1
|
Strieker S, Radon K, Forster F, Örnek ÖK, Wengenroth L, Schmotz W, Sonnemann F, Hoopmann M, Hepp M, Nowak D, Weinmann T, Rakete S. Biomonitoring of lead in blood of children living in a former mining area in Lower Saxony, Germany. Environ Sci Pollut Res Int 2024:10.1007/s11356-024-32719-x. [PMID: 38594562 DOI: 10.1007/s11356-024-32719-x] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/26/2024] [Indexed: 04/11/2024]
Abstract
Environmental exposure to lead substantially decreased over the past decades. However, soil of former mining areas still contains high lead levels. We therefore performed a biomonitoring study among children living in two former mining communities in Lower Saxony, Germany. In these communities, soil contains lead levels of 1000 to 30,000 mg/kg. Overall, 75 children (6-10 years of age) attending the two primary schools of the study area took part in the study. Parents completed a short questionnaire on sociodemographics, and children provided capillary whole blood samples. We analysed lead using inductively coupled plasma tandem mass spectrometer. We compared the results to current German (20 μg/l for boys, 15 μg/l for girls) and US (35 μg/l) reference values. Potential associations between questionnaire information and lead results were tested using lead as continuous outcome and using lead dichotomized at the reference values. Finally, we analysed spatial patterns of elevated biomonitoring results. Of all children, 48% exceeded the German reference values for lead (5% expected) and 8% the US reference value (2.5% expected). Children 6-8 years of age were more likely to exceed German reference values (63%) than 9-10 year old children were (32%; pFisher = 0.01). No other questionnaire information was statistically significantly associated with biomonitoring results. Additionally, we did not find any indication of spatial clustering. In conclusion, we observed elevated blood lead levels in primary school children living in a former mining area. In the next step, exposure pathways need to be identified to implement effective public health measures.
Collapse
Affiliation(s)
- Sonja Strieker
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - Özlem Köseoglu Örnek
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
- Department of Nursing Science, Universität Witten/Herdecke, Witten, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany.
| | - Walter Schmotz
- District of Goslar, Department of Construction & Environment-Soil Protection and Waste Monitoring, Goslar, Germany
| | - Finn Sonnemann
- District of Goslar, Department of Construction & Environment-Soil Protection and Waste Monitoring, Goslar, Germany
| | | | - Martin Hepp
- District of Goslar, Department of Public Health Services, Goslar, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| | - Stefan Rakete
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Ziemssenstr. 1, D-80336, Munich, Germany
| |
Collapse
|
2
|
Weinmann T, Ordenewitz LK, Schlüter JA, Jung J, Kerber K, Finkeldey L, Heinen F, Landgraf MN. Establishing a multidisciplinary specialist centre for fetal alcohol spectrum disorders-Lessons learned from a model project in Germany. Child Care Health Dev 2024; 50:e13143. [PMID: 37317477 DOI: 10.1111/cch.13143] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 05/22/2023] [Accepted: 05/30/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Inadequate coordination between relevant professionals hampers the provision of appropriate care for individuals with fetal alcohol spectrum disorder (FASD). Integrated, multidisciplinary care is thus urgently required. Hence, we aimed at establishing the first university-bound, interdisciplinary specialist centre for FASD in Germany, systematically collecting data on its utilisation and evaluation by attendees. METHODS After our centre started to provide consultation and support services in July 2019 until May 2021, we collected 233 questionnaires on the centre's utilisation (including attendees' sociodemographic characteristics and the topics on which they requested consultation, e.g., general information about FASD, consultation on therapy options, and educational consultation). Ninety-four of 136 individuals who received consultation at our centre submitted an evaluation questionnaire that recorded attendees' satisfaction with the support they had received (e.g., the extent to which the consultation met their needs). RESULTS Of 233 participants who completed the utilisation questionnaire, 81.8% were female, and 56.7% were aged 40 to 60 years. Moreover, 42% were foster parents, while 38% were professionals. Most attendees had questions on FASD in general as well as on a specific child or adolescent with FASD. Almost three quarters of the attendees requested consultation on adequate therapies for FASD patients, while 64% had questions on parenting issues. The overall quality of the consultation was rated very well. DISCUSSION Our service was used by both caregivers and professionals who reported numerous and complex concerns and needs. Professionally sound and multidisciplinary services are viable instruments to meet those needs, bearing the potential for quick and notable relief among individuals affected. We propose further advancement of networking and coordination between care providers, the expansion of multidisciplinary services, and securing early diagnosis and consistency of care as relevant steps to even better support children and adolescents with FASD and their families in the future.
Collapse
Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lisa K Ordenewitz
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Julia A Schlüter
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Jessica Jung
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Katharina Kerber
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Lukas Finkeldey
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
3
|
Mittermeier I, Merlic D, Braschl S, Sealtiel L, Weilnhammer V, Quartucci C, Weinmann T, Adorjan K, Gerstner D, Heinze S, Herr C, Sirrenberg M. Mental health and work-related factors in healthcare workers in a pandemic - meta-analysis. PSYCHOL HEALTH MED 2023; 28:3005-3051. [PMID: 36967568 DOI: 10.1080/13548506.2023.2193750] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/08/2023] [Indexed: 03/28/2023]
Abstract
Due to the SARS-CoV-2 pandemic, healthcare workers worldwide faced major challenges in the form of psychological stress. The aim of this systematic literature review and meta-analysis is to identify mental health consequences and associated work-related factors in healthcare workers during a pandemic and to quantify the influence of associated work-related factors on mental health consequences. A systematic literature search according to PRISMA was conducted on 5 August 2021 using the databases PubMed Central and APA PsychInfo. The included studies investigated the mental health consequences and associated work-related factors in healthcare workers in a pandemic. In addition, we performed a risk of bias analysis to assess the study quality of the included studies using the JBI checklists. Random-effect models and pooled effect estimators were used for the meta-analysis. The Chi2 and I2 statistics were used to identify the statistical heterogeneity. Additional sensitivity analysis was performed. From a total of 3,910 publications, 43 studies met the inclusion criteria. These studies provided 15 stress consequences and 20 stress factors. The most frequently reported stress factors were 'contact with COVID-19 patients', 'no education or training in handling infectious diseases' and 'insufficient protective equipment'. Anxiety, stress, and depression were the most common outcomes identified. Analyses showed an increase in anxiety scores among HCWs who cared for COVID-19 patients, as well as a rise in depressive symptoms due to inadequate or no personal protective equipment. In this review, various pandemic-associated stress factors and stress consequences of healthcare workers were observed. With the results, criteria for effective measures and interventions can be developed to minimize the risk of stress consequences.
Collapse
Affiliation(s)
- Isabella Mittermeier
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Deborah Merlic
- Institute for Medical Information Processing, Biometry and Epidemiology (IBE) at the Ludwig-Maximilians-University, Munich, Germany
| | - Sophie Braschl
- TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Luca Sealtiel
- TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
| | - Veronika Weilnhammer
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Caroline Quartucci
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Munich, Germany
| | - Kristina Adorjan
- Department of Psychiatry and Psychotherapy, University Hospital, Munich, Germany
| | - Doris Gerstner
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
| | - Stefanie Heinze
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Munich, Germany
| | - Caroline Herr
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Munich, Germany
| | - Manuela Sirrenberg
- Institute for Occupational Health and Product Safety Environmental Health, Bavarian Health and Food Safety Authority, Munich, Germany
| |
Collapse
|
4
|
Weinmann T, Finkeldey L, Wittmann E, Kerber K, Schlueter JA, Zillinger I, Maciejok A, Heinen F, Landgraf MN. Prognostic factors for long-term outcome in children with fetal alcohol spectrum disorders. Res Dev Disabil 2023; 136:104481. [PMID: 36924617 DOI: 10.1016/j.ridd.2023.104481] [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] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 02/22/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Known protective factors for long-term outcome in children with fetal alcohol spectrum disorders (FASD) are early diagnosis and a stable, non-violent supportive environment. Which factors contribute to the stability of care is not yet known. Thus, the aim of our study was to evaluate whether the age at diagnosis and the complexity of brain dysfunction play a role for placement changes in children with FASD. MATERIALS AND METHODS An online survey was conducted among caregivers and professionals caring for children with FASD and seeking help at the German FASD Competence Centre Bavaria (N = 232). The survey collected information about diagnosis, brain dysfunctions, behavioural factors influencing everyday life and changes of placement. The association of timing of diagnosis, brain dysfunctions and neurobehavioral impairment with changes of placement (<2 vs. 2 or more changes) was evaluated via logistic regression models. RESULTS About 50% of the children received their diagnosis of FASD after the age of 5 years. The complexity of brain dysfunctions in children with FASD affecting everyday life was high. 15% of the children experienced four or more changes of placement. Children with more neuropsychological impairments experienced more changes of placement (OR: 2.53, 95% CI: 1.36-4.71). CONCLUSIONS Even though our results need to be interpreted with caution due to methodological limitations such as the use of a convenience sample and limited statistical power, they imply that severely affected children with FASD experience a less stable environment. These children may therefore be at high risk for a negative prognosis. To warrant a better prognosis for the affected children, professionals urgently need to pay attention to early recognition and the complexity of neuropsychological impairments in children with FASD as well as to the support that caregivers urgently need.
