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PURPOSE: Cancer and its treatment may affect cognitive function through a number of direct and indirect pathways including inflammation, lipid metabolism, vascular damage, and changes in the blood-brain barrier. While short-term treatment-related cognitive changes are well recognized, only limited research is available in older, long-term survivors of cancer. METHODS: Using NHANES data from 1999 to 2002, 408 cancer survivors and 2639 non-cancer participants aged 60 years old and above were identified. Cognitive function of these groups were compared using the Digit Symbol Substitution Test (DSST) and self-reported problems with memory or confusion. RESULTS: After adjustment for covariates, cancer survivors scored, on average, 1.99 points lower on the DSST compared to non-cancer survivors (-1.99, 95 % CI -3.94, -0.05). Cancer survivors also had 17 % higher odds of self-reporting problems with memory or confusion (OR 1.17, 95 % CI 0.89, 1.53). CONCLUSION: In this nationally representative sample of older US adults, cancer survivors had lower DSST scores than non-survivors and had more self-reported problems with memory or confusion.
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Cognição/fisiologia , Neoplasias/psicologia , Sobreviventes/psicologia , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Memória/fisiologia , Neoplasias/reabilitação , Inquéritos Nutricionais , Sobreviventes/estatística & dados numéricosRESUMO
Tics and tic disorders can significantly impact children, but limited screening tools and diagnostic challenges may delay access to care. The current study attempted to address these gaps by evaluating sensitivity and specificity of the Motor or Vocal Inventory of Tics (MOVeIT), a tic symptom screener, and the Description of Tic Symptoms (DoTS), a brief diagnostic assessment for tic disorders. Children (n=100, age 6-17 years old) with tic disorders attending a Tourette specialty clinic and a community-recruited sample without tics completed a gold-standard assessment by a tic expert; these evaluations were compared to child self-report and parent and teacher report versions of the MOVeIT, and child and parent versions of the DoTS. The parent and child MOVeIT met or exceeded pre-specified 85% sensitivity and specificity criteria for detecting the presence of tics when compared to a gold-standard tic expert diagnosis. The Teacher MOVeIT had lower sensitivity (71.4%) but good specificity (95.7%) for identifying any tic symptoms compared to gold standard. For determination of the presence or absence of any tic disorder, sensitivity of both parent and child DoTS was 100%; specificity of the parent DoTS was 92.7% and child DoTS specificity was 75.9%. More work may be needed to refine the teacher MOVeIT, but it is also recognized that tic expression may vary by setting. While the MOVeIT and DoTS parent and child questionnaires demonstrated adequate sensitivity and specificity for determining the presence of tics and tic disorders in this well-defined sample, additional testing in a general population is warranted.
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INTRODUCTION: Older adults are more susceptible to a common respiratory infection: pneumonia. Nearly 1 million older adults per year are hospitalized for community-acquired pneumonia in the United States. OBJECTIVE: To examine whether wearing removable dentures are associated with an increased risk of pneumonia incidence in a geriatric population. METHODS: We conducted a retrospective cohort study among patients >65 y of age within a large academic health system (University of Rochester Medical Center). The medical and dental electronic records from 2010 to 2018 were reviewed and used for data collection. The exposure was removable denture wearing. The main outcome variables were the incidence of pneumonia and time to event of pneumonia. A Cox proportional hazards regression was used to examine the association between pneumonia onset and wearing removable dentures, adjusting for demographics, socioeconomic status, and medical and dental conditions. RESULTS: A total of 2,364 patients were included, with 1,189 (50.29%) in the denture-wearing group and 1,175 (49.70%) in the non-denture wearing group. The annual pneumonia incidence rate per 100,000 persons was 1,191 in the denture-wearing group and 128 per 100,000 persons in the non-denture wearing group, with a crude incidence rate ratio of 9.33 (95% CI, 5.41 to 18.81; P < 0.0001). The mean ± SD age of the pneumonia onset was 78.0 ± 10.0 and 78.6 ± 9.0 y among denture-wearing and nonwearing groups (P = 0.84). The time to event of pneumonia was associated with removable denture wearing (yes/no; hazard ratio, 7.68 [95% CI, 3.91 to 15.08]; P < 0.001) after adjusting for covariates. CONCLUSIONS: Wearing removable dentures was found to be a risk predictor for pneumonia incidence among the geriatric population even after accounting for other risk factors. KNOWLEDGE TRANSFER STATEMENT: Wearing removable dentures was found to be a risk predictor of pneumonia incidence among older adults. Although the current study does not imply a causal relationship between denture wearing and pneumonia, clinicians and older patients could reference the study results when choosing dental prostheses to restore missing teeth.
