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1.
Artigo em Inglês | MEDLINE | ID: mdl-33818663

RESUMO

PURPOSE: Greater body fatness is a probable cause of advanced prostate cancer (PCa). Body fat distribution and timing of exposure may be relevant. We investigated associations between body size trajectories and PCa incidence in a population-based case-control study in Montreal, Canada. METHODS: Cases (n = 1,931), aged ≤ 75 years, were diagnosed with PCa in 2005-2009; 1,994 controls were selected from the electoral list. Interviews were conducted to assess body mass index (BMI) and Stunkard's silhouette at ages 20, 40, 50, 60 years, and before interview. Current waist and hip circumferences were measured, and a predictive model estimated waist circumference in the past. BMI and waist circumference trajectories were determined to identify subgroups. Logistic regression estimated odds ratios (OR) and 95% confidence intervals (CI) for the association between anthropometric indicators and PCa. RESULTS: Subjects with a current BMI ≥ 30 kg/m2 had a lower risk of overall PCa (OR 0.71, 95% CI 0.59-0.85). Associations with adult BMI followed similar trends for less and more aggressive tumors, with stronger inverse relationships in early adulthood. Contrastingly, current waist circumference ≥ 102 cm was associated with elevated risk of high-grade PCa (OR 1.33, 95% CI 1.03-1.71). Men with increasing BMI or waist circumference adult trajectories had a lower risk of PCa, especially low-grade, than those in the normal-stable range. This was especially evident among men in the obese-increase group for BMI and waist circumference. CONCLUSION: Abdominal obesity increased the risk of aggressive PCa. The inverse relationship between body size trajectories and PCa may reflect PSA hemodilution, lower detection, and/or a true etiological effect.

2.
Int J Cancer ; 148(1): 99-105, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32930425

RESUMO

Polygenic hazard score (PHS) models are associated with age at diagnosis of prostate cancer. Our model developed in Europeans (PHS46) showed reduced performance in men with African genetic ancestry. We used a cross-validated search to identify single nucleotide polymorphisms (SNPs) that might improve performance in this population. Anonymized genotypic data were obtained from the PRACTICAL consortium for 6253 men with African genetic ancestry. Ten iterations of a 10-fold cross-validation search were conducted to select SNPs that would be included in the final PHS46+African model. The coefficients of PHS46+African were estimated in a Cox proportional hazards framework using age at diagnosis as the dependent variable and PHS46, and selected SNPs as predictors. The performance of PHS46 and PHS46+African was compared using the same cross-validated approach. Three SNPs (rs76229939, rs74421890 and rs5013678) were selected for inclusion in PHS46+African. All three SNPs are located on chromosome 8q24. PHS46+African showed substantial improvements in all performance metrics measured, including a 75% increase in the relative hazard of those in the upper 20% compared to the bottom 20% (2.47-4.34) and a 20% reduction in the relative hazard of those in the bottom 20% compared to the middle 40% (0.65-0.53). In conclusion, we identified three SNPs that substantially improved the association of PHS46 with age at diagnosis of prostate cancer in men with African genetic ancestry to levels comparable to Europeans.

3.
Prev Med Rep ; 20: 101167, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32939332

RESUMO

This study aimed at characterizing anthropometric indicators that can be used as alternatives to measurements for assessing overall obesity over adulthood and abdominal obesity among men. We used data from a population-based case-control study of prostate cancer conducted in Montreal, Canada in 2005-2012. It included men aged ≤ 75 years, 1872 of which were newly diagnosed with prostate cancer, and 1918 others randomly selected from the electoral list. In-person interviews elicited reports of height as well as of weight, pants size and Stunkard's silhouette at 5 time points over adulthood, i.e., for the ages of 20, 40, 50 and 60 years, if applicable, and at the time of interview. Waist and hip circumferences were measured by interviewers following a validated protocol. Analyses were conducted on the overall sample of 3790 subjects, after having confirmed that results did not differ according to disease status. Stunkard's silhouette scale proved to be an easy-to-administer tool that reflects well reported body mass index, either recently or decades in the past among adult males. It was discriminatory enough to classify individuals according to commonly-used obesity categories. We observed that a model including age, reported pants size, silhouette and weight can reasonably predict current abdominal obesity. In conclusion, alternative anthropometric indicators can serve as valuable means to assess overall and abdominal obesity when measurements cannot be envisaged in the context of epidemiological studies.