Collapse
Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Lukas Finkeldey
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Esther Wittmann
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Katharina Kerber
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Julia A Schlueter
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Iris Zillinger
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Anja Maciejok
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany
| | - Mirjam N Landgraf
- Department of Paediatric Neurology and Developmental Medicine, German FASD Competence Centre Bavaria, Dr. von Hauner Children's Hospital, LMU Hospital Munich, Ludwig-Maximilians-Universität, Lindwurmstr. 5, 80337 Munich, Germany.
| |
Collapse
|
5
|
Weinmann T, Forster F, Hell K, Gerlich J, Wengenroth L, Schlotz W, Vogelberg C, von Mutius E, Nowak D, Radon K. Work-related stress and atopic dermatitis: Results from the study on occupational allergy risks. J Occup Environ Hyg 2023; 20:109-119. [PMID: 36441057 DOI: 10.1080/15459624.2022.2151604] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Chronic stress at work is ubiquitous in modern societies. However, its influence on atopic dermatitis (AD) has hardly been investigated. This study aimed to elucidate the association between work-related stress and AD via a longitudinal study. The analysis comprised data from three phases (2002-2003, 2007-2009, 2017-2018) of the prospective Study on Occupational Allergy Risks (SOLAR), including 1,240 young adults aged 16 to 18 years at baseline (61% female) who were originally recruited for the International Study of Asthma and Allergies in Childhood Phase II in 1995-1996. AD was assessed at all three phases based on self-reports of a physician's diagnosis and symptoms. Work-related stress was measured at all three periods using the work discontent and work overload scales from the Trier Inventory for the Assessment of Chronic Stress with adaptions to school and university. Generalized estimating equations were used to analyze the association between stress and AD, treating work discontent and work overload first as continuous and then as categorical exposure variables. We observed 50 AD cases (4%) at SOLAR I, 48 (4%) at SOLAR II, and 42 (3%) at SOLAR III. A one-point increase in the work discontent score was associated with an odds ratio (OR) for AD of 1.05 (95% confidence interval [CI], 1.00-1.10). The respective increase in the work overload score led to an OR of 1.03 (95% CI, 0.99-1.06). In the categorical analysis, there was no clear indication of elevated odds of AD in the highest vs. lowest exposure group (4th vs. 1st quartile: OR, 1.53; 95% CI, 0.92-2.53 for work discontent; OR, 1.38, 95% CI, 0.83-2.27 for work overload). Altogether, we observed limited to no evidence for an association between work-related stress and AD. Our study's ability to detect stronger evidence may have been compromised by shortcomings such as nondifferential misclassification of the outcome or insufficient statistical precision due to small numbers of AD cases. Another explanation could be that AD predominantly becomes evident in childhood, not in adulthood.
Collapse
Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Katharina Hell
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, LMU Munich, Munich, Germany
- Pettenkofer School of Public Health, Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Wolff Schlotz
- Max Planck Institute of Empirical Aesthetics, Frankfurt am Main, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - Erika von Mutius
- Dr. v. Haunersches Kinderspital, University Hospital, LMU Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| |
Collapse
|
6
|
Koseoglu Ornek O, Waibel J, Wullinger P, Weinmann T. Precarious employment and migrant workers' mental health: a systematic review of quantitative and qualitative studies. Scand J Work Environ Health 2022; 48:327-350. [PMID: 35262741 PMCID: PMC9527784 DOI: 10.5271/sjweh.4019] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 11/16/2022] Open
Abstract
Objectives Evidence suggests that precarious employment can have detrimental effects on workers’ health, including mental health. Migrant workers are discussed to be especially vulnerable to such effects. Thus, we systematically reviewed existing research on the association between precarious employment and migrant workers’ mental health. Methods Three electronic databases (Web of Science, PsycINFO and PubMed/Medline) were searched for original articles on quantitative and qualitative studies published from January 1970 to February 2022 in English, German, Turkish and Spanish. Multiple dimensions of precarious employment were considered as exposure, with mental health problems as outcomes. Narrative synthesis and thematic analyses were performed to summarize the findings of the included studies along with risk of bias and quality assessment. Results The literature search resulted in 1557 original articles, 66 of which met the inclusion criteria – 43 were of high quality and 22 were of moderate quality. The most common exposure dimensions analyzed in the studies included temporariness, vulnerability, poor interpersonal relationships, disempowerment, lacking workers’ rights and low income. The outcome measures included stress, depression, anxiety and poor general mental health. The prevalence of these outcomes varied between 10–75% among the included quantitative studies. All qualitative studies reported one or more dimensions of precarious employment as an underlying factor of the development of mental health problems among migrants. Of 33 quantitative studies, 23 reported evidence for an association between dimensions of precarious employment and mental health. Conclusion The results of this review support the hypothesis that precarious employment is associated with migrant workers’ mental health.
Collapse
Affiliation(s)
- Ozlem Koseoglu Ornek
- Ozlem Koseoglu Ornek, Occupational and Environmental Epidemiology & Net Teaching Unit; Institute and Clinic for Occupational, Social and Environmental Medicine; University Hospital, LMU Munich, Munich, Germany.
| | | | | | | |
Collapse
|
7
|
Strieker S, Weinmann T, Gerlich J, von Mutius E, Nowak D, Radon K, Wengenroth L. Farm living and allergic rhinitis from childhood to young adulthood - prospective results of the GABRIEL study. J Allergy Clin Immunol 2022; 150:1209-1215.e2. [PMID: 35779667 DOI: 10.1016/j.jaci.2022.05.027] [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: 01/11/2022] [Revised: 04/19/2022] [Accepted: 05/17/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Growing up on a farm is associated with a reduced prevalence of respiratory allergies in childhood. It is unknown whether this protective effect remains into adulthood. OBJECTIVES We aimed to prospectively investigate the relationship between farm exposure and prevalence of allergic rhinitis and wheeze from childhood to early adulthood. METHODS Participants from phase 2 of the GABRIEL (Multidisciplinary Study to Identify the Genetic and Environmental Causes of Asthma in the European Community) study living in southern Germany (aged 6-11 years at baseline; 20-25 at follow-up) were invited to complete a questionnaire on sociodemographic data, farm contact, respiratory symptoms, and potential confounders. Odds ratios (OR) with 95% confidence intervals (95% CI) were modelled using generalized estimating equations (GEE). RESULTS Of the 2,276 phase 2 participants, 1,501 (66%) answered the follow-up questionnaire of which 1,333 could be included in the analyses. Living on a farm was associated with reduced prevalence of allergic rhinitis (persistent farm living OR 0.4; 95% CI 0.2-0.6; only baseline farm living 0.4; 0.2-0.8). The odds ratio for developing symptoms from baseline to follow-up was almost three (OR 2.7; 95% CI 2.1-3.3), irrespective of farm living. For symptoms of wheeze, no statistically significant association with farm living was observed. CONCLUSIONS The protective effect of farm living on allergic rhinitis persists from childhood to early adulthood. Continuing exposure over puberty does not add to the effect. This confirms that the window of opportunity for a protective effect might be found in childhood.
Collapse
Affiliation(s)
- Sonja Strieker
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Munich Centre of Health Sciences (MC-Health), Munich, Germany
| | - Erika von Mutius
- Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Dr. v. Haunersches Kinderspital, University Hospital, LMU Munich, Munich, Germany; Institute of Asthma and Allergy Prevention (IAP), Helmholtz Zentrum München, Deutsches Forschungszentrum für Gesundheit und Umwelt (GmbH)
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Munich Centre of Health Sciences (MC-Health), Munich, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital. LMU Munich, Munich, Germany; Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), Munich, Germany; Munich Centre of Health Sciences (MC-Health), Munich, Germany.
| |
Collapse
|
8
|
Forster F, Ege MJ, Gerlich J, Weinmann T, Kreißl S, Weinmayr G, Genuneit J, Nowak D, von Mutius E, Vogelberg C, Radon K. Trajectories of asthma and allergy symptoms from childhood to adulthood. Allergy 2022; 77:1192-1203. [PMID: 34473346 DOI: 10.1111/all.15075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 01/05/2023]
Abstract
BACKGROUND Phenotypes of asthma and allergic diseases are mainly studied separately for children and adults. To explore the role of adolescence and young adulthood, we investigated symptom trajectories at the transition from childhood into adulthood. METHODS Latent class analysis (LCA) was conducted in a population initially recruited for the German arm of Phase II of the International Study of Asthma and Allergies in Childhood and followed-up three times until their early 30s (N=2267). Indicators included in LCA were 12-month prevalences of symptoms of wheeze, rhinoconjunctivitis, and eczema. Latent classes were further characterised regarding important traits such as skin prick tests. Logistic regression models were used to investigate associations with environmental determinants such as smoking and occupational exposures. RESULTS Six latent classes were identified: an asymptomatic one as well as three with single and two with co-occurring symptoms. All trajectories essentially established between baseline assessment at around 10 years and the first follow-up at around 17 years. Probabilities for symptoms increased from childhood to adolescence, especially for wheeze-related latent classes, while they remained constant in adulthood. Wheeze-related latent classes were also positively associated with exposures during adolescence (e.g. active smoking). CONCLUSION Distinct trajectories of asthma and allergy symptoms establish from childhood through adolescence and stabilize during early adulthood. This pattern was most notable in wheeze-related latent classes which also showed the strongest positive associations with environmental exposures in adolescence/young adulthood. Therefore, not only childhood but also adolescence is relevant for disease development and offers considerable potential for prevention and health promotion.
Collapse
Affiliation(s)
- Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
| | - Markus Johannes Ege
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
- Dr. v. Hauner Children’s Hospital University Hospital, LMU Munich Munich Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
| | - Sylvia Kreißl
- Paediatric Department University Hospital Carl Gustav Carus Dresden, TU Dresden Dresden Germany
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry University of Ulm Ulm Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry University of Ulm Ulm Germany
- Pediatric Epidemiology, Department of Pediatrics, Medical Faculty Leipzig University Leipzig Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
| | - Erika von Mutius
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
- Dr. v. Hauner Children’s Hospital University Hospital, LMU Munich Munich Germany
| | - Christian Vogelberg
- Paediatric Department University Hospital Carl Gustav Carus Dresden, TU Dresden Dresden Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine University Hospital, LMU Munich Munich Germany
- Comprehensive Pneumology Center (CPC) Munich, member German Center for Lung Research (DZL) Munich Germany
| |
Collapse
|
9
|
Castaño-Vinyals G, Sadetzki S, Vermeulen R, Momoli F, Kundi M, Merletti F, Maslanyj M, Calderon C, Wiart J, Lee AK, Taki M, Sim M, Armstrong B, Benke G, Schattner R, Hutter HP, Krewski D, Mohipp C, Ritvo P, Spinelli J, Lacour B, Remen T, Radon K, Weinmann T, Petridou ET, Moschovi M, Pourtsidis A, Oikonomou K, Kanavidis P, Bouka E, Dikshit R, Nagrani R, Chetrit A, Bruchim R, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Kojimahara N, Yamaguchi N, Ha M, Choi K, Kromhout H, Goedhart G, 't Mannetje A, Eng A, Langer CE, Alguacil J, Aragonés N, Morales-Suárez-Varela M, Badia F, Albert A, Carretero G, Cardis E. Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study. Environ Int 2022; 160:107069. [PMID: 34974237 DOI: 10.1016/j.envint.2021.107069] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [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: 06/02/2021] [Revised: 12/22/2021] [Accepted: 12/24/2021] [Indexed: 06/14/2023]
Abstract
In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.
