1
|
Milder CM, Borrego D, Preston DL, Villoing D, Kwon TE, Miller DL, Alexander BH, Linet MS, Lee C, Kitahara CM. Occupational Radiation Dose Trends in U.S. Radiologic Technologists Assisting with Fluoroscopically Guided Interventional Procedures, 1980-2020. J Vasc Interv Radiol 2024:S1051-0443(24)00272-0. [PMID: 38599279 DOI: 10.1016/j.jvir.2024.03.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 03/20/2024] [Accepted: 03/30/2024] [Indexed: 04/12/2024] Open
Abstract
PURPOSE To summarize dose trends from 1980 to 2020 for 19,651 U.S. Radiologic Technologists who reported assisting with fluoroscopically guided interventional procedures (FGIPs), overall and by work history characteristics. MATERIALS AND METHODS A total of 762,310 annual personal dose equivalents at a 10-mm reference depth (doses) during 1980-2020 for 43,823 participants of the U.S. Radiologic Technologists (USRT) cohort who responded to work history questionnaires administered during 2012-2014 were summarized. This population included 19,651 technologists who reported assisting with FGIP (≥1 time per month for ≥12 consecutive months) at any time during the study period. Doses corresponding to assistance with FGIP were estimated in terms of proximity to patients, monthly procedure frequency, and procedure type. Box plots and summary statistics (eg, medians and percentiles) were used to describe annual doses and dose trends. RESULTS Median annual dose corresponding to assistance with FGIP was 0.65 mSv (interquartile range [IQR], 0.60-1.40 mSv; 95th percentile, 6.80). Higher occupational doses with wider variability were associated with close proximity to patients during assistance with FGIP (median, 1.20 mSv [IQR, 0.60-4.18 mSv]; 95th percentile, 12.66), performing ≥20 FGIPs per month (median, 0.75 mSv [IQR, 0.60-2.40 mSv]; 95th percentile, 9.44), and assisting with high-dose FGIP (median, 0.70 mSv [IQR, 0.60-1.90 mSv]; 95th percentile, 8.30). CONCLUSIONS Occupational doses corresponding to assistance with FGIP were generally low but varied with exposure frequency, procedure type, and proximity to patients. These results highlight the need for vigilant dose monitoring, radiation safety training, and proper protective equipment.
Collapse
Affiliation(s)
- Cato M Milder
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
| | - David Borrego
- Center for Science and Technology, Radiation Protection Division, Office of Radiation and Indoor Air, U.S. Environmental Protection Agency, Washington D.C
| | | | | | - Tae-Eun Kwon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Donald L Miller
- Center for Devices and Radiological Health, U.S. Food and Drug Administration, Silver Spring, Maryland
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Choonsik Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Rockville, Maryland
| |
Collapse
|
2
|
Alexander BH, Ryan A, Church TR, Kim H, Olsen GW, Logan PW. Mortality and cancer incidence in perfluorooctanesulfonyl fluoride production workers. Am J Ind Med 2024; 67:321-333. [PMID: 38345456 DOI: 10.1002/ajim.23568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 11/28/2023] [Accepted: 01/24/2024] [Indexed: 03/16/2024]
Abstract
BACKGROUND Exposure to per- and polyfluoroalkyl substances (PFAS) has been associated with several health outcomes, though few occupationally-exposed populations have been studied. We evaluated mortality and cancer incidence in a cohort of perfluorooctanesulfonyl fluoride-based specialty chemical manufacturing workers. METHODS The cohort included any employee who ever worked at the facility from 1961 to 2010 (N = 4045), with a primary interest in those who had 365 cumulative days of employment (N = 2659). Vital status and mortality records were obtained through 2014 and the cohort was linked to state cancer registries to obtain incident cancer cases from 1995 to 2014. Cumulative exposure was derived from a comprehensive exposure reconstruction that estimated job-specific perfluorooctanesulfonate (PFOS)-equivalents (mg/m3 ) exposure. Overall and exposure-specific standardized mortality ratios (SMR) were estimated in reference to the US population. Hazard ratios (HRs) and 95% confidence interval (CI) for cumulative PFOS-equivalent exposure (log2 transformed) were estimated within the cohort for specific causes of death and incident cancers using a time-dependent Cox model. RESULTS Death rates were lower than expected except for cerebrovascular disease (SMR = 2.42, 95% CI = 1.25-4.22) and bladder cancer (SMR = 3.91, 95% CI = 1.07-10.02) in the highest exposure quartile. Within the cohort, the incidence of bladder, colorectal, and pancreatic cancer were positively associated with exposure, however except for lung cancer (HR = 1.05, 95% CI = 1.00-1.11) the CIs did not exclude an HR of 1. CONCLUSIONS This study provides some evidence that occupational exposure to PFOS is associated with bladder and lung cancers and with cerebrovascular disease.
Collapse
Affiliation(s)
- Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew Ryan
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Timothy R Church
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Hyun Kim
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Geary W Olsen
- 3M, Corporate Occupational Medicine, St. Paul, Minnesota, USA
| | - Perry W Logan
- 3M, Corporate Industrial Hygiene (retired), St. Paul, Minnesota, USA
| |
Collapse
|
3
|
Rau A, Tarr GA, Baldomero AK, Wendt CH, Alexander BH, Berman JD. Heat and Cold Wave-Related Mortality Risk among United States Veterans with Chronic Obstructive Pulmonary Disease: A Case-Crossover Study. Environ Health Perspect 2024; 132:27004. [PMID: 38334741 PMCID: PMC10855215 DOI: 10.1289/ehp13176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 12/20/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a heterogeneous pulmonary disease affecting 16 million Americans. Individuals with COPD are susceptible to environmental disturbances including heat and cold waves that can exacerbate disease symptoms. OBJECTIVE Our objective was to estimate heat and cold wave-associated mortality risks within a population diagnosed with a chronic respiratory disease. METHODS We collected individual level data with geocoded residential addresses from the Veterans Health Administration on 377,545 deceased patients with COPD (2016 to 2021). A time stratified case-crossover study was designed to estimate the incidence rate ratios (IRR) of heat and cold wave mortality risks using conditional logistic regression models examining lagged effects up to 7 d. Attributable risks (AR) were calculated for the lag day with the strongest association for heat and cold waves, respectively. Effect modification by age, gender, race, and ethnicity was also explored. RESULTS Heat waves had the strongest effect on all-cause mortality at lag day 0 [IRR: 1.04; 95% confidence interval (CI): 1.02, 1.06] with attenuated effects by lag day 1. The AR at lag day 0 was 651 (95% CI: 326, 975) per 100,000 veterans. The effect of cold waves steadily increased from lag day 2 and plateaued at lag day 4 (IRR: 1.04; 95% CI: 1.02, 1.07) with declining but still elevated effects over the remaining 7-d lag period. The AR at lag day 4 was 687 (95% CI: 344, 1,200) per 100,000 veterans. Differences in risk were also detected upon stratification by gender and race. DISCUSSION Our study demonstrated harmful associations between heat and cold waves among a high-risk population of veterans with COPD using individual level health data. Future research should emphasize using individual level data to better estimate the associations between extreme weather events and health outcomes for high-risk populations with chronic medical conditions. https://doi.org/10.1289/EHP13176.
Collapse
Affiliation(s)
- Austin Rau
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Gillian A.M. Tarr
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Arianne K. Baldomero
- Pulmonary, Allergy, Critical Care, and Sleep Medicine Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Chris H. Wendt
- Pulmonary, Allergy, Critical Care, and Sleep Medicine Section, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, University of Minnesota School of Medicine, Minneapolis, Minnesota, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Jesse D. Berman
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| |
Collapse
|
4
|
Le VTH, Berman JD, Wattenberg EV, Ngo TV, Tran QA, Alexander BH. Temperature-related emergency injury visits in Hanoi, Vietnam. Inj Prev 2024; 30:33-38. [PMID: 37863513 PMCID: PMC10850667 DOI: 10.1136/ip-2023-044946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/29/2023] [Indexed: 10/22/2023]
Abstract
BACKGROUND The short-term association between increasing temperatures and injury has been described in high-income countries, but less is known for low-income and-middle-income countries, including Vietnam. METHODS We used emergency injury visits (EIV) data for 2017-2019 from 733 hospitals and clinics in Hanoi, Vietnam to examine the effects of daily temperature on EIV. Time-series analysis with quasi-Poisson models was used to estimate a linear relative risk increase (RRI) for overall populations and ones stratified by age and sex. Exposure-response curves estimated non-linear associations as an RR between daily temperature and injury. Models were adjusted for the day of week, holidays, daily relative humidity, daily particulate matter, and long-term and seasonal trends. RESULTS AND CONCLUSIONS A total of 39 313 EIV were recorded averaging 36 injuries daily. Injuries more likely occurred in males and those aged 15-44, and aged 44-60. For linear effects, a 5°C increase in same day mean temperature was associated with an overall increased EIV (RRI 4.8; 95% CI 2.3 to 7.3) with males (RRI 5.9; 95% CI 3.0 to 8.9) experiencing a greater effect than females (RRI 3.0; 95% CI -0.5 to 6.5). Non-linear effects showed an increase in EIV at higher temperatures compared with the threshold temperature of 15°C, with the greatest effect at 33°C (RR 1.3; 95% CI 1.2 to 1.6). Further research to investigate temperature-injury among different populations and by the cause of injury is warranted.
Collapse
Affiliation(s)
- Vu Thuy Huong Le
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Jesse D Berman
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Elizabeth V Wattenberg
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| | - Toan Van Ngo
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Quynh Anh Tran
- Environmental Health Department, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Viet Nam
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA
| |
Collapse
|
5
|
Charlier D, Wilson M, Modderman C, Cortus E, Janni K, Peterson C, Schossow M, Alexander BH, Bender JB. Assessing Self-reported Occupational Hazards of Manure Applicators in the Upper Midwest. J Agromedicine 2023; 28:230-238. [PMID: 35689356 DOI: 10.1080/1059924x.2022.2089423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Manure management on farms presents potential risks to human health and safety, including infectious, chemical, and physical exposures that may result in injury or fatality. Toxic gases and confined spaces are among the most common hazards. These hazards are especially salient for the Upper Midwest of the United States. This study characterizes the occupational health and safety practices and experiences of manure applicators in Minnesota. This cross-sectional study surveyed 162 commercial manure applicators about their work characteristics, safety practices, and health and safety experiences. Respondents reported an average of 17 hours per day applying manure during the busy season, which typically occurs several weeks each year. One hundred and thirty-one (90%) of 145 respondents did not regularly use gas monitors during application. Thirty-three (37%) of 90 respondents reported at least one symptom of gas exposure during manure application work. Those that worked with swine manure were more likely to report symptoms of gas exposure than those who did not work with swine (OR 9.5; CI: 2.0, 89.0). Those that had entered confined spaces were more likely to report symptoms of gas exposure than those who had not entered confined spaces (OR 4.4; CI: 0.1, 1.1). Fourteen (9%) of 150 respondents reported being injured when applying manure. Manure work can be hazardous and may be associated with injury and gas exposure. These findings offer a starting point for future research and intervention to protect and improve the health and safety of applicators.
Collapse
Affiliation(s)
- Devon Charlier
- Upper Midwest Agricultural Safety and Health Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melissa Wilson
- Department of Soil, Water, and Climate, University of Minnesota, Saint Paul, Minnesota, USA
| | - Chryseis Modderman
- Department of Soil, Water, and Climate, University of Minnesota, Saint Paul, Minnesota, USA
| | - Erin Cortus
- Department of Bioproducts and Biosystems Engineering, University of Minnesota, Saint Paul, Minnesota, USA
| | - Kevin Janni
- Department of Bioproducts and Biosystems Engineering, University of Minnesota, Saint Paul, Minnesota, USA
| | - Carol Peterson
- Upper Midwest Agricultural Safety and Health Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Megan Schossow
- Upper Midwest Agricultural Safety and Health Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruce H Alexander
- Upper Midwest Agricultural Safety and Health Center, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeff B Bender
- Upper Midwest Agricultural Safety and Health Center, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
6
|
Liu D, Linet MS, Albert PS, Landgren AM, Kitahara CM, Iwan A, Clerkin C, Kohler B, Alexander BH, Penberthy L. Ascertainment of Incident Cancer by US Population-Based Cancer Registries Versus Self-Reports and Death Certificates in a Nationwide Cohort Study, the US Radiologic Technologists Study. Am J Epidemiol 2022; 191:2075-2083. [PMID: 35872590 PMCID: PMC10144614 DOI: 10.1093/aje/kwac121] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 03/23/2022] [Accepted: 07/06/2022] [Indexed: 02/01/2023] Open
Abstract
Follow-up of US cohort members for incident cancer is time-consuming, is costly, and often results in underascertainment when the traditional methods of self-reporting and/or medical record validation are used. We conducted one of the first large-scale investigations to assess the feasibility, methods, and benefits of linking participants in the US Radiologic Technologists (USRT) Study (n = 146,022) with the majority of US state or regional cancer registries. Follow-up of this cohort has relied primarily on questionnaires (mailed approximately every 10 years) and linkage with the National Death Index. We compared the level of agreement and completeness of questionnaire/death-certificate-based information with that of registry-based (43 registries) incident cancer follow-up in the USRT cohort. Using registry-identified first primary cancers from 1999-2012 as the gold standard, the overall sensitivity was 46.5% for self-reports only and 63.0% for both self-reports and death certificates. Among the 37.0% false-negative reports, 27.8% were due to dropout, while 9.2% were due to misreporting. The USRT cancer reporting patterns differed by cancer type. Our study indicates that linkage to state cancer registries would greatly improve completeness and accuracy of cancer follow-up in comparison with questionnaire self-reporting. These findings support ongoing development of a national US virtual pooled registry with which to streamline cohort linkages.
