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Tsai SS, Yang CY. Effects of long-term exposure to ambient fine particulate air pollution on all-cause mortality in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:942-949. [PMID: 37743654 DOI: 10.1080/15287394.2023.2261025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
According to the US Environmental Protection Agency's Integrated Science Assessment (ISA), there is a causal relationship between fine particulate matter (PM2.5) exposure and increased mortality rates. A similar association was also reported by the International Agency for Research on Cancer (IARC). While many studies are available on this relationship between PM exposure and elevated mortality frequency in Europe and North America, there are limited investigations in Asia. Thus, the aim of this study was to perform an ecological investigation to determine the relationship between exposure to ambient PM2.5 levels and all-cause mortality in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized all-cause mortality rates were calculated for male and female residents of these areas from 2010 to 2020. Weighted-multiple regression analyses were used to obtain adjusted risk ratio (RR) controlling for possible confounding by urbanization level, physician density, and annual mean household income. Annual PM2.5 levels of each municipality were divided into tertiles. Data demonstrated that men residing in areas with intermediate tertile PM2.5 levels (21.06 to 27.29 µg/m3) and the highest tertiles levels (27.30-33.11 µg/m3) exhibited adjusted RRs of 1.06 (95% CI = 1.03-1.08) and 1.13 (95% CI = 1.10-1.16), respectively. Women in these locations displayed a similar risk, 1.03 (0.99-1.06) and 1.07 (1.04-1.11), respectively. These findings indicate that ambient exposure to PM2.5 increased risk for all-cause mortality rates in both men and women in Taiwan during this time period.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
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Dehghani S, Moshfeghinia R, Ramezani M, Vali M, Oskoei V, Amiri-Ardekani E, Hopke P. Exposure to air pollution and risk of ovarian cancer: a review. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 38:439-450. [PMID: 35575767 DOI: 10.1515/reveh-2021-0129] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 04/15/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES Exposure to air pollution has destructive health consequences and a potential role in ovarian cancer etiology. We conducted a systematic review of the studies assessing the associations between ovarian malignancy and exposure to air pollutants. CONTENT The included studies were categorized based on types of measured ambient air pollutants, including particulate matter (five studies), gases (two studies), air pollutant mixtures (eight studies), and traffic indicators for air pollution (only one study). Because of the heterogeneity of quantitative data of the reviewed studies, we qualitatively reviewed the air pollution role in ovarian cancer risk with representing incidence and/or the mortality rate of ovarian cancer in related with air pollution. Nine studies were ecological study design. Except for one, all studies confirmed a positive correlation between exposure to ambient air pollution (AAP) and increased ovarian cancer risks. SUMMARY We concluded that prolonged air pollution exposure through possible mechanisms, estrogen-like effects, and genetic mutations might affect ovarian tumorigenesis. This research surveyed the limitations of the previous studies, including issues with ambient air pollution surveillance and assessing the exposure, determining the air pollution sources, data analysis approaches, and study designs. OUTLOOK Finally, the authors provide suggestions for future environmental epidemiological inquiries on the impact of exposure to ambient air pollution on ovarian malignancy.
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Affiliation(s)
- Samaneh Dehghani
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Moshfeghinia
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- MPH Department, Medical School, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahsan Ramezani
- Assistant Professor of Emergency Medicine, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mohebat Vali
- Department of Epidemiology, School of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahide Oskoei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Amiri-Ardekani
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Association of Indigenous Knowledge, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Phytopharmaceutical (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Philip Hopke
- Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
- Institute for a Sustainable Environment, Clarkson University, Potsdam, NY, USA
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Tsai SS, Hsu CT, Yang C. Risk of death from liver cancer in relation to long-term exposure to fine particulate air pollution in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2023; 86:135-143. [PMID: 36752360 DOI: 10.1080/15287394.2023.2168225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
According to the International Agency for Research on Cancer (IARC), airborne fine particulate matter (PM2.5), which is categorized as a Group I carcinogen, was found to lead to predominantly lung as well as other cancer types in humans. Hepatocellular carcinoma (HCC) is endemic in Taiwan where it is the second and fourth foremost cause of cancer deaths in men and women, respectively. Taiwan's mortality rates for liver cancer vary considerably from one region to another, suggesting that the environment may exert some influence on deaths attributed to liver cancer. The aim of this investigation was to perform an ecologic study to examine the possible link between ambient PM2.5 levels and risk of liver cancer in 66 in Taiwan municipalities. To undertake this investigation, annual PM2.5 levels and age-standardized liver cancer mortality rates were calculated for male and female residents of these areas from 2010 to 2019. Data were tested using weighted-multiple regression analyses to compute adjusted risk ratio (RR) controlling for urbanization level and physician density. Annual PM2.5 levels of each municipality were divided into tertiles. The adjusted RRs for males residing in those areas with intermediate tertile levels (21.85 to 28.21 ug/m3) and the highest tertiles levels (28.22-31.23 ug/m3) of PM2.5 were 1.29 (95% CI = 1.25-1.46) and 1.41 (95% CI = 1.36-1.46), respectively. Women in these locations shared a similar risk, 1.32 (1.25-1.4) and 1.41 (1.34-1.49), respectively. Evidence indicated that PM2.5 increased risk of mortality rates attributed to liver cancer in both men and women in Taiwan.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Chun-Ta Hsu
- Department of Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - ChunYuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
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Wang L, Sun W, Moudon AV, Zhu YG, Wang J, Bao P, Zhao X, Yang X, Jia Y, Zhang S, Wu S, Cai Y. Deciphering the impact of urban built environment density on respiratory health using a quasi-cohort analysis of 5495 non-smoking lung cancer cases. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 850:158014. [PMID: 35981573 DOI: 10.1016/j.scitotenv.2022.158014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Lung cancer is a major health concern and is influenced by air pollution, which can be affected by the density of urban built environment. The spatiotemporal impact of urban density on lung cancer incidence remains unclear, especially at the sub-city level. We aimed to determine cumulative effect of community-level density attributes of the built environment on lung cancer incidence in high-density urban areas. METHODS We selected 78 communities in the central city of Shanghai, China as the study site; communities included in the analysis had an averaged population density of 313 residents per hectare. Using data from the city cancer surveillance system, an age-period-cohort analysis of lung cancer incidence was performed over a five-year period (2009-2013), with a total of 5495 non-smoking/non-secondhand smoking exposure lung cancer cases. Community-level density measures included the density of road network, facilities, buildings, green spaces, and land use mixture. RESULTS In multivariate models, built environment density and the exposure time duration had an interactive effect on lung cancer incidence. Lung cancer incidence of birth cohorts was associated with road density and building coverage across communities, with a relative risk of 1·142 (95 % CI: 1·056-1·234, P = 0·001) and 1·090 (95 % CI: 1·053-1·128, P < 0·001) at the baseline year (2009), respectively. The relative risk increased exponentially with the exposure time duration. As for the change in lung cancer incidence over the five-year period, lung cancer incidence of birth cohorts tended to increase faster in communities with a higher road density and building coverage. CONCLUSION Urban planning policies that improve road network design and building layout could be important strategies to reduce lung cancer incidence in high-density urban areas.
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Affiliation(s)
- Lan Wang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China.