Collapse
Affiliation(s)
- G Castaño-Vinyals
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - S Sadetzki
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Ministry of Health, Jerusalem, Israel
| | - R Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - F Momoli
- School of Epidemiology and Public Health, University of Ottawa, Canada; Risk Science International, Ottawa, Canada
| | - M Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - F Merletti
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | | | | | - J Wiart
- Laboratoire de Traitement et Communication de l'Information (LTCI), Telecom Paris, Institut Polytechnique de Paris, 91120 Palaiseau, France
| | - A-K Lee
- Radio Technology Research Department, Electronics and Telecommunications Research Institute (ETRI), Yuseong-gu, Daejeon, Korea
| | - M Taki
- Department of Electrical & Electronic Engineering, Graduate Schools of Science and Engineering, Tokyo Metropolitan University, Tokyo, Japan
| | - M Sim
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - B Armstrong
- School of Population and Global Health, The University of Western Australia, Perth 6009, Australia
| | - G Benke
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - R Schattner
- School of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - H-P Hutter
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Austria
| | - D Krewski
- Risk Science International, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada; McLaughlin Centre for Population Health Risk Assessment, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - C Mohipp
- University of Ottawa, Ottawa, Canada
| | - P Ritvo
- York University, Toronto, Ontario, Canada
| | - J Spinelli
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - B Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France; Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - T Remen
- Inserm UMR 1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - K Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - T Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - E Th Petridou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece; Dept of Hygiene and Epidemiology, Medical School, National and Kapodistrian University of Athens, Greece
| | - M Moschovi
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - A Pourtsidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - K Oikonomou
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - P Kanavidis
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - E Bouka
- Hellenic Society for Social Pediatrics & Health Promotion, Greece
| | - R Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India
| | - R Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre, Kharghar, Navi Mumbai 410210, India; Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstrasse 30, 28359 Bremen, Germany
| | - A Chetrit
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - R Bruchim
- Cancer & Radiation Epidemiology Unit, Gertner Institute for Epidemiology & Health Policy Research, Sheba Medical Center, Tel-Hashomer, Israel
| | - M Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - E Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and CPO-Piemonte, Turin, Italy
| | - G Filippini
- Scientific Director's Office, Carlo Besta Foundation and Neurological Institute, Milan, Italy
| | - L Miligi
- Environmental and Occupational Epidemiology Branch, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - S Mattioli
- Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Italy
| | - N Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Graduate School of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - N Yamaguchi
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan; Saiseikai Research Institute of Care and Welfare, Tokyo, Japan
| | - M Ha
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - K Choi
- Department of Preventive Medicine, Dankook University College of Medicine, 119 Dandae-ro, Cheonan, Chungnam, South Korea
| | - H Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - G Goedhart
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, the Netherlands
| | - A 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - A Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - C E Langer
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - J Alguacil
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - N Aragonés
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, 28035 Madrid, Spain
| | - M Morales-Suárez-Varela
- CIBER Epidemiologia y Salud Pública, Madrid, Spain; Unit of Public Health and Environmental Care, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, Valencia, Spain
| | - F Badia
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Cartogràfic i Geològic de Catalunya, Barcelona, Spain
| | - A Albert
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain
| | - G Carretero
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain; Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain
| | - E Cardis
- Barcelona Institute of Global Health (ISGlobal), 88 Doctor Aiguader, E-08003 Barcelona, Spain; University Pompeu Fabra, Barcelona, Spain; CIBER Epidemiologia y Salud Pública, Madrid, Spain.
| |
Collapse
|
10
|
Rodríguez-Molina D, Berglund F, Blaak H, Flach CF, Kemper M, Marutescu L, Gradisteanu GP, Popa M, Spießberger B, Weinmann T, Wengenroth L, Chifiriuc MC, Larsson DGJ, Nowak D, Radon K, de Roda Husman AM, Wieser A, Schmitt H. Carriage of ESBL-producing Enterobacterales in wastewater treatment plant workers and surrounding residents - the AWARE Study. Eur J Clin Microbiol Infect Dis 2021:10.1007/s10096-021-04387-z. [PMID: 34902088 PMCID: PMC8667530 DOI: 10.1007/s10096-021-04387-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022]
Abstract
To investigate whether wastewater treatment plant (WWTP) workers and residents living in close proximity to a WWTP have elevated carriage rates of ESBL-producing Enterobacterales, as compared to the general population. From 2018 to 2020, we carried out a cross-sectional study in Germany, the Netherlands, and Romania among WWTP workers (N = 344), nearby residents (living ≤ 300 m away from WWTPs; N = 431) and distant residents (living ≥ 1000 m away = reference group; N = 1165). We collected information on potential confounders via questionnaire. Culture of participants' stool samples was performed with ChromID®-ESBL agar plates and species identification with MALDI-TOF-MS. We used logistic regression to estimate the odds ratio (OR) for carrying ESBL-producing E. coli (ESBL-EC). Sensitivity analyses included stratification by country and interaction models using country as secondary exposure. Prevalence of ESBL-EC was 11% (workers), 29% (nearby residents), and 7% (distant residents), and higher in Romania (28%) than in Germany (7%) and the Netherlands (6%). Models stratified by country showed that within the Romanian population, WWTP workers are about twice as likely (aOR = 2.34, 95% CI: 1.22-4.50) and nearby residents about three times as likely (aOR = 3.17, 95% CI: 1.80-5.59) to be ESBL-EC carriers, when compared with distant residents. In stratified analyses by country, we found an increased risk for carriage of ESBL-EC in Romanian workers and nearby residents. This effect was higher for nearby residents than for workers, which suggests that, for nearby residents, factors other than the local WWTP could contribute to the increased carriage.
Collapse
Affiliation(s)
- Daloha Rodríguez-Molina
- Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany.
- Institute for Medical Information Processing, Biometry, and Epidemiology - IBE, LMU Munich, Munich, Germany.
- Pettenkofer School of Public Health, Munich, Germany.
| | - Fanny Berglund
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Hetty Blaak
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Carl-Fredrik Flach
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Merel Kemper
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Luminita Marutescu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Gratiela Pircalabioru Gradisteanu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Marcela Popa
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Beate Spießberger
- German Centre for Infection Research (DZIF) Partner Site Munich, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Munich, Germany
- Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
| | - Tobias Weinmann
- Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany
| | - Laura Wengenroth
- Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany
| | - Mariana Carmen Chifiriuc
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - D G Joakim Larsson
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Dennis Nowak
- Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany
- German Center for Lung Research (DZL), Comprehensive Pneumology Center Munich (CPC-M), Munich, Germany
| | - Katja Radon
- Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 5, 80336, Munich, Germany
| | - Ana Maria de Roda Husman
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Andreas Wieser
- German Centre for Infection Research (DZIF) Partner Site Munich, Munich, Germany
- Max Von Pettenkofer Institute, Faculty of Medicine, LMU Munich, Munich, Germany
- Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, Munich, Germany
| | - Heike Schmitt
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| |
Collapse
|
11
|
Ordenewitz LK, Weinmann T, Schlüter JA, Moder JE, Jung J, Kerber K, Greif-Kohistani N, Heinen F, Landgraf MN. Evidence-based interventions for children and adolescents with fetal alcohol spectrum disorders - A systematic review. Eur J Paediatr Neurol 2021; 33:50-60. [PMID: 34058625 DOI: 10.1016/j.ejpn.2021.02.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/02/2021] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Brain function deficits cause strong negative impacts for the everyday lives of children and adolescents with fetal alcohol spectrum disorders (FASD). Therefore, evidence-based intervention programs that are specifically designed for patients with FASD are needed but still scarce. The aim of the presented article is a systematic literature review of evidence-based intervention strategies for children and adolescents with FASD. MATERIALS AND METHODS A comprehensive systematic literature search was conducted in several relevant databases to identify randomized-controlled intervention studies for children and adolescents with FASD. RESULTS We identified 25 randomized-controlled studies regarding interventions in FASD. Overall, evidence indicating that some therapeutic interventions are effective in children and adolescents with FASD was found. Even though evidence-based interventions rarely lead to improvements of performance into a "normal range", those measures can alleviate negative consequences of prenatal alcohol exposure and relieve daily burdens. CONCLUSION There are only a few randomized-controlled trials regarding therapy research for children and adolescents with FASD. Their results indicate that especially the combination of parent and child sessions present a promising approach for the treatment of FASD. Positive treatment effects of interventions seem to be domain specific, except for interventions regarding self-regulation or social interaction.
Collapse
Affiliation(s)
- Lisa K Ordenewitz
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Julia A Schlüter
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Judith E Moder
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Jessica Jung
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Katharina Kerber
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Naschla Greif-Kohistani
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and Developmental Medicine, LMU Center for Development and Children with Medical Complexity, German FASD Competence Center Bavaria, Dr. von Hauner Children's Hospital, LMU University Hospital Munich, Ludwig-Maximilians-University, Munich, Germany.
| |
Collapse
|
12
|
Moder JE, Ordenewitz LK, Schlüter JA, Weinmann T, Altebäumer P, Jung J, Heinen F, Landgraf MN. [Fetal alcohol spectrum disorders-diagnosis, prognosis, and prevention]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2021; 64:747-754. [PMID: 33942146 PMCID: PMC8187172 DOI: 10.1007/s00103-021-03329-6] [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: 10/02/2020] [Accepted: 03/19/2021] [Indexed: 11/23/2022]
Abstract
Die Fetale Alkoholspektrumstörung ist eine der häufigsten bei Geburt bestehenden chronischen Erkrankungen, die zum Großteil nicht oder fehldiagnostiziert wird. Dies führt zu inadäquater, ineffektiver Förderung und Therapie der erkrankten Kinder sowie mangelnder Unterstützung der betroffenen Familien. Daraus resultiert nicht nur ein hohes Maß an Sekundärerkrankungen, sondern auch eine Einbuße in der Möglichkeit der Sekundär- und Tertiärprävention bei erkrankten Kindern und betroffenen Familien. Sekundär und Tertiärprävention sind jedoch bei richtiger und rechtzeitiger Diagnose möglich. Die Primärprävention im Bereich Alkoholkonsum in der Schwangerschaft und Fetale Alkoholspektrumstörung muss auch in Zukunft sowohl von medizinischer als auch politischer Seite strukturiert, interdisziplinär und wissenschaftlich basiert geplant und durchgeführt werden. Neben der Aufklärung der Allgemeinbevölkerung ist hierbei die Wissensvermittlung an ÄrztInnen und andere medizinisch-psychologisch-pädagogische Fachkräfte besonders relevant.
