Highest Tertile Of Exposure Research Articles

An Updated Evaluation of Atrazine-Cancer Incidence Associations among Pesticide Applicators in the Agricultural Health Study Cohort.

Atrazine is a common agricultural herbicide in the United States. Few epidemiologic studies have evaluated cancer risks. Previous analyses within the Agricultural Health Study (AHS) have found some evidence of associations with cancer at some sites. We updated exposure information, incident cases, and follow-up time to assess the associations between atrazine use and cancer at specific sites in the AHS. Information about lifetime pesticide use was reported at enrollment (1993-1997) and follow-up (1999-2005). Among 53,562 pesticide applicators in North Carolina and Iowa, we identified 8,915 incident cases through cancer registry linkages through 2014 (North Carolina)/2017 (Iowa). We used Poisson regression to evaluate the association between ever/never and intensity-weighted lifetime days of atrazine use and incident cancer risk controlling for several confounders. We also evaluated lagged exposures and age-stratified risk. Approximately 71.2% of applicators reported ever using atrazine, which was associated with lung cancer [; 95% confidence interval (CI): 1.04, 1.46]. Aggressive prostate cancer risk was increased in the highest quartile (; 95% CI: 0.95, 1.52; ), particularly among those years old (; 95% CI: 1.61, 5.75; ; ). Among applicators years of age, ever-atrazine use was associated with non-Hodgkin lymphoma (NHL) (; 95% CI: 1.10, 5.38; ). For soft tissue sarcoma, there was an elevated risk in the highest tertile of exposure (: 2.54; 95% CI: 0.97, 6.62; ). In analyses with exposure lagged by 25 years, there was an elevated risk of pharyngeal (; 95% CI: 1.45, 6.36; ) and kidney (; 95% CI: 1.15, 2.29; ) cancers. We observed suggestive associations with some malignancies in overall, age-specific, and lagged analyses. Associations with aggressive prostate cancer and NHL were apparent among those diagnosed at younger ages and with cancers of the pharynx and kidney, and soft tissue sarcomas were observed in lagged analyses. Further work is needed to confirm these observed associations and elucidate potential underlying mechanisms. https://doi.org/10.1289/EHP13684.

Prenatal maternal pesticide exposure in relation to sleep health of offspring during adolescence

Study objectivesThe neurobiological processes involved in establishing sleep regulation are vulnerable to environmental exposures as early as seven weeks of gestation. Studies have linkedin utero pesticide exposure to childhood sleep-disordered breathing. However, the impact of in utero pesticide exposure on the sleep health of adolescents remains unexplored. Materials and methodsData from 137 mother-adolescent pairs from a Mexico City cohort were analyzed. We used maternal urinary 3-phenoxybenzoic acid (3-PBA, pyrethroid metabolite) and 3, 5, 6-trichloro-2-pyridinol (TCPy, chlorpyrifos metabolite) from trimester three to estimate in utero pesticide exposure. Among adolescents, we obtained repeated measures of objectively assessed sleep duration, midpoint, and fragmentation using wrist-actigraphy devices for 7 consecutive days in 2015 and 2017. Unstratified and sex-stratified associations between maternal urinary 3-PBA and TCPy and adolescent sleep measures were examined using generalized linear mixed models (GLMMs). We also examined the interactive effects of maternal pesticide exposure and offspring sex on sleep outcomes. Results3-PBA and TCPy were detected in 44.4% and 93% of urine samples, respectively. Adjusted findings demonstrated that higher exposure to maternal TCPy was associated with longer sleep duration and later sleep timing. Findings from interaction tests between maternal pesticide exposure and offspring sex were not statistically significant, although adjusted sex-stratified findings showed that the association between TCPy with duration and midpoint was evident only among female offspring. To illustrate, those in the highest tertile of exposure had a 59 minute (95% CI: 12.2, 104.8) (p, trend = 0.004) longer sleep duration and a 0.6 hour (95% CI: 0.01, 1.3) (p, trend = 0.01) later sleep midpoint. We found no significant associations between 3-PBA and sleep outcomes. ConclusionWithin a cohort of mother-adolescent pairs, we found associations between maternal prenatal pesticide exposure and longer sleep duration and later sleep timing among adolescent offspring. Further, this association may be female-specific.

