Niagara Counties Research Articles

Effect of extreme temperatures on daily emergency room visits for mental disorders.

Relatively few studies investigated the effects of extreme temperatures (both heat and cold) on mental health (ICD-9: 290-319; ICD-10: F00-F99) and the potential effect modifications by individuals' age, sex, and race. We aimed to explore the effect of extreme temperatures of both heat and cold on the emergency room (ER) visits for mental health disorders, and conducted a stratified analysis to identify possible susceptible population in Erie and Niagara counties, NY, USA. To assess the short-term impacts of daily maximum temperature on ER visits related to mental disorders (2009-2015), we applied a quasi-Poisson generalized linear model combined with a distributed lag non-linear model (DLNM). The model was adjusted for day of the week, precipitation, long-term time trend, and seasonality. We found that there were positive associations between short-term exposure to extreme ambient temperatures and increased ER visits for mental disorders, and the effects can vary by individual factors. We found heat effect (relative risk (RR) = 1.16; 95% confidence intervals (CI), 1.06-1.27) on exacerbated mental disorders became intense in the study region and subgroup of population (the elderly) being more susceptible to extreme heat than any other age group. For extreme cold, we found that there is a substantial delay effect of 14 days (RR = 1.25; 95% CI = 1.08-1.45), which is particularly burdensome to the age group of 50-64 years old and African-Americans. Our findings suggest that there is a positive association between short-term exposure to extreme ambient temperature (heat and cold) and increased ER visits for mental disorders, and the effects vary as a function of individual factors, such as age and race.

Adaptive spatial sampling design for environmental field prediction using low-cost sensing technologies

The last decade has seen an explosion in data sources available for monitoring and prediction of environmental phenomena. While several inferential methods have been developed to make predictions on the underlying process by combining these data, an optimal sampling design for additional data collection in the presence of multiple heterogeneous sources has not yet been developed. Here, we provide an adaptive spatial design strategy based on a utility function that combines both prediction uncertainty and risk-factor criteria. Prediction uncertainty is obtained through a spatial data fusion approach based on fixed rank kriging that can tackle data with differing spatial supports and signal-to-noise ratios. We focus on the application of low-cost portable sensors, which tend to be relatively noisy, for air pollution monitoring, where data from regulatory stations as well as numeric modeling systems are also available. Although we find that spatial adaptive sampling designs can help to improve predictions and reduce prediction uncertainty, low-cost portable sensors are only likely to be beneficial if they are sufficient in number and quality. Our conclusions are based on a multi-factorial simulation experiment, and on a realistic simulation of pollutants in the Erie and Niagara counties in Western New York.

MP06-05 GEO-MAPPING AND SPATIAL ANALYSIS OF ENVIRONMENTAL EXPOSURES IN PATIENTS WITH BLADDER CANCER IN UPSTATE NEW YORK: AN EXPLORATORY STUDY

