1
|
Palli D, Berrino F, Vineis P, Tumino R, Panico S, Masala G, Saieva C, Salvini S, Ceroti M, Pala V, Sieri S, Frasca G, Giurdanella MC, Sacerdote C, Fiorini L, Celentano E, Galasso R, Decarli A, Krogh V. A Molecular Epidemiology Project on Diet and Cancer: The Epic-Italy Prospective Study. Design and Baseline Characteristics of Participants. TUMORI JOURNAL 2018; 89:586-93. [PMID: 14870823 DOI: 10.1177/030089160308900602] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
EPIC-Italy is the Italian section of a larger project known as EPIC (European Prospective Investigation into Cancer and Nutrition), a prospective study on diet and cancer carried out in 10 European countries. In the period 1993-1998, EPIC-Italy completed the recruitment of 47,749 volunteers (15,171 men, 32,578 women, aged 35-65 years) in 4 different areas covered by cancer registries: Varese (12,083 volunteers) and Turin (10,604) in the Northern part of the country; Florence (13,597) and Ragusa (6,403) in Central and Southern Italy, respectively. An associate center in Naples enrolled 5,062 women. Detailed information for each individual volunteer about diet and life-style habits, anthropometric measurements and a blood sample was collected, after signing an informed consent form. A food frequency questionnaire specifically developed for the Italian dietary pattern was tested in a pilot phase. A computerized data base with the dietary and lifestyle information of each participant was completed. Blood samples were processed in the same day of collection, aliquoted (RBC, WBC, serum and plasma) and stored in liquid nitrogen containers. Follow-up procedures were validated and implemented for the identification of newly diagnosed cancer cases. Cancer incidence was related to dietary habits and biochemical markers of food consumption and individual susceptibility in order to test the role of diet-related exposure in the etiology of cancer and its interaction with other environmental or genetic determinants. The comparability of information in a prospective study design is much higher than in other studies. The availability of such a large biological bank linked to individual data on dietary and life-style exposures also provides the unique opportunity of evaluating the role of selected genotypes involved in the metabolism of chemical compounds and DNA repair, potentially related to the risk of cancer, in residents of geographic areas of Italy characterized by specific cancer risk and different dietary patterns. Baseline characteristics of participants are briefly described.
Collapse
Affiliation(s)
- Domenico Palli
- UO Epidemiologia Molecolare e Nutrizionale, Centro per lo Studio e la Prevenzione Oncologica (CSPO), Istituto Scientifico della Regione Toscana, Florence, Italy.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Fischer F, Kraemer A. Factors associated with secondhand smoke exposure in different settings: Results from the German Health Update (GEDA) 2012. BMC Public Health 2016; 16:327. [PMID: 27080515 PMCID: PMC4832471 DOI: 10.1186/s12889-016-3007-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 04/07/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The ubiquity of secondhand smoke (SHS) exposure at home or in private establishments, workplaces and public areas poses several challenges for the reduction of SHS exposure. This study aimed to describe the prevalence of SHS exposure in Germany and key factors associated with exposure. Results were also differentiated by place of exposure. METHODS A secondary data analysis based on the public use file of the German Health Update 2012 was conducted (n = 13,933). Only non-smokers were included in the analysis. In a multivariable logistic regression model the factors associated with SHS exposure were calculated. In addition, a further set of multivariable logistic regressions were calculated for factors associated with the place of SHS exposure (workplace, at home, bars/discotheques, restaurants, at the house of a friend). RESULTS More than a quarter of non-smoking study participants were exposed to SHS. The main area of exposure was the workplace (40.9 %). The multivariable logistic regression indicated young age as the most important factor associated with SHS exposure. The odds for SHS exposure was higher in men than in women. The likelihood of SHS exposure decreased with higher education. SHS exposure and the associated factors varied between different places of exposure. CONCLUSIONS Despite several actions to protect non-smokers which were implemented in Germany during the past years, SHS exposure still remains a relevant risk factor at a population level. According to the results of this study, particularly the workplace and other public places such as bars and discotheques have to be taken into account for the development of strategies to reduce SHS exposure.