Relationships between indicators of cardiovascular disease and intensity of oil and natural gas activity in Northeastern Colorado

Oil and natural gas (O&G) extraction emits pollutants that are associated with cardiovascular disease, the leading cause of mortality in the United States. We evaluated associations between intensity of O&G activity and cardiovascular disease indicators. Between October 2015 and May 2016, we conducted a cross-sectional study of 97 adults living in Northeastern Colorado. For each participant, we collected 1-3 measurements of augmentation index, systolic and diastolic blood pressure (SBP and DBP), and plasma concentrations of interleukin (IL)- 1β, IL-6, IL-8 and tumor necrosis factor alpha (TNF-α). We modelled the intensity of O&G activity by weighting O&G well counts within 16 km of a participant's home by intensity and distance. We used linear models accounting for repeated measures within person to evaluate associations. Adjusted mean augmentation index differed by 6.0% (95% CI: 0.6, 11.4%) and 5.1% (95%CI: -0.1, 10.4%) between high and medium, respectively, and low exposure tertiles. The greatest mean IL-1β, and α-TNF plasma concentrations were observed for participants in the highest exposure tertile. IL-6 and IL-8 results were consistent with a null result. For participants not taking prescription medications, the adjusted mean SBP differed by 6 and 1 mm Hg (95% CIs: 0.1, 13 mm Hg and -6, 8 mm Hg) between the high and medium, respectively, and low exposure tertiles. DBP results were similar. For participants taking prescription medications, SBP and DBP results were consistent with a null result. Despite limitations, our results support associations between O&G activity and augmentation index, SBP, DBP, IL-1β, and TNF-α. Our study was not able to elucidate possible mechanisms or environmental stressors, such as air pollution and noise.

Cadmium exposure and cognitive abilities and behavior at 10 years of age: A prospective cohort study

BackgroundWe have previously reported inverse associations of prenatal and childhood cadmium exposure with cognition in 5-year-old Bangladeshi children. ObjectivesTo assess if cadmium exposure affected cognition and behavior in the Bangladeshi children at 10 years. MethodsCadmium exposure was assessed by urinary concentrations at 10 (n = 1498) and 5 years of age (n = 1453), and of the mothers in early pregnancy (n = 1299), measured by ICP-MS. Cognitive abilities were assessed with Wechsler Intelligence Scale for Children (4th edition) and behavior with the parent-rated Strengths and Difficulties Questionnaire. ResultsIn multivariable-adjusted models, urinary cadmium at 10 years was inversely associated with Full scale IQ and most of the sub-scales. Associations were mainly observed in boys, in whom the difference in Full scale IQ was 7.0 scores (95% CI: –11, −2.7), corresponding to 0.21 SD, when comparing those in the highest (range: 0.30–2.6 μg/L) and lowest tertile of urinary cadmium (0.036–0.18 μg/L). Urinary cadmium at 5 years was inversely, but not significantly, associated with IQ. Children in the highest exposure tertile at 10 years also had poorer Prosocial behavior scores. The association appeared strongest in girls, in whom the corresponding OR for Prosocial scores in relation to cadmium exposure at 10 years and prenatally was 0.58 (95% CI: 0.34, 0.99) and 0.48 (95% CI: 0.25, 0.93), respectively. ConclusionChildhood cadmium exposure was associated with lower intelligence in boys, and there were indications of altered behavior in girls for both prenatal and childhood exposures. Findings are of concern as similar exposure levels are common world-wide.

Lead, cadmium and mercury in cerebrospinal fluid and risk of amyotrophic lateral sclerosis: A case-control study.