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I1 Apr 2018MP06-05 GEO-MAPPING AND SPATIAL ANALYSIS OF ENVIRONMENTAL EXPOSURES IN PATIENTS WITH BLADDER CANCER IN UPSTATE NEW YORK: AN EXPLORATORY STUDY Hijab Khan, Zhu Jin, Ahmed Aly Hussein, Youssef Ahmed, Samantha Bulkilvish, Shelby Hall, Renuka Kannappan, Omer Rana, Peter Rogerson, Samina Raja, and Khurshid Guru Hijab KhanHijab Khan More articles by this author , Zhu JinZhu Jin More articles by this author , Ahmed Aly HusseinAhmed Aly Hussein More articles by this author , Youssef AhmedYoussef Ahmed More articles by this author , Samantha BulkilvishSamantha Bulkilvish More articles by this author , Shelby HallShelby Hall More articles by this author , Renuka KannappanRenuka Kannappan More articles by this author , Omer RanaOmer Rana More articles by this author , Peter RogersonPeter Rogerson More articles by this author , Samina RajaSamina Raja More articles by this author , and Khurshid GuruKhurshid Guru More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.197AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The potential association of environmental exposures with bladder cancer is yet to be elucidated. We aimed to map patients treated with bladder cancer at our institution using Geographic Information Systems (GIS), and further attempted to identify and describe any environmental "hot spots." METHODS A retrospective review of our prospectively maintained database for patients with bladder cancer who visited our institution between 2006 and 2016 was performed. ArcGIS (v 10.4) was used to map patient residential addresses in Erie and Niagara counties in Upstate New York. We also conducted a “Hot Spot” analysis using the Getis-Ord Gi* statistic (using 90-99% confidence intervals). Analysis was conducted at the census block level (the smallest geographic unit used by the US Census Bureau) and accounted for population density of patients older than 50 years. Hot spots were further described in terms of water body quality (using reports from the New York State Department of Environmental Conservation) and industrial site presence (using data from the Environmental Protection Agency Facility Registry Service). RESULTS Out of 1543 patients with bladder cancer who visited our institution, 49% lived in Erie and Niagara counties. The mean age was 68 years (SD=13), 68% were males, and 55% used tobacco. Four hot spots were identified (Figure 1). Poor water quality was present in 3 and industrial sites were identified in 2 out of the 4 hot spots (Table 1). Water was contaminated with priority organic pollutants in one hot spot and pathogens in another. Additional suspected contaminants were present in 2 hot spots. Industrial sites produced specialty chemicals and processed food in one hot spot and fabricated metal at a second. CONCLUSIONS Spatial clustering of patients in 4 hotspots was identified in Erie and Niagara counties in Upstate New York. Within these hot spots, water quality and industrial sites of environmental concern were also identified. Future work will involve determining the relationship between these exposures, patient characteristics, and prevalence of bladder cancer. © 2018FiguresReferencesRelatedDetailsCited byYankelevich G, Dreher P, Taylor Z, Kim D, Buckley M, Larson S, Belkoff L, Bernstein G and Edwards D (2021) Socio-Environmental Conditions Associated with Geospatial Clusters of Urothelial Carcinoma: A Multi-Institutional AnalysisJournal of Urology, VOL. 206, NO. 6, (1390-1402), Online publication date: 1-Dec-2021. Volume 199Issue 4SApril 2018Page: e53-e54 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Hijab Khan More articles by this author Zhu Jin More articles by this author Ahmed Aly Hussein More articles by this author Youssef Ahmed More articles by this author Samantha Bulkilvish More articles by this author Shelby Hall More articles by this author Renuka Kannappan More articles by this author Omer Rana More articles by this author Peter Rogerson More articles by this author Samina Raja More articles by this author Khurshid Guru More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Shared polymorphisms and modifiable behavior factors for myocardial infarction and high cholesterol in a retrospective population study.

Genetic and environmental (behavior, clinical, and demographic) factors are associated with increased risks of both myocardial infarction (MI) and high cholesterol (HC). It is known that HC is major risk factor that may cause MI. However, whether there are common single nucleotide polymorphism (SNPs) associated with both MI and HC is not firmly established, and whether there are modulate and modified effects (interactions of genetic and known environmental factors) on either HC or MI, and whether these joint effects improve the predictions of MI, is understudied.The purpose of this study is to identify novel shared SNPs and modifiable environmental factors on MI and HC. We assess whether SNPs from a metabolic pathway related to MI may relate to HC; whether there are moderate effects among SNPs, lifestyle (smoke and drinking), HC, and MI after controlling other factors [gender, body mass index (BMI), and hypertension (HTN)]; and evaluate prediction power of the joint and modulate genetic and environmental factors influencing the MI and HC.This is a retrospective study with residents of Erie and Niagara counties in New York with a history of MI or with no history of MI. The data set includes environmental variables (demographic, clinical, lifestyle). Thirty-one tagSNPs from a metabolic pathway related to MI are genotyped. Generalized linear models (GLMs) with imputation-based analysis are conducted for examining the common effects of tagSNPs and environmental exposures and their interactions on having a history of HC or MI.MI, BMI, and HTN are significant risk factors for HC. HC shows the strongest effect on risk of MI in addition to HTN; gender and smoking status while drinking status shows protective effect on MI. rs16944 (gene IL-1β) and rs17222772 (gene ALOX) increase the risks of HC, while rs17231896 (gene CETP) has protective effects on HC either with or without the clinical, behavioral, demographic factors with different effect sizes that may indicate the existence of moderate or modifiable effects. Further analysis with the inclusions of gene–gene and gene–environmental interactions shows interactions between rs17231896 (CETP) and rs17222772 (ALOX); rs17231896 (CETP) and gender. rs17237890 (CETP) and rs2070744 (NOS3) are found to be significantly associated with risks of MI adjusted by both SNPs and environmental factors. After multiple testing adjustments, these effects diminished as expected. In addition, an interaction between drinking and smoking status is significant. Overall, the prediction power in successfully classifying MI status is increased to 80% with inclusions of all significant tagSNPs and environmental factors and their interactions compared with environmental factors only (72%).Having a history of either HC or MI has significant effects on each other in both directions, in addition to HTN and gender. Genes/SNPs identified from this analysis that are associated with HC may be potentially linked to MI, which could be further examined and validated through haplotype-pairs analysis with appropriate population stratification corrections, and function/pathway regulation analysis to eliminate the limitations of the current analysis.