Collapse
Affiliation(s)
- Danping Liu
- Correspondence to Dr. Danping Liu, Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Room 7E630, Rockville, MD 20850 (e-mail: )
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Mai JZ, Kitahara CM, Sargen MR, Little MP, Alexander BH, Linet MS, Tucker MA, Cahoon EK. Use of Nonsteroidal Anti-Inflammatory Drugs and Incidence of Melanoma in the United States Radiologic Technologists Study. Cancer Prev Res (Phila) 2022; 15:727-732. [PMID: 35902885 PMCID: PMC9633366 DOI: 10.1158/1940-6207.capr-22-0229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/27/2022] [Indexed: 01/31/2023]
Abstract
Although NSAIDs have been associated with both reduced and increased cutaneous melanoma risk, few studies have examined these associations by ultraviolet radiation (UVR) or personal sun-sensitivity. We examined the associations between NSAID use and first primary invasive cutaneous melanoma among 58,227 non-Hispanic white participants in the United States Radiologic Technologists cohort study. Poisson regression was used to calculate rate ratios (RR) and 95% likelihood-based confidence intervals (CI), adjusting for attained age, birth cohort, and ambient UVR. No significant association of melanoma was observed for any use of NSAIDs (RR, 0.87; 95% CI, 0.71-1.09). The relative risks of melanoma for the highest categories of aspirin and other NSAID use (≥5 times per month vs. none) were 0.93 (95% CI, 0.74-1.16) and 1.02 (95% CI, 0.83-1.25), respectively. Further analyses did not reveal dose-response for trends in frequency of NSAID use or interactions with sex, UVR, eye and hair color, and skin complexion. In this large nationwide study, NSAID use was not associated with melanoma risk. PREVENTION RELEVANCE NSAIDs have been associated with both reduced and increased melanoma risk. However, few studies have examined the role of UVR or personal sun-sensitivity on these associations. Our findings strengthen the evidence that NSAID use is not associated with melanoma risk, even in sun-sensitive subgroups.
Collapse
Affiliation(s)
- Jim Z. Mai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Michael R. Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| | - Elizabeth K. Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services
| |
Collapse
|
8
|
Le VTH, Berman JD, Tran QA, Wattenberg EV, Alexander BH. The Effects of Daily Temperature on Crime Events in Urban Hanoi, Vietnam Using Seven Years of Data (2013-2019). Int J Environ Res Public Health 2022; 19:13906. [PMID: 36360786 PMCID: PMC9657037 DOI: 10.3390/ijerph192113906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/17/2022] [Accepted: 10/21/2022] [Indexed: 06/16/2023]
Abstract
The effects of temperature on behavior change and mental health have previously been explored, but the association between temperature and crime is less well understood, especially in developing countries. Single-city-level data were used to evaluate the association between the short-term effects of temperature on crime events in urban Hanoi, Vietnam. We used quasi-Poisson regression models to investigate the linear effects and distributed lag non-linear models to investigate the non-linear association between daily temperature and daily crime events from 2013 to 2019. There were 3884 crime events, including 1083 violent crimes and 2801 non-violent crimes during the 7-year study period. For both linear and non-linear effects, there were positive associations between an increase in daily temperature and crime, and the greatest effects were observed on the first day of exposure (lag 0). For linear effects, we estimated that each 5 °C increase in daily mean temperature was associated with a 9.9% (95%CI: 0.2; 20.5), 6.8% (95%CI: 0.6; 13.5), and 7.5% (95%CI: 2.3; 13.2) increase in the risk of violent, non-violent, and total crime, respectively. For non-linear effects, however, the crime risk plateaued at 30 °C and decreased at higher exposures, which presented an inverted U-shape response with a large statistical uncertainty.
Collapse
Affiliation(s)
- Vu Thuy Huong Le
- Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
- Department of Environmental Health, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 10000, Vietnam
| | - Jesse D. Berman
- Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Quynh Anh Tran
- Department of Environmental Health, School of Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 10000, Vietnam
| | - Elizabeth V. Wattenberg
- Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bruce H. Alexander
- Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| |
Collapse
|
9
|
Mai JZ, Zhang R, Sargen MR, Little MP, Alexander BH, Tucker MA, Kitahara CM, Cahoon EK. Reproductive factors, hormone use, and incidence of melanoma in a cohort of US Radiologic Technologists. Hum Reprod 2022; 37:1059-1068. [PMID: 35174864 PMCID: PMC9308393 DOI: 10.1093/humrep/deac029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 01/05/2022] [Indexed: 12/17/2023] Open
Abstract
STUDY QUESTION Are reproductive factors and exogenous hormone use associated with incidence of cutaneous melanoma while accounting for ultraviolet radiation (UVR) exposure across different life periods and sun sensitivity factors? SUMMARY ANSWER Earlier age at menarche and late age at first birth, but not other estrogen-related factors were associated with an increased incidence rate of melanoma, with higher risks observed for earlier age at menarche and light hair color at age 15 years. WHAT IS KNOWN ALREADY Although estrogens have been recognized as photosensitizing, previous studies have reported inconsistent findings for the association of melanoma with estrogen-related factors. Most have not collected detailed skin cancer risk factors and have not thoroughly investigated effect modification by ambient UVR and sun sensitivity. STUDY DESIGN, SIZE, DURATION Participants in the US Radiologic Technologists study, an occupational cohort of 146 022 radiologic technologists (73% women), were included and followed during the four time periods (1983-1989, 1994-1998, 2003-2005 and 2012-2014). PARTICIPANTS/MATERIALS, SETTING, METHODS Non-Hispanic white female participants who completed both the second (baseline) and third questionnaires, and did not report having cancer (except keratinocyte carcinoma) at baseline, were included and followed from their age at completion of the second (baseline) questionnaire until the earlier of first primary cancer diagnosis, including invasive melanoma of the skin, or completion of either the third or fourth questionnaire. Reproductive and exogenous hormonal factors were ascertained from the second (baseline) questionnaire, which also collected information on demographic, lifestyle factors and sun sensitivity factors. Ambient UVR was assigned by linking geocoded residential locations, based on self-reported residential history information collected from the third questionnaire to satellite-based ambient UVR data from the National Aeronautics and Space Administration's Total Ozone Mapping Spectrometer database. To examine the association of reproductive factors, exogenous hormone use, and first primary invasive melanoma of the skin, we used Poisson regression to calculate rate ratios (RRs) and 95% likelihood-based CIs, adjusting for attained age, birth cohort, lifetime average annual ambient UVR, contraceptives and menopausal hormone therapy use. To address the effect modification of ambient UVR exposure and sun sensitivities on melanoma risk, we conducted likelihood-ratio tests for multiplicative interaction. MAIN RESULTS AND THE ROLE OF CHANCE Over a median follow-up time of 17.1 years, 0.95% of eligible participants had an incident first primary melanoma (n = 444). Higher melanoma incidence rates were observed in participants with older attained age, blue/green/gray eye color, blonde/red/auburn natural hair color at age 15, fair skin complexion, and higher UVR. We found an increased incidence rate of melanoma in women who experienced menarche at an earlier age (13, 12 and <12 years vs ≥14 years: RR = 1.48, 95% CI = 1.11-1.98; 1.19, 0.89-1.61; 1.26, 0.93-1.73), and in women with older age at first birth (25-29 and ≥30 years vs <25 years; 1.09, 0.86-1.39; 1.48, 1.12-1.95; P-value for trend = 0.006). However, no significant association was observed for other reproductive factors, and for all exogenous hormone use. The associations of melanoma incidence for most reproductive factors and exogenous hormone use were not modified by ambient UVR, eye color, natural hair color at age 15 and skin complexion. The exception was that natural hair color at age 15 modified the associations of melanoma for age at menarche (P-value for interaction = 0.004) and age at first birth among parous women (0.005). In participants with blonde/red/auburn natural hair color at age 15, we found increased risk of melanoma among women who experienced menarche at age 13, 12 and <12 years (vs ≥14 years: RR = 3.54, 95% CI = 1.98-6.90; 2.51, 1.37-4.98; 2.66, 1.41-5.36, respectively; P-value for trend = 0.10). However, the association between age at menarche and melanoma was null in participants with brown/black natural hair color at age 15. LIMITATIONS, REASONS FOR CAUTION Information on reproductive history and exogenous hormone use was self-reported. We did not have information on specific doses or formulations of exogenous hormone medications or breastfeeding. WIDER IMPLICATIONS OF THE FINDINGS Women residing in areas of high ambient UVR and those with blonde/red/auburn natural hair color may constitute an additional high-risk group in need of more frequent skin cancer screening. Identifying susceptible periods of exposure or factors that modify UVR susceptibility may aid in guiding more targeted guidelines for melanoma prevention. STUDY FUNDING/COMPETING INTEREST(S) This research was supported by the Intramural Research Program, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services. Authors declare no conflict of interest. TRIAL REGISTRATION NUMBER N/A.
Collapse
Affiliation(s)
- Jim Z Mai
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Rui Zhang
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Michael R Sargen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Mark P Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Margaret A Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| | - Elizabeth K Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA
| |
Collapse
|
10
|
Shao Y, Hwang J, MacLehose RF, Alexander BH, Mandel JH, Raynor PC, Ramachandran G. Reconstructing Historical Exposures to Respirable Dust and Respirable Silica in the Taconite Mining Industry for 1955-2010. Ann Work Expo Health 2021; 66:459-471. [PMID: 34864842 DOI: 10.1093/annweh/wxab099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/29/2021] [Accepted: 10/21/2021] [Indexed: 11/12/2022] Open
Abstract
The goal of this study was to reconstruct the historical respirable silica (RS) and respirable dust (RD) exposures of workers in the Minnesota taconite industry from 1955 to 2010 as part of several epidemiological studies for assessing the association between exposure to components of taconite dusts and the development of respiratory diseases. A job-exposure matrix (JEM) was developed that uses 9127 RS and 19 391 RD occupational hygiene historical measurements. Historical RS and RD data were extracted from several sources and were grouped into seven mines and then into eight departments [Concentrating, Crushing, Janitor, Mining, Office/control room, Pelletizing, Shop (mobile), and Shop (stationary)]. Within each department, we applied a two-level random-intercept regression model which assumes that the natural log of Y (RD or RS concentration) changes over time at a constant rate. Among all predicted RD and RS values, we found that larger RD values were located in the following departments: Crushing, Concentrating, Pelletizing, and Shop (mobile). Larger RS values were located only in either Crushing or Shop (mobile). The annual rates of change for historical RD and RS exposures were between -3.3 and 3.2%. The silica percentage in the dust varied by mine/department with the highest value of 29.3% in Mine F (Crushing) and the lowest value of 2.1% in Mine B (Pelletizing). The predicted historical RD and RS arithmetic mean exposures ranged between <0.075 and 3.14 mg m-3, and between <0.005 and 0.36 mg m-3, respectively. The result of this study is a JEM by mine, department, and year for RD and RS for epidemiological studies.