Collapse
Affiliation(s)
- Florian Fischer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501, Bielefeld, Germany.
| | - Alexander Kraemer
- Department of Public Health Medicine, School of Public Health, Bielefeld University, P.O. Box 100 131, 33501, Bielefeld, Germany
| |
Collapse
|
3
|
Balachandar V, Kumar BL, Suresh K, Sasikala K. Evaluation of chromosome aberrations in subjects exposed to environmental tobacco smoke in Tamilnadu, India. BULLETIN OF ENVIRONMENTAL CONTAMINATION AND TOXICOLOGY 2008; 81:270-276. [PMID: 18626558 DOI: 10.1007/s00128-008-9489-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2007] [Accepted: 06/04/2008] [Indexed: 05/26/2023]
Abstract
Numerous expert panels have concluded that there is sufficient evidence to classify involuntary smoking (or passive smoking) as carcinogenic to humans. The aim of this study is to establish whether passive smoking increases the frequency of chromosomal aberrations (CA) in peripheral blood lymphocytes compared to controls in Tamil Nadu, India. In the present study, CA increased with an increase in environmental tobacco smoke (ETS) and active smoke exposure period in passive smokers quantified on the basis of serum cotinine levels. The passive subjects were compared with healthy normal controls to validate the results. In conclusion, these data are compatible with the current knowledge on the mechanisms of carcinogenesis of tobacco-related cancers, occurring not only in active smokers but with a high biological plausibility also in passive smokers.
Collapse
Affiliation(s)
- V Balachandar
- Division of Human Genetics, Department of Zoology, Bharathiar University, Coimbatore 641046, India.
| | | | | | | |
Collapse
|
4
|
Rudatsikira EM, Knutsen SF, Job JS, Singh PN, Yel D, Montgomery SB, Petersen FF, Ferry LH. Exposure to environmental tobacco smoke in the nonsmoking population of Cambodia. Am J Prev Med 2008; 34:69-73. [PMID: 18083453 DOI: 10.1016/j.amepre.2007.09.018] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Revised: 07/29/2007] [Accepted: 09/19/2007] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To estimate the extent of environmental tobacco smoke (ETS) exposure among nonsmokers in the adult population of Cambodia. METHODS A cross-sectional survey was conducted on a nationally representative sample of 13,988 Cambodian adults in 2005. Information on smoking and exposure to ETS was obtained by trained interviewers using a standard questionnaire. RESULTS Overall, 37.4% of the 10,263 nonsmoking responders, or an estimated 1,629,700 nonsmoking Cambodians, were exposed to ETS. One third of pregnant women (31.4%) were exposed to ETS at home. In both unadjusted and adjusted models, men were less likely to be exposed to ETS at home (OR=0.34; 95% CI=0.29-0.41) and more likely to be exposed to ETS at work and in public places (OR=3.08; 95% CI=2.14-4.43 and OR=2.17; 95% CI=1.82-2.59, respectively). Education was inversely related to ETS exposure at home (OR=0.51; 95% CI=0.27-0.96 for 10 years of education vs 5 years or less). Legislators, senior officials, and managers were less likely to be exposed to ETS at home than professionals (OR=0.13; 95% CI=0.04-0.46), but more likely to be exposed at work or in public places. Rural residence was associated with higher ETS exposure in the home (OR=2.52; 95% CI=1.71-3.71) and lower ETS exposure at work (OR=0.42; 95% CI=0.24-0.76) compared to urban residence. CONCLUSIONS The high prevalence of ETS exposure among adult Cambodians indicates an urgent need for specific measures such as public awareness campaigns, policies, and regulations to protect nonsmokers in Cambodia.
Collapse
Affiliation(s)
- Emmanuel M Rudatsikira
- Department of Global Health, Loma Linda University, School of Public Health, Loma Linda, California 92354, USA.
| | | | | | | | | | | | | | | |
Collapse
|
5
|
Twose J, Schiaffino A, García M, Borras JM, Fernández E. Correlates of exposure to second-hand smoke in an urban Mediterranean population. BMC Public Health 2007; 7:194. [PMID: 17683585 PMCID: PMC1963452 DOI: 10.1186/1471-2458-7-194] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Accepted: 08/05/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To describe the socio-demographic factors associated with exposure to second-hand smoke (SHS) in different settings (home, leisure, and workplace). METHODS We analysed cross-sectional data on self-reported SHS exposure in 1059 non-daily smokers interviewed in the Cornellà Health Interview Survey Follow-up Study in 2002. We calculated age-adjusted prevalence rates and prevalence rate ratios of SHS exposure at home, at the workplace, during leisure time, and in any of these settings. RESULTS The age-standardized prevalence rate of SHS exposure in any setting was 69.5% in men and 62.9% in women. Among men, 25.9% reported passive smoking at home, 55.1% during leisure time, and 34.0% at the workplace. Among women, prevalence rates in these settings were 34.1%, 44.3% and 30.1%, respectively. Overall exposure to SHS decreased with age in both men and women. In men, SHS exposure was related to marital status, physical activity, smoking, and alcohol intake. In women, SHS exposure was related to educational level, marital status, occupational status, self-perceived health, smoking-related illness, and alcohol intake. CONCLUSION The prevalence of SHS exposure in this population was high. The strongest association with exposure were found for age and occupational status in men, and age and educational level in women.
