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We have studied the alterations in the use of curative treatment and the outcome for lung cancer patients in Norway 2001-2016. The Cancer Registry of Norway has a practically complete registration of all cancer diagnoses, treatments given and deaths. For the years 2001-2016, 43,137 patients were diagnosed with lung cancer. Stereotactic radiotherapy was established nationwide from 2008 and its use has increased, and in 2016, 8.8% were given this treatment. In addition 20.6% were operated and 8.5% were treated with conventional radiotherapy. Thus 37.9% of those diagnosed were treated with intention to cure, compared to 22.9% in 2001 (p < 0.0001). Further, the median survival for the whole group diagnosed with lung cancer increased from 6.0 (95% CI 5.6-6.7) months in 2001 to 11.8 (95% CI 10.9-12.7) in 2016. The 5 year survival increased from 9.4 (95% CI 8.1-10.8)% to 19.9 (95% CI 19.2-20.6)% in the same period. In 2016 the age adjusted incidence rate was 59.5 per 100,000 (Norwegian standard) and had increased significantly in both sexes. There had also been an increase in mean age at diagnosis and the proportion diagnosed in an early stage. The increase in curative treatment has been paralleled with a doubling in both the median and 5-year survival. The present results are used for surveillance and as a benchmark, and we are looking forward to reaching a proportion of 40% of patients given curative treatment.
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Neoplasias Pulmonares/radioterapia , Radiocirurgia/métodos , Carcinoma de Pequenas Células do Pulmão/radioterapia , Técnicas Estereotáxicas , Adulto , Idoso , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Sistema de Registros , Carcinoma de Pequenas Células do Pulmão/mortalidade , Taxa de Sobrevida , Resultado do TratamentoRESUMO
Cysteine is a rare and conserved amino acid involved in most cellular functions. The thiol group of cysteine can be subjected to diverse oxidative modifications that regulate many physio-pathological states. In the present work, a Cysteine-specific Phosphonate Adaptable Tag (CysPAT) was synthesized to selectively label cysteine-containing peptides (Cys peptides) followed by their enrichment with titanium dioxide (TiO2) and subsequent mass spectrometric analysis. The CysPAT strategy was developed using a synthetic peptide, a standard protein and subsequently the strategy was applied to protein lysates from Hela cells, achieving high specificity and enrichment efficiency. In particular, for Cys proteome analysis, the method led to the identification of 7509 unique Cys peptides from 500 µg of HeLa cell lysate starting material. Furthermore, the method was developed to simultaneously enrich Cys peptides and phosphorylated peptides. This strategy was applied to SILAC labeled Hela cells subjected to 5 min epidermal growth factor (EGF) stimulation. In total, 10440 unique reversibly modified Cys peptides (3855 proteins) and 7339 unique phosphopeptides (2234 proteins) were simultaneously identified from 250 µg starting material. Significant regulation was observed in both phosphorylation and reversible Cys modification of proteins involved in EGFR signaling. Our data indicates that EGF stimulation can activate the well-known phosphorylation of EGFR and downstream signaling molecules, such as mitogen-activated protein kinases (MAPK1 and MAPK3), however, it also leads to substantial modulation of reversible cysteine modifications in numerous proteins. Several protein tyrosine phosphatases (PTPs) showed a reduction of the catalytic Cys site in the conserved putative phosphatase HC(X)5R motif indicating an activation and subsequent de-phosphorylation of proteins involved in the EGF signaling pathway. Overall, the CysPAT strategy is a straight forward, easy and promising method for studying redox proteomics and the simultaneous enrichment strategy offers an excellent solution for characterization of cross-talk between phosphorylation and redox induced reversible cysteine modifications.