| | - Wenyao Sun
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China
| | - Anne Vernez Moudon
- Department of Urban Design and Planning and Urban Form Laboratory, University of Washington, Seattle, USA
| | - Yong-Guan Zhu
- Key Laboratory of Urban Environment and Health, Institute of Urban Environment, Chinese Academy of Sciences, Xiamen, China; State Key Laboratory of Urban and Regional Ecology, Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Pingping Bao
- Shanghai Center for Disease Prevention and Control, Shanghai, China
| | - Xiaojing Zhao
- Department of Thoracic Surgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoming Yang
- Jing'an District Center for Disease Control and Prevention, Shanghai 200072, China
| | - Yinghui Jia
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China
| | - Surong Zhang
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China
| | - Shuang Wu
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China
| | - Yuxi Cai
- College of Architecture and Urban Planning, Tongji University, Shanghai, China; Key Laboratory of Ecology and Energy-saving Study of Dense Habitat, Shanghai, China
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Tsai SS, Chen CC, Yang CY. The impacts of reduction in ambient fine particulate (PM 2.5) air pollution on life expectancy in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2022; 85:913-920. [PMID: 35993974 DOI: 10.1080/15287394.2022.2110343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Fine particulate matter, particles less than 2.5 um in diameter (PM2.5), is an important environmental human health factor to consider. The long- and short-term influence of PM2.5 on health has been extensively studied in relation to many health outcomes, although few investigations examined the consequences of chronic ambient PM2.5 on life expectancy, which constitutes an important gauge of public human health status. Therefore, the aim of this study was to investigate the effects of reducing ambient PM2.5 levels in Taiwan on life expectancy there from 2000 to 2020. Officially reported island-wide annually average concentrations of ambient PM2.5, county-level life expectancies, and demographic and socioeconomic and proxy variable were collected for the prevalence of smoking from various national public agencies and organizations, since variables these might potentially confound life expectancy results. The relationship between changes in ambient PM2.5 levels and life expectancy were determined using linear regression. Data demonstrated that counties with greater reductions in ambient PM2.5 concentrations were associated with higher life expectancies. Adjusting for alterations in demographic and socioeconomic variables and proxy parameter, the prevalence of smoking data from a multiple regression model, it was found that a 0.3-year rise in life expectancy was noted for each 10 ug/m3 decrease in PM2.5 in those counties. Our findings show that reducing ambient PM2.5 levels play an important role for prolongation of life expectancy in Taiwan.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Chih-Cheng Chen
- Department of Pediatrics, College of Medicine, Kaohsiung Chang- Gung Memorial Hospital and Chang-Gung University, Kaohsiung, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
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Hsu CY, Xie HX, Wong PY, Chen YC, Chen PC, Wu CD. A mixed spatial prediction model in estimating spatiotemporal variations in benzene concentrations in Taiwan. CHEMOSPHERE 2022; 301:134758. [PMID: 35490755 DOI: 10.1016/j.chemosphere.2022.134758] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 04/12/2022] [Accepted: 04/25/2022] [Indexed: 06/14/2023]
Abstract
It is well known benzene negatively impacts human health. This study is the first to predict spatial-temporal variations in benzene concentrations for the entirety of Taiwan by using a mixed spatial prediction model integrating multiple machine learning algorithms and predictor variables selected by Land-use Regression (LUR). Monthly benzene concentrations from 2003 to 2019 were utilized for model development, and monthly benzene concentration data from 2020, as well as mobile monitoring vehicle data from 2009 to 2019, served as external data for verifying model reliability. Benzene concentrations were estimated by running six LUR-based machine learning algorithms; these algorithms, which include random forest (RF), deep neural network (DNN), gradient boosting (GBoost), light gradient boosting (LightGBM), CatBoost, extreme gradient boosting (XGBoost), and ensemble algorithms (a combination of the three best performing models), can capture how nonlinear observations and predictions are related. The results indicated conventional LUR captured 79% of the variability in benzene concentrations. Notably, the LUR with ensemble algorithm (GBoost, CatBoost, and XGBoost) surpassed all other integrated methods, increasing the explanatory power to 92%. This study establishes the value of the proposed ensemble-based model for estimating spatiotemporal variation in benzene exposure.
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Affiliation(s)
- Chin-Yu Hsu
- Department of Safety, Health and Environmental Engineering, Ming Chi University of Technology, Taiwan; Center for Environmental Sustainability and Human Health, Ming Chi University of Technology, Taiwan
| | - Hong-Xin Xie
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan
| | - Pei-Yi Wong
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Cheng Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Department of Occupational Safety and Health, China Medical University, Taichung, Taiwan
| | - Pau-Chung Chen
- National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Chih-Da Wu
- Department of Geomatics, National Cheng Kung University, Tainan, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
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7
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Tsai SS, Chiu YW, Weng YH, Yang CY. Association between fine particulate air pollution and the risk of death from lung cancer in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2022; 85:431-438. [PMID: 35216542 DOI: 10.1080/15287394.2022.2040672] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Airborne fine particulate matter (PM2.5) has been classified as a Group I carcinogen leading to lung cancer in humans by the International Agency for Research on Cancer (IARC). In Taiwan, where there is a growing incidence of this disease, lung cancer is currently the leading cause of cancer-associated deaths in women and second leading cause of deaths in men. Because tobacco use is rare in Taiwan, especially amongst women, the high incidence of this type of cancer was suggested to be attributed to the other external contaminants, including airborne PM2 pollution. In this ecologic study, a possible association between ambient air PM2.5 exposure and likelihood of death attributed to lung cancer was examined in Taiwan in 66 municipalities. Annual PM2.5 levels and age-standardized lung cancer mortality rates for male and female residents were calculated for years 2010 to 2019. Weighted-multiple regression was applied to analyze our data, adjusting for level of urbanization and physician density. For males, the adjusted risk ratios (RRs) for lung cancer mortality were 1.01 for municipalities with PM2.5 levels 21.85-28.21 ug/m3 and 1.07 for municipalities with 28.22-31.23 ug/m3, compared to those with the lowest PM2.5 levels. For females, these adjusted RRs were 0.99 and 1.06, respectively. Data demonstrated an association between chronic exposure to high levels of PM2.5 and increased likelihood of death attributed to lung cancer for both men and women in Taiwan. Further studies are needed to explore the relationship between PM2.5 air pollution exposure and risk of lung cancer histologic subtype.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Wen Chiu
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yi-Hao Weng
- Division of Neonatology, Department of Pediatrics, Chang Gung,Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
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Gotfrit J, Thangarasa T, Dudani S, Goodwin R, Tang PA, Monzon J, Dennis K, Cheung WY, Marginean H, Vickers M. The impact of driving time, distance, and socioeconomic factors on outcomes of patients with locally advanced rectal cancer. PUBLIC HEALTH IN PRACTICE 2020; 1:100012. [PMID: 36101686 PMCID: PMC9461354 DOI: 10.1016/j.puhip.2020.100012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/06/2020] [Accepted: 05/12/2020] [Indexed: 11/25/2022] Open
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Yang CY. Deaths from colon cancer among farmers in Taiwan: a mortality odds ratio study. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:1137-1142. [PMID: 31826720 DOI: 10.1080/15287394.2019.1702312] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Few studies have examined the association between increased risk of colon cancer development and occupation of farming. Data thus far have been inconsistent with respect to a correlation between farming and colon cancer occurrence. This type of study has not been undertaken in Asia. The aim of this investigation was to utilize the mortality odds ratio (MOR) design to estimate the relative risk (RR) of mortality attributed to colon cancer in farmers in Taiwan. Utilizing Taiwan's Death Certificate Registry, data were collected on subjects who died between 1997-2009. Our study group was comprised of individuals 50 years of age and higher who died of colon cancer, while the control group consisted of subjects the same age who died of all other causes excluding cancers. Multiple logistic regression was performed to compute the MOR adjusted for gender, age at death, year of death, marital status, and urbanization levels. Of the 32,456 farmers who died, 558 were attributed to die of colon cancer. Farmers in Taiwan had a significantly lower risk of mortality from colon cancer than non-farmers (MOR = 0.85, 95% CI = 0.78-0.93), similar to estimates reported in previous meta-analyses. Occupational physical activity or higher consumption of vegetables and fruits might have contributed to the lower risk of death due to colon cancer. The basis for these observations requires further examination as it appears that lifestyle is a crucial factor in colon cancer development.
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Affiliation(s)
- Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute, Miaoli, Taiwan
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10
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Chen CC, Chen PS, Yang CY. Relationship between fine particulate air pollution exposure and human adult life expectancy in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2019; 82:826-832. [PMID: 31438783 DOI: 10.1080/15287394.2019.1658386] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Among the air pollutants, particulate matter with an aerodynamic diameter less than 2.5 um (PM2.5) is of particular interest to environmental medicine as epidemiologic studies consistently reported that long-term exposure to PM2.5 is associated with increased risk of premature death in adults. Life expectancy is a well-documented and important measure of overall public health policy. However, few investigators examined the relationship between PM2.5 levels and adult life expectancy. In this Taiwan-wide study, county-level annual mean PM2.5 concentrations data were collected concomitantly with potential confounding variables including demographic and socioeconomic status, as well as smoking prevalence. Subsequently, these PM2.5 data were analyzed with respect to county-level adult life expectancy data for the period 2010 to 2017. Linear regression was used to determine the relationship between PM2.5 and life expectancy in adults. Residents residing in the counties characterized as containing higher levels of PM2.5 exhibited significantly reduced life expectancy after controlling for potential confounders. For each 10 ug/m3 increase in PM2.5 there was an estimated mean decrease in life expectancy in adults of 0.3 years. The results of this study shed light on the relationship between fine particulate air pollution exposure and risk to human health in Taiwan.