Collapse
Affiliation(s)
- Yuan Shao
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA.,Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Richard F MacLehose
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Jeffrey H Mandel
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Peter C Raynor
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
11
|
Little MP, Lee T, Kimlin MG, Kitahara CM, Zhang R, Alexander BH, Linet MS, Cahoon EK. Lifetime Ambient UV Radiation Exposure and Risk of Basal Cell Carcinoma by Anatomic Site in a Nationwide U.S. Cohort, 1983-2005. Cancer Epidemiol Biomarkers Prev 2021; 30:1932-1946. [PMID: 34289968 DOI: 10.1158/1055-9965.epi-20-1815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/31/2021] [Accepted: 07/12/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cutaneous basal cell carcinoma (BCC) has long been associated with UV radiation (UVR) exposure, but data are limited on risks by anatomic site. METHODS We followed 63,912 cancer-free White U.S. radiologic technologists from cohort entry (1983-1989/1994-1998) to exit (date first BCC via 2003-2005 questionnaire). We estimated associations between cumulative ambient UVR and relative/absolute risks of self-reported BCC by anatomic location via Poisson models. RESULTS For incident first primary BCC in 2,124 subjects (mean follow-up, 16.9 years) log[excess relative risks] (ERR) of BCC per unit cumulative ambient UVR = 1.27/MJ cm-2 [95% confidence interval (CI): 0.86-1.68; P trend < 0.001] did not vary by anatomic site (P = 0.153). However, excess absolute risks of BCC per unit cumulative ambient UVR were large for the head/neck = 5.46/MJ cm-2/104 person-year (95% CI: 2.92-7.36; P trend < 0.001), smaller for the trunk (2.56; 95% CI: 1.26-3.33; P trend = 0.003), with lesser increases elsewhere. There were lower relative risks, but higher absolute risks, for those with Gaelic ancestry (P < 0.001), also higher absolute risks among those with fair complexion, but relative and absolute risks were not generally modified by other constitutional, lifestyle or medical factors for any anatomic sites. Excess absolute and relative risk was concentrated 5-15 years before time of follow-up. CONCLUSIONS BCC relative and absolute risk rose with increasing cumulative ambient UVR exposure, with absolute risk highest for the head/neck, to a lesser extent in the trunk. IMPACT These associations should be evaluated in other White and other racial/ethnic populations along with assessment of possible modification by time outdoors, protective, and behavioral factors.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland.
| | - Terrence Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Michael G Kimlin
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Rui Zhang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland
| |
Collapse
|
12
|
Villoing D, Borrego D, Preston DL, Alexander BH, Rose A, Salasky M, Linet MS, Lee C, Kitahara CM. Trends in Occupational Radiation Doses for U.S. Radiologic Technologists Performing General Radiologic and Nuclear Medicine Procedures, 1980-2015. Radiology 2021; 300:605-612. [PMID: 34156301 DOI: 10.1148/radiol.2021204501] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background Occupational doses to most medical radiation workers have declined substantially since the 1950s because of improvements in radiation protection practices. However, different patterns may have emerged for radiologic technologists working with nuclear medicine because of the higher per-procedure doses and increasing workloads. Purpose To summarize annual occupational doses during a 36-year period for a large cohort of U.S. radiologic technologists and to compare dose between general radiologic technologists and those specializing in nuclear medicine procedures. Materials and Methods Annual personal dose equivalents (referred to as doses) from 1980 to 2015 were summarized for 58 434 (62%) participants in the U.S. Radiologic Technologists (USRT) cohort who responded to the most recent mailed work history survey (years 2012-2014) and reported never regularly performing interventional procedures. Doses were partitioned according to the performance of nuclear medicine (yes or no, frequency, procedure type) by calendar year. Annual dose records were described by using summary statistics (eg, median and 25th and 75th percentiles). Results Median annual doses related to performance of general radiologic procedures decreased from 0.60 mSv (interquartile range [IQR], 0.10-1.9 mSv) in 1980 to levels below the limits of detection by 2015, whereas annual doses related to performance of nuclear medicine procedures remained relatively high during this period (median, 1.2 mSv; IQR, 0.12-3.0 mSv). Higher median annual doses were associated with more frequent (above vs below the median) performance of diagnostic nuclear medicine procedures (≥35 vs <35 times per week; 1.6 mSv [IQR, 0.30-3.3 mSv] and 0.9 mSv [IQR, 0.10-2.6 mSv]). Higher and more variable annual doses were associated with more frequent performance of cardiac nuclear medicine (≥10 times per week) and PET (nine or more times per week) examinations (median, 1.6 mSv [IQR, 0.30-2.2 mSv] and 2.2 mSv [IQR, 0.10-4.6 mSv], respectively). Conclusion Annual doses to U.S. radiologic technologists performing general radiologic procedures declined during a 36-year period. However, consistently higher and more variable doses were associated with the performance of nuclear medicine procedures, particularly cardiac nuclear medicine and PET procedures. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Mettler and Guiberteau in this issue.
Collapse
Affiliation(s)
- Daphnée Villoing
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - David Borrego
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Dale L Preston
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Bruce H Alexander
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - André Rose
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Mark Salasky
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Martha S Linet
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Choonsik Lee
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| | - Cari M Kitahara
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609 Medical Center Dr, Rockville, MD 20850 (D.V., D.B., A.R., M.S.L., C.L., C.M.K.); Hirosoft International, Eureka, Calif (D.L.P.); Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.); Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colo (B.H.A.); and Landauer, Glenwood, Ill (M.S.)
| |
Collapse
|
13
|
Shao Y, MacLehose RF, Lin L, Hwang J, Alexander BH, Mandel JH, Ramachandran G. A Bayesian Approach for Determining the Relationship Between Various Elongate Mineral Particles (EMPs) Definitions. Ann Work Expo Health 2020; 64:993-1006. [PMID: 33196824 DOI: 10.1093/annweh/wxaa074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 04/12/2020] [Accepted: 06/25/2020] [Indexed: 11/13/2022] Open
Abstract
A variety of dimensions (lengths and widths) of elongate mineral particles (EMPs) have been proposed as being related to health effects. In this paper, we develop a mathematical approach for deriving numerical conversion factors (CFs) between these EMP exposure metrics and applied it to the Minnesota Taconite Health Worker study which contains 196 different job exposure groups (28 similar exposure groups times 7 taconite mines). This approach comprises four steps: for each group (i) obtain EMP dimension information using ISO-TEM 10312/13794 analysis; (ii) use bivariate lognormal distribution to characterize overall EMP size distribution; (iii) use a Bayesian approach to facilitate the formation of the bivariate lognormal distribution; (iv) derive conversion factors between any pair of EMP definitions. The final CFs allow the creation of job exposure matrices (JEMs) for alternative EMP metrics using existing EMP exposures already characterized according to the National Institute of Occupational Safety and Health (NIOSH)-defined EMP exposure metric (length >5 µm with an aspect ratio ≥3.0). The relationships between the NIOSH EMP and other EMP definitions provide the basis of classification of workers into JEMs based on alternate definitions of EMP for epidemiological studies of mesothelioma, lung cancer, and non-malignant respiratory disease.
Collapse
Affiliation(s)
- Yuan Shao
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Richard F MacLehose
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, MN, USA
| | - Lifeng Lin
- Department of Statistics, Florida State University, Tallahassee, FL, USA
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Jeffrey H Mandel
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
14
|
Linet MS, Little MP, Kitahara CM, Cahoon EK, Doody MM, Simon SL, Alexander BH, Preston DL. Occupational radiation and haematopoietic malignancy mortality in the retrospective cohort study of US radiologic technologists, 1983-2012. Occup Environ Med 2020; 77:822-831. [PMID: 32967989 DOI: 10.1136/oemed-2019-106346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 04/27/2020] [Accepted: 06/07/2020] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To evaluate cumulative occupational radiation dose response and haematopoietic malignancy mortality risks in the US radiologic technologist cohort. METHODS Among 110 297 radiologic technologists (83 655 women, 26 642 men) who completed a baseline questionnaire sometime during 1983-1998, a retrospective cohort study was undertaken to assess cumulative, low-to-moderate occupational radiation dose and haematopoietic malignancy mortality risks during 1983-2012. Cumulative bone marrow dose (mean 8.5 mGy, range 0-430 mGy) was estimated based on 921 134 badge monitoring measurements during 1960-1997, work histories and historical data; 35.4% of estimated doses were based on badge measurements. Poisson regression was used to estimate excess relative risk of haematopoietic cancers per 100 milligray (ERR/100 mGy) bone-marrow absorbed dose, adjusting for attained age, sex and birth year. RESULTS Deaths from baseline questionnaire completion through 2012 included 133 myeloid neoplasms, 381 lymphoid neoplasms and 155 leukaemias excluding chronic lymphocytic leukaemia (CLL). Based on a linear dose-response, no significant ERR/100 mGy occurred for acute myeloid leukaemia (ERR=0.0002, 95% CI <-0.02 to 0.24, p-trend>0.5, 85 cases) or leukaemia excluding CLL (ERR=0.05, 95% CI <-0.09 to 0.24, p-trend=0.21, 155 cases). No significant dose-response trends were observed overall for CLL (ERR<-0.023, 95% CI <-0.025 to 0.18, p-trend=0.45, 32 cases), non-Hodgkin lymphoma (ERR=0.03, 95% CI <-0.2 to 0.18, p-trend=0.4, 201 cases) or multiple myeloma (ERR=0.003, 95% CI -0.02 to 0.16, p-trend>0.5, 112 cases). Findings did not differ significantly by demographic factors, smoking or specific radiological procedures performed. CONCLUSION After follow-up averaging 22 years, there was little evidence of a relationship between occupational radiation exposure and myeloid or lymphoid haematopoietic neoplasms.
Collapse
Affiliation(s)
- Martha S Linet
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Mark P Little
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Cari M Kitahara
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Elizabeth K Cahoon
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Michele M Doody
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Steven L Simon
- National Cancer Institute Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Dale L Preston
- self-employed at Hirosoft International, Eureka, California, USA
| |
Collapse
|
15
|
Velazquez-Kronen R, Gilbert ES, Linet MS, Moysich KB, Freudenheim JL, Wactawski-Wende J, Simon SL, Cahoon EK, Alexander BH, Doody MM, Kitahara CM. Lung cancer mortality associated with protracted low-dose occupational radiation exposures and smoking behaviors in U.S. radiologic technologists, 1983-2012. Int J Cancer 2020; 147:3130-3138. [PMID: 32506420 DOI: 10.1002/ijc.33141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 04/23/2020] [Accepted: 05/20/2020] [Indexed: 11/09/2022]
Abstract
In the Japanese atomic bomb survivors, risk of lung cancer has been shown to increase with greater acute exposure to ionizing radiation. Although similar findings have been observed in populations exposed to low-dose, protracted radiation, such studies lack information on cigarette smoking history, a potential confounder. In a cohort of 106 068 U.S. radiologic technologists, we examined the association between estimated cumulative lung absorbed dose from occupational radiation exposure and lung cancer mortality. Poisson regression models, adjusted for attained age, sex, birth cohort, pack-years smoked and years since quitting smoking, were used to calculate linear excess relative risks (ERR) per 100 mGy, using time-dependent cumulative lung absorbed dose, lagged 10 years. Mean cumulative absorbed dose to the lung was 25 mGy (range: 0-810 mGy). During the 1983 to 2012 follow-up, 1090 participants died from lung cancer. Greater occupational radiation lung dose was not associated with lung cancer mortality overall (ERR per 100 mGy: -0.02, 95% CI: <0-0.13). However, significant dose-response relationships were observed for some subgroups, which might be false-positive results given the number of statistical tests performed. As observed in other studies of radiation and smoking, the interaction between radiation and smoking appeared to be sub-multiplicative with an ERR per 100 mGy of 0.41 (95% CI: 0.01-1.15) for those who smoked <20 pack-years and -0.03 (95% CI: <0-0.15) for those who smoked ≥20 pack-years. Our study provides some evidence that greater protracted radiation exposure in the low-dose range is positively associated with lung cancer mortality.
Collapse
Affiliation(s)
- Raquel Velazquez-Kronen
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA.,Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Ethel S Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Kirsten B Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, New York, USA
| | - Jo L Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
| | - Steven L Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Michele M Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, Maryland, USA
| |
Collapse
|
16
|
Huong LTT, Hanh TTT, Toan LQ, Trang DTH, Quynh NT, Anh NQ, Long TK, Fenwick S, Ha NT, Alexander BH. Training need assessment for a master training program in Environmental Health program in Vietnam. AIMS Public Health 2020; 7:197-212. [PMID: 32258200 PMCID: PMC7109530 DOI: 10.3934/publichealth.2020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2019] [Accepted: 03/09/2020] [Indexed: 11/18/2022] Open
Abstract
Vietnam is facing a shortage of skilled Environmental health workforce. A Training Needs Assessment was conducted to develop a list of environmental health tasks, a list of core competencies and assess the need for a Master of Environmental Health training program in Vietnam. To answer these questions, a cross-sectional study was conducted in Vietnam in 2017, using both qualitative and quantitative methods. The qualitative study involved a desk review, 29 in-depth interviews, two consultative workshops, and two expert meetings. For the quantitative component, 298 environmental health staff working at different levels completed a structured postal questionnaire. Results showed that different sectors were implementing various environmental health tasks but that there was currently no training program focusing on environmental health in Vietnam. Thirteen core competencies for a Master of Environmental Health were recommended. An urgent need to develop training programs to help building environmental health competencies at the Masters degree level was uniformly expressed. This could be achieved by developing a Master of Public Health with an Environmental Health stream in the short-term and a Master of Environmental Health program in the long-term.
