Association of occupational heat exposure and colorectal cancer in the MCC-Spain study

OBJECTIVE

Heat exposure and heat stress/strain is a concern for many workers. There is increasing interest in potential chronic health effects of occupational heat exposure, including cancer risk. We examined potential associations of occupational heat exposure and colorectal cancer (CRC) risk in a large Spanish multi-case--control study.

METHODS

We analyzed data on 1198 histologically confirmed CRC cases and 2690 frequency-matched controls. The Spanish job-exposure matrix, MatEmEsp, was used to assign heat exposure estimates to the lifetime occupations of participants. Three exposure indices were assessed: ever versus never exposed, cumulative exposure and duration (years). We estimated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for potential confounders.

RESULTS

Overall, there was no association of ever, compared with never, occupational heat exposure and CRC (OR 1.09, 95% CI 0.92-1.29). There were also no associations observed according to categories of cumulative exposure or duration, and there was no evidence for a trend. There was no clear association of ever occupational heat exposure and CRC in analysis conducted among either men or women when analyzed separately. Positive associations were observed among women in the highest categories of cumulative exposure (OR 1.81, 95% CI 1.09-3.03) and duration (OR 2.89, 95% CI 1.50-5.59) as well as some evidence for a trend (P<0.05).

CONCLUSION

Overall, this study provides no clear evidence for an association between occupational heat exposure and CRC.

Occupational heat exposure and prostate cancer risk: A pooled analysis of case-control studies

BACKGROUND

Heat exposures occur in many occupations. Heat has been linked to key carcinogenic processes, however, evidence for associations with cancer risk is sparse. We examined potential associations between occupational heat exposure and prostate cancer risk in a multi-country study.

METHODS

We analysed a large, pooled dataset of 3142 histologically confirmed prostate cancer cases and 3512 frequency-matched controls from three countries: Canada, France, and Spain. Three exposure indices: ever exposure, lifetime cumulative exposure and duration of exposure, were developed using the Finnish Job-Exposure Matrix, FINJEM, applied to the lifetime occupational history of participants. We estimated odds ratios (ORs) and 95% confidence intervals (CIs), using conditional logistic regression models stratified by 5-year age groups and study, adjusting for potential confounders. Potential interactions with exposure to other occupational agents were also explored.

RESULTS

Overall, we found no association for ever occupational heat exposure (OR 0.97; 95% CI 0.87, 1.09), nor in the highest categories of lifetime cumulative exposure (OR 1.04; 95% CI 0.89, 1.23) or duration (OR 1.03; 95% CI 0.88, 1.22). When using only the Spanish case-control study and a Spanish Job Exposure Matrix (JEM), some weakly elevated ORs were observed.

CONCLUSIONS

Findings from this study provide no clear evidence for an association between occupational heat exposure and prostate cancer risk.

Occupational Heat Exposure and Breast Cancer Risk in the MCC-Spain Study

BACKGROUND

Mechanisms linking occupational heat exposure with chronic diseases have been proposed. However, evidence on occupational heat exposure and cancer risk is limited.

METHODS

We evaluated occupational heat exposure and female breast cancer risk in a large Spanish case-control study. We enrolled 1,738 breast cancer cases and 1,910 frequency-matched population controls. A Spanish job-exposure matrix, MatEmEsp, was used to assign estimates of the proportion of workers exposed (P ≥ 25% for at least 1 year) and work time with heat stress (wet bulb globe temperature ISO 7243) for each occupation. We used three exposure indices: ever versus never exposed, lifetime cumulative exposure, and duration of exposure (years). We estimated ORs and 95% confidence intervals (CI), applying a lag period of 5 years and adjusting for potential confounders.

RESULTS

Ever occupational heat exposure was associated with a moderate but statistically significant higher risk of breast cancer (OR 1.22; 95% CI, 1.01-1.46), with significant trends across categories of lifetime cumulative exposure and duration (P _trend = 0.01 and 0.03, respectively). Stronger associations were found for hormone receptor-positive disease (OR ever exposure = 1.38; 95% CI, 1.12-1.67). We found no confounding effects from multiple other common occupational exposures; however, results attenuated with adjustment for occupational detergent exposure.

CONCLUSIONS

This study provides some evidence of an association between occupational heat exposure and female breast cancer risk.

IMPACT

Our results contribute substantially to the scientific literature. Further investigations are needed considering multiple occupational exposures.

Ab Initio and DFT Study of the Geometric Structures and Static Dipole (Hyper)polarizabilities of Aromatic Anions

The geometries and the static dipole (hyper)polarizabilities (alpha, beta, gamma) of a series of aromatic anions were investigated at the ab initio (HF, MP2, and MP4) and density functional theory DFT (B3LYP) levels of theory. The anions chosen for the present study are the benzenethiolate (Ph-S-), benzenecarboxylate (Ph-CO2-), benzenesulfinate (Ph-SO2-), benzenesulfonate (Ph-SO3-), and 1,3-benzenedicarboxylate (1,3-Ph-(CO2)2(2-)). For benzenethiolate anion, additional alpha, beta, and gamma calculations were performed at the coupled cluster CCSD level with MP2 optimized geometries. The standard diffuse and polarized 6-31+G(d,p) basis set was employed in conjunction to the ab initio and DFT methods. Additional HF calculations were performed with the 6-311++G(3d,3p) basis set for all the anions. The correlated electric properties were evaluated numerically within the formalism of finite field. The optimized geometries were analyzed in terms of the few reports about the phenolate and sulfonate ions. The results show that electron correlation effects on the polarizabilities are very important in all the anion series. Was found that Ph-SO2- is highly polarizable in terms of alpha and beta, and the Ph-S- is the highest second hyperpolarizable in the series. The results of alpha were rationalized in terms of the analysis of the polarization of charge based in Mulliken atomic population and the structural features of the optimized geometries of anions, whereas the large differences in the beta and gamma values in the series were respectively interpreted in terms of the bond length alternation BLA and the separation of charge in the aromatic ring by effects of the substitution. These results allowed us to suggest the benzenesulfinate and benzenethiolate anions as promising candidates that should be incorporated in ionic materials for second and third-order nonlinear optical devices.

