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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; 31:29971-29978. [PMID: 38594562 PMCID: PMC11058760 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] [MESH Headings] [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.
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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
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Hau EM, Sláma T, Essig S, Michel G, Wengenroth L, Bergstraesser E, von der Weid NX, Schindera C, Kuehni CE. Validation of self-reported cardiovascular problems in childhood cancer survivors by contacting general practitioners: feasibility and results. BMC Prim Care 2024; 25:81. [PMID: 38459512 PMCID: PMC10921568 DOI: 10.1186/s12875-024-02322-7] [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] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 02/23/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Epidemiological studies often rely on self-reported health problems and validation greatly improves study quality. In a study of late effects after childhood cancer, we validated self-reported cardiovascular problems by contacting general practitioners (GPs). This paper describes: (a) the feasibility of this approach; and (b) the agreement between survivor-reports and reports from their GP. METHODS The Swiss Childhood Cancer Survivor Study (SCCSS) contacts all childhood cancer survivors registered in the Swiss Childhood Cancer Registry since 1976 who survived at least 5 years from cancer diagnosis. We validated answers of all survivors who reported a cardiovascular problem in the questionnaire. Reported cardiovascular problems were hypertension, arrhythmia, congestive heart failure, myocardial infarction, angina pectoris, stroke, thrombosis, and valvular problems. In the questionnaire, we further asked survivors to provide a valid address of their GP and a consent for contact. We sent case-report forms to survivors' GPs and requested information on cardiovascular diagnoses of their patients. To determine agreement between information reported by survivors and GPs, we calculated Cohen's kappa (κ) coefficients for each category of cardiovascular problems. RESULTS We used questionnaires from 2172 respondents of the SCCSS. Of 290 survivors (13% of 2172) who reported cardiovascular problems, 166 gave consent to contact their GP and provided a valid address. Of those, 135 GPs (81%) replied, and 128 returned the completed case-report form. Survivor-reports were confirmed by 54/128 GPs (42%). Of the 54 GPs, 36 (28% of 128) confirmed the problems as reported by the survivors; 11 (9% of 128) confirmed the reported problem(s) and gave additional information on more cardiovascular outcomes; and seven GPs (5% of 128) confirmed some, but not all cardiovascular problems. Agreement between GPs and survivors was good for stroke (κ = 0.79), moderate for hypertension (κ = 0.51), arrhythmias (κ = 0.41), valvular problems (κ = 0.41) and thrombosis (κ = 0.56), and poor for coronary heart disease (κ = 0.15) and heart failure (κ = 0.32). CONCLUSIONS Despite excellent GP compliance, it was found unfeasible to validate self-reported cardiovascular problems via GPs because they do not serve as gatekeepers in the Swiss health care system. It is thus necessary to develop other validation methods to improve the quality of patient-reported outcomes.
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Affiliation(s)
- Eva-Maria Hau
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Tomáš Sláma
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Stefan Essig
- Center for Primary and Community Care, University of Lucerne, Lucerne, Switzerland
| | - Gisela Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva Bergstraesser
- Paediatric Palliative Care and Children's Research Center CRC, University Children's Hospital Zurich, Zurich, Switzerland
| | - Nicolas X von der Weid
- Division of Paediatric Oncology/Haematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Christina Schindera
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Oncology/Haematology, University Children's Hospital Basel, University of Basel, Basel, Switzerland
| | - Claudia E Kuehni
- Childhood Cancer Research Group, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.