4.
Nutrients ; 12(7)2020 Jun 27.
Artigo em Inglês | MEDLINE | ID: mdl-32605059

RESUMO

This study describes the association between dietary patterns and prostate cancer (PCa) risk in a population-based case-control study conducted in Montreal, Canada (2005-2012). Cases (n = 1919) were histologically confirmed, aged ≤75 years. Concomitantly, controls (n = 1991) were randomly selected from the electoral list and frequency-matched to cases by age (±5 years). During face-to-face interviews, a 63-item food frequency questionnaire focusing on the two years before diagnosis/interview was administered. Three dietary patterns were identified from principal component analysis. Unconditional logistic regression estimated the association between dietary patterns and PCa, adjusting for age, ethnicity, education, family history, and timing of last PCa screening. When comparing scores in the highest vs. lowest quartiles, the Healthy Eating pattern was associated with a decreased risk of overall PCa (Odds ratio (OR) = 0.76, 95% confidence interval (CI) = 0.61, 0.93); this association was stronger for high-grade cancers (OR = 0.66, 95% CI = 0.48, 0.89). By contrast, the Western Sweet and Beverages pattern was associated with an elevated risk of overall PCa (OR = 1.35, 95% CI = 1.10, 1.66). The Western Salty and Alcohol pattern was not associated with PCa risk. These findings suggest that some dietary patterns influence PCa development.

5.
Eur Urol ; 78(3): 316-320, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32409115

RESUMO

Although men of African ancestry have a high risk of prostate cancer (PCa), no genes or mutations have been identified that contribute to familial clustering of PCa in this population. We investigated whether the African ancestry-specific PCa risk variant at 8q24, rs72725854, is enriched in men with a PCa family history in 9052 cases, 143 cases from high-risk families, and 8595 controls of African ancestry. We found the risk allele to be significantly associated with earlier age at diagnosis, more aggressive disease, and enriched in men with a PCa family history (32% of high-risk familial cases carried the variant vs 23% of cases without a family history and 12% of controls). For cases with two or more first-degree relatives with PCa who had at least one family member diagnosed at age <60 yr, the odds ratios for TA heterozygotes and TT homozygotes were 3.92 (95% confidence interval [CI] = 2.13-7.22) and 33.41 (95% CI = 10.86-102.84), respectively. Among men with a PCa family history, the absolute risk by age 60 yr reached 21% (95% CI = 17-25%) for TA heterozygotes and 38% (95% CI = 13-65%) for TT homozygotes. We estimate that in men of African ancestry, rs72725854 accounts for 32% of the total familial risk explained by all known PCa risk variants. PATIENT SUMMARY: We found that rs72725854, an African ancestry-specific risk variant, is more common in men with a family history of prostate cancer and in those diagnosed with prostate cancer at younger ages. Men of African ancestry may benefit from the knowledge of their carrier status for this genetic risk variant to guide decisions about prostate cancer screening.

6.
Am J Respir Crit Care Med ; 202(3): 402-411, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32330395

RESUMO

Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes.Objectives: We expanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations.Methods: We used a quantitative EC job-exposure matrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for all-cause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men.Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 µg/m3 were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined.Conclusions: We observed a consistent exposure-response relationship between EC exposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.