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Cisteína/química , Organofosfonatos/síntese química , Peptídeos/química , Proteômica/métodos , Cromatografia Líquida/métodos , Fator de Crescimento Epidérmico/farmacologia , Receptores ErbB/metabolismo , Células HeLa , Humanos , Marcação por Isótopo , Organofosfonatos/química , Fosfopeptídeos/química , Fosforilação , Transdução de Sinais/efeitos dos fármacos , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , TitânioRESUMO
OBJECTIVES: To investigate the association between tobacco smoking and disease activity, treatment adherence and treatment responses among patients with psoriatic arthritis (PsA) initiating the first tumour necrosis factor α inhibitor therapy (TNFi) in routine care. METHODS: Observational cohort study based on the Danish nationwide DANBIO registry. Kaplan-Meier plots, logistic and Cox regression analyses by smoking status (current/previous/never smoker) were calculated for treatment adherence, ACR20/50/70-responses and EULAR-good-response. Additional stratified analyses were performed according to gender and TNFi-subtype (adalimumab/etanercept/infliximab). RESULTS: Among 1388 PsA patients included in the study, 1148 (83%) had known smoking status (33% current, 41% never and 26% previous smokers). Median follow-up time was 1.22â years (IQR 0.44-2.96). At baseline, current smokers had lower Body Mass Index (27â kg/m(2) (23-30)/28â kg/m(2) (24-31)) (median (IQR)), shorter disease duration (3â years (1-8)/5â years (2-10)), lower swollen joint count (2 (0-5)/3 (1-6)), higher visual-analogue-scale (VAS) patient global (72â mm (54-87)/68â mm (50-80)), VAS fatigue (72â mm (51-86)/63â mm (40-77)) and Health Assessment Questionnaire (HAQ) score (1.1 (0.7 to 1.5)/1.0 (0.5 to 1.5)) than never smokers (all p<0.05). Current smokers had shorter treatment adherence than never smokers (1.56â years (0.97 to 2.15)/2.43â years (1.88 to 2.97), (median (95% CI)), log rank p=0.02) and poorer 6 months' EULAR-good-response rates (23%/34%), ACR20 (24%/33%) and ACR50 response rates (17%/24%) (all p<0.05), most pronounced in men. In current smokers, the treatment adherence was poorer for infliximab (HR) 1.62, 95% CI 1.06 to 2.48) and etanercept (HR 1.74, 1.14 to 2.66) compared to never smokers, but not for adalimumab (HR 0.80, 0.52 to 1.23). CONCLUSION: In PsA, smokers had worse baseline patient-reported outcomes, shorter treatment adherence and poorer response to TNFi's compared to non-smokers. This was most pronounced in men and in patients treated with infliximab or etanercept.
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Artrite Psoriásica/tratamento farmacológico , Etanercepte/uso terapêutico , Infliximab/uso terapêutico , Receptores do Fator de Necrose Tumoral/antagonistas & inibidores , Sistema de Registros , Fumar/efeitos adversos , Adulto , Antirreumáticos/uso terapêutico , Artrite Psoriásica/metabolismo , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do TratamentoRESUMO
Workflow managers play a critical role in the efficient planning and execution of complex workloads. A handful of these already exist within the world of computational materials discovery, but their dynamic capabilities are somewhat lacking. The PerQueue workflow manager is the answer to this need. By utilizing modular and dynamic building blocks to define a workflow explicitly before starting, PerQueue can give a better overview of the workflow while allowing full flexibility and high dynamism. To exemplify its usage, we present four use cases at different scales within computational materials discovery. These encapsulate high-throughput screening with Density Functional Theory, using active learning to train a Machine-Learning Interatomic Potential with Molecular Dynamics and reusing this potential for kinetic Monte Carlo simulations of extended systems. Lastly, it is used for an active-learning-accelerated image segmentation procedure with a human-in-the-loop.
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OBJECTIVES: Prior investigations identified an association between airborne cadmium and lung cancer but questions remain regarding confounding by arsenic, a well-established lung carcinogen. METHODS: A cadmium smelter population exhibiting excess lung cancer was re-analysed using a retrospective exposure assessment for arsenic (As), updated mortality (1940-2002), a revised cadmium (Cd) exposure matrix and improved work history information. RESULTS: Cumulative exposure metrics for both cadmium and arsenic were strongly associated making estimation of their independent effects difficult. Standardised mortality ratios (SMRs) were modelled with Poisson regression with the contribution of arsenic to lung cancer risk constrained by exposure-response estimates previously reported. The results demonstrate (1) a statistically significant effect of Cd independent of As (SMR=3.2 for 10 mg-year/m(3) Cd, p=0.012), (2) a substantial healthy worker effect for lung cancer (for unexposed workers, SMR=0.69) and (3) a large deficit in lung cancer mortality among Hispanic workers (SMR=0.27, p=0.009), known to have low lung cancer rates. A supralinear dose-rate effect was observed (contribution to risk with increasing exposure intensity has declining positive slope). Lung cancer mortality was somewhat better predicted using a cadmium burden metric with a half-life of about 20-25 years. CONCLUSIONS: These findings support an independent effect for cadmium in risk of lung cancer mortality. 1/1000 excess lifetime risk of lung cancer death is predicted from an airborne exposure of about 2.4 µg/m(3) Cd.
