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Shi DS, Rinsky JL, Grimes GR, Chiu SK. Health Hazard Evaluations of occupational cancer cluster concerns: the USA, January 2001-December 2020. Occup Environ Med 2024; 81:109-112. [PMID: 37932036 PMCID: PMC10897873 DOI: 10.1136/oemed-2023-108988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 10/05/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES To describe recent investigations of potential workplace cancer clusters. METHODS We identified Health Hazard Evaluations (HHEs) of cancer concerns during 2001-2020. We described information about industry, requestors, cancer characteristics, investigative procedures, and determinations about the presence of a cluster (ie, presence of excess cases, unusual case distribution or exposure). RESULTS Of 5754 HHEs, 174 included cancer concerns, comprising 1%-5% of HHEs per year. In 123 HHEs, the cancer cluster concerns involved different cancer primary sites. Investigation procedures varied but included record review (n=63, 36%) and site visits (n=22, 13%). Of 158 HHEs with a cluster determination by investigator(s), 151 (96%) were not considered cancer clusters. In seven HHEs, investigators found evidence of a cluster, but occupational exposure to a carcinogen was not identified. CONCLUSIONS The proportion of HHEs on workplace cancer cluster concerns remained steady over time; most did not meet the definition of a cluster or uncover an occupational cause. Public health practitioners can use this information to provide updated context when addressing workplace cancer cluster concerns and as motivation to refine investigative approaches. More broadly, this review highlights an opportunity to identify best practices on how to apply community cluster investigation methods to the workplace.
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Affiliation(s)
- Dallas S Shi
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica L Rinsky
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - George R Grimes
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
| | - Sophia K Chiu
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA
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Park EH, Kang MJ, Jung KW, Park EH, Yun EH, Kim HJ, Kong HJ, Choi CK, Im JS, Seo HG. Regional disparities in major cancer incidence in Korea, 1999-2018. Epidemiol Health 2023; 45:e2023089. [PMID: 37857340 PMCID: PMC10867526 DOI: 10.4178/epih.e2023089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/13/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVES This study investigated regional disparities in the incidence of 8 major cancers at the municipal level in Korea during 1999-2018 and evaluated the presence or absence of hot spots of cancer clusters during 2014-2018. METHODS The Korea National Cancer Incidence Database was used. Age-standardized incidence rates were calculated by gender and region at the municipal level for 4 periods of 5 years and 8 cancer types. Regional disparities were calculated as both absolute and relative measures. The possibility of clusters was examined using global Moran's I with a spatial weight matrix based on adjacency or distance. RESULTS Regional disparities varied depending on cancer type and gender during the 20-year study period. For men, the regional disparities of stomach, colon and rectum, lung, and liver cancer declined, and those of thyroid and prostate cancer recently decreased, despite an overall increasing incidence. For women, regional disparities in stomach, colon and rectum, lung, liver, and cervical cancer declined, that of thyroid cancer recently decreased, despite an overall increasing incidence, and that of breast cancer steadily increased. In 2014-2018, breast cancer (I, 0.61; 95% confidence interval [CI], 0.53 to 0.70) showed a high probability of cancer clusters in women, and liver cancer (I, 0.48; 95% CI, 0.40 to 0.56) showed a high probability of cancer clusters in men. CONCLUSIONS Disparities in cancer incidence that were not seen at the national level were discovered at the municipal level. These results could provide important directions for planning and implementing local cancer policies.
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Affiliation(s)
- Eun Hye Park
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Public Health, Seoul National University, Seoul, Korea
| | - Mee Joo Kang
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Kyu-Won Jung
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Eun Hye Park
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - E Hwa Yun
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hye-Jin Kim
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hyun-Joo Kong
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Chang Kyun Choi
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jeong-Soo Im
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Hong Gwan Seo
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
| | - The Community of Population-Based Regional Cancer Registries*
- Korea Central Cancer Registry, National Cancer Center, Goyang, Korea
- Division of Cancer Registration and Surveillance, National Cancer Control Institute, National Cancer Center, Goyang, Korea
- Graduate School of Public Health, Seoul National University, Seoul, Korea
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
- National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
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Peptenatu D, Nedelcu ID, Pop CS, Simion AG, Furtunescu F, Burcea M, Andronache I, Radulovic M, Jelinek HF, Ahammer H, Gruia AK, Grecu A, Popa MC, Militaru V, Drăghici CC, Pintilii RD. The Spatial-Temporal Dimension of Oncological Prevalence and Mortality in Romania. GEOHEALTH 2023; 7:e2023GH000901. [PMID: 37799773 PMCID: PMC10549965 DOI: 10.1029/2023gh000901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 10/07/2023]
Abstract
The objective of this study was to identify spatial disparities in the distribution of cancer hotspots within Romania. Additionally, the research aimed to track prevailing trends in cancer prevalence and mortality according to a cancer type. The study covered the timeframe between 2008 and 2017, examining all 3,181 territorial administrative units. The analysis of spatial distribution relied on two key parameters. The first parameter, persistence, measured the duration for which cancer prevalence exceeded the 75th percentile threshold. Cancer prevalence refers to the total number of individuals in a population who have been diagnosed with cancer at a specific time point, including both newly diagnosed cases (occurrence) and existing cases. The second parameter, the time continuity of persistence, calculated the consecutive months during which cancer prevalence consistently surpassed the 75th percentile threshold. Notably, persistence of elevated values was also evident in lowland regions, devoid of any discernible direct connection to environmental conditions. In conclusion, this work bears substantial relevance to regional health policies, by aiding in the formulation of prevention strategies, while also fostering a deeper comprehension of the socioeconomic and environmental factors contributing to cancer.