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Affiliation(s)
- Chih-Cheng Chen
- Department of Pediatrics, College of Medicine , Kaohsiung , Taiwan
- Chang-Gung Memorial Hospital and Chang-Gung University , Kaohsiung , Taiwan
| | - Pei-Shih Chen
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University , Kaohsiung City , Taiwan
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University , Kaohsiung , Taiwan
- National Institute of Environmental Health Sciences, National Health Research Institute , Miaoli , Taiwan
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11
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Pikala M, Burzyńska M, Maniecka-Bryła I. Epidemiology of Mortality Due to Prostate Cancer in Poland, 2000-2015. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162881. [PMID: 31409038 PMCID: PMC6721133 DOI: 10.3390/ijerph16162881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2019] [Revised: 08/09/2019] [Accepted: 08/11/2019] [Indexed: 12/24/2022]
Abstract
The aim of the study was to assess trends in mortality and years of life lost due to prostate cancer (PCa) in Poland in 2000–2015. The crude death rates (CDR), standardised death rates (SDR), standard expected years of life lost per living person (SEYLLp) and per death (SEYLLd) values were calculated. Joinpoint models were used to analyse time trends. In the study period, 61,928 men died of PCa. The values of mortality rates in 2000 (per 100,000) were: CDR = 16.97, SDR = 16.17, SEYLLp = 332.1. In 2015, the values of all rates increased: CDR = 26.22, SDR = 16.69, SEYLLp = 429.5. However, the SEYLLd value decreased from 15.62 to one man who died due to PCa in 2000 to 13.78 in 2015. The highest SEYLLp values occurred in the group of men with primary education (619.5 in 2000 and 700.7 in 2015). They were respectively 2.24 and 2.96 times higher than in men with higher education (275.7 and 237.1). SEYLLp values increased in urban areas (from 295.7 to 449.4), slightly changed in the rural areas (from 391.5 to 400.2). Unfavorable trends in mortality due to PCa in Poland require explanation of the causes and implementation of appropriate actions aimed at mortality reducing.
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Affiliation(s)
- Małgorzata Pikala
- Department of Epidemiology and Biostatistics, the Chair of Social and Preventive Medicine of the Medical University of Lodz, 90-136 Lodz, Poland.
| | - Monika Burzyńska
- Department of Epidemiology and Biostatistics, the Chair of Social and Preventive Medicine of the Medical University of Lodz, 90-136 Lodz, Poland
| | - Irena Maniecka-Bryła
- Department of Epidemiology and Biostatistics, the Chair of Social and Preventive Medicine of the Medical University of Lodz, 90-136 Lodz, Poland
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12
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Dasgupta P, Baade PD, Aitken JF, Ralph N, Chambers SK, Dunn J. Geographical Variations in Prostate Cancer Outcomes: A Systematic Review of International Evidence. Front Oncol 2019; 9:238. [PMID: 31024842 PMCID: PMC6463763 DOI: 10.3389/fonc.2019.00238] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 03/18/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Previous reviews of geographical disparities in the prostate cancer continuum from diagnosis to mortality have identified a consistent pattern of poorer outcomes with increasing residential disadvantage and for rural residents. However, there are no contemporary, systematic reviews summarizing the latest available evidence. Our objective was to systematically review the published international evidence for geographical variations in prostate cancer indicators by residential rurality and disadvantage. Methods: Systematic searches of peer-reviewed articles in English published from 1/1/1998 to 30/06/2018 using PubMed, EMBASE, CINAHL, and Informit databases. Inclusion criteria were: population was adult prostate cancer patients; outcome measure was PSA testing, prostate cancer incidence, stage at diagnosis, access to and use of services, survival, and prostate cancer mortality with quantitative results by residential rurality and/or disadvantage. Studies were critically appraised using a modified Newcastle-Ottawa Scale. Results: Overall 169 studies met the inclusion criteria. Around 50% were assessed as high quality and 50% moderate. Men from disadvantaged areas had consistently lower prostate-specific antigen (PSA) testing and prostate cancer incidence, poorer survival, more advanced disease and a trend toward higher mortality. Although less consistent, predominant patterns by rurality were lower PSA testing, prostate cancer incidence and survival, but higher stage disease and mortality among rural men. Both geographical measures were associated with variations in access and use of prostate cancer-related services for low to high risk disease. Conclusions: This review found substantial evidence that prostate cancer indicators varied by residential location across diverse populations and geographies. While wide variations in study design limited comparisons across studies, our review indicated that internationally, men living in disadvantaged areas, and to a lesser extent more rural areas, face a greater prostate cancer burden. This review highlights the need for a better understanding of the complex social, environmental, and behavioral reasons for these variations, recognizing that, while important, geographical access is not the only issue. Implementing research strategies to help identify these processes and to better understand the central role of disadvantage to variations in health outcome are crucial to inform the development of evidence-based targeted interventions.
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Affiliation(s)
- Paramita Dasgupta
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
| | - Peter D Baade
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,School of Mathematical Sciences, Queensland University of Technology, Brisbane, QLD, Australia
| | - Joanne F Aitken
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Nicholas Ralph
- Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia.,St Vincent's Private Hospital, Toowoomba, QLD, Australia.,School of Nursing & Midwifery, University of Southern Queensland, Toowoomba, QLD, Australia
| | - Suzanne Kathleen Chambers
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.,Health and Wellness Institute, Edith Cowan University, Perth, WA, Australia.,Faculty of Health, University of Technology, Sydney, NSW, Australia
| | - Jeff Dunn
- Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia.,Institute for Resilient Regions, University of Southern Queensland, Toowoomba, QLD, Australia.,Faculty of Health, University of Technology, Sydney, NSW, Australia
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13
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Yang Z, Wang Q, Liu P. Extreme temperature and mortality: evidence from China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2019; 63:29-50. [PMID: 30411250 DOI: 10.1007/s00484-018-1635-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 06/08/2023]
Abstract
The frequency, intensity, and duration of extreme temperature events are expected to rise in the future and increase the related health risks of human beings. Using a novel, nationwide dataset that links extreme temperature and mortality, we estimated the short-term and long-term effects of extreme temperature on mortality in China during 2002-2013. Both extreme hot and extreme cold had immediate and long-term effects on all-cause mortality. Annual deaths per 100,000 people due to extreme hot and cold in the long term were considerably larger compared to the short term. The change in cold spell duration indicator exhibited the greatest effects on annual deaths per 100,000 people among a set of extreme weather indicators. Furthermore, cities with low economic development levels were more vulnerable to extreme temperature, compared to cities with high economic development levels. Our results offer important policy implications for developing a regional-specific extreme weather plan to handle extreme temperature events in China.
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Affiliation(s)
- Zhiming Yang
- Donlinks School of Economics and Management, University of Science and Technology Beijing, Beijing, 100083, China
| | - Qing Wang
- School of Business, Dalian University of Technology, Panjin, 124221, Liaoning, China.
- School of Public Health, Shandong University, Jinan, 250100, Shandong, China.
| | - Pengfei Liu
- Department of Aquaculture and Fisheries, University of Arkansas at Pine Bluff, 1200 N. University Drive, Box 4912, Pine Bluff, AR, 71601, USA
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14
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Qin L, Kao YW, Lin YL, Peng BY, Deng WP, Chen TM, Lin KC, Yuan KSP, Wu ATH, Shia BC, Wu SY. Recurrent aphthous stomatitis may be a precursor or risk factor for specific cancers: A case-control frequency-matched study. Cancer Med 2018; 7:4104-4114. [PMID: 30009475 PMCID: PMC6089185 DOI: 10.1002/cam4.1685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 06/07/2018] [Accepted: 06/24/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Recurrent aphthous stomatitis (RAS) is considered a prophase symptom in patients with specific cancers. This study assessed the association between RAS and subsequent onset of cancer based on a nationwide population-based database in Taiwan. MATERIALS AND METHODS We selected study participants from the National Health Insurance Research Database from January 2000 to December 2008. Patients in the non-RAS cohort were matched to case study patients at a 1:1 ratio through frequency matching. All participants were followed up for at least 5 years, and those who received cancer diagnoses during follow-up were identified. RESULTS Among 52 307 patients with and 52 304 patients without RAS, the combined hazard ratio (HR) of all subsequent cancer cases was 1.3 (95% confidence interval [CI]: 1.25-1.35, P = 0). RAS diagnosis was associated with risk for cancers of the head and neck (aHR = 2, 95% CI: 1.8-2.3), colon (aHR = 1.2, 95% CI: 1.1-1.4), liver (aHR = 1.1, 95% CI: 1-1.3), pancreas (aHR = 1.4, 95% CI: 1.1-1.7), skin (aHR = 1.4, 95% CI: 1.2-1.7), breast (aHR = 1.2, 95% CI: 1.1-1.4), and prostate (aHR = 1.5, 95% CI: 1.3-1.8), as well as hematologic cancers (aHR = 1.6, 95% CI: 1.3-1.9). A higher risk was observed for male patients (aHR = 1.35, 95% CI: 1.28-1.42) than for female patients (aHR = 1.25, 95% CI: 1.18-1.31) with RAS. CONCLUSIONS RAS was associated with specific cancers. Susceptible RAS patients should be screened for specific cancers.