Assuntos
Adenocarcinoma de Pulmão/epidemiologia , Carcinoma de Células Grandes/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Fumar Cigarros/epidemiologia , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Emissões de Veículos , Adulto , Idoso , Canadá/epidemiologia , Carbono , Europa (Continente)/epidemiologia , Feminino , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores Sexuais
7.
Cancer Epidemiol ; 65: 101696, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32203929

RESUMO

Lymphoma etiology remains ill-defined, but immune factors seem to play a major role. The Bacillus Calmette-Guérin (BCG) vaccine, a non-specific stimulator of the cellular immune response, could influence lymphoma risk. Previous studies addressing this issue showed conflicting results. In this study, we performed a systematic review and meta-analysis to synthesize the epidemiological evidence. We conducted a systematic search of all relevant articles in PubMed, Embase, Library and Archives Canada, and Cochrane databases, up to November 1st 2018. A total of 11 studies were included. Each study was summarized, methodological quality was assessed by independent evaluators, and a consensus score was generated. Heterogeneity and publication bias were evaluated. Summary odds ratios (ORs) and 95 % confidence intervals (CIs) were estimated separately for Hodgkin's lymphoma (HL) and non-Hodgkin's lymphoma (NHL) by either a fixed effect (FE) or a random effect (RE) model depending on heterogeneity. In this meta-analysis, BCG vaccination was not associated with HL (FE summary OR = 1.10; 95 % CI 0.93-1.30), but positively associated with NHL (RE summary OR = 1.20; 95 % CI 1.01-1.43). However, when restricting to higher quality studies, no association was found between BCG vaccination and either HL (RE summary OR = 0.97; 95 % CI 0.67-1.43) or NHL (RE summary OR = 1.15; 95 % CI 0.84-1.59). Overall, our findings do not support that BCG vaccination is associated with lymphoma risk. Yet, lack of statistical power and relatively high heterogeneity among studies prevent us from making definitive conclusions. Future studies investigating this issue are needed, using robust methodology.


Assuntos
Vacina BCG/administração & dosagem , Linfoma não Hodgkin/epidemiologia , Vacina BCG/efeitos adversos , Humanos , Linfoma não Hodgkin/diagnóstico por imagem , Linfoma não Hodgkin/etiologia , Vacinação/efeitos adversos , Vacinação/estatística & dados numéricos
8.
Nutrients ; 12(3)2020 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-32121075

RESUMO

We studied the association between food intake, based on the extent of processing, and prostate cancer risk in a population-based case-control study conducted in Montreal, Canada in 2005-2012. Incident prostate cancer cases (n = 1919) aged ≤75 years were histologically confirmed. Population controls (n = 1991) were randomly selected from the electoral list and frequency-matched to cases by age (±5 years). A 63-item food frequency questionnaire focusing on the two years prior to diagnosis/interview was administered by interviewers. The NOVA classification was used to categorize foods based on processing level. Unconditional logistic regression estimated the association between food intake and prostate cancer risk, adjusting for age, education, ethnicity, family history, and timing of last prostate cancer screening. Consumption of unprocessed or minimally processed foods showed a slight, inverse association (Odd ratio [OR] 0.86, 95% confidence interval [CI] 0.70-1.07; highest vs. lowest quartile) with prostate cancer. An increased risk was observed with higher intake of processed foods (OR 1.29, 95%CI 1.05-1.59; highest vs. lowest quartile), but not with consumption of ultra-processed food and drinks. The associations with unprocessed/minimally processed foods and processed foods were slightly more pronounced for high-grade cancers (ORs 0.80 and 1.33, respectively). Findings suggest that food processing may influence prostate cancer risk.