Ethanol-glycine irrigating fluid for transurethral resection of the prostate in practice

OBJECTIVE

To evaluate the usefulness of a tracer of 1% ethanol in 1. 5% glycine in the early detection of irrigation fluid absorption during transurethral resection of the prostate (TURP).

PATIENTS AND METHODS

Patients (120) undergoing TURP were irrigated with 1% ethanol in 1.5% glycine solution and their expired air tested for alcohol every 10 min during the procedure.

RESULTS

In all, 112 patients were assessed; over half of the patients absorbed the irrigation fluid and they had a significantly lower postoperative serum sodium concentration (P < 0.002). Fourteen patients (12.5%) absorbed over 500 mL and two (1.8%) developed clinical features of the TUR syndrome. The experience of the surgeon, the weight of resected chips and the operative duration were not significantly predictive of absorption.

CONCLUSION

A tracer amount of ethanol in the irrigant is reliable for detecting absorption. Irrigating fluid absorption was unpredictable, thus supporting the case for routine monitoring.

Suprapubic catheterization: a suitable procedure for clinical nurse specialists in selected patients

OBJECTIVE

To assess the feasibility and advantages of urology clinical nurse specialists (NSs) extending their professional role to include inserting initial suprapubic catheters in selected patients in the hospital and community setting.

PATIENTS AND METHODS

A urology NS, who is also the district continence adviser, was formally taught by a consultant urologist how to insert suprapubic catheters using the 'Add-a-Cath' introducer technique (Femcare, UK). Once deemed competent, the NS was indemnified by the Trust to carry out the procedure in carefully selected patients using a safe and unequivocal protocol.

RESULTS

Over a period of 40 months, the NS undertook the procedure in 164 patients, with 64 being catheterized in the community. There were no serious complications in the series and during the period studied, only 17 patients were referred back to the urologists for catheterization under formal theatre conditions.

CONCLUSION

Initial suprapubic catheterization can be carried out safely by trained NSs in selected patients. This extended professional role has helped to improve the continuity and quality of care for patients who require long-term catheterization. The NS was also a valuable source of training for junior medical staff who have limited experience with suprapubic catheterization.

The role of the plain X-ray in the assessment of prostatic symptoms

OBJECTIVE

To assess the contribution of a plain X-ray of the kidney, ureters and bladder (KUB) to the assessment of patients presenting with symptoms of bladder outlet obstruction.

PATIENTS AND METHODS

All patients presenting to the 'Prostate' clinic at Weston General Hospital during the 12 months from 1 May 1993 to 30 April 1994 were assessed clinically by a history, examination and routine investigations that included a KUB examined and reported by a radiologist. Patients were followed and treatment instituted as deemed appropriate. The contribution made to the management of the patient by the KUB was assessed.

RESULTS

Of the 292 patients, 234 had no relevant abnormality detected: four patients had evidence of a bladder calculus, whilst in four osteosclerotic areas were noted on the pelvis and lumbar spine. Of the remainder, 14 (5%) had upper urinary tract calcification. In no patients did the KUB influence their immediate management. Those with asymptomatic upper tract stones were offered a yearly follow-up.

CONCLUSIONS

The routine use of the KUB as a means of investigating lower urinary tract symptoms in the male may no longer be necessary.

Cerebellar manifestations of prostatic carcinoma

We present two patients known to have prostate cancer who presented with acute cerebellar signs. The neurological deficit of the first patient was due to a paraneoplastic cerebellar manifestation and progressed, despite evidence of response of the primary prostate tumour to hormonal manipulation. The second case, resulting from a solitary cerebellar metastasis, was amenable to surgical intervention and subsequent hormonal manipulation. This latter patient has experienced no recurrent neurological signs after a period of 7 years follow-up. This is the first report of a paraneoplastic cerebellar deficit and, to our knowledge, only the sixth case of parenchymatous cerebellar metastasis of prostatic origin to appear in the literature.

B5 tumour marker and urine cytology in diagnosis and follow-up of transitional cell bladder cancer

The correlation between a new tumor marker, B5, and tumour behaviour in bladder cancer was recorded and an assessment made of the value of combining the B5 test with urine cytology for predicting the presence of tumour. The study group included 57 new patients, of whom 32 were B5 positive at diagnosis and were well marked by B5 on follow-up. There were no false positive shifts in new patients who became free of observable tumour, whilst 1 of 13 patients with persistent disease showed a false negative shift. When the findings from 199 cystoscopies were compared with the results of B5 and urine cytology, B5 was found to improve the prediction of recurrent tumour over cytology alone. Moreover, a high incidence of occult malignancy (7/19) was found in patients where cystoscopy had failed to show recurrence but whose combined marker results were both positive.