Risk Of Respiratory Cancer Research Articles

Assessing lifetime occupational chrysotile inhalation exposure, respiratory symptoms, and lung cancer risk among brake maintenance workers in Malaysia.

This study aimed to estimate workers' occupational lifetime exposure to chrysotile and examine the respiratory symptoms and lung cancer risk. A total of 112 workers were interviewed about their occupational histories. Exposure modeling using information on the determinants of exposure was used to estimate chrysotile emissions. The cumulative lifetime exposure was then assessed for each worker. Respiratory symptoms were obtained using a validated questionnaire. Lung cancer mortality rate was also predicted using a model. Almost all the workers were male and young (mean age = 30 years, SD = 7). The estimated lifetime occupational chrysotile inhalation exposure ranged from 0.0001 to 0.0486 f/mL.years (median = 0.0018 f/mL.years, IQR = 0.486). A high prevalence of cough symptom (11.7%), and low estimated cancer risk (<1%) were reported. In conclusion, the lung cancer risk among our cohort of workers was at a low level because of lower cumulative lifetime occupational chrysotile exposure.

Advanced progress of the relationship between renin-angiotensin-aldosterone system inhibitors and cancers.

Hypertension and cancers are the most common causes of death in humans, as well as common co-diseases among elderly population. Studies have shown that hypertension is associated with carcinogenesis. The renin-angiotensin-aldosterone system (RAAS) is a crucial regulatory system of blood pressure, fluid, and electrolyte homeostasis, which plays an essential role in the pathogenesis of hypertension, whose mechanism is relatively clear. Studies have indicated that RAAS also widely exists in cancer tissues of different systems, which can affect the risk of cancers by stimulating cancer angiogenesis, participating in cancer-related oxidative stress, and regulating cancer-related immunity. Therefore, inhibiting RAAS activity seems beneficial to decreasing the risk of cancers. As one of the most commonly used antihypertensive drugs, RAAS inhibitors have been widely used in clinical practice. However, the conclusions of clinical studies on the relationship between RAAS inhibitors and cancers are not entirely consistent, which has been widely concerned by clinicians. The latest findings suggest that while RAAS inhibitors may reduce the risk of digestive cancers, respiratory cancers, urological cancers, gynecological cancers, and skin cancers, ACEIs may increase the risk of lung cancer, endometrial cancer, basal cell carcinoma, and squamous cell carcinoma. This article comprehensively reviews animal experiments, clinical studies, and meta-analyses on the relationship between RAAS inhibitors and cancers, to provide references for related studies in the future.

Appendix removal affects the subsequent cancer risk in Asian adults: A territory-wide population-based cohort study

Human appendix is critical for the maintenance of intestinal homeostasis. Appendicectomy has been the optimal treatment of acute appendicitis, yet the cancer incidence after appendix removal remains unclear. In this territory-wide retrospective cohort study, adult participants who underwent appendicectomy from 2000 to 2018 were retrieved from a population database (n = 43,983), while matched reference participants were retrieved as controls (n = 85,853). After appendicectomy, the overall cancer risk was significantly increased (subdistribution hazard ratio (SHR) = 1.124) compared to the non-appendicectomy group. Appendicectomy-treated males had higher cancer risk than males without appendicectomy (SHR = 1.197), while such difference was not observed in female participants. Significant increase in cancer risk was also observed in elder participants (age >60) with appendicectomy (SHR = 1.390). Appendicectomy was positively correlated with the risk of digestive tract and respiratory cancers including colon (SHR = 1.440), pancreas (SHR = 1.930), and trachea, bronchus, and lung (SHR = 1.394). In contrast, the risk of liver cancer was markedly decreased after appendicectomy (SHR = 0.713). In conclusion, we reported the association of appendicectomy with subsequent cancer incidence. These findings highlight the potential complication after appendix removal and the necessity of post-operative management to monitor and prevent long-term adverse events.

The Impact of Malnutrition on the Developing Lung and Long-Term Lung Health: A Narrative Review of Global Literature.