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We are pleased to introduce this special issue of Neurotoxicology. It reproduces Volume 7, Number 1 of the Seychelles Medical and Dental Journal (SMDJ), initially published in November 2004. Publication of the SMDJ was discontinued in 2005 and the manuscripts it published are no longer accessible to the scientific community. The papers in this special issue lay the background for the Seychelles Child Development Study (SCDS) and provide valuable data on the MeHg exposures that occurred at Niigata, Japan. They are relevant to the ongoing debate over whether the consumption of fish and consequently low-level exposure to methylmercury (MeHg) is a risk to human health.
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Desenvolvimento Infantil/efeitos dos fármacos , Exposição Ambiental/efeitos adversos , Compostos de Metilmercúrio/toxicidade , Animais , Criança , Feminino , Peixes , Contaminação de Alimentos , Humanos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , SeichelesRESUMO
PROBLEM: Markers of maternal inflammation may determine infant birth outcomes. METHOD OF STUDY: Maternal serum samples were collected at 28 weeks gestation (nâ¯=â¯1418) in the Seychelles Child Development Study Nutrition Cohort 2 and analyzed for immune markers by MSD multiplex assay, including cytokines from the Th1 (IFN-γ, IL-1ß, IL-2 and TNF-α) and Th2 (IL-4, IL-5, IL-10) subsets, with IL-6, MCP-1, TARC, sFlt-1 and VEGF-D. Associations of log-transformed immune markers with birthweight, length, head circumference and gestational age were assessed by multiple linear regression models, which were adjusted for maternal age, BMI, parity, child sex, gestational age and socioeconomic status. RESULTS: Neither total Th1, Th2 nor Th1:Th2 were significantly associated with any birth outcome. However, the angiogenesis marker VEGF-D was predictive of a lower birthweight, (ßâ¯=â¯-0.058, Pâ¯=â¯0.017) and birth length (ßâ¯=â¯-0.088, Pâ¯=â¯0.001) after adjusting for covariates. Higher concentrations of CRP were predictive of a lower birthweight (ßâ¯=â¯-0.057, Pâ¯=â¯0.023) and IL-2 (ßâ¯=â¯0.073, Pâ¯=â¯0.009) and the chemokine MCP-1 (ßâ¯=â¯0.067, Pâ¯=â¯0.016) were predictive of a longer gestational age. CONCLUSIONS: In our cohort of healthy pregnant women, we found no evidence for associations between the Th1 or Th2 inflammatory markers with birth outcomes. However, VEGF-D and CRP appear to predict lower birthweight and IL-2 and MCP-1 a longer gestation. Greater understanding is required of the variation in these immune markers at different gestational stages, as well as the factors which may regulate their balance in healthy pregnancy. nâ¯=â¯233.