- Paediatric Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Berglund F, Rodríguez-Molina D, Gradisteanu Pircalabioru G, Blaak H, Chifiriuc MC, Czobor Barbu I, Flach CF, Gheorghe-Barbu I, Măruțescu L, Popa M, de Roda Husman AM, Wengenroth L, Schmitt H, Larsson DGJ. The resistome and microbiome of wastewater treatment plant workers - The AWARE study. Environ Int 2023; 180:108242. [PMID: 37816267 DOI: 10.1016/j.envint.2023.108242] [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: 05/23/2023] [Revised: 09/27/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023]
Abstract
Urban wastewater treatment plants harbor a large collection of antibiotic resistant enteric bacteria. It is therefore reasonable to hypothesize that workers at such plants would possess a more diverse set of resistant enteric bacteria, compared to the general population. To address this hypothesis, we have compared the fecal microbiome and resistome of 87 workers at wastewater treatment plants (WWTPs) from Romania and the Netherlands to those of 87 control individuals, using shotgun metagenomics. Controlling for potential confounders, neither the total antibiotic resistance gene (ARG) abundance, nor the overall bacterial composition were significantly different between the two groups. If anything, the ARG richness was slightly lower in WWTP workers, and in a stratified analysis the total ARG abundance was significantly lower in Dutch workers compared to Dutch control participants. We identified country of residence, together with recent antibiotic intake in the Dutch population, as the largest contributing factors to the total abundance of ARGs. A striking side-finding was that sex was associated with carriage of disinfectant resistance genes, with women in both Romania and the Netherlands having significantly higher abundance compared to men. A follow up investigation including an additional 313 publicly available samples from healthy individuals from three additional countries showed that the difference was significant for three genes conferring resistance to chemicals commonly used in cosmetics and cleaning products. We therefore hypothesize that the use of cosmetics and, possibly, cleaning products leads to higher abundance of disinfectant resistance genes in the microbiome of the users. Altogether, this study shows that working at a WWTP does not lead to a higher abundance or diversity of ARGs and no large shifts in the overall gut microbial composition in comparison to participants not working at a WWTP. Instead, other factors such as country of residence, recent antibiotic intake and sex seem to play a larger role.
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Affiliation(s)
- Fanny Berglund
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Daloha Rodríguez-Molina
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, Munich, Germany
| | - Gratiela Gradisteanu Pircalabioru
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania; Academy of Romanian Scientists, Bucharest, Romania
| | - Hetty Blaak
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Mariana-Carmen Chifiriuc
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania; Academy of Romanian Scientists, Bucharest, Romania
| | - Ilda Czobor Barbu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
| | - Carl-Fredrik Flach
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Irina Gheorghe-Barbu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
| | - Luminița Măruțescu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
| | - Marcela Popa
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, Bucharest, Romania
| | - Ana Maria de Roda Husman
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU (Ludwig-Maximilians-Universität) Munich, Munich, Germany
| | - Heike Schmitt
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - D G Joakim Larsson
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden.
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Marutescu LG, Popa M, Gheorghe-Barbu I, Barbu IC, Rodríguez-Molina D, Berglund F, Blaak H, Flach CF, Kemper MA, Spießberger B, Wengenroth L, Larsson DGJ, Nowak D, Radon K, de Roda Husman AM, Wieser A, Schmitt H, Pircalabioru Gradisteanu G, Vrancianu CO, Chifiriuc MC. Wastewater treatment plants, an "escape gate" for ESCAPE pathogens. Front Microbiol 2023; 14:1193907. [PMID: 37293232 PMCID: PMC10244645 DOI: 10.3389/fmicb.2023.1193907] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Accepted: 05/09/2023] [Indexed: 06/10/2023] Open
Abstract
Antibiotics are an essential tool of modern medicine, contributing to significantly decreasing mortality and morbidity rates from infectious diseases. However, persistent misuse of these drugs has accelerated the evolution of antibiotic resistance, negatively impacting clinical practice. The environment contributes to both the evolution and transmission of resistance. From all anthropically polluted aquatic environments, wastewater treatment plants (WWTPs) are probably the main reservoirs of resistant pathogens. They should be regarded as critical control points for preventing or reducing the release of antibiotics, antibiotic-resistant bacteria (ARB), and antibiotic-resistance genes (ARGs) into the natural environment. This review focuses on the fate of the pathogens Enterococcus faecium, Staphylococcus aureus, Clostridium difficile, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacteriaceae spp. (ESCAPE) in WWTPs. All ESCAPE pathogen species, including high-risk clones and resistance determinants to last-resort antibiotics such as carbapenems, colistin, and multi-drug resistance platforms, were detected in wastewater. The whole genome sequencing studies demonstrate the clonal relationships and dissemination of Gram-negative ESCAPE species into the wastewater via hospital effluents and the enrichment of virulence and resistance determinants of S. aureus and enterococci in WWTPs. Therefore, the efficiency of different wastewater treatment processes regarding the removal of clinically relevant ARB species and ARGs, as well as the influence of water quality factors on their performance, should be explored and monitored, along with the development of more effective treatments and appropriate indicators (ESCAPE bacteria and/or ARGs). This knowledge will allow the development of quality standards for point sources and effluents to consolidate the WWTP barrier role against the environmental and public health AR threats.