Worldwide, over 2 billion children under the age of 5 experience stunting, wasting, or are underweight. Malnutrition contributes to 45% of all deaths in this age group (approximately 3.1 million deaths) [1]. Poverty, food insecurity, suboptimal feeding practices, climate change, and conflict are all contributing factors. Malnutrition causes significant respiratory problems, including increased risk of respiratory infections, impaired lung function, and increased risk of subsequent adult respiratory disease, including asthma, COPD, and lung cancer. Childhood malnutrition not only has serious consequences for children's health but it also has numerous consequences on wellbeing and educational attainment. Childhood malnutrition is a complex and multifaceted problem. However, by understanding and addressing the underlying causes, and investing in prevention and treatment programs, it is possible to maximize children's health and wellbeing on a global scale. This narrative review will focus on the impact of childhood malnutrition on lung development, the consequent respiratory disease, and what actions can be taken to reduce the burden of malnutrition on lung health.

Common skin cancers and their association with other non-cutaneous primary malignancies: a review of the literature.

It has long been recognized that a history of skin cancer puts one at risk for additional primary skin cancers. However, more variable data exists for the risk of developing a non-cutaneous primary cancer following a diagnosis of skin cancer. The data are most variable for Basal Cell Carcinoma (BCC), the most common and least aggressive type of skin cancer. While early studies imply that BCC does not impart a larger risk of other primary non-cutaneous cancers, more recent studies with larger populations suggest otherwise. The cancers most significantly associated with BCC are lip, oropharyngeal, and salivary gland cancer. There is also burgeoning evidence to suggest a link between BCC and prostate, breast, and colorectal cancer, but more data are needed to draw a concrete conclusion. Squamous Cell Carcinoma (SCC), the second most common type of skin cancer, has a slightly more defined risk to other non-cutaneous primary malignancies. There is a notable link between SCC and non-Hodgkin's lymphoma (NHL), possibly due to immunosuppression. There is also an increased risk of other cancers derived from squamous epithelium following SCC, including oropharyngeal, lip, and salivary gland cancer. Some studies also suggest an increased risk of respiratory tract cancer following SCC, possibly due to shared risk factors. Melanoma, a more severe type of skin cancer, shows a well-defined risk of additional primary non-cutaneous malignancies. The most significant of these risks include NHL, thyroid cancer, prostate cancer, and breast cancer along with a host of other cancers. Each of these three main skin cancer types has a profile of genetic mutations that have also been linked to non-cutaneous malignancies. In this review, we discuss a selection of these genes to highlight the complex interplay between different tumorigenesis processes.

546 - Patient preferences for treatment attributes in moderate-to-severe atopic dermatitis: a discrete choice experiment

Abstract Introduction/Background Atopic dermatitis (AD) affects approximately 5-10% of adults worldwide, significantly burdening affected patients. Newer treatments for moderate-to-severe AD, including biologic therapies and Janus-kinase (JAK) inhibitors, are associated with varied levels of efficacy, safety, monitoring, and administration requirements. Yet, patient preferences for different treatment options are not well characterized. Objectives A discrete choice experiment (DCE) was designed to quantify the extent to which AD patients in the United States (US) value different treatment attributes. Methods An online DCE survey was conducted in June 2023. Eligible participants included US adults (≥ 18 years) with self-reported moderate-to-severe AD or experience with systemic therapy, diagnosed with AD for ≥1 year, with inadequate response to topical treatments. DCE attributes were selected based on qualitative interviews with patients and clinical input, including attributes related to efficacy (i.e., sustained improvement in skin appearance, itch control), safety (i.e., risk of respiratory infection, cancer, and heart problems), treatment administration, and blood test frequency. Participants were presented 12 choice tasks, each presenting two hypothetical treatment profiles, and selected one profile from each task that reflected their preferred option. A conditional logit regression model was used to assess patient preferences for attributes. Sensitivity analyses were conducted, excluding patients who failed validity tests. Results A diverse group of 300 participants completed the survey (mean age: 45 years; 22% non-white or mixed; 70% female; 66% employed). Approximately half received their first AD treatment of any kind 5 or more years ago (50%), had experienced severe symptoms (50%), and had experience with systemic therapy (52%). Participants preferred treatments with higher efficacy, lower risk of AEs, and less frequent blood tests (p &amp;lt; 0.05). Frequency and mode of administration (i.e., oral vs. injectable) did not impact preferences (p &amp;gt; 0.05). On average, participants were willing to accept a reduction of 35.4, 17.7, and 1.2 percentage points in the probability of achieving itch control to receive a treatment with 1 percentage point less risk of cancer, heart problems, and respiratory infections, respectively. Treatment attributes, from high to low relative importance, were itch control (38%), followed by risk of cancer (23%), risk of respiratory infections (18%), risk of heart problems (11%), sustained improvement in skin appearance (5%), blood test frequency (3%), and frequency and mode of administration (2%). Results were similar in sensitivity analyses, indicating the robustness of the findings. Conclusions Patients with moderate-to-severe AD preferred treatments that maximize itch control while minimizing the risk of AEs (cancer, respiratory infections, heart problems), whereas mode of administration had little impact on preferences. Understanding patients’ preferences may help improve shared decision-making.