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Peso ao Nascer/imunologia , Idade Gestacional , Inflamação/diagnóstico , Segundo Trimestre da Gravidez/imunologia , Adulto , Biomarcadores/sangue , Proteína C-Reativa/análise , Proteína C-Reativa/imunologia , Contagem de Linfócito CD4 , Quimiocina CCL2/sangue , Quimiocina CCL2/imunologia , Feminino , Humanos , Recém-Nascido , Inflamação/sangue , Inflamação/imunologia , Interleucina-2/sangue , Interleucina-2/imunologia , Masculino , Idade Materna , Gravidez , Segundo Trimestre da Gravidez/sangue , Seicheles , Células Th1/imunologia , Células Th2/imunologia , Fator D de Crescimento do Endotélio Vascular/sangue , Fator D de Crescimento do Endotélio Vascular/imunologia , Adulto JovemRESUMO
The occupational epidemiological literature on extremely low frequency electric and magnetic fields (EMF) and health encompasses a large number of studies of varying design and quality that have addressed many health outcomes, including various cancers, cardiovascular disease, depression and suicide, and neurodegenerative diseases, such as Alzheimer disease and amyotrophic lateral sclerosis (ALS). At a 2006 workshop we reviewed studies of occupational EMF exposure with an emphasis on methodological weaknesses, and proposed analytical ways to address some of these. We also developed research priorities that we hope will address remaining uncertainties. Broadly speaking, extensive epidemiological research conducted during the past 20 years on occupational EMF exposure does not indicate strong or consistent associations with cancer or any other health outcomes. Inconsistent results for many of the outcomes may be attributable to numerous shortcomings in the studies, most notably in exposure assessment. There is, however, no obvious correlation between exposure assessment quality and observed associations. Nevertheless, for future research, the highest priorities emerge in both the areas of exposure assessment and investigation of ALS. To better assess exposure, we call for the development of a more complete job-exposure matrix that combines job title, work environment and task, and an index of exposure to electric fields, magnetic fields, spark discharge, contact current, and other chemical and physical agents. For ALS, we propose an international collaborative study capable of illuminating a reported association with electrical occupations by disentangling the potential roles of electric shocks, magnetic fields and bias. Such a study will potentially lead to evidence-based measures to protect public health.
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Campos Eletromagnéticos/efeitos adversos , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Monitoramento Ambiental/métodos , Monitoramento Epidemiológico , Previsões , Humanos , Neoplasias Induzidas por Radiação/epidemiologia , Neoplasias Induzidas por Radiação/etiologia , Doenças Neurodegenerativas/epidemiologia , Doenças Neurodegenerativas/etiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/análise , Medição de Risco/métodosRESUMO
Background: Frailty is considered to be an important risk factor for mortality in hospitalized patients. This study evaluates a preoperative frailty-screening tool called Anesthesia Geriatric Evaluation (AGE). Research into the concept of frailty, with a focus on multidisciplinary team meetings, may provide further insight for health care professionals in the understanding of frailty in everyday care situations. Methods: The research method chosen for this research is QUAGOL: Qualitative Analysis Guide of Leuven, which aims to reconstruct the story of the participants on a theoretical level and analyze the concepts found. Results: The following themes illustrate the analyzed concepts found: competence, resilience, sharing responsibility, broad frame of reference, obligation, and significance. Conclusion: AGE seems to create more awareness among health care professionals about frailty and tries to involve patients in their care process by making them aware of their abilities, motivation, and involving them in decisions to be made. This study shows that a shared decision-making process for surgical patients is often difficult to accomplish since AGE is still a paternalistic process of a multidisciplinary team with a medical perspective.
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BACKGROUND: Tic disorders, including Tourette syndrome, are complex, multisymptom diseases, yet the impact of these disorders on affected children, families, and communities is not well understood. METHODS: To improve the understanding of the impacts of Tourette syndrome, two research groups conducted independent cross-sectional studies using qualitative and quantitative measures. They focused on similar themes, but distinct scientific objectives, and the sites collaborated to align methods of independent research proposals with the aim of increasing the analyzable sample size. RESULTS: Site 1 (University of Rochester) was a Pediatric Neurology referral center. Site 2 (University of South Florida) was a Child Psychiatry referral center. A total of 205 children with tic disorders were enrolled from both studies. The University of Rochester also enrolled 100 control children in order to clearly isolate impacts of Tourette syndrome distinct from those occurring in the general population. The majority of children with tic disorders (n = 191, 93.1%) had Tourette syndrome, the primary population targeted for these studies. Children with Tourette syndrome were similar across sites in terms of tic severity and the occurrence of comorbid conditions. The occurrence of psychiatric comorbidities in the control group was comparable with that in the general pediatric population of the United States, making this a well-justified comparison group. CONCLUSIONS: Through collaboration, two sites conducting independent research developed convergent research methods to enable pooling of data, and by extension increased power, for future analyses. This method of collaboration is a novel model for future epidemiological research of tic disorders.