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Arsênio/toxicidade , Cádmio/toxicidade , Carcinógenos Ambientais/toxicidade , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/mortalidade , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Adulto , Humanos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/mortalidade , Análise de Regressão , Estudos Retrospectivos , Estados Unidos/epidemiologia , Adulto JovemRESUMO
BACKGROUND: LDL cholesterol (LDL-C) is a modifiable cardiovascular disease risk factor. We used 3 LDL-C methods to study the agreement between fasting and postprandial LDL-C in type 2 diabetes (T2DM) patients. METHODS: We served 74 T2DM patients a standardized meal and sampled blood at fasting and 1.5, 3.0, 4.5, and 6.0 h postprandially. We measured LDL-C by use of modified ß quantification (MBQ), the Friedewald equation (FE), and a direct homogeneous assay (DA). We evaluated agreement using 95% limits of agreement (LOA) within ±0.20 mmol/L (±7.7 mg/dL). RESULTS: LDL-C concentrations at all postprandial times disagreed with those at fasting for all methods. In 66 patients who had complete measurements with all LDL-C methods, maximum mean differences (95% LOA) in postprandial vs fasting LDL-C were -0.16 mmol/L (-0.51; 0.19) [-6.2 mg/dL (-19.7; 7.3)] with MBQ at 3 h; -0.36 mmol/L (-0.89; 0.17) [-13.9 mg/dL (-34; 6.6)] with FE at 4.5 h; and -0.24 mmol/L (-0.62; 0.05) [-9.3 mg/dL (-24; 1.9)] with DA at 6.0 h. In postprandial samples, FE misclassified 38% of patients (two-thirds of statin users) into lower Adult Treatment Panel III (ATP III) risk categories. Greater disagreement between fasting and postprandial LDL-C was observed in individuals with postprandial triglyceride concentrations >2.08 mmol/L (>184 mg/dL) and in women (interactions: P ≤ 0.038). CONCLUSIONS: Differences up to 0.89 mmol/L (34 mg/dL) between fasting and postprandial LDL-C concentrations, with postprandial LDL-C concentrations usually being lower, were found in T2DM by 3 different LDL-C methods. Such differences are potentially relevant clinically and suggest that, irrespective of measurement method, postprandial LDL-C concentrations should not be used to assess cardiovascular disease risk.
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LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , HDL-Colesterol/sangue , Jejum , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Triglicerídeos/sangueRESUMO
Experimental studies suggest that B vitamins such as niacin, folate, riboflavin, vitamin B6 and vitamin B12 may protect against DNA damage induced by ionising radiation (IR). However, to date, data from IR-exposed human populations are not available. We examined the intakes of these B vitamins and their food sources in relation to the frequency of chromosome translocations as a biomarker of cumulative DNA damage, in eighty-two male airline pilots. Dietary intakes were estimated by using a self-administered semi-quantitative FFQ. Translocations in peripheral blood lymphocytes were scored by using fluorescence in situ hybridisation whole-chromosome painting. Negative binomial regression was used to estimate rate ratios and 95 % CI, adjusted for age and occupational and lifestyle factors. We observed a significant inverse association between translocation frequency and dietary intake of niacin (P = 0·02): adjusted rate ratio for subjects in the highest tertile compared with the lowest tertile was 0·58 (95 % CI 0·40, 0·83). Translocation frequency was not associated with total niacin intake from food and supplements as well as dietary or total intake of folate, riboflavin or vitamin B6 or B12. However, the adjusted rate ratios were significant for subjects with ≥ median compared with < median intake of whole grains (P = 0·03) and red and processed meat (P = 0·01): 0·69 (95 % CI 0·50, 0·96) and 1·56 (95 % CI 1·13, 2·16), respectively. Our data suggest that a high intake of niacin from food or a diet high in whole grains but low in red and processed meat may protect against cumulative DNA damage in IR-exposed persons.