Exposure to neurotoxic chemicals such as pesticides, selenium, and heavy metals have been suggested to play a role in the etiology of amyotrophic lateral sclerosis (ALS). We assessed exposure to lead, cadmium, and mercury in 38 ALS patients (16 men and 22 females) and 38 hospital-admitted controls by using their cerebrospinal fluid (CSF) content as biomarker. We determined CSF heavy metal levels with inductively coupled plasma sector field mass spectrometry, according to a methodology specifically developed for this biological matrix. ALS patients had higher median values for Pb (155 vs. 132ng/L) but lower levels for Cd (36 vs. 72ng/L) and Hg (196 vs. 217ng/L). In the highest tertile of exposure, ALS odds ratio was 1.39 (95% CI 0.48-4.25) for Pb, 0.29 (0.08-1.04) for Cd and 3.03 (0.52-17.55) for Hg; however, no dose-response relation emerged. Results were substantially confirmed after conducting various sensitivity analyses, and after stratification for age and sex. Though interpretation of these results is limited by the statistical imprecision of the estimates, and by the possibility that CSF heavy metal content may not reflect long-term antecedent exposure, they do not lend support to a role of the heavy metals cadmium, lead and mercury in ALS etiology.

Survival and cardiovascular events in men treated with testosterone replacement therapy: an intention-to-treat observational cohort study

Conflicting evidence exists for the association between testosterone replacement therapy and mortality and cardiovascular events. The US Food and Drug Administration recently cautioned that testosterone replacement therapy might increase risk of heart attack and stroke, based on evidence from studies with short treatment duration and follow-up. No previous study has assessed the effect of duration of testosterone treatment on these outcomes. We aimed to assess the association between long-term use of testosterone replacement therapy and mortality, cardiovascular events, and prostate cancer diagnoses, using a time-varying exposure analysis. We did a population-based matched cohort study of men aged 66 years or older newly treated with testosterone replacement therapy and controls matched for age, region of residence, comorbidity, diabetes status, and index year from 2007-12 in Ontario, Canada, using data from the Ontario Drug Benefit database, the Canadian Institute for Health Information (CIHI) Discharge Abstract Database, the CIHI National Ambulatory Care Reporting System, the Ontario Health Insurance Plan database, the Ontario Myocardial Infarction Database, the Ontario Diabetes Database, the Ontario Cancer Registry, and the Registered Persons database. We assessed the association between cumulative testosterone replacement therapy exposure and mortality, cardiovascular events, and prostate cancer using marginal models with a time-varying testosterone exposure. We included 10 311 men treated with testosterone replacement therapy and 28 029 controls between Jan 1, 2007, and June 30, 2012. Over a median follow-up of 5·3 years (IQR 3·6-7·5) in the testosterone replacement therapy group and 5·1 years (3·4-7·4) in the control group, patients treated with testosterone replacement therapy had lower mortality than did controls (hazard ratio [HR] 0·88, 95% CI 0·84-0·93). Patients in the lowest tertile of testosterone exposure had increased risk of mortality (HR 1·11, 95% CI 1·03-1·20) and cardiovascular events (HR 1·26, 95% CI 1·09-1·46) compared with controls. By contrast, those in the highest tertile of testosterone exposure had decreased risk of mortality (HR 0·67, 95% CI 0·62-0·73) and cardiovascular events (HR 0·84, 95% CI 0·72-0·98), with a significant trend across tertiles (p<0·0001). Risk of prostate cancer diagnosis was decreased for those with the highest tertile of exposure (HR 0·60, 95% CI 0·45-0·80) compared with controls, but not for those with the shortest exposure. Long-term exposure to testosterone replacement therapy was associated with reduced risks of mortality, cardiovascular events, and prostate cancer. However, testosterone replacement therapy increased the risk of mortality and cardiovascular events with short durations of therapy. In view of the limitations of observational data and the potential for selection bias, these results warrant confirmation in a randomised trial. Physicians' Services Incorporated Foundation and Ajmera Family Chair in Urologic Oncology.