Collapse
Affiliation(s)
- Jorge Twose
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain
- Organització Catalana de Transplantaments
| | - Anna Schiaffino
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Montse García
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
| | - Josep Maria Borras
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Clinical Sciences, Universitat de Barcelona, Spain
| | - Esteve Fernández
- Cancer Prevention and Control Unit, Institut Català d'Oncologia, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Spain
- Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Spain
| |
Collapse
|
6
|
Vineis P, Hoek G, Krzyzanowski M, Vigna-Taglianti F, Veglia F, Airoldi L, Overvad K, Raaschou-Nielsen O, Clavel-Chapelon F, Linseisen J, Boeing H, Trichopoulou A, Palli D, Krogh V, Tumino R, Panico S, Bueno-De-Mesquita HB, Peeters PH, Lund E E, Agudo A, Martinez C, Dorronsoro M, Barricarte A, Cirera L, Quiros JR, Berglund G, Manjer J, Forsberg B, Day NE, Key TJ, Kaaks R, Saracci R, Riboli E. Lung cancers attributable to environmental tobacco smoke and air pollution in non-smokers in different European countries: a prospective study. Environ Health 2007; 6:7. [PMID: 17302981 PMCID: PMC1803768 DOI: 10.1186/1476-069x-6-7] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2006] [Accepted: 02/15/2007] [Indexed: 05/06/2023]
Abstract
BACKGROUND Several countries are discussing new legislation on the ban of smoking in public places, and on the acceptable levels of traffic-related air pollutants. It is therefore useful to estimate the burden of disease associated with indoor and outdoor air pollution. METHODS We have estimated exposure to Environmental Tobacco Smoke (ETS) and to air pollution in never smokers and ex-smokers in a large prospective study in 10 European countries (European Prospective Investigation into Cancer and Nutrition)(N = 520,000). We report estimates of the proportion of lung cancers attributable to ETS and air pollution in this population. RESULTS The proportion of lung cancers in never- and ex-smokers attributable to ETS was estimated as between 16 and 24%, mainly due to the contribution of work-related exposure. We have also estimated that 5-7% of lung cancers in European never smokers and ex-smokers are attributable to high levels of air pollution, as expressed by NO2 or proximity to heavy traffic roads. NO2 is the expression of a mixture of combustion (traffic-related) particles and gases, and is also related to power plants and waste incinerator emissions. DISCUSSION We have estimated risks of lung cancer attributable to ETS and traffic-related air pollution in a large prospective study in Europe. Information bias can be ruled out due to the prospective design, and we have thoroughly controlled for potential confounders, including restriction to never smokers and long-term ex-smokers. Concerning traffic-related air pollution, the thresholds for indicators of exposure we have used are rather strict, i.e. they correspond to the high levels of exposure that characterize mainly Southern European countries (levels of NO2 in Denmark and Sweden are closer to 10-20 ug/m3, whereas levels in Italy are around 30 or 40, or higher).Therefore, further reduction in exposure levels below 30 ug/m3 would correspond to additional lung cancer cases prevented, and our estimate of 5-7% is likely to be an underestimate. Overall, our prospective study draws attention to the need for strict legislation concerning the quality of air in Europe.