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Affiliation(s)
- Lei Qin
- School of Statistics, University of International Business and Economics, Beijing, China
| | - Yi-Wei Kao
- Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei, Taiwan
| | - Yueh-Lung Lin
- School of Mathematical Sciences, University of Nottingham Ningbo China, Ningbo, China
| | - Bou-Yue Peng
- Department of Dentistry, Taipei Medical University Hospital, Taipei, Taiwan
| | - Win-Ping Deng
- Graduate Institute of Biomedical Materials and Engineering, Taipei Medical University, Taipei, Taiwan
| | - Tsung-Ming Chen
- Department of Otorhinolaryngology, Shuang-Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kuan-Chou Lin
- Department of Oral and Maxillofacial Surgery, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Kevin Sheng-Po Yuan
- Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Alexander T H Wu
- Ph.D. Program for Translational Medicine, Taipei Medical University, Taipei, Taiwan
| | - Ben-Chang Shia
- College of Management, Taipei Medical University, Taipei, Taiwan
| | - Szu-Yuan Wu
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China.,Department of Radiation Oncology, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan.,Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,Epidemiology and Bioinformatics Center, Wanfang Hospital, Taipei Medical University, Taipei, Taiwan
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15
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Tsai SS, Weng YH, Chiu YW, Yang CY. Farming and mortality rates attributed to non-Hodgkin's lymphoma in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2017; 81:31-36. [PMID: 29182467 DOI: 10.1080/15287394.2017.1408362] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 11/20/2017] [Indexed: 06/07/2023]
Abstract
Previous studies suggested an elevated risk of non-Hodgkin's lymphoma (NHL) among farmers. To date, no apparent study examined the association between farming and NHL in Asian countries. The aim of this study was to investigate whether farmers in Taiwan exhibited an increased risk of mortality attributed to NHL. To this end, a mortality odds ratio (MOR) study was conducted to estimate the relative risk of mortality attributed to NHL for farmers in Taiwan. Data on the decedents enrolled in this investigation were derived from the death certificate database for the period 1997-2009. The study group comprised individuals who died from NHL and who were 50 years or older. The control group consisted of subjects who died from all other causes, excluding cancers, in the corresponding age group. Multiple logistic regression analysis was performed to compute the MOR, with adjustments for gender, age at death, year of death, marital status, and urbanizational levels. Among 32,456 deceased farmers, 205 died due to NHL. Farmers were found to have a nonsignificantly higher MOR than nonfarmers. This risk estimate is similar to estimates in previous meta-analyses. The MOR for NHL was higher among farmers who died 65 years or older than among those who died at younger ages. The findings indicate that farming in Taiwan may increase the risk of death attributed to NHL. Exposure to pesticides might be an influential factor contributing to high risk of mortality attributed to NHL among farmers and therefore needs to be further investigated.
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Affiliation(s)
- Shang-Shyue Tsai
- a Department of Healthcare Administration , I-Shou University , Kaohsiung , Taiwan
| | - Yi-Hao Weng
- b Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital , Chang Gung University College of Medicine , Taipei , Taiwan
| | - Ya-Wen Chiu
- c Master Program in Global Health and Development, College of Public Health , Taipei Medical University , Taipei , Taiwan
| | - Chun-Yuh Yang
- d Department of Public Health, College of Health Sciences , Kaohsiung Medical University , Kaohsiung , Taiwan
- e National Institute of Environmental Health Sciences , National Health Research Institute , Miaoli , Taiwan
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16
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Parity, Age at First Birth, and Risk of Death from Bladder Cancer: A Population-Based Cohort Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13121197. [PMID: 27918463 PMCID: PMC5201338 DOI: 10.3390/ijerph13121197] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/23/2016] [Accepted: 11/23/2016] [Indexed: 11/30/2022]
Abstract
The evidence is limited on the relationship between reproductive factors and bladder cancer (BC). We studied 1,292,462 women who had a first and singleton delivery between 1 January 1978 and 31 December 1987. Each woman in the study cohort was tracked from their first childbirth to 31 December 2009. Vital status of the women was determined by crosswalking records with a computerized mortality database. We used Cox proportional hazard regression models to estimate the hazard ratios (HRs) of death from BC associated with maternal age at first birth and parity. The data showed 63 BC deaths during 34,980,246 person-years of follow-up. BC mortality rate was 0.90 cases for every 100,000 person-years. Compared with women who gave birth under the age of 23, the adjusted HR was 1.24 (95% confidence interval (CI) = 0.66–2.35) for women who gave birth between age 23 and 26 and 2.30 (95% CI = 1.21–4.39) for women who gave birth over the age of 26. Increasing age at first birth (p for trend = 0.01) is associated with a trend in increasing risk of BC mortality. Relative to women who had a single childbirth, the adjusted HRs were 1.17 (95% CI = 0.51–2.69) for women who gave birth to two children, and 1.31 (95% CI = 0.56–3.10) for women with three or more childbirths, respectively. These results were not statistically significant. Study results suggests that giving birth at an early age may confer a protective effect on the risk of death from BC.
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17
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Tseng CH. Type 2 Diabetes Mellitus and Kidney Cancer Risk: A Retrospective Cohort Analysis of the National Health Insurance. PLoS One 2015; 10:e0142480. [PMID: 26559055 PMCID: PMC4641625 DOI: 10.1371/journal.pone.0142480] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 10/22/2015] [Indexed: 12/29/2022] Open
Abstract
Purpose To evaluate the association between incidence of any kidney cancer and type 2 diabetes mellitus. Methods A random sample of 1,000,000 subjects covered by the National Health Insurance was recruited. A total of 998728 people (115655 diabetes and 883073 non-diabetes) without kidney cancer at recruitment were followed from 2003 to 2005. The cumulative incidence of kidney cancer from 2003 to 2005 in diabetic patients and non-diabetic people in all ages and in age <40, 40–64, 65–74 and ≥75 years were calculated in the diabetic patients and the non-diabetic people, respectively. Logistic regression was used to estimate the odds ratios comparing diabetic patients to non-diabetic people in the respective age groups. Multivariable-adjusted odds ratios for kidney cancer with regards to diabetes status and diabetes duration (as a continuous variable or categorized into subgroups of non-diabetes, diabetes duration <1 year, 1–2.9 years, 3–4.9 years and ≥5 years) were estimated after multivariable adjustment. The multivariable-adjusted odds ratios for all baseline variables were also estimated for diabetic patients and non-diabetic people, respectively. Results The 3-year cumulative incidence of kidney cancer in the diabetic patients and the non-diabetic people was 166.9 and 33.1 per 100,000 person-years, respectively. The incidence increased with regards to increasing age in both the diabetic patients and the non-diabetic people, but a higher risk of kidney cancer for the diabetic patients compared to the non-diabetic people was consistently observed in different age groups. After multivariable adjustment, the odds ratio for diabetic patients versus non-diabetic people was 1.7 (95% confidence interval: 1.3–2.1, P<0.01). While compared to the non-diabetic people, the odds ratio (95% confidence interval) for diabetes duration <1, 1–2.9 years, 3–4.9 years and ≥5 years was 1.5 (0.8–2.7), 1.6 (1.0–2.4), 1.6 (1.1–2.4) and 1.7 (1.3–2.3), respectively (P-trend <0.01). Analyses conducted in the diabetic patients and the non-diabetic people, respectively, consistently showed age, nephropathy and end-stage renal disease as significant risk factors of kidney cancer. Additionally, living in metropolitan Taipei region might also be associated with a higher risk of kidney cancer in the non-diabetic people, indicating a potential link between kidney cancer and some factors related to urbanization. Conclusions Patients with type 2 diabetes mellitus have a significantly higher risk of kidney cancer.