Environmental cadmium and lead exposure and anti-Müllerian hormone in pregnant women.

Anti-Müllerian Hormone (AMH) has been suggested as a marker for ovarian function. Cadmium and lead have been suggested to reduce female fecundity. In this study we aimed to investigate whether environmental exposure to cadmium and lead was associated with alterations in serum-AMH. The associations between serum-AMH and whole blood cadmium or lead were investigated by general linear models in a population-based sample of 117 pregnant women. The mean concentrations of blood cadmium and lead were 0.71μg/L and 17.4μg/L, respectively. The mean serum-AMH was 17.3pmol/L. No association between lead and AMH was detected. In the cadmium analysis the adjusted mean AMH level (95% CI) in the highest exposure tertile was 12.4 (6.4;23.8) compared to 5.6 (2.7;11.4) in the lowest exposure tertile (p=0.06). The study provides suggestive evidence that environmental exposure to cadmium, but not lead, may alter the level of AMH.

Arsenic and lung disease mortality in Bangladeshi adults.

Chronic arsenic exposure through drinking water is a public health problem affecting millions of people worldwide, including at least 30 million in Bangladesh. We prospectively investigated the associations of arsenic exposure and arsenical skin lesion status with lung disease mortality in Bangladeshi adults. Data were collected from a population-based sample of 26,043 adults, with an average of 8.5 years of follow-up (220,157 total person-years). There were 156 nonmalignant lung disease deaths and 90 lung cancer deaths ascertained through October 2013. We used Cox proportional hazards models to estimate adjusted hazard ratios and 95% confidence intervals (CIs) for lung disease mortality. Creatinine-adjusted urinary total arsenic was associated with nonmalignant lung disease mortality, with persons in the highest tertile of exposure having a 75% increased risk for mortality (95% CI = 1.15-2.66) compared with those in the lowest tertile of exposure. Persons with arsenical skin lesions were at increased risk of lung cancer mortality (hazard ratio = 4.53 [95% CI = 2.82-7.29]) compared with those without skin lesions. This prospective investigation of lung disease mortality, using individual-level arsenic measures and skin lesion status, confirms a deleterious effect of ingested arsenic on mortality from lung disease. Further investigations should evaluate effects on the incidence of specific lung diseases, more fully characterize dose-response, and evaluate screening and biomedical interventions to prevent premature death among arsenic-exposed populations, particularly among those who may be most susceptible to arsenic toxicity.

Birth Outcomes and Maternal Residential Proximity to Natural Gas Development in Rural Colorado

Background: Birth defects are a leading cause of neonatal mortality. Natural gas development (NGD) emits several potential teratogens, and U.S. production of natural gas is expanding.Objectives: We examined associations between maternal residential proximity to NGD and birth outcomes in a retrospective cohort study of 124,842 births between 1996 and 2009 in rural Colorado.Methods: We calculated inverse distance weighted natural gas well counts within a 10-mile radius of maternal residence to estimate maternal exposure to NGD. Logistic regression, adjusted for maternal and infant covariates, was used to estimate associations with exposure tertiles for congenital heart defects (CHDs), neural tube defects (NTDs), oral clefts, preterm birth, and term low birth weight. The association with term birth weight was investigated using multiple linear regression.Results: Prevalence of CHDs increased with exposure tertile, with an odds ratio (OR) of 1.3 for the highest tertile (95% CI: 1.2, 1.5); NTD prevalence was associated with the highest tertile of exposure (OR = 2.0; 95% CI: 1.0, 3.9, based on 59 cases), compared with the absence of any gas wells within a 10-mile radius. Exposure was negatively associated with preterm birth and positively associated with fetal growth, although the magnitude of association was small. No association was found between exposure and oral clefts.Conclusions: In this large cohort, we observed an association between density and proximity of natural gas wells within a 10-mile radius of maternal residence and prevalence of CHDs and possibly NTDs. Greater specificity in exposure estimates is needed to further explore these associations.Citation: McKenzie LM, Guo R, Witter RZ, Savitz DA, Newman LS, Adgate JL. 2014. Birth outcomes and maternal residential proximity to natural gas development in rural Colorado. Environ Health Perspect 122:412–417; http://dx.doi.org/10.1289/ehp.1306722