9.
BMC Cancer ; 20(1): 171, 2020 Mar 03.
Artigo em Inglês | MEDLINE | ID: mdl-32126982

RESUMO

BACKGROUND: Silica and asbestos are recognized lung carcinogens. However, their role in carcinogenesis at other organs is less clear. Clearance of inhaled silica particles and asbestos fibers from the lungs may lead to translocation to sites such as the bladder where they may initiate carcinogenesis. We used data from a Canadian population-based case-control study to evaluate the associations between these workplace exposures and bladder cancer. METHODS: Data from a population-based case-control study were used to characterize associations between workplace exposure to silica and asbestos and bladder cancer among men. Bladder cancer cases (N = 658) and age-frequency matched controls (N = 1360) were recruited within the National Enhanced Cancer Surveillance System from eight Canadian provinces (1994-97). Exposure concentration, frequency and reliability for silica and asbestos were assigned to each job, based on lifetime occupational histories, using a combination of job-exposure profiles and expert review. Exposure was modeled as ever/never, highest attained concentration, duration (years), highest attained frequency (% worktime) and cumulative exposure. Odds ratios (OR) and their 95% confidence intervals (CI) were estimated using adjusted logistic regression. RESULTS: A modest (approximately 20%) increase in bladder cancer risk was found for ever having been exposed to silica, highest attained concentration and frequency of exposure but this increase was not statistically significant. Relative to unexposed, the odds of bladder cancer were 1.41 (95%CI: 1.01-1.98) times higher among men exposed to silica at work for ≥27 years. For asbestos, relative to unexposed, an increased risk of bladder cancer was observed for those first exposed ≥20 years ago (OR:2.04, 95%CI:1.25-3.34), those with a frequency of exposure of 5-30% of worktime (OR:1.45, 95%CI:1.06-1.98), and for those with < 10 years of exposure at low concentrations (OR:1.75, 95%CI:1.10-2.77) and the lower tertile of cumulative exposure (OR:1.69, 95%CI:1.07-2.65). However, no clear exposure-response relationships emerged. CONCLUSIONS: Our results indicate a slight increase in risk of bladder cancer with exposure to silica and asbestos, suggesting that the effects of these agents are broader than currently recognized. The findings from this study inform evidence-based action to enhance cancer prevention efforts, particularly for workers in industries with regular exposure.


Assuntos
Asbestos/efeitos adversos , Doenças Profissionais/epidemiologia , Dióxido de Silício/efeitos adversos , Neoplasias da Bexiga Urinária/epidemiologia , Adulto , Idoso , Canadá , Estudos de Casos e Controles , Medicina Baseada em Evidências , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Neoplasias da Bexiga Urinária/induzido quimicamente
10.
J Med Screen ; 27(4): 215-222, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32000565

RESUMO

OBJECTIVES: If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005-2012). METHODS: Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. RESULTS: Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10-0.65), construction (0.44, 0.25-0.79), machining (0.45, 0.21-0.97), and teaching (0.37, 0.20-0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. CONCLUSIONS: Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.

11.
Ann Work Expo Health ; 64(1): 13-24, 2020 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-31671187

RESUMO

The CANJEM job-exposure matrix compiles expert evaluations of 31 673 jobs from four population-based case-control studies conducted in Montreal. For each job, experts had derived indices of intensity, frequency, and probability of exposure to 258 agents. CANJEM summarizes the exposures assigned to jobs into cells defined by occupation/industry, agent, and period. Some cells may, however, be less populated than others, resulting in uncertain estimates. We developed a modelling framework to refine the estimates of sparse cells by drawing on information available in adjacent cells. Bayesian hierarchical logistic and linear models were used to estimate the probability of exposure and the geometric mean (GM) of frequency-weighted intensity (FWI) of cells, respectively. The hierarchy followed the Canadian Classification and Dictionary of Occupations (CCDO) classification structure, allowing for exposure estimates to be provided across occupations (seven-digit code), unit groups (four-digit code), and minor groups (three-digit code). The models were applied to metallic dust, formaldehyde, wood dust, silica, and benzene, and four periods, adjusting for the study from which jobs were evaluated. The models provided estimates of probability and FWI for all cells that pulled the sparsely populated cells towards the average of the higher-level group. In comparisons stratified by cell sample size, shrinkage of the estimates towards the group mean was marked below 5 jobs/cell, moderate from 5 to 9 jobs/cell, and negligible at ≥10 jobs/cell. The modelled probability of three-digit cells were slightly smaller than their descriptive estimates. No systematic trend in between-study differences in exposure emerged. Overall, the modelling framework for FWI appears to be a suitable approach to refine CANJEM estimates. For probability, the models could be improved by methods better adapted to the large number of cells with no exposure.

