Occupational exposure limits for reproductive toxicants - A comparative analysis.

We investigated the level of protection of reproductive and developmental toxicity offered through occupational exposure limits (OELs) and Derived No-Effect Levels for workers' inhalation exposure (wDNELs). We compared coverage of substances that have a harmonised classification as reproductive toxicant 1 A or 1B (Repr.1 A/B), numerical values and scientific basis of 12 lists of OELs and wDNELs from REACH Registrants' and the Committee for Risk Assessment. Across the 14 sources of OELs and wDNELs, 53 % of the Repr1A/B-substances had at least one exposure limit (counting groups of metals as one entry). Registrants' wDNELs covered the largest share, 40 %. The numerical values could be highly variable for the same substance across the lists. How often reproductive toxicity is identified as the critical effect varies between the examined lists, both due to different assessments of the same substance and different substance coverage. Reviewing the margin of safety to reproductive toxicity cited in the documents, we found that 15 % of safety margins were lower to reproductive toxicity than the critical effect. To conclude, neither the REACH nor work environment legislation supply wDNELs or OELs for a substantial share of known reproductive toxicants. EU OELs cover among the fewest substances in the range, and in many cases national OELs or wDNELs are set at more conservative levels.

Time Patterns in Internal Human Exposure Data to Bisphenols, Phthalates, DINCH, Organophosphate Flame Retardants, Cadmium and Polyaromatic Hydrocarbons in Europe.

Human biomonitoring (HBM) data in Europe are often fragmented and collected in different EU countries and sampling periods. Exposure levels for children and adult women in Europe were evaluated over time. For the period 2000-2010, literature and aggregated data were collected in a harmonized way across studies. Between 2011-2012, biobanked samples from the DEMOCOPHES project were used. For 2014-2021, HBM data were generated within the HBM4EU Aligned Studies. Time patterns on internal exposure were evaluated visually and statistically using the 50th and 90th percentiles (P50/P90) for phthalates/DINCH and organophosphorus flame retardants (OPFRs) in children (5-12 years), and cadmium, bisphenols and polycyclic aromatic hydrocarbons (PAHs) in women (24-52 years). Restricted phthalate metabolites show decreasing patterns for children. Phthalate substitute, DINCH, shows a non-significant increasing pattern. For OPFRs, no trends were statistically significant. For women, BPA shows a clear decreasing pattern, while substitutes BPF and BPS show an increasing pattern coinciding with the BPA restrictions introduced. No clear patterns are observed for PAHs or cadmium. Although the causal relations were not studied as such, exposure levels to chemicals restricted at EU level visually decreased, while the levels for some of their substitutes increased. The results support policy efficacy monitoring and the policy-supportive role played by HBM.

Application of human biomonitoring data to support policy development, raise awareness and environmental public health protection among countries within the HBM4EU project.

Most countries have acknowledged the importance of assessing and quantifying their population's internal exposure from chemicals in air, water, soil, food and other consumer products due to the potential health and economic impact. Human biomonitoring (HBM) is a valuable tool which can be used to quantify such exposures and effects. Results from HBM studies can also contribute to improving public health by providing evidence of individuals' internal chemical exposure as well as data to understand the burden of disease and associated costs thereby stimulating the development and implementation of evidence-based policy. To have a holistic view on HBM data utilisation, a multi-case research approach was used to explore the use of HBM data to support national chemical regulations, protect public health and raise awareness among countries participating in the HBM4EU project. The Human Biomonitoring for Europe (HBM4EU) Initiative (https://www.hbm4eu.eu/) is a collaborative effort involving 30 countries, the European Environment Agency (EEA) and the European Commission (contracting authority) to harmonise procedures across Europe and advance research into the understanding of the health impacts of environmental chemical exposure. One of the aims of the project was to use HBM data to support evidence based chemical policy and make this information timely and directly available for policy makers and all partners. The main data source for this article was the narratives collected from 27 countries within the HBM4EU project. The countries (self-selection) were grouped into 3 categories in terms of HBM data usage either for public awareness, policy support or for the establishment HBM programme. Narratives were analysed/summarised using guidelines and templates that focused on ministries involved in or advocating for HBM; steps required to engage policy makers; barriers, drivers and opportunities in developing a HBM programme. The narratives reported the use of HBM data either for raising awareness or addressing environmental/public health issues and policy development. The ministries of Health and Environment were reported to be the most prominent entities advocating for HBM, the involvement of several authorities/institutions in the national hubs was also cited to create an avenue to interact, discuss and gain the attention of policy makers. Participating in European projects and the general population interest in HBM studies were seen as drivers and opportunities in developing HBM programmes. A key barrier that was cited by countries for establishing and sustaining national HBM programmes was funding which is mainly due to the high costs associated with the collection and chemical analysis of human samples. Although challenges and barriers still exist, most countries within Europe were already conversant with the benefits and opportunities of HBM. This article offers important insights into factors associated with the utilisation of HBM data for policy support and public awareness.