Lower respiratory tract microbiome and lung cancer risk prediction in patients with diffuse lung parenchymal lesions.

In clinical practice, imaging manifestations of diffuse lung parenchymal lesions are common and indicative of various diseases, making differential diagnosis difficult. Some of these lesions are eventually diagnosed as lung cancer. Because respiratory microorganisms play an important role in lung cancer development, we searched for microbial markers that could predict the risk of lung cancer by retrospectively analyzing the lower respiratory tract (LRT) microbiome of 158 patients who were hospitalized in the First Affiliated Hospital of Guangzhou Medical University (March 2021-March 2023) with diffuse lung parenchymal lesions. The final diagnosis was lung cancer in 21 cases, lung infection in 93 cases, and other conditions (other than malignancy and infections) in 44 cases. The patient's clinical characteristics and the results of metagenomic next-generation sequencing of bronchoalveolar lavage fluid (BALF) were analyzed. Body mass index (BMI) and LRT microbial diversity (Shannon, Simpson, species richness, and Choa1 index) were significantly lower (P< 0.001, respectively) and Lactobacillus acidophilus relative abundance in the LRT was significantly higher (P< 0.001) in patients with lung cancer. The relative abundance of L. acidophilus in BALF combined with BMI was a good predictor of lung cancer risk (area under the curve = 0.985, accuracy = 98.46%, sensitivity = 95.24%, and specificity = 100.00%; P< 0.001). Our study showed that an imbalance in the component ratio of the microbial community, diminished microbial diversity, and the presence of specific microbial markers in the LRT predicted lung cancer risk in patients with imaging manifestations of diffuse lung parenchymal lesions.

Respiratory Tract Cancer Incidences across Industry Groups: A Nationwide Cohort Study with More Than 70 Million Person-Years of Follow-Up.

The number of cases and incidence rates of laryngeal and lung cancers have been increasing globally. Therefore, identifying the occupational causes of such cancers is an important concern for policymakers to prevent cancers and deaths. We used national health insurance service claims data in Korea. We included 10,786,000 workers aged between 25 and 64 years. In total, 74,366,928 total person-years of follow-up were included in this study with a mean follow-up of 6.89 years for each person. The standardized incidence ratio (SIR) and 95% confidence intervals (CIs) referenced with the total workers were estimated. For laryngeal cancer, increased SIRs were observed in the land transportation industry among male workers (SIR [95% CI]: 1.65 [1.02-2.53]). For lung cancer, elevated SIRs were observed in the industries including animal production (1.72 [1.03-2.68]), fishing (1.70 [1.05-2.60]), mining (1.69 [1.22-2.27]), travel (1.41 [1.00-1.93]), and transportation (1.22 [1.15-1.30]) among male workers. For female works, healthcare (2.08 [1.04-3.72]) and wholesale (1.88 [1.18-2.85]) industries were associated with a high risk of lung cancer. As an increased risk of respiratory tract cancers has been identified in employees associated with certain industries, appropriate policy intervention is needed to prevent occupational cancers.

Disposable E-Cigarettes and Associated Health Risks: An Experimental Study.