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Affiliation(s)
- Chin-Hsiao Tseng
- Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Division of Environmental Health and Occupational Medicine of the National Health Research Institutes, Zhunan, Taiwan
- * E-mail:
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18
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Jou HJ, Siao RY, Tsai YS, Chen YT, Li CY, Chen CC. Postdischarge rehospitalization and in-hospital mortality among Taiwanese women with hip fracture. Taiwan J Obstet Gynecol 2015; 53:43-7. [PMID: 24767645 DOI: 10.1016/j.tjog.2012.04.042] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2012] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To explore the factors concerning postdischarge rehospitalization and in-hospital mortality among Taiwanese women older than 50 years with hip fracture. MATERIALS AND METHODS The National Health Insurance database from 2000 to 2006 was used to identity relevant cases. Women inpatients aged over 50 years with new-onset hip fracture in 2003 were identified. We analyzed the factors affecting postdischarge rehospitalization and in-hospital mortality. RESULTS In 2003, there were 9467 new-onset hip fracture inpatients claimed among Taiwanese women aged over 50 years. The 3-year cumulative rates of rehospitalization after discharge and in-hospital mortality rate were 11.01% (1043) and 7.10% (672), respectively. The factors determined to be related to rehospitalization were patient age, hospital level, length of stay of the initial hospitalization due to hip fracture, and Charlson comorbidity index (CCI) score. The factors determined to be related to in-hospital mortality were age, urbanization level of region where patients were insured, hospital level, length of stay of the initial hospitalization due to hip fracture, and CCI score. CONCLUSION Characteristics of women aged over 50 years with hip fracture remain an important issue based on high rehospitalization and in-hospital mortality rates. We have identified related risk factors that may be helpful in treating hip fracture among this population segment.
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Affiliation(s)
- Hei-Jen Jou
- Department of Obstetrics and Gynecology, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Ruo-Yan Siao
- Department of Healthcare Development, Taiwan Adventist Hospital, Taipei, Taiwan
| | - You-Shih Tsai
- Department of Orthopedics, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Yi-Tui Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine National Cheng Kung University, Tainan, Taiwan
| | - Chu-Chieh Chen
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
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19
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Baade PD, Yu XQ, Smith DP, Dunn J, Chambers SK. Geographic Disparities in Prostate Cancer Outcomes - Review of International Patterns. Asian Pac J Cancer Prev 2015; 16:1259-75. [DOI: 10.7314/apjcp.2015.16.3.1259] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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20
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Sharp L, Donnelly D, Hegarty A, Carsin AE, Deady S, McCluskey N, Gavin A, Comber H. Risk of several cancers is higher in urban areas after adjusting for socioeconomic status. Results from a two-country population-based study of 18 common cancers. J Urban Health 2014; 91:510-25. [PMID: 24474611 PMCID: PMC4074316 DOI: 10.1007/s11524-013-9846-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Some studies suggest that there are urban-rural variations in cancer incidence but whether these simply reflect urban-rural socioeconomic variation is unclear. We investigated whether there were urban-rural variations in the incidence of 18 cancers, after adjusting for socioeconomic status. Cancers diagnosed between 1995 and 2007 were extracted from the population-based National Cancer Registry Ireland and Northern Ireland Cancer Registry and categorised by urban-rural status, based on population density of area of residence at diagnosis (rural <1 person per hectare, intermediate 1-15 people per hectare, urban >15 people per hectare). Relative risks (RR) were calculated by negative binomial regression, adjusting for age, country and three area-based markers of socioeconomic status. Risks were significantly higher in both sexes in urban than rural residents with head and neck (males RR urban vs. rural = 1.53, 95 % CI 1.42-1.64; females RR = 1.29, 95 % CI 1.15-1.45), esophageal (males 1.21, 1.11-1.31; females 1.21, 1.08-1.35), stomach (males 1.36, 1.27-1.46; females 1.19, 1.08-1.30), colorectal (males 1.14, 1.09-1.18; females 1.04, 1.00-1.09), lung (males 1.54, 1.47-1.61; females 1.74, 1.65-1.84), non-melanoma skin (males 1.13, 1.10-1.17; females 1.23, 1.19-1.27) and bladder (males 1.30, 1.21-1.39; females 1.31, 1.17-1.46) cancers. Risks of breast, cervical, kidney and brain cancer were significantly higher in females in urban areas. Prostate cancer risk was higher in rural areas (0.94, 0.90-0.97). Other cancers showed no significant urban-rural differences. After adjusting for socioeconomic variation, urban-rural differences were evident for 12 of 18 cancers. Variations in healthcare utilization and known risk factors likely explain some of the observed associations. Explanations for others are unclear and, in the interests of equity, warrant further investigation.
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Affiliation(s)
- Linda Sharp
- National Cancer Registry Ireland, Building 6800, Cork Airport Business Park, Kinsale Road, Cork, Ireland,
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21
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Chen BK, Yang CY. Differences in age-standardized mortality rates for avoidable deaths based on urbanization levels in Taiwan, 1971-2008. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:1776-93. [PMID: 24503974 PMCID: PMC3945567 DOI: 10.3390/ijerph110201776] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 01/10/2014] [Accepted: 01/17/2014] [Indexed: 11/29/2022]
Abstract
The World is undergoing rapid urbanization, with 70% of the World population expected to live in urban areas by 2050. Nevertheless, nationally representative analysis of the health differences in the leading causes of avoidable mortality disaggregated by urbanization level is lacking. We undertake a study of temporal trends in mortality rates for deaths considered avoidable by the Concerted Action of the European Community on Avoidable Mortality for four different levels of urbanization in Taiwan between 1971 and 2008. We find that for virtually all causes of death, age-standardized mortality rates (ASMRs) were lower in more urbanized than less urbanized areas, either throughout the study period, or by the end of the period despite higher rates in urbanized areas initially. Only breast cancer had consistently higher AMSRs in more urbanized areas throughout the 38-year period. Further, only breast cancer, lung cancer, and ischemic heart disease witnessed an increase in ASMRs in one or more urbanization categories. More urbanized areas in Taiwan appear to enjoy better indicators of health outcomes in terms of mortality rates than less urbanized areas. Access to and the availability of rich healthcare resources in urban areas may have contributed to this positive result.
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Affiliation(s)
- Brian K Chen
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, 915 Greene Street, Columbia, SC 29208, USA.
| | - Chun-Yuh Yang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung 807, Taiwan.
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Tsai SS, Chiu HF, Yang CY. Trihalomethanes in drinking water and the risk of death from esophageal cancer: does hardness in drinking water matter? JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2013; 76:120-130. [PMID: 23294300 DOI: 10.1080/15287394.2013.738410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The objectives of this study were to (1) examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of esophageal cancer occurrence and (2) determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop esophageal cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to esophageal cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All esophageal cancer deaths in the 53 municipalities from 2006 through 2010 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level <4.9 ppb, the adjusted odds ratio (OR) with 95% confidence interval (CI) for esophageal cancer was 1.02 (0.84-1.23) for individuals who resided in municipalities served by drinking water with a TTHM exposure ≥4.9 ppb. There was evidence of an interaction between drinking-water TTHM levels and low Ca and Mg intake. Our findings showed that the correlation between TTHM exposure and risk of esophageal cancer development was influenced by Ca and Mg levels in drinking water. This is the first study to report effect modification by Ca and Mg intake from drinking water on the correlation between TTHM exposure and risk of esophageal cancer occurrence. Increased knowledge of the interaction between Ca, Mg, and TTHM in reducing risk of esophageal cancer development will aid in public policymaking and standard setting for drinking water.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Health Care Administration, I-Shou University, Kaohsiung, Taiwan
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23
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Angkurawaranon C, Wattanatchariya N, Doyle P, Nitsch D. Urbanization and Non-communicable disease mortality in Thailand: an ecological correlation study. Trop Med Int Health 2012; 18:130-40. [DOI: 10.1111/tmi.12038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - Pat Doyle
- London School of Hygiene and Tropical Medicine; London; UK
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Tsai PJ. Application of Moran's test with an empirical Bayesian rate to leading health care problems in Taiwan in a 7-year period (2002-2008). Glob J Health Sci 2012; 4:63-77. [PMID: 22980379 PMCID: PMC4776905 DOI: 10.5539/gjhs.v4n5p63] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2012] [Accepted: 07/01/2012] [Indexed: 12/22/2022] Open
Abstract
Purpose: This study focused on using Moran’s tests and logistic regression to detect changes in spatial clustering for females and males. Methods: For spatial distribution analysis, an average morbidity rate for a 7-year period was calculated. Medical cases from Taiwan National Health Insurance (NHI) were used as the numerator, and the denominator was the average mid-year population. Spatial analysis techniques, with a morbidity-smoothing coefficient estimate based on the empirical Bayesian method, were incorporated and applied to global and local Moran tests. In addition, we used a logistic regression model to test the characteristics of similarity and dissimilarity between males and females and to formulate the common spatial risk. Results: The mean found by local spatial autocorrelation analysis was used to identify spatial cluster patterns. There is great interest in discovering the relationship between leading health care problems and spatial risk factors. For example, in Taiwan, the geographic distribution of clusters where neoplasms were prevalent was found to closely correspond to the locations in the arseniasis-endemic areas of Southwestern and Northeastern Taiwan, as well as to locations in the Tainan urban area (for females) and clusters in Changhua County and Yunlin County (for males). The high-density populations in urban areas showed carcinogen clusters in Taiwan’s 3 main urban centers (i.e., Taipei, Taichung, and Kaohsiung) for female neoplasms. Conclusion: Cluster mapping helped clarify issues such as the spatial aspects of both the internal and external correlations for leading health care events. This information greatly assists in assessing spatial risk factors, which facilitates the planning of the most advantageous types of health care policies, as well as the implementation of effective health care services.