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Cromossomos/ultraestrutura , Dieta , Niacina/uso terapêutico , Translocação Genética/efeitos dos fármacos , Adulto , Biomarcadores/metabolismo , Dano ao DNA , Ácido Fólico/química , Humanos , Linfócitos/citologia , Masculino , Pessoa de Meia-Idade , Niacina/química , Ciências da Nutrição , Exposição Ocupacional , Espectrofotometria Infravermelho/métodos , Vitamina B 12/metabolismo , Vitamina B 6/metabolismoRESUMO
OBJECTIVE: Perchloroethylene (PCE) is a known animal carcinogen and probable human carcinogen. Dry cleaning exposures, particularly PCE, are also associated with renal toxicity. The objective was to follow-up a cohort of dry cleaners to evaluate mortality and assess end-stage renal disease (ESRD) morbidity. METHODS: This study adds 8 years of mortality follow-up for 1704 dry cleaning workers in four cities. Employees eligible for inclusion worked for ≥1 year before 1960 in a shop using PCE as the primary solvent. Life table analyses for mortality and ESRD morbidity were conducted. Only employees alive on 1 January 1977 were included in ESRD analyses. RESULTS: Overall cancer deaths were in significant excess in this cohort (standardised mortality ratio (SMR) 1.22, 95% CI 1.09 to 1.36). Oesophageal, lung and tongue cancers had significant excesses of deaths. Oesophageal cancer risk was highest among those employed in a PCE-using shop for ≥5 years with ≥20 years' latency since first such employment. Deaths from non-malignant underlying diseases of the stomach and duodenum were in significant excess. Hypertensive ESRD morbidity was significantly elevated in the entire cohort (standardised incidence ratio (SIR) 1.98, 95% CI 1.11 to 3.27), and among workers employed only in PCE-using dry cleaning shops for ≥5 years. CONCLUSION: Employment in the dry cleaning industry and occupational exposure to PCE are associated with an increased risk for ESRD and for cancer at several sites. The employment duration findings for oesophageal cancer and hypertensive ESRD further support an association with PCE exposure instead of lifestyle or socioeconomic factors.
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Falência Renal Crônica/epidemiologia , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Solventes/toxicidade , Tetracloroetileno/toxicidade , Adulto , Duodenopatias/induzido quimicamente , Duodenopatias/mortalidade , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/induzido quimicamente , Neoplasias de Cabeça e Pescoço/mortalidade , Humanos , Incidência , Falência Renal Crônica/induzido quimicamente , Lavanderia , Masculino , Morbidade , Doenças Profissionais/induzido quimicamente , Gastropatias/induzido quimicamente , Gastropatias/mortalidade , Fatores de Tempo , Estados Unidos/epidemiologia , Adulto JovemRESUMO
OBJECTIVES: To construct a job-exposure matrix (JEM) for an Ohio beryllium processing facility between 1953 and 2006 and to evaluate temporal changes in airborne beryllium exposures. METHODS: Quantitative area- and breathing-zone-based exposure measurements of airborne beryllium were made between 1953 and 2006 and used by plant personnel to estimate daily weighted average (DWA) exposure concentrations for sampled departments and operations. These DWA measurements were used to create a JEM with 18 exposure metrics, which was linked to the plant cohort consisting of 18,568 unique job, department and year combinations. The exposure metrics ranged from quantitative metrics (annual arithmetic/geometric average DWA exposures, maximum DWA and peak exposures) to descriptive qualitative metrics (chemical beryllium species and physical form) to qualitative assignment of exposure to other risk factors (yes/no). Twelve collapsed job titles with long-term consistent industrial hygiene samples were evaluated using regression analysis for time trends in DWA estimates. RESULTS: Annual arithmetic mean DWA estimates (overall plant-wide exposures including administration, non-production, and production estimates) for the data by decade ranged from a high of 1.39 µg/m(3) in the 1950s to a low of 0.33 µg/m(3) in the 2000s. Of the 12 jobs evaluated for temporal trend, the average arithmetic DWA mean was 2.46 µg/m(3) and the average geometric mean DWA was 1.53 µg/m(3). After the DWA calculations were log-transformed, 11 of the 12 had a statistically significant (p < 0.05) decrease in reported exposure over time. CONCLUSIONS: The constructed JEM successfully differentiated beryllium exposures across jobs and over time. This is the only quantitative JEM containing exposure estimates (average and peak) for the entire plant history.