Alzheimer's Disease Association with Metals and Metalloids Concentration in Blood and Urine.

As there is some evidence that the risk for Alzheimer's disease (AD) is partially attributable to environmental exposure to some metals and metalloids, we examined an association between AD and arsenic, chromium, and selenium in 53 AD patients and 217 controls. Urinary arsenic, blood chromium, and selenium were determined by inductively coupled plasma mass spectrometry. Logistic regression models calculating odds ratios (ORs) and 95% confidence intervals (CI) were used to estimate AD association with arsenic, chromium, and selenium. In AD patients, urinary arsenic and blood chromium were significantly higher, while blood selenium was significantly lower compared to controls. Increased blood selenium was related to a significant decrease in the odds of AD after adjustment for risk factors. Blood selenium per 1 kg × 10-9/m3 × 10-4 increment was associated with 1.4 times lower risk of AD (OR = 0.71; 95% CI 0.58-0.87). A significant increase in the odds of AD associated with increased blood chromium was also seen in the adjusted model: the OR per 1 kg × 10-9/m3 × 10-3 chromium increment was 2.39 (95% CI 1.32-4.31). The association of urinary arsenic with the risk of AD was not significant. The data obtained provide evidence that selenium reduces the risk of Alzheimer's disease, while chromium increases it.

Potential Relationship between Cerebral Fractional Tissue Oxygen Extraction (FTOE) and the Use of Sedative Agents during the Perioperative Period in Neonates and Infants.

Fractional tissue oxygen extraction (FTOE) by means of cerebral near-infrared spectroscopy (NIRS) provides information about oxygen uptake in the brain. Experimental animal data suggest that sedative agents decrease cerebral oxygen demand. The aim of the present study was to investigate the association between the cerebral FTOE and the use of pre and intraoperative sedative agents in infants aged 1-90 days. Cerebral NIRS was continuously applied during open major non-cardiac surgery in 46 infants. The main outcomes were the mean intraoperative FTOE and the percentage (%) of time of intraoperative hyperoxiaFTOE relative to the total duration of anesthesia. HyperoxiaFTOE was defined as FTOE ≤ 0.1. Cumulative doses of sedative agents (benzodiazepines and morphine), given up to 24 h preoperatively, correlated with the mean intraoperative FTOE (Spearman's rho = -0.298, p = 0.0440) and were predictive for the % of time of intraoperative hyperoxiaFTOE (ß (95% CI) 47.12 (7.32; 86.92)) when adjusted for the patients' age, type of surgery, preoperative hemoglobin, intraoperative sevoflurane and fentanyl dose, mean intraoperative arterial blood pressure, and end-tidal CO2 by multivariate 0.75 quantile regression. There was no association with 0.5 quantile regression. We observed the suggestive positive association of decreased fractional cerebral tissue oxygen extraction and the use of sedative agents in neonates and infants undergoing surgery.

Cadmium Exposure and Risk of Breast Cancer by Histological and Tumor Receptor Subtype in White Caucasian Women: A Hospital-Based Case-Control Study.