Abstract P303: Low Albumin and Risk of Type 2 Diabetes

Type 2 diabetes (T2DM) is a burdensome, costly and debilitating disease that causes premature morbidity and mortality. Recent evidence suggests that T2DM is in part an inflammatory disease. It is well known that serum albumin is a negative acute phase reactant, yet few studies have examined the association between albumin and risk of T2DM. The purpose of this analysis was to prospectively examine the association between serum albumin and incident type 2 diabetes in middle-aged and older adults from a defined population. The Western New York Health Study enrolled apparently healthy participants ages 35-79 yrs from Niagara and Erie counties, NY. For this report, at baseline (1996-2001) all participants from the Western New York Health Study had fasting plasma glucose <110 mg/dl. At follow-up, six years later each case (n=61) was matched with up to three controls (n=158) on gender, race/ethnicity, the year of study enrollment, and baseline fasting glucose <110 mg/dl or 110-125 mg/dl. Diabetes at follow-up was defined as: 1) fasting plasma glucose > 125 mg/dl; 2) random glucose >199 mg/dl; or 3) a physician diagnosis and receiving antidiabetic medication. Conditional logistic regression was used to estimate the odds ratio (95% CI) of developing type 2 diabetes by tertile of baseline albumin adjusted for the matching criteria and additional covariates including BMI, smoking and physical activity. Mean age was 58 years; 60% women; 93% White. Multivariate analyses indicated that cases had lower baseline albumin concentrations (OR = 0.41, 95%CI: 0.17, 0.99 (p=0.04; lowest tertile vs highest) (p trend < 0.05). Further analyses indicated that this relation was independent of hs-CRP and IL-6. Stratification by smoking status did not alter the findings. The results of this analysis support the hypothesis that individuals with lower albumin concentrations were more likely to develop type 2 diabetes than those with higher levels.

The Association Between Central Fat Distribution and Recurrent Cardiovascular Disease Events in Female Survivors of Nonfatal Myocardial Infarction

Visceral fat has been shown to be an important predictor of metabolic alterations that lead to increased cardiovascular disease (CVD) risk factors, morbidity, and mortality. The aim of this study was to investigate the association between central fat distribution and the risk of recurrent coronary events among a cohort of female myocardial infarction (MI) survivors. Participants included 356 women (mean ± SD age, 55 ± 8.71 years) discharged alive after an incident MI from hospitals in Erie and Niagara (New York) counties between 1996 and 2004. A recurrent cardiovascular event was any nonfatal or fatal International Classification of Diseases, Ninth Revision-coded diagnosis between 390 and 450. The mean ± SD follow-up time was 4.01 ± 2.6 years. Interviews and self-administered follow-up surveys were used to collect pertinent information, and a search of the National Death Index Plus database was completed. Eighty-five women experienced a recurrent cardiovascular event. Using Cox proportional hazards analyses, the crude model for body mass index suggested that after incident MI, women had a 39% risk of a recurrent CVD event (hazard ratio [HR], 1.39; confidence interval [CI], 0.76-2.54; P = .293), whereas crude models for waist circumference and sagittal abdominal distention showed the risk to be more than twice as high (HR, 2.12; CI, 1.08-4.16; P = .010; and HR, 2.16; CI, 1.09-4.28; P = .037, respectively). Both measures of central fat distribution appeared to be better predictors of recurrent cardiovascular events when compared with body mass index, whereas sagittal abdominal distention was the better predictor compared with waist circumference, even after multivariate adjustment. After adjusting for secondary prevention interventions-statin, aspirin, β-blocker use, and physical activity-the risk of recurrent event was observed to decrease by about 1%. These results suggest that central fat distribution is positively associated with a recurrence of cardiovascular events after incident MI in women. The absence of decreased risk with secondary prevention interventions suggests that more investigation into the association of central abdominal fat and secondary prevention management is warranted.

