and comparative analysis were used to compare alcohol consumption categories. Logistic regressions were performed to examine the relationships between health factors and alcohol consumption categories. 70% of the sample reported having at least one drink per week; 4.5% of males and 6.8% of females were high-risk drinkers according to the current guidelines. There were no significant associations between the current alcohol categories with demographics, behavioral risk factors or health conditions. Using the new guidelines, 21% of males and females were classified as high-risk drinkers, respectively. Diabetes and having an illness or disability before retirement was protective of high-risk drinking in males while having diabetes and poorer physical health was protective of high-risk drinking in females. The prevalence of high-risk drinkers is dependent on what alcohol classifications are used. Further studies are needed to determine the causal relationships between health-related factors and alcohol using standardized definitions of alcohol consumption.

Exploring gender differences in the longitudinal association between bullying and risk behaviours with Body Mass Index among COMPASS youth in Canada.

The purpose of this study was to identify gender differences in the association between bullying and Body Mass Index (BMI) longitudinally. Longitudinal data (2013-2015) from 4510 youth (Ontario, Canada) were used to model BMI with consecutive bullying status prospectively, adjusting for previously identified gender-specific health risk behaviour latent classes. To assess for gender differences, these mixed-effects models were stratified by gender. Youth who were victims of bullying (VoB) were more active, engaged in more substance use and reported higher BMI than their non-victim of bullying (NVoB) peers. The gender-specific mixed-models showed that there are gender differences in the association between bullying and BMI. Among females, repeated bullying was associated with higher odds of having overweight/obesity [by 51% (95% C.I. = 1.03, 2.23)] at follow-up. Among male youth, being a VoB at the previous wave only, was associated with higher odds of having overweight/obesity [by 60% (95% C.I. = 1.11, 2.29)] at follow-up. In contrast with previous literature that measured BMI during adulthood (i.e., years after school victimization), our study adds a unique contribution to the literature that across one year (while youth are still in secondary school), bullying is associated with higher odds of weight status and BMI among female and male youth. Since this increase occurs during secondary school, school-based programs aimed at decreasing youth bullying behaviours and addressing increases in BMI before youth leave school are of paramount importance.

A gender-stratified, multilevel latent class assessment of chronic disease risk behaviours' association with Body Mass Index among youth in the COMPASS study.

This paper sought to examine chronic disease risk behaviour latent classes and their association with Body Mass Index (BMI), assessing for gender differences. Participants were youth (n = 116,086; grades 9-12) enrolled in the COMPASS study (Ontario, Canada) during 2013, 2014, 2015. Multilevel latent class analysis was used to identify underlying, homogenous classes of youths' engagement in physical activity, smoking, binge drinking and marijuana use. Adjusted multilevel models regressed BMI on the latent classes controlling for ethnicity and grade. Three latent classes were identified: active experimenters (ACE), inactive clean youth (INC) and inactive substance users (INSU). This study found that gender differences are apparent in chronic disease risk behaviour latent classes and their association with BMI. INC males (OR = 0.85, 95% CI = 0.78, 0.93) were associated with a lower odds of overweight/obesity relative to active males who experimented with substance use. As for females, the class with the highest proportion of youth using substances were associated with higher odds (Females: OR = 1.2, 95% CI = 1.1, 1.4) of overweight/obesity relative to their active experimenting peers. As such, youth in latent classes with substance use are associated with higher BMI and weight status. Successful interventions may include school policies/programs that limit screen time use, as they were seen to have a positive effect on PA engagement and including social-influences approaches for substance use. Future research and interventions should be gender-specific as our results show that different latent classes are associated with obesity across genders.

The impact of different seats and whole-body vibration exposures on truck driver vigilance and discomfort.