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Affiliation(s)
- Luminita Gabriela Marutescu
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Marcela Popa
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Irina Gheorghe-Barbu
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Ilda Czobor Barbu
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Daloha Rodríguez-Molina
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 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, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Hetty Blaak
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Carl-Fredrik Flach
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden
| | - Merel Aurora Kemper
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - 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
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - D. G. Joakim Larsson
- Department of Infectious Diseases, Institute of Biomedicine, University of Gothenburg, Gothenburg, Sweden
- Centre for Antibiotic Resistance Research in Gothenburg (CARe), University of Gothenburg, Gothenburg, Sweden
| | - 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
| | - Ana Maria de Roda Husman
- Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 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 for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Gratiela Pircalabioru Gradisteanu
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Romanian Academy of Sciences, Bucharest, Romania
| | - Corneliu Ovidiu Vrancianu
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - Mariana Carmen Chifiriuc
- Department of Microbiology and Immunology, Faculty of Biology, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
- The Romanian Academy, Bucharest, Romania
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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.
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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
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Markovic A, Wengenroth L, Schlüter J, Kerber K, Parisi C, Strieker S, Bartelt A, Heinen F, Landgraf MN. 9/m mit unklaren Impulsdurchbrüchen. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01662-x] [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: 11/16/2022]
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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.
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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.
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Rodríguez-Molina D, Berglund F, Blaak H, Flach CF, Kemper M, Marutescu L, Pircalabioru Gradisteanu G, Popa M, Spießberger B, Wengenroth L, Chifiriuc MC, Larsson DGJ, Nowak D, Radon K, de Roda Husman AM, Wieser A, Schmitt H. International Travel as a Risk Factor for Carriage of Extended-Spectrum β-Lactamase-Producing Escherichia coli in a Large Sample of European Individuals—The AWARE Study. IJERPH 2022; 19:ijerph19084758. [PMID: 35457624 PMCID: PMC9029788 DOI: 10.3390/ijerph19084758] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/10/2022] [Accepted: 04/13/2022] [Indexed: 02/06/2023]
Abstract
Antibiotic resistance (AR) is currently a major threat to global health, calling for a One Health approach to be properly understood, monitored, tackled, and managed. Potential risk factors for AR are often studied in specific high-risk populations, but are still poorly understood in the general population. Our aim was to explore, describe, and characterize potential risk factors for carriage of Extended-Spectrum Beta-Lactamase-resistant Escherichia coli (ESBL-EC) in a large sample of European individuals aged between 16 and 67 years recruited from the general population in Southern Germany, the Netherlands, and Romania. Questionnaire and stool sample collection for this cross-sectional study took place from September 2018 to March 2020. Selected cultures of participants’ stool samples were analyzed for detection of ESBL-EC. A total of 1183 participants were included in the analyses: 333 from Germany, 689 from the Netherlands, and 161 from Romania. Travels to Northern Africa (adjusted Odds Ratio, aOR 4.03, 95% Confidence Interval, CI 1.67–9.68), Sub-Saharan Africa (aOR 4.60, 95% CI 1.60–13.26), and Asia (aOR 4.08, 95% CI 1.97–8.43) were identified as independent risk factors for carriage of ESBL-EC. Therefore, travel to these regions should continue to be routinely asked about by clinical practitioners as possible risk factors when considering antibiotic therapy.
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Affiliation(s)
- Daloha Rodríguez-Molina
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (L.W.); (D.N.); (K.R.)
- Institute for Medical Information Processing, Biometry and Epidemiology—IBE, LMU Munich, 81377 Munich, Germany
- Pettenkofer School of Public Health, 81377 Munich, Germany
- Correspondence: ; Tel.: +49-(89)-4400-52358; Fax: +49-(89)-4400-54954
| | - Fanny Berglund
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
| | - Hetty Blaak
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (H.B.); (M.K.); (A.M.d.R.H.); (H.S.)
| | - Carl-Fredrik Flach
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
| | - Merel Kemper
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (H.B.); (M.K.); (A.M.d.R.H.); (H.S.)
| | - Luminita Marutescu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania; (L.M.); (G.P.G.); (M.P.); (M.C.C.)