12.
Int J Cancer ; 146(7): 1800-1809, 2020 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-31199510

RESUMO

Results of epidemiologic studies of physical activity and ovarian cancer risk are inconsistent. Few have attempted to measure physical activity over the lifetime or in specific age windows, which may better capture etiologically relevant exposures. We examined participation in moderate-to-vigorous recreational physical activity (MVPA) in relation to ovarian cancer risk. In a population-based case-control study conducted in Montreal, Canada from 2011 to 2016 (485 cases and 887 controls), information was collected on lifetime participation in various recreational physical activities, which was used to estimate MVPA for each participant. MVPA was represented as average energy expenditure over the lifetime and in specific age-periods in units of metabolic equivalents (METs)-hours per week. Odds ratios (OR) and 95% confidence intervals (CI) for the relation between average MVPA and ovarian cancer risk were estimated using multivariable logistic regression models. Confounding was assessed using directed acyclic graphs combined with a change-in-estimate approach. The adjusted OR (95% CI) for each 28.5 MET-hr/week increment of lifetime recreational MVPA was 1.11 (0.99-1.24) for ovarian cancer overall. ORs for individual age-periods were weaker. When examined by menopausal status, the OR (95% CI) for lifetime MVPA was 1.21 (1.00-1.45) for those diagnosed before menopause and 1.04 (0.89-1.21) for those diagnosed postmenopausally. The suggestive positive associations were stronger for invasive ovarian cancers and more specifically for high-grade serous carcinomas. These results do not support a reduced ovarian cancer risk associated with MVPA.


Assuntos
Exercício Físico , Atividades de Lazer , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Razão de Chances , Medição de Risco , Fatores de Risco , Adulto Jovem
13.
Occup Environ Med ; 76(9): 668-671, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31413189

RESUMO

OBJECTIVES: The causes of kidney cancer are not well understood though occupational exposures are thought to play a role. Crystalline silica is a known human carcinogen, and despite previous links with kidney disease, there have been few studies investigating its association with kidney cancer. We addressed this research gap using a population-based case-control study of Canadian men. METHODS: Questionnaire data were obtained from individuals with histologically confirmed kidney cancer, and population-based controls recruited from eight Canadian provinces (1994-1997). An industrial hygienist characterised participants' lifetime occupational exposure, and their confidence in the assessment (possibly, probably or definitely exposed) to silica on three dimensions (intensity, frequency and duration), and cumulative exposure was estimated. Logistic regression was used to estimate ORs and 95% CIs, adjusting for potential confounders. RESULTS: Nearly half of the 689 kidney cancer cases (49%) and 2369 controls (44%) had ever been occupationally exposed to crystalline silica. In a fully adjusted model, workers ever-exposed to silica had a slightly increased risk of kidney cancer relative to those who were unexposed (OR 1.10, 95% CI 0.92 to 1.32). Odds were modestly (and generally not statistically significantly) increased for models with duration of exposure and cumulative exposure, though exposure-response relationships were not evident. CONCLUSIONS: Our findings do not provide evidence that occupational exposure to crystalline silica increases risk of kidney cancer in men.


Assuntos
Neoplasias Renais/epidemiologia , Exposição Ocupacional , Dióxido de Silício/efeitos adversos , Adulto , Idoso , Canadá/epidemiologia , Estudos de Casos e Controles , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Inquéritos e Questionários
14.
Am J Epidemiol ; 188(10): 1801-1811, 2019 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-31360990

RESUMO

Night-shift work involving disruption of circadian rhythms has been associated with breast cancer risk. A role in prostate cancer is also suspected, but evidence is limited. We investigated the association between night-shift work and prostate cancer incidence in the Prostate Cancer and Environment Study (PROtEuS), a population-based case-control study conducted in 2005-2012 in Montreal, Quebec, Canada. Participants were 1,904 prostate cancer cases (432 high-grade cancers) and 1,965 population controls. Detailed work schedules for each job held for at least 2 years (n = 15,724) were elicited in face-to-face interviews. Night-shift work was defined as having ever worked ≥3 hours between midnight and 5:00 am ≥3 nights/month for ≥1 year. Unconditional logistic regression was used to estimate odds ratios and 95% confidence intervals for the association between night-shift work and prostate cancer, adjusting for age, ancestry, and education. No association was found between overall prostate cancer and night-shift work metrics, including ever exposure, duration, intensity, cumulative exposure, rotating shifts, and early-morning shifts. For none of the exposure indices was there evidence of heterogeneity in odds ratios between low- and high-grade cancers. Sensitivity analyses restricting exposures to ≥7 nights/month or considering screening history yielded similar results. Our findings lend no support for a major role of night-shift work in prostate cancer development.