The use of electronic nicotine delivery systems (ENDS), including disposable e-cigarettes, has been prevalent. Existing chemical analyses of ENDS focused on e-liquids rather than aerosols and failed to consider particle sizes and aerosol respiratory deposition fractions, which are key factors for inhalation doses. This study investigated the organic chemical and metal constituents in size-segregated ENDS aerosol and assessed the deposited doses and health risks of these substances. Aerosol chemical analyses were conducted on two popular disposable ENDS products: Puff Bar (Grape) and Air Bar (Watermelon Ice). An ENDS aerosol was generated and delivered into a Micro-Orifice Uniform Deposit Impactor to collect size-segregated aerosol samples, in which organic chemicals and metals were analyzed. Daily and lifetime doses for each chemical were estimated. Cancer and non-cancer risk assessments were conducted based on the deposited doses. We found that e-cigarette aerosol contains certain harmful organic chemicals and metals documented to result in respiratory problems. Estimated respiratory cancer risks corresponding to chromium from both ENDS products and nickel from Air Bar (Watermelon Ice) were substantially above the conventionally acceptable risk. The method, findings, and implications can contribute to the extant literature of ENDS toxicity studies as well as inform tobacco regulation and future large-scale studies.

Differential role of chronic liver diseases on the incidence of cancer: a longitudinal analysis among 248,224 outpatients in Germany

BackgroundChronic liver diseases, especially chronic hepatitis, are a known risk factor for the development of liver cancer. However, the risk of total cancer development and malignant potential from these diseases is largely unknown. Systematic data on the risk of cancer development from these diseases are missing. Therefore, the goal of this study is to analyze the risk of total cancer development in chronic liver diseases.MethodsA cohort of 15,706 patients with chronic hepatitis and 15,706 patients without hepatitis were matched by propensity scoring from outpatient practices in Germany over a period of 15 years. Cox regression models were conducted to study the association between alcoholic hepatitis, autoimmune hepatitis, hepatitis B, hepatitis C and cancer incidence, including liver, other digestive organs, skin, prostate, breast and lymphoid and hematopoietic tissue cancer.ResultsWithin 10 years of the index date, 19.3% of patients with alcoholic hepatitis and 13.4% of non-hepatitis individuals were diagnosed with cancer (log-rank p = 0.035). These proportions were 15.0 vs. 9.9% (p = 0.078) for autoimmune hepatitis, 8.7 vs. 7.1% (p = 0.015) for hepatitis B, and 12.7 vs. 7.6% (p < 0.001) for hepatitis C. In regression analyses, only alcoholic hepatitis (HR: 1.84, 95% CI 1.32–2.54) and hepatitis C (HR: 2.10, 95% CI 1.77–2.50) were significantly associated with increased risk of cancer. There was a very strong positive association between hepatitis C and liver cancer (HR: 78.2 (95% CI 10.9–560.7). Furthermore, hepatitis C was associated with an increased risk of respiratory organ cancer (HR: 2.59, 95% CI 1.42–4.73).ConclusionThis study confirms the strong association between chronic hepatitis and liver cancer, but also with an overall elevated cancer risk, and especially of cancer in the respiratory tract in patients with chronic hepatitis C.

How long-term metal and lead exposure among foundry workers affect COVID-19 infection outcomes in Jordan.

Foundry workers face a number of occupational health hazards, which may lead to an increased risk of respiratory disease, cancer, and anxiety level and are associated with endocrine, hematologic, renal, and neurological problems in humans. This study aims to evaluated thyroid functions, glutathione level, and the risk of infection with SARS-CoV-2 after vaccinated (two doses of the BNT162b2 mRNA COVID-19 vaccine) foundry workers in Jordan. We examined the efficacy BNT162b2 vaccine by calculating the rate of mortality and the degree of severity from mild to severe respiratory infections in 105 adult males foundry workers occupationally exposed to metals and Pb who had been received two doses, 21 days apart, of the BNT162b2 vaccine. Seventy-five male subjects not exposed to the Pb and who received two shots of the BNT162b2 vaccine (Pfizer–BioNTech) served as the control group. In foundry workers who were infected with COVID-19, the mortality rate (0%) was similar as in the control group (0%), and increased transmission of infection with SARS-CoV-2; the non-hospitalized infections increased nearly 3.4-times and hospitalized infections increased 4.29-times among people exposed to lead and metal contamination compared to the healthy persons control group. Also, among the foundry workers, the blood lead, FT3, and FT4 levels were significantly higher (p < 0.0001) and the levels of glutathione and TSH were significantly decreased (p < 0.0001) compared with the control group. In conclusion, long-term exposure to Pb is associated with a risk of infection with COVID-19 despite the 2 doses of the BNT162b2 vaccine (Pfizer–BioNTech). Also, exposure to Pb is associated with hyperthyroidism and a reduction in glutathione.