Laboratory studies have shown that exposure to whole-body vibration (WBV) increases physical and mental fatigue, which are common issues professional drivers face. The objective of this study was to determine whether altering WBV exposures had any effect on driver vigilance and discomfort. A repeated measures crossover design of five truck drivers with regular 10-h routes was used. Active and passive suspension truck seats were evaluated. For each seat, WBV exposures were measured. Participants completed a discomfort questionnaire and a reaction time task before and after their shift for two weeks, one week per seat. Compared with the passive seat, the active seat significantly reduced WBV exposures, decrements in the optimal and mean reaction times (p = 0.02, 0.047, respectively), and discomfort in the lower back and wrist(s)/forearm(s) (p < 0.01, 0.01, respectively). Study results indicated that reducing WBV helps reduce discomfort and maintain vigilance, which may improve drivers' health and reduce the risk of truck collisions. Practitioner Summary: The active suspension seat used in this study reduced truck drivers' exposure to whole-body vibration (WBV) by over 33% in relation to their current industry standard passive suspension seat. This study demonstrated that reducing truck drivers' exposure to WBV reduced fatigue and discomfort development over a workday.

The impact of psychological factors on self-reported sleep disturbance among people living in the vicinity of wind turbines.

Canada's wind energy capacity has grown from approximately 137MW (MW) in 2000 to over 9700MW in 2014, and this progressive development has made Canada the fifth-largest market in the world for the installation of new wind turbines (WTs). Although wind energy is now one of the fastest growing sources of power in Canada and many other countries, the growth in both number and size of WTs has raised questions regarding potential health impacts on individuals who live close to such turbines. This study is the first published research using a prospective cohort design, with noise and sleep measurements obtained before and after installation of WTs to investigate effect of such turbines on self-reported sleep disturbances of nearby residents. Subjective assessment of sleep disturbance was conducted in Ontario, Canada through standard sleep and sleepiness scales, including the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), and Epworth daytime Sleepiness Scale (ESS). Both audible and infra-sound noises were also measured inside the bedroom. Descriptive and comparison analyses were performed to investigate the effect of WT exposure on sleep data. Results of the analysis show that participants reported poorer sleep quality if they had a negative attitude to WTs, if they had concerns related to property devaluation, and if they could see turbines from their properties. This study provides evidence for the role of individual differences and psychological factors in reports of sleep disturbance by people living in the vicinity of WTs.

Before-after field study of effects of wind turbine noise on polysomnographic sleep parameters.

Wind is considered one of the most advantageous alternatives to fossil energy because of its low operating cost and extensive availability. However, alleged health-related effects of exposure to wind turbine (WT) noise have attracted much public attention and various symptoms, such as sleep disturbance, have been reported by residents living close to wind developments. Prospective cohort study with synchronous measurement of noise and sleep physiologic signals was conducted to explore the possibility of sleep disturbance in people hosting new industrial WTs in Ontario, Canada, using a pre and post-exposure design. Objective and subjective sleep data were collected through polysomnography (PSG), the gold standard diagnostic test, and sleep diary. Sixteen participants were studied before and after WT installation during two consecutive nights in their own bedrooms. Both audible and infrasound noises were also concurrently measured inside the bedroom of each participant. Different noise exposure parameters were calculated (LAeq, LZeq) and analyzed in relation to whole-night sleep parameters. Results obtained from PSG show that sleep parameters were not significantly changed after exposure. However, reported sleep qualities were significantly (P = 0.008) worsened after exposure. Average noise levels during the exposure period were low to moderate and the mean of inside noise levels did not significantly change after exposure. The result of this study based on advanced sleep recording methodology together with extensive noise measurements in an ecologically valid setting cautiously suggests that there are no major changes in the sleep of participants who host new industrial WTs in their community. Further studies with a larger sample size and including comprehensive single-event analyses are warranted.

Dissemination and use of a participatory ergonomics guide for workplaces.