Exposure to traffic emissions: Associations with biomarkers of antioxidant status and oxidative damage

BackgroundOxidative stress has been implicated as a possible mechanism for adverse health effects associated with traffic emissions. We examined the association of an estimate of traffic emissions with blood biomarkers of antioxidant capacity (glutathione, glutathione peroxidase, trolox-equivalent antioxidant capacity) and oxidative damage (thiobarbituric acid-reactive substances (TBARS)) among 1810 healthy women, randomly selected from Erie and Niagara Counties in Western New York. MethodsA geographic traffic emission and meteorological dispersion model was used to estimate annual polycyclic aromatic hydrocarbon (PAH) exposure from traffic emissions for each woman based on her residence at the time of study. Associations of traffic-related PAH exposure with measures of oxidative stress and antioxidant capacity were examined in multiple regression analyses with adjustment for potential confounders. ResultsHigher traffic-related PAH exposure was associated with decreased glutathione and increased glutathione peroxidase. Stronger associations between traffic-related PAH exposure and levels of glutathione and glutathione peroxidase were suggested among nonsmoking women without secondhand smoke exposure, especially among premenopausal nonsmoking women. Associations were also stronger for measurements made in warmer months. ConclusionsThese findings suggest that PAHs or other components of traffic emissions may impact anti-oxidative capacity among healthy women, particularly premenopausal non-smokers without secondhand smoke exposure.

Clustering of place of birth for women with breast cancer: differences by tumor characteristics

There is increasing evidence that exposures in early life affect breast cancer risk, and that breast cancer etiology differs by tumor subtype. If environmental exposures in early life contribute to risk, it is expected that there would be clustering of women with breast cancer by their place of birth, and that clustering might differ by subtype. We examined spatial associations between place of birth and breast cancer by subtype, using hormone receptor status and molecular profiles of breast tumors. Data were drawn from the Western New York Exposures and Breast Cancer study, a population-based case-control study of incident, pathologically confirmed breast cancer (1996-2001) in Erie and Niagara Counties. Included were women born in the study area (579 cases and 931 controls). Clustering of breast cancer subgroups relative to controls was examined by the k-function method in groups stratified by estrogen receptor (ER), progesterone receptor (PR), and HER2 status, and by DNA methylation status and p53 mutation status, and the k-function difference was used to compare relative spatial aggregation and spatial range of the difference between case subgroups and controls. We found a tendency to cluster among ER positive, PR positive, and HER2 negative cases (i.e., luminal A subtype), especially among premenopausal women, but not among the other groups defined by hormonal receptor status, or by either methylation or p53 mutation status. While our findings cannot rule out clustering of cases by birth place because of shared behaviors related to residence location, they also suggest that early life environmental exposures may affect subsequent breast cancer risk, and that premenopausal breast tumors of the luminal A subtype may be more affected by these early life exposures than other subtypes.