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania
| | - Gratiela Pircalabioru Gradisteanu
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania; (L.M.); (G.P.G.); (M.P.); (M.C.C.)
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania
| | - Marcela Popa
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania; (L.M.); (G.P.G.); (M.P.); (M.C.C.)
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania
| | - Beate Spießberger
- German Centre for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany; (B.S.); (A.W.)
- Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 81377 Munich, Germany
- Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, 80802 Munich, Germany
| | - Laura Wengenroth
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (L.W.); (D.N.); (K.R.)
| | - Mariana Carmen Chifiriuc
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest and the Academy of Romanian Scientists, 050657 Bucharest, Romania; (L.M.); (G.P.G.); (M.P.); (M.C.C.)
- Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, 030018 Bucharest, Romania
| | - D. G. Joakim Larsson
- Department of Infectious Diseases, Institute of Biomedicine, The Sahlgrenska Academy, University of Gothenburg, 40530 Gothenburg, Sweden; (F.B.); (C.-F.F.); (D.G.J.L.)
- Centre for Antibiotic Resistance Research (CARe), University of Gothenburg, 40530 Gothenburg, Sweden
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (L.W.); (D.N.); (K.R.)
- Comprehensive Pneumology Center Munich (CPC-M), German Center for Lung Research (DZL), 80336 Munich, Germany
| | - Katja Radon
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, 80336 Munich, Germany; (L.W.); (D.N.); (K.R.)
| | - Ana Maria de Roda Husman
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (H.B.); (M.K.); (A.M.d.R.H.); (H.S.)
| | - Andreas Wieser
- German Centre for Infection Research (DZIF), Partner Site Munich, 80336 Munich, Germany; (B.S.); (A.W.)
- Max von Pettenkofer Institute, Faculty of Medicine, LMU Munich, 81377 Munich, Germany
- Department of Infectious Diseases and Tropical Medicine, LMU University Hospital Munich, 80802 Munich, Germany
| | - Heike Schmitt
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, 3721 MA Bilthoven, The Netherlands; (H.B.); (M.K.); (A.M.d.R.H.); (H.S.)
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9
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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.
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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
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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.
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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.)
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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.
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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
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12
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Rodríguez-Molina D, Mang P, Schmitt H, Chifiriuc MC, Radon K, Wengenroth L. Do wastewater treatment plants increase antibiotic resistant bacteria or genes in the environment? Protocol for a systematic review. Syst Rev 2019; 8:304. [PMID: 31806019 PMCID: PMC6894476 DOI: 10.1186/s13643-019-1236-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 11/17/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Antibiotic resistance is a global public health threat. Water from human activities is collected at wastewater treatment plants where processes often do not sufficiently neutralize antibiotic resistant bacteria and genes, which are further shed into the local environment. This protocol outlines the steps to conduct a systematic review based on the Population, Exposure, Comparator and Outcome (PECO) framework, aiming at answering the question "Are antimicrobial-resistant enterobacteriaceae and antimicrobial resistance genes present (O) in air and water samples (P) taken either near or downstream or downwind or down-gradient from wastewater treatment plants (E), as compared to air and water samples taken either further away or upstream or upwind or up-gradient from such wastewater treatment plant (C)?" Presence of antimicrobial-resistant bacteria and genes will be quantitatively measured by extracting their prevalence or concentration, depending on the reviewed study. METHODS We will search PubMed, EMBASE, the Cochrane database and Web of Science for original articles published from 1 Jan 2000 to 3 Sep 2018 with language restriction. Articles will undergo a relevance and a design screening process. Data from eligible articles will be extracted by two independent reviewers. Further, we will perform a risk of bias assessment using a decision matrix. We will synthesize and present results in narrative and tabular form and will perform a meta-analysis if heterogeneity of results allows it. DISCUSSION Antibiotic resistance in environmental samples around wastewater treatment plants may pose a risk of exposure to workers and nearby residents. Results from the systematic review outlined in this protocol will allow to estimate the extend of exposure, to inform policy making and help to design future studies.