Collapse
Affiliation(s)
- Paolo Vineis
- Imperial College London, London UK (Paolo Vineis: and University of Torino, Italy)
- Department of Epidemiology and Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Gerard Hoek
- Department of Environmental and Occupational Health, Utrecht University, Utrecht, The Netherlands
| | - Michal Krzyzanowski
- World Health Organization, European Centre for Environment and Health, Bonn, Germany
| | | | | | - Luisa Airoldi
- Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Kim Overvad
- Department of Clinical Epidemiology, Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark
| | | | - Francoise Clavel-Chapelon
- INSERM, (Institut National de la Santé et de la Recherche Médicale), ERI 20, EA 4045, and Institut Gustave Roussy, Villejuif, F-94805, France
| | - Jacob Linseisen
- Division of Clinical Epidemiology, Deutsches Krebsforschungszentrum, Heidelberg, Germany
| | - Heiner Boeing
- German Institute of Human Nutrition, PotsdamRehbücke, Germany
| | - Antonia Trichopoulou
- Department of Hygiene and Epidemiology, Medical School, University of Athens, Greece
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, and Molecular Biology Laboratory, CSPO-Scientific Institute of Tuscany, Florence, Italy
| | - Vittorio Krogh
- Department of Epidemiology, National Cancer Istitute, Milan, Italy
| | - Rosario Tumino
- Cancer Registry, Azienda Ospedaliera "Civile M.P. Arezzo", Ragusa, Italy
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Sperimentale, Università Federico II, Naples, Italy
| | - H Bas Bueno-De-Mesquita
- Centre for Nutrition and Health, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Petra H Peeters
- Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht, The Netherlands
| | - Eiliv Lund E
- Institute of Community Medicine, University of Tromso, Norway
| | - Antonio Agudo
- Department of Epidemiology, Catalan Institute of Oncology Barcelona, Consejería de Sanidad y Servicios Sociales, Spain
| | | | | | | | - Lluis Cirera
- Department of Epidemiology, Regional Health Council, Murcia, Spain
| | - J Ramon Quiros
- Public Health and Health Planning Directorate, Asturias, Spain
| | - Goran Berglund
- Malmö Diet and Cancer Study, Lund University, Malmö, Sweden
| | - Jonas Manjer
- Dept of Surgery, Malmö University Hospital, Malmö, Sweden
| | - Bertil Forsberg
- Department of Public Health and Clinical Medicine, University of Umeå, Sweden
| | | | - Tim J Key
- Cancer Research UK Epidemiology Unit, University of Oxford, UK
| | - Rudolf Kaaks
- International Agency for Research on Cancer, Lyon, France
| | | | - Elio Riboli
- Imperial College London, London UK (Paolo Vineis: and University of Torino, Italy)
| |
Collapse
|
7
|
Fracasso ME, Doria D, Franceschetti P, Perbellini L, Romeo L. DNA damage and repair capacity by comet assay in lymphocytes of white-collar active smokers and passive smokers (non- and ex-smokers) at workplace. Toxicol Lett 2006; 167:131-41. [PMID: 17027201 DOI: 10.1016/j.toxlet.2006.09.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2006] [Revised: 08/31/2006] [Accepted: 09/01/2006] [Indexed: 11/16/2022]
Abstract
The comet assay has been widely used to quantify DNA damage in isolated lymphocytes from subjects exposed to several environmental or occupational substances, especially for estimation of oxidative damage in the DNA, which is well-known to be induced by tobacco smoke. Passive smoking or environmental tobacco smoke (ETS) has been included among those substances that cause cancer with sufficient evidence in humans. In this study, we analyzed, by the alkaline version of comet assay, the lymphocyte DNA damage of white-collar active smokers and non- and ex-smokers exposed to ETS at the workplace. We investigated basal DNA damage, DNA oxidation by formamidopyrimidine glycosylase (Fpg), the repair capacity H2O2-induced DNA damage by kinetics studies and lymphocyte GSH levels, the major intracellular defense against exogenous oxidative stress imposed by cigarette smoking. Our results indicated high basal DNA damage with clear significant correlations with urinary nicotine and cotinine, number of cigarettes/day, and an inverse significant correlation with GSH cellular content in active smokers. Significant Fpg-sensitive sites were found in smokers (> 85%), considerably high but not significant in passive non- and ex-smokers (> 51% and 37%, respectively). The DNA repair capacity had seriously decreased in non-smokers > smokers > ex-smokers, while the same damage was repaired in a short time in never smokers.
Collapse
Affiliation(s)
- Maria Enrica Fracasso
- Department of Medicine and Public Health, Section of Pharmacology, University of Verona, Policlinico GB Rossi, P.le Scuro 10, 37134 Verona, Italy.
| | | | | | | | | |
Collapse
|