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Poluentes Ocupacionais do Ar/análise , Berílio/análise , Exposição Ocupacional/análise , Monitoramento Ambiental/métodos , Humanos , Exposição Ocupacional/estatística & dados numéricos , Saúde Ocupacional , Estudos RetrospectivosRESUMO
OBJECTIVES: Beryllium has been identified as a human carcinogen on the basis of animal and epidemiological studies. The authors recently reported updated associations between lung cancer and beryllium exposure in a large, pooled occupational cohort. The authors conducted the present study to evaluate the shape of exposure-response associations between different exposure metrics and lung cancer in this cohort, considering potential confounders (race, plant, professional and short-term work status, and exposure to other lung carcinogens). METHODS: The authors conducted Cox proportional hazards regression analyses of lung cancer risk with cumulative, mean and maximum 'daily weighted average' (DWA) exposure among 5436 workers, using age-based risk sets. Different exposure-response curves were fitted to the exposure metrics, including categorical, power, restricted cubic spline and piecewise log-linear fits. RESULTS: The authors found significant positive associations between lung cancer and mean (p < 0.0001) and maximum (p < 0.0001) exposure, adjusting for age, birth cohort and plant, and for cumulative (p = 0.0017) beryllium exposure, adjusting for these factors plus short-term work status and exposure to asbestos. The best-fitting models were generally categorical or piecewise log-linear, with the steepest increase in lung cancer risk between 0 and 10 µg/m(3) for both mean and maximum DWA exposure and between 0 and 200 µg/m(3)-days for cumulative DWA exposure. The estimated mean DWA beryllium exposure associated with 10(-3) excess lifetime risk based on the piecewise log-linear model is 0.033 µg/m(3). CONCLUSION: This study provides evidence that lung cancer risk is elevated at levels near the current US Occupational Safety and Health Administration beryllium exposure limit of 2.0 µg/m(3) DWA for workers.
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Berílio/toxicidade , Carcinógenos/toxicidade , Neoplasias Pulmonares/induzido quimicamente , Doenças Profissionais/induzido quimicamente , Relação Dose-Resposta a Droga , Monitoramento Ambiental/métodos , Métodos Epidemiológicos , Monitoramento Epidemiológico , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Estados Unidos/epidemiologiaRESUMO
OBJECTIVES: To extend follow-up of cause-specific mortality in workers at seven beryllium processing plants and to estimate associations between mortality risk and beryllium exposure. METHODS: 9199 workers were followed for mortality from 1940 through 2005. Standardised mortality ratios (SMRs) were estimated based on US population comparisons for lung, nervous system and urinary tract cancers, chronic obstructive pulmonary disease (COPD), chronic kidney disease, and categories containing chronic beryllium disease (CBD) and cor pulmonale. Associations with maximum and cumulative exposure were calculated for a subset of the workers. RESULTS: Overall mortality in the cohort compared with the US population was elevated for lung cancer (SMR 1.17; 95% CI 1.08 to 1.28), COPD (SMR 1.23; 95% CI 1.13 to 1.32), and the categories containing CBD (SMR 7.80; 95% CI 6.26 to 9.60) and cor pulmonale (SMR 1.17; 95% CI 1.08 to 1.26). Mortality rates for most diseases of interest increased with time-since-hire. For the category including CBD, rates were substantially elevated compared to the US population across all exposure groups. Workers whose maximum beryllium exposure was ≥ 10 µg/m(3) had higher rates of lung cancer, urinary tract cancer, COPD and the category containing cor pulmonale than workers with lower exposure. Significant positive trends with cumulative exposure were observed for nervous system cancers (p = 0.0006) and, when short-term workers were excluded, lung cancer (p = 0.01), urinary tract cancer (p = 0.003) and COPD (p < 0.0001). CONCLUSION: These findings reaffirm that lung cancer and CBD, and suggest that COPD and nervous system and urinary tract cancers, are related to beryllium exposure. Cigarette smoking and exposure to other lung carcinogens are unlikely to explain these elevations.