Assuntos
Neoplasias da Próstata/etiologia , Jornada de Trabalho em Turnos/efeitos adversos , Idoso , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Quebeque/epidemiologia , Fatores de Risco , Jornada de Trabalho em Turnos/estatística & dados numéricos
15.
Ann Work Expo Health ; 63(6): 701-705, 2019 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-30982846

RESUMO

BACKGROUND: Work histories generally cover all jobs held for ≥1 year. However, it may be time and cost prohibitive to conduct a detailed exposure assessment for each such job. While disregarding short-term jobs can reduce the assessment burden, this can be problematic if those jobs contribute important exposure information towards understanding disease aetiology. OBJECTIVE: To characterize short-term jobs, defined as lasting more than 1 year, but less than 2 years, in a population-based study conducted in Montreal, Canada. METHODS: In 2005-2012, we collected work histories for some 4000 participants in a case-control study of prostate cancer. Overall, subjects had held 19 462 paid jobs lasting ≥1 year, including 3655 short-term jobs. Using information from interviews and from the Canadian Classification and Dictionary of Occupations, we characterized short-term jobs and compared them to jobs held ≥2 years. RESULTS: Short-term jobs represented <4% of subjects' work years on average. Forty-five per cent of subjects had at least one short-term job; of these, 49% had one, 24% had two, and 27% had at least three. Half of all short-term jobs had been held before the age of 24. Short-term jobs entailed more often exposure to fumes, odours, dust, and/or poor ventilation than longer jobs (17 versus 13%), as well as outdoor work (10 versus 5%) and heavy physical activity (16 versus 12%). CONCLUSIONS: Short-term jobs occurred often in early careers and more frequently entailed potentially hazardous exposures than longer-held jobs. However, as they represented a small proportion of work years, excluding them should have a marginal impact on lifetime exposure assessment.


Assuntos
Exposição Ocupacional/análise , Ocupações/estatística & dados numéricos , Adulto , Poluentes Ocupacionais do Ar , Canadá , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
16.
Environ Health ; 18(1): 14, 2019 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-30770757

RESUMO

BACKGROUND: While the expert-based occupational exposure assessment approach has been considered the reference method for retrospective population-based studies, its implementation in large study samples has become prohibitive. To facilitate its application and improve upon it we developed, in the context of a Montreal population-based study of prostate cancer (PROtEuS), a hybrid approach combining job-exposure profiles (JEPs) summarizing expert evaluations from previous studies and expert review. We aim to describe the hybrid expert method and its impacts on the exposures assigned in PROtEuS compared to those from a previous study coded using the traditional expert method. METHODS: Applying the hybrid approach, experts evaluated semi-quantitative levels of confidence, concentration and frequency of exposure to 313 agents for 16,065 jobs held by 4005 subjects in PROtEuS. These assessments were compared to those from a different set of jobs coded in an earlier study of lung cancer, conducted on the same study base, for 90 blue-collar occupations and 203 agents. Endpoints evaluated included differences in the number of exposures and in the distribution of ratings across jobs, and the within-occupation variability in exposure. RESULTS: Compared to jobs from the lung cancer study, jobs in PROtEuS had on average 0.3 more exposures. PROtEuS exposures were more often assigned definite confidence ratings, but concentration and frequency levels tended to be lower. The within-occupation variability in ratings assigned to jobs were lower in PROtEuS jobs for all metrics. This was particularly evident for concentration, although considerable variability remained with over 40% of occupation/agent cells in PROtEuS exposed at different levels. The hybrid approach reduced coding time by half, compared to the traditional expert assessment. CONCLUSIONS: The new hybrid expert approach improved on efficiency and transparency, and resulted in greater confidence in assessments, compared to the traditional expert method applied in an earlier study involving a similar set of jobs. Assigned ratings were more homogeneous with the hybrid approach, possibly reflecting clearer guidelines for coding, greater coherence between experts and/or reliance on summaries of past assessments. Nevertheless, significant within-occupation variability remained with the hybrid approach, suggesting that experts took into account job-specific factors in their assessments.