Collapse
Affiliation(s)
- Judith E Moder
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland
| | - Lisa K Ordenewitz
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Julia A Schlüter
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Tobias Weinmann
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Institut und Poliklinik für Arbeits‑, Sozial- und Umweltmedizin, LMU Klinikum München, München, Deutschland
| | - Philine Altebäumer
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland
| | - Jessica Jung
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Florian Heinen
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland.,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland
| | - Mirjam N Landgraf
- Deutsches FASD KOMPETENZZENTRUM Bayern, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, Lindwurmstraße 4, 80337, München, Deutschland. .,Abteilung Neuropädiatrie, Entwicklungsneurologie und Sozialpädiatrie, LMU Zentrum für Entwicklung und komplex chronisch kranke Kinder - iSPZ Hauner, Dr. von Haunersches Kinderspital, LMU Klinikum München, München, Deutschland.
| |
Collapse
|
13
|
Wengenroth L, Berglund F, Blaak H, Chifiriuc MC, Flach CF, Pircalabioru GG, Larsson DGJ, Marutescu L, van Passel MWJ, Popa M, Radon K, de Roda Husman AM, Rodríguez-Molina D, Weinmann T, Wieser A, Schmitt H. Antibiotic Resistance in Wastewater Treatment Plants and Transmission Risks for Employees and Residents: The Concept of the AWARE Study. Antibiotics (Basel) 2021; 10:antibiotics10050478. [PMID: 33919179 PMCID: PMC8143112 DOI: 10.3390/antibiotics10050478] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 11/18/2022] Open
Abstract
Antibiotic resistance has become a serious global health threat. Wastewater treatment plants may become unintentional collection points for bacteria resistant to antimicrobials. Little is known about the transmission of antibiotic resistance from wastewater treatment plants to humans, most importantly to wastewater treatment plant workers and residents living in the vicinity. We aim to deliver precise information about the methods used in the AWARE (Antibiotic Resistance in Wastewater: Transmission Risks for Employees and Residents around Wastewater Treatment Plants) study. Within the AWARE study, we gathered data on the prevalence of two antibiotic resistance phenotypes, ESBL-producing E. coli and carbapenemase-producing Enterobacteriaceae, as well as on their corresponding antibiotic resistance genes isolated from air, water, and sewage samples taken from inside and outside of different wastewater treatment plants in Germany, the Netherlands, and Romania. Additionally, we analysed stool samples of wastewater treatment plant workers, nearby residents, and members of a comparison group living ≥1000 m away from the closest WWTP. To our knowledge, this is the first study investigating the potential spread of ESBL-producing E. coli, carbapenemase-producing Enterobacteriaceae, and antibiotic resistance genes from WWTPs to workers, the environment, and nearby residents. Quantifying the contribution of different wastewater treatment processes to the removal efficiency of ESBL-producing E. coli, carbapenemase-producing Enterobacteriaceae, and antibiotic resistance genes will provide us with evidence-based support for possible mitigation strategies.
Collapse
Affiliation(s)
- Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, 80336 Munich, Germany; (K.R.); (D.R.-M.); (T.W.)
- Correspondence:
| | - Fanny Berglund
- Centre for Antibiotic Resistance Research at University of Gothenburg, Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, 405 30 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
| | - Hetty Blaak
- Centre Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands; (H.B.); (M.W.J.v.P.); (A.M.d.R.H.); (H.S.)
| | - Mariana Carmen Chifiriuc
- Earth, Environment and Life Sciences Division, Research Institute, University of Bucharest, 050657 Bucharest, Romania; (M.C.C.); (G.G.P.); (L.M.); (M.P.)
| | - Carl-Fredrik Flach
- Centre for Antibiotic Resistance Research at University of Gothenburg, Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, 405 30 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
| | - Gratiela Gradisteanu Pircalabioru
- Earth, Environment and Life Sciences Division, Research Institute, University of Bucharest, 050657 Bucharest, Romania; (M.C.C.); (G.G.P.); (L.M.); (M.P.)
| | - D. G. Joakim Larsson
- Centre for Antibiotic Resistance Research at University of Gothenburg, Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, 405 30 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
| | - Luminita Marutescu
- Earth, Environment and Life Sciences Division, Research Institute, University of Bucharest, 050657 Bucharest, Romania; (M.C.C.); (G.G.P.); (L.M.); (M.P.)
| | - Mark W. J. van Passel
- Centre Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands; (H.B.); (M.W.J.v.P.); (A.M.d.R.H.); (H.S.)
- Directorate of International Affairs, Ministry of Health, Welfare and Sport, 2500 EJ The Hague, The Netherlands
| | - Marcela Popa
- Earth, Environment and Life Sciences Division, Research Institute, University of Bucharest, 050657 Bucharest, Romania; (M.C.C.); (G.G.P.); (L.M.); (M.P.)
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, 80336 Munich, Germany; (K.R.); (D.R.-M.); (T.W.)
| | - Ana Maria de Roda Husman
- Centre Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands; (H.B.); (M.W.J.v.P.); (A.M.d.R.H.); (H.S.)
| | - Daloha Rodríguez-Molina
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, 80336 Munich, Germany; (K.R.); (D.R.-M.); (T.W.)
- Institute for Medical Information Processing, Biometry, and Epidemiology—IBE, LMU (Ludwig-Maximilians-Universität) Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, 80336 Munich, Germany; (K.R.); (D.R.-M.); (T.W.)
| | - Andreas Wieser
- Division of Infectious Diseases and Tropical Medicine, LMU (Ludwig-Maximilians-Universität) University Hospital, 80802 Munich, Germany;
- Faculty of Medicine, Max von Pettenkofer Institute, LMU (Ludwig-Maximilians-Universität), 80336 Munich, Germany
| | - Heike Schmitt
- Centre Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), 3721 MA Bilthoven, The Netherlands; (H.B.); (M.W.J.v.P.); (A.M.d.R.H.); (H.S.)
| |
Collapse
|
14
|
Forster F, Kreißl S, Wengenroth L, Vogelberg C, von Mutius E, Schaub B, Nowak D, Weinmann T, Radon K, Gerlich J. Third Follow-Up of the Study on Occupational Allergy Risks (SOLAR III) in Germany: Design, Methods, and Initial Data Analysis. Front Public Health 2021; 9:591717. [PMID: 33748056 PMCID: PMC7969718 DOI: 10.3389/fpubh.2021.591717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Asthma and allergies are complex diseases affected by genetic and environmental factors, such as occupational and psychosocial factors, as well as interactions between them. Although childhood is a critical phase in the development of asthma and allergies, few cohort studies on occupational outcomes followed up participants from childhood onwards. We present design, methods, and initial data analysis for the third follow-up of SOLAR (Study on Occupational Allergy Risks), a prospective and population-based German asthma and allergy cohort. Methods: The SOLAR cohort was initially recruited in 1995-1996 for Phase II of the German branch of the International Study of Asthma and Allergies in Childhood (ISAAC II) and followed up three times since, in 2002-2003, 2007-2009, and 2017-2018. During the third follow-up (SOLAR III), participants were between 29 and 34 years old. Since SOLAR focuses on occupational exposures, follow-ups were conducted at important points in time of the development of participants' career. To evaluate the potential of selection bias, responders and non-responders were compared based on variables from earlier study phases. In responders, frequency and pattern of missing values were examined and compared within the subsets of paper and online versions of the used questionnaires. Results: In total, 1,359 participants completed the questionnaire of the third follow-up (47.3% of eligible participants). Initially, the cohort started with 6,399 participants from the ISAAC II questionnaire study. A selection process led to a study population that is more female, higher educated, smokes less and has a higher proportion of certain asthma and allergy symptoms (also in their parents) than the initial cohort. Pattern and frequency of missing values were different for paper and online questionnaires. Discussion: The third follow-up of the SOLAR cohort offers the opportunity to analyze the course of asthma and allergies and their associations to environmental, occupational and psychosocial risk factors over more than 20 years from childhood to adulthood. Selection processes within the cohort might lead to bias that needs to be considered in future analyses.
Collapse
Affiliation(s)
- Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Sylvia Kreißl
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, Technical University Dresden, Dresden, Germany
| | - Erika von Mutius
- Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany.,Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Bianca Schaub
- Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany.,Dr. von Hauner Children's Hospital, University Hospital, Ludwig Maximilian University Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, Ludwig Maximilian University Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, German Centre for Lung Research, Munich, Germany
| |
Collapse
|
15
|
Veit C, Herrera R, Weinmayr G, Genuneit J, Windstetter D, Vogelberg C, von Mutius E, Nowak D, Radon K, Gerlich J, Weinmann T. Long-term effects of asthma medication on asthma symptoms: an application of the targeted maximum likelihood estimation. BMC Med Res Methodol 2020; 20:307. [PMID: 33327942 PMCID: PMC7739451 DOI: 10.1186/s12874-020-01175-9] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/23/2020] [Indexed: 11/10/2022] Open
Abstract
Background Long-term effectiveness of asthma control medication has been shown in clinical trials but results from observational studies with children and adolescents are lacking. Marginal structural models estimated using targeted maximum likelihood methods are a novel statistiscal approach for such studies as it allows to account for time-varying confounders and time-varying treatment. Therefore, we aimed to calculate the long-term risk of reporting asthma symptoms in relation to control medication use in a real-life setting from childhood to adulthood applying targeted maximum likelihood estimation. Methods In the prospective cohort study SOLAR (Study on Occupational Allergy Risks) we followed a German subsample of 121 asthmatic children (9–11 years old) of the ISAAC II cohort (International Study of Asthma and Allergies in Childhood) until the age of 19 to 24. We obtained self-reported questionnaire data on asthma control medication use at baseline (1995–1996) and first follow-up (2002–2003) as well as self-reported asthma symptoms at baseline, first and second follow-up (2007–2009). Three hypothetical treatment scenarios were defined: early sustained intervention, early unsustained intervention and no treatment at all. We performed longitudinal targeted maximum likelihood estimation combined with Super Learner algorithm to estimate the relative risk (RR) to report asthma symptoms at SOLAR I and SOLAR II in relation to the different hypothetical scenarios. Results A hypothetical intervention of early sustained treatment was associated with a statistically significant risk increment of asthma symptoms at second follow-up when compared to no treatment at all (RR: 1.51, 95% CI: 1.19–1.83) or early unsustained intervention (RR:1.38, 95% CI: 1.11–1.65). Conclusions While we could confirm the tagerted maximum likelihood estimation to be a usable and robust statistical tool, we did not observe a beneficial effect of asthma control medication on asthma symptoms. Because of potential due to the small sample size, lack of data on disease severity and reverse causation our results should, however, be interpreted with caution.