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Affiliation(s)
- Daloha Rodríguez-Molina
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany.
| | - Petra Mang
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
| | - Heike Schmitt
- Centre of Infectious Disease Control, National Institute for Public Health and the Environment, Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven, The Netherlands
| | - Mariana Carmen Chifiriuc
- Department of Microbiology and Immunology, Faculty of Biology, University of Bucharest, Bucharest, Romania.,Earth, Environmental and Life Sciences Section, Research Institute of the University of Bucharest, University of Bucharest, Bucharest, Romania
| | - 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
| | - Laura Wengenroth
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstr. 1, 80336, Munich, Germany
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13
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Weiss A, Sommer G, Schindera C, Wengenroth L, Karow A, Diezi M, Michel G, Kuehni CE, Ammann R, Scheinemann K, Ansari M, Beck Popovic M, Brazzola P, Greiner J, Grotzer M, Hengartner H, Kuehne T, Rössler J, Niggli F, Schilling F, von der Weid N. Hearing loss and quality of life in survivors of paediatric CNS tumours and other cancers. Qual Life Res 2018; 28:515-521. [DOI: 10.1007/s11136-018-2021-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/02/2018] [Indexed: 12/20/2022]
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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
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Körber F, Wengenroth L, Oberthuer A, Mehler K, Kribs A, Keller T. Einfluss von intranasal verabreichter Muttermilch bei Frühgeborenen mit hochgradigen intraventrikulären Blutungen – erste sonografische Ergebnisse. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600309] [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: 10/19/2022]
Affiliation(s)
- F Körber
- Universitätsklinik Köln, Institut für Diagnostische und Interventionelle Radiologie – Schwerpunkt Kinderradiologie, Köln
| | - L Wengenroth
- Uniklinik Köln, Klinik und Poliklinik f. Kinder- u. Jugendmedizin, Schwerpunkt Neonatologie und Pädiatrische Intensivstation, Köln
| | - A Oberthuer
- Uniklinik Köln, Klinik und Poliklinik f. Kinder- u. Jugendmedizin, Schwerpunkt Neonatologie und Pädiatrische Intensivstation, Köln
| | - K Mehler
- Uniklinik Köln, Klinik und Poliklinik f. Kinder- u. Jugendmedizin, Schwerpunkt Neonatologie und Pädiatrische Intensivstation, Köln
| | - A Kribs
- Uniklinik Köln, Klinik und Poliklinik f. Kinder- u. Jugendmedizin, Schwerpunkt Neonatologie und Pädiatrische Intensivstation, Köln
| | - T Keller
- Uniklinik Köln, Klinik und Poliklinik f. Kinder- u. Jugendmedizin, Schwerpunkt Neonatologie und Pädiatrische Intensivstation, Köln
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Belle F, Wengenroth L, Weiss A, Sommer G, Popovic MB, Ansari M, Bochud M, Kuehni C. SUN-P082: Low Adherence to Dietary Recommendations in Adult Childhood Cancer Survivors. Clin Nutr 2016. [DOI: 10.1016/s0261-5614(16)30425-3] [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: 10/21/2022]
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Lupatsch JE, Wengenroth L, Rueegg CS, Teuffel O, Gumy-Pause F, Kuehni CE, Michel G. Follow-up care of adolescent survivors of childhood cancer: The role of health beliefs. Pediatr Blood Cancer 2016; 63:318-25. [PMID: 26398593 DOI: 10.1002/pbc.25755] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Accepted: 08/20/2015] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about follow-up care attendance of adolescent survivors of childhood cancer, and which factors foster or hinder attendance. Attending follow-up care is especially important for adolescent survivors to allow for a successful transition into adult care. We aimed to (i) describe the proportion of adolescent survivors attending follow-up care; (ii) describe adolescents' health beliefs; and (iii) identify the association of health beliefs, demographic, and medical factors with follow-up care attendance. PROCEDURE Of 696 contacted adolescent survivors diagnosed with cancer at ≤ 16 years of age, ≥ 5 years after diagnosis, and aged 16-21 years at study, 465 (66.8%) completed the Swiss Childhood Cancer Survivor Study questionnaire. We assessed follow-up care attendance and health beliefs, and extracted demographic and medical information from the Swiss Childhood Cancer Registry. Cross-sectional data were analyzed using descriptive statistics and logistic regression models. RESULTS Overall, 56% of survivors reported attending follow-up care. Most survivors (80%) rated their susceptibility for late effects as low and believed that follow-up care may detect and prevent late effects (92%). Few (13%) believed that follow-up care is not necessary. Two health beliefs were associated with follow-up care attendance (perceived benefits: odds ratio [OR]: 1.56; 95% confidence interval [CI]: 1.07-2.27; perceived barriers: OR: 0.70; 95%CI: 0.50-1.00). CONCLUSIONS We show that health beliefs are associated with actual follow-up care attendance of adolescent survivors of childhood cancer. A successful model of health promotion in adolescent survivors should, therefore, highlight the benefits and address the barriers to keep adolescent survivors in follow-up care.