As the majority of experimental studies suggest cadmium being metalloestrogen, we examined cadmium/breast cancer (BC) association by histological and tumor receptor subtype in 509 invasive BC patients and 1170 controls. Urinary cadmium was determined by atomic absorption spectrometry, and categorized using tertiles of its distribution in the controls: <0.18, 0.18-0.33, >0.33 kg × 10-9/kg × 10-3 creatinine. Relative to the lowest category of urinary cadmium adjusted odds ratio (OR) of ductal BC was 1.18 (95% confidence interval (CI): 0.89-1.58) in the intermediate and 1.53 (95% CI: 1.15-2.04) in the highest category. There was a significant association for hormone receptor-positive ductal BC: ORs per category increase were 1.34 (95% CI: 1.14-1.59) for estrogen receptor-positive (ER+), 1.33 (95% CI: 1.09-1.61) for progesterone receptor-positive (PR+) and 1.35 (95% CI: 1.11-1.65) for ER+/PR+ BC. We found a significant association between cadmium and human epidermal growth factor receptor 2-negative (HER2-) ductal BC. The strongest association with cadmium was for ER+/PR+/HER2- ductal BC. The associations between cadmium and lobular BC with hormone receptor-positive and HER2- were positive but insignificant. There was no evidence that the associations with cadmium differed for cancers with different tumor histology (p-heterogeneity > 0.05). This study provides evidence that urinary cadmium is associated with the risk of hormone receptor-positive and HER2- breast cancer independent of tumor histology.

Association between lifetime exposure to passive smoking and risk of breast cancer subtypes defined by hormone receptor status among non-smoking Caucasian women.

Tobacco smoking is inconsistently associated with breast cancer. Although some studies suggest that breast cancer risk is related to passive smoking, little is known about the association with breast cancer by tumor hormone receptor status. We aimed to explore the association between lifetime passive smoking and risk of breast cancer subtypes defined by estrogen receptor and progesterone receptor status among non-smoking Caucasian women. A hospital-based case-control study was performed in 585 cases and 1170 controls aged 28-90 years. Information on lifetime passive smoking and other factors was collected via a self-administered questionnaire. Logistic regression was used for analyses restricted to the 449 cases and 930 controls who had never smoked actively. All statistical tests were two-sided. Adjusted odds ratio of breast cancer was 1.01 (95% confidence interval (CI): 0.72-1.41) in women who experienced exposure to passive smoking at work, 1.88 (95% CI: 1.38-2.55) in women who had exposure at home, and 2.80 (95% CI: 1.84-4.25) in women who were exposed at home and at work, all compared with never exposed regularly. Increased risk was associated with longer exposure: women exposed ≤ 20 years and > 20 years had 1.27 (95% CI: 0.97-1.66) and 2.64 (95% CI: 1.87-3.74) times higher risk of breast cancer compared with never exposed (Ptrend < 0.001). The association of passive smoking with hormone receptor-positive breast cancer did not differ from that with hormone receptor-negative breast cancer (Pheterogeneity > 0.05). There was evidence of interaction between passive smoking intensity and menopausal status in both overall group (P = 0.02) and hormone receptor-positive breast cancer group (P < 0.05). In Caucasian women, lifetime exposure to passive smoking is associated with the risk of breast cancer independent of tumor hormone receptor status with the strongest association in postmenopausal women.

Assessment of risk factors for cerebral oxygen desaturation during neonatal and infant general anesthesia: an observational, prospective study.