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Família , Projetos de Pesquisa , Transtornos de Tique/epidemiologia , Transtornos de Tique/psicologia , Adolescente , Criança , Pré-Escolar , Comorbidade , Comportamento Cooperativo , Estudos Transversais , Família/psicologia , Feminino , Humanos , Masculino , Pesquisa Qualitativa , Transtornos de Tique/complicações , Estados Unidos/epidemiologiaRESUMO
High risk HPVs (human papillomaviruses) are causally involved in the development of cervical cancer. However, other factors, such as somatic genetic alterations also play a decisive role in malignant conversion of cervical keratinocytes. Mutations and chromosomal aberrations are known to influence the pattern of gene expression. Therefore we used the recently developed RT-PCR based method of differential display of mRNAs to detect differences in gene expression which correlate with tumorigenicity. Non-tumorigenic HPV16-immortalized human foreskin keratinocytes (HPK IA) were compared with their tumorigenic counterparts and 49 different genes were identified which were either up- or downregulated. The identified genes encode proteins of the cytoskeleton and the extracellular matrix, the nuclear splicing apparatus, transcription regulators and membrane-associated proteins. The expression pattern of all genes was also examined by RNA-RNA in situ hybridization in biopsies of normal cervical epithelium, precancerous lesions and cancers. Two genes, C4.8 and C21.7, are of particular interest because their expression is upregulated in a subset of high grade precancerous lesions and in over 58% of cancers. These two genes may therefore be considered as putative progression markers. C4.8 is a new member of the transmembrane 4 (TM-4) protein family which includes tumor-associated antigens such as CD63 and TAPA-1, whereas C21.7 shows no significant homologies to any known genes or proteins.
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Biomarcadores Tumorais/genética , Papillomaviridae/fisiologia , Infecções por Papillomavirus/genética , Infecções Tumorais por Vírus/genética , Neoplasias do Colo do Útero/genética , Sequência de Aminoácidos , Animais , Sequência de Bases , Colo do Útero/patologia , DNA de Neoplasias , Progressão da Doença , Feminino , Humanos , Dados de Sequência Molecular , Infecções por Papillomavirus/fisiopatologia , Análise de Sequência de DNA , Homologia de Sequência de Aminoácidos , Infecções Tumorais por Vírus/fisiopatologia , Neoplasias do Colo do Útero/fisiopatologiaRESUMO
Epidemiologic and experimental research on the potential carcinogenic effects of extremely low frequency electromagnetic fields (EMF) has now been conducted for over two decades. Cancer epidemiology studies in relation to EMF have focused primarily on brain cancer and leukemia, both from residential sources of exposure in children and adults and from occupational exposure in adult men. Because genotoxic effects of EMF have not been shown, most recent laboratory research has attempted to show biological effects that could be related to cancer promotion. In this report, we briefly review residential and occupational EMF studies on brain cancer. We also provide a general review of experimental studies as they relate both to the biological plausibility of an EMF-brain cancer relation and to the insufficiency of such research to help guide exposure assessment in epidemiologic studies. We conclude from our review that no recent research, either epidemiologic or experimental, has emerged to provide reasonable support for a causal role of EMF on brain cancer.