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Affiliation(s)
- D. Peptenatu
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - I. D. Nedelcu
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - C. S. Pop
- Carol Davila University of Medicine and PharmacyBucharestRomania
| | - A. G. Simion
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - F. Furtunescu
- Carol Davila University of Medicine and PharmacyBucharestRomania
| | - M. Burcea
- Faculty of Administration and BusinessUniversity of BucharestBucharestRomania
| | - I. Andronache
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - M. Radulovic
- Department of Experimental OncologyInstitute of Oncology and Radiology of SerbiaBelgradeSerbia
| | - H. F. Jelinek
- Department of Biomedical Engineering and Healthcare Engineering Innovation CenterKhalifa UniversityAbu DhabiUnited Arab Emirates
| | - H. Ahammer
- Division of Medical Physics and BiophysicsGSRCMedical University of GrazGrazAustria
| | - A. K. Gruia
- Faculty of Administration and BusinessUniversity of BucharestBucharestRomania
| | - A. Grecu
- Faculty of Administration and BusinessUniversity of BucharestBucharestRomania
| | - M. C. Popa
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - V. Militaru
- Faculty of MedicineIuliu Haţieganu University of Medicine and Pharmacy Cluj‐NapocaCluj‐NapocaRomania
| | - C. C. Drăghici
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
| | - R. D. Pintilii
- Research Center for Integrated Analysis and Territorial Management—CAIMTFaculty of GeographyUniversity of BucharestBucharestRomania
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Klaus CA, Henry KA, Il'yasova D. Capturing emergency dispatch address points as geocoding candidates to quantify delimited confidence in residential geolocation. Int J Health Geogr 2023; 22:25. [PMID: 37752482 PMCID: PMC10523746 DOI: 10.1186/s12942-023-00347-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND In response to citizens' concerns about elevated cancer incidence in their locales, US CDC proposed publishing cancer incidence at sub-county scales. At these scales, confidence in patients' residential geolocation becomes a key constraint of geospatial analysis. To support monitoring cancer incidence in sub-county areas, we presented summary metrics to numerically delimit confidence in residential geolocation. RESULTS We defined a concept of Residential Address Discriminant Power (RADP) as theoretically perfect within all residential addresses and its practical application, i.e., using Emergency Dispatch (ED) Address Point Candidates of Equivalent Likelihood (CEL) to quantify Residential Geolocation Discriminant Power (RGDP) to approximate RADP. Leveraging different productivity of probabilistic, deterministic, and interactive geocoding record linkage, we simultaneously detected CEL for 5,807 cancer cases reported to North Carolina Central Cancer Registry (NC CCR)- in January 2022. Batch-match probabilistic and deterministic algorithms matched 86.0% cases to their unique ED address point candidates or a CEL, 4.4% to parcel site address, and 1.4% to street centerline. Interactively geocoded cases were 8.2%. To demonstrate differences in residential geolocation confidence between enumeration areas, we calculated sRGDP for cancer cases by county and assessed the existing uncertainty within the ED data, i.e., identified duplicate addresses (as CEL) for each ED address point in the 2014 version of the NC ED data and calculated ED_sRGDP by county. Both summary RGDP (sRGDP) (0.62-1.00) and ED_sRGDP (0.36-1.00) varied across counties and were lower in rural counties (p < 0.05); sRGDP correlated with ED_sRGDP (r = 0.42, p < 0.001). The discussion covered multiple conceptual and economic issues attendant to quantifying confidence in residential geolocation and presented a set of organizing principles for future work. CONCLUSIONS Our methodology produces simple metrics - sRGDP - to capture confidence in residential geolocation via leveraging ED address points as CEL. Two facts demonstrate the usefulness of sRGDP as area-based summary metrics: sRGDP variability between counties and the overall lower quality of residential geolocation in rural vs. urban counties. Low sRGDP for the cancer cases within the area of interest helps manage expectations for the uncertainty in cancer incidence data. By supplementing cancer incidence data with sRGDP and ED_sRGDP, CCRs can demonstrate transparency in geocoding success, which may help win citizen trust.
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Affiliation(s)
| | - Kevin A Henry
- Department of Geography, Environment and Urban Studies, Temple University, Philadelphia, PA, USA
- Division of Cancer Prevention and Control, Fox Chase Cancer Center, Philadelphia, PA, USA
| | - Dora Il'yasova
- Center for Social and Clinical Research, National Minority Quality Forum, Washington, DC, USA
- Department of Community and Family Health, Duke University School of Medicine, Durham, NC, USA
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Clevenger LM, Wrenn JD, Bena J, Sodhi G, Tullio K, Singh AD. Clustering of uveal melanoma: County wide analysis within Ohio. PLoS One 2023; 18:e0290284. [PMID: 37594976 PMCID: PMC10437964 DOI: 10.1371/journal.pone.0290284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/19/2023] [Indexed: 08/20/2023] Open
Abstract
PURPOSE To determine if a greater than expected number of cases (clustering) of uveal melanoma occurred within Ohio for any specific region or time period as compared to others. DESIGN Analysis of population database. METHODS Ohio Cancer Incidence Surveillance System (OCISS) database (2000-2019) was accessed for the diagnosis of uveal melanoma using the International Classification of Disease for Oncology codes: C69.3 (choroid), C69.4 (ciliary body and iris). Counties within Ohio were grouped by geographic regions (7) and socioeconomic variables. Age- and race-standardized incidence ratios (SIR) were calculated to determine temporal or geographic clustering. RESULTS Over the twenty-year period, the total number of uveal melanoma cases reported within Ohio were 1,617 with the overall age-adjusted annual incidence of 6.72 cases per million population (95% CI 6.30-7.16). There was an increase in the incidence of uveal melanoma over 20 years (p<0.001) across seven geographic regions, but no significant difference in incidence rates between the regions. There was no difference in incidence based on county classification by age composition (p = 0.14) or education level (p = 0.11). Counties with a low median household income (p<0.001), those classified as urban (p = 0.004), and those with a greater minority population (p = 0.004) had lower incidence. Less populated counties had a higher incidence of uveal melanoma (p<0.001). CONCLUSIONS There is no evidence of geographic or temporal clustering of uveal melanoma within Ohio from 2000 to 2019.