BACKGROUND: Cerebral oxygen saturation (rSO2c) decrease from baseline greater than 20 % during infant cardiac surgery was associated with postoperative neurologic changes and neurodevelopmental impairment at 1 year of age. So far, there is no sufficient evidence to support the routine monitoring of rSO2c during general surgical procedures in children. We aimed to find out the frequency of cerebral desaturation 20 % or more from baseline and to identify possible predictors of change in cerebral oxygen saturation during neonatal and infant general surgery. METHODS: Forty-four infants up to 3 months of age were recruited. Before induction of anesthesia, two pediatric cerebral sensors were placed bilaterally to the forehead region and monitoring of regional cerebral saturation of oxygen was started and continued throughout the surgery. Simultaneously, mean arterial blood pressure (MAP), pulse oximetry (SpO2), heart rate (HR), endtidal CO2, expired fraction of sevoflurane and rectal temperature were recorded. The main outcome measure was rSO2c value drop-off ≥20 % from baseline. Mann-Whitney U-test, chi-squared test, simple and multiple linear regression models were used for statistical analysis. RESULTS: Forty-three infants were analyzed. Drop-off ≥20 % in rSO2c from baseline occurred in 8 (18.6 %) patients. There were no differences in basal rSO2c, SpO2, HR, endtidal CO2, expired fraction of sevoflurane and rectal temperature between patients with and without desaturation 20 % or more from baseline. But the two groups differed with regard to gestation, preoperative mechanical ventilation and the use of vasoactive medications and red blood cell transfusions during surgery. Simple linear regression model showed, that gestation, age, preoperative mechanical ventilation and mean arterial pressure corresponding to minimal rSO2c value during anesthesia (MAPminrSO2c) were associated with a change in rSO2c values. Multiple regression model including all above mentioned variables, revealed that only MAPminrSO2c was predictive for a change in rSO2c values (ß (95 % confidence interval) -0.28 (-0.52-(-0.04)) p = 0.02). CONCLUSIONS: Cerebral oxygen desaturation ≥20 % from baseline occurred in almost one fifth of patients. Although different perioperative factors can predispose to cerebral oxygenation changes, arterial blood pressure seems to be the most important. Gestation as another possible risk factor needs further investigation. TRIAL REGISTRATION: The international registration number NCT02423369 . Retrospectively registered on April 2015.

The Association of Low-To-Moderate Alcohol Consumption with Breast Cancer Subtypes Defined by Hormone Receptor Status.

BACKGROUND: Alcohol is a well-established risk factor for breast cancer, but pathways involved in alcohol-related breast carcinogenesis are not clearly defined. We examined the association between low-to-moderate alcohol intake and breast cancer subtypes by tumor hormone receptor status. MATERIALS AND METHODS: A hospital-based case-control study was performed in 585 cases and 1,170 controls. Information on alcohol intake and other risk factors was collected via a questionnaire. Logistic regression was used for analyses. All statistical tests were two-sided. RESULTS: The odds ratio of breast cancer was 1.75 (95% confidence interval [CI]: 1.21-2.53) in women who consumed ≤5 drinks/week, and 3.13 (95% CI: 1.81-5.43) in women who consumed >5 drinks/week, both compared with non-drinkers for ≥10 years, after adjustment for age and other confounders. The association of alcohol intake with estrogen receptor-positive breast cancer was stronger than with estrogen receptor-negative: the odds ratio per 1 category increase was 2.05 (95% CI: 1.49-2.82) and 1.29 (95% CI: 0.85-1.94) (P-heterogeneity = 0.07). There was no evidence of an interaction between alcohol intake and menopausal status (P = 0.19) in overall group; however, it was significant in estrogen receptor-positive breast cancer (P = 0.04). CONCLUSIONS: Low-to-moderate alcohol intake is associated with the risk of estrogen receptor-positive breast cancer with the strongest association in postmenopausal women. Since alcohol intake is a modifiable risk factor of breast cancer, every woman should be informed and advised to control alcohol use.

Association between cadmium and breast cancer risk according to estrogen receptor and human epidermal growth factor receptor 2: epidemiological evidence.

The study aimed to examine the association between cadmium (Cd) and the risk of breast cancer according to estrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2). A hospital-based case-control study was carried out in 585 cases and 1,170 controls. Information on possible risk factors was collected via a structured questionnaire. Urinary Cd was determined by atomic absorption spectrometry. The ER and HER2 levels in tumor tissue were analyzed by immunohistochemistry. Logistic regression was used to calculate odds ratios (ORs) and 95 % confidence intervals (CIs) for breast cancer by creatinine-adjusted urinary Cd. Women with greater creatinine-adjusted urine Cd (3rd quartile: 0.241-0.399 µg/g and 4th quartile: ≥ 0.4 µg/g) experienced 1.6 times higher risk of breast cancer compared with those having Cd concentration lower than 0.147 µg/g (1st quartile) [OR = 1.6, (95 % CI 1.19, 2.17) and OR = 1.62 (95 % CI 1.19, 2.21), respectively, P trend = 0.001] after adjustment for age and other confounders. Both ER+ and HER2- cases from the highest quartile of urine Cd exhibited approximately twice the breast cancer risk of those in the lowest quartile [OR = 1.9, (95 % CI 1.31, 2.74) and OR = 1.87, (95 % CI 1.33, 2.62), respectively, P trend <0.001) after adjustment for confounders. The data support cadmium as a risk factor for breast cancer, especially for both ER+ and HER2- cancer patients.