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Berílio/toxicidade , Doenças Profissionais/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Beriliose/mortalidade , Relação Dose-Resposta a Droga , Monitoramento Ambiental/métodos , Métodos Epidemiológicos , Monitoramento Epidemiológico , Humanos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Neoplasias do Sistema Nervoso/induzido quimicamente , Neoplasias do Sistema Nervoso/mortalidade , Doenças Profissionais/mortalidade , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/análise , Doença Pulmonar Obstrutiva Crônica/induzido quimicamente , Doença Pulmonar Obstrutiva Crônica/mortalidade , Fumar/efeitos adversos , Fatores de Tempo , Estados Unidos/epidemiologia , Neoplasias Urológicas/induzido quimicamente , Neoplasias Urológicas/mortalidadeRESUMO
BACKGROUND: Person-years analysis is a fundamental tool of occupational epidemiology. A life table analysis system (LTAS), previously developed by the National Institute for Occupational Safety and Health, was limited by its platform and analysis and reporting capabilities. We describe the updating of LTAS for the Windows operating system (LTAS.NET) with improved properties. SOFTWARE DEVELOPMENT PROCESS: A group of epidemiologists, programmers, and statisticians developed software, platform, and computing requirements. Statistical methods include the use of (indirectly) standardized mortality ratios, (directly) standardized rate ratios, confidence intervals, and P values based on the normal approximation and exact Poisson methods, and a trend estimator for linear exposure-response associations. SOFTWARE FEATURES: We show examples using LTAS.NET to stratify and analyze multiple fixed and time-dependent variables. Data import, stratification, and reporting options are highly flexible. Users may export stratified data for Poisson regression modeling. CONCLUSIONS: LTAS.NET incorporates improvements that will facilitate more complex person-years analysis of occupational cohort data.
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Métodos Epidemiológicos , Tábuas de Vida , National Institute for Occupational Safety and Health, U.S./estatística & dados numéricos , Saúde Ocupacional/estatística & dados numéricos , Software/estatística & dados numéricos , Estudos de Coortes , Intervalos de Confiança , Humanos , Neoplasias Pulmonares/epidemiologia , Modelos Estatísticos , Estados Unidos/epidemiologiaRESUMO
An important effect of the frequency chirp of the optical transmitter in radio over multimode fiber links is put into evidence experimentally and modeled theoretically for the first time, to our knowledge. This effect can have an important impact in short-range connections, where, although intermodal dispersion does not generally cause unacceptable limitations to the transmittable bandwidth, the presence of modal noise must be accurately kept under control, since it determines undesired real-time fluctuations of the link.
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OBJECTIVES: 1-Bromopropane (1-BP) is an alternative for ozone depleting and other solvents; it is used in aerosol products, adhesives, and cleaning solvents. There is concern that 1-BP may be a reproductive and neurological toxicant. Mercapturic acid conjugates are excreted in urine from 1-BP metabolism involving debromination. The main objectives were to evaluate urinary bromide [Br(-)] and N-acetyl-S-(n-propyl)-L-cysteine (AcPrCys) for assessing 1-BP exposure in workers with low exposure. METHODS: Workers' 1-BP exposures were measured in their breathing zones with gas chromatography-flame ionization detection via NIOSH 1025. Urine specimens were obtained over a 48-h period at five facilities using vapor degreasers and one adhesive manufacturer. All of the workers' urine was collected into composite samples and analyzed separately representing daily time intervals: at work, after work but before bedtime, and upon awakening. Urinary metabolites were analyzed using intra-coupled plasma-mass spectroscopy for Br(-), and high-performance liquid chromatography and electro-spray ionization mass spectroscopy for AcPrCys. RESULTS: Time-weighted average (TWA) geometric mean (GM) breathing zone concentrations of 1-BP at vapor degreasing facilities were 2.6 and 0.31 ppm, respectively, for workers near degreasers and those remote from degreasers. Urine metabolites showed the same trend as TWA exposures: higher levels were observed for workers near degreasers (48-h GM Br(-) = 8.9 vs. 3.7; 48-h GM AcPrCys = 1.3 vs. 0.12, respectively). Associations of Br(-) and AcPrCys concentrations with 1-BP TWA were statistically significant near degreasers (p < 0.01). CONCLUSIONS: This study shows that urinary Br(-) and AcPrCys are useful biomarkers of workers' 1-BP exposures using analyses sensitive enough to measure low exposure jobs.