Musculoskeletal disorders (MSDs) result in lost-time injury claims and lost productivity worldwide, placing a substantial burden on workers and workplaces. Participatory ergonomics (PE) is a popular approach to reducing MSDs; however, there are challenges to implementing PE programmes. Using evidence to overcome challenges may be helpful but the impacts of doing so are unknown. We sought to disseminate an evidence-based PE tool and to describe its use. An easy-to-use, evidence-based PE Guide was disseminated to workplace parties, who were surveyed about using the tool. The greatest barrier to using the tool was a lack of time. Reported tool use included for training purposes, sharing and integrating the tool into existing programmes. New actions related to tool use included training, defining team responsibilities and suggesting programme implementation steps. Evidence-based tools could help ergonomists overcome some challenges involved in implementing injury reduction programmes such as PE. Practitioner Summary Practitioners experience challenges implementing programmes to reduce the burden of MSDs in workplaces. Implementing participatory interventions requires multiple workplace parties to be 'on-board'. Disseminating and using evidence-based guides may help to overcome these challenges. Using evidence-based tools may help ergonomics practitioners implement PE programmes.

Impacts of Industrial Wind Turbine Noise on Sleep Quality: Results From a Field Study of Rural Residents in Ontario, Canada.

The objectives of this study were to determine whether grid-connected industrial wind turbines (IWTs) are a risk factor for poor sleep quality, and if IWT noise is associated with sleep parameters in rural Ontarians. A daily sleep diary and actigraphy-derived measures of sleep were obtained from 12 participants from an IWT community and 10 participants from a comparison community with no wind power installations. The equivalent and maximum sound pressure levels within the bedroom were also assessed. No statistically significant differences were observed between IWT residents and non-IWT residents for any of the parameters measured in this study. Actigraphy and sleep diaries are feasible tools to understand the impact of IWTs on the quality of sleep for nearby residents. Further studies with larger sample sizes should be conducted to determine whether the lack of statistical significance observed here is a result of sample size, or reflects a true lack of association.

Detecting within- and between-day manifestations of neuromuscular fatigue at work: an exploratory study.

Cumulative neuromuscular fatigue may result from exposure to physically demanding work, such as repetitive and/or sustained work with insufficient recovery. The aims of this exploratory study were to develop a battery of field usable fatigue measures and to document hand/arm fatigue in physically demanding work over multiple workdays and after a weekend break. Sixteen plumbers were observed for five days and measures of handgrip force, variability, tremor and discomfort were obtained pre-, mid- and post-shift. This exploratory study demonstrated increasing fatigue of the hand/arm over the day and persistent fatigue from Tuesday to Friday, and that a number of the measures did not return to baseline values following a weekend break. The findings provide preliminary evidence of cumulative fatigue in residential plumbing and insight into neuromuscular fatigue measurement. However, further work is needed to develop and refine a set of fatigue measures to detect neuromuscular fatigue at the workplace. PRACTITIONER SUMMARY: Cumulative fatigue has been linked to long-term health outcomes, including work-related musculoskeletal disorders. This paper presents findings from a physically demanding job (i.e. plumbing) revealing persistent fatigue over the work shift(s) and insufficient recovery after a weekend break, and provides insight into fatigue measurement at the workplace.

Can a Low-Phosphate Diet for Chronic Kidney Disease Treat Cancer? An Interdisciplinary Literature Review.

Background: Cancer therapeutics have a low success rate in clinical trials. An interdisciplinary approach is needed to translate basic, clinical, and remote fields of research knowledge into novel cancer treatments. Recent research has identified high dietary phosphate intake as a risk factor associated with cancer incidence. A model of tumor dynamics predicted that reducing phosphate levels sequestered in the tumor microenvironment could substantially reduce tumor size. Coincidently, a low-phosphate diet is already in use to help patients with chronic kidney disease manage high serum phosphate levels. Methods: A grounded-theory literature-review method was used to synthesize interdisciplinary findings from the basic and clinical sciences, including oncology, nephrology, nutritional epidemiology, and dietetic research on cancer. Results: Findings of tumor remission associated with fasting and a ketogenic diet, which lower intake of dietary phosphate, support the hypothesis that a low-phosphate diet will reduce levels of phosphate sequestered in the tumor microenvironment and reduce tumor size. Additionally, long-term effects of a low-phosphate diet may reverse dysregulated phosphate metabolism associated with tumorigenesis and prevent cancer recurrence. Conclusions: Evidence in this article provides the rationale to test a low-phosphate diet as a dietary intervention to reduce tumor size and lower risk of cancer recurrence.