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Neoplasias Encefálicas/etiologia , Campos Eletromagnéticos/efeitos adversos , Neoplasias Induzidas por Radiação/etiologia , Adulto , Neoplasias Encefálicas/epidemiologia , Cálcio/fisiologia , Transformação Celular Neoplásica/efeitos da radiação , Criança , Análise por Conglomerados , Cocarcinogênese , Exposição Ambiental , Radicais Livres , Humanos , Melatonina/metabolismo , Modelos Biológicos , Neoplasias Induzidas por Radiação/epidemiologia , Exposição Ocupacional , Radiação não Ionizante/efeitos adversos , Características de Residência , Risco , Taxa Secretória/efeitos da radiação , Estados Unidos/epidemiologiaRESUMO
PURPOSE: This population-based case-control study examined occupational exposure to electromagnetic fields in relation to female breast cancer incidence among 843 breast cancer cases and 773 controls. METHODS: Exposure was classified based on work in the two longest-held jobs, and indices of cumulative exposure to magnetic fields based on a measurement survey. RESULTS: Female breast cancer was not associated with employment as an office or industrial worker. For the total study population, cumulative exposure over the entire career, and in the past 0-10 and 10-20 years generally showed odds ratios (ORs) close to the null. Moderately elevated risks were found for intermediate but not high levels of cumulative exposure accumulated 20 or more years ago (OR = 1.5; 95% CI = 1.1-2.0). Associations were stronger for premenopausal women (OR = 1.7; 95% CI = 1.1-2.7) in the past 10-20 years, and those with estrogen-receptor positive (ER+) breast tumors (OR = 2.06; 95% CI = 1.1-4.0). No consistent dose-response patterns were observed. CONCLUSIONS: These findings give little support to the hypothesis that electromagnetic fields cause cancer of the female breast.
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Neoplasias da Mama/etiologia , Campos Eletromagnéticos/efeitos adversos , Exposição Ocupacional/efeitos adversos , Adulto , Idoso , Neoplasias da Mama/epidemiologia , Estudos de Casos e Controles , Climatério , Feminino , Humanos , Pessoa de Meia-Idade , North Carolina/epidemiologia , Ocupações , Razão de Chances , Risco , Fatores de TempoRESUMO
This case-control study examined occupational sunlight exposure and death from non-Hodgkin lymphoma (NHL) and NHL subtypes among 188 cases and 1880 controls selected from a cohort of 138,905 male electric utility workers. Exposure was classified according to work history linked to indices of cumulative sunlight exposure. Odds ratios and 95% confidence intervals were derived from conditional logistic regression models and were conditioned on the matching factors birth year and ethnicity. Mortality from NHL and intermediate/high-grade lymphomas was not related to cumulative sunlight exposure, with odds ratios around the null. For low-grade lymphomas, a dose-response gradient was observed for exposure in the past 12 to 21 years, but this result seemed to be sensitive to cut points for categorization of cumulative exposure. These data do not provide evidence for an association between occupational sunlight exposure and mortality from NHL or NHL subtypes.
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Linfoma não Hodgkin/mortalidade , Doenças Profissionais/mortalidade , Centrais Elétricas , Luz Solar/efeitos adversos , Adulto , Idoso , Eletricidade , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Análise de SobrevidaRESUMO
The etiology of prostate cancer is uncertain, but intake of omega-3 polyunsaturated fatty acids (n-3 PUFAs) may play a role. We evaluated prostate specific antigen (PSA) levels with fish consumption (the primary source of n-3 PUFAs) and calculated PUFA intake. Serum PSA concentrations were available from 6018 men who participated in the 2003-2010 National Health and Nutrition Examination Survey (NHANES). Fish consumption was calculated via 30-day Food Frequency Questionnaire data, whereas n-3 PUFA intake was calculated from 24-h dietary recalls. We employed multivariable logistic and linear regression models to evaluate the association of these exposure variables with PSA levels while controlling for relevant covariates. PSA levels were lower in men who ate more breaded fish, but no other types of fish consumption or n-3 PUFA intake were associated with PSA levels. Our findings provide little evidence for a role of fish or n-3 PUFA consumption in influencing PSA levels.