Assessment of a questionnaire for breast cancer case-control studies.

The aim of the present study was to assess criterion validity and external reliability of a questionnaire on risk factors for breast cancer. Materials and Methods. Women with breast cancer diagnosis (the cases) (N=40) and matched individuals without cancer (the controls) (N=40) were asked to fill in a questionnaire twice: on a day of admission to hospital (Q1) and on a day before discharge (Q2), with a time interval of 4-6 days. The questionnaire included questions (N=150) on demographic and socioeconomic factors, diseases in the past, family history of cancer, woman's health, smoking, alcohol use, diet, physical activity, and work environment. Criterion validity of the questionnaire Q2 relative to reference questionnaire Q1 was assessed with the Spearman correlation coefficient (SCC); external reliability of the questionnaire was measured in terms of the intraclass correlation coefficient (ICC). Statistical analysis was performed with SPSS 16. Results. The responses to most of the questions on socioeconomic factors, family history on cancer, female health, lifestyle risk factors (smoking, alcohol use, physical activity) correlated substantially in both the cases and the controls with SCC and ICC>0.7 (p<0.01). Statistically non significant relationships defined only between the responses on amount of beer the cases drank at the ages up to 25 years and 26-35 years as well as time of use of estrogen and estrogens-progestin during menopause by the cases. Moderate and substantial SCC and ICC were determined for different food items. Only the response of the cases on veal consumption did not correlate significantly. Conclusions. The questionnaire on breast cancer risk factors is valid and reliable for most of the questions included.

What are the predictors of self-assessed health in Lithuanian health professionals?

BACKGROUND AND OBJECTIVE: Scientific evidence indicates that patient safety and access to health care is linked to the well-being of health professionals. The self-assessed health status has been widely used as a health measure in different surveys. The aim of this study was to examine and determine the factors related to the self-assessed health status of health professionals. MATERIAL AND METHODS: The cross-sectional questionnaire surveys of nurses and physicians were carried out in randomly selected hospitals. A total of 1025 health professionals (739 nurses and 286 physicians) from 3 hospitals of different size located in 1 geographical region of Lithuania participated in the survey. The response rate among the nurses and the physicians was 89.2% and 52.5%, respectively. The overall response rate was 74.7%. The data on self-assessed health, demographic factors, anthropometric data, blood pressure, cholesterol level in blood, personal history of diseases, smoking, and alcohol consumption were gathered with the help of the questionnaire. RESULTS: About two-thirds (64.1%) of the health professionals reported good or quite good health, and only 1.5% of the respondents reported quite poor or poor health. Multivariate logistic regression analysis revealed that the SAH status of health professionals was dependent on age (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05 [Model 1]; OR, 1.04; 95% CI, 1.02-1.06 [Model 2]), diseases (OR, 7.32; 95%, 5.18-10.35), heart diseases (OR, 12.09; 95% CI, 2.9-50.35), hypertension (OR, 2.53; 95% CI, 1.55-4.14), cancer (OR, 6.19; 95% CI, 1.27-30.13), gastrointestinal (OR, 3.54; 95% CI, 1.59-7.86) and musculoskeletal diseases (OR, 3.21; 95% CI, 1.71-6.02), smoking (OR, 2.1; 95% CI, 1.28-3.45 [Model 1]; OR, 2.00; 95% CI, 1.26-3.16 [Model 2]), and occupation (OR, 1.47; 95% CI, 1.04-2.07 [ Model 1]; OR, 1.54; 95% CI, 1.11-2.16 [Model 2]). CONCLUSIONS: Diseases are the main predictors of self-assessed health in health professionals. Advancing age and smoking also contribute to poorer self-assessed health.

Cadmium concentration in biological media of breast cancer patients.