Health Comparisons Between Truck Drivers and the General Population Using the Canadian Community Health Survey.

BACKGROUND: This study examined and compared risk factors and health conditions of truck drivers compared with the general Canadian population. METHODS: This study used the Canadian Community Health Survey consisting of 991 male truck drivers and 29,958 male respondents of the general population. RESULTS: Compared with the general population, truck drivers were older, less educated, had lower incomes, worked more hours, and were more likely to be widowed/separated/divorced. In addition, truck drivers had significantly higher rates of cardiovascular disease and obesity and were more likely to be sedentary, smoke, drive when fatigued, and eat unhealthy compared with the general population. CONCLUSIONS: Multicomponent interventions are needed to address the poor lifestyle practices of truckers to reduce the high rates of morbidity.

Did you have an impact? A theory-based method for planning and evaluating knowledge-transfer and exchange activities in occupational health and safety.

Few evaluation tools are available to assess knowledge-transfer and exchange interventions. The objective of this paper is to develop and demonstrate a theory-based knowledge-transfer and exchange method of evaluation (KEME) that synthesizes 3 theoretical frameworks: the promoting action on research implementation of health services (PARiHS) model, the transtheoretical model of change, and a model of knowledge use. It proposes a new term, keme, to mean a unit of evidence-based transferable knowledge. The usefulness of the evaluation method is demonstrated with 4 occupational health and safety knowledge transfer and exchange (KTE) implementation case studies that are based upon the analysis of over 50 pre-existing interviews. The usefulness of the evaluation model has enabled us to better understand stakeholder feedback, frame our interpretation, and perform a more comprehensive evaluation of the knowledge use outcomes of our KTE efforts.

Breast Cancer and Bone Mineral Density in a U.S. Cohort of Middle-Aged Women: Associations with Phosphate Toxicity.

Breast cancer is associated with phosphate toxicity, the toxic effect from dysregulated phosphate metabolism that can stimulate tumorigenesis. Phosphate toxicity and dysregulated phosphate metabolism are also associated with bone mineral abnormalities, including excessive bone mineral loss and deposition. Based on shared associations with dysregulated phosphate metabolism and phosphate toxicity, a hypothesis proposed in the present mixed methods-grounded theory study posits that middle-aged women with incidence of breast cancer had a greater magnitude of changes in bone mineral density over time compared with women who remained cancer-free. To test this hypothesis, a mixed-effects model was used to analyze the associations of breast cancer incidence with spinal bone mineral density changes in the U.S. Study of Women's Health Across the Nation. Compared with women in the cohort who remained cancer-free, women who self-reported breast cancer had higher bone mineral density at baseline, but had more rapid losses in bone mineral density during follow-up visits. These findings agree with the hypothesis that a greater magnitude of changes in bone mineral density over time is associated with breast cancer in a cohort of middle-aged women. The findings also have implications for studies investigating dysregulated phosphate metabolism and phosphate toxicity as causative factors of bone metastasis in metastatic breast cancer. Additionally, the authors previously found increased breast cancer risk associated with high dietary phosphate intake in the same cohort of middle-aged women, and more studies should investigate a low-phosphorus diet to reduce bone mineral abnormalities and tumorigenesis in breast cancer patients.

High Dietary Phosphorus Is Associated with Increased Breast Cancer Risk in a U.S. Cohort of Middle-Aged Women.