Disruption of mitochondrial redox homeostasis as a mechanism of antimony-induced reactive oxygen species and cytotoxicity

Occupational and environmental Sb exposure has been associated with increased risk of respiratory diseases and lung cancer, but the toxicities and molecular mechanisms of Sb have been less investigated. In the present study, we first analyzed the Sb toxicity profile of lung adenocarcinoma A549 cells, and found that Sb dose-dependently decreased the cell viability and arrested cell cycle at G2/M but did not induce apoptosis. We next investigated the role of reactive oxygen species (ROS) involved in Sb-induced cytotoxicity. The results showed that Sb did not significantly induce cytosolic ROS production by NADPH oxidase (NOX) and the NOX inhibitors did not ameliorate the Sb-induced cell viability loss in A549 cells. However, the level of mitochondrial ROS (mtROS) was significantly increased in Sb-exposed cells and the mitochondria-targeted antioxidant significantly improved cell viability. These results suggested that mitochondria but not NOX is the major source of ROS production and mtROS plays a critical role in Sb-induced cytotoxicity. Furthermore, we found that Sb induced mitochondria dysfunction including the significant decrease of ATP level and mitochondrial membrane potential. Finally, Sb exposure decreased the activity of complex I and complex III, the level of -SH and GSH in mitochondria, and the activity of mitochondrial GR, GPx and TrxR, but increased the mitochondrial SOD activity, suggesting the disruption of mitochondrial redox homeostasis. Taken together, these findings suggested that Sb impaired mitochondrial redox homeostasis, resulting in formation of mtROS, thereby inhibited mitochondrial function and led to cytotoxicity.

Determining the association between repeatedly elevated serum gamma-glutamyltransferase levels and risk of respiratory cancer: A nationwide population-based cohort study.

BackgroundAlthough elevated serum gamma‐glutamyltransferase (GGT) is a known indicator of increased risk of several cancers, the clinical value of repeated measurements of GGT has not been determined. Therefore, we aimed to investigate whether repeatedly elevated serum GGT levels are associated with the risk of respiratory cancer incidence.MethodsWe included participants who had undergone the Korean Health screening four times during 2009–2012 and had previously undergone four consecutive examinations. Those who were diagnosed with respiratory cancer before the date of examination were excluded. The participants obtained one GGT point if their GGT levels were in the highest quartile (the quartile 4 group). We analyzed the association between GGT points and respiratory cancer incidence by Cox proportional hazard models.ResultsDuring mean follow‐up of 6.39 ± 1.2 years, 3,559,109 participants were enrolled. Of them, 8,944 (0.34%) men and 1,484 (0.14%) women were newly diagnosed with respiratory cancer. In multivariate analysis adjusted for confounding factors, male participants with 4 GGT points had a significantly higher hazards of developing respiratory cancer than those with 0 GGT points (hazard ratio [HR]: 1.39; 95% confidence interval [CI]: 1.31–1.48). Among female, participants with the highest points of GGT also had sixfold increased risk of developing laryngeal cancer. However, no significant association was observed between GGT points and lung cancer incidence among women (HR: 0.95; 95% CI: 0.81–1.11).ConclusionRepeatedly elevated serum levels of GGT were associated with a higher risk of respiratory cancer incidence, especially in men. This finding suggests that physicians can identify a person with a higher risk of respiratory cancer through a simple repeated measurement of GGT.

Eating disorders and the risk of developing cancer: a systematic review.

Evidence concerning eating disorders as risk toward developing cancer is sparse. Energy restriction might be cancer protective, while malnutrition, vomiting, laxative and substance use might stimulate cancer development. We examined whether individuals with an eating disorder (not restricted to anorexia nervosa) had a different risk of developing cancer. A systematic search on Medline and Embase until 28th April 2020 identified relevant human original research publications, including all populations and all cancer types. From 990 records, 6 case reports and 9 cohorts were included. Some cohorts found a decreased breast (3/5 studies) or cervical (1/2) cancer risk, while an increased esophageal (2/3), liver (1/1), brain (1/1 in men) and respiratory (2/4) cancer risk, but other cancer risks were non-significant, and an increased mortality overall (1/2), frombreast (1/1), female genital (1/1) and skin (1/1) cancer in eating disorder patients. The case reports further described esophageal cancer and leukemia. No clear statistical differences in cancer risk were found depending on eating disorder type, perhaps due tothe small sample size (n = 1783 for other than anorexia nervosa). The literature on eating disorders and cancer risk is sparse with many gaps. Hormonal changes, sexual activity, nutritional status, vomiting and concomitant tobacco/alcohol abuse may explain increased/decreased cancer risk. Future large studies (now 1-366 cancer cases) that also include men (now 4.7%), bulimia nervosa (now 3.8%) and several cancer sites (now mainly breast cancer) are needed and should foresee longer follow-up time (now 5.4-15.2years) and extensive confounder adjustment (now only age and sex). Level I, systematic review.

