Publications (11)30.46 Total impact
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Article: Cosmic radiation and mortality from cancer among male German airline pilots: extended cohort follow-up.
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ABSTRACT: Commercial airline pilots are exposed to cosmic radiation and other specific occupational factors, potentially leading to increased cancer mortality. This was analysed in a cohort of 6,000 German cockpit crew members. A mortality follow-up for the years 1960-2004 was performed and occupational and dosimetry data were collected for this period. 405 deaths, including 127 cancer deaths, occurred in the cohort. The mortality from all causes and all cancers was significantly lower than in the German population. Total mortality decreased with increasing radiation doses (rate ratio (RR) per 10 mSv: 0.85, 95 % CI: 0.79, 0.93), contrasting with a non-significant increase of cancer mortality (RR per 10 mSv: 1.05, 95 % CI: 0.91, 1.20), which was restricted to the group of cancers not categorized as radiogenic in categorical analyses. While the total and cancer mortality of cockpit crew is low, a positive trend of all cancer with radiation dose is observed. Incomplete adjustment for age, other exposures correlated with duration of employment and a healthy worker survivor effect may contribute to this finding. More information is expected from a pooled analysis of updated international aircrew studies.European Journal of Epidemiology 06/2012; 27(6):419-29. · 4.71 Impact Factor -
Article: Cancer mortality among German aircrew: second follow-up.
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ABSTRACT: Aircrew members are exposed to cosmic radiation and other specific occupational factors. In a previous analysis of a large cohort of German aircrew, no increase in cancer mortality or dose-related effects was observed. In the present study, the follow-up of this cohort of 6,017 cockpit and 20,757 cabin crew members was extended by 6 years to 2003. Among male cockpit crew, the resulting all-cancer standardized mortality ratio (SMR) (n = 127) is 0.6 (95% CI 0.5-0.8), while for brain tumors it is 2.1 (95% CI 1.0-3.9). The cancer risk is significantly raised (RR = 2.2, 95% CI 1.2-4.1) among cockpit crew members employed 30 years or more compared to those employed less than 10 years. Among both female and male cabin crew, the all-cancer SMR and that for most individual cancers are close to 1. The SMR for breast cancer among female crew is 1.2 (95% CI 0.8-1.8). Non-Hodgkin's Lymphoma among male cabin crew is increased (SMR 4.2; 95% CI 1.3-10.8). However, cancers associated with radiation exposure are not raised in the cohort. It is concluded that among cockpit crew cancer mortality is low, particularly for lung cancer. The positive trend of all cancer with duration of employment persists. The increased brain cancer SMR among cockpit crew requires replication in other cohorts. For cabin crew, cancer mortality is generally close to population rates. Cosmic radiation dose estimates will allow more detailed assessments, as will a pooling of updated aircrew studies currently in planning.Biophysik 10/2009; 49(2):187-94. · 1.70 Impact Factor -
Article: Exposure and mortality in a cohort of German nuclear power workers.
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ABSTRACT: A historical cohort study of German nuclear power workers was set up to investigate the overall and cancer mortality risk related to a long-term low-level exposure to ionising radiation. The cohort was part of an international collaborative study whose pooled analyses were carried out at the International Agency for Research on Cancer (IARC), Lyon, and published recently. Due to delays in data collection, data from the German cohort were not included in these analyses. This cohort includes 4,844 employees who worked in any of 10 nuclear power plants, between 1 January 1991 and 31 December 1997. Sixty-eight deaths among men were observed in 31,000 person years, and none among women. Standardized mortality ratios (SMRs) were computed for all causes of death, all cancers, cardiovascular diseases, external causes, and all other causes. Overall, a strong healthy worker effect was observed (all-cause SMR = 0.54, 95% CI 0.42-0.67), and no increase in total cancer mortality was seen (SMR = 0.66, 95% CI 0.43-0.95). These results are in line with and complement IARC results. Figures are yet too small for stable risk estimates and further work is therefore under way to include more power plants, and to extend the follow-up until the year 2005.Biophysik 03/2008; 47(1):95-9. · 1.70 Impact Factor -
Article: Effect of Berkson measurement error on parameter estimates in Cox regression models.
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ABSTRACT: We study the effect of additive and multiplicative Berkson measurement error in Cox proportional hazard model. By plotting the true and the observed survivor function and the true and the observed hazard function dependent on the exposure one can get ideas about the effect of this type of error on the estimation of the slope parameter corresponding to the variable measured with error. As an example, we analyze the measurement error in the situation of the German Uranium Miners Cohort Study both with graphical methods and with a simulation study. We do not see a substantial bias in the presence of small measurement error and in the rare disease case. Even the effect of a Berkson measurement error with high variance, which is not unrealistic in our example, is a negligible attenuation of the observed effect. However, this effect is more pronounced for multiplicative measurement error.Lifetime Data Analysis 06/2007; 13(2):261-72. · 0.92 Impact Factor -
Article: Mortality from cancer and other causes among male airline cockpit crew in Europe.