Collapse
Affiliation(s)
- Carolin Veit
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilian University Munich (LMU), Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Ronald Herrera
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.,Paediatric Epidemiology, Hospital for Children and Adolescents, University of Leipzig Medical Center, Leipzig, Germany
| | - Doris Windstetter
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Erika von Mutius
- Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany.,Dr. v. Haunersches Kinderspital, LMU University Hospital Munich, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany.,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital Munich, Munich, Germany. .,Comprehensive Pneumology Center CPC LMU Munich, member of the German Center for Lung Research (DZL), Munich, Germany.
| |
Collapse
|
16
|
Pasqual E, Castaño-Vinyals G, Thierry-Chef I, Kojimahara N, Sim MR, Kundi M, Krewski D, Momoli F, Lacour B, Remen T, Radon K, Weinmann T, Petridou E, Moschovi M, Dikshit R, Sadetski S, Maule M, Farinotti M, Ha M, 't Mannetje A, Alguacil J, Aragonés N, Vermeulen R, Kromhout H, Cardis E. Exposure to Medical Radiation during Fetal Life, Childhood and Adolescence and Risk of Brain Tumor in Young Age: Results from The MOBI-Kids Case-Control Study. Neuroepidemiology 2020; 54:343-355. [PMID: 32200380 DOI: 10.1159/000506131] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 01/20/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND We explored the association between ionizing radiation (IR) from pre-natal and post-natal radio-diagnostic procedures and brain cancer risk within the MOBI-kids study. METHODS MOBI-kids is an international (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, New Zealand, Spain, The Netherlands) case-control study including 899 brain tumor (645 neuroepithelial) cases aged 10-24 years and 1,910 sex-, age-, country-matched controls. Medical radiological history was collected through personal interview. We estimated brain IR dose for each procedure, building a look-up table by age and time period. Lifetime cumulative doses were calculated using 2 and 5 years lags from the diagnostic date. Risk was estimated using conditional logistic regression. Neurological, psychological and genetic conditions were evaluated as potential confounders. The main analyses focused on neuroepithelial tumors. RESULTS Overall, doses were very low, with a skewed distribution (median 0.02 mGy, maximum 217 mGy). ORs for post-natal exposure were generally below 1. ORs were increased in the highest dose categories both for post and pre-natal exposures: 1.63 (95% CI 0.44-6.00) and 1.55 (0.57-4.23), respectively, based on very small numbers of cases. The change in risk estimates after adjustment for medical conditions was modest. CONCLUSIONS There was little evidence for an association between IR from radio-diagnostic procedures and brain tumor risk in children and adolescents. Though doses were very low, our results suggest a higher risk for pre-natal and early life exposure, in line with current evidence.
Collapse
Affiliation(s)
- Elisa Pasqual
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Gemma Castaño-Vinyals
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Isabelle Thierry-Chef
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Noriko Kojimahara
- Department of Public Health, School of Medicine, Tokyo Women's Medical University, Tokyo, Japan
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michael Kundi
- Department of Environmental Health, Center for Public Health, Medical University Vienna, Vienna, Austria
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, Ottawa, Ontario, Canada.,Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Franco Momoli
- Ottawa Hospital Research Institute, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France.,Inserm U1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris, France.,Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Thomas Remen
- French National Registry of Childhood Solid Tumors, CHRU, Nancy, France.,Inserm U1153, Center of Research in Epidemiology and StatisticS (CRESS), Paris, France.,Paris University, Epidemiology of Childhood and Adolescent Cancers Team (EPICEA), Paris, France
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.,Unit of Clinical Epidemiology, Karolinska Institute, Stockholm, Sweden
| | - Maria Moschovi
- Haematology-Oncology Unit, First Department of Pediatrics, National and Kapodistrian University of Athens, Medical School, "Aghia Sophia" Children's Hospital, Athens, Greece
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre, Mumbai, India
| | - Siegal Sadetski
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - Milena Maule
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin, Turin, Italy
| | - Mariangela Farinotti
- Unit of Neuroepidemiology, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Juan Alguacil
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Nuria Aragonés
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Cancer Epidemiology Section, Public Health Division, Department of Health of Madrid, Madrid, Spain
| | - Roel Vermeulen
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Kromhout
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain, .,Universitat Pompeu Fabra (UPF), Barcelona, Spain, .,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain,
| |
Collapse
|
17
|
Koseoglu Ornek O, Weinmann T, Waibel J, Radon K. Precarious employment and migrant workers' mental health: a protocol for a systematic review of observational studies. Syst Rev 2020; 9:50. [PMID: 32145747 PMCID: PMC7060985 DOI: 10.1186/s13643-020-01313-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Accepted: 02/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Precarious employment has become an urgent public health issue at a global scale with potential consequences for quality of life and health of employees, especially in vulnerable groups such as migrants. The primary aim of this systematic review is thus to analyze and summarize existing research on the association between precarious employment and migrant workers' mental health. METHODS We will search PubMed/MEDLINE, PsycINFO, Web of Science (from January 1970 onwards) for original articles on observational studies (e.g., cohort, case-control and cross-sectional, and qualitative) published in English, German, Turkish, and Spanish. The primary outcome will be depression and anxiety disorders. Secondary outcomes will be burnout, sleeping problems, and occupational stress. Two reviewers will independently screen all citations, full-text articles, and abstract data. Potential conflicts will be resolved through discussion. The methodological quality (or risk of bias) of individual studies will be appraised using an appropriate tool. A narrative synthesis will summarize and explain the characteristics and findings of the studies. If feasible, we will conduct random effects meta-analyses where appropriate. DISCUSSION This systematic review will analyze the ways in which precarious employment affects migrant workers' mental health and the process that underlies this relationship. The results from the systematic review outlined in this protocol will be of interest to labor and health professionals, policy makers, labor unions, and non-governmental organizations. Our findings may encourage and impel related policy makers to establish human-focused, safe and healthy work environments, and workplace conditions. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42019132560.
Collapse
Affiliation(s)
- Ozlem Koseoglu Ornek
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany
- Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Dolapdere Kampus, Hacıahmet Mahallesi, Pir Hüsamettin Sokak No: 20, 34440 Beyoğlu, Istanbul, Turkey
| | - Tobias Weinmann
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany
| | - Julia Waibel
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany
| | - Katja Radon
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany
| |
Collapse
|
18
|
Rajput Z, Hering KG, Kraus T, Tannapfel A, Sonnenschein G, Centmayer A, Radon K, Nowak D, Weinmann T. Investigating the association between occupational exposure to asbestos and ovarian carcinoma: results from a pilot study in Germany. BMC Public Health 2019; 19:1341. [PMID: 31640610 PMCID: PMC6805637 DOI: 10.1186/s12889-019-7590-7] [Citation(s) in RCA: 4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 09/04/2019] [Indexed: 01/06/2023] Open
Abstract
Background The aim of this pilot study was to assess the feasibility of a large-scale epidemiologic investigation elucidating the quantitative association between occupational exposure to asbestos and ovarian cancer in former German asbestos workers. Methods Between December 2017 and May 2018, a random sample of one thousand insured woman registered at the health service of a German trade association as formerly occupationally exposed to asbestos were invited to participate in a pilot study. Participation included a phone interview using a standardised questionnaire. The feasibility of the project was evaluated using a priori defined criteria. They included response, number of cases, eligibility of the questionnaire data for exact estimation of asbestos fibre-years, and availability of relevant medical documentation (imaging procedures, medical reports, and histologic materials). Results The response (17%) was clearly below the intended number of 60%. With six tumour suspects, of which two could be confirmed by medical documents, the number of cases was within the expected range of two to eleven cases. Exact asbestos fibre-year estimations could be performed for 29% of all interviewees, but only for one suspected case. Medical documentation could be collected for only few participants, while no histology reports could be obtained for all cases. Thus, only the feasibility criterion of the expected number of cases was fulfilled. Conclusion The results of the pilot study indicate that the planned project is feasible only to a very limited extent. For further planning of the study, measures to improve recruitment of participants are necessary.
Collapse
Affiliation(s)
- Zara Rajput
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, München, Germany
| | - Kurt Georg Hering
- Department of Diagnostic Radiology, Radiooncology and Nuclear Medicine, Radiological Clinic, Miner's Hospital, Dortmund, Germany
| | - Thomas Kraus
- Institute for Occupational, Social and Environmental Medicine, RWTH Aachen University, Aachen, Germany
| | - Andrea Tannapfel
- Institute for Pathology, Ruhr University Bochum, Bochum, Germany
| | | | - Alexandra Centmayer
- Gesundheitsvorsorge (GVS), Berufsgenossenschaft Energie Textil Elektro Medienerzeugnisse (BG ETEM), Augsburg, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, München, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, München, Germany
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, München, Germany.
| |
Collapse
|
19
|
Forster F, Weinmann T, Gerlich J, Schlotz W, Weinmayr G, Genuneit J, Windstetter D, Vogelberg C, von Mutius E, Nowak D, Radon K. Work-related stress and incident asthma and rhinitis: results from the SOLAR study. Int Arch Occup Environ Health 2019; 92:673-681. [PMID: 30656403 DOI: 10.1007/s00420-019-01402-x] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 01/13/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study analyzes the association of work-related stress with incident asthma and rhinitis in young adults with a special focus on gender-specific differences. METHODS Incident asthma, wheezing and rhinitis were measured in a cohort of 2051 young German adults (aged 16-18 years at baseline) recruited by the prospective population-based SOLAR study (Study of Occupational Allergy Risks). Work-related stress was measured by the Trier Inventory for the Assessment of Chronic Stress (TICS). Two TICS scales, work overload and work discontent, were analysed. Logistic regression was conducted to calculate odds ratios (OR) and 95% confidence intervals (CI). RESULTS In females, the odds for incident asthma were found to be 17% higher for each increase of the work discontent score by one point (OR 1.17, 95% CI 1.04-1.31). In males, no association was statistically significant. Incident rhinitis showed no association with any exposure variable. CONCLUSION This study shows a link between work-related stress and incident asthma which seems to be confined to women. This study adds evidence about the association of work-related stress and asthma in young adults and can contribute to prevention for that particular age group.