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Ácidos Graxos Ômega-3/sangue , Peixes , Antígeno Prostático Específico/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Neoplasias da Próstata/sangue , Neoplasias da Próstata/epidemiologia , Alimentos MarinhosRESUMO
BACKGROUND: Fish are important sources of protein and contain a variety of nutrients, such as n-3 long-chain polyunsaturated fatty acids (PUFA), essential for normal brain development. Nevertheless, all fish also contain methyl mercury (MeHg), a known neurotoxicant in adequate dosage. Our studies of the Seychelles Child Development Study (SCDS) Main Cohort enrolled in 1989-1990 (n=779) have found no consistent pattern of adverse MeHg effects at exposures achieved by daily fish consumption. Rather, we have observed evidence of improved performance on some cognitive endpoints as prenatal MeHg exposure increases in the range studied. These observations cannot be related to MeHg and may reflect the role of unmeasured covariates such as essential nutrients present in fish. To determine if these associations persist into young adulthood, we examined the relationship between prenatal MeHg exposure, recent PUFA exposure and subjects' neurodevelopment and behavior at 19 years of age. METHODS: We examined 533 participants using the following test battery: the Profile of Mood States-Bipolar (POMS-Bi); Finger Tapping; Kaufman Brief Intelligence Test (K-BIT); measures of Fine Motor Control and Complex Perceptual Motor Control; and Visual Spatial Contrast Sensitivity. We collected the following covariates: maternal IQ, family life course stressors, socioeconomic status, and subjects' recent postnatal MeHg, sex, and computer use. Primary analyses (based on N=392-475) examined covariate-adjusted associations in multiple linear regression models with prenatal MeHg as the primary exposure measure. Secondary analyses additionally adjusted for total n-6 and fish-related n-3 PUFA measured in the subjects' serum at the 19-year examination. RESULTS: Study participants had a mean prenatal MeHg exposure of 6.9 ppm, and a mean recent postnatal exposure of 10.3 ppm. There were no adverse associations between prenatal MeHg and any of the measured endpoints. For recent postnatal MeHg exposure, however, adverse associations were observed for Finger Tapping (non-dominant hand) among women and for the K-BIT Matrices for both sexes, with or without adjustment for PUFA. CONCLUSION: Our findings continue to provide no evidence for an adverse effect of prenatal MeHg exposure on development in a cohort that consumes fish daily. Observations for postnatal MeHg exposure will need to be confirmed using more comprehensive exposure measures.
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Desenvolvimento do Adolescente/efeitos dos fármacos , Compostos de Metilmercúrio/toxicidade , Efeitos Tardios da Exposição Pré-Natal/induzido quimicamente , Efeitos Tardios da Exposição Pré-Natal/psicologia , Adolescente , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-6/sangue , Feminino , Contaminação de Alimentos , Humanos , Masculino , Testes Neuropsicológicos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/sangue , Seicheles , Adulto JovemRESUMO
BACKGROUND: Occupational sunlight exposure was examined in relation to death from suicide in a United States cohort of 138,905 male electric utility workers. METHODS: Case-control sampling included 536 deaths from suicide and 5,348 eligible controls randomly selected from the cohort. Exposure was classified based on work history linked to indices of cumulative sunlight exposure. RESULTS: Mortality from suicide was not associated with estimates of recent and career occupational sunlight exposure, with adjusted odds ratios around unity. Occupational sunlight exposure was positively associated with nonviolent suicides, but no dose-response gradient was observed and risk estimates were notably imprecise. CONCLUSIONS: These data provide evidence against an association between occupational sunlight exposure and mortality from suicide.
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Exposição Ocupacional , Suicídio/estatística & dados numéricos , Luz Solar , Estudos de Casos e Controles , Humanos , Masculino , Razão de Chances , Fatores de RiscoRESUMO
BACKGROUND: Mortality patterns were examined in a United States cohort of 138,905 male electric utility workers from five companies to help interpret previous studies of health effects in this industry. METHODS: Using Poisson regression techniques, internal cohort analyses examined total mortality, cardiovascular disease, and cancer in relation to duration of employment in each of nineteen occupational categories which comprise utility operations. RESULTS: Relative to workers who were never involved in utility operations (e.g., administrative workers), mortality rate ratios among operations workers were higher for total mortality, cardiovascular disease, and total cancer. Lung cancer risk was consistently elevated, whereas increased mortality for other cancers was less consistent. CONCLUSIONS: The results of this study indicate excess risk of total mortality, cardiovascular disease, and some cancers among electric utility workers, which could be related to both occupational and non-occupational risk factors.