The study aimed to determine and compare cadmium (Cd) concentration in different biological media of breast cancer and benign breast tumor patients. Concentration of Cd was determined in breast tissue, urine, and blood of 57 breast cancer and 51 benign tumor patients. Two samples of breast tissue from each patient, i.e., tumor and healthy tissue were taken for the analysis. Cd in biological media was determined by atomic absorption spectrometry (Perkin-Elmer, Zeeman 3030). The mean Cd concentration in breast cancer patients was 0.053 µg/g (95% confidence intervals, CI 0.042-0.065) for tumor sample and 0.02 µg/g (95% CI 0.014-0.026) for healthy breast tissue sample (P < 0.001). In benign tumor patients, the figures were as follows: 0.037 µg/g (95% CI 0.023-0.051) and 0.032 µg/g (95% CI 0.018-0.047) (P > 0.05). Cd content in malignant tumor significantly differed from that in benign tumor (P < 0.01). Cancer patients with positive estrogen receptors (ERs) had significantly greater concentration of breast tissue Cd compared to patients with negative ERs (P = 0.035). Adjusted for creatinine, Cd in urine was significantly higher in cancer patients than in controls (P < 0.001). In cancer patients, a positive Spearman's correlation was found between Cd in tumor and healthy breast tissue, blood (r = 0.44 and r = 0.39, respectively, P < 0.01). Correlation between Cd in urine of cancer patients and number of cigarettes smoked during lifetime was suggestive (r = 0.59, P = 0.075). The data obtained show higher concentration of cadmium in breast tumor and urine of cancer patients and support a possible relationship between cadmium and breast cancer.

Environmental factors and breast cancer.

This review summarizes the results of studies on the effects of environment on breast cancer risk. As known risk factors such as reproductive life, inheritance, and socioeconomic status are estimated to explain only about half of the breast cancer cases, it has been thought that environmental factors could also be related to the risk of this disease. It is known that ionizing radiation is an environmental risk factor increasing the risk of breast cancer. The data of experimental studies show that some organochlorines could be associated with breast cancer risk although the data from epidemiological studies are not consistent due to the difficulties to assess exposure and other risk factors. Recent experimental studies show that cadmium is an environmental factor that mimics the effects of estradiol in estrogen-responsive breast cancer cell lines while solar radiation possibly decreases the risk due to protective effect of vitamin D. The data on the effect of electromagnetic fields are not consistent. Although evidence about the effect of environmental factors on the risk of breast cancer is not convincing, some of these factors together with inheritance, reproductive life, and age at exposure could be associated with an increased risk of the disease.

[Association between cadmium and breast cancer]. / Sasajos tarp kadmio ir kruties vezio.

Cadmium is a known human lung carcinogen, although some studies indicate a link between cadmium exposure and human breast cancer. The objective of this study was to assess cadmium concentration in breast tissue samples of patients with breast cancer and benign breast tumor. MATERIAL AND METHODS. The concentration of cadmium was determined in breast tissue samples of 21 breast cancer and 19 benign tumor patients. Two samples of breast tissue from each patient, i.e. tumor and normal tissue close to tumor, were taken for the analysis. Cadmium was determined by atomic absorption spectrometry (Perkin-Elmer, Zeeman 3030). RESULTS. In patients with breast cancer, the mean cadmium concentration was 33.1 ng/g (95% CI, 21.9-44.4) in malignant breast tissue and 10.4 ng/g (95% CI, 5.6-15.2) in normal breast tissue (P=0.002). In patients with benign tumor, the corresponding values were 17.5 ng/g (95% CI, 8.4-26.5) and 11.8 ng/g (95% CI, 5.1-18.5) (P=0.3144). There was a statistically significant difference in cadmium concentration between malignant and benign breast tissues (P=0.009). CONCLUSION. The data obtained show that cadmium concentration is significantly higher in malignant breast tissue as compared with normal breast tissue of the same women or benign breast tissue. Further studies are necessary to determine the association between cadmium concentration in malignant breast tissue and estrogen receptor level, and smoking.

Salt-preserved foods and risk of gastric cancer.

