Cancer incidence after an open cut coal mine fire.

Using population-level cancer diagnosis data, we compared cancer incidence in locations affected by smoke from a six week-long open cut coal mine fire in regional Victoria, Australia, up to seven years following the event. There was no detectable effect on cancer incidence overall. While several subgroups exhibited changes, these were more likely due to statistical chance rather than real effects. These findings may be limited by low statistical power and short duration of follow up. To confirm the influence of open cut coal mine fires on cancer incidence, further research and an extended follow-up duration are necessary.

Prevalence and risk factors for silicosis among a large cohort of stone benchtop industry workers.

OBJECTIVES: High silica content artificial stone has been found to be associated with silicosis among stone benchtop industry (SBI) workers. The objectives of this study were to determine the prevalence of and risk factors for silicosis among a large cohort of screened SBI workers, and determine the reliability of respiratory function testing (RFT) and chest x-ray (CXR) as screening tests in this industry. METHODS: Subjects were recruited from a health screening programme available to all SBI workers in Victoria, Australia. Workers undertook primary screening, including an International Labour Office (ILO) classified CXR, and subject to prespecified criteria, also underwent secondary screening including high-resolution CT (HRCT) chest and respiratory physician assessment. RESULTS: Among 544 SBI workers screened, 95% worked with artificial stone and 86.2% were exposed to dry processing of stone. Seventy-six per cent (414) required secondary screening, among whom 117 (28.2%) were diagnosed with silicosis (median age at diagnosis 42.1 years (IQR 34.8-49.7)), and all were male. In secondary screening, silicosis was associated with longer SBI career duration (12 vs 8 years), older age, lower body mass index and smoking. In those with silicosis, forced vital capacity was below the lower limit of normal in only 14% and diffusion capacity for carbon monoxide in 13%. Thirty-six (39.6%) of those with simple silicosis on chest HRCT had an ILO category 0 CXR. CONCLUSION: Screening this large cohort of SBI workers identified exposure to dry processing of stone was common and the prevalence of silicosis was high. Compared with HRCT chest, CXR and RFTs had limited value in screening this high-risk population.

Ever and cumulative occupational exposure and lung function decline in longitudinal population-based studies: a systematic review and meta-analysis.

OBJECTIVES: Adverse occupational exposures can accelerate age-related lung function decline. Some longitudinal population-based studies have investigated this association. This study aims to examine this association using findings reported by longitudinal population-based studies. METHODS: Ovid Medline, PubMed, Embase, and Web of Science were searched using keywords and text words related to occupational exposures and lung function and 12 longitudinal population-based studies were identified using predefined inclusion criteria. The quality of the studies was assessed using the Newcastle-Ottawa Scale. Lung function decline was defined as annual loss of forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) or the ratio (FEV1/FVC). Fixed and random-effects meta-analyses were conducted to calculate pooled estimates for ever and cumulative exposures. Heterogeneity was assessed using the I2 test, and publication bias was evaluated using funnel plots. RESULTS: Ever exposures to gases/fumes, vapours, gases, dusts, fumes (VGDF) and aromatic solvents were significantly associated with FEV1 decline in meta-analyses. Cumulative exposures for these three occupational agents observed a similar trend of FEV1 decline. Ever exposures to fungicides and cumulative exposures to biological dust, fungicides and insecticides were associated with FEV1 decline in fixed-effect models only. No statistically significant association was observed between mineral dust, herbicides and metals and FEV1 decline in meta-analyses. CONCLUSION: Pooled estimates from the longitudinal population-based studies have provided evidence that occupational exposures are associated with FEV1 decline. Specific exposure control and respiratory health surveillance are required to protect the lung health of the workers.

Exposure to wildfire-related PM2.5 and site-specific cancer mortality in Brazil from 2010 to 2016: A retrospective study.