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Affiliation(s)
- Leanne M. Clevenger
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Jacquelyn D. Wrenn
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - James Bena
- Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Guneet Sodhi
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Katherine Tullio
- Cancer Health Analytics, Taussig Cancer Institute, Cleveland Clinic and Health Equity (Ohio), CareSource, Columbus, Ohio, United States of America
| | - Arun D. Singh
- Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
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Slavik CE, Yiannakoulias N. Investigating reports of cancer clusters in Canada: a qualitative study of public health communication practices and investigation procedures. Health Promot Chronic Dis Prev Can 2022; 42:490-502. [PMID: 36383159 PMCID: PMC9903850 DOI: 10.24095/hpcdp.42.11/12.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION: Public health officials provide an important public service responding to community concerns around cancer and often receive requests to investigate patterns of cancer incidence and communicate findings with citizens. In this study, we identified procedures Canadian public health officials followed when investigating reports of cancer clusters, and explored the challenges officials faced conducting risk communication with communities. METHODS: Thirteen interviews were administered by telephone with 15 officials across Canadian jurisdictions and analyzed using thematic analysis. A content analysis of procedural documents received from five provinces was also undertaken. RESULTS: A third of provinces/territories in this study did not use any consistent guidelines to investigate reports of cancer clusters, a third used their own guidelines and a third used guidelines from other countries. Each Canadian jurisdiction identified a different agency or individual responsible for investigating cluster inquiries. Officials in most interviews considered public education to be the primary objective of risk communication during an investigation. Officials in only 4 of 13 interviews cited an overall positive response from the public after investigating reports of a cancer cluster. CONCLUSION: Differences in practices used to investigate suspected cancer clusters by public health officials were revealed in this work. Establishing pan-Canadian cancer cluster guidelines could improve procedural consistency across jurisdictions and offer enhanced opportunities to compare cluster responses for evaluation. A reporting system to track reported clusters may improve information sharing between federal, provincial/territorial and local investigators. During formal investigations, face-to-face participatory communication approaches should be explored to improve citizen engagement and manage community concerns.
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Affiliation(s)
- Catherine E Slavik
- School of Earth, Environment & Society, McMaster University, Hamilton, Ontario, Canada
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Niko Yiannakoulias
- School of Earth, Environment & Society, McMaster University, Hamilton, Ontario, Canada
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Schultz R. Investigating the health impacts of the Ranger uranium mine on Aboriginal people. Med J Aust 2021; 215:157-159.e1. [PMID: 34333775 DOI: 10.5694/mja2.51198] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Rosalie Schultz
- Environment and Ecology Special Interest Group, Public Health Association of Australia, Canberra, ACT.,Centre for Remote Health, Flinders University, Alice Springs, NT
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Lim H, Lee YH, Bae S, Koh DH, Yoon M, Lee BE, Kim JS, Kwon HJ. Cancer cluster among small village residents near the fertilizer plant in Korea. PLoS One 2021; 16:e0247661. [PMID: 33630917 PMCID: PMC7906407 DOI: 10.1371/journal.pone.0247661] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 02/10/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES In Jang-jeom, a small village in Hamra-myeon, Iksan-si, Jeollabuk-do, South Korea, residents raised concerns about a suspected cancer cluster that they attributed to a fertilizer plant near the village. We aimed to investigate whether the cancer incidence in the village was higher than that in the general Korean population when the factory was in operation (2001-2017) and whether living in the village was associated with a higher risk of cancer. METHODS Using national population data and cancer registration data of South Korea, we estimated the standardized incidence ratios (SIRs) in the village to investigate whether more cancer cases occurred in the village compared to other regions. The SIRs were standardized by age groups of 5 years and sex. In order to investigate whether residence in the village increased the risk of cancer, a retrospective cohort was constructed using National Health Insurance Service (NHIS) databases. We estimated the cancer hazard ratios (HRs) using the Cox proportional hazard model, and defined the exposed area as the village of Jang-jeom, and the unexposed or control area as the village neighborhood in Hamra-myeon. We considered potential confounding variables such as age, sex, and income index in the models. Additionally, we measured polycyclic aromatic hydrocarbons (PAHs) and tobacco-specific nitrosamines (TSNAs), suspected carcinogens that may have caused the cancer cluster, in samples collected from the plant and the village. RESULTS Twenty-three cancer cases occurred in Jang-jeom from 2001 to 2017. Between 2010 and 2016, the incidence rates of all cancers (SIR: 2.05, except thyroid cancer: 2.22), non-melanoma skin cancer (SIR: 21.14, female: 25.41), and gallbladder (GB) and biliary tract cancer in men (SIR: 16.01) in the village were higher than those in the national population in a way that was statistically significant. In our cohort analysis that included only Hamra-myeon residents who have lived there for more than 7 years, we found a statistically significant increase in the risk of all cancers (HR: 1.99, except thyroid cancer: 2.20), non-melanoma skin cancer (HR: 11.60), GB and biliary tract cancer (HR: 15.24), liver cancer (HR: 6.63), and gastric cancer (HR: 3.29) for Jang-jeom residents compared to other Hamra area residents. We identified PAHs and TSNAs in samples of deposited dust and residual fertilizer from the plant and TSNAs in dust samples from village houses. CONCLUSIONS The results of the SIR calculation and cancer risk analyses of Jang-jeom village residents from the retrospective cohort design showed consistency in the effect size and direction, suggesting that there was a cancer cluster in Jang-jeom. This study would be a good precedent for cancer cluster investigation.