공간현상 분석을 위한 GIS 기반의 공간통계적 접근방법에 관한 고찰: 공간 군집지역 탐색을 위한 공간검색통계량의 실증적 사례분석

When analyzing geographical phenomena, two properties need to be considered. One is the spatial dependence structure and the other is a variation or an uncertainty inhibited in a geographic space. Two problems are encountered due to the properties. Firstly, spatial dependence structure, which is conceptualized as spatial autocorrelation, generates heterogeneous geographic landscape in a spatial process. Secondly, generic statistics, although suitable for dealing with stochastic uncertainty, tacitly ignores location information im plicit in spatial data. GIS is a versatile tool for manipulating locational information, while spatial statistics are suitable for investigating spatial uncertainty. Therefore, integrating spatial statistics to GIS is considered as a plausible strategy for appropriately understanding geographic phenomena of interest. Geographic hot-spot analysis is a key tool for identifying abnormal locations in many domains (e.g., criminology, epidemiology, etc.) and is one of the most prominent applications by utilizing the integration strategy. The article aims at reviewing spatial statistical perspective for analyzing spatial processes in the framework of GIS by carrying out empirical analysis. Illustrated is the analysis procedure of using spatial scan statistic for detecting clusters in the framework of GIS. The empirical analysis targets for identifying spatial clusters of breast cancer incidents in Erie and Niagara counties, New York.

Intervention to Promote Smoke-Free Policies Among Multiunit Housing Operators

To assess the efficacy of an intervention to encourage the adoption of smoke-free policies among owners and managers of multiunit housing. A pretest-posttest quasi-experimental design was employed. The study population included 287 multiunit housing operators (MUHOs) from across New York State who were recruited to complete a baseline survey designed to assess policies about smoking in the housing units that they owned and/or managed. Subjects were surveyed between March and July 2008 (n = 128 intervention, n = 159 control) and recontacted 1 year later to complete a follow-up survey (n = 59 intervention, n = 95 control). An informational packet on the benefits of implementing a smoke-free policy was mailed to MUHOs in the New York State counties of Erie and Niagara between March and July 2008. For comparison purposes, a sample of MUHOs located outside of Erie and Niagara counties who did not receive the information packet were identified to serve as control subjects. Logistic regression was used to assess predictors of policy interest, concern, and implementation at follow-up. Predictors included: intervention group, baseline status, respondent smoking status, survey type, government-subsidy status, quantity of units operated, and average building size, construction type, and age. Multiunit housing operators who received the information packet were more likely to report interest in adopting a smoke-free policy (OR = 6.49, 95% CI = 1.44-29.2), and less likely to report concerns about adopting such a policy (OR = 0.16, 95% CI = 0.04-0.66) compared to MUHOs who did not receive the information packet; however, the rate of adoption of smoke-free policies was comparable between the groups. Sending MUHOs an information packet on the benefits of adopting a smoke-free policy was effective in addressing concerns and generating interest toward smoke-free policies but was not sufficient in itself to generate actual policy adoption.

Abstract 5610: Air pollution exposure and promoter methylation of E-cadherin, p16, and RAR-β in breast cancer tumors from cases in the WEB study

Abstract Purpose: Aberrant methylation has been shown to be associated with breast cancer tumor tissue samples and ambient air pollution exposure has been shown to be associated with aberrant methylation of gene promoter regions; we investigated potential associations between air pollution exposure in early life and promoter methylation of genes among breast cancer tumors. Methods: Paraffin embedded, formalin fixed tumor tissue blocks were obtained for 803 breast cancer cases participating in the WEB study and assayed for DNA methylation status of three promoters regions of E-cadherin, p16 and RAR-β. Methylation specific PCR was used to determine methylation status. Historical annual ambient total suspended particulate matter (TSP) concentration (μg/m3) was collected from 87 air monitoring sites in Erie and Niagara Counties dating as far back as the late 1950's. Residential addresses were obtained for the time of birth, time of menarche, time of first birth if applicable, and 10 years prior to diagnosis with breast cancer. Using Arc View software, the addresses were geocoded and overlaid with the air pollution information to estimate exposure to TSP at each time point. TSP exposures varied greatly over time, therefore they were categorized into high and low based on the mean exposure among the non-breast cancer controls in the WEB study. This analysis consists of case-case comparisons, comparing TSP exposure to DNA methylation status among breast cancer patients. Odds ratios and 95% confidence limits were calculated with unconditional logistic regression, adjusting for potential confounders. We stratified all analyses by menopausal status. Results: Among pre- but not postmenopausal women, there was an increased likelihood of a case having methylation of the p16 promoter region for those exposed to >109.03 μg/m3 of TSP at first birth compared to those exposed to ≤109.03 μg/m3 (n=123; OR=6.5, 95% CI: 1.2-34. 1). E-cadherin promoter region methylation was inversely associated with high TSP at birth (> 137.88 μg/m3) among the pre-menopausal women (n=138; OR=0.2, 95% CI: 0.1-0.8) but not for post-menopausal women (n=289; OR=0.8, 95% CI: 0.4-1.6) nor for the other genes. There was no evidence of association between TSP exposures and RAR-β promoter region methylation for any of the time periods. Conclusion: Air pollution exposure at birth was much higher than exposure at later times due to increasing regulation. Exposure to higher levels of TSP at birth was associated with decreased likelihood of promoter region methylation for E-cadherin, particularly for premenopausal cases. TSP exposure at the time of a first birth was associated with increased likelihood of p16 promoter methylation in pre- but not postmenopausal breast tumors. While our results are necessarily preliminary, they suggest that exposure to air pollutants in early life may affect promoter methylation of E-cadherin and p16 genes. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5610. doi:10.1158/1538-7445.AM2011-5610