BACKGROUND: Long-term exposure to fine particles ≤2.5 µm in diameter (PM2.5) has been linked to cancer mortality. However, the effect of wildfire-related PM2.5 exposure on cancer mortality risk is unknown. This study evaluates the association between wildfire-related PM2.5 and site-specific cancer mortality in Brazil, from 2010 to 2016. METHODS AND FINDINGS: Nationwide cancer death records were collected during 2010-2016 from the Brazilian Mortality Information System. Death records were linked with municipal-level wildfire- and non-wildfire-related PM2.5 concentrations, at a resolution of 2.0° latitude by 2.5° longitude. We applied a variant difference-in-differences approach with quasi-Poisson regression, adjusting for seasonal temperature and gross domestic product (GDP) per capita. Relative risks (RRs) and 95% confidence intervals (CIs) for the exposure for specific cancer sites were estimated. Attributable fractions and cancer deaths were also calculated. In total, 1,332,526 adult cancer deaths (age ≥ 20 years), from 5,565 Brazilian municipalities, covering 136 million adults were included. The mean annual wildfire-related PM2.5 concentration was 2.38 µg/m3, and the annual non-wildfire-related PM2.5 concentration was 8.20 µg/m3. The RR for mortality from all cancers was 1.02 (95% CI 1.01-1.03, p < 0.001) per 1-µg/m3 increase of wildfire-related PM2.5 concentration, which was higher than the RR per 1-µg/m3 increase of non-wildfire-related PM2.5 (1.01 [95% CI 1.00-1.01], p = 0.007, with p for difference = 0.003). Wildfire-related PM2.5 was associated with mortality from cancers of the nasopharynx (1.10 [95% CI 1.04-1.16], p = 0.002), esophagus (1.05 [95% CI 1.01-1.08], p = 0.012), stomach (1.03 [95% CI 1.01-1.06], p = 0.017), colon/rectum (1.08 [95% CI 1.05-1.11], p < 0.001), larynx (1.06 [95% CI 1.02-1.11], p = 0.003), skin (1.06 [95% CI 1.00-1.12], p = 0.003), breast (1.04 [95% CI 1.01-1.06], p = 0.007), prostate (1.03 [95% CI 1.01-1.06], p = 0.019), and testis (1.10 [95% CI 1.03-1.17], p = 0.002). For all cancers combined, the attributable deaths were 37 per 100,000 population and ranged from 18/100,000 in the Northeast Region of Brazil to 71/100,000 in the Central-West Region. Study limitations included a potential lack of assessment of the joint effects of gaseous pollutants, an inability to capture the migration of residents, and an inability to adjust for some potential confounders. CONCLUSIONS: Exposure to wildfire-related PM2.5 can increase the risks of cancer mortality for many cancer sites, and the effect for wildfire-related PM2.5 was higher than for PM2.5 from non-wildfire sources.

Loss of life expectancy from PM2.5 in Brazil: A national study from 2010 to 2018.

BACKGROUND: Long-term exposure to PM2.5 is proved to be linked with mortality. However, limited studies have estimated the PM2.5 related loss of life expectancy (LLE) and its changing trends. How much life expectancy would be improved if PM2.5 pollution is reduced to the new WHO air quality guideline (AQG) level is unclear. METHODS: Data on deaths from all-causes, cancer, cardiovascular and respiratory diseases were collected from 5,565 Brazilian municipalities during 2010-2018. A difference-in-differences approach with quasi-Poisson regression was applied to examine the PM2.5-years of life lost (YLL) associations and PM2.5 associated LLE. RESULTS: The annual PM2.5 concentration in each municipality from 2010 to 2018 was 7.7 µg/m3 in Brazil. Nationally, with each 10 µg/m3 increase in five-year-average (current and previous four years) concentrations of PM2.5, the relative risks (RRs) were 1.18 (95% CI: 1.15-1.21) for YLL from all-causes, 1.22 (1.16-1.28) from cancer, 1.12 (1.08-1.17) from cardiovascular and 1.17 (1.10-1.25) from respiratory diseases. Life expectancy could be improved by 1.09 (95% CI: 0.92-1.25) years by limiting PM2.5 concentration to the national lowest level (2.9 µg/m3), specifically, 0.20 (0.15-0.24) years for cancer, 0.16 (0.11-0.22) years for cardiovascular and 0.09 (0.05-0.13) years for respiratory diseases, with significant disparities across regions and municipalities. Life expectancy would be improved by 0.78 (0.66-0.90) years by setting the new WHO AQG PM2.5 concentration level of 5 µg/m3 as an acceptable threshold. CONCLUSIONS: Using nationwide death records in Brazil, we found that long-term exposure to PM2.5 was associated with reduced life expectancy from all-causes, cancer, cardiovascular and respiratory diseases with regional inequalities and different trends. PM2.5 pollution abatement to below the WHO AQG level would improve this loss of life expectancy in Brazil.

