Exposure to chlorinated solvents and lung cancer: results of the ICARE study.

OBJECTIVE: To investigate the role of occupational exposure to chlorinated solvents in lung cancer aetiology. METHODS: ICARE (Investigation of occupational and environmental CAuses of REspiratory cancers) is a French, multicentre, population-based, case-control study. Information on the lifelong work history of 2926 cases and 3555 controls was collected using standardised questionnaires. Occupational exposures were assessed using job-exposure matrices for five chlorinated solvents. Solvents were studied separately and in combinations. ORs were computed using unconditional logistic regression models adjusted for classic risk factors, including a history of cigarette smoking and exposure to asbestos. Adjustment for socioeconomic status (SES) was also made. RESULTS: After adjustment for exposure to asbestos, we observed a positive, statistically significant association with lung cancer for men and women exposed to a combination of perchloroethylene (PCE), trichloroethylene and dichloromethane (DCM). Further adjustment for SES slightly decreased this association. In contrast, no statistically significant associations were found for other solvent combinations. CONCLUSIONS: These results suggest that exposure to PCE may constitute a risk factor for lung cancer, especially among women, who seem to have a higher prevalence of exposure than men.

Sociodemographic factors and attitudes toward food affordability and health are associated with fruit and vegetable consumption in a low-income French population.

Determinants of fruit and vegetable consumption, including affordability and attitudes, have been poorly investigated, especially in European deprived populations. Our objective was to analyze various determinants of low consumption of fruits and vegetables in disadvantaged participants. Our participants were randomized into 2 groups, 1 which received nutritional advice alone and 1 that also received vouchers that were exchangeable for fruits and vegetables during a 12-mo period. Socioeconomic characteristics, food insufficiency, affordability, and motivation for eating fruits and vegetables were assessed. A short FFQ was administered. Determinants of consumption of <1 fruit or vegetable/d were analyzed using multivariate logistic regression. A total of 295 participants were included (mean age 44.8 y; 133 men, 162 women). At baseline, mean daily consumption of fruits and vegetables was 2.13 +/- 1.57 times/d. Nearly 30% of the sample did not eat fruits and vegetables every day. Determinants of low fruit and vegetable consumption were: age younger than 55 y, education level lower than tertiary, and absence of financial means for buying fruits and vegetables daily. Other determinants were affordability (whether fruits and vegetables are affordable, lack of money in preventing healthy diet) and attitudes (whether one's own diet is healthy, whether or not fruits and vegetables improve health, whether eating fruits and vegetables is a pleasure). Thus, determinants of inadequate consumption of fruits and vegetables in this deprived French population are numerous. The impact of financial difficulties is crucial, as is the perception of affordability of fruits and vegetables.

Macrovascular and microvascular dysfunction in the metabolic syndrome.

The metabolic syndrome (MetS) is associated with increased risk of type-2 diabetes and cardiovascular disease (CVD). We hypothesized that both small and large arteries may be impaired in subjects with the MetS, even in the absence of known CVD or diabetes. We compared both skin capillary density (CD) and pulse-wave velocity (PWV) in 36 cases with the MetS with those from 108 age- and gender-matched controls from the SU.VIM.AX-2 cohort. Compared with controls, MetS subjects demonstrated increased PWV (12.2+/-2.8 vs. 10.7+/-1.9 m s(-1), P=0.005) and lower functional CD (83.1+/-15.7 vs. 89.4+/-14.2 capillaries per mm(2), P=0.03). Functional CD was inversely related to fasting glucose, triglycerides (TGs) and HOMA-IR (all P<0.05). On the other hand, no association was found between CD and BP or with PWV. In multivariate models, the odds ratios (95% confidence interval) for one standard deviation change, for having an impaired PWV (>or=12 m s(-1), n=44), were: 1.65 (1.11-2.45) for systolic BP and 1.93 (1.25-2.99) for TG only. For impaired CD (