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Affiliation(s)
- Hyungryul Lim
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Chungcheongnam-do, Republic of Korea
| | - Yong-Han Lee
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Chungcheongnam-do, Republic of Korea
| | - Sanghyuk Bae
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Do-Hyun Koh
- Citizen Science Institute, Goyang, Gyeonggi-do, Republic of Korea
| | - Mira Yoon
- Environmental Research Department, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Bo-Eun Lee
- Environmental Research Department, National Institute of Environmental Research, Incheon, Republic of Korea
| | - Jeong-Soo Kim
- Institute for Environmental Safety and Health, Seoul, Republic of Korea
| | - Ho-Jang Kwon
- Department of Preventive Medicine, College of Medicine, Dankook University, Cheonan, Chungcheongnam-do, Republic of Korea
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Valbuena-Garcia AM, Rodriguez-Villamizar LA, Uribe-Pérez CJ, Moreno-Corzo FE, Ortiz-Martinez RG. A spatial analysis of childhood cancer and industrial air pollution in a metropolitan area of Colombia. Pediatr Blood Cancer 2020; 67:e28353. [PMID: 32452157 DOI: 10.1002/pbc.28353] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 03/13/2020] [Accepted: 04/06/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Air pollutants are considered carcinogenic to humans. In some European countries, an association between industrial air pollution and childhood cancer has been established. This relationship has not been addressed in Latin America, despite the spatial variability of air pollutants that may limit the extrapolation of the results to other geographical areas. OBJECTIVE To conduct a spatial analysis of the relationship between childhood cancer and proximity to industrial sources of air pollution in a metropolitan area of Colombia. METHODS Incident cases of childhood cancers were obtained from the Population-based Cancer Registry of the Metropolitan Area of Bucaramanga during 2000-2015. Local and focused cluster tests were used for the detection of spatial clusters, and the Poisson multivariable model was used to evaluate the combined effects of spatial variables. RESULTS The Kulldorff's focused test found a significant spatial cluster (P < 0.001) around one industrial agglomerate and the multivariable model results suggests that the distance effect is modified by the directional effect of the wind. CONCLUSION A spatial cluster of incident cases of childhood cancer occurred in the municipality of Bucaramanga, Colombia. Our finding supports the hypothesis that childhood cancer might be related with industrial air pollution exposure in a Latin American city.
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Affiliation(s)
| | | | - Claudia Janeth Uribe-Pérez
- Population Registry of Cancer of the Metropolitan Area of Bucaramanga, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
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Witte C, Hungerford LL, Rideout BA, Papendick R, Fowler JH. Spatiotemporal network structure among "friends of friends" reveals contagious disease process. PLoS One 2020; 15:e0237168. [PMID: 32760155 PMCID: PMC7410232 DOI: 10.1371/journal.pone.0237168] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/21/2020] [Indexed: 12/05/2022] Open
Abstract
Disease transmission can be identified in a social network from the structural patterns of contact. However, it is difficult to separate contagious processes from those driven by homophily, and multiple pathways of transmission or inexact information on the timing of infection can obscure the detection of true transmission events. Here, we analyze the dynamic social network of a large, and near-complete population of 16,430 zoo birds tracked daily over 22 years to test a novel “friends-of-friends” strategy for detecting contagion in a social network. The results show that cases of avian mycobacteriosis were significantly clustered among pairs of birds that had been in direct contact. However, since these clusters might result due to correlated traits or a shared environment, we also analyzed pairs of birds that had never been in direct contact but were indirectly connected in the network via other birds. The disease was also significantly clustered among these friends of friends and a reverse-time placebo test shows that homophily could not be causing the clustering. These results provide empirical evidence that at least some avian mycobacteriosis infections are transmitted between birds, and provide new methods for detecting contagious processes in large-scale global network structures with indirect contacts, even when transmission pathways, timing of cases, or etiologic agents are unknown.