Estimation of RF and ELF dose by anatomical location in the brain from wireless phones in the MOBI-Kids study.

Wireless phones (both mobile and cordless) emit not only radiofrequency (RF) electromagnetic fields (EMF) but also extremely low frequency (ELF) magnetic fields, both of which should be considered in epidemiological studies of the possible adverse health effects of use of such devices. This paper describes a unique algorithm, developed for the multinational case-control MOBI-Kids study, that estimates the cumulative specific energy (CSE) and the cumulative induced current density (CICD) in the brain from RF and ELF fields, respectively, for each subject in the study (aged 10-24 years old). Factors such as age, tumour location, self-reported phone models and usage patterns (laterality, call frequency/duration and hands-free use) were considered, as was the prevalence of different communication systems over time. Median CSE and CICD were substantially higher in GSM than 3G systems and varied considerably with location in the brain. Agreement between RF CSE and mobile phone use variables was moderate to null, depending on the communication system. Agreement between mobile phone use variables and ELF CICD was higher overall but also strongly dependent on communication system. Despite ELF dose distribution across the brain being more diffuse than that of RF, high correlation was observed between RF and ELF dose. The algorithm was used to systematically estimate the localised RF and ELF doses in the brain from wireless phones, which were found to be strongly dependent on location and communication system. Analysis of cartographies showed high correlation across phone models and across ages, however diagonal agreement between these cartographies suggest these factors do affect dose distribution to some level. Overall, duration and number of calls may not be adequate proxies of dose, particularly as communication systems available for voice calls tend to become more complex with time.

Predictors of psychological stress in silica-exposed workers in the artificial stone benchtop industry.

BACKGROUND AND OBJECTIVE: Artificial stone benchtops are a popular kitchen product, but dust from their preparation and installation contains respirable crystalline silica, which causes silicosis. Silicosis is a preventable, permanent lung disease. The aim of this study was to assess mental health in workers from the artificial stone benchtop industry at risk of silicosis. METHODS: Workers from the artificial stone benchtop industry undergoing assessment for silica-associated disease were included. Information on demographics; occupational, medical and smoking history; modified Medical Research Council dyspnoea scale; Perceived Stress Scale (PSS-10) questionnaire; spirometry; and chest x-ray was collected. Univariate and multivariate regression analyses were conducted. RESULTS: Of the 547 participants, the majority were men, aged under 45 years, in the industry for less than 10 years. With each increase of dyspnoea score, PSS-10 scores increased. Higher PSS-10 scores were also observed in those no longer in the industry, with a history of anxiety or depression, attending assessment early in the programme and a medium exposure duration. Participants who used an interpreter reported lower stress. No difference was observed across job title, age, sex, smoking, spirometry or chest x-ray categories after multivariate analysis. CONCLUSION: This study identified workers with dyspnoea as likely to report higher stress. Other factors, such as leaving the industry, early attendance and a history of anxiety or depression, are also helpful in identifying workers at risk of poorer mental health outcomes.