UNLABELLED: Gastric cancer is one of the main health issues in Lithuania. The risk factors of the disease are related to nutrition and environment. There were no epidemiological studies on this subject in the country. The aim of the study was to assess the relationship between risk of gastric cancer and consumption of salt and salt-preserved food. MATERIAL AND METHODS: A hospital based case-control study included 379 cases with newly histologically confirmed diagnosis of gastric cancer and 1,137 controls that were cancer and gastric diseases free. Cases and controls matched by gender and age (+/-5 years). Ratio of cases and controls was 1:3. A questionnaire was used to collect information on possible risk factors of gastric cancer. The odds ratios (OR) and 95% confidence intervals (CI) for gastric cancer were calculated by a conditional logistic regression. RESULTS: Cases had significantly lower education level and mostly resided in villages. After adjustments for other dietary habits and smoking, alcohol consumption, family history on cancer, education level, and residence, higher risk of gastric cancer was found for those using salt additionally to prepared meal or those who liked salty food. After controlling for other food items that were associated with gastric cancer and smoking, alcohol consumption, family history on cancer, education level, and residence, body mass index at 20 years of age, and physical activity, intake of salted meat (OR=1.85, 95% CI=1.12-3.04, 1-3 times/month vs. almost never; OR=2.21, 95% CI=1.43-3.42, > or =1-2 times/week vs. almost never), smoked meat (OR=1.79, 95% CI=1.23-2.60, > or =3-4 times/week vs. < or =1-2 times/week), smoked fish (OR=1.70, 95% CI=1.13-2.53, > or =1-2 times/week vs. < or =1-3 times/month) was significantly associated with an increased risk of gastric cancer. Consumption of salted mushrooms was found to increase the risk of gastric cancer, however, this increase was not statistically significant. In conclusion, higher risk of gastric cancer is found for people that like salty food, salt-preserved meat as well as fish.

[Vegetables and fruits and risk of stomach cancer]. / Darzoviu bei vaisiu vartojimas ir skrandzio vezio rizika.

OBJECTIVE: Stomach cancer is the second common cause of death in Lithuania and most countries of the world. Nevertheless, there were no reports of epidemiological studies on stomach cancer in Lithuania. Therefore, a hospital-based case-control study has been carried out in order to assess the associations between vegetables and fruits and risk of stomach cancer. MATERIAL AND METHODS: Hospital-based case-control study included 379 cases with newly histologically confirmed diagnose of stomach cancer and 1137 controls that were free of cancer and stomach diseases. Cases and controls were matched by gender and age (+/-5 yr). Information on demographic variables, family history on cancer, life-style habits, such as diet, smoking, alcohol consumption, and physical activity was collected by a questionnaire. Conditional logistic regression was used to compute the odds ratio (OR) and their 95% confidence intervals (CI). RESULTS: After adjustment for other food items (vegetables, fruits, different types of meat, processed meat and fish, dairy and starchy products, coffee, green tea), that were related to outcome, smoking, alcohol use, family history on cancer, education level and residence, stomach cancer risk was inversely associated with consumption of raw vegetables such as cabbage (OR=0.24; 95% CI=0.10-0.57; > or =1-3 times/month vs. almost never), carrots (OR=0.42, 95% CI=0.20-0.86; 1-6 times/week vs. almost never) and garlic (OR=0.59, 95% CI=0.37-0.96; 1-6 times/week vs. almost never). Protective effect has been observed for intake of broccoli (OR=0.52, 95% CI=0.28-0.98; 1-4 times/week vs. < or =1-3 times/month). There were no statistically significant associations between stomach cancer risk and consumption of citrus or others fruits. In conclusion, higher consumption of raw vegetables such as cabbage, carrots, garlic as well as broccoli may decrease a risk of stomach cancer, whereas intake of citrus fruits has no relation with a reduced risk of the disease.

[Passive smoking and respiratory health of children]. / Pasyvus rukymas ir vaiku kvepavimo sutrikimai.