An updated systematic review and meta-analysis on adherence to mediterranean diet and risk of cancer

PurposeThe aim of current systematic review was to update the body of evidence on associations between adherence to the Mediterranean diet (MedDiet) and risk of cancer mortality, site-specific cancer in the general population; all-cause, and cancer mortality as well as cancer reoccurrence among cancer survivors.MethodsA literature search for randomized controlled trials (RCTs), case–control and cohort studies published up to April 2020 was performed using PubMed and Scopus. Study-specific risk estimates for the highest versus lowest adherence to the MedDiet category were pooled using random-effects meta-analyses. Certainty of evidence from cohort studies and RCTs was evaluated using the NutriGrade scoring system.ResultsThe updated search revealed 44 studies not identified in the previous review. Altogether, 117 studies including 3,202,496 participants were enclosed for meta-analysis. The highest adherence to MedDiet was inversely associated with cancer mortality (RRcohort: 0.87, 95% CI 0.82, 0.92; N = 18 studies), all-cause mortality among cancer survivors (RRcohort: 0.75, 95% CI 0.66, 0.86; N = 8), breast (RRobservational: 0.94, 95% CI 0.90, 0.97; N = 23), colorectal (RRobservational: 0.83, 95% CI 0.76, 0.90; N = 17), head and neck (RRobservational: 0.56, 95% CI 0.44, 0.72; N = 9), respiratory (RRcohort: 0.84, 95% CI 0.76, 0.94; N = 5), gastric (RRobservational: 0.70, 95% CI 0.61, 0.80; N = 7), bladder (RRobservational: 0.87, 95% CI 0.76, 0.98; N = 4), and liver cancer (RRobservational: 0.64, 95% CI 0.54, 0.75; N = 4). Adhering to MedDiet did not modify risk of blood, esophageal, pancreatic and prostate cancer risk.ConclusionIn conclusion, our results suggest that highest adherence to the MedDiet was related to lower risk of cancer mortality in the general population, and all-cause mortality among cancer survivors as well as colorectal, head and neck, respiratory, gastric, liver and bladder cancer risks. Moderate certainty of evidence from cohort studies suggest an inverse association for cancer mortality and colorectal cancer, but most of the comparisons were rated as low or very low certainty of evidence.

COMPARING VITAMIN D STATUS IN CENTRAL ASIA AND NORTHERN EUROPE

Over the past two decades, the understanding of the roles of vitamin D has expanded to include many nonskeletal effects such as reduced risk of acute respiratory tract infections, autoimmune diseases, cancer, cardiovascular disease, diabetes mellitus, neurological diseases, and adverse pregnancy and birth outcomes. The role of vitamin D for optimal health is well known in Western developed countries but less so in Central Asian countries. This narrative review compares the status of vitamin D between Central Asian countries and Northern European countries. The analysis also summarizes the evidence for the beneficial effects of vitamin D and recommendations for Central Asian countries.

Incorporating ToxCast™ data into naphthalene human health risk assessment

Chronic inhalation of naphthalene causes nasal olfactory epithelial tumors in rats and benign lung adenomas in mice. The available human data do not establish an association between naphthalene and increased respiratory cancer risk. Therefore, cancer risk assessment of naphthalene in humans depends predominantly on experimental evidence from rodents. The United States Environmental Protection Agency's (US EPA) Toxicity Forecaster (ToxCast™) database contains data from 710 in vitro assays for naphthalene, the majority of which were conducted in human cells. Of these assays, only 18 were active for naphthalene, and all were in human liver cells. No assays were active in human bronchial epithelial cells. In our analysis, all of the active naphthalene ToxCast assay data were reviewed and used to: 1) determine naphthalene human inhalation concentrations corresponding to relevant activity concentrations for all active naphthalene assays, using a physiologically based pharmacokinetic (PBPK) model; and 2) evaluate the transcriptional responses for active assays in the context of consistency with the larger naphthalene data set and proposed modes of action (MoAs) for naphthalene toxicity and carcinogenicity. The transcriptional responses in liver cells largely reflect cellular activities related to oxidative stress and chronic inflammation. Overall, the results from our analysis of the active ToxCast assays for naphthalene are consistent with conclusions from our earlier weight-of-evidence evaluation for naphthalene carcinogenesis.