Collapse
Affiliation(s)
- Felix Forster
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany. .,Institute for Medical Informatics, Biometry, and Epidemiology, LMU Munich, Munich, Germany. .,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany.
| | - Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany.,Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany.,Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Wolff Schlotz
- Max Planck Institute of Empirical Aesthetics, Frankfurt am Main, Germany
| | - Gudrun Weinmayr
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Doris Windstetter
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Erika von Mutius
- Dr. v. Haunersches Kinderspital, University Hospital, LMU Munich, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr.1, 80336, Munich, Germany.,Comprehensive Pneumology Centre Munich, Member of German Centre for Lung Research, Munich, Germany.,Munich Center of Health Sciences (MC-Health), Munich, Germany
| |
Collapse
|
20
|
Weinmann T, Vetter C, Karch S, Nowak D, Radon K. Shift work and cognitive impairment in later life - results of a cross-sectional pilot study testing the feasibility of a large-scale epidemiologic investigation. BMC Public Health 2018; 18:1256. [PMID: 30428871 PMCID: PMC6234599 DOI: 10.1186/s12889-018-6171-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 10/31/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The effect of shift work on impairment of cognition in later life has not yet been sufficiently investigated. Therefore, we aimed at testing the feasibility of a large-scale epidemiologic study examining this putative association in a pilot study. METHODS Between January and April 2017, a cross-sectional study invited a random sample of 425 former and current employees of a German university hospital aged 55 years and older to undergo a cognitive test battery (including the Repeatable Battery for the Assessment of Neuropsychological Status, Trail Making Test, Letter-Number Span, and Vocabulary Test) and to complete a self-administered questionnaire on socio-demographic characteristics, chronotype, sleep, occupational history including shift work, and medical history. Fifty percent of the invitees were registered in the hospital's occupational records as currently working or having worked in a shift system. The feasibility of a large-scale study was evaluated by the response of the study sample and the completeness of data. In addition, we calculated the prevalence of shift work and cognitive impairment in the study population. RESULTS Seventy five subjects (18%) completed the questionnaire, of whom 47 (11% of the total sample) participated in cognitive testing. In all but four items assessed in the questionnaire, the proportion of missing data was below 10 %, suggesting that the quality of collected data can be considered as high. Eighty percent of the participants reported that they ever worked in a shift system, indicating selective participation by exposure to shift work. With respect to chronotype, the majority of the study subjects rated themselves as rather evening type, while a quarter considered themselves as definite morning type. All cognitive tests could be carried out completely. We observed slight difficulties in at least one of the cognitive tests in 17 participants (36%) while two participants (4%) showed more pronounced signs of cognitive impairment. CONCLUSION The present pilot study only partially supported the feasibility of the planned large-scale study. As response rates were low and depended on exposure to shift work, a better way of sampling and recruitment needs to be identified. The questionnaire and the test battery appear to be viable instruments.
Collapse
Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, CO USA
| | - Susanne Karch
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
- Munich Center of Health Sciences (MC-Health), Munich, Germany
| |
Collapse
|
21
|
Weinmann T, Radon K, Sukalla F, Gerlich J, Barth S, Nowak D, Karnowski V. Developing an Awareness Campaign to Reduce Second Hand Smoke Among Disadvantaged Families-A Participatory M-Health Approach. Int J Environ Res Public Health 2018; 15:ijerph15091945. [PMID: 30200621 PMCID: PMC6164457 DOI: 10.3390/ijerph15091945] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/03/2018] [Accepted: 09/05/2018] [Indexed: 12/22/2022]
Abstract
Children from disadvantaged families are particularly exposed to second hand smoke in their home environment. Using a mixed methods participatory approach, we aimed at identifying suitable media channels and appropriate content for a campaign increasing caregivers' knowledge about the risks of second hand smoke (SHS) exposure for their children and appropriate measures for exposure reduction. In the first phase of the mixed method design, we evaluated knowledge and norms about children's SHS and perceived barriers for avoiding it. To this end, we conducted 26 one-to-one interviews with smoking caregivers of children below the age of six years. Subsequently, we developed and illustrated core messages and identified appropriate communication channels. These were evaluated in focus group discussions by 20 of the 26 interview participants. After a final revision, 121 caregivers evaluated the campaign via an online questionnaire. Online social networks were identified as the most suitable media channel. For these, we developed animated photos with voiceovers addressing the potential consequences of SHS for children. The overall rating of the campaign messages was promising. Participants confirmed that it was important to address the issue in social media. However, sharing the pictures was considered unlikely due to the sensitive topic of the campaign, while the importance of doctors or scientists being recognizable as a source was highlighted. Employing a participatory approach, we developed an m-health campaign, which can now be disseminated in social networks to reach the target population. The effectiveness of the campaign should be evaluated.
Collapse
Affiliation(s)
- Tobias Weinmann
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany.
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Deutsches Zentrum für Lungenforschung (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany.
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany.
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Deutsches Zentrum für Lungenforschung (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany.
| | - Freya Sukalla
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Department of Communication Studies and Media Research, LMU Munich, Oettingenstr. 67, 80538 Munich, Germany.
- Institute of Communication and Media Studies, University of Leipzig, Burgstr. 21, 04109 Leipzig, Germany.
| | - Jessica Gerlich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany.
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Deutsches Zentrum für Lungenforschung (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany.
| | - Swaantje Barth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany.
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Deutsches Zentrum für Lungenforschung (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany.
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336 Munich, Germany.
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Comprehensive Pneumology Center Munich (CPC-M), Deutsches Zentrum für Lungenforschung (DZL), Max-Lebsche-Platz 31, 81377 Munich, Germany.
| | - Veronika Karnowski
- Munich Center of Health Sciences (MC-Health), LMU Munich, Ludwigstr. 28, 80539 Munich, Germany.
- Department of Communication Studies and Media Research, LMU Munich, Oettingenstr. 67, 80538 Munich, Germany.
| |
Collapse
|
22
|
Goedhart G, van Wel L, Langer CE, de Llobet Viladoms P, Wiart J, Hours M, Kromhout H, Benke G, Bouka E, Bruchim R, Choi KH, Eng A, Ha M, Huss A, Kiyohara K, Kojimahara N, Krewski D, Lacour B, 't Mannetje A, Maule M, Migliore E, Mohipp C, Momoli F, Petridou ET, Radon K, Remen T, Sadetzki S, Sim M, Weinmann T, Cardis E, Vrijheid M, Vermeulen R. Recall of mobile phone usage and laterality in young people: The multinational Mobi-Expo study. Environ Res 2018; 165:150-157. [PMID: 29704776 DOI: 10.1016/j.envres.2018.04.018] [Citation(s) in RCA: 12] [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] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 04/16/2018] [Accepted: 04/18/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To study recall of mobile phone usage, including laterality and hands-free use, in young people. METHODS Actual mobile phone use was recorded among volunteers aged between 10 and 24 years from 12 countries by the software application XMobiSense and was compared with self-reported mobile phone use at 6 and 18 months after using the application. The application recorded number and duration of voice calls, number of text messages, amount of data transfer, laterality (% of call time the phone was near the right or left side of the head, or neither), and hands-free usage. After data cleaning, 466 participants were available for the main analyses (recorded vs. self-reported phone use after 6 months). RESULTS Participants were on average 18.6 years old (IQR 15.2-21.8 years). The Spearman correlation coefficients between recorded and self-reported (after 6 months) number and duration of voice calls were 0.68 and 0.65, respectively. Number of calls was on average underestimated by the participants (adjusted geometric mean ratio (GMR) self-report/recorded = 0.52, 95% CI = 0.47-0.58), while duration of calls was overestimated (GMR=1.32, 95%, CI = 1.15-1.52). The ratios significantly differed by country, age, maternal educational level, and level of reported phone use, but not by time of the interview (6 vs. 18 months). Individuals who reported low mobile phone use underestimated their use, while individuals who reported the highest level of phone use were more likely to overestimate their use. Individuals who reported using the phone mainly on the right side of the head used it more on the right (71.1%) than the left (28.9%) side. Self-reported left side users, however, used the phone only slightly more on the left (53.3%) than the right (46.7%) side. Recorded percentage hands-free use (headset, speaker mode, Bluetooth) increased with increasing self-reported frequency of hands-free device usage. Frequent (≥50% of call time) reported headset or speaker mode use corresponded with 17.1% and 17.2% of total call time, respectively, that was recorded as hands-free use. DISCUSSION These results indicate that young people can recall phone use moderately well, with recall depending on the amount of phone use and participants' characteristics. The obtained information can be used to calibrate self-reported mobile use to improve estimation of radiofrequency exposure from mobile phones.
Collapse
Affiliation(s)
- Geertje Goedhart
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands
| | - Luuk van Wel
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands.