Assuntos
Neoplasias/epidemiologia , Exposição Ocupacional/análise , Adulto , Idoso , Estudos de Casos e Controles , Humanos , Masculino , Pessoa de Meia-Idade , Quebeque/epidemiologia , Projetos de Pesquisa
17.
Prev Med Rep ; 13: 205-213, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30705807

RESUMO

The purpose of this study was to describe dietary patterns among 1636 French-speaking men residing in Montreal, Canada and to assess sociodemographic and lifestyle characteristics of men adhering to the dietary patterns identified. Participants were population controls from the Prostate Cancer and Environment Study, a case-control study conducted between 2006 and 2011 in Montreal. Information on diet was collected using a food frequency questionnaire, and principal component analysis, a data-driven method and a posteriori method, was used to identify dietary patterns. Three dietary patterns were identified; Healthy, Modified Western - Salty and Modified Western - Sweet patterns accounted for 7.0%, 5.4%, and 3.2% of the variance, respectively. The Healthy pattern was characterized by consumption of fruits, vegetables, vegetable soup, chicken, fish and seafood, cheese, rice, yogurt, and wine. The Modified Western - Salty pattern included high loadings for beef, pork, chicken, hot-dogs or sausages, cold cuts, bacon, barbecue cooking, meat slightly blackened, potatoes, pasta with tomato sauce, pizza, pastries, dark carbonated soft drinks, ice cream, and white bread. The third pattern, labelled as Modified Western - Sweet, had high loadings of cookies, muffins, cakes, pastries, pies, ice cream, fruits and vegetables. In multivariate analyses, the Healthy pattern was positively associated with higher income and education, moderate recreational physical activity and less heavy smoking, and inversely associated with French ancestry. The Modified Western - Salty pattern was positively associated with French, other European, and Latino ancestries, and with married and common-law relationships. Finally, the Modified Western - Sweet pattern was more common among men of French ancestry and users of vitamin/mineral supplements. The Healthy pattern has been frequently observed in other Western populations, but the other two are described for the first time in a study population of men.

18.
Scand J Work Environ Health ; 45(2): 183-193, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30614502

RESUMO

Objective Studies of loud noise exposure and vestibular schwannomas (VS) have shown conflicting results. The population-based INTERPHONE case‒control study was conducted in 13 countries during 2000-2004. In this paper, we report the results of analyses on the association between VS and self-reported loud noise exposure. Methods Self-reported noise exposure was analyzed in 1024 VS cases and 1984 matched controls. Life-long noise exposure was estimated through detailed questions. Odds ratios (OR) and 95% confidence intervals (CI) were estimated using adjusted conditional logistic regression for matched sets. Results The OR for total work and leisure noise exposure was 1.6 (95% CI 1.4-1.9). OR were 1.5 (95% CI 1.3-1.9) for only occupational noise, 1.9 (95% CI 1.4-2.6) for only leisure noise and 1.7 (95% CI 1.2-2.2) for exposure in both contexts. OR increased slightly with increasing lag-time. For occupational exposures, duration, time since exposure start and a metric combining lifetime duration and weekly exposure showed significant trends of increasing risk with increasing exposure. OR did not differ markedly by source or other characteristics of noise. Conclusion The consistent associations seen are likely to reflect either recall bias or a causal association, or potentially indicate a mixture of both.