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Affiliation(s)
- Judith E Lupatsch
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Laura Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Corina S Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Oliver Teuffel
- Departement of Pediatric Hematology-Oncology, Bern University Hospital, Bern, Switzerland
| | - Fabienne Gumy-Pause
- Department of Pediatrics, University Hospital of Geneva, Geneva, Switzerland
| | - Claudia E Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Gisela Michel
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
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Magi T, Kuehni CE, Torchetti L, Wengenroth L, Lüer S, Frei-Erb M. Use of Complementary and Alternative Medicine in Children with Cancer: A Study at a Swiss University Hospital. PLoS One 2015; 10:e0145787. [PMID: 26694320 PMCID: PMC4687920 DOI: 10.1371/journal.pone.0145787] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 12/08/2015] [Indexed: 11/18/2022] Open
Abstract
Background Though complementary and alternative medicine (CAM) are frequently used by children and adolescents with cancer, there is little information on how and why they use it. This study examined prevalence and methods of CAM, the therapists who applied it, reasons for and against using CAM and its perceived effectiveness. Parent-perceived communication was also evaluated. Parents were asked if medical staff provided information on CAM to patients, if parents reported use of CAM to physicians, and what attitude they thought physicians had toward CAM. Study Design All childhood cancer patients treated at the University Children’s Hospital Bern between 2002–2011 were retrospectively surveyed about their use of CAM. Results Data was collected from 133 patients (response rate: 52%). Of those, 53% had used CAM (mostly classical homeopathy) and 25% of patients received information about CAM from medical staff. Those diagnosed more recently were more likely to be informed about CAM options. The most frequent reason for choosing CAM was that parents thought it would improve the patient’s general condition. The most frequent reason for not using CAM was lack of information. Of those who used CAM, 87% perceived positive effects. Conclusions Since many pediatric oncology patients use CAM, patients’ needs should be addressed by open communication between families, treating oncologists and CAM therapists, which will allow parents to make informed and safe choices about using CAM.
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Affiliation(s)
- Tatjana Magi
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Institute of Complementary Medicine, University of Bern, Bern, Switzerland
| | - Claudia E. Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Loredana Torchetti
- Institute of Complementary Medicine, University of Bern, Bern, Switzerland
| | - Laura Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Sonja Lüer
- Division of Pediatric Hematology/Oncology, University Children’s Hospital Bern, Inselspital, Bern, Switzerland
| | - Martin Frei-Erb
- Institute of Complementary Medicine, University of Bern, Bern, Switzerland
- * E-mail:
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Wengenroth L, Rueegg CS, Michel G, Gianinazzi ME, Essig S, von der Weid NX, Grotzer M, Kuehni CE. Concentration, working speed and memory: cognitive problems in young childhood cancer survivors and their siblings. Pediatr Blood Cancer 2015; 62:875-82. [PMID: 25645276 PMCID: PMC5916869 DOI: 10.1002/pbc.25396] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [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: 05/30/2014] [Accepted: 11/19/2014] [Indexed: 11/08/2022]
Abstract
BACKGROUND Cognitive problems can have a negative effect on a person's education, but little is known about cognitive problems in young childhood cancer survivors (survivors). This study compared cognitive problems between survivors and their siblings, determined if cognitive problems decreased during recent treatment periods and identified characteristics associated with the presence of a cognitive problem in survivors. METHODS As part of the Swiss Childhood Cancer Survivor Study, a questionnaire was sent to all survivors, aged 8-20 years, registered in the Swiss Childhood Cancer Registry, diagnosed at age <16 years, who had survived ≥ 5 years. Parent-reported (aged 8-15 years) and self-reported (aged 16-20 years) cognitive problems (concentration, working speed, memory) were compared between survivors and siblings. Multivariable logistic regression was used to identify characteristics associated with cognitive problems in survivors. RESULTS Data from 840 survivors and 247 siblings were analyzed. More often than their siblings, survivors reported problems with concentration (12% vs. 6%; P = 0.020), slow working speed (20% vs. 8%; P = 0.001) or memory (33% vs. 15%; P < 0.001). Survivors from all treatment periods were more likely to report a cognitive problem than were siblings. Survivors of CNS tumors (OR = 2.82 compared to leukemia survivors, P < 0.001) and those who had received cranial irradiation (OR = 2.10, P = 0.010) were most severely affected. CONCLUSION Childhood cancer survivors, even those treated recently (2001-2005), remain at risk to develop cognitive problems, suggesting a need to improve therapies. Survivors with cognitive problems should be given the opportunity to enter special education programs.