An exploration of the trajectory of psychological distress associated with exposure to smoke during the 2014 Hazelwood coal mine fire.

Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM2.5) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM2.5 exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM2.5 from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults.

Associations between long-term exposure to PM2.5 and site-specific cancer mortality: A nationwide study in Brazil between 2010 and 2018.

Long-term exposure to PM2.5 has been linked to lung cancer incidence and mortality, but limited evidence existed for other cancers. This study aimed to assess the association between PM2.5 on cancer specific mortality. An ecological study based on the cancer mortality data collected from 5,565 Brazilian cities during 2010-2018 using a difference-in-differences approach with quasi-Poisson regression, was applied to examine PM2.5-cancer mortality associations. Globally gridded annual average surface PM2.5 concentration was extracted and linked with the residential municipality of participants in this study. Sex, age stratified and exposure-response estimations were also conducted. Totalling 1,768,668 adult cancer deaths records of about 208 million population living across 5,565 municipalities were included in this study. The average PM2.5 concentration was 7.63 µg/m3 (standard deviation 3.32) with range from 2.95 µg/m3 to 28.5 µg/m3. With each 10 µg/m3 increase in three-year-average (current year and previous two years) concentrations of PM2.5, the relative risks (RR) of cancer mortality were 1.16 (95% confidence interval [CI]: 1.11-1.20) for all-site cancers. The PM2.5 exposure was significantly associated with several cancer-specific mortalities including oral, nasopharynx, oesophagus, and stomach, colon rectum, liver, gallbladder, larynx, lung, bone, skin, female breast, cervix, prostate, brain and leukaemia. No safe level of PM2.5 exposure was observed in the exposure-response curve for all types of cancer. In conclusion, with nationwide cancer death records in Brazil, we found that long-term exposure to ambient PM2.5 increased risks of mortality for many cancer types. Even low level PM2.5 concentrations had significant impacts on cancer mortality.

Long-term impacts of coal mine fire-emitted PM2.5 on hospitalisation: a longitudinal analysis of the Hazelwood Health Study.

BACKGROUND: Little is known about the long-term health impacts of exposures to landscape fire smoke. We aimed to evaluate the association between exposure to coal mine fire-related particulate matter 2.5 µm or less in diameter (PM2.5) and hospitalisation in the 5 years following the 6-week Hazelwood coal mine fire in Australia in 2014. METHODS: We surveyed 2725 residents (mean age: 58.3 years; 54.3% female) from an exposed and a comparison town. Individual PM2.5 exposures during the event were estimated using modelled PM2.5 concentrations related to the coal mine fire and self-reported location data. The individual exposure and survey data were linked with hospitalisation records between January 2009 and February 2019. Recurrent event survival analysis was used to evaluate relationships between PM2.5 exposure and hospitalisation following mine fire, adjusting for important covariates. RESULTS: Each 10-µg/m3 increase in mine fire-related PM2.5 was associated with a 9% increased hazard [hazard ratio (HR) = 1.09; 95% confidence interval (CI): 1.01, 1.17] of respiratory hospitalisation over the next 5 years, with stronger associations observed for females (HR = 1.16; 95% CI: 1.06, 1.27) than males (HR = 0.99; 95% CI: 0.89, 1.11). In particular, increased hazards were observed for hospitalisations for asthma (HR = 1.43; 95% CI: 1.19, 1.73) and chronic obstructive pulmonary disease (HR = 1.14; 95% CI: 1.02, 1.28). No such association was found for hospitalisations for cardiovascular diseases, mental illness, injuries, type 2 diabetes, renal diseases or neoplasms. CONCLUSIONS: A 6-week exposure to coal mine fire-related PM2.5 was associated with increased hazard of respiratory hospitalisations over the following 5 years, particularly for females.

Cancer and mortality in coal mine workers: a systematic review and meta-analysis.