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Affiliation(s)
- Pui-Jen Tsai
- Center for General Education, Aletheria University, New Taipei, Republic of China (Taiwan).
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25
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Hung LJ, Chan TF, Wu CH, Chiu HF, Yang CY. Traffic air pollution and risk of death from ovarian cancer in Taiwan: fine particulate matter (PM2.5) as a proxy marker. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2012; 75:174-182. [PMID: 22251265 DOI: 10.1080/15287394.2012.641200] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The relationship between mortality attributed to ovarian cancer and exposure to ambient air pollutants was examined using an ecological design. The study areas consisted of 61 municipalities in Taiwan. Air quality data for recorded concentrations of fine particulate matter (PM2.5) from study municipalities for 2006-2009 were obtained as a marker of traffic emissions. These were used as a proxy for polycyclic aromatic hydrocarbons (PAH) exposure. Age-standardized mortality rates for ovarian cancer were calculated for the study municipalities for the years 1999-2008. A weighted multiple regression model was employed to calculate the adjusted risk ratio (RR) in relation to PM2.5 levels. After adjusting for urbanization level and fertility rate, the adjusted RR values (95% confidence interval [CI]) for ovarian cancer were 1.2 (1.02-1.41) for the municipalities with PM2.5 levels between 30.48 μg/m3 and 39.41 μg/m3 and 1.2 (1.03-1.39) for the municipalities with PM2.5 levels between 39.48 μg/m3 and 51.1 μg/m3, compared to the municipalities with PM2.5 levels less than 30.39 μg/m3. Results showed that individuals who resided in municipalities with higher levels of PM2.5, a proxy measure of PAH, were at an increased risk of death from ovarian cancer compared to those subjects living in municipalities with the lowest PM2.5. The findings of this study warrant further investigation into the role of exposure to air pollutants in the etiology of ovarian cancer development.
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Affiliation(s)
- Li-Ju Hung
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, and Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Chiu HF, Tsai SS, Chen PS, Liao YH, Liou SH, Wu TN, Yang CY. Traffic air pollution and risk of death from gastric cancer in Taiwan: petrol station density as an indicator of air pollutant exposure. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2011; 74:1215-1224. [PMID: 21797773 DOI: 10.1080/15287394.2011.590100] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
To investigate the relationship between air pollution and risk of death attributed to gastric cancer, a matched cancer case-control study was conducted using deaths that occurred in Taiwan from 2004 through 2008. Data for all eligible gastric cancer deaths were obtained and compared to a control group consisting of individuals who died from causes other than neoplasms and diseases that were associated with gastrointestinal (GIT) disorders. The controls were pair-matched to the cancer cases by gender, year of birth, and year of death. Each matched control was randomly selected from the set of possible controls for each cancer case. Data for the number of petrol stations in study municipalities were collected from two major petroleum supply companies. The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The exposed individuals were subdivided into three categories (≤25th percentile; 25th-75th percentile; >75th percentile) according to PSD in the residential municipality. Results showed that individuals who resided in municipalities with the highest PSD were at an increased risk of death attributed to gastric cancer compared to those subjects living in municipalities with the lowest PSD. The findings of this study warrant further investigation of the role of traffic air pollution exposure in the etiology of gastric cancer.
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Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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27
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Elevated oestrogen receptor splice variant ERαΔ5 expression in tumour-adjacent hormone-responsive tissue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2010; 7:3871-89. [PMID: 21139866 PMCID: PMC2996214 DOI: 10.3390/ijerph7113871] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 10/27/2010] [Accepted: 10/29/2010] [Indexed: 12/25/2022]
Abstract
Susceptibility to prostate or endometrial cancer is linked with obesity, a state of oestrogen excess. Oestrogen receptor (ER) splice variants may be responsible for the tissue-level of ER activity. Such micro-environmental regulation may modulate cancer initiation and/or progression mechanisms. Real-time reverse transcriptase (RT) polymerase chain reaction (PCR) was used to quantitatively assess the levels of four ER splice variants (ERαΔ3, ERαΔ5, ERβ2 and ERβ5), plus the full-length parent isoforms ERα and ERβ1, in high-risk [tumour-adjacent prostate (n = 10) or endometrial cancer (n = 9)] vs. low-risk [benign prostate (n = 12) or endometrium (n = 9)], as well as a comparison of UK (n = 12) vs. Indian (n = 15) benign prostate. All three tissue groups expressed the ER splice variants at similar levels, apart from ERαΔ5. This splice variant was markedly raised in all of the tumour-adjacent prostate samples compared to benign tissues. Immunofluorescence analysis for ERβ2 in prostate tissue demonstrated that such splice variants are present in comparable, if not greater, amounts as the parent full-length isoform. This small pilot study demonstrates the ubiquitous nature of ER splice variants in these tissue sites and suggests that ERαΔ5 may be involved in progression of prostate adenocarcinoma.
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Chiu HF, Tsai SS, Wu TN, Yang CY. Effect modification of the association between trihalomethanes and pancreatic cancer by drinking water hardness: evidence from an ecological study. ENVIRONMENTAL RESEARCH 2010; 110:513-518. [PMID: 20382379 DOI: 10.1016/j.envres.2010.03.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2009] [Revised: 02/26/2010] [Accepted: 03/17/2010] [Indexed: 05/29/2023]
Abstract
The objective of this study was to examine the relationship between total trihalomethanes (TTHM) levels in public water supplies and risk of pancreatic cancer and to determine whether calcium (Ca) and magnesium (Mg) levels in drinking water modify the effects of TTHM on risk to develop pancreatic cancer. A matched case-control study was used to investigate the relationship between the risk of death attributed to pancreatic cancer and exposure to TTHM in drinking water in 53 municipalities in Taiwan. All pancreatic cancer deaths in the 53 municipalities from 1998 through 2007 were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. Controls were deaths from other causes and were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each cancer case. Data on TTHM levels in drinking water were collected from Taiwan Environmental Protection Administration. Information on the levels of Ca and Mg in drinking water was obtained from the Taiwan Water Supply Corporation. The municipality of residence for cancer cases and controls was presumed to be the source of the subject's TTHM, Ca, and Mg exposure via drinking water. Relative to individuals whose TTHM exposure level < 4.9ppb, the adjusted OR (95% CI) for pancreatic cancer was 1.01 (0.85-1.21) for individuals who resided in municipalities served by drinking water with a TTHM exposure > 4.9ppb. There was no evidence of an interaction of drinking water TTHM levels with low Ca intake via drinking water. However, we observed evidence of an interaction between drinking water TTHM concentrations and Mg intake via drinking water. Our findings showed that the correlation between TTHM exposure and risk of pancreatic cancer is influenced by Mg in drinking water. Increased knowledge of the interaction between Mg and TTHM in reducing pancreatic cancer risk will aid in public policy making and standard setting.