Research has shown that high amounts of dietary phosphorus that are twice the amount of the U.S. dietary reference intake of 700 mg for adults are associated with all-cause mortality, phosphate toxicity, and tumorigenesis. The present nested case-control study measured the relative risk of self-reported breast cancer associated with dietary phosphate intake over 10 annual visits in a cohort of middle-aged U.S. women from the Study of Women's Health Across the Nation. Analyzing data from food frequency questionnaires, the highest level of daily dietary phosphorus intake, >1800 mg of phosphorus, was approximately equivalent to the dietary phosphorus levels in menus promoted by the United States Department of Agriculture. After adjusting for participants' energy intake, this level of dietary phosphorus was associated with a 2.3-fold increased risk of breast cancer incidence compared to the reference dietary phosphorus level of 800 to 1000 mg, which is based on recommendations from the U.S. National Kidney Foundation, (RR: 2.30, 95% CI: 0.94-5.61, p = 0.07). Despite the lack of statistical significance, likely due to the small sample size of the cohort, the present nested case-control study's clinically significant effect size, dose-response, temporality, specificity, biological plausibility, consistency, coherence, and analogy with other research findings meet the criteria for inferred causality in observational studies, warranting further investigations. Furthermore, these findings suggest that a low-phosphate diet should be tested on patients with breast cancer.

Evolving pipe joining methods and their association to musculoskeletal symptoms for residential plumbers.

BACKGROUND: Recently the plumbing trade has transitioned from traditional copper piping to flexible plastic piping (PEX) for residential water distribution systems. However, there has been very limited research into the ergonomic implications of the modernized processes. OBJECTIVE: This research documents the physical workload and risks of musculoskeletal disorders (MSDs) with the use of new tools and processes for joining piping. The research also identifies the factors which can facilitate or limit the use of new ergonomically beneficial tools. METHODS: This mixed methods research included workplace observations, interviews, an experiment, a survey of plumbers in residential construction and focus groups with both plumbers and plumbing contractors. RESULTS: Advantages and disadvantages of the various techniques for joining pipes showed that manual crimping has advantages (i.e., productivity and lower cost) that make it desirable for plumbing contractors. Power devices, which were not widely used, have great potential to reduce MSD risks especially if the size and weight of the tools decreases with newer technologies. A continuing barrier is the cost of power equipment. CONCLUSION: The move to provide ergonomically beneficial tools was not as rapid as the willingness to change piping materials. Productivity and costs of tools are barriers to ergonomic interventions.

Biological Embedding of Psychosocial Stressors Within a Sample of Canadian Firefighters: An Exploratory Analysis.

OBJECTIVE: We wanted to determine whether the biological embedding of perceived psychosocial stress could be observed within a sample of Canadian firefighters. METHODS: We collected sociodemographic and general health-related information from 58 firefighters. In addition, measures of work-related and general life psychosocial stress, perceived social support, and physiological parameters thought to reflect the embedding of stress were gathered and analyzed using analysis of variance and linear regression models. RESULTS: Despite observing a positive relationship between psychosocial stress and allostatic load, the association was not significant; however, age did significantly predict allostatic load ( B = 0.09, P = 0.04). Notably, our participants reported abundant social support that was inversely associated with perceived stress. CONCLUSIONS: Although perceived stress did not significantly affect allostatic load in our sample, high levels of social support may have provided an important countervailing force.

The Path from Survey Development to Knowledge Activism: A Case Study of the Use of a Physical Loads Survey in a Retail Workplace.

Workers at a multi-site retailer were concerned that they were experiencing higher than anticipated work-related musculoskeletal disabilities (MSDs). They approached union leadership and academic researchers and a Participatory Action Research (PAR) project was developed which culminated in a targeted online Physical Loads Survey (PLS). The goal was to initiate discussions to design a preventative collaborative ergonomic program. Survey results confirmed that during a shift, workers had significant exposure to standing, carrying loads of more than 25 lbs, pushing and pulling loads greater than 225 lbs, and repetitive arm and hand movements. The successful survey was the first step in the development of a proactive health and safety program. The union proceeded without management participation and was able to move beyond knowledge creation to knowledge activism and change.