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Acetilcisteína/análogos & derivados , Brometos/urina , Manufaturas , Exposição Ocupacional/análise , Solventes/análise , Acetilcisteína/urina , Adulto , Poluentes Ocupacionais do Ar/análise , Monitoramento Ambiental , Feminino , Humanos , Hidrocarbonetos Bromados/análise , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos , Fatores de TempoRESUMO
INTRODUCTION: Hospital-acquired infections (HAI) are a significant cause of morbidity and mortality. Only point prevalence analyses of HAI have been recorded in Denmark. The aim of this study was to investigate the incidence and prevalence of HAI in patients admitted to departments of internal medicine. MATERIAL AND METHODS: The study involved seven departments and was designed as a cohort study based on reviews of medical records. Except for patients who had previously been admitted within the preceding 30 days, the study included all patients admitted for more than 48 hours during the 45-day study period. HAI was defined according to the criteria established by the Center for Disease Control and Prevention, USA. RESULTS: The incidence of HAI was 1.7 (62/3,568) per 100 days at risk (95% confidence interval (CI) 1.4-2.2), while the total prevalence of HAI was 9.7% (345/3,568) (95% CI 8.7-10.6). Exposure to bladder catheter was associated with an increased risk of urinary tract infection, incidence rate ratio 4.9; (95% CI 1.8-11.5). For the initial 14 days of hospitalization, the incidence of HAI was independent, while the prevalence increased linearly with duration of admittance. CONCLUSION: The incidence of HAI was relatively constant during the initial 14-day-period of hospitalization, suggesting that shortening the period will have no major impact on the incidence of HAI. The prevalence was 9.7%, which is in line with results from prior studies.
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Infecção Hospitalar/epidemiologia , Tempo de Internação/estatística & dados numéricos , Estudos de Coortes , Dinamarca/epidemiologia , Humanos , Incidência , Distribuição de Poisson , Prevalência , Estatísticas não Paramétricas , Cateterismo Urinário/efeitos adversos , Infecções Urinárias/etiologiaRESUMO
Previous studies report that truck drivers are at increased risk for illness and on-the-job mortality. It is unknown whether owner-operator truck drivers face the same risks as employee drivers, yet few studies have targeted owner-operators as a study population. This study examined the overall and cause-specific mortality ratios for a cohort with owner-operator truck drivers constituting 69% of the study population. Of the 26 major disease classifications and 92 specific causes of death examined, only mortality due to transportation accidents was significantly elevated (standardized mortality ratio=1.52, 95% confidence interval=1.36-1.70). Leading causes of death were ischemic heart disease and lung cancer, although risk was below that of the general population. Transportation accidents pose a particular hazard for members of the trade association. The absence of excess disease mortality deserves careful interpretation, and may be due to both a strong healthy worker effect and a short monitoring period.
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Acidentes de Trânsito/mortalidade , Neoplasias Pulmonares/mortalidade , Veículos Automotores/estatística & dados numéricos , Isquemia Miocárdica/mortalidade , Saúde Ocupacional/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Estados Unidos/epidemiologiaRESUMO
1-Bromopropane (1-BP) has been marketed as an alternative for ozone depleting and other solvents; it is used in aerosol products, adhesives, metal, precision, and electronics cleaning solvents. Mechanisms of toxicity of 1-BP are not fully understood, but it may be a neurological and reproductive toxicant. Sparse exposure information prompted this study using 1-BP air sampling and urinary metabolites. Mercapturic acid conjugates are excreted in urine from 1-BP metabolism involving debromination. Research objectives were to evaluate the utility of urinary N-acetyl-S-(n-propyl)-L-cysteine (AcPrCys) for assessing exposure to 1-BP and compare it to urinary bromide [Br((-))] previously reported for these workers. Forty-eight-hour urine specimens were obtained from 30 workers at two factories where 1-BP spray adhesives were used to construct polyurethane foam seat cushions. Urine specimens were also obtained from 21 unexposed control subjects. All the workers' urine was collected into composite samples representing three time intervals: at work, after work but before bedtime, and upon awakening. Time-weighted average (TWA) geometric mean breathing zone concentrations were 92.4 and 10.5 p.p.m. for spraying and non-spraying jobs, respectively. Urinary AcPrCys showed the same trend as TWA exposures to 1-BP: higher levels were observed for sprayers. Associations of AcPrCys concentrations, adjusted for creatinine, with 1-BP TWA exposure were statistically significant for both sprayers (P < 0.05) and non-sprayers (P < 0.01). Spearman correlation coefficients for AcPrCys and Br((-)) analyses determined from the same urine specimens were highly correlated (P < 0.0001). This study confirms that urinary AcPrCys is an important 1-BP metabolite and an effective biomarker for highly exposed foam cushion workers.