Dose-Response of Women’s Health-Related Quality of Life (HRQoL) and Life Satisfaction to Physical Activity

To examine the dose-response relationship between health related quality of life (HRQoL) and life satisfaction (outcomes) and duration of recreational physical activity (exposure). Further, to explore whether these relationships depend on type of physical activity (PA). 793 Australian rural-living women self-reported on duration of recreational PA; HRQoL via SF-36 Mental Component Summary (MCS) and Physical Component Summary (PCS); and a life satisfaction scale. ANOVAs and ANCOVAs investigated differences in outcomes (MCS, PCS, and life satisfaction) between tertiles of exposure to recreational PA, and types of PA (club sport, gymnasium, walking), with adjustment for potential confounders. A significant positive dose-response relationship was found between PCS and level of PA. Furthermore, this relationship depended on type of PA, with club-sport participants recording higher PCS than non-club-sport participants in all but the highest tertile of exposure. Life satisfaction and MCS were not significantly related to level of PA. Physical health was positively associated with level of recreational PA, with club sport participation contributing greater benefits at low to moderate exposures than participation in gymnasium or walking activities.

Association of Childhood Obesity With Maternal Exposure to Ambient Air Polycyclic Aromatic Hydrocarbons During Pregnancy

There are concerns that prenatal exposure to endocrine-disrupting chemicals increases children's risk of obesity. African-American and Hispanic children born in the Bronx or Northern Manhattan, New York (1998-2006), whose mothers underwent personal air monitoring for polycyclic aromatic hydrocarbon (PAH) exposure during pregnancy, were followed up to ages 5 (n = 422) and 7 (n = 341) years. At age 5 years, 21% of the children were obese, as were 25% of those followed to age 7 years. After adjustment for child's sex, age at measurement, ethnicity, and birth weight and maternal receipt of public assistance and prepregnancy obesity, higher prenatal PAH exposures were significantly associated with higher childhood body size. In adjusted analyses, compared with children of mothers in the lowest tertile of PAH exposure, children of mothers in the highest exposure tertile had a 0.39-unit higher body mass index z score (95% confidence interval (CI): 0.08, 0.70) and a relative risk of 1.79 (95% CI: 1.09, 2.96) for obesity at age 5 years, and they had a 0.30-unit higher body mass index z score (95% CI: 0.01, 0.59), a 1.93-unit higher percentage of body fat (95% CI: 0.33, 3.54), and a relative risk of 2.26 (95% CI: 1.28, 4.00) for obesity at age 7 years. The data indicate that prenatal exposure to PAHs is associated with obesity in childhood.

Abstract B32: Levels of metabolites of naphthalene in urine predict translocations in peripheral blood lymphocytes in children