Collapse
Affiliation(s)
- Le Thi Thanh Huong
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Tran Thi Tuyet Hanh
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Luu Quoc Toan
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Do Thi Hanh Trang
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Nguyen Thuy Quynh
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Nguyen Quynh Anh
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Tran Khanh Long
- Queensland University of Technology, Brisbane, QLD, Australia
| | - Stanley Fenwick
- Cummings School of Veterinary Medicine, Tufts University, 200 Westoboro Rd., North Grafton, MA 01536, USA
| | - Nguyen Thanh Ha
- Hanoi University of Public Health, 1A Duc Thang Rd, Duc Thang Ward, North Tu Liem District, Hanoi, Vietnam
| | - Bruce H Alexander
- School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA
| |
Collapse
|
17
|
Shao Y, Hwang J, Alexander BH, Mandel JH, MacLehose RF, Ramachandran G. Reconstructing historical exposures to elongate mineral particles (EMPs) in the taconite mining industry for 1955-2010. J Occup Environ Hyg 2019; 16:817-826. [PMID: 31647751 DOI: 10.1080/15459624.2019.1676431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
As part of ongoing epidemiological studies for assessing the association between exposure to dust from taconite operations and the development of respiratory diseases, the goal of this study was to reconstruct the exposures of workers to elongate mineral particle (EMP) in the Minnesota taconite mining industry from 1955-2010. Historical NIOSH-7400 and equivalent EMP personal exposure data were extracted from two sources: (1) the Mine Safety and Health Administration (MSHA) online database recorded for all inspection results since 1978 with 655 EMP monitoring records from 1978-2010 for 13 MSHA Mine IDs associated with this study; and (2) the mining companies' internal monitoring reports contained 96 personal EMP exposure records. NIOSH-7400 EMP personal exposures were measured for workers in different jobs in all active mines in 2010 by obtaining 1,285 personal samples. After data treatment, all data were grouped into seven mines and eight departments. Within each mine-department, the yearly EMP mean concentration in f/cc for each year of operation was predicted using two approaches. The performance of two approaches varied by situation. The assumptions underlying each approach described in this article have limitations. A linear regression based on limited historical measurements and those made in 2010-2011 (Approach 1) does not yield reasonable and plausible values of the slope. Approach 2 assumes that the EMP and the respirable dust in the same department share the same historical time trend. This approach allowed us to avail of the more reasonable slope estimates from the historical respirable dust data set and yielded more plausible historical exposure estimates for most locations. This work with two different job exposure matrix (JEMs) provides a unique research opportunity to study the potential impact of exposure assessment to epidemiological results. Both JEMs are being used to assess associations between EMP and respiratory disease in epidemiological studies.
Collapse
Affiliation(s)
- Yuan Shao
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffrey H Mandel
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard F MacLehose
- Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| |
Collapse
|
18
|
Gallagher LG, Ilango S, Wundes A, Stobbe GA, Turk KW, Franklin GM, Linet MS, Freedman DM, Alexander BH, Checkoway H. Lifetime exposure to ultraviolet radiation and the risk of multiple sclerosis in the US radiologic technologists cohort study. Mult Scler 2019; 25:1162-1169. [PMID: 29932357 PMCID: PMC10561656 DOI: 10.1177/1352458518783343] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Low exposure to ultraviolet radiation (UVR) from sunlight may be a risk factor for developing multiple sclerosis (MS). Possible pathways may be related to effects on immune system function or vitamin D insufficiency, as UVR plays a role in the production of the active form of vitamin D in the body. OBJECTIVE This study examined whether lower levels of residential UVR exposure from sunlight were associated with increased MS risk in a cohort of radiologic technologists. METHODS Participants in the third and fourth surveys of the US Radiologic Technologists (USRT) Cohort Study eligible (N = 39,801) for analysis provided complete residential histories and reported MS diagnoses. MS-specialized neurologists conducted medical record reviews and confirmed 148 cases. Residential locations throughout life were matched to satellite data from NASA's Total Ozone Mapping Spectrometer (TOMS) project to estimate UVR dose. RESULTS Findings indicate that MS risk increased as average lifetime levels of UVR exposures in winter decreased. The effects were consistent across age groups <40 years. There was little indication that low exposures during summer or at older ages were related to MS risk. CONCLUSION Our findings are consistent with the hypothesis that UVR exposure reduces MS risk and may ultimately suggest prevention strategies.
Collapse
Affiliation(s)
- Lisa G. Gallagher
- Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Sindana Ilango
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA
| | - Annette Wundes
- Department of Neurology, University of Washington, Seattle, WA
| | - Gary A. Stobbe
- Department of Neurology, University of Washington, Seattle, WA
| | | | - Gary M. Franklin
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA
| | - Martha S. Linet
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, NIH, DHHS, Bethesda, MD
| | - D. Michal Freedman
- National Cancer Institute, Division of Cancer Epidemiology and Genetics, NIH, DHHS, Bethesda, MD
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Harvey Checkoway
- Department of Family Medicine and Public Health, University of California San Diego, San Diego, CA
- Department of Neurosciences, University of California San Diego, San Diego, CA
| |
Collapse
|
19
|
Velazquez-Kronen R, Borrego D, Gilbert ES, Miller DL, Moysich K, Freudenheim JL, Wactawski-Wende J, Cahoon EK, Little MP, Millen AE, Balter S, Alexander BH, Simon SL, Linet MS, Kitahara CM. Cataract risk in US radiologic technologists assisting with fluoroscopically guided interventional procedures: a retrospective cohort study. Occup Environ Med 2019; 76:317-325. [PMID: 30890565 PMCID: PMC6686674 DOI: 10.1136/oemed-2018-105360] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 01/30/2019] [Accepted: 02/18/2019] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To assess radiation exposure-related work history and risk of cataract and cataract surgery among radiologic technologists assisting with fluoroscopically guided interventional procedures (FGIP). METHODS This retrospective study included 35 751 radiologic technologists who reported being cataract-free at baseline (1994-1998) and completed a follow-up questionnaire (2013-2014). Frequencies of assisting with 21 types of FGIP and use of radiation protection equipment during five time periods (before 1970, 1970-1979, 1980-1989, 1990-1999, 2000-2009) were derived from an additional self-administered questionnaire in 2013-2014. Multivariable-adjusted relative risks (RRs) for self-reported cataract diagnosis and cataract surgery were estimated according to FGIP work history. RESULTS During follow-up, 9372 technologists reported incident physician-diagnosed cataract; 4278 of incident cases reported undergoing cataract surgery. Technologists who ever assisted with FGIP had increased risk for cataract compared with those who never assisted with FGIP (RR: 1.18, 95% CI 1.11 to 1.25). Risk increased with increasing cumulative number of FGIP; the RR for technologists who assisted with >5000 FGIP compared with those who never assisted was 1.38 (95% CI 1.24 to 1.53; p trend <0.001). These associations were more pronounced for FGIP when technologists were located ≤3 feet (≤0.9 m) from the patient compared with >3 feet (>0.9 m) (RRs for >5000 at ≤3 feet vs never FGIP were 1.48, 95% CI 1.27 to 1.74 and 1.15, 95% CI 0.98 to 1.35, respectively; pdifference=0.04). Similar risks, although not statistically significant, were observed for cataract surgery. CONCLUSION Technologists who reported assisting with FGIP, particularly high-volume FGIP within 3 feet of the patient, had increased risk of incident cataract. Additional investigation should evaluate estimated dose response and medically validated cataract type.
Collapse
Affiliation(s)
- Raquel Velazquez-Kronen
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA, 14214
| | - David Borrego
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Ethel S. Gilbert
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Donald L. Miller
- Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD, USA, 20993
| | - Kirsten Moysich
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA, 14263
| | - Jo L. Freudenheim
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA, 14214
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA, 14214
| | - Elizabeth K. Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Mark P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Amy E. Millen
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA, 14214
| | - Stephen Balter
- Departments of Radiology and Medicine, Columbia University, New York, NY, USA, 10032
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA, 55455
| | - Steven L. Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, U.S. Department of Health and Human Services, Bethesda, MD, USA, 20892
| |
Collapse
|
20
|
Mandel JH, Odo NU, Alexander BH. Potential Problems with Determining Elongate Mineral Particle (EMP) Potency (Comments on article entitled, "A Comparison of Asbestos Fiber Potency and Elongate Mineral Particle (EMP) Potency for Mesothelioma in Humans"). Toxicol Appl Pharmacol 2019; 370:131-132. [PMID: 30851279 DOI: 10.1016/j.taap.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 03/01/2019] [Accepted: 03/02/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Jeffrey H Mandel
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, United States of America.
| | | | - Bruce H Alexander
- University of Minnesota School of Public Health, Division of Environmental Health Sciences, Minneapolis, MN, United States of America.
| |
Collapse
|
21
|
Huynh T, Ramachandran G, Quick H, Hwang J, Raynor PC, Alexander BH, Mandel JH. Ambient Fine Aerosol Concentrations in Multiple Metrics in Taconite Mining Operations. Ann Work Expo Health 2019; 63:77-90. [PMID: 30351393 DOI: 10.1093/annweh/wxy086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 09/21/2018] [Indexed: 11/13/2022] Open
Abstract
Studies in environmental epidemiology and of occupational cohorts have implicated the effects of fine particulates with increased risk of cardiovascular diseases. Motivated by this evidence, we conducted an ambient air monitoring campaign to characterize fine aerosol concentrations around various taconite ore processes in six taconite mines in northeastern Minnesota. The ore processes were first categorized into 16 broad work areas/buildings. We then took air samples at 91 fixed locations using an array of direct-reading instruments to obtain measurements of mass (PM2.5 or particles with aerodynamic diameter <2.5 µm, and respirable particulate matter or RPM), alveolar-deposited surface area (ADSA), and particle number (PN) concentrations. At each location, a respirable gravimetric pump (which was used for calibration purposes) and the instruments measured the ambient dust level for 4 h producing ~240 1-min averaging real-time measurements. To analyze these data, we fit a Bayesian hierarchical model with an autoregressive order 1 correlation structure to estimate pooled concentrations for the 16 work areas/buildings while accounting for temporal correlation. PM2.5 and RPM average ambient concentrations were highly correlated to each other (Pearson's correlation = 0.98), followed by ADSA and PN correlation (R = 0.77). Office and control room areas were found to have the lowest concentrations in all four metrics when compared to other groups. Distinguishing between concentration levels among the remaining groups was more difficult due to the high uncertainty associated with the geometric mean estimates. The geometric standard deviation within location (GSDWL) generally ranged from 1 to 3 for all exposure metrics, except for a few locations that may have had changes in the work activities that generated the observed peaks and variability during the sampling duration. The geometric standard deviation between locations estimates were generally higher than GSDWL, which may indicate larger variability in the processes/activities between locations within each broad work area/building. Future work may look into whether it is feasible to use area measurements for epidemiological investigation and use personal measurements (if available) to validate such approach.
Collapse
Affiliation(s)
- Tran Huynh
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Harrison Quick
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Jooyeon Hwang
- Department of Occupational and Environmental Health, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Peter C Raynor
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jeffrey H Mandel
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| |
Collapse
|
22
|
Little MP, Kitahara CM, Cahoon EK, Bernier MO, Velazquez-Kronen R, Doody MM, Borrego D, Miller JS, Alexander BH, Simon SL, Preston DL, Hamada N, Linet MS, Meyer C. Occupational radiation exposure and risk of cataract incidence in a cohort of US radiologic technologists. Eur J Epidemiol 2018; 33:1179-1191. [PMID: 30151727 PMCID: PMC10645574 DOI: 10.1007/s10654-018-0435-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 08/18/2018] [Indexed: 12/13/2022]
Abstract
It has long been known that relatively high-dose ionising radiation exposure (> 1 Gy) can induce cataract, but there has been no evidence that this occurs at low doses (< 100 mGy). To assess low-dose risk, participants from the US Radiologic Technologists Study, a large, prospective cohort, were followed from date of mailed questionnaire survey completed during 1994-1998 to the earliest of self-reported diagnosis of cataract/cataract surgery, cancer other than non-melanoma skin, or date of last survey (up to end 2014). Cox proportional hazards models with age as timescale were used, adjusted for a priori selected cataract risk factors (diabetes, body mass index, smoking history, race, sex, birth year, cumulative UVB radiant exposure). 12,336 out of 67,246 eligible technologists reported a history of diagnosis of cataract during 832,479 person years of follow-up, and 5509 from 67,709 eligible technologists reported undergoing cataract surgery with 888,420 person years of follow-up. The mean cumulative estimated 5-year lagged eye-lens absorbed dose from occupational radiation exposures was 55.7 mGy (interquartile range 23.6-69.0 mGy). Five-year lagged occupational radiation exposure was strongly associated with self-reported cataract, with an excess hazard ratio/mGy of 0.69 × 10-3 (95% CI 0.27 × 10-3 to 1.16 × 10-3, p < 0.001). Cataract risk remained statistically significant (p = 0.030) when analysis was restricted to < 100 mGy cumulative occupational radiation exposure to the eye lens. A non-significantly increased excess hazard ratio/mGy of 0.34 × 10-3 (95% CI - 0.19 × 10-3 to 0.97 × 10-3, p = 0.221) was observed for cataract surgery. Our results suggest that there is excess risk for cataract associated with radiation exposure from low-dose and low dose-rate occupational exposures.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA.