Prevalence and predictors of smoke-free policy implementation and support among owners and managers of multiunit housing

Exposure to secondhand smoke causes disease and premature death. Although many municipalities have instituted policies prohibiting smoking in public areas, personal living areas remain largely unregulated. Individuals who reside in multiunit housing (MUH) facilities where smoking is permitted are particularly susceptible to involuntary exposure. This study assessed the prevalence and predictors of smoke-free policy implementation and support among owners and managers of MUH throughout Western New York State. A telephone survey was administered to a sample of owners and managers of MUH buildings in the Erie and Niagara counties, New York. A total of 127 respondents completed the survey between March and July 2008 (62% response rate). Logistic regression was used to assess predictors of policy implementation and support, while adjusting for participant smoking status, quantity of units owned/managed, government subsidy status, as well as building age, construction type, and size. Only 13% of participants reported smoking restrictions within any of their buildings. Among those without a smoke-free policy, 75% would be interested in restricting smoking in at least one of their units, with interest being significantly higher among participants with government-subsidized units (odds ratio = 3.12, 95% CI = 1.14-8.52). Primary barriers to policy implementation included concern over increased vacancy (27%) and a decreased market base (21%). Few Western New York MUH owners and managers have implemented smoke-free policies in their buildings, but most are receptive to doing so. Therefore, opportunities exist for interventions to enhance policy acceptance, implementation, and enforcement among these individuals.

A Comparison of Three Methods for Identifying Transport-Based Exclusion: A Case Study of Children's Access to Urban Opportunities in Erie and Niagara Counties, New York

ABSTRACT Achieving transport sustainability is contingent on many factors, including transportation services being provided equitably regardless of race, income, gender, disability, and/or any other differentiating characteristics. A major risk of inequitable service provision is that without sufficient accessibility via transport, populations are put at a disadvantage, which may result in conditions of exclusion. At the present time, however, the dimensions of transport-based social exclusion are not fully understood, and the elusive nature of the concept renders it difficult to quantify. In this paper, three methods for identifying transport-excluded populations are examined and compared. The first follows a traditional approach to identifying disadvantaged groups by means of an inequality index based on deprivation. The other two techniques are accessibility-based, and work with a detailed travel diary data set. The study is conducted in the counties of Erie and Niagara, New York, and the population examined is composed of children between the ages of 5 and 18 years old. The results reveal how the models differentially identify excluded populations and should inform planners and practitioners of the implications for choosing between these different approaches.