Abstract Chromosomal aberrations (CAs) and translocations (TRNS) (subtype of CAs) are a validated biomarker of increased cancer risk in adults. Prenatal exposure to semi-volatile air PAH predicts levels of stable CAs in neonatal (cord) blood. Urinary levels of 1 and 2 naphthol, metabolites of naphthalene, an IARC class2b possible carcinogen, appear elevated in the CCCEH birth cohort. We hypothesize that concurrent exposure to naphthalene is associated with development of CAs and TRNS in children. Whole blood from 113 five year old children (68 girls) participating in the CCCEH birth cohort composed of Dominican (DomAm) (N=66) and African-Americans (AfrAm) (N=47) was processed fresh for Whole Chromosome Paint (WCP)-Fluorescent In Situ Hybridization using WCP for chromosomes 1-6. 400 Cell Equivalents [CE]) were scored for each child. TRNS were scored in accordance with the PAINT convention and frequencies were expressed per 100 CE. Levels of PAH metabolites were measured using MSGC in spot urine samples (Sjodin laboratory, CDC) collected concurrently and adjusted for urine specific gravity (SG). We examined predictors of presence of CA's or TRNS. For predicting frequency of CA and TRNS, mean ratios were derived for doubling of naphthol levels using negative binomial models. Results: 35 children had CA's and 20 had TRNS. Geometric means among AfrAm were 3490.2 for 1naphthol, and 3005.1 for 2naphthol, and 3336.4 and 5256.6 for 1 &amp; 2naphthol in DomAm children. Levels of 1&amp; 2 napthol did not vary with presence of a smoker in the child's home. 2naphthol (but not 1napthol) was higher in girls (p= 0.08) and in DomAm (p=0.01). After adjusting for gender and ethnicity, presence of both CA's and TRNS was predicted by increasing levels of 1- and 2- naphthol: OR for presence of CA's with increasing 1naphthol: (1.23; 95%CI:1.01, 1.48); and with 2napthol (1.19; 0.90, 1.56), but the effect was significantly higher in DomAms for both 1naphthol (1.63;1.21, 2.19) &amp; 2naphthol (1.44; 1.02, 2.04). For TRNS, the OR was 1.55 (1.11,2.17) for 1naphthol, and 1.92 (1.20-3.08) for 2naphthol. Frequency of CA's was predicted by 1naph (MR1.38; 1.10, 1.72) in DomAm but not in AfrAm (RR0.90; 0.65, 1.25). The association between naphthols and frequency of TRNS did not differ by ethnicity. To examine possible dose-response, levels of 2naphthol were grouped into tertiles using the lowest tertile as the referent group. After adjusting for gender/ethnicity, the proportion with TRNS present increased with increasing 2naphthol (though trend p = 0.09). Children with 2napthol in the highest tertile were significantly more likely to have translocations (OR 4.29; 95% CI: 1.11-16.55) when compared with children in the lowest tertile. Similarly, children with increasing 2-naphthol levels had increasing frequency of TRNS though the overall trend was not significant: mean TRNS frequencies for children in the highest tertile of exposure had a ratio of 3.23; (95%CI: 0.85-12.50) compared with those in the lowest tertile. The effect of increasing naphthol on aberrations or translocations was not dominated by any one chromosome, in contrast to our findings in newborns and prenatal air-PAH. Together these findings support our earlier findings that PAH exposure is associated with formation of TRNS, and suggests a dose response pattern with exposure to naphthalene, and an ethnic difference in susceptibility to formation of CAs. Citation Information: Cancer Prev Res 2010;3(12 Suppl):B32.

Exposure to cannabis in popular music and cannabis use among adolescents.

Cannabis use is referenced frequently in American popular music, yet it remains uncertain whether exposure to these references is associated with actual cannabis use. We aimed to determine if exposure to cannabis in popular music is associated independently with current cannabis use in a cohort of urban adolescents. We surveyed all 9th grade students at three large US urban high schools. We estimated participants' exposure to lyrics referent to cannabis with overall music exposure and content analyses of their favorite artists' songs. Outcomes included current (past 30 days) and ever use of cannabis. We used multivariable regression to assess independent associations between exposures and outcomes while controlling for important covariates. Each of the 959 participants was exposed to an estimated 27 cannabis references per day [correction added on 19 January 2010, after first online publication: 40 has been changed to 27] (standard deviation = 73 [correction added on 19 January 2010, after first online publication: 104 has been changed to 73]). Twelve per cent (n = 108) were current cannabis users and 32% (n = 286) had ever used cannabis. Compared with those in the lowest tertile of total cannabis exposure in music, those in the highest tertile of exposure were almost twice as likely to have used cannabis in the past 30 days (odds ratio = 1.83; 95% confidence interval = 1.04, 3.22), even after adjusting for socio-demographic variables, personality characteristics and parenting style. As expected, however, there was no significant relationship between our cannabis exposure variable and a sham outcome variable of alcohol use. This study supports an independent association between exposure to cannabis in popular music and early cannabis use among urban American adolescents.