| | - Chelsea E Langer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Patricia de Llobet Viladoms
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Joe Wiart
- Chaire C2M, LTCI, Telecom ParisTech, Université Paris-Saclay, France
| | - Martine Hours
- Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment (UMRESTTE), Université de Lyon/The French Institute of science and technology for transport, development and networks (IFSTTAR), Lyon, France
| | - Hans Kromhout
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands
| | - Geza Benke
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Revital Bruchim
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Kyung-Hwa Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Amanda Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Anke Huss
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands
| | - Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Daniel Krewski
- School of Epidemiology and Public Health, University of Ottawa, Canada
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumours, CHU, Nancy, Inserm UMRS-1153, CRESS-EPICEA, University of Paris-Sorbonne, Paris, France
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy
| | - Charmaine Mohipp
- French National Registry of Childhood Solid Tumours, CHU, Nancy, Inserm UMRS-1153, CRESS-EPICEA, University of Paris-Sorbonne, Paris, France
| | - Franco Momoli
- School of Epidemiology and Public Health, University of Ottawa, Canada; Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Canada; Ottawa Hospital Research Institute, Canada
| | - Eleni Th Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Katja Radon
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Thomas Remen
- French National Registry of Childhood Solid Tumours, CHU, Nancy, France
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Malcolm Sim
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Tobias Weinmann
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Elisabeth Cardis
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Biomedical Research Centre Network for Epidemiology and Public Health (CIBERESP), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, PO Box 80178, 3508 TD Utrecht, the Netherlands
| |
Collapse
|
23
|
Langer CE, de Llobet P, Dalmau A, Wiart J, Goedhart G, Hours M, Benke GP, Bouka E, Bruchim R, Choi KH, Eng A, Ha M, Karalexi M, Kiyohara K, Kojimahara N, Krewski D, Kromhout H, Lacour B, 't Mannetje A, Maule M, Migliore E, Mohipp C, Momoli F, Petridou E, Radon K, Remen T, Sadetzki S, Sim MR, Weinmann T, Vermeulen R, Cardis E, Vrijheid M. Patterns of cellular phone use among young people in 12 countries: Implications for RF exposure. Environ Int 2017; 107:65-74. [PMID: 28668725 DOI: 10.1016/j.envint.2017.06.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 05/29/2017] [Accepted: 06/05/2017] [Indexed: 06/07/2023]
Abstract
Characterizing exposure to radiofrequency (RF) fields from wireless telecommunications technologies during childhood and adolescence is a research priority in investigating the health effects of RF. The Mobi-Expo study aimed to describe characteristics and determinants of cellular phone use in 534 young people (10-24years) in 12 countries. The study used a specifically designed software application installed on smartphones to collect data on the use of wireless telecommunications devices within this age group. The role of gender, age, maternal education, calendar period, and country was evaluated through multivariate models mutually adjusting for all variables. Call number and duration were higher among females compared to males (geometric mean (GM) ratio 1.17 and 1.42, respectively), among 20-24year olds compared to 10-14year olds (GM ratio 2.09 and 4.40, respectively), and among lowest compared to highest social classes (GM ratio 1.52 and 1.58, respectively). The number of SMS was higher in females (GM ratio 1.46) and the middle age group (15-19year olds: GM ratio 2.21 compared to 10-14year olds) and decreased over time. Data use was highest in the oldest age group, whereas Wi-Fi use was highest in the middle age group. Both data and Wi-Fi use increased over time. Large differences in the number and duration of calls, SMS, and data/Wi-Fi use were seen by country, with country and age accounting for up to 50% of the variance. Hands-free and laterality of use did not show significant differences by sex, age, education, study period, or country. Although limited by a convenience sample, these results provide valuable insights to the design, analysis, and interpretation of future epidemiological studies concerning the health effects of exposure resulting from cellular phone use in young people. In addition, the information provided by this research may be used to design strategies to minimize RF exposure.
Collapse
Affiliation(s)
- Chelsea E Langer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain.
| | - Patricia de Llobet
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Albert Dalmau
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Joe Wiart
- Chaire C2M, LTCI, Telecom ParisTech, Universite Paris-Saclay, 75013 Paris, France
| | - Geertje Goedhart
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Martine Hours
- Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment (UMRESTTE), Universite de Lyon/The French Institute of Science and Technology for Transport, Development and Networks (IFSTTAR), Lyon, France
| | - Geza P Benke
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Revital Bruchim
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Kyung-Hwa Choi
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Amanda Eng
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Republic of Korea
| | - Maria Karalexi
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Kosuke Kiyohara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University, Tokyo, Japan
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Canada
| | - Hans Kromhout
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumours, CHU, Nancy, Inserm UMRS-1153, CRESS-EPICEA, University of Paris-Sorbonne, Paris, France
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University, Wellington, New Zealand
| | - Milena Maule
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy
| | - Enrica Migliore
- Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin and AOU Città della Salute e della Scienza di Torino, Italy
| | - Charmaine Mohipp
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Canada
| | - Franco Momoli
- Children's Hospital of Eastern Ontario Research Institute, Ottawa Hospital Research Institute, University of Ottawa, Canada
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, National and Kapodistrian University of Athens, Athens, Greece
| | - Katja Radon
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Thomas Remen
- French National Registry of Childhood Solid Tumours, CHU, Nancy, France
| | - Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Malcolm R Sim
- Department of Epidemiology & Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia
| | - Tobias Weinmann
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Elisabeth Cardis
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Spain; Universitat Pompeu Fabra, Barcelona, Spain
| |
Collapse
|
24
|
Langbein A, Schumacher B, Spitzer S, Deneke T, Krug J, Barth S, Karolyi L, Weinmann T, Scharfe F, Windmueller V, Schallmaier P, Schade A. P513Left atrial appendage occlusion with the Watchman device in patients with high risk of thromboembolism and contraindications for oral anticoagulation: procedural data and long term outcome. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
25
|
Forster F, Weinmann T, Wengenroth L, Mutius E, Schaub B, Vogelberg C. Design und aktueller Stand der ACROSSOLAR-Studie zur Untersuchung des Verlaufs und der Ätiologie von Asthma und Allergien. Das Gesundheitswesen 2017. [DOI: 10.1055/s-0037-1605922] [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] [Indexed: 10/18/2022]
Affiliation(s)
- F Forster
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München, Arbeits- und Umweltepidemiologie, München
| | - T Weinmann
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München, Arbeits- und Umweltepidemiologie, München
| | - L Wengenroth
- Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, LMU München, Arbeits- und Umweltepidemiologie, München
| | - E Mutius
- Dr. v. Haunersches Kinderspital, LMU München, München
| | - B Schaub
- Dr. v. Haunersches Kinderspital, LMU München, München
| | - C Vogelberg
- Universitätsklinikum Carl Gustav Carus, Dresden
| |
Collapse
|
26
|
Weinmann T, Gerlich J, Heinrich S, Nowak D, Mutius EV, Vogelberg C, Genuneit J, Lanzinger S, Al-Khadra S, Lohse T, Motoc I, Walter V, Radon K. Association of household cleaning agents and disinfectants with asthma in young German adults. Occup Environ Med 2017; 74:684-690. [PMID: 28483971 DOI: 10.1136/oemed-2016-104086] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We scrutinised the association of private use of household sprays and disinfectants with asthma incidence in young adults in the transition from school to working life. METHODS Between 2007 and 2009,2051 young adults aged 19-24 years living in two major German cities took part in the Study on Occupational Allergy Risks II. Self-reported exposure to household sprays and disinfectants was characterised according to a composite score for frequency of use as no use (score=0), low use (score between 1 and the median), medium use (score between the median and the 90th percentile) and high use (score above the 90th percentile). Two outcome variables (current asthma and current wheezing) with four mutually exclusive categories (never, incident, persistent and remittent) were used for the risk analyses. Multinomial logistic regression models examined the association between the frequency of using household sprays and disinfectants with asthma and wheezing adjusting for potential confounders. RESULTS Compared with no use, high use of disinfectants was associated with a more than twofold increased odds of incident asthma (OR 2.79, 95% CI 1.14 to 6.83). In addition, low/medium use of disinfectants was associated with remittent asthma (OR 2.39, 95% CI 1.29 to 4.47). The evidence for an association between high usage of household sprays and asthma incidence was weak (OR 2.79, 95% CI 0.84 to 9.20). CONCLUSION Our results support the hypothesis of an association between the use of cleaning products and elevated risks for asthma and wheezing in young adults at the start of working life.
Collapse
Affiliation(s)
- Tobias Weinmann
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Jessica Gerlich
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Sabine Heinrich
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Dennis Nowak
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| | - Erika von Mutius
- Dr. v. Haunersches Kinderspital, University Hospital of Munich (LMU), Munich, Germany
| | - Christian Vogelberg
- Paediatric Department, University Hospital Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany
| | - Jon Genuneit
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Stefanie Lanzinger
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | | | - Tina Lohse
- Epidemiology, Biostatistics and Prevention Institute, Chronic Disease Epidemiology, University of Zurich, Zurich, Switzerland
| | - Irina Motoc
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
| | - Viola Walter
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katja Radon
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany
| |
Collapse
|
27
|
Sadetzki S, Langer CE, Bruchim R, Kundi M, Merletti F, Vermeulen R, Kromhout H, Lee AK, Maslanyj M, Sim MR, Taki M, Wiart J, Armstrong B, Milne E, Benke G, Schattner R, Hutter HP, Woehrer A, Krewski D, Mohipp C, Momoli F, Ritvo P, Spinelli J, Lacour B, Delmas D, Remen T, Radon K, Weinmann T, Klostermann S, Heinrich S, Petridou E, Bouka E, Panagopoulou P, Dikshit R, Nagrani R, Even-Nir H, Chetrit A, Maule M, Migliore E, Filippini G, Miligi L, Mattioli S, Yamaguchi N, Kojimahara N, Ha M, Choi KH, Mannetje A', Eng A, Woodward A, Carretero G, Alguacil J, Aragones N, Suare-Varela MM, Goedhart G, Schouten-van Meeteren AAYN, Reedijk AAMJ, Cardis E. The MOBI-Kids Study Protocol: Challenges in Assessing Childhood and Adolescent Exposure to Electromagnetic Fields from Wireless Telecommunication Technologies and Possible Association with Brain Tumor Risk. Front Public Health 2014; 2:124. [PMID: 25295243 PMCID: PMC4172002 DOI: 10.3389/fpubh.2014.00124] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [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: 07/17/2014] [Accepted: 08/05/2014] [Indexed: 12/18/2022] Open
Abstract
The rapid increase in mobile phone use in young people has generated concern about possible health effects of exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF). MOBI-Kids, a multinational case-control study, investigates the potential effects of childhood and adolescent exposure to EMF from mobile communications technologies on brain tumor risk in 14 countries. The study, which aims to include approximately 1,000 brain tumor cases aged 10-24 years and two individually matched controls for each case, follows a common protocol and builds upon the methodological experience of the INTERPHONE study. The design and conduct of a study on EMF exposure and brain tumor risk in young people in a large number of countries is complex and poses methodological challenges. This manuscript discusses the design of MOBI-Kids and describes the challenges and approaches chosen to address them, including: (1) the choice of controls operated for suspected appendicitis, to reduce potential selection bias related to low response rates among population controls; (2) investigating a young study population spanning a relatively wide age range; (3) conducting a large, multinational epidemiological study, while adhering to increasingly stricter ethics requirements; (4) investigating a rare and potentially fatal disease; and (5) assessing exposure to EMF from communication technologies. Our experience in thus far developing and implementing the study protocol indicates that MOBI-Kids is feasible and will generate results that will contribute to the understanding of potential brain tumor risks associated with use of mobile phones and other wireless communications technologies among young people.