Passive smoking has been shown to be a risk factor for respiratory diseases in children. Some authors reported reduced lung function of children exposed to passive smoking. The purpose of the study was to assess the prevalence of exposure to passive smoking and its relation to respiratory health of Kaunas children. In 1998-2000 a cross-sectional survey was conducted in 20 kindergartens of Kaunas. Survey participants were 594 children (356 boys and 238 girls) aged 6-7 years. Children's parents filled out a questionnaire of the Swiss Study on Childhood Allergy and Respiratory Symptoms with Respect to Air Pollution designed on the basis of International Study of Asthma and Allergy in Childhood. Exposure to passive smoking was determined by an answer "everyday" or "sometimes" to the question "How often is your child in surrounding where someone smokes?". The parameters of respiratory function (FVC, FEV1, FEV1/FVC, FEF25, FEF50, FEF75, PEF) were measured with Pony Graphics 3.5. Response rate was 58.6% to 69.2% depending on a kindergarten. More than two fifth of children were exposed to passive smoking at home. Cough that lasted for at least four weeks during the past year was experienced by 24.5% and 16.9% of children with and without exposure to passive smoking (p<0.05). Wheezing in the past was found in 43% and 27% of children in groups compared (p<0.05). There was a significant difference in prevalence of sneezing or a runny/blocked nose when a child did not have a cold among children with and without exposure to passive smoking (46.6% and 36.6%, respectively, p<0.05). FEF25, FEF50, FEF75 and PEF of exposed girls were significantly lower than that of girls not exposed to passive smoking. Multiple regression analysis that included variables such as passive smoking, family history of allergy, smoked mother during pregnancy, gas stove and pets in child's room showed that FEF25 and FEF50 in girls were related to passive smoking. Our data show that more than two fifth of children are exposed to passive smoking which is associated with increased prevalence of chronic cough, wheezing, running nose and sneezing without cold. Passive smoking is also related to decreased lung function, especially for small airway flows.

Content of lead in human hair from people with various exposure levels in Lithuania.

A study has been performed to estimate if hair lead (Pb) can be used assessing environmental and occupational exposure to the metal. From 1994-1997, 622 ceramic plant employees, 520 randomly selected controls from Kaunas without occupational exposure to Pb aged 18-64 years, and 380 10-13 year old children living in Kaunas participated in this study. The concentration of Pb in the hair samples was measured by atomic absorption spectrometry. The geometric mean of Pb in the hair of workers occupationally exposed to Pb was significantly higher than that in persons not exposed to the metal (7.6 microg/g, 95% CI = 6.5-8.7 for exposed workers, 3.2 microg/g, 95% CI = 2.8-3.6 for not exposed workers and 2.6 microg/g, 95% CI = 2.4-2.9 for randomly selected controls, p < 0.05). Pb content in hair of boys and girls was 2.9 microg/g (95% CI = 2.6-3.3) and 3.1 microg/g (95% CI = 2.6-3.6), respectively. Lead in hair was not related to gender. Multiple regression analysis in adults with age as a continuous variable showed a positive relationship between Pb in hair and age. Also different exposure levels were significantly related to Pb in hair. In men, a positive association was found between Pb in hair and smoking. The data obtained suggest that human hair could be used to identify lead exposure in epidemiological surveys.

[Atmosphere air pollution and health of Kaunas children]. / Atmosferos oro tarsos itaka Kauno miesto vaiku sveikatai.

Many studies support the impact of long-term exposure to air pollution on respiratory and allergic symptoms and illnesses. The aim of the study was to assess the prevalence of respiratory and allergic symptoms and illnesses in children living in 4 districts of Kaunas, to estimate the indices of respiratory function and to assess the relationship between mentioned indices and air pollutants such as dust, sulfur dioxide and nitrogen dioxide. A cross-sectional survey included 840 Kaunas children (34 subjects in Senamiestis, 288 in Zaliakalnis, 128 in Petrasiunai and 390 in Silainiai) aged 6-7 years, whose parents filled out the questionnaire and children performed respiratory function test. Response rate varied from 58.6 percent to 69.2 percents depending on district. Questionnaire of International Study of Asthma and Allergy in Childhood (ISAAC) was used. The parameters of respiratory function (FVC, FEV1, FEV1/FVC, MEF25, MEF50, MEF75, PEF) were measured with Pony Graphics 3.5. The data showed that prevalence of respiratory and allergic symptoms and illnesses in children living in 4 districts of Kaunas did not differ significantly. In most of the cases it was similar to that found in Riga and Tallinn. There is a significant relationship between MEF25, MEF50, MEF75, PEF and sex as well as gas for cooking.