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Affiliation(s)
- Carmel Witte
- Disease Investigations, San Diego Zoo Global, San Diego, California, United States of America
- Department of Family Medicine and Public Health, University of California, La Jolla, California, United States of America
- Graduate School of Public Health, San Diego State University, San Diego, California, United States of America
- * E-mail:
| | - Laura L. Hungerford
- Department of Population Health Sciences, Virginia-Maryland College of Veterinary Medicine, Blacksburg, Virginia, United States of America
| | - Bruce A. Rideout
- Disease Investigations, San Diego Zoo Global, San Diego, California, United States of America
| | - Rebecca Papendick
- Disease Investigations, San Diego Zoo Global, San Diego, California, United States of America
| | - James H. Fowler
- Department of Political Science, University of California, San Diego, La Jolla, California, United States of America
- Division of Global Public Health, University of California, San Diego, La Jolla, California, United States of America
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11
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Nethery RC, Yang Y, Brown AJ, Dominici F. A causal inference framework for cancer cluster investigations using publicly available data. JOURNAL OF THE ROYAL STATISTICAL SOCIETY. SERIES A, (STATISTICS IN SOCIETY) 2020; 183:1253-1272. [PMID: 34262243 PMCID: PMC8276584 DOI: 10.1111/rssa.12567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Often, a community becomes alarmed when high rates of cancer are noticed, and residents suspect that the cancer cases could be caused by a known source of hazard. In response, the US Centers for Disease Control and Prevention recommend that departments of health perform a standardized incidence ratio (SIR) analysis to determine whether the observed cancer incidence is higher than expected. This approach has several limitations that are well documented in the existing literature. In this paper we propose a novel causal inference framework for cancer cluster investigations, rooted in the potential outcomes framework. Assuming that a source of hazard representing a potential cause of increased cancer rates in the community is identified a priori, we focus our approach on a causal inference estimand which we call the causal SIR (cSIR). The cSIR is a ratio defined as the expected cancer incidence in the exposed population divided by the expected cancer incidence for the same population under the (counterfactual) scenario of no exposure. To estimate the cSIR we need to overcome two main challenges: 1) identify unexposed populations that are as similar as possible to the exposed one to inform estimation of the expected cancer incidence under the counterfactual scenario of no exposure, and 2) publicly available data on cancer incidence for these unexposed populations are often available at a much higher level of spatial aggregation (e.g. county) than what is desired (e.g. census block group). We overcome the first challenge by relying on matching. We overcome the second challenge by building a Bayesian hierarchical model that borrows information from other sources to impute cancer incidence at the desired level of spatial aggregation. In simulations, our statistical approach was shown to provide dramatically improved results, i.e., less bias and better coverage, than the current approach to SIR analyses. We apply our proposed approach to investigate whether trichloroethylene vapor exposure has caused increased cancer incidence in Endicott, New York.
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Affiliation(s)
| | - Yue Yang
- Harvard T.H. Chan School of Public Health, Boston MA, USA
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Wah W, Ahern S, Earnest A. A systematic review of Bayesian spatial-temporal models on cancer incidence and mortality. Int J Public Health 2020; 65:673-682. [PMID: 32449006 DOI: 10.1007/s00038-020-01384-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Revised: 04/26/2020] [Accepted: 05/02/2020] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES This study aimed to review the types and applications of fully Bayesian (FB) spatial-temporal models and covariates used to study cancer incidence and mortality. METHODS This systematic review searched articles published within Medline, Embase, Web-of-Science and Google Scholar between 2014 and 2018. RESULTS A total of 38 studies were included in our study. All studies applied Bayesian spatial-temporal models to explore spatial patterns over time, and over half assessed the association with risk factors. Studies used different modelling approaches and prior distributions for spatial, temporal and spatial-temporal interaction effects depending on the nature of data, outcomes and applications. The most common Bayesian spatial-temporal model was a generalized linear mixed model. These models adjusted for covariates at the patient, area or temporal level, and through standardization. CONCLUSIONS Few studies (4) modelled patient-level clinical characteristics (11%), and the applications of an FB approach in the forecasting of spatial-temporally aligned cancer data were limited. This review highlighted the need for Bayesian spatial-temporal models to incorporate patient-level prognostic characteristics through the multi-level framework and forecast future cancer incidence and outcomes for cancer prevention and control strategies.
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Affiliation(s)
- Win Wah
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Arul Earnest
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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Francis SS, Enders C, Hyde R, Gao X, Wang R, Ma X, Wiemels JL, Selvin S, Metayer C. Spatial-Temporal Cluster Analysis of Childhood Cancer in California. Epidemiology 2020; 31:214-223. [PMID: 31596791 PMCID: PMC9005107 DOI: 10.1097/ede.0000000000001121] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
BACKGROUND The observance of nonrandom space-time groupings of childhood cancer has been a concern of health professionals and the general public for decades. Many childhood cancers are suspected to have initiated in utero; therefore, we examined the spatial-temporal randomness of the birthplace of children who later developed cancer. METHODS We performed a space-time cluster analysis using birth addresses of 5,896 cases and 23,369 population-based, age-, sex-, and race/ethnicity-matched controls in California from 1997 to 2007, evaluating 20 types of childhood cancer and three a priori designated subgroups of childhood acute lymphoblastic leukemia (ALL). We analyzed data using a newly designed semiparametric analysis program, ClustR, and a common algorithm, SaTScan. RESULTS We observed evidence for nonrandom space-time clustering for ALL diagnosed at 2-6 years of age in the South San Francisco Bay Area (ClustR P = 0.04, SaTScan P = 0.07), and malignant gonadal germ cell tumors in a region of Los Angeles (ClustR P = 0.03, SaTScan P = 0.06). ClustR did not identify evidence of clustering for other childhood cancers, although SaTScan suggested some clustering for Hodgkin lymphoma (P = 0.09), astrocytoma (P = 0.06), and retinoblastoma (P = 0.06). CONCLUSIONS Our study provides evidence that childhood ALL diagnosed at 2-6 years and malignant gonadal germ cell tumors sporadically occurs in nonrandom space-time clusters. Further research is warranted to identify epidemiologic features that may inform the underlying etiology.