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ABSTRACT: Airline pilots and flight engineers are exposed to ionizing radiation of cosmic origin and other occupational and life-style factors that may influence their health status and mortality. In a cohort study in 9 European countries we studied the mortality of this occupational group. Cockpit crew cohorts were identified and followed-up in Denmark, Finland, Germany, Great Britain, Greece, Iceland, Italy, Norway and Sweden, including a total of 28,000 persons. Observed and expected deaths for the period 1960-97 were compared based on national mortality rates. The influence of period and duration of employment was analyzed in stratified and Poisson regression analyses. The study comprised 547,564 person-years at risk, and 2,244 deaths were recorded in male cockpit crew (standardized mortality ratio [SMR] = 0.64, 95% confidence interval [CI] = 0.61-0.67). Overall cancer mortality was decreased (SMR = 0.68; 95% CI = 0.63-0.74). We found an increased mortality from malignant melanoma (SMR = 1.78, 95% CI = 1.15-2.67) and a reduced mortality from lung cancer (SMR = 0.53, 95% CI = 0.44-0.62). No consistent association between employment period or duration and cancer mortality was observed. A low cardiovascular mortality and an increased mortality caused by aviation accidents were noted. Our study shows that cockpit crew have a low overall mortality. The results are consistent with previous reports of an increased risk of malignant melanoma in airline pilots. Occupational risk factors apart from aircraft accidents seem to be of limited influence with regard to the mortality of cockpit crew in Europe.International Journal of Cancer 11/2003; 106(6):946-52. · 5.44 Impact Factor -
Article: Mortality from cancer and other causes among airline cabin attendants in Europe: a collaborative cohort study in eight countries.
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ABSTRACT: There is concern about the health effects of exposure to cosmic radiation during air travel. To study the potential health effects of this and occupational exposures, the authors investigated mortality patterns among more than 44,000 airline cabin crew members in Europe. A cohort study was performed in eight European countries, yielding approximately 655,000 person-years of follow-up. Observed numbers of deaths were compared with expected numbers based on national mortality rates. Among female cabin crew, overall mortality (standardized mortality ratio (SMR) = 0.80, 95% confidence interval (CI): 0.73, 0.88) and all-cancer mortality (SMR = 0.78, 95% CI: 0.66, 0.95) were slightly reduced, while breast cancer mortality was slightly but nonsignificantly increased (SMR = 1.11, 95% CI: 0.82, 1.48). In contrast, overall mortality (SMR = 1.09, 95% CI: 1.00, 1.18) and mortality from skin cancer (for malignant melanoma, SMR = 1.93, 95% CI: 0.70, 4.44) among male cabin crew were somewhat increased. The authors noted excess mortality from aircraft accidents and from acquired immunodeficiency syndrome in males. Among airline cabin crew in Europe, there was no increase in mortality that could be attributed to cosmic radiation or other occupational exposures to any substantial extent. The risk of skin cancer among male crew members requires further attention.American Journal of Epidemiology 08/2003; 158(1):35-46. · 5.22 Impact Factor -
Article: Cohort mortality study of German cockpit crew, 1960-1997.
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ABSTRACT: Cockpit crew in civil aviation are exposed to several potential health hazards, among them cosmic ionizing radiation. To assess the influence of occupational and other factors on mortality we conducted a cohort study among cockpit crew. All pilots and other cockpit personnel of two German airlines were traced through registries and other sources for the period 1960-1997. Standardized mortality ratios, with German population rates as the reference, were calculated. We estimated the individual radiation dose based on individual job histories and assessed dose-response trends in stratified and regression analyses. We compiled a cohort of 6061 male cockpit personnel, yielding 105,037 person-years of observation. The maximum estimated individual radiation dose was 80.5 mSv. Among 255 deaths overall (standardized mortality ratio [SMR] = 0.48; 95% confidence interval [CI] = 0.42-0.54) there were 76 cancer deaths (SMR = 0.56; CI = 0.43 - 0.74). Most cancer and cardiovascular SMRs were reduced. A slight increase was seen for brain cancer (SMR = 1.68; CI = 0.66-3.62). Employment duration was associated with the all-cancer mortality in Poisson regression analyses. No other dose-response relation was found. German cockpit crew have a low overall and cancer mortality. The role of occupational causes, and particularly cosmic radiation, appears limited.Epidemiology 12/2002; 13(6):693-9. · 5.57 Impact Factor -
Article: Mortality from cancer and other causes among airline cabin attendants in Germany, 1960-1997.