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Affiliation(s)
- Hui-Fen Chiu
- Department of Pharmacology, Kaohsiung Medical University, Kaohsiung, Taiwan
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29
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Ho CK, Peng CY, Yang CY. Traffic air pollution and risk of death from bladder cancer in Taiwan using petrol station density as a pollutant indicator. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2010; 73:23-32. [PMID: 19953417 DOI: 10.1080/15287390903248869] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
To investigate the relationship between air pollution and risk of death from bladder cancer, a matched cancer case-control study was conducted using deaths that occurred in Taiwan from 1997 through 2006. Data for all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than cancer or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data for the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The present study showed that individuals who resided in municipalities with high PSD levels were at an increased risk of death from bladder cancer compared to subjects living in municipalities with a low PSD level; however, the differences are not statistically significant. The findings of this study warrant further investigation of the role of vehicular air pollutant emissions in the etiology of bladder cancer development.
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Affiliation(s)
- Chi-Kung Ho
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Liu CC, Tsai SS, Chiu HF, Wu TN, Chen CC, Yang CY. Ambient exposure to criteria air pollutants and risk of death from bladder cancer in Taiwan. Inhal Toxicol 2009; 21:48-54. [PMID: 18923949 DOI: 10.1080/08958370802207326] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To investigate the relationship between air pollution and risk of death from bladder cancer, the authors conducted a matched case-control study using deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of people who died from causes other than cancer or diseases associated with genitourinary problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Classification of exposure to municipality air pollution was based on the measured levels of nitrogen dioxide and sulfur dioxide. The results of the present study show that there is a significant positive association between the levels of air pollution and bladder cancer mortality. The adjusted odds ratios (95% confidence interval) were 1.37 (1.03-1.82) for the group with medium air pollution level and 1.98 (1.36-2.88) for the group with high air pollution level when compared to the group with the low air pollution level. Trend analyses showed statistically significant trend in risk of death from bladder cancer with increasing air pollution level. The findings of this study warrant further investigation of the role of air pollutants in the etiology of bladder cancer.
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Affiliation(s)
- Chia-Chia Liu
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, 100 Shih-Chuan 1st Road, Kaohsiung, Taiwan
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31
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Tsai SS, Tiao MM, Kuo HW, Wu TN, Yang CY. Association of bladder cancer with residential exposure to petrochemical air pollutant emissions in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2009; 72:53-59. [PMID: 19034794 DOI: 10.1080/15287390802476934] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
To investigate the relationship between petrochemical air pollution and risk of death due to bladder cancer, studies were conducted using a matched cancer case-control model based upon deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible bladder cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of individuals who died from causes other than neoplasms or diseases associated with genitourinary problems. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into three levels (< or =25th percentile; 25th-50th percentile; >50th percentile). Subjects who lived in the group of municipalities characterized by the high levels of petrochemical air pollution had a significantly higher risk of death attributed to bladder cancer than subjects in the group that lived in municipalities with the lowest petrochemical air pollution levels, after controlling for possible confounders. The findings of this study warrant further investigation of the role of petrochemical air pollution in the etiology of bladder cancer.
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Affiliation(s)
- Shang-Shyue Tsai
- Department of Health Care Administration, I-Shou University, Kaohsiung County, Taiwan
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Chang CC, Tsai SS, Chiu HF, Wu TN, Yang CY. Traffic air pollution and lung cancer in females in Taiwan: petrol station density as an indicator of disease development. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2009; 72:651-657. [PMID: 19308850 DOI: 10.1080/15287390902733515] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
To investigate the relationship between traffic air pollution exposure and development of lung cancer in females, studies were conducted using a matched cancer case-control model into deaths that occurred in Taiwan from 1997 through 2006. Data on all eligible lung cancer deaths in females were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of women who died from causes other than neoplasms or diseases that were associated with respiratory problems. The controls were pair matched to the cancer cases by year of birth and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data on the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer; PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in ambient evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The results showed that there was a significant exposure-response relationship between PSD and risk of lung cancer in females after controlling for possible confounders. The findings of this study warrant further investigation of the role of traffic air pollution exposure in the etiology of lung cancer.
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Affiliation(s)
- Chih-Ching Chang
- Department of Environmental and Occupational Health, National Cheng Kung University, Tainan
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33
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Weng HH, Tsai SS, Chiu HF, Wu TN, Yang CY. Childhood leukemia and traffic air pollution in Taiwan: petrol station density as an indicator. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2009; 72:83-7. [PMID: 19034797 DOI: 10.1080/15287390802477338] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
To investigate the relationship between traffic air pollution exposure and development of childhood leukemia (14 yr of age or younger), a matched case-control study was conducted using childhood deaths that occurred in Taiwan from 1996 through 2006. Data on all eligible childhood leukemia deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of children who died from causes other than neoplasms or diseases that were not associated with respiratory complications. The controls were pair matched to the cancer cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Data on the number of petrol stations in study municipalities were collected from the two major petroleum supply companies, Chinese Petroleum Corporation (CPC) and Formosa Petrochemical Corporation (FPCC). The petrol station density (per square kilometer) (PSD) for study municipalities was used as an indicator of a subject's exposure to benzene and other hydrocarbons present in evaporative losses of petrol or to air emissions from motor vehicles. The subjects were divided into tertiles according to PSD in their residential municipality. The results showed that there was a significant exposure-response relationship between PSD and the risk of leukemia development in young children after controlling for possible confounders. The findings of this study warrant further investigation of the role of traffic air pollution exposure in the etiology of childhood leukemia.
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Affiliation(s)
- Hsu-Huei Weng
- College of Health Sciences, Institute of Occupational Safety and Health, Kaohsiung, Taiwan
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34
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Demographic Differences between Cancer Survivors and those who Die Quickly of their Disease. Clin Oncol (R Coll Radiol) 2008; 20:647-56. [DOI: 10.1016/j.clon.2008.05.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2007] [Revised: 05/01/2008] [Accepted: 05/06/2008] [Indexed: 11/22/2022]
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35
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Weng HH, Tsai SS, Chiu HF, Wu TN, Yang CY. Association of childhood leukemia with residential exposure to petrochemical air pollution in taiwan. Inhal Toxicol 2008; 20:31-6. [PMID: 18236219 DOI: 10.1080/08958370701758734] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To investigate the relationship between petrochemical air pollution and childhood leukemia (19 yr of age or younger), the authors conducted a matched case-control study using childhood deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible childhood leukemia deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of children who died from causes other than neoplasms or diseases that were not associated with respiratory problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into three levels (< or =25th percentile; 25th-75th percentile; > 75th percentile) according to the levels of the index just described. After controlling for possible confounders, results showed that children who lived in the group of municipalities characterized by the highest levels of petrochemical air pollution had a statistically significant higher risk of developing leukemia than the group that lived in municipalities with the lowest petrochemical air pollution levels. The results of this study shed important light on the relationship between the Taiwan petrochemical industry and human health risks.
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Affiliation(s)
- Hsu-Huei Weng
- Graduate Institute of Occupational Safety and Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
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36
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Liu CC, Tsai SS, Chiu HF, Wu TN, Yang CY. Ambient exposure to criteria air pollutants and female lung cancer in Taiwan. Inhal Toxicol 2008; 20:311-7. [PMID: 18300049 DOI: 10.1080/08958370701866107] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
To investigate the relationship between air pollution and female lung cancer, the authors conducted a matched case-control study using female deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible female lung cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of women who died from causes other than cancer or diseases associated with respiratory problems. The controls were pair-matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Classification of exposure to municipality air pollution was based on the measured levels of nitrogen dioxide and carbon monoxide. The results of the present study show that there is a significant positive association between the levels of air pollution and female lung cancer mortality. The adjusted odds ratios (95% confidence interval) were 1.24 (1.03-1.50) for the group with medium air pollution level and 1.46 (1.18-1.81) for the group with high air pollution level when compared to the group with the low air pollution level. Trend analyses showed statistically significant trend in risk of female lung cancer with increasing air pollution level. The findings of this study warrant further investigation of the role of air pollutants in the etiology of lung cancer.
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Affiliation(s)
- Chia-Chia Liu
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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37
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Weng HH, Tsai SS, Chen CC, Chiu HF, Wu TN, Yang CY. Childhood leukemia development and correlation with traffic air pollution in Taiwan using nitrogen dioxide as an air pollutant marker. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2008; 71:434-8. [PMID: 18306090 DOI: 10.1080/15287390701839042] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
To investigate the relationship between traffic air pollution and development of childhood leukemia (14 yr of age or younger), studies were conducted on a matched cancer case-control cohort using childhood deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible childhood leukemia deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of children who died from causes other than neoplasms or from diseases that were not associated with respiratory complications. The controls were pair matched to the cases by gender, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. Air quality data for recorded concentrations of nitrogen dioxide (NO2) from study municipalities for 1995-2005 were obtained as an indicator of a subject's exposure to air emissions from motor vehicles. The subjects were divided into tertiles according to the levels of NO2 in their residential municipality. The results showed that there was a significant exposure-response relationship between exposure to traffic exhaust pollutants and the risk of leukemia among young children after controlling for possible confounders. The findings of this study warrant further investigation of the role of traffic air pollution in the etiology of childhood leukemia.