Assuntos
Acetilcisteína/análogos & derivados , Adesivos/metabolismo , Poluentes Ocupacionais do Ar/urina , Brometos/urina , Cromatografia Líquida de Alta Pressão/métodos , Acetilcisteína/urina , Adesivos/toxicidade , Adulto , Biomarcadores/urina , Feminino , Humanos , Hidrocarbonetos Bromados/metabolismo , Hidrocarbonetos Bromados/toxicidade , Masculino , Espectrometria de Massas/métodosRESUMO
In tungsten refining and manufacturing processes, a series of tungsten oxides are typically formed as intermediates in the production of tungsten powder. The present study was conducted to characterize airborne tungsten-containing fiber dimensions, elemental composition and concentrations in the US tungsten refining and manufacturing industry. During the course of normal employee work activities, seven personal breathing zone and 62 area air samples were collected and analyzed using National Institute for Occupational Safety and Health (NIOSH) fiber sampling and counting methods to determine dimensions, composition and airborne concentrations of fibers. Mixed models were used to identify relationships between potential determinants and airborne fiber concentrations. Results from transmission electron microscopy analyses indicated that airborne fibers with length >0.5 microm, diameter >0.01 microm and aspect ratios > or =3:1 were present on 35 of the 69 air samples collected. Overall, the airborne fibers detected had a geometric mean length approximately 3 microm and diameter approximately 0.3 microm. Ninety-seven percent of the airborne fibers identified were in the thoracic fraction (i.e. aerodynamic diameter < or = 10 microm). Energy dispersive X-ray spectrometry results indicated that airborne fibers prior to the carburization process consisted primarily of tungsten and oxygen, with other elements being detected in trace quantities. Based on NIOSH fiber counting 'B' rules (length > 5 microm, diameter < 3 microm and aspect ratio > or = 5:1), airborne fiber concentrations ranged from below the limit of detection to 0.085 fibers cm(-3), with calcining being associated with the highest airborne concentrations. The mixed model procedure indicated that process temperature had a marginally significant relationship to airborne fiber concentration. This finding was expected since heated processes such as calcining created the highest airborne fiber concentrations. The finding of airborne tungsten-containing fibers in this occupational setting needs to be confirmed in similar settings and demonstrates the need to obtain information on the durability and associated health effects of these fibers.
Assuntos
Poluentes Ocupacionais do Ar/análise , Metalurgia , Material Particulado/análise , Tungstênio/análise , Monitoramento Ambiental/métodos , Humanos , Modelos Estatísticos , Saúde Ocupacional , Tamanho da Partícula , Estados UnidosRESUMO
PURPOSE: The purpose of this study was to collect baseline prevalence data on the health problems faced by minority, white, and female farm operators. METHODS: An occupational health survey of farm operators was conducted by the U.S. Department of Agriculture, National Agricultural Statistics Service between February and August 2000. A stratified random sample of farm operators from 50 U.S. states based on the 1997 Census of Agriculture was selected for telephone interview. Interviews were primarily conducted using a computer assisted telephone instrument system. RESULTS: Population prevalences were calculated for 7137 farm operators. Prevalences were greatest for musculoskeletal discomfort, followed by respiratory problems, hearing loss, and hypertension. Generally, Latino and Asian American operators had lower prevalences for health problems than white non-Latino and white operators, respectively. African-American operators had greater prevalences for hypertension, and osteoarthritis, but lower prevalences for hearing loss, skin problems, heart problems, and cancer than white operators. American Indian or Alaska Native operators had higher prevalences for musculoskeletal problems, skin problems, and hypertension. CONCLUSIONS: Prevalences for the different ethnicity and race groups are not the same. Studies that combine racial and ethnic groups, or study only white and non-Latino farm operators may overestimate or underestimate the prevalence of health conditions in the entire farm operator population.
Assuntos
Doenças dos Trabalhadores Agrícolas/etnologia , Doenças dos Trabalhadores Agrícolas/epidemiologia , Agricultura , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Demografia , Feminino , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Saúde Ocupacional , Vigilância da População , Prevalência , Fatores Sexuais , Estados Unidos/epidemiologiaRESUMO
This paper reports on the first application of a liquid crystal infiltrated photonic bandgap fiber used as a tunable filter in an optical transmission system. The device allows low-cost amplified spontaneous emission (ASE) noise filtering and gain equalization with low insertion loss and broad tunability. System experiments show that the use of this filter increases for times the distance over which the optical signal-to-noise ratio (OSNR) is sufficient for error-free transmission with respect to the case in which no filtering is used.