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Affiliation(s)
- Stephen Starko Francis
- Department of Neurological Surgery, University of California, San Francisco, USA
- Division of Epidemiology, University of Nevada, Reno, USA
| | - Catherine Enders
- Division of Epidemiology, University of California, Berkeley, USA
| | - Rebecca Hyde
- Division of Epidemiology, University of California, Berkeley, USA
| | - Xing Gao
- Division of Epidemiology, University of California, Berkeley, USA
| | - Rong Wang
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, USA
| | - Xiaomei Ma
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, USA
| | - Joseph L. Wiemels
- Department of Genetic Epidemiology, University of Southern California, USA
| | - Steve Selvin
- Division of Epidemiology, University of California, Berkeley, USA
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14
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Environmental Influences on Mammographic Breast Density in California: A Strategy to Reduce Breast Cancer Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234731. [PMID: 31783496 PMCID: PMC6926682 DOI: 10.3390/ijerph16234731] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/21/2019] [Accepted: 11/22/2019] [Indexed: 12/17/2022]
Abstract
State legislation in many U.S. states, including California, mandates informing women if they have dense breasts on screening mammography, meaning over half of their breast tissue is comprised of non-adipose tissue. Breast density is important to interpret screening sensitivity and is an established breast cancer risk factor. Environmental chemical exposures may play an important role in this, especially during key windows of susceptibility for breast development: in utero, during puberty, pregnancy, lactation, and the peri-menopause. There is a paucity of research, however, examining whether environmental chemical exposures are associated with mammographic breast density, and even less is known about environmental exposures during windows of susceptibility. Now, with clinical breast density scoring being reported routinely for mammograms, it is possible to find out, especially in California, where there are large study populations that can link environmental exposures during windows of susceptibility to breast density. Density scores are now available throughout the state through electronic medical records. We can link these with environmental chemical exposures via state-wide monitoring. Studying the effects of environmental exposure on breast density may provide valuable monitoring and etiologic data to inform strategies to reduce breast cancer risk.
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Cheng Y, Nathanail CP. A study of "cancer villages" in Jiangsu Province of China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:1932-1946. [PMID: 30460653 DOI: 10.1007/s11356-018-3758-4] [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] [Received: 12/24/2017] [Accepted: 11/13/2018] [Indexed: 06/09/2023]
Abstract
China's economic boom has created many environmental and health challenges, including so-called cancer villages. This study, the first to use the lens of "cancer villages" at provincial level, examines the correlation between changes in Jiangsu cancer villages and economic and environmental quality indicators identified as being relevant, and hence to highlight environmental issues that should be mitigated to protect public health. Since 2001, 25 cancer villages have been reported in Jiangsu. The distribution pattern of these villages is of a cluster whose mean centre had moved from Suzhou city in 2001 to Taizhou in 2006 and 2011. By applying the buffer analysis tool of ArcGIS10.2.2 using 3-km and 5-km radius buffer, to examine the relationship between these cancer villages and the surrounding rivers, it was revealed that 76% of the villages fall within the 3-km buffer zone, and 88% are within the 5-km buffer zone. A fairly strong correlation between the cancer villages and annual GDP, as well as pollutant discharge, was found, with correlation coefficients of 0.94 for Jiangsu, 0.89 for Northern Jiangsu, 0.93 for Central Jiangsu, 0.83 for Southern Jiangsu and 0.64 for city level. The change of newly added cancer villages is significantly influenced by the discharge of sewage water (raising COD) and SO2, and the peak of newly added cancer villages, as well as discharge of COD and SO2 all occurred in 2005. For four cities, the total sewage water discharge and SO2 emissions are consistent with the order of the distribution density of the villages. The phenomenon of cancer villages in China will gradually be resolved as the government takes effective measures to tackle environmental issues coupled with people's increasing environmental and health awareness.
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Affiliation(s)
- Yuanyuan Cheng
- School of Environmental Science & Engineering, Suzhou University of Science & Technology, No.1 Kerui Road, Suzhou, China.
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16
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Sequential tests for monitoring methods to detect elevated incidence - a simulation study. BMC Cancer 2018; 18:384. [PMID: 29618322 PMCID: PMC5885463 DOI: 10.1186/s12885-018-4259-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 03/20/2018] [Indexed: 11/10/2022] Open
Abstract
Background Common cancer monitoring practice is seldom prospective and rather driven by public requests. This study aims to assess the performance of a recently developed prospective cancer monitoring method and the statistical tools used, in particular the sequential probability ratio test in regard to specificity, sensitivity, observation time and heterogeneity of size of the geographical unit. Methods A simulation study based on a predefined selection of cancer types, geographical unit and time period was set up. Based on the population structure of Lower Saxony the mean number of cases of three diagnoses were randomly assigned to the geographical units during 2008–2012. A two-stage monitoring procedure was then executed considering the standardized incidence ratio and sequential probability ratio test. Scenarios were constructed differing by the simulation of clusters, significance level and test parameter indicating a risk to be elevated. Results Performance strongly depended on the choice of the test parameter. If the expected numbers of cases were low, the significance level was not fully exhausted. Hence, the number of false positives was lower than the chosen significance level suggested, leading to a high specificity. Sensitivity increased with the expected number of cases and the amount of risk and decreased with the size of the geographical unit. Conclusions The procedure showed some desirable properties and is ready to use for a few settings but demands adjustments for others. Future work might consider refinements of the geographical structure. Inhomogeneous unit size could be addressed by a flexible choice of the test parameter related to the observation time.