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ABSTRACT: Airline cabin attendants are exposed to several potential occupational hazards, including cosmic radiation. Little is known about the mortality pattern and cancer risk of these persons. The authors conducted a historical cohort study among cabin attendants who had been employed by two German airlines in 1953 or later. Mortality follow-up was completed through December 31, 1997. The authors computed standardized mortality ratios (SMRs) for specific causes of death using German population rates. The effect of duration of employment was evaluated with Poisson regression. The cohort included 16,014 women and 4,537 men (approximately 250,000 person-years of follow-up). Among women, the total number of deaths (n = 141) was lower than expected (SMR = 0.79, 95% confidence interval (CI): 0.67, 0.94). The SMR for all cancers (n = 44) was 0.79 (95% CI: 0.54, 1.17), and the SMR for breast cancer (n = 19) was 1.28 (95% CI: 0.72, 2.20). The SMR did not increase with duration of employment. Among men, 170 deaths were observed (SMR = 1.10, 95% CI: 0.94, 1.28). The SMR for all cancers (n = 21) was 0.71 (95% CI: 0.41, 1.18). The authors found a high number of deaths from acquired immunodeficiency syndrome (SMR = 40; 95% CI: 28.9, 55.8) and from aircraft accidents among the men. In this cohort, ionizing radiation probably contributed less to the small excess in breast cancer mortality than reproductive risk factors. Occupational causes seem not to contribute strongly to the mortality of airline cabin attendants.American Journal of Epidemiology 10/2002; 156(6):556-65. · 5.22 Impact Factor -
Article: Effect of Berkson measurement error on parameter estimates in Cox regression models
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ABSTRACT: We study the effect of additive and multiplicative Berkson measurement error in Cox proportional hazard model. By plotting the true and the observed Survivor function and the true and the observed hazard function dependent on the exposure one can get ideas about the effect of this type of error on the estimation of the slope parameter corresponding to the variable measured with error. As an example we analyze the measurement error in the situation of the German Uranium Miners Study both with the graphical methods and with a simulation study. We do not see a substantial bias in the presence of small measurement error and in the rare disease case. Ever the effect of a Berkson measurement error with high variance, which is not unrealistic in our example, is a negligible attentuation of the observed effect. This effect is more pronounced for multiplicative measurement error. -
Article: Bias of maximum-likelihood estimates in logistic and Cox regression models: a comparative simulation study
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ABSTRACT: Parameter estimates of logistic and Cox regression models are biased for finite samples. In a simulation study we investigated for both models the behaviour of the bias in relation to sample size and further parameters. In the case of a dichotomous explanatory variable x the magnitude of the bias is strongly influenced by the baseline risk defined by the constants of the models and the risk resulting for the high risk group. To conduct a direct comparison of the bias of the two models analyses were based on the same simulated data. Overall, the bias of the two models appear to be similar, however, the Cox model has less bias in situations where the baseline risk is high. -
Article: Mortality from cancer and other causes among airline cabin attendants in Europe: a collaborative cohort study in eight countries
[show abstract] [hide abstract]
ABSTRACT: There is concern about the health effects of exposure to cosmic radiation during air travel. To study the potential health effects of this and occupational exposures, the authors investigated mortality patterns among more than 44,000 airline cabin crew members in Europe. A cohort study was performed in eight European countries, yielding approximately 655,000 person-years of follow-up. Observed numbers of deaths were compared with expected numbers based on national mortality rates. Among female cabin crew, overall mortality (standardized mortality ratio (SMR) = 0.80, 95% confidence interval (CI): 0.73, 0.88) and all-cancer mortality (SMR = 0.78, 95% CI: 0.66, 0.95) were slightly reduced, while breast cancer mortality was slightly but nonsignificantly increased (SMR = 1.11, 95% CI: 0.82, 1.48). In contrast, overall mortality (SMR = 1.09, 95% CI: 1.00, 1.18) and mortality from skin cancer (for malignant melanoma, SMR = 1.93, 95% CI: 0.70, 4.44) among male cabin crew were somewhat increased. The authors noted excess mortality from aircraft accidents and from acquired immunodeficiency syndrome in males. Among airline cabin crew in Europe, there was no increase in mortality that could be attributed to cosmic radiation or other occupational exposures to any substantial extent. The risk of skin cancer among male crew members requires further attention.
Top co-authors
Top Journals
Institutions
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2008–2009
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Johannes Gutenberg-Universität Mainz
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI)
Mainz, Rhineland-Palatinate, Germany
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2007
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Ludwig-Maximilian-University of Munich
München, Bavaria, Germany
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