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
- Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
| | - Raquel Velazquez-Kronen
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Michele M Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - David Borrego
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Jeremy S Miller
- Information Management Services, Silver Spring, MD, 20904, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, 55409, USA
| | - Steven L Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | | | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 9609 Medical Center Drive, Bethesda, MD, 20892-9778, USA
| | - Craig Meyer
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, 55409, USA
| |
Collapse
|
23
|
Kitahara CM, Preston DL, Neta G, Little MP, Doody MM, Simon SL, Sigurdson AJ, Alexander BH, Linet MS. Occupational radiation exposure and thyroid cancer incidence in a cohort of U.S. radiologic technologists, 1983-2013. Int J Cancer 2018. [DOI: org/10.1002/ijc.31270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Affiliation(s)
- Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| | | | - Gila Neta
- Division of Cancer Control and Population Sciences, Implementation Science; National Cancer Institute, National Institutes of Health; Bethesda MD
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| | - Michele M. Doody
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| | - Steven L. Simon
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| | - Alice J. Sigurdson
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health; University of Minnesota; Minneapolis MN
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch; National Cancer Institute, National Institutes of Health; Bethesda MD
| |
Collapse
|
24
|
Peck ME, Jenpanich C, Amonsin A, Bunpapong N, Chanachai K, Somrongthong R, Alexander BH, Bender JB. Knowledge, Attitudes and Practices Associated with Brucellosis among Small-Scale Goat Farmers in Thailand. J Agromedicine 2018; 24:56-63. [PMID: 30350754 DOI: 10.1080/1059924x.2018.1538916] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES This study aimed to identify occupational risk factors for brucellosis among small scale goat farmers in Thailand. METHODS To better understand farmers' knowledge, attitudes and practices associated with brucellosis we interviewed 51 farmers and tested 314 goats for Brucella melitensis. RESULTS All serological samples tested negative for Brucella infection. Based on previous research and estimates provided from the Thai national brucellosis surveillance system, zero seropositivity was less than expected. Findings from interviews with farmers demonstrate that most respondents were relatively new to goat farming with just over half (53%) reporting owning goats for five or fewer years. The majority of respondents demonstrated important gaps in knowledge on disease transmission in animals and knowledge of human brucellosis was particularly limited with just over half (54%) reporting that humans could become infected. Participants had a very low perceived risk of infection with the majority (91.7%) reporting that they or a member of their household were not at risk of the disease. CONCLUSION Overall findings from this study support that brucellosis poses an occupational risk to goat farmers with specific areas of concern including weak awareness of disease transmission to humans and lack of knowledge on specific safe farm practices such as quarantine practices. Findings from this study contribute to a more comprehensive understanding of brucellosis in Thailand by identifying specific occupational risk factors and describing areas where farmer education and training should be strengthened.
Collapse
Affiliation(s)
- Megan E Peck
- a Veterinary Population Medicine Department, College of Veterinary Medicine , University of Minnesota , Saint Paul , MN , USA
| | - Chayanee Jenpanich
- b Department of Livestock Development , Ministry of Agriculture , Bangkok , Thailand
| | - Alongkorn Amonsin
- c Faculty of Veterinary Science , Chulalongkorn University , Bangkok , Thailand
| | - Napawan Bunpapong
- c Faculty of Veterinary Science , Chulalongkorn University , Bangkok , Thailand
| | - Karoon Chanachai
- d Department of Livestock Development , Ministry of Agriculture , Bangkok , Thailand
| | - Ratana Somrongthong
- e College of Public Health Sciences , Chulalongkorn University , Bangkok , Thailand
| | - Bruce H Alexander
- f Division of Environmental Health Sciences, School of Public Health , University of Minnesota , Minneapolis , MN , USA
| | - Jeff B Bender
- g School of Public Health Environmental Health Sciences , University of Minnesota , Minneapolis , MN , USA
| |
Collapse
|
25
|
Delavar A, Freedman DM, Velazquez-Kronen R, Little MP, Kitahara CM, Alexander BH, Linet MS, Cahoon EK. Ultraviolet radiation and incidence of cataracts in a nationwide US cohort. Ophthalmic Epidemiol 2018; 25:403-411. [PMID: 30095320 PMCID: PMC10655928 DOI: 10.1080/09286586.2018.1501077] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 07/11/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE We examine the risk of cataract and cataract surgery with measures of ultraviolet radiation (UVR) exposure and UVR sensitivity in a large, nationwide population of indoor workers. METHODS Participants from the US Radiologic Technologists Study were followed from age at baseline survey (2003-2005) to age at earliest of cataract diagnosis, cataract surgery, or completion of last survey (2012-2013). UVR-related factors included satellite-based ambient UVR linked to lifetime residences, time spent outdoors across various age periods, history of blistering sunburns, prior diagnosis of keratinocyte carcinoma, and iris color. We used Cox proportional hazards models with age as timescale to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for cataract and cataract surgery. RESULTS Participants had a median age of entry of 54.0 years, were 80.0% female, and 95.7% white. Of the 44, 891 eligible participants, 9399 cases of cataract and 3826 cases of cataract surgery were reported. Ambient UVR (quintile 5 vs. 1) was associated with an increased risk of cataract (HR = 1.08; 95% CI: 1.01-1.16) and cataract surgery (HR = 1.16; 95% CI: 1.05-1.29). Lifetime average time spent outdoors was not associated with cataract risk. History of blistering sunburns before and after age 15, but not previous keratinocyte carcinoma diagnosis was associated with both cataract and cataract surgery. CONCLUSION Our results suggest a modest role for residence-based ambient UVR and cataract risk among indoor workers in the United States.
Collapse
Affiliation(s)
- Arash Delavar
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - D. Michal Freedman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Raquel Velazquez-Kronen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Mark P. Little
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Cari M. Kitahara
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Martha S. Linet
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Elizabeth K. Cahoon
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
| |
Collapse
|
26
|
Bernier MO, Doody MM, Van Dyke ME, Villoing D, Alexander BH, Linet MS, Kitahara CM. Work history and radioprotection practices in relation to cancer incidence and mortality in US radiologic technologists performing nuclear medicine procedures. Occup Environ Med 2018; 75:533-561. [PMID: 29720482 PMCID: PMC6051924 DOI: 10.1136/oemed-2017-104559] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Revised: 03/19/2018] [Accepted: 04/03/2018] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Technologists working in nuclear medicine (NM) are exposed to higher radiation doses than most other occupationally exposed populations. The aim of this study was to estimate the risk of cancer in NM technologists in relation to work history, procedures performed and radioprotection practices. METHODS From the US Radiologic Technologists cohort study, 72 755 radiologic technologists who completed a 2003-2005 questionnaire were followed for cancer mortality through 31 December 2012 and for cancer incidence through completion of a questionnaire in 2012-2013. Multivariable-adjusted models were used to estimate HRs for total cancer incidence and mortality by history of ever performing NM procedures and frequency of performing specific diagnostic or therapeutic NM procedures and associated radiation protection measures by decade. RESULTS During follow-up (mean=7.5 years), 960 incident cancers and 425 cancer deaths were reported among the 22 360 technologists who worked with NM procedures. We observed no increased risk of cancer incidence (HR 0.96, 95% CI 0.89 to 1.04) or death (HR 1.05, 95% CI 0.93 to 1.19) among workers who ever performed NM procedures. HRs for cancer incidence but not mortality were higher for technologists who began performing therapeutic procedures in 1960 and later compared with the 1950s. Frequency of performing diagnostic or therapeutic NM procedures and use of radioprotection measures were not consistently associated with cancer risk. No clear associations were observed for specific cancers, but results were based on small numbers. CONCLUSION Cancer incidence and mortality were not associated with NM work history practices, including greater frequency of procedures performed.
Collapse
Affiliation(s)
- Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
- Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | | | - Daphnee Villoing
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology & Genetics, National Cancer Institute, Rockville, MD, USA
| |
Collapse
|
27
|
Little MP, Kitahara CM, Cahoon EK, Bernier MO, Velazquez-Kronen R, Doody MM, Borrego D, Miller JS, Alexander BH, Simon SL, Preston DL, Meyer C, Linet MS, Hamada N. Occupational radiation exposure and glaucoma and macular degeneration in the US radiologic technologists. Sci Rep 2018; 8:10481. [PMID: 29992993 PMCID: PMC6041262 DOI: 10.1038/s41598-018-28620-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/21/2018] [Indexed: 12/02/2022] Open
Abstract
There are well-documented associations of glaucoma with high-dose radiation exposure, but only a single study suggesting risk of glaucoma, and less conclusively macular degeneration, associated with moderate-dose exposure. We assessed risk of glaucoma and macular degeneration associated with occupational eye-lens radiation dose, using participants from the US Radiologic Technologists Study, followed from the date of surveys in 1994-1998, 2003-2005 to the earliest of diagnosis of glaucoma or macular degeneration, cancer other than non-melanoma skin cancer, or date of last survey (2012-2014). We excluded those with baseline disease or previous radiotherapy history. Cox proportional hazards models with age as timescale were used. There were 1631 cases of newly self-reported doctor-diagnosed cases of glaucoma and 1331 of macular degeneration among 69,568 and 69,969 eligible subjects, respectively. Estimated mean cumulative eye-lens absorbed dose from occupational radiation exposures was 0.058 Gy. The excess relative risk/Gy for glaucoma was -0.57 (95% CI -1.46, 0.60, p = 0.304) and for macular degeneration was 0.32 (95% CI -0.32, 1.27, p = 0.381), suggesting that there is no appreciable risk for either endpoint associated with low-dose and low dose-rate radiation exposure. Since this is the first examination of glaucoma and macular degeneration associated with low-dose radiation exposure, this result needs to be replicated in other low-dose studies.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA.
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
- Laboratory of Epidemiology, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay aux Roses, France
| | - Raquel Velazquez-Kronen
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - Michele M Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - David Borrego
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - Jeremy S Miller
- Information Management Services, Silver Spring, Maryland, 20904, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, 55409, USA
| | - Steven L Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | | | - Craig Meyer
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, 55409, USA
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, 20892-9778, USA
| | - Nobuyuki Hamada
- Radiation Safety Research Center, Nuclear Technology Research Laboratory, Central Research Institute of Electric Power Industry (CRIEPI), 2-11-1 Iwado-kita, Komae, Tokyo, 201-8511, Japan
| |
Collapse
|
28
|
Little MP, Lim H, Friesen MC, Preston DL, Doody MM, Sigurdson AJ, Neta G, Alexander BH, Chang LA, Cahoon EK, Simon SL, Linet MS, Kitahara CM. Assessment of thyroid cancer risk associated with radiation dose from personal diagnostic examinations in a cohort study of US radiologic technologists, followed 1983-2014. BMJ Open 2018; 8:e021536. [PMID: 29764888 PMCID: PMC5961563 DOI: 10.1136/bmjopen-2018-021536] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To assess whether personal medical diagnostic procedures over life, but particularly those associated with exposure in adulthood, were associated with increased thyroid cancer risk. DESIGN Participants from the US Radiologic Technologists Study, a large, prospective cohort, were followed from the date of first mailed questionnaire survey completed during 1983-1989 to the earliest date of self-reported diagnosis of thyroid cancer or of any other cancer than non-melanoma skin cancer (NMSC) in any of three subsequent questionnaires up to the last in 2012-2014. SETTING US nationwide, occupational cohort. PARTICIPANTS US radiologic technologists with exclusion of: those who reported a previous cancer apart from NMSC on the first questionnaire; those who reported a cancer with an unknown date of diagnosis on any of the questionnaires; and those who did not respond to both the first questionnaire and at least one subsequent questionnaire. PRIMARY OUTCOME MEASURE We used Cox proportional hazards models with age as timescale to compute HRs and 95% CI for thyroid cancer in relation to cumulative 5-year lagged diagnostic thyroid dose. RESULTS There were 414 self-reported thyroid cancers (n=275 papillary) in a cohort of 76 415 persons. Cumulative thyroid dose was non-significantly positively associated with total (excess relative risk/Gy=2.29 (95% CI -0.91 to 7.01, p=0.19)) and papillary thyroid cancer (excess relative risk/Gy=4.15 (95% CI -0.39, 11.27, p=0.08)) risk. These associations were not modified by age at, or time since, exposure and were independent of occupational exposure. CONCLUSION Our study provides weak evidence that thyroid dose from diagnostic radiation procedures over the whole of life, in particular associated with exposure in adulthood, influences adult thyroid cancer risk.
Collapse
Affiliation(s)
- Mark P Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Hyeyeun Lim
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Melissa C Friesen
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | | | - Michele M Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Alice J Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Gila Neta
- Division of Cancer Control and Population Sciences, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Lienard A Chang
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
- Department of Radiation Safety and Imaging Physics, Houston Methodist Hospital, Houston, Texas, USA
| | - Elizabeth K Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Steven L Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Martha S Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| | - Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, Maryland, USA
| |
Collapse
|
29
|
Perlman D, Mandel JH, Odo N, Ryan A, Lambert C, MacLehose RF, Ramachandran G, Alexander BH. Pleural abnormalities and exposure to elongate mineral particles in Minnesota iron ore (taconite) workers. Am J Ind Med 2018. [PMID: 29516526 DOI: 10.1002/ajim.22828] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Iron ore (taconite) mining and processing are an important industry in northern Minnesota and western Michigan. Concerns around exposures have centered largely on exposure to non-asbestiform amphibole elongate mineral particles (EMPs) found in the eastern portion of the Minnesota iron range. METHODS A cross sectional survey was undertaken of current and former taconite workers and spouses along with a detailed exposure assessment. Participants provided an occupational history and had a chest radiograph performed. RESULTS A total of 1188 workers participated. Potential exposures to non-amphibole EMPs were evident across multiple jobs in all active mines. Pleural abnormalities were found in 16.8% of workers. There was an association of pleural abnormalities with cumulative EMP exposure that was not specific to the eastern portion of the range. CONCLUSION There was evidence of a mild to moderate increase in pleural abnormalities in this population of miners, associated with geographically non-specific cumulative EMP exposure.