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Affiliation(s)
- L Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Switzerland
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Wengenroth L, Rueegg C, Michel G, Essig S, Ammann R, Bergstraesser E, Kuehni C. Life partnerships in childhood cancer survivors, their siblings, and the general population. Pediatr Blood Cancer 2014; 61:538-45. [PMID: 24136901 PMCID: PMC5917072 DOI: 10.1002/pbc.24821] [Citation(s) in RCA: 35] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 09/13/2013] [Indexed: 11/10/2022]
Abstract
BACKGROUND Life partnerships other than marriage are rarely studied in childhood cancer survivors (CCS). We aimed (1) to describe life partnership and marriage in CCS and compare them to life partnerships in siblings and the general population; and (2) to identify socio-demographic and cancer-related factors associated with life partnership and marriage. METHODS As part of the Swiss Childhood Cancer Survivor Study (SCCSS), a questionnaire was sent to all CCS (aged 20-40 years) registered in the Swiss Childhood Cancer Registry (SCCR), aged <16 years at diagnosis, who had survived ≥ 5 years. The proportion with life partner or married was compared between CSS and siblings and participants in the Swiss Health Survey (SHS). Multivariable logistic regression was used to identify factors associated with life partnership or marriage. RESULTS We included 1,096 CCS of the SCCSS, 500 siblings and 5,593 participants of the SHS. Fewer CCS (47%) than siblings (61%, P < 0.001) had life partners, and fewer CCS were married (16%) than among the SHS population (26%, P > 0.001). Older (OR = 1.14, P < 0.001) and female CCS (OR = 1.85, <0.001) were more likely to have life partners. CCS who had undergone radiotherapy, bone marrow transplants (global P Treatment = 0.018) or who had a CNS diagnosis (global P Diagnosis < 0.001) were less likely to have life partners. CONCLUSION CCS are less likely to have life partners than their peers. Most CCS with a life partner were not married. Future research should focus on the effect of these disparities on the quality of life of CCS.
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Affiliation(s)
- L. Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - C.S. Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - G. Michel
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - S. Essig
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - R.A. Ammann
- Department of Pediatrics, University of Bern, Bern, Switzerland
| | - E. Bergstraesser
- Department of Oncology, University Children’s Hospital, Zurich, Switzerland
| | - C.E. Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland,Correspondence to: Claudia E. Kuehni, Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland.