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Ortega-García JA, López-Hernández FA, Cárceles-Álvarez A, Fuster-Soler JL, Sotomayor DI, Ramis R. Childhood cancer in small geographical areas and proximity to air-polluting industries. ENVIRONMENTAL RESEARCH 2017; 156:63-73. [PMID: 28319819 PMCID: PMC5685507 DOI: 10.1016/j.envres.2017.03.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 02/02/2017] [Accepted: 03/06/2017] [Indexed: 05/13/2023]
Abstract
AIM Pediatric cancer has been associated with exposure to certain environmental carcinogens. The purpose of this work is to analyse the relationship between environmental pollution and pediatric cancer risk. METHOD We analysed all incidences of pediatric cancer (<15) diagnosed in a Spanish region during the period 1998-2015. The place of residence of each patient and the exact geographical coordinates of main industrial facilities was codified in order to analyse the spatial distribution of cases of cancer in relation to industrial areas. Focal tests and focused Scan methodology were used for the identification of high-incidence-rate spatial clusters around the main industrial pollution foci. RESULTS The crude rate for the period was 148.0 cases per 1,000,0000 children. The incidence of pediatric cancer increased significantly along the period of study. With respect to spatial distribution, results showed significant high incidence around some industrial pollution foci group and the Scan methodology identify spatial clustering. We observe a global major incidence of non Hodgkin lymphomas (NHL) considering all foci, and high incidence of Sympathetic Nervous System Tumour (SNST) around Energy and Electric and organic and inorganic chemical industries foci group. In the analysis foci to foci, the focused Scan test identifies several significant spatial clusters. Particularly, three significant clusters were identified: the first of SNST was around energy-generating chemical industries (2 cases versus the expected 0.26), another of NHL was around residue-valorisation plants (5 cases versus the expected 0.91) and finally one cluster of Hodgkin lymphoma around building materials (3 cases versus the expected 2.2) CONCLUSION: Results suggest a possible association between proximity to certain industries and pediatric cancer risk. More evidences are necessary before establishing the relationship between industrial pollution and pediatric cancer incidence.
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Affiliation(s)
- Juan A Ortega-García
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5), Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain.
| | | | - Alberto Cárceles-Álvarez
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5), Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - José L Fuster-Soler
- Oncology & Hematology Section, Pediatrics Department, Clinical University Hospital Virgen de la Arrixaca, Murcia, Spain
| | - Diana I Sotomayor
- Pediatric Environmental Health Speciality Unit, Department of Paediatrics, Laboratory of Environmental and Human Health (A5), Institute of Biomedical Research, IMIB-Arrixaca, Clinical University Hospital Virgen de la Arrixaca, University of Murcia, Murcia, Spain
| | - Rebeca Ramis
- Environmental Epidemiology and Cancer Unit, National Centre for Epidemiology, Instituto de Salud Carlos III - ISCIII, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain
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Rosenthal M, Johnson CJ, Scoppa S, Carter K. Two Suspected Worksite or Occupational Cancer Clusters Investigated Using the Cancer Data Registry and Multiple Primary Standardized Incidence Ratios in SEER *Stat-Idaho, 2013-2014. JOURNAL OF REGISTRY MANAGEMENT 2016; 41:128-133. [PMID: 28121313 PMCID: PMC7147979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND Investigations of suspected cancer clusters are resource intensive and rarely identify true clusters: among 428 publicly reported US investigations during 1990-2011, only 1 etiologic cluster was identified. In 2013, the Cancer Data Registry of Idaho (CDRI) was contacted regarding a suspected cancer cluster at a worksite (Cluster A) and among an occupational cohort (Cluster B). We investigated to determine whether these were true clusters. METHODS We derived investigation cohorts for Cluster A from facility-provided employee records and for Cluster B from professional licensing records. We used Registry PlusTM Link Plus to conduct probabilistic linkage of cohort members to the CDRI registry and completed matching through manual review by using LexisNexis®, Accurint®, and the Social Security Death Index. We calculated standardized incidence ratios (SIR) using the MP-SIR session type in SEER*Stat and Idaho and US referent populations. RESULTS For Cluster A, we identified 34 cancer cases during 9,689 person-years; compared with Idaho and US rates, 95 percent CIs for SIRs included 1.0 for 24 of 24 primary site categories. For Cluster B, we identified 78 cancer cases during 15,154 person-years; compared with Idaho rates, 95 percent CI for SIRs included 1.0 for 23 of 24 primary site categories and was less than 1.0 for lung and bronchus cancers, and compared with US rates, 95 percent CI for SIRs included 1.0 for 22 of 24 primary site categories and was less than 1.0 for lung and bronchus and colorectal cancers. CONCLUSION We identified no statistically significant excess in cancer incidence in either cohort. SEER*Stat's MP-SIR is an efficient tool for performing SIR assessments, a Centers for Disease Control and Prevention/Council of State and Territorial Epidemiologists-recommended step when investigating suspected cancer clusters.