Western New York Stormwater Coalition: Compliance through Collaboration

The Erie County Department of Environment and Planning initiated a regional strategy to assist the local municipal governments from Erie and Niagara Counties i…

Indicators of Sexual and Somatic Development and Adolescent Body Size in Relation to Prostate Cancer Risk: Results From a Case-Control Study

To examine the relationship between the indicators of sexual and somatic development (ie, age at first shaving and maximal shoe size) and adolescent anthropometric characteristics (ie, body size at age 10 to 13 years) and prostate cancer risk. We analyzed the data from a population-based case-control study in Erie and Niagara Counties, New York. The participants were 64 men with incident, primary, histologically confirmed, clinically apparent (Stage B and greater) prostate cancer and 218 controls, who had been frequency matched by age and residential area. Information regarding the variables of interest was self-reported. We compared the adjusted mean age at first shaving and age at maximal shoe size and calculated the odds of body size at ages 10 to 13 years using logistic regression models. The patients showed no evidence of older age at first shaving (adjusted mean, 18.0 versus 17.8 years, P = 0.46) or significant evidence of older age at the maximal shoe size (20.1 versus 17.6 years, P <0.05). The participants who defined themselves as being as heavy as or heavier than their peers at age 10 to 13 years showed a decreased prostate cancer risk compared with participants who were thinner than their peers (odds ratio 0.36, 95% confidence interval 0.15 to 0.83; and odds ratio 0.38, 95% confidence interval 0.17 to 0.87, respectively). Our results support a role for the indicators of somatic development and adolescent body size in predicting prostate cancer risk, suggesting that risk determinants operating early in life affect men's subsequent prostate cancer risk.

Periodontal disease and risk of myocardial infarction: the role of gender and smoking

Studies examining the association between periodontal disease and coronary heart disease have shown a consistent but weak to moderate relationship. Limited data have been reported in women and the role of smoking has not been fully clarified. A population-based case-control study examining the association between periodontal disease (PD) and acute non-fatal myocardial infarction (MI) was conducted in Erie and Niagara counties in Western New York State. Cases (574) were discharged alive from local hospitals with MI diagnosis. Controls (887) were county residents randomly selected from the NY State Department of Motor Vehicles rolls and Health Care Financing Administration files. Periodontal disease was assessed using clinical attachment loss (CAL). Among men (415 cases), the odds ratio (OR) of the association between mean CAL (mm) and MI, adjusting for the effects of age, body mass index (BMI), physical activity, hypertension, cholesterol, diabetes, and total pack-years of cigarette smoking was 1.34 (1.15-1.57). In women (120 cases), the corresponding OR was 2.08 (1.47-2.94). The estimate of this association among non-smokers, also adjusting for age, gender, BMI, physical activity, hypertension, cholesterol, diabetes, and total pack-years of cigarette smoking, was 1.40 (1.06-1.86), while it was 1.49 (1.26-1.77) among smokers. This study provides evidence of an association between PD and incident MI in both genders. This association appears to be independent from the possible confounding effect of smoking.

Exposure to traffic emissions throughout life and risk of breast cancer: the Western New York Exposures and Breast Cancer (WEB) study

We previously reported that total suspended particulates exposure (a measure of air pollution) at the time of birth was related to increased postmenopausal breast cancer risk. In this study, we examined breast cancer risk in relation to exposure to air pollution from traffic emissions throughout life. We conducted a case-control study of breast cancer. Participants were women, aged 35-79, residents of Erie and Niagara Counties. Cases had incident, primary, histologically confirmed breast cancer. Controls were randomly selected from the population, frequency-matched on age and race. Using lifetime residential histories, exposure to traffic emissions was modeled for each woman using her residence as a proxy. Estimates were calculated for residence at menarche, her first birth, and 20 and 10 years before interview. Unconditional logistic regression was used to calculate odds ratios (OR) and 95% confidence intervals (CI). Higher exposure to traffic emissions at the time of menarche was associated with increased risk of premenopausal breast cancer (OR 2.05, 95% CI 0.92-4.54, p for trend 0.03); and at the time of a woman's first birth for postmenopausal breast cancer (OR 2.57, 95% CI 1.16-5.69, p for trend 0.19). Statistically significant associations were limited to lifetime non-smokers; there was a significant interaction between exposure at time of menarche and smoking for premenopausal women. Our findings add to accumulating evidence that early life exposures impact breast cancer risk and provide indication of potential importance of traffic emissions in risk of breast cancer.