Coal mine workers are exposed to a number of workplace hazards which may increase the risk of cancer and mortality. We conducted a systematic review and meta-analysis to investigate cancer and mortality in coal mine workers We searched in Ovid Medline, PubMed, Embase and Web of Science databases using keywords and text words related to coal mines, cancer and mortality and identified 36 full-text articles using predefined inclusion criteria. Each study's quality was assessed using the Newcastle-Ottawa Scale. We performed random-effect meta-analyses including 21 of the identified articles evaluating cancer and/or mortality of coal mine workers. The meta-analysis showed an increased risk of all-cause mortality (SMR 1.14, 95% CI 1.00 to 1.30) and mortality from non-malignant respiratory disease (NMRD) (3.59, 95% CI 3.00 to 4.30) in cohorts with coal workers' pneumoconiosis (CWP). We found a somewhat increased risk of stomach cancer (1.11, 95% CI 0.97 to 1.35) and of mortality from NMRD (1.26, 95% CI 0.99 to 1.61) in the cohorts of coal miners with unknown CWP status. The meta-analysis also showed a decreased risk of prostate cancer and cardiovascular and cerebrovascular mortality among coal miners. This may be a result of the healthy worker effect and possible lower smoking rates, and perhaps also reflect the physically active nature of many jobs in coal mines. The meta-analysis for lung cancer did not show increased risk in coal miners with CWP (1.49, 95% CI 0.70 to 3.18) or for coal miners of unknown CWP status (1.03, 95% CI 0.91 to 1.18). Lower smoking rates in coal mine workers could explain why case-control studies where smoking was controlled for showed higher risks for lung cancer than were seen in cohort studies. Coal mine workers are at increased risk of mortality from NMRD but decreased risk of prostate cancer and cardiovascular and cerebrovascular mortality. Studies of coal mine workers need long-term follow-up to identify increased mortality and cancer incidence.

Impacts of High Concentration, Medium Duration Coal Mine Fire Related PM2.5 on Cancer Incidence: 5-Year Follow-Up of the Hazelwood Health Study.

No studies have investigated the cancer outcomes from high level medium duration coal mine fire fine particulate matter ⩽2.5 µm in diameter (PM2.5) exposure. We included 2208 Morwell residents (exposed) and 646 Sale residents (unexposed) who participated in the Hazelwood Health Study Adult Survey. Competing risk regression models were used to evaluate relationships between coal mine fire exposure and cancer incidence, adjusting for known confounders. There were 137 cancers in the exposed and 27 in the unexposed over 14 849 person-years of follow-up. A higher risk of cancer incidence was observed for Morwell participants (HR = 1.67 [95% CI 1.05-2.67]), but no evidence to suggest associations between PM2.5 exposure and incidence of all cancers (HR = 1.02 [95% CI 0.91-1.13]), or site-specific cancers. There is no strong evidence that exposure to high concentrations of mine fire-related PM2.5 over a prolonged period could explain the higher risk in exposed population in this study.

Cohort studies of long-term exposure to outdoor particulate matter and risks of cancer: A systematic review and meta-analysis.

Robust evidence is needed for the hazardous effects of outdoor particulate matter (PM) on mortality and morbidity from all types of cancers. To summarize and meta-analyze the association between PM and cancer, published articles reporting associations between outdoor PM exposure and any type of cancer with individual outcome assessment that provided a risk estimate in cohort studies were identified via systematic searches. Of 3,256 records, 47 studies covering 13 cancer sites (30 for lung cancer, 12 for breast cancer, 11 for other cancers) were included in the quantitative evaluation. The pooled relative risks (RRs) for lung cancer incidence or mortality associated with every 10-µg/m3 PM2.5 or PM10 were 1.16 (95% confidence interval [CI], 1.10-1.23; I2 = 81%) or 1.22 (95% CI, 1.02-1.45; I2 = 96%), respectively. Increased but non-significant risks were found for breast cancer. Other cancers were shown to be associated with PM exposure in some studies but not consistently and thus warrant further investigation.