Collapse
Affiliation(s)
- David Perlman
- Department of Medicine; University of Minnesota School of Medicine; Minneapolis Minnesota
| | - Jeffrey H. Mandel
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| | | | - Andy Ryan
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Christine Lambert
- Department of Medicine; University of Minnesota School of Medicine; Minneapolis Minnesota
| | - Richard F. MacLehose
- Division of Epidemiology and Community Health; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering; Johns Hopkins Bloomberg School of Public Health; Baltimore Maryland
| | - Bruce H. Alexander
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| |
Collapse
|
30
|
Raynor PC, Engelman S, Murphy D, Ramachandran G, Bender JB, Alexander BH. Effects of Gestation Pens Versus Stalls and Wet Versus Dry Feed on Air Contaminants in Swine Production. J Agromedicine 2018; 23:40-51. [DOI: 10.1080/1059924x.2017.1387633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Peter C. Raynor
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Shannon Engelman
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Darby Murphy
- Center for Animal Health and Food Safety, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Gurumurthy Ramachandran
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffrey B. Bender
- Center for Animal Health and Food Safety, College of Veterinary Medicine, University of Minnesota, St. Paul, Minnesota, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
31
|
Peck ME, Chanachai K, Jenpanich C, Amonsin A, Alexander BH, Bender JB. Seroprevalence of brucellosis in goats and sheep in Thailand: Results from the Thai National Brucellosis Surveillance System from 2013 to 2015. Transbound Emerg Dis 2018; 65:799-805. [PMID: 29460417 DOI: 10.1111/tbed.12826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Indexed: 12/17/2022]
Abstract
In Thailand, brucellosis re-emerged in humans in 2003 and is considered a public health risk to goat farmers as the disease is endemic in small ruminants. The Thai Department of Livestock Development (DLD) established a nationwide surveillance system for brucellosis in goats and sheep in 1997. Using data from this surveillance system, we describe the seroprevalence of brucellosis from 2013 to 2015 in small ruminants and the spatial distribution of the disease throughout Thailand. Surveillance data collected included the number of animals and herds tested, the province of the animal and herd and the laboratory results. Seroprevalence was estimated at both the animal and herd levels. During the 3-year period, 443,561 goats and sheep were tested for brucellosis by the DLD throughout Thailand using the Rose Bengal Plate Test (RBPT) and the enzyme-linked immunosorbent assay test for Brucella. Among the 3 years, 2013 had the highest proportion of herds that tested positive for brucellosis at 13.80% (95% CI, 12.52, 15.16). Overall, this study found that brucellosis seroprevalence in small ruminants is decreasing throughout Thailand. However, there is variability in the spread of the disease with provinces in the eastern and western regions of Thailand having higher proportions of animals and herds testing positive. Overall provinces in the south had the lowest proportion of animals and herds testing positive for brucellosis. Periodic review of surveillance data documents the impact of the current brucellosis control programme and supports a targeted response in higher prevalence regions when there are limited financial resources for control measures.
Collapse
Affiliation(s)
- M E Peck
- Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - K Chanachai
- Department of Livestock Development, Ministry of Agriculture, Phaya Thai, Khet Ratchathewi, Krung Thep Maha Nakhon, Bangkok, Thailand
| | - C Jenpanich
- Department of Livestock Development, Ministry of Agriculture, Phaya Thai, Khet Ratchathewi, Krung Thep Maha Nakhon, Bangkok, Thailand
| | - A Amonsin
- Faculty of Veterinary Science, Chulalongkorn University, Pathumwan, Bangkok, Thailand
| | - B H Alexander
- Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - J B Bender
- Environmental Health Sciences, University of Minnesota School of Public Health, Minneapolis, MN, USA
| |
Collapse
|
32
|
Kitahara CM, Preston DL, Neta G, Little MP, Doody MM, Simon SL, Sigurdson AJ, Alexander BH, Linet MS. Occupational radiation exposure and thyroid cancer incidence in a cohort of U.S. radiologic technologists, 1983-2013. Int J Cancer 2018; 143:2145-2149. [PMID: 29355960 DOI: 10.1002/ijc.31270] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 12/01/2017] [Accepted: 01/09/2018] [Indexed: 11/10/2022]
Abstract
Although childhood exposure to ionizing radiation is a well-established risk factor for thyroid cancer, the risk associated with adulthood exposure remains unclear. We prospectively examined the association between cumulative, low-to-moderate dose occupational radiation exposure to the thyroid and thyroid cancer incidence in the U.S. Radiologic Technologists cohort. The study included 89,897 members who completed at least two of four mailed questionnaires and were cancer-free at the time of the first questionnaire. Cumulative occupational thyroid radiation dose (mean = 57 mGy, range = 0-1,600 mGy) was estimated based on self-reported work histories, historical data and, during the years 1960-1997, 783,000 individual film badge measurements. During follow-up, we identified 476 thyroid cancer cases. We used Poisson regression to estimate excess relative risk of thyroid cancer per 100 milliGray (ERR/100 mGy) absorbed dose to the thyroid gland. After adjusting for attained age, sex, birth year, body mass index and pack-years smoked, we found no association between thyroid dose and thyroid cancer risk (ERR/100 mGy = -0.05, 95% CI <-0.10, 0.34). In this large cohort study of radiologic technologists, protracted, low-to-moderate dose ionizing radiation exposure to the thyroid gland in adulthood was not associated with an increased risk of thyroid cancer.
Collapse
Affiliation(s)
- Cari M Kitahara
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | - Gila Neta
- Division of Cancer Control and Population Sciences, Implementation Science, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Mark P Little
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Michele M Doody
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Steven L Simon
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Alice J Sigurdson
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Bruce H Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Martha S Linet
- Division of Cancer Epidemiology and Genetics, Radiation Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD
| |
Collapse
|
33
|
Wei C, Gerberich SG, Ryan AD, Alexander BH, Church TR, Manser M. Risk factors for unintentional occupational injury among urban transit bus drivers: a cohort longitudinal study. Ann Epidemiol 2017; 27:763-770. [DOI: 10.1016/j.annepidem.2017.09.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 09/17/2017] [Accepted: 09/20/2017] [Indexed: 10/18/2022]
|
34
|
Suarez-Lopez JR, Butcher CR, Gahagan S, Checkoway H, Alexander BH, Al-Delaimy WK. Acetylcholinesterase activity and time after a peak pesticide-use period among Ecuadorian children. Int Arch Occup Environ Health 2017; 91:175-184. [PMID: 29026987 DOI: 10.1007/s00420-017-1265-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 10/02/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE Mother's Day (May) is a holiday with substantial demand for flowers, associated with heightened flower production and escalated pesticide use. The effect of spray seasons on pesticide exposures of children living in agricultural communities but who do not work in agriculture is poorly understood. In this study, we estimated the association of time after Mother's Day harvest with children's acetylcholinesterase (AChE) activity. AChE is a physiological marker of organophosphate/carbamate pesticide exposures that may take up to 3 months to normalize after its inhibition. METHODS We examined 308 children, aged 4-9 years, in Ecuadorian agricultural communities during a low flower-production season but within 63-100 days (mean: 81.5 days, SD: 10.9) after Mother's Day harvest. We quantified AChE activity (mean: 3.14 U/mL, SD: 0.49) from a single finger-stick sample. RESULTS We observed positive linear associations between time after the harvest and AChE among participants living near plantations. The associations were strongest among participants living within 233 m [(0.15 U/mL (95% CI 0.02, 0.28)], slightly weaker among participants living within 234-532 m [0.11 U/mL (0.00, 0.23)], and not associated among participants at greater distances. Similar findings were observed across categories of areas of flower plantations within 500 m of homes. CONCLUSIONS These cross-sectional findings suggest that a peak pesticide-use period can decrease AChE activity of children living near plantations. These seasonal pesticide exposures could induce short- and long-term developmental alterations in children. Studies assessing exposures at multiple times in relation to pesticide spray seasons among children who do not work in agriculture are needed.
Collapse
Affiliation(s)
- Jose Ricardo Suarez-Lopez
- Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego. 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA.
- Department of Family and Preventive Medicine, University of California-San Diego, 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA.
| | - Cheyenne R Butcher
- Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego. 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
| | - Sheila Gahagan
- Division of Academic General Pediatrics, Child Development and Community Health, Department of Pediatrics, University of California, 9500 Gilman Drive #0832, La Jolla, CA, 92093-0832, USA
| | - Harvey Checkoway
- Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego. 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, 420 Delaware St. SE, MMC 807, Minneapolis, MN, 55455, USA
| | - Wael K Al-Delaimy
- Division of Global Health, Department of Family Medicine and Public Health, University of California, San Diego. 9500 Gilman Drive #0725, La Jolla, CA, 92093-0725, USA
| |
Collapse
|
35
|
Bernier MO, Journy N, Villoing D, Doody MM, Alexander BH, Linet MS, Kitahara CM. Cataract Risk in a Cohort of U.S. Radiologic Technologists Performing Nuclear Medicine Procedures. Radiology 2017; 286:592-601. [PMID: 29019450 DOI: 10.1148/radiol.2017170683] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To estimate the risk of cataract in a cohort of nuclear medicine (NM) radiologic technologists on the basis of their work histories and radiation protection practices. Materials and Methods In the years 2003-2005 and 2012-2013, 42 545 radiologic technologists from a U.S. prospective study completed questionnaires in which they provided information regarding their work histories and cataract histories. Cox proportional hazards models, stratified according to birth-year cohort (born before 1940 or born in 1940 or later) and adjusted for age, sex, and race, were used to estimate hazard ratios (HRs) for the risk of cataract in radiologic technologists according to NM work history practices according to decade. Results During the follow-up period (mean follow-up, 7½ years), 7137 incident cataracts were reported. A significantly increased risk of cataract (HR, 1.08; 95% confidence interval [CI]: 1.03, 1.14) was observed among workers who performed an NM procedure at least once-as opposed to never. Risks of cataract were increased in the group who had performed a diagnostic (HR, 1.07; 95% CI: 1.01, 1.12) or therapeutic (HR, 1.10; 95% CI: 1.04, 1.17) NM procedure. Risks were higher for those who had first performed diagnostic NM procedures in the 1980s to early 2000s (HR, 1.30; 95% CI: 1.08, 1.58) and those who had performed therapeutic NM procedures in the 1970s (HR, 1.11; 95% CI: 1.01, 1.23) and in the 1980s to early 2000s (HR, 1.14; 95% CI: 1.02, 1.29). With the exception of a significantly increased risk associated with performing therapeutic NM procedures without shielding the radiation source in the 1980s (HR, 1.32; 95% CI: 1.04, 1.67), analyses revealed no association between cataract risk and specific radiation protection technique used. Conclusion An increased risk of cataract was observed among U.S. radiologic technologists who had performed an NM procedure at least once. This association should be examined in future studies incorporating estimated lens doses. © RSNA, 2017.
Collapse
Affiliation(s)
- Marie-Odile Bernier
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Neige Journy
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Daphnee Villoing
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Michele M Doody
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Bruce H Alexander
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Martha S Linet
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| | - Cari M Kitahara
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Dr, Rockville, MD 20850 (M.O.B., N.J., D.V., M.M.D., M.S.L., C.M.K.); Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France (M.O.B.); and Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minn (B.H.A.)
| |
Collapse
|
36
|
Schofield KE, Alexander BH, Gerberich SG, MacLehose RF. Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders. J Safety Res 2017; 62:101-105. [PMID: 28882256 DOI: 10.1016/j.jsr.2017.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2017] [Accepted: 06/20/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Insurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders. METHODS Workers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI). RESULTS Compared no LP contact, one contact was associated with a 27% reduction of risk (HR=0.73, CI=0.65-0.82), two with a 41% (HR=0.59, CI=0.51-0.68), and three or more contacts with a 28% reduction of risk (HR=0.72, CI=0.65-0.81). CONCLUSIONS LP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries. PRACTICAL APPLICATIONS Reduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.