Association between anemia and quality of life in a population sample of individuals with chronic obstructive pulmonary disease

BackgroundSeveral studies investigated the association of anemia with health related quality of life (HRQL) in patients with chronic disease. However, there is little evidence regarding the association of anemia with HRQL in patients with chronic obstructive pulmonary disease (COPD).MethodsThis is a post-hoc analysis of a study which enrolled a population of adults aged 35–79 randomly selected from residents of Erie and Niagara Counties, NY, between 1996 and 2000. In addition to demographic information and physical measurements, we obtained spirometry data and hemoglobin levels. We used modified Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria to define COPD, and World Health Organization (WHO) criteria to define anemia. To assess HRQL we used the Short Form-36 (SF-36) to assess physical functioning (PF), physical component summary (PCS) measures and mental component summary (MCS) measures.ResultsIn the entire study population (n = 2704), respondents with anemia had lower scores on the physical functioning domain [45.4 (SD10.9) vs. 49.2 (SD 9.1); p < 0.0001]. Among patients with COPD (n = 495) the PF scores (39.9 vs. 45.4) and the PCS (41.9 vs. 45.9) were significantly lower in individuals with anemia compared to those without. In multiple regression analysis, the association between hemoglobin and PCS was positive (regression coefficient 0.02, p = 0.003). There was no significant association of hemoglobin with PF scores or the mental component summary measure after adjusting for covariates in patients with COPD.ConclusionIn patients with moderate to very severe COPD anemia may be associated with worse HRQL. However, co-morbidities may explain part or all of this association in these patients.

Internet cigarette purchasing among 9th grade students in western New York: 2000–2001 vs. 2004–2005

Objective. To assess trends and correlates of youth cigarette purchasing behavior on the Internet. Methods. In 2000–2001, Roswell Park Cancer Institute conducted a survey asking 7019 ninth grade students in Erie and Niagara Counties in New York State about their tobacco use and purchasing habits, including use of the Internet to buy cigarettes. The 2004–2005 survey is a replication of the 2000–2001 survey. Both surveys used an anonymous, self-administered questionnaire survey. These data were combined in order to examine trends in youth smoking behavior. Results. Students surveyed in 2004–2005 were 2.6 times more likely (95% CI: 1.5, 4.6) to have purchased cigarettes over the Internet in the 30 days prior to the survey than those surveyed in 2001 (5.2% to 1.6%); however, the intention to use the Internet as a cigarette source in the future did not change between survey periods. Conclusion. Youth online cigarette purchasing has increased but intention to use the Internet to purchase cigarettes in the future has remained the same, suggesting that this trend may be reaching a plateau. Recent public efforts to reduce online cigarette sales will need to be evaluated in order to determine which policy or combination of policies are most effective.

The Use of Different Measurements and Definitions of Periodontal Disease in the Study of the Association Between Periodontal Disease and Risk of Myocardial Infarction

The role of periodontal disease as an independent risk factor for cardiovascular disease (CVD) has been under debate because of the inconsistency of findings across studies. One of the major issues is the method used to assess or define periodontal disease. The present study assesses if the observed association between periodontal disease and incident myocardial infarction (MI) depends on the measurements and/or criteria used to define periodontal disease. A population-based case-control study to evaluate the association between PD and risk of MI was conducted between 1997 and 2001 in Western New York with 537 cases and 800 controls, aged 35 to 69 years. Cases were survivors of incident MI from local hospitals in Erie and Niagara counties. Controls were randomly selected from residents of the same counties. Periodontal disease was assessed using interproximal clinical attachment loss (CAL), probing depth (PD), alveolar crest height (ACH), and number of missing teeth. From these measurements, four different case definitions of periodontal disease were created. Using the continuous forms of periodontal measurements, the odds ratios (ORs) (95% confidence interval) of the association with incident MI were 1.46 (1.26 to 1.69), 2.19 (1.66 to 2.89), 1.30 (1.14 to 1.49), and 1.04 (1.02 to 1.07) for mean CAL, PD, ACH, and number of missing teeth, respectively. Regardless of the case definition of periodontal disease, the estimates of the association with incident MI were statistically significant. The observed association between periodontal disease and incident MI was consistent across different measurements and/or case definitions of periodontal disease used. The magnitude of the association varies depending on the measurements or the criteria used to define periodontal disease.