Cancer incidence in agricultural workers: Findings from an international consortium of agricultural cohort studies (AGRICOH).

BACKGROUND: Agricultural work can expose workers to potentially hazardous agents including known and suspected carcinogens. This study aimed to evaluate cancer incidence in male and female agricultural workers in an international consortium, AGRICOH, relative to their respective general populations. METHODS: The analysis included eight cohorts that were linked to their respective cancer registries: France (AGRICAN: n = 128,101), the US (AHS: n = 51,165, MESA: n = 2,177), Norway (CNAP: n = 43,834), Australia (2 cohorts combined, Australian Pesticide Exposed Workers: n = 12,215 and Victorian Grain Farmers: n = 919), Republic of Korea (KMCC: n = 8,432), and Denmark (SUS: n = 1,899). For various cancer sites and all cancers combined, standardized incidence ratios (SIR) and 95% confidence intervals (CIs) were calculated for each cohort using national or regional rates as reference rates and were combined by random-effects meta-analysis. RESULTS: During nearly 2,800,000 person-years, a total of 23,188 cancers were observed. Elevated risks were observed for melanoma of the skin (number of cohorts = 3, meta-SIR = 1.18, CI: 1.01-1.38) and multiple myeloma (n = 4, meta-SIR = 1.27, CI: 1.04-1.54) in women and prostate cancer (n = 6, meta-SIR = 1.06, CI: 1.01-1.12), compared to the general population. In contrast, a deficit was observed for the incidence of several cancers, including cancers of the bladder, breast (female), colorectum, esophagus, larynx, lung, and pancreas and all cancers combined (n = 7, meta-SIR for all cancers combined = 0.83, 95% CI: 0.77-0.90). The direction of risk was largely consistent across cohorts although we observed large between-cohort variations in SIR for cancers of the liver and lung in men and women, and stomach, colorectum, and skin in men. CONCLUSION: The results suggest that agricultural workers have a lower risk of various cancers and an elevated risk of prostate cancer, multiple myeloma (female), and melanoma of skin (female) compared to the general population. Those differences and the between-cohort variations may be due to underlying differences in risk factors and warrant further investigation of agricultural exposures.

Occupational silica exposure in an Australian systemic sclerosis cohort.

OBJECTIVE: To determine the frequency of self-reported occupational exposure to silica in SSc patients enrolled in the Australian Scleroderma Cohort Study, and to compare the disease characteristics of the silica-exposed patients with those of the non-exposed patients. METHOD: Data collected over a 12-year period from 1670 SSc patients were analysed. We compared the demographic and clinical characteristics of those who reported occupational silica exposure with those who did not. A subgroup analysis of male patients was performed, as well as a multivariable analysis of correlates of silica exposure. RESULTS: Overall, 126 (7.5%) of the cohort reported occupational silica exposure. These individuals were more likely to be male (73 of 231, i.e. 31.6% males exposed) and to have worked in mining and construction industries. Those who reported silica exposure were younger at the onset of SSc skin involvement [odds ratio (OR) 0.9, P = 0.02], of male gender (OR 14.9, P < 0.001), have joint contractures (OR 1.8, P = 0.05) and have higher physical disability as defined by scleroderma HAQ (OR 1.4, P = 0.01). CONCLUSION: The highest percentage of silica exposure was found in males. These patients were more likely to have the presence of certain clinical manifestations and Scl-70 antibody, which is known to confer a poor prognosis. These findings support the association between occupational silica exposure and the subsequent development of SSc. Further investigation is required to describe the range of clinical manifestations and disease course, including prognosis and treatment response, in those diagnosed with occupationally induced SSc compared with idiopathic SSc.

Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study.

BACKGROUND: We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. METHODS: MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. RESULTS: Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. CONCLUSIONS: There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.

Mortality and cancer incidence among male volunteer Australian firefighters.