Assuntos
Neuroma Acústico/epidemiologia , Ruído Ocupacional/estatística & dados numéricos , Exposição Ocupacional/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
19.
Ann Work Expo Health ; 63(1): 45-53, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30304470

RESUMO

Objectives: To estimate the inter-rater agreement between exposure assessment to asthmagens in current jobs by algorithms based on task-based questionnaires (OccIDEAS) and by experts. Methods: Participants in a cross-sectional national survey of exposure to asthmagens (AWES-Asthma) were randomly split into two subcohorts of equal size. Subcohort 1 was used to determine the most common asthmagen groups and occupational groups. From subcohort 2, a random sample of 200 participants was drawn and current occupational exposure (yes/no) was assessed in these by OccIDEAS and by two experts independently and then as a consensus. Inter-rater agreement was estimated using Cohen's Kappa coefficient. The null hypothesis was set at 0.4, because both the experts and the automatic algorithm assessed the exposure using the same task-based questionnaires and therefore an agreement better than by chance would be expected. Results: The Kappa coefficients for the agreement between the experts and the algorithm-based assessments ranged from 0.37 to 1, while the agreement between the two experts ranged from 0.29 to 0.94, depending on the agent being assessed. After discussion by both experts the Kappa coefficients for the consensus decision and OccIDEAS were significantly larger than 0.4 for 7 of the 10 asthmagen groups, while overall the inter-rater agreement was greater than by chance (P < 0.0001). Conclusions: The web-based application OccIDEAS is an appropriate tool for automated assessment of current exposure to asthmagens (yes/no), and requires less time-consuming work by highly-qualified research personnel than the traditional expert-based method. Further, it can learn and reuse expert determinations in future studies.


Assuntos
Algoritmos , Alérgenos/análise , Monitoramento Ambiental/métodos , Exposição Ocupacional/análise , Adulto , Asma/prevenção & controle , Estudos Transversais , Monitoramento Ambiental/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisadores , Adulto Jovem
20.
Ann Work Expo Health ; 63(1): 22-33, 2019 01 07.
Artigo em Inglês | MEDLINE | ID: mdl-30312388

RESUMO

Objectives: The CANJEM general population job-exposure matrix summarizes expert evaluations of 31 673 jobs from four population-based case-control studies of cancer conducted in Montreal, Canada. Intensity in each CANJEM cell is represented as relative distributions of the ordinal (low, medium, high) ratings of jobs assigned by the experts. We aimed to apply quantitative concentrations to CANJEM cells using Canadian historical measurements from the Canadian Workplace Exposure Database (CWED), taking exposure to wood dust as an example. Methods: We selected 5170 personal and area wood dust measurements from 31 occupations (2011 Canadian National Occupational Classification) with a non-zero exposure probability in CANJEM between 1930 and 2005. The measurements were taken between 1981 and 2003 (median 1989). A Bayesian hierarchical model was applied to the wood dust concentrations with occupations as random effects, and sampling duration, year, sample type (area or personal), province, and the relative proportion of jobs exposed at medium and high intensity in CANJEM cells as fixed effects. Results: The estimated geometric mean (GM) concentrations for a CANJEM cell with all jobs exposed at medium or high intensity were respectively 1.3 and 2.4 times higher relative to a cell with all jobs at low intensity. An overall trend of -3%/year in exposure was observed. Applying the model estimates to all 198 cells in CANJEM with some exposure assigned by the experts, the predicted 8-hour, personal wood dust GM concentrations by occupation for 1989 ranged from 0.48 to 1.96 mg m-3. Conclusions: The model provided estimates of wood dust concentrations for any CANJEM cell with exposure, applicable for quantitative risk assessment at the population level. This framework can be implemented for other agents represented in both CANJEM and CWED.


Assuntos
Poeira/análise , Exposição Ocupacional/análise , Medição de Risco/métodos , Madeira , Teorema de Bayes , Canadá , Estudos de Casos e Controles , Coleta de Dados/métodos , Bases de Dados Factuais , Monitoramento Ambiental/métodos , Humanos , Exposição por Inalação/análise , Ocupações/classificação
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