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Doenças Cardiovasculares/mortalidade , Causas de Morte , Eletricidade , Neoplasias/mortalidade , Doenças Profissionais/mortalidade , Ocupações , Adulto , Estudos de Coortes , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição de Poisson , Valores de Referência , Medição de Risco , Fatores de Risco , Estudos de Amostragem , Estados Unidos/epidemiologiaRESUMO
OBJECTIVE: To examine mortality from suicide in relation to estimated exposure to extremely low-frequency electromagnetic fields in a cohort of 138,905 male electric utility workers. METHODS: Case-control sampling, which included 536 deaths from suicide and 5, 348 eligible controls. Exposure was classified based on work in the most common jobs with increased exposure to magnetic fields and indices of cumulative exposure to magnetic fields based on a measurement survey. RESULTS: Suicide mortality was increased relative to work in exposed jobs and with indices of exposure to magnetic fields. Increased odds ratios (ORs) were found for years of employment as an electrician (OR, 2.18; 95% confidence interval [CI], 1.25-3.80) or line worker (OR, 1.59; 95% CI, 1.18-2.14), whereas a decreased OR was found for power plant operators (OR, 0.67; 95% CI, 0.33-1.40). A dose-response gradient with exposure to magnetic fields was found for exposure in the previous year, with a mortality OR of 1.70 (95% CI, 1.00-2.90) in the highest exposure category. Stronger associations, with ORs in the range of 2.12 to 3.62, were found for men younger than 50 years. CONCLUSIONS: These data provide evidence for an association between occupational electromagnetic fields and suicide that warrants further evaluation. A plausible mechanism related to melatonin and depression provides a direction for additional laboratory research and epidemiologic evaluation.
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Depressão/etiologia , Campos Eletromagnéticos/efeitos adversos , Exposição Ocupacional/efeitos adversos , Suicídio/estatística & dados numéricos , Adulto , Estudos de Casos e Controles , Estudos de Coortes , Fatores de Confusão Epidemiológicos , Depressão/mortalidade , Humanos , Modelos Logísticos , Masculino , Melatonina/fisiologia , Pessoa de Meia-Idade , Ocupações , Razão de Chances , Fatores de RiscoRESUMO
OBJECTIVES: This nested case-control study examines mortality from suicide in relation to estimated exposure to extremely low frequency electromagnetic fields (EMFs) in a cohort of 138,905 male electric utility workers. METHODS: Case-control sampling included 536 deaths from suicide and 5348 eligible controls. Exposure was classified based on work in the most common jobs with increased exposure to magnetic fields and indices of cumulative exposure to magnetic fields based on a measurement survey. RESULTS: Suicide mortality was increased relative to work in exposed jobs and with indices of exposure to magnetic fields. Increased odds ratios (ORs) were found for years of employment as an electrician (OR 2.18; 95% confidence interval (95% CI) 1.25 to 3.80) or lineman (OR 1.59; 95% CI 1.18 to 2.14), whereas a decreased OR was found for power plant operators (OR 0.67; 95% CI 0.33 to 1.40). A dose response gradient with exposure to magnetic fields was found for exposure in the previous year, with a mortality OR of 1.70 (95% CI 1.00 to 2.90) in the highest exposure category. Stronger associations, with ORs in the range of 2.12-3.62, were found for men <50 years of age. CONCLUSION: These data provide evidence for an association between occupational electromagnetic fields and suicide that warrants further evaluation. A plausible mechanism related to melatonin and depression provides a direction for additional laboratory research as well as epidemiological evaluation.