OBJECTIVES: This study aims to investigate mortality and cancer incidence of Australian male volunteer firefighters and of subgroups of firefighters by duration of service, era of first service and the number and type of incidents attended. METHODS: Participating fire agencies supplied records of individual volunteer firefighters, including incidents attended. The cohort was linked to the Australian National Death Index and Australian Cancer Database. standardised mortality ratios (SMRs) and standardised incidence ratios (SIRs) for cancer were calculated. Firefighters were grouped into tertiles by duration of service and by number of incidents attended and relative mortality ratios and relative incidence ratios calculated. RESULTS: Compared with the general population, there were significant decreases in overall cancer incidence and in most major cancer categories. Prostate cancer incidence was increased compared with the general population, but this was not related to the number of incidents attended. Kidney cancer was associated with increased attendance at fires, particularly structural fires.The overall risk of mortality was significantly decreased, and all major causes of death were significantly reduced for volunteer firefighters. There was evidence of an increased mortality from ischaemic heart disease, with increased attendance at fires. CONCLUSION: Volunteer firefighters have a reduced risk of mortality and cancer incidence compared with the general population, which is likely to be a result of a 'healthy-volunteer' effect and, perhaps, lower smoking rates.

Assessment of personal exposure from radiofrequency-electromagnetic fields in Australia and Belgium using on-body calibrated exposimeters.

The purposes of this study were: i) to demonstrate the assessment of personal exposure from various RF-EMF sources across different microenvironments in Australia and Belgium, with two on-body calibrated exposimeters, in contrast to earlier studies which employed single, non-on-body calibrated exposimeters; ii) to systematically evaluate the performance of the exposimeters using (on-body) calibration and cross-talk measurements; and iii) to compare the exposure levels measured for one site in each of several selected microenvironments in the two countries. A human subject took part in an on-body calibration of the exposimeter in an anechoic chamber. The same subject collected data on personal exposures across 38 microenvironments (19 in each country) situated in urban, suburban and rural regions. Median personal RF-EMF exposures were estimated: i) of all microenvironments, and ii) across each microenvironment, in two countries. The exposures were then compared across similar microenvironments in two countries (17 in each country). The three highest median total exposure levels were: city center (4.33V/m), residential outdoor (urban) (0.75V/m), and a park (0.75V/m) [Australia]; and a tram station (1.95V/m), city center (0.95V/m), and a park (0.90V/m) [Belgium]. The exposures across nine microenvironments in Melbourne, Australia were lower than the exposures across corresponding microenvironments in Ghent, Belgium (p<0.05). The personal exposures across urban microenvironments were higher than those for rural or suburban microenvironments. Similarly, the exposure levels across outdoor microenvironments were higher than those for indoor microenvironments.

New Onset of Chronic Diseases and Changes in Lifestyle Risk Factors Among Gulf War Veterans: A Longitudinal Comparison of High and Low Symptom Reporters.

OBJECTIVE: The aim of this study was to compare new chronic diseases onset and longitudinal changes in lifestyle risk factors between Gulf War veterans with different symptom reporting. METHODS: Data were collected from Gulf War veterans over two periods, and participants were grouped according to baseline symptom reporting. Logistic, nominal, and ordinal regressions were used for between-group comparisons. RESULTS: The veterans comprised low, moderate, and high symptom reporters. New onset of sleep apnea [odds ratio (OR) = 9.49; 95% confidence interval (CI) = 3.48 to 25.86], musculoskeletal (OR = 8.70; 95% CI = 4.17 to 18.17), psychological (OR = 5.36; 95% CI = 2.46 to 11.70), and cardiovascular (OR = 3.86; 95% CI = 1.33 to 11.23) conditions was elevated in high versus low symptom reporters. Although odds of obesity and alcohol use increased over time and smoking halved, the changes were similar across groups. CONCLUSIONS: These findings show increasing obesity and alcohol use, and indicate that high symptomatology among veterans may predict future disease onset.