Collapse
Affiliation(s)
- Siegal Sadetzki
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center , Ramat Gan , Israel
| | - Chelsea Eastman Langer
- Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain ; Universitat Pompeu Fabra (UPF) , Barcelona , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Revital Bruchim
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center , Ramat Gan , Israel
| | - Michael Kundi
- Center for Public Health, Institute of Environmental Health, Medical University Vienna , Vienna , Austria
| | - Franco Merletti
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin , Turin , Italy
| | - Roel Vermeulen
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University , Utrecht , Netherlands
| | - Hans Kromhout
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University , Utrecht , Netherlands
| | - Ae-Kyoung Lee
- Radio Technology Research Department, Electronics and Telecommunication Research Institute (ETRI) , Daejeon , South Korea
| | - Myron Maslanyj
- Centre for Radiation, Chemical and Environmental Hazards, Public Health England , Chilton , UK
| | - Malcolm R Sim
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne , VIC , Australia
| | - Masao Taki
- Department of Electrical Engineering, Tokyo Metropolitan University , Tokyo , Japan
| | | | | | - Elizabeth Milne
- Telecom Institute for Child Health Research Western Australia , Perth, WA , Australia
| | - Geza Benke
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne , VIC , Australia
| | - Rosa Schattner
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne , VIC , Australia
| | - Hans-Peter Hutter
- Center for Public Health, Institute of Environmental Health, Medical University Vienna , Vienna , Austria
| | - Adelheid Woehrer
- Clinical Institute of Neurology, Medical University Vienna , Vienna , Austria
| | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health , Ottawa, ON , Canada ; Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa , Ottawa, ON , Canada
| | - Charmaine Mohipp
- Children's Hospital of Eastern Ontario , Ottawa, ON , Canada ; University of Ottawa , Ottawa, ON , Canada
| | - Franco Momoli
- Ottawa Hospital Research Institute , Ottawa, ON , Canada ; Children's Hospital of Eastern Ontario Research Institute , Ottawa, ON , Canada
| | - Paul Ritvo
- Research, Prevention and Cancer Control, Cancer Care Ontario , Ontario, ON , Canada
| | - John Spinelli
- Cancer Control Research, British Columbia Cancer Agency , Vancouver, BC , Canada
| | - Brigitte Lacour
- French National Registry of Childhood Solid Tumors, CHU , Nancy , France ; UMRS 1018, CESP, INSERM , Villejuif , France
| | - Dominique Delmas
- French National Registry of Childhood Solid Tumors, CHU , Nancy , France
| | - Thomas Remen
- French National Registry of Childhood Solid Tumors, CHU , Nancy , France
| | - Katja Radon
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU) , Munich , Germany
| | - Tobias Weinmann
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU) , Munich , Germany
| | - Swaantje Klostermann
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU) , Munich , Germany
| | - Sabine Heinrich
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU) , Munich , Germany
| | - Eleni Petridou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Evdoxia Bouka
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Paraskevi Panagopoulou
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens , Athens , Greece
| | - Rajesh Dikshit
- Centre for Cancer Epidemiology, Tata Memorial Centre , Mumbai , India
| | - Rajini Nagrani
- Centre for Cancer Epidemiology, Tata Memorial Centre , Mumbai , India
| | - Hadas Even-Nir
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center , Ramat Gan , Israel
| | - Angela Chetrit
- Cancer and Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center , Ramat Gan , Israel
| | - Milena Maule
- Unit of Cancer Epidemiology, Department of Medical Sciences, University of Turin , Turin , Italy
| | - Enrica Migliore
- Unit of Cancer Epidemiology, Citta' della Salute e della Scienza, University of Turin , Turin , Italy
| | - Graziella Filippini
- Neuroepidemiology Research Unit, Instituto Nazionale Neurologico C. Besta , Milan , Italy
| | - Lucia Miligi
- Unit of Occupational and Environmental Epidemiology, Institute for the Study and Prevention of Cancer , Florence , Italy
| | - Stefano Mattioli
- Department of Medical and Surgical Sciences, University of Bologna , Bologna , Italy
| | - Naohito Yamaguchi
- Department of Public Health, Tokyo Women's Medical University , Tokyo , Japan
| | - Noriko Kojimahara
- Department of Public Health, Tokyo Women's Medical University , Tokyo , Japan
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine , Cheonan , South Korea
| | - Kyung-Hwa Choi
- Department of Public Health, Graduate School of Dankook University , Cheonan , South Korea
| | - Andrea 't Mannetje
- Centre for Public Health Research, Massey University , Wellington , New Zealand
| | - Amanda Eng
- Centre for Public Health Research, Massey University , Wellington , New Zealand
| | - Alistair Woodward
- School of Population Health, University of Auckland , Auckland , New Zealand
| | - Gema Carretero
- Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain ; Universitat Pompeu Fabra (UPF) , Barcelona , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| | - Juan Alguacil
- Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva , Huelva , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Huelva , Spain
| | - Nuria Aragones
- Cancer and Environmental Epidemiology Area, National Center for Epidemiology, Carlos III Institute of Health , Madrid , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain
| | - Maria Morales Suare-Varela
- Ciber Epidemiología y Salud Pública (CIBERESP) , Madrid , Spain ; Área de Medicina Preventiva y Salud Pública, Universitat de Valencia , Valencia , Spain
| | - Geertje Goedhart
- Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University , Utrecht , Netherlands
| | - A Antoinette Y N Schouten-van Meeteren
- Department of Paediatric Oncology, Academic Medical Center, Emma Children's Hospital, University of Amsterdam , Amsterdam , Netherlands ; Dutch Childhood Oncology Group (DCOG) , Den Haag , Netherlands
| | | | - Elisabeth Cardis
- Centre for Research in Environmental Epidemiology (CREAL) , Barcelona , Spain ; Universitat Pompeu Fabra (UPF) , Barcelona , Spain ; Ciber Epidemiología y Salud Pública (CIBERESP) , Barcelona , Spain
| |
Collapse
|
28
|
Spitzer SG, Karolyi L, Scharfe F, Weinmann T, Raemmler C, Otto T, Kadalie CT. Does PV isolation with a multipolar ablation catheter influence the incidence of PV stenosis in patients with paroxysmal or persistent AF? Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht309.p4127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
29
|
Weinmann T, Radon K. [Health effects of aircraft noise: current evidence]. Gesundheitswesen 2013; 75:63-4. [PMID: 23359262 DOI: 10.1055/s-0032-1331777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
30
|
Bhardwaj M, Baum U, Markevych I, Mohamed A, Weinmann T, Nowak D, Radon K. Are primary school students exposed to higher noise levels than secondary school students in Germany? Int J Occup Environ Med 2013; 4:2-11. [PMID: 23279793] [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] [Subscribe] [Scholar Register] [Received: 09/21/2012] [Accepted: 11/23/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Noise, one of the major environmental nuisances, affects the learning ability of children negatively. OBJECTIVE With the assumption that in the existing German 4-type school system children are exposed to various noise levels in each type of school, we investigated the association between children's school type and environmental noise level. METHODS In this cross-sectional study, we included 550 children, primary and secondary school students, aged 8-12 years, and who lived in 4 Bavarian cities. The environmental noise level was assessed by personal 24-h dosimeter measurements. The associations of interest were assessed by linear regression. RESULTS The average day noise level of 80.0 dB(A) was relatively high, exceeding the threshold level of 60 dB(A). In the model adjusted for sex, socioeconomic status (SES), and place of residence, noise level was significantly higher for primary schools by almost 2.3 dB(A); however, after additional adjustments for age, this association was distorted. The mean night noise level of 43.7 dB(A) was not associated with the school level. We could not find any significant differences in the noise level between different types of secondary schools. CONCLUSION We found evidence that in Germany, children, especially of a younger age from primary school, are exposed to high noise levels during day in and outside the school environment. School administration and parents should work to make schools less noisy and more accomplished for learning to achieve a bright future for the children.
Collapse
Affiliation(s)
- M Bhardwaj
- Clinical Center of the Ludwig-Maximilian-University of Munich, Munich, Germany.
| | | | | | | | | | | | | |
Collapse
|
31
|
Weinmann T, Sárközi E, Praml G, von Kries R, Ehrenstein V, Nowak D, Radon K. [Objective assessment of total noise exposure over 24 hours: a cross-sectional study in Bavaria]. Gesundheitswesen 2011; 74:710-5. [PMID: 21901666 DOI: 10.1055/s-0031-1285864] [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] [Indexed: 10/17/2022]
Abstract
INTRODUCTION Noise can affect well-being and performance of individuals and might be associated with an increased risk of cardiovascular events. To date most epidemiological studies considered exposure from a single source of noise. The EU Environmental Noise Directive (2002/49/EC) requires a summative measurement of ambient noise. This study aimed to capture the participants' exposure to environmental noise by means of personal noise dosimetry. METHODS Children (n=628, participation=61%, age 8-12 years), adolescents (n=632, participation=58%, age 13-17 years) and adults (n=482, participation=40%, age 18-65 years) were selected randomly from the population registry of 4 Bavarian towns and were invited to participate in a 24-h measurement using noise dosimetry. Noise exposures during day and night were analyzed separately. In addition, predictors of noise exposure were assessed. RESULTS For daytime noise exposure mean±standard deviation were in children 80.0±5.8 dB(A), in adolescents 76.0±6.2 dB(A), in adults 72.1±6.1 dB(A) (p(ANOVA)<0.001). During the day personal noise exposure was statistically significantly higher for participants from smaller towns than for those living in Munich, while nighttime noise exposure was highest for participants from Munich [44.1±7.2 dB(A)]. CONCLUSION The summative noise exposure in urban Bavaria is high, in particular among children at daytime. Increased exposure levels in children might be caused by themselves while, e.g., playing. Whether the higher daytime exposure in towns is due to high noise levels commuting between home and work has to be assessed in future studies.
Collapse
Affiliation(s)
- T Weinmann
- AG Arbeits- und Umweltepidemiologie & NetTeaching, Institut und Poliklinik für Arbeits-, Sozial- und Umweltmedizin, Klinikum der Universität München
| | | | | | | | | | | | | |
Collapse
|
32
|
Weinmann T, Ehrenstein V, von Kries R, Nowak D, Radon K. Subjective and objective personal noise exposure and hypertension: an epidemiologic approach. Int Arch Occup Environ Health 2011; 85:363-71. [DOI: 10.1007/s00420-011-0679-7] [Citation(s) in RCA: 12] [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: 02/09/2011] [Accepted: 07/01/2011] [Indexed: 11/29/2022]
|