S-ethyl-N,N-dipropylthiocarbamate exposure and cancer incidence among male pesticide applicators in the agricultural health study: a prospective cohort.

BackgroundThe Agricultural Health Study (AHS) is a prospective cohort study of licensed pesticide applicators from Iowa and North Carolina enrolled between 1993 and 1997. EPTC (S-ethyl-N,N-dipropylthiocarbamate) is a thiocarbamate herbicide used in every region of the United States. The U.S. Environmental Protection Agency reports that EPTC is most likely not a human carcinogen; however, the previous epidemiologic data on EPTC exposure and cancer risk were limited.ObjectivesThe purpose of this study was to examine cancer incidence and EPTC use in 48,378 male pesticide applicators enrolled in the AHS.MethodsWe estimated the rate ratio (RR) and 95% confidence intervals (CIs) for all cancers and selected cancer sites using Poisson regression. We assessed EPTC exposure using two quantitative metrics: lifetime exposure days and intensity-weighted lifetime exposure days, a measure that accounts for application factors that modify personal exposure likelihood.ResultsAmong the 9,878 applicators exposed to EPTC, 470 incident cancer cases were diagnosed during the follow-up period ending December 2004 compared with the 1,824 cases among individuals reporting no use. Although EPTC was associated with colon cancer in the highest tertile of both lifetime exposure days and intensity-weighted lifetime days (RR = 2.09; 95% CI, 1.26–3.47 and RR = 2.05; 95% CI, 1.34–3.14, respectively) and the trend test was < 0.01 for both, the pattern of RR was not monotonic with increasing use. There was a suggestion of an association with leukemia. No other associations were observed.ConclusionIn this analysis, EPTC use appeared to be associated with colon cancer and leukemia. However, given the relatively small number of cases in the highest exposure tertile, results should be interpreted with caution, and further investigations are needed.

Lung cancer risk and occupational exposure to meat and live animals

An increased risk of lung cancer has been reported for butchers and meat workers in several cohort studies, although confounding from tobacco smoking could not be ruled out in any of these studies. These exposures, as well as a potential risk associated with contact with live animals, are addressed here in a large case-control study with full adjustment for smoking. More than 5,900 subjects were included in a case-control study conducted in 7 European countries. For each job they employed local experts who assessed the exposure to a number of occupational agents, including (i) meat aerosols and (ii) live animals, on the basis of detailed occupational questionnaires. Information on tobacco consumption and other risk factors was also collected. A small increased risk of lung cancer was observed with exposure to meat aerosols, after adjusting for smoking, (odds ratio (OR)=1.27, 95% confidence interval (CI): 0.92, 1.75), which was most apparent for the upper tertile of cumulative exposure (OR=1.73, 95% CI: 1.03, 2.92). A similar overall effect was observed for exposure to live animals, with an increased risk observed for a high frequency of exposure, (OR=1.69, 95% CI: 1.21, 2.36) and a high intensity of exposure, (OR=1.85, 95% CI: 1.16, 2.94), with significant trends for increasing frequency (p=0.012), intensity (p=0.015) and cumulative exposure (p=0.024). In conclusion, this study provides evidence for an association between exposure to meat aerosols and lung cancer apparent in the highest tertile of exposure. The authors identified a more consistent association with exposure to live animals.