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Affiliation(s)
- Mariana Rosenthal
- Epidemic Intelligence Service Officer assigned to the Idaho Department of Health and Welfare, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Steve Scoppa
- Information Management Services Inc, Calverton, Maryland
| | - Kris Carter
- Career Epidemiology Field Officer assigned to the Idaho Department of Health and Welfare, Centers for Disease Control and Prevention, Atlanta, Georgia
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Barbadoro P, Agostini M, D'Errico MM, Di Stanislao F, Filippetti F, Giuliani S, Prospero E. Application of space-time disease clustering by administrative databases in Italy: Adverse Reproductive Outcomes (AROs) and residential exposure. Popul Health Metr 2015; 13:36. [PMID: 26705395 PMCID: PMC4690256 DOI: 10.1186/s12963-015-0070-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Accepted: 12/10/2015] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND The aims of this study were to estimate the existence of clusters of AROs in the municipalities of the Marches Region (Central Italy) after complaints from residents living near an abandoned landfill site. METHODS Cases of AROs (i.e., congenital malformation, chromosomal abnormalities, and low birth weight) were retrieved from hospital discharge data. SaTScan and GeoDa were used to check for the presence of clusters at a regional and a small area level. Moreover, at a small area/neighborhood level, smoothed rates were calculated, and a case-control approach was used to assess the residence in proximity to the abandoned landfill as an independent risk factor for AROs. RESULTS AROs were associated with the price per square meter of the accommodations in the area of residence (OR 2.53, 95 % CI 2.06-3.10). On the other hand, residence within one kilometer of the landfill (OR 0.04, 95 % CI 0.01-0.23) and maternal age greater than 35 years (OR 0.96, 95 % CI 0.92-0.99) were protective. CONCLUSIONS Residency in proximity to the abandoned landfill was not a risk factor for the occurrence of AROs. The results show that basic information, such as the price of accommodations in different neighborhoods, could be of interest in order to target training programs for women living in difficult conditions and highlights the potential role of the building environment in perinatal health. However, we note that aside from the data provided by Geographic Information Systems in public health, collection of the patient's residential address was unreliable for selected conditions. Future efforts should emphasize the patient's residential address as information important for evaluating the health of individuals instead of being merely administrative data.
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Affiliation(s)
- Pamela Barbadoro
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | | | - Marcello M D'Errico
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | - Francesco Di Stanislao
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
| | | | - Sara Giuliani
- School of Hygiene and Preventive Medicine, Università Politecnica delle Marche, Ancona, Italy
| | - Emilia Prospero
- Department of Biomedical Science and Public Health, Università Politecnica delle Marche, Via Tronto 10/a, Ancona, 60125 AN Italy
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Mueller W, Gilham C. Childhood leukemia and proximity to nuclear power plants: A systematic review and meta-analysis. J Cancer Policy 2015. [DOI: 10.1016/j.jcpo.2015.10.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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21
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Dolk H, Loane M, Teljeur C, Densem J, Greenlees R, McCullough N, Morris J, Nelen V, Bianchi F, Kelly A. Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system. Eur J Epidemiol 2015; 30:1153-64. [PMID: 25840712 PMCID: PMC4684832 DOI: 10.1007/s10654-015-0012-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 03/03/2015] [Indexed: 12/13/2022]
Abstract
Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan "moving window" technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4% of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35% were an unusual aggregation of cases, while 56% were explained by data quality or diagnostic issues, and 9% were not investigated. For confirmed clusters, the registries' course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.
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Affiliation(s)
- Helen Dolk
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK.
| | - Maria Loane
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Conor Teljeur
- Department Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - James Densem
- Biomedical Computing Ltd, St. Leonards-on-Sea, UK
| | - Ruth Greenlees
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Nichola McCullough
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Joan Morris
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Vera Nelen
- Provinciaal Instituut voor Hygiëne, Antwerp, Belgium
| | - Fabrizio Bianchi
- Unit of Epidemiology, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Alan Kelly
- Department Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
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Dolk H, Loane M, Teljeur C, Densem J, Greenlees R, McCullough N, Morris J, Nelen V, Bianchi F, Kelly A. Detection and investigation of temporal clusters of congenital anomaly in Europe: seven years of experience of the EUROCAT surveillance system. Eur J Epidemiol 2015. [PMID: 25840712 DOI: 10.1007/s10654-015-0012-y.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Detection and investigation of congenital anomaly clusters is one part of surveillance to detect new or changing teratogenic exposures in the population. The EUROCAT (European Surveillance of Congenital Anomalies) cluster monitoring system and results are described here. Monitoring was conducted annually from 2007 to 2013 for 18 registries covering an annual birth population up to 0.5 million births. For each registry and 72 anomaly subgroups, the scan "moving window" technique was used to detect clusters in time occurring within the last 2 years based on estimated date of conception. Registries conducted preliminary investigations using a standardised protocol to determine whether there was cause for concern, and expert review was used at key points. 165 clusters were detected, a rate of 3.4% of all 4823 cluster tests performed over 7 years, more than expected by chance. Preliminary investigations of 126 new clusters confirmed that 35% were an unusual aggregation of cases, while 56% were explained by data quality or diagnostic issues, and 9% were not investigated. For confirmed clusters, the registries' course of action was continuing monitoring. Three confirmed clusters continued to grow in size for a limited period in subsequent monitoring. This system is best suited to early detection of exposures which are sudden, widespread and/or highly teratogenic, and was reassuring in demonstrating an absence of a sustained exposure of this type. Such proactive monitoring can be run efficiently without overwhelming the surveillance system with false positives, and serves an additional purpose of data quality control.
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Affiliation(s)
- Helen Dolk
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK.
| | - Maria Loane
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Conor Teljeur
- Department Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
| | - James Densem
- Biomedical Computing Ltd, St. Leonards-on-Sea, UK
| | - Ruth Greenlees
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Nichola McCullough
- EUROCAT Central Registry, WHO Collaborating Centre for Surveillance of Congenital Anomalies, Institute for Nursing and Health Research, Ulster University, Shore Rd, Newtownabbey, BT370QB, UK
| | - Joan Morris
- Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK
| | - Vera Nelen
- Provinciaal Instituut voor Hygiëne, Antwerp, Belgium
| | - Fabrizio Bianchi
- Unit of Epidemiology, CNR Institute of Clinical Physiology, Pisa, Italy
| | - Alan Kelly
- Department Public Health and Primary Care, Trinity College Dublin, Dublin, Ireland
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