Collapse
Affiliation(s)
- Katherine E Schofield
- University of Minnesota Duluth, Duluth, MN, USA; University of Minnesota, Minneapolis, MN, USA.
| | | | | | | |
Collapse
|
37
|
Abstract
BACKGROUND The prevalence of hyperthyroidism and hypothyroidism is 0.5-4% in iodine-replete communities, but it is 5-10 times higher in women than in men. Those conditions are associated with a broad range of metabolic disorders and cardiovascular diseases. Biological evidence of a role of thyroid hormones in carcinogenesis also exists. However, the association between thyroid dysfunction and cardiovascular disease or cancer mortality risk remains controversial. In a large cohort of women, the associations of hyperthyroidism and hypothyroidism with cause-specific mortality were evaluated after nearly 30 years of follow-up. METHODS The prospective study included 75,076 women aged 20-89 years who were certified as radiologic technologists in the United States in 1926-1982, completed baseline questionnaires in 1983-1998 from which medical history was ascertained, and reported no malignant disease or benign thyroid disease except thyroid dysfunction. A passive follow-up of this cohort was performed through the Social Security Administration database and the National Death Index-Plus. Cause-specific mortality risks were compared according to self-reported thyroid status, with proportional hazards models adjusted for baseline year and age, race/ethnicity, body mass index, family history of breast cancer, and life-style and reproductive factors. RESULTS During a median follow-up of 28 years, 2609 cancer, 1789 cardiovascular or cerebrovascular, and 2442 other non-cancer deaths were recorded. Women with hyperthyroidism had an elevated risk of breast cancer mortality after 60 years of age (hazard ratio [HR] = 2.04 [confidence interval (CI) 1.16-3.60], 13 cases in hyperthyroid women) compared to women without thyroid disease. Hypothyroid women had increased mortality risks for diabetes mellitus (HR = 1.58 [CI 1.03-2.41], 27 cases in hypothyroid women), cardiovascular disease (HR = 1.20 [CI 1.01-1.42], 179 cases), and cerebrovascular disease (HR = 1.45 [CI 1.01-2.08], 35 cases, when restricting the follow-up to ≥10 years after baseline). Other causes of death were not associated with hyperthyroidism or hypothyroidism, though there was a suggestion of an elevated risk of ovarian cancer mortality in hyperthyroid women based on very few cases. CONCLUSION The excess mortality risks observed in a large, prospective 30-year follow-up of patients with thyroid dysfunction require confirmation, and, if replicated, further investigation will be needed because of the clinical implications.
Collapse
Affiliation(s)
- Neige M.Y. Journy
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Marie-Odile Bernier
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
- Laboratoire d'épidémiologie des rayonnements ionisants, Service de Radiobiologie et d'Epidémiologie, Institut de Radioprotection et de Sûreté Nucléaire, Fontenay-aux-Roses, France
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| |
Collapse
|
38
|
Hwang J, Ramachandran G, Raynor PC, Alexander BH, Mandel JH. A comprehensive assessment of exposures to respirable dust and silica in the taconite mining industry. J Occup Environ Hyg 2017; 14:377-388. [PMID: 28388309 DOI: 10.1080/15459624.2016.1263392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This study assessed the present-day levels (year 2010-2011) of exposure to respirable dust (RD) and respirable silica (RS) in taconite mines and evaluated how the mining process influences exposure concentrations. Personal samples (n = 679) were collected to assess exposure levels of workers to RD and RS at six mines in the Mesabi Iron Range of Minnesota. The RD and RS concentrations were measured using the National Institute for Occupational Safety and Health (NIOSH) 0600 and NIOSH 7500, respectively. Between-mine, between-SEG (similar exposure groups), within-SEG, and within-worker components of variability for RD and RS exposures were estimated using a two- or three-way nested random-effects ANOVA model. The majority of RD concentrations across all mines were below the Mine Safety and Health Administration (MSHA) Permissible Exposure Limit (PEL). The highest concentrations of RD were often observed in either the Pelletizing or Crushing departments, which are inherently dusty operations. With a few exceptions, the concentrations of RS in the crushing and concentrating processes were higher than those in the other mining processes, as well as higher than the American Conference of Governmental Industrial Hygienists (ACGIH) Threshold Limit Value (TLV) for RS. The magnetic separation and flotation processes in the concentrating department reduced the levels of RS significantly, and lowered the percentage of quartz in RD in the pelletizing department. There was little variability among the six mines or between the two mineralogically distinct zones for either RD or RS exposures. The between-SEG variability for RS did not differ substantially across most of the mines and was a major component of exposure variance. The within-SEG (or between-worker) variance component was typically the smallest because in many instances one worker from a SEG within a mine was monitored multiple times. Some of these findings were affected by the degree of censoring in each SEG and mine, characteristics of the taconite rock, seasonal effects during sampling, or the tasks assigned to each job in that mine.
Collapse
Affiliation(s)
- Jooyeon Hwang
- a Division of Environmental Health Sciences , School of Public Health, University of Minnesota , Minneapolis , Minnesota
| | - Gurumurthy Ramachandran
- b Department of Environmental Health and Engineering , Bloomberg School of Public Health, Johns Hopkins University , Baltimore , Maryland
| | - Peter C Raynor
- a Division of Environmental Health Sciences , School of Public Health, University of Minnesota , Minneapolis , Minnesota
| | - Bruce H Alexander
- a Division of Environmental Health Sciences , School of Public Health, University of Minnesota , Minneapolis , Minnesota
| | - Jeffrey H Mandel
- a Division of Environmental Health Sciences , School of Public Health, University of Minnesota , Minneapolis , Minnesota
| |
Collapse
|
39
|
Abstract
Only 2% of Minnesota's employed population worked in agriculture between the years 2005 and 2012. However, this small portion of the state's employed population accounted for 31% of total work-related deaths in the state during that same time period. During a similar time period, 2007-2013, the contribution of agriculture to Minnesota's gross domestic product increased from approximately 1.5% to about 2.3%. This article describes the economic impact of injuries related to farm work between the years 2004 and 2010. Using hospital discharge data and the Census of Fatal Occupational Injuries (CFOI), estimates of the number of injuries and fatalities related to agricultural work were compiled. A cost of illness model was applied to these injury and fatality estimates to calculate the related indirect and direct costs in 2010 dollars. Estimated total costs, in 2010 dollars, ranged between $21 and $31 million annually over the 7-year study period. The majority of the costs were attributable to indirect costs, such as lost productivity at work and home. Fatal injuries accrued the largest proportion of the estimated costs followed by hospitalized and nonhospitalized injuries. A sensitivity analysis was performed to evaluate the impact each selected data source had upon the cost estimate. The magnitude of the costs associated with these injuries argues for better surveillance of injury related to agriculture to prioritize resources and evaluate intervention and prevention programs.
Collapse
Affiliation(s)
- Adrienne M K Landsteiner
- a Center for Occupational Health and Safety , Minnesota Department of Health , St. Paul , Minnesota , USA
| | - Patricia M McGovern
- b School of Public Health, University of Minnesota , Minneapolis , Minnesota , USA
| | - John A Nyman
- b School of Public Health, University of Minnesota , Minneapolis , Minnesota , USA
| | - Bruce H Alexander
- b School of Public Health, University of Minnesota , Minneapolis , Minnesota , USA
| | - Paula G Lindgren
- a Center for Occupational Health and Safety , Minnesota Department of Health , St. Paul , Minnesota , USA
| | - Allan N Williams
- a Center for Occupational Health and Safety , Minnesota Department of Health , St. Paul , Minnesota , USA
| |
Collapse
|
40
|
Mandel JH, Alexander BH, Ramachandran G. A review of mortality associated with elongate mineral particle (EMP) exposure in occupational epidemiology studies of gold, talc, and taconite mining. Am J Ind Med 2016; 59:1047-1060. [PMID: 27699808 DOI: 10.1002/ajim.22641] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Mining of gold, taconite, and talc may involve exposure to elongate mineral particles (EMP). The involved EMPs are typically non-asbestiform, include dimensions that regulatory definitions exclude, and have been less studied. METHODS A review of the literature was undertaken for this exposure and occupational epidemiological studies that occur in gold, talc, and taconite mining. RESULTS Quantitative EMP exposure information in these industries is incomplete. However, there are consistent findings of pneumoconiosis in each of these types of mining. A recent case-control study suggests a possible association between this exposure and mesothelioma. Lung cancer is inconsistently reported in these industries and is an unlikely outcome of non-asbestiform EMP exposure. There is evidence of cardiovascular mortality excess across all of these types of mining. CONCLUSIONS Non-malignant respiratory disease and cardiovascular mortality have been consistently increased in these industries. Further investigation, including additional insights for the role of non-asbestiform EMP, is warranted. Am. J. Ind. Med. 59:1047-1060, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Jeffrey H. Mandel
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Bruce H. Alexander
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| | - Gurumurthy Ramachandran
- Division of Environmental Health Sciences; University of Minnesota School of Public Health; Minneapolis Minnesota
| |
Collapse
|
41
|
Van Dyke ME, Drozdovitch V, Doody MM, Lim H, Bolus NE, Simon SL, Alexander BH, Kitahara CM. Historical Patterns in the Types of Procedures Performed and Radiation Safety Practices Used in Nuclear Medicine From 1945-2009. Health Phys 2016; 111:37-46. [PMID: 27218293 PMCID: PMC4880417 DOI: 10.1097/hp.0000000000000519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The authors evaluated historical patterns in the types of procedures performed in diagnostic and therapeutic nuclear medicine and the associated radiation safety practices used from 1945-2009 in a sample of U.S. radiologic technologists. In 2013-2014, 4,406 participants from the U.S. Radiologic Technologists (USRT) Study who previously reported working with medical radionuclides completed a detailed survey inquiring about the performance of 23 diagnostic and therapeutic radionuclide procedures and the use of radiation safety practices when performing radionuclide procedure-related tasks during five time periods: 1945-1964, 1965-1979, 1980-1989, 1990-1999, and 2000-2009. An overall increase in the proportion of technologists who performed specific diagnostic or therapeutic procedures was observed across the five time periods. Between 1945-1964 and 2000-2009, the median frequency of diagnostic procedures performed substantially increased (from 5 wk to 30 wk), attributable mainly to an increasing frequency of cardiac and non-brain PET scans, while the median frequency of therapeutic procedures performed modestly decreased (from 4 mo to 3 mo). Also a notable increase was observed in the use of most radiation safety practices from 1945-1964 to 2000-2009 (e.g., use of lead-shielded vials during diagnostic radiopharmaceutical preparation increased from 56 to 96%), although lead apron use dramatically decreased (e.g., during diagnostic imaging procedures, from 81 to 7%). These data describe historical practices in nuclear medicine and can be used to support studies of health risks for nuclear medicine technologists.
Collapse
Affiliation(s)
- Miriam E. Van Dyke
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Vladimir Drozdovitch
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Hyeyeun Lim
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Norman E. Bolus
- Department of Clinical & Diagnostic Sciences, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| |
Collapse
|
42
|
Rajaraman P, Doody MM, Yu CL, Preston DL, Miller JS, Sigurdson AJ, Freedman DM, Alexander BH, Little MP, Miller DL, Linet MS. Cancer Risks in U.S. Radiologic Technologists Working With Fluoroscopically Guided Interventional Procedures, 1994-2008. AJR Am J Roentgenol 2016; 206:1101-8; quiz 1109. [PMID: 26998721 PMCID: PMC10986158 DOI: 10.2214/ajr.15.15265] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
OBJECTIVE The purpose of this study was to examine risks of cancer incidence and mortality among U.S. radiation technologists performing or assisting with fluoroscopically guided interventional procedures. SUBJECTS AND METHODS A nationwide prospective cohort of 90,957 radiologic technologists, who responded to a 1994-1998 survey that collected information on whether they had ever worked with fluoroscopically guided interventional procedures, was followed through completion of a subsequent cohort survey during 2003-2005 (for cancer incidence) or December 31, 2008 (for cancer mortality). Sex-adjusted hazard ratios (HRs) and 95% CIs were calculated by use of Cox proportional hazards models for incidence and mortality from all cancers other than nonmelanoma skin cancer and for specific cancer outcomes in participants who reported ever performing fluoroscopically guided interventional procedures compared with technologists who never performed these procedures. RESULTS The analysis showed an approximately twofold increased risk of brain cancer mortality (HR, 2.55; 95% CI, 1.48-4.40) and modest elevations in incidence of melanoma (HR, 1.30; 95% CI, 1.05-1.61) and in breast cancer incidence (HR, 1.16; 95% CI, 1.02-1.32) but not mortality (HR, 1.07; 95% CI, 0.69-1.66) among technologists who performed fluoroscopically guided interventional procedures compared with those who never performed these procedures. Although there was a small suggestive increase in incidence of all cancers combined, excluding nonmelanoma skin cancers (HR, 1.08; 95% CI, 1.00-1.17), mortality from all cancers combined, excluding nonmelanoma skin cancers, was not elevated (HR, 1.00; 95% CI, 0.88-1.14). We similarly observed no elevated risk of cancers of the thyroid, skin other than melanoma, prostate, lung, or colon and rectum or of leukemia that was not chronic lymphocytic leukemia among workers who performed fluoroscopically guided interventional procedures. CONCLUSION We observed elevated risks of brain cancer, breast cancer, and melanoma among technologists who performed fluoroscopically guided interventional procedures. Although exposure to low-dose radiation is one possible explanation for these increased risks, these results may also be due to chance or unmeasured confounding by nonradiation risk factors. Our results must be confirmed in other studies, preferably with individual radiation dose data.