A 37-year Update on Mortality Patterns in an Expanded Cohort of Vermont Talc Miners and Millers

The aim of this study was to update a cohort of Vermont talc workers to include 37 additional years of follow-up time. Standardized mortality ratios (SMR) and 95% confidence intervals (CIs) were calculated for 70+ causes of death. US population mortality rates were used as reference. All-cause mortality was 30% higher than the US population (SMR 133.4, 95% CI, 119.7 to 148.3). Significant elevations occurred in nonmalignant respiratory disease (NMRD) (SMR 273.0, 95% CI, 210.2 to 348.6) and other nonmalignant respiratory disease (ONMRD) (SMR 413.1, 95% CI, 287.7 to 574.5). ONMRD was elevated across all length of employment categories and a test for linear trend was significant (P = 0.007). This study provides further evidence that excess deaths among Vermont talc workers are due largely to excess mortality from NMRD; there is no evidence of increased risk of respiratory cancer.

A systematic review of the health impacts of occupational exposure to wildland fires.

The aim of the paper is to summarize the evidence of health impacts of occupational exposure to wildland fires. The authors searched 3 databases for relevant articles and screened the results. After full-text review, articles were included based on pre-determined criteria. The authors identified 32 relevant articles. Occupational exposure to wildland fires affects lung function in the short term and may increase the risk of hypertension in the long term. Exposure to wildland fires is also associated with post-traumatic stress symptoms. There was insufficient evidence to comment on most longer-term risks, and in particular on respiratory disease or cancer risks. Further research is required to understand whether occupational exposure to wildland fires results in clinically significant impacts on respiratory function, and to further clarify the relationship between occupational exposure and blood pressure, mental health, and cancer outcomes. Int J Occup Med Environ Health. 2019;32(2):121-40.

Ambient NO2 Exposure and Respiratory Cancer Risk in S&amp;#227;o Paulo, Brazil

The International Agency for Research on Cancer (IARC) has classified outdoor air pollution as carcinogenic to humans (Group 1). This evidence has been based on predominantly studies from the global North. However, there is a dearth of evidence from low-middle income countries, including those within South America. We studied the association between exposure to ambient air pollution and mortality of respiratory cancers in the city of S&amp;#227;o Paulo, Brazil. Mortality data (between 2002 and 2013) for all individuals above the age of 20 years was derived from the Municipal Department of Health. Outcomes of interest were coded by the International Classification of Diseases (ICD-10). A total of 19,500 deaths attributable to respiratory cancers (12,826 in men, 6,674 in women) were geocoded by residential zip code. Annual estimates of NO2 (between 1997 and 2011) were obtained from the global NO2 land use regression model. Study population was divided in five exposure groups based on centiles of exposure: 0-25, 26-50, 51-75, 76-90 and &amp;gt; 90. Age-adjusted Binomial Negative Regression models were developed, stratifying by deprivation index and gender. We observed an increased risk of respiratory mortality in association with increased NO2 concentrations. The IRRs for all individuals ranged from 1.10 (95% CI 1.03-1.18), in the lower exposed group, to 1.30 (95% CI 1.20-1.41) in the highest exposed group. The IRRs among men ranged from 1.07 (95% CI 0.98-1.16) to 1.26 (95% CI 1.14-1.39) and women ranged from 1.16 (95% CI 1.04-1.30) to 1.36 (95% CI 1.20-1.55). Our results showed that exposure to ambient NO2 were associated with an increased risk of mortality of respiratory cancers in the city of S&amp;#227;o Paulo. These results strengthen the observation on air pollution and lung cancer risk by extending the evidence base to South-America aiding to a more refined estimate of the Global Burden of Disease of air pollution to health.