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Affiliation(s)
- Hsu-Huei Weng
- Graduate Institute of Occupational Safety and Health, College of Health Science, Kaohsiung Medical University, Kaohsiung, Taiwan
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38
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Liu CC, Chen CC, Wu TN, Yang CY. Association of brain cancer with residential exposure to petrochemical air pollution in Taiwan. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2008; 71:310-314. [PMID: 18214804 DOI: 10.1080/15287390701738491] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
To investigate the relationship between petrochemical air pollution and brain cancer (29 yr of age or younger), the authors conducted a matched case-control study using deaths that occurred in Taiwan from 1995 through 2005. Data on all eligible brain cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of subjects who died from causes other than neoplasms or diseases that were not associated with respiratory problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. The proportion of a municipality's total population employed in the petrochemical industry in a municipality was used as an indicator of a resident's exposure to air emissions from the petrochemical industry. The subjects were divided into tertiles according to the levels of the index just described. Subjects who lived in the group of municipalities characterized by the highest levels of petrochemical air pollution had a statistically significant higher risk of developing brain cancer than the group that lived in municipalities with the lowest petrochemical air pollution levels after controlling for possible confounders (OR = 1.65, 95% CI = 1.00-2.73). The findings of this study warrant further investigation of the role of petrochemical air pollution in the etiology of brain cancer.
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Affiliation(s)
- Chia-Chia Liu
- Institute of Occupational Safety and Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
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Chiu HF, Cheng MH, Tsai SS, Wu TN, Kuo HW, Yang CY. Outdoor air pollution and female lung cancer in Taiwan. Inhal Toxicol 2006; 18:1025-31. [PMID: 16966302 DOI: 10.1080/08958370600904561] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To investigate the relationship between air pollution and female lung cancer, the authors conducted a matched case-control study using female deaths that occurred in Taiwan from 1994 through 2003. Data on all eligible female lung cancer deaths were obtained from the Bureau of Vital Statistics of the Taiwan Provincial Department of Health. The control group consisted of women who died from causes other than cancer or diseases associated with respiratory problems. The controls were pair matched to the cases by sex, year of birth, and year of death. Each matched control was selected randomly from the set of possible controls for each case. A municipality-based aggregate index of long-term exposure to air pollution was created by dividing the annual average of the measured values for each pollutant by the National Ambient Air Quality Standard for that pollutant. The ratios for each pollutant were scaled to a 100-point scale and then averaged together to generate an index value representing the net burden of these pollutants, with each weighted equally. The subjects were divided into tertiles according to the levels of the index just described. Women who lived in the group of municipalities with highest levels of air pollution exposure index were at a statistically significant increased lung cancer risk compared to the group living in municipalities with the lowest air pollution exposure index after controlling for possible confounders (OR = 1.28, 95% CI = 1.02-1.61). The findings of this study warrant further investigation of the role of air pollutants in the etiology of lung cancer.
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Affiliation(s)
- Hui-Fen Chiu
- Institute of Pharmacology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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40
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Gilligan T. Social disparities and prostate cancer: mapping the gaps in our knowledge. Cancer Causes Control 2005; 16:45-53. [PMID: 15750857 DOI: 10.1007/s10552-004-1291-x] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2004] [Accepted: 07/11/2004] [Indexed: 11/26/2022]
Abstract
To evaluate the current state of our knowledge regarding social disparities and prostate cancer and to map the domains where substantial knowledge has been acquired as well as those where little is known, with the purpose of identifying important areas for future research. A Medline research was conducted to identify published papers regarding social disparities in prostate cancer since 1990. The results of this review are presented in a social disparities and prostate cancer grid designed to highlight which domains of social disparities have been researched and which neglected. The major social disparity in prostate cancer concerns the extremely high prostate cancer incidence and mortality seen among black Americans. This is also the area where the most research has been performed. Low socioeconomic position is associated with poorer prostate cancer outcomes but not with higher prostate cancer incidence. It remains poorly defined to what extent racial/ethnic differences in prostate cancer result from differences in socioeconomic position (SEP). Understanding the causes of the high prostate cancer mortality seen among black men remains the major challenge in the area of social disparities and prostate cancer.
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Affiliation(s)
- Timothy Gilligan
- Department of Medicine, Department of Medical Oncology, Harvard Medical School, Dana-Farber Cancer Institute, 44 Binnery St, D-1230 Boston, MA 02115, USA.
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41
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Hsu RB, Chen RJ, Chou NK, Ko WJ, Wang SS, Chu SH. Low incidence of malignancy after transplantation in Chinese heart allograft recipients. Transpl Int 2005; 18:283-8. [PMID: 15730487 DOI: 10.1111/j.1432-2277.2004.00029.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
This study sought to assess the incidence of neoplastic disease after transplantation in Chinese heart allograft recipients. A total of 156 patients (130 male and 26 female; mean age, 45.8 +/- 15.7 years), surviving more than 30 days after transplantation, were enrolled in this study. The mean follow up duration was 51.2 +/- 33.0 months. Six patients (3.8%) developed neoplastic diseases after transplantation: post-transplant lymphoproliferative diseases in four and solid tumors in two patients. There was no skin cancer or Kaposi's sarcoma. Solid tumors affected the prostate, liver and urinary bladder in two patients. The cumulative incidence of neoplastic disease was 2.1% at 1 year, 3.6% at 5 years, and 10.1% at 10 years after transplantation. The incidence of post-transplant neoplastic disease was low in Chinese heart allograft recipients. It resulted from a relative paucity of Kaposi's sarcoma and skin cancers in Chinese population.
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Affiliation(s)
- Ron-Bin Hsu
- Department of Surgery, National Taiwan University Hospital, National Taiwan University College of Medicine, No. 7 Chung-Shan S. Road, Taipei 100, Taiwan
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Yang CY, Cheng MF, Tsai SS, Hung CF. Fluoride in drinking water and cancer mortality in Taiwan. ENVIRONMENTAL RESEARCH 2000; 82:189-193. [PMID: 10702326 DOI: 10.1006/enrs.1999.4018] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The possibility that cancer risk is associated with naturally fluoridated water in Taiwan is examined. The 1982-1991 age-adjusted mortality rates for cancer for 10 municipalities whose water supplies contained the highest naturally occurring fluoride concentrations in Taiwan were compared to those rates for 10 matched municipalities with unfluoridated water. The two groups had similar urbanization levels and sociodemographic characteristics. Our study does not support the suggestion that fluoridation of water supplies is associated with an increase in cancer mortality in Taiwan.
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Affiliation(s)
- C Y Yang
- School of Public Health, Kaohsiung Medical College, Kaohsiung, 80708, Taiwan
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Abstract
Incidence rates for non-Hodgkin's lymphoma (NHL) have been rising throughout the world for several decades, and no convincing explanation exists for the majority of this increase. The commonest subtypes of NHL have no well-defined aetiological factors but lymphoma development has been linked with exposure to a variety of chemicals, including nitrates, pesticides, herbicides, and solvents. Benzene, a solvent and important constituent of petrochemical products, is a potent lymphomagen in experimental animals and high-dose exposure in humans is associated with both acute myeloid leukaemia and NHL. Much current interest centres on the possibility that environmental benzene exposure in the general public may underlie a proportion of the increase in NHL. Seventy per cent of benzene exposure in the environment is derived from vehicle exhaust emissions, whose increase has closely paralleled the rise in frequency of the disease. Mathematical modelling has been used to calculate an acceptable concentration of benzene in air based on risk estimates derived from industrial exposure, but the recommended target concentration in the U.K. of 1 ppb is regularly exceeded in urban locations. Detailed investigation of the health effects of low-level benzene exposure awaits an accurate assay for quantifying long-term human exposure. The (32)P post-labelling technique for the detection of toxin-specific DNA adducts is extremely sensitive and has been applied in the biomonitoring of exposure to a number of carcinogens, but benzene-DNA adducts have to date proved elusive of detection.
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Affiliation(s)
- S R O'Connor
- Department of Histopathology, Leicester Royal Infirmary NHS Trust, Leicester, U.K
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