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Gianinazzi ME, Rueegg CS, Wengenroth L, Bergstraesser E, Rischewski J, Ammann RA, Kuehni CE, Michel G. Adolescent survivors of childhood cancer: are they vulnerable for psychological distress? Psychooncology 2013; 22:2051-8. [DOI: 10.1002/pon.3249] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 12/03/2012] [Accepted: 01/03/2013] [Indexed: 11/09/2022]
Affiliation(s)
- Micol E. Gianinazzi
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Corina S. Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Laura Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Eva Bergstraesser
- Department of Oncology; University Children's Hospital; Steinwiesstrasse 75; 8032; Zurich; Switzerland
| | - Johannes Rischewski
- Department of Pediatric Oncology and Hematology; Children's Hospital; 6000; Lucerne; Switzerland
| | - Roland A. Ammann
- Department of Pediatrics; University of Bern, Inselspital; 3010; Bern; Switzerland
| | - Claudia E. Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
| | - Gisela Michel
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine; University of Bern; Finkenhubelweg 11; 3012; Bern; Switzerland
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Rueegg CS, Michel G, Wengenroth L, von der Weid NX, Bergstraesser E, Kuehni CE. Physical performance limitations in adolescent and adult survivors of childhood cancer and their siblings. PLoS One 2012; 7:e47944. [PMID: 23082232 PMCID: PMC3474773 DOI: 10.1371/journal.pone.0047944] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 09/25/2012] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study investigates physical performance limitations for sports and daily activities in recently diagnosed childhood cancer survivors and siblings. METHODS The Swiss Childhood Cancer Survivor Study sent a questionnaire to all survivors (≥ 16 years) registered in the Swiss Childhood Cancer Registry, who survived >5 years and were diagnosed 1976-2003 aged <16 years. Siblings received similar questionnaires. We assessed two types of physical performance limitations: 1) limitations in sports; 2) limitations in daily activities (using SF-36 physical function score). We compared results between survivors diagnosed before and after 1990 and determined predictors for both types of limitations by multivariable logistic regression. RESULTS The sample included 1038 survivors and 534 siblings. Overall, 96 survivors (9.5%) and 7 siblings (1.1%) reported a limitation in sports (Odds ratio 5.5, 95%CI 2.9-10.4, p<0.001), mainly caused by musculoskeletal and neurological problems. Findings were even more pronounced for children diagnosed more recently (OR 4.8, CI 2.4-9.6 and 8.3, CI 3.7-18.8 for those diagnosed <1990 and ≥ 1990, respectively; p=0.025). Mean physical function score for limitations in daily activities was 49.6 (CI 48.9-50.4) in survivors and 53.1 (CI 52.5-53.7) in siblings (p<0.001). Again, differences tended to be larger in children diagnosed more recently. Survivors of bone tumors, CNS tumors and retinoblastoma and children treated with radiotherapy were most strongly affected. CONCLUSION Survivors of childhood cancer, even those diagnosed recently and treated with modern protocols, remain at high risk for physical performance limitations. Treatment and follow-up care should include tailored interventions to mitigate these late effects in high-risk patients.
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Affiliation(s)
- Corina S. Rueegg
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Gisela Michel
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Laura Wengenroth
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Nicolas X. von der Weid
- Paediatric Hematology-Oncology Unit, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
| | - Eva Bergstraesser
- Department of Oncology, University Children's Hospital Zurich, Zurich, Switzerland
| | - Claudia E. Kuehni
- Swiss Childhood Cancer Registry, Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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Radon K, Carvalho D, Calvo MJ, Struempell S, Herrera V, Wengenroth L, Kausel G, Marchetti N, Rojas DS, Russ P, Hege I. Implementation of virtual patients in the training for occupational health in Latin America. Int J Occup Environ Health 2011; 17:63-70. [PMID: 21344821 DOI: 10.1179/107735211799031068] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Health professionals trained in occupational health are essential to reduce the burden of occupational accidents and diseases. However, training resources are limited globally. We aimed to promote occupational health and safety (OHS) using virtual patients (VPs) in Brazil, Chile, and Germany. Virtual patients were created in three Latin-American health centers. So-called "partner VPs" comparing the distinct health care systems were designed. Translation, adaptation to different medical and legal systems, expert review, implementation into under- and postgraduate teaching, and user evaluation were performed. Twelve VPs covering traditional and contemporary OHS issues are available in Spanish, Portuguese, and English. Overall, 2371 students used the VPs. The number of Latin American users who evaluated VP content and relevance for their professional career was statistically significantly higher than the number of German students. VPs are a feasible learning method for OHS in middle-income countries. Partner VPs seem to be useful for teaching global aspects.
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Affiliation(s)
- Katja Radon
- University Hospital of Munich (LMU), Ziemssenstr 180336 Munich, Germany.
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Radon K, Carvalho D, Calvo MJ, Struempell S, Herrera V, Wengenroth L, Kausel G, Marchetti N, Rojas DS, Russ P, Hege I. Implementation of Virtual Patients in the Training for Occupational Health in Latin America. International Journal of Occupational and Environmental Health 2011. [DOI: 10.1179/oeh.2011.17.1.63] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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