Collapse
Affiliation(s)
- Preetha Rajaraman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
- Center for Global Health, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Chu Ling Yu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | | | | | - Alice J. Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - D. Michal Freedman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Mark P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Donald L. Miller
- Office of In Vitro Diagnostics and Radiological Health, Center for Devices and Radiological Health, Food and Drug Administration, Silver Spring, MD, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| |
Collapse
|
43
|
Alexander BH, Bender JB, Kampa D, Keifer MC, Liebman AK, Peterson C, Rasmussen R, Schiller L, Schloesser B, Sheridan C. Growing Agricultural Education: Embracing Health and Safety. J Agromedicine 2016; 21:298-300. [PMID: 27088663 DOI: 10.1080/1059924x.2016.1179240] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Bruce H Alexander
- a School of Public Health , University of Minnesota , Minneapolis , Minnesota , USA
| | - Jeff B Bender
- b College of Veterinary Medicine , University of Minnesota , St. Paul , Minnesota , USA
| | - Diane Kampa
- a School of Public Health , University of Minnesota , Minneapolis , Minnesota , USA
| | - Matthew C Keifer
- c National Farm Medicine Center , Marshfield Clinic Research Foundation , Marshfield , Wisconsin , USA
| | | | - Carol Peterson
- b College of Veterinary Medicine , University of Minnesota , St. Paul , Minnesota , USA
| | - Ruth Rasmussen
- b College of Veterinary Medicine , University of Minnesota , St. Paul , Minnesota , USA
| | - Lisa Schiller
- e College of Nursing and Health Sciences , University of Wisconsin-Eau Claire , Eau Claire , Wisconsin , USA
| | - Brad Schloesser
- f Southern Minnesota Center of Agriculture , South Central College , Mankato , Minnesota , USA
| | | |
Collapse
|
44
|
Mandel JH, Ramachandran G, Alexander BH. Increased Lung Cancer Mortality in Taconite Mining: The Potential for Disease from Elongate Mineral Particle Exposure. Chem Res Toxicol 2016; 29:136-41. [DOI: 10.1021/acs.chemrestox.5b00472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Jeffrey H. Mandel
- University of Minnesota School of Public Health, Division of Environmental
Health Sciences, Minneapolis, Minnesota 55455, United States
| | - Gurumurthy Ramachandran
- University of Minnesota School of Public Health, Division of Environmental
Health Sciences, Minneapolis, Minnesota 55455, United States
| | - Bruce H. Alexander
- University of Minnesota School of Public Health, Division of Environmental
Health Sciences, Minneapolis, Minnesota 55455, United States
| |
Collapse
|
45
|
Lambert CS, Alexander BH, Ramachandran G, MacLehose RF, Nelson HH, Ryan AD, Mandel JH. A case-control study of mesothelioma in Minnesota iron ore (taconite) miners. Occup Environ Med 2015; 73:103-9. [PMID: 26655961 DOI: 10.1136/oemed-2015-103105] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 10/28/2015] [Indexed: 11/03/2022]
Abstract
OBJECTIVES An excess of mesothelioma has been observed in iron ore miners in Northeastern Minnesota. Mining and processing of taconite iron ore generate exposures that include elongate mineral particles (EMPs) of amphibole and non-amphibole origin. We conducted a nested case-control study of mesothelioma in a cohort of 68,737 iron ore miners (haematite and taconite ore miners) to evaluate the association between mesothelioma, employment and EMP exposures from taconite mining. METHODS Mesothelioma cases (N=80) were identified through the Minnesota Cancer Surveillance System (MCSS) and death certificates. Four controls of similar age were selected for each case with 315 controls ultimately eligible for inclusion. Mesothelioma risk was evaluated by estimating rate ratios and 95% CIs with conditional logistic regression in relation to duration of taconite industry employment and cumulative EMP exposure [(EMP/cc)×years], defined by the National Institute for Occupational Safety and Health (NIOSH) 7400 method. Models were adjusted for employment in haematite mining and potential exposure to commercial asbestos products used in the industry. RESULTS All mesothelioma cases were male and 57 of the cases had work experience in the taconite industry. Mesothelioma was associated with the number of years employed in the taconite industry (RR=1.03, 95% CI 1.00 to 1.06) and cumulative EMP exposure (RR=1.10, 95% CI 0.97 to -1.24). No association was observed with employment in haematite mining. CONCLUSIONS These results support an association between mesothelioma and employment duration and possibly EMP exposure in taconite mining and processing. The type of EMP was not determined. The potential role of commercial asbestos cannot be entirely ruled out.
Collapse
Affiliation(s)
- Christine S Lambert
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gurumurthy Ramachandran
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Richard F MacLehose
- Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Heather H Nelson
- Division of Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew D Ryan
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jeffrey H Mandel
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
46
|
Lee T, Sigurdson AJ, Preston DL, Cahoon EK, Freedman DM, Simon SL, Nelson K, Matanoski G, Kitahara CM, Liu JJ, Wang T, Alexander BH, Doody MM, Linet MS, Little MP. Occupational ionising radiation and risk of basal cell carcinoma in US radiologic technologists (1983-2005). Occup Environ Med 2015; 72:862-9. [PMID: 26350677 PMCID: PMC10641595 DOI: 10.1136/oemed-2015-102880] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Accepted: 08/17/2015] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To determine risk for incident basal cell carcinoma from cumulative low-dose ionising radiation in the US radiologic technologist cohort. METHODS We analysed 65,719 Caucasian technologists who were cancer-free at baseline (1983-1989 or 1994-1998) and answered a follow-up questionnaire (2003-2005). Absorbed radiation dose to the skin in mGy for estimated cumulative occupational radiation exposure was reconstructed for each technologist based on badge dose measurements, questionnaire-derived work history and protection practices, and literature information. Radiation-associated risk was assessed using Poisson regression and included adjustment for several demographic, lifestyle, host and sun exposure factors. RESULTS Cumulative mean absorbed skin dose (to head/neck/arms) was 55.8 mGy (range 0-1735 mGy). For lifetime cumulative dose, we did not observe an excess radiation-related risk (excess relative risk/Gy=-0.01 (95% CI -0.43 to 0.52). However, we observed that basal cell carcinoma risk was increased for radiation dose received before age 30 (excess relative risk/Gy=0.59, 95% CI -0.11 to 1.42) and before 1960 (excess relative risk/Gy=2.92, 95% CI 1.39 to 4.45). CONCLUSIONS Basal cell carcinoma risk was unrelated to low-dose radiation exposure among radiologic technologists. Because of uncertainties in dosimetry and sensitivity to model specifications, both our null results and our findings of excess risk for dose received before age 30 and exposure before 1960 should be interpreted with caution.
Collapse
Affiliation(s)
- Terrence Lee
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Alice J. Sigurdson
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | | | - Elizabeth K. Cahoon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - D. Michal Freedman
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Steven L. Simon
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Kenrad Nelson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Genevieve Matanoski
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cari M. Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Jason J. Liu
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Timothy Wang
- Department of Dermatology, Johns Hopkins School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Bruce H. Alexander
- Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Michele M. Doody
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| | - Mark P. Little
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Rockville, MD 20892-9778, MD, USA
| |
Collapse
|
47
|
Cahoon EK, Kitahara CM, Ntowe E, Bowen EM, Doody MM, Alexander BH, Lee T, Little MP, Linet MS, Freedman DM. Female Estrogen-Related Factors and Incidence of Basal Cell Carcinoma in a Nationwide US Cohort. J Clin Oncol 2015; 33:4058-65. [PMID: 26527779 PMCID: PMC4669591 DOI: 10.1200/jco.2015.62.0625] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose UV radiation exposure is the primary risk factor for basal cell carcinoma (BCC), the most common human malignancy. Although the photosensitizing properties of estrogens have been recognized for decades, few studies have examined the relationship between reproductive factors or exogenous estrogen use and BCC. Methods Using data from the US Radiologic Technologists Study, a large, nationwide, prospective cohort, we assessed the relationship between reproductive factors, exogenous estrogen use, and first primary BCC while accounting for sun exposure, personal sun sensitivity, and lifestyle factors for geographically dispersed women exposed to a wide range of ambient UV radiation. Results Elevated risk of BCC was associated with late age at natural menopause (hazard ratio [HR] for ≥ 55 years v 50 to 54 years, 1.50; 95% CI, 1.04 to 2.17) and any use of menopausal hormone therapy (MHT; HR, 1.16; 95% CI, 1.03 to 1.30; P for trend for duration = .001). BCC risk was most increased among women reporting natural menopause who used MHT for 10 or more years versus women who never used MHT (HR, 1.97; 95% CI, 1.35 to 2.87). Risk of BCC was not associated with age at menarche, parity, age at first birth, infertility, use of diethylstilbestrol by participant's mother, age at hysterectomy, or use of oral contraceptives. Conclusion These analyses confirm a previous finding of increased risk of BCC associated with MHT. Novel findings of increased BCC risk associated with MHT in women experiencing natural menopause and for late age at natural menopause warrant further investigation. Users of MHT may constitute an additional high-risk group in need of more frequent skin cancer screening.
Collapse
Affiliation(s)
- Elizabeth K Cahoon
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Cari M Kitahara
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Estelle Ntowe
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Emily M Bowen
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Michele M Doody
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Bruce H Alexander
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Terrence Lee
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Mark P Little
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Martha S Linet
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| | - D Michal Freedman
- Elizabeth K. Cahoon, Cari M. Kitahara, Estelle Ntowe, Emily M. Bowen, Michele M. Doody, Terrence Lee, Mark P. Little, Martha S. Linet, and D. Michal Freedman, National Cancer Institute, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD; and Bruce H. Alexander, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
48
|
Allen EM, Alexander BH, MacLehose RF, Nelson HH, Ramachandran G, Mandel JH. Cancer incidence among Minnesota taconite mining industry workers. Ann Epidemiol 2015; 25:811-5. [PMID: 26381550 PMCID: PMC4576455 DOI: 10.1016/j.annepidem.2015.08.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Revised: 08/10/2015] [Accepted: 08/19/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate cancer incidence among Minnesota taconite mining workers. METHODS We evaluated cancer incidence between 1988 and 2010 in a cohort of 40,720 Minnesota taconite mining workers used between 1937 and 1983. Standardized incidence ratios (SIRs) with 95% confidence intervals (CIs) were estimated by comparing numbers of incident cancers with frequencies in the Minnesota Cancer Surveillance System. SIRs for lung cancer by histologic subtypes were also estimated. We adjusted for out-of-state migration and conducted a probabilistic bias analysis for smoking-related cancers. RESULTS A total of 5700 cancers were identified, including 51 mesotheliomas and 973 lung cancers. The SIRs for lung cancer and mesothelioma were 1.3 (95% CI = 1.2-1.4) and 2.4 (95% CI = 1.8-3.2), respectively. Stomach, laryngeal, and bladder cancers were also elevated. However, adjusting for potential confounding by smoking attenuated the estimates for lung (SIR = 1.1, 95% CI = 1.0-1.3), laryngeal (SIR = 1.2, 95% CI = 0.8-1.6), oral (SIR = 0.9, 95% CI = 0.7-1.2), and bladder cancers (SIR = 1.0, 95% CI = 0.8-1.1). CONCLUSIONS Taconite workers may have an increased risk for certain cancers. Lifestyle and work-related factors may play a role in elevated morbidity. The extent to which mining-related exposures contribute to disease burden is being investigated.
Collapse
Affiliation(s)
- Elizabeth M Allen
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis.
| | - Bruce H Alexander
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis
| | | | | | | | - Jeffrey H Mandel
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis
| |
Collapse
|
49
|
Landsteiner AMK, McGovern PM, Alexander BH, Lindgren PG, Williams AN. Incidence Rates and Trend of Serious Farm-Related Injury in Minnesota, 2000–2011. J Agromedicine 2015; 20:419-26. [DOI: 10.1080/1059924x.2015.1075449] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | | | - Bruce H. Alexander
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Paula G. Lindgren
- Center for Occupational Health and Safety, Minnesota Department of Health, St. Paul, Minnesota, USA
| | - Allan N. Williams
- Center for Occupational Health and Safety, Minnesota Department of Health, St. Paul, Minnesota, USA
| |
Collapse
|
50
|
Rajaraman P, Doody MM, Yu CL, Preston DL, Miller JS, Sigurdson AJ, Freedman DM, Alexander BH, Little MP, Miller DL, Linet MS. Incidence and mortality risks for circulatory diseases in US radiologic technologists who worked with fluoroscopically guided interventional procedures, 1994–2008. Occup Environ Med 2015; 73:21-7. [DOI: 10.1136/oemed-2015-102888] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 08/17/2015] [Indexed: 01/10/2023]
|