RESULTS OF A POPULATION-BASED CASE-CONTROL STUDY ON IONISING RADIATION AS A RISK FACTOR FOR LEUKAEMIA AND MALIGNANT LYMPHOMA

ISEE-175 Background: From December 1989 to Mai 1991 five incident acute leukaemia cases ⇐ 15 years were observed in the vicinity of the nuclear power plant Krümmel, in the Elbmarsch region near Hamburg. A retrospective incidence study on leukaemia, malignant lymphoma, multiple myeloma and other monoclonal, hematologic neoplasia (1984–1993) conducted in the 3 adjacent counties yielded elevated SIR in adults of both sexes in the 5km-region around the plant. As a consequence, the Northern Germany Leukaemia and Lymphoma Study (NLL) an analytic case-control study was commissioned and funded by the responsible ministries in Schleswig-Holstein and Lower Saxony. Methods: In the NLL we compared 1430 cases with monoclonal, lymphatic and myeloid neoplasia (first diagnosis before or at age 75 years, Dx 1986–1998) to 3041 controls from 6 counties around Hamburg, matched by age and sex. Controls were randomly selected from population registries. Exposure assessment is based on standardized computer-assisted, face-to-face interviews including all relevant sources of ionising radiation (emissions from nuclear power plants in routine operation, diagnostic X-rays/nuclear medicine, radiation/nuclear therapy, occupational exposure). Exposure to emissions from nuclear power plants was calculated referring to distance, wind direction and, specific radionuclides, considering external radiation/inhalation and ingestion separately as exposure pathways. Individual doses were weighted with interview information on time spent in each residence and at each workplace and the consumption of specific food categories. Alternatively, exposure was operationalised in a time-weighted distance score. All risk estimates are based on conditional logistic regression models, adjusted for possible confounders like smoking and social class. Results: For lymphatic entities we found odds ratios around 1.0 (non-exposed = reference, exposure classified as tertiles). For myeloid entities one increased, statistical significant OR was observed in men (1st exposure tertile: OR 2.08, p=0.017). Generally the distance score yielded similar results. In myeloid entities, again only for men, however, we found an increasing risk over categories of exposure (p for linear trend = 0.06; highest tertile of exposure: OR = 2.12 / p=0.026). Conclusion: The NLL included all patients of leukaemia and malignant lymphoma in the study region. Therefore, results refer to the largest possible number of cases in the region. A consistently increased risk for the general population for exposure to radionuclide emissions from nuclear power plants in normal operation cannot be confirmed. Strictly regional or temporal exposures e.g., due to accidental releases or other incidents, however, cannot be excluded, based on the present analysis.

ASSOCIATIONS OF POLYCYCLIC ORGANIC MATTER IN OUTDOOR AIR WITH DECREASED BIRTH WEIGHT: A PILOT CROSS-SECTIONAL ANALYSIS

The association between births that are small for gestational age and outdoor airborne polycyclic organic matter (POM) was examined in New Jersey, a highly urban state. This pilot study utilizes a cross-sectional investigation combining maternal and pregnancy outcome information from birth certificates with air toxics data from the U.S. Environmental Protection Agency Cumulative Exposure Project and census data at the census tract level. The exposure categories were based on tertiles of modeled average POM concentrations for each census tract in New Jersey. High POM exposure was positively associated with delivery of "small for gestational age" (SGA) births. After adjustment for potential individual-level confounding factors, the odds ratios for term, preterm, and all SGA were 1.22 (1.16-1.27), 1.26 (1.07-1.49), and 1.22 (1.17-1.27), respectively, for the highest exposure tertile in the urban population of the state (89% of the state's birth population). For group-level variables, the corresponding ORs were 1.12 (1.07-1.18), 1.23 (1.02-1.47), and 1.13 (1.07-1.18). The results of this study suggest that residential exposure to airborne polycyclic organic matter (POM) is associated with increased prevalence of "small for gestational age" births among urban population. Cross-sectional investigations combining air dispersion models with routinely collected population-based health and census data could be a useful approach for identifying the hazardous air pollutants of greatest public health concern.