Elisabeth Cardis

Publications of Elisabeth Cardis

• Comparison of exposure estimates in the Finnish job-exposure matrix FINJEM with a JEM derived from expert assessments performed in Montreal.

  Authors: Jérôme Lavoué, Javier Pintos, Martie Van Tongeren, Laurel Kincl, Lesley Richardson, T Kauppinen, Elisabeth Cardis, Jack Siemiatycki

  Occupational and environmental medicine. 04/2012;

  ContextRetrospective exposure assessment in population-based case-control studies poses a major challenge due to the wide range of occupations and industries involved. The FINJEM is a genericContextRetrospective exposure assessment in population-based case-control studies poses a major challenge due to the wide range of occupations and industries involved. The FINJEM is a generic job-exposure matrix (JEM) developed in Finland, which represents a potentially cost-effective exposure assessment tool. While FINJEM has been used in several studies outside Finland, little is known of its applicability in other countries.MethodsWe compared prevalence and intensity of exposure in FINJEM with a JEM developed from expert assessments of occupational histories obtained in a population-based case-control study in Montreal. Agreement for prevalence of exposure was measured by weighted κ coefficients between prevalence categories. Agreement for exposure intensity was measured by Spearman correlation coefficients between cells with non-null exposure.ResultsThe comparison involved 27 chemicals, the time period 1945-1995 and included 4743 jobs initially assessed by the Montreal experts. 4293 combinations of agent, occupational title and period were available for comparison of prevalence. Agent-specific prevalence was consistently higher in the Montreal JEM (median difference 1.7%). Agent-specific κ values between prevalence categories varied from 0.89 (welding fumes) to 0.07 (flour dust). The comparison of exposure levels involved 14 agents and 198 cells with non-null exposure in both sources. Agent-specific Spearman correlation varied from 0.89 (flour dust) to -0.35 (benzo(a)pyrene).ConclusionOur observations suggest that information concerning several agents (eg, metals, welding fumes) can be successfully transported from Finland to Canada and probably other countries. However, for other agents, there was considerable disagreement, and hence, transportability of FINJEM cannot be assumed by default.

• Analysis of three-dimensional SAR distributions emitted by mobile phones in an epidemiological perspective.

  Authors: Isabelle Deltour, Joe Wiart, Masao Taki, Kanako Wake, Nadège Varsier, Simon Mann, Joachim Schüz, Elisabeth Cardis

  Bioelectromagnetics. 06/2011; 32(8):634-43.

  The three-dimensional distribution of the specific absorption rate of energy (SAR) in phantom models was analysed to detect clusters of mobile phones producing similar spatial deposition of energy inThe three-dimensional distribution of the specific absorption rate of energy (SAR) in phantom models was analysed to detect clusters of mobile phones producing similar spatial deposition of energy in the head. The clusters' characteristics were described from the phones external features, frequency band and communication protocol. Compliance measurements with phones in cheek and tilt positions, and on the left and right side of a physical phantom were used. Phones used the Personal Digital Cellular (PDC), Code division multiple access One (CdmaOne), Global System for Mobile Communications (GSM) and Nordic Mobile Telephony (NMT) communication systems, in the 800, 900, 1500 and 1800 MHz bands. Each phone's measurements were summarised by the half-ellipsoid in which the SAR values were above half the maximum value. Cluster analysis used the Partitioning Around Medoids algorithm. The dissimilarity measure was based on the overlap of the ellipsoids, and the Manhattan distance was used for robustness analysis. Within the 800 MHz frequency band, and in part within the 900 MHz and the 1800 MHz frequency bands, weak clustering was obtained for the handset shape (bar phone, flip with top and flip with central antennas), but only in specific positions (tilt or cheek). On measurements of 120 phones, the three-dimensional distribution of SAR in phantom models did not appear to be related to particular external phone characteristics or measurement characteristics, which could be used for refining the assessment of exposure to radiofrequency energy within the brain in epidemiological studies such as the Interphone.

• Indications of possible brain-tumour risk in mobile-phone studies: should we be concerned?

  Authors: Elisabeth Cardis, Siegal Sadetzki

  Occupational and environmental medicine. 03/2011; 68(3):169-71.

• Reprocessed uranium exposure and lung cancer risk.

  Authors: Irina Guseva Canu, Sophie Jacob, Elisabeth Cardis, Pascal Wild, Sylvaine Caër-Lorho, Bernard Auriol, Dominique Laurier, Margot Tirmarche

  Health physics. 09/2010; 99(3):308-13.

  This study investigated the risk of lung cancer in regards to protracted occupational exposure to reprocessed uranium compounds. Two thousand seven hundred and nine male workers employed at the AREVAThis study investigated the risk of lung cancer in regards to protracted occupational exposure to reprocessed uranium compounds. Two thousand seven hundred and nine male workers employed at the AREVA NC uranium processing plant between 1960 and 2005 in France were included in the cohort. Historical exposure to reprocessed uranium compounds classified by their solubility type was assessed on the basis of the plant's specific job-exposure matrix. Cox proportional hazard models adjusted for attained age, calendar period, and socioeconomic status were used to estimate relative risks in regards of each type of uranium compound. The relative risk of lung cancer tended to increase with decreasing solubility of reprocessed uranium compounds. The highest-though not statistically significant-relative risk was observed among workers exposed to slowly soluble reprocessed uranium dioxide. This study is the first suggesting an increasing risk of lung cancer associated with exposure to reprocessed uranium. Our results are consistent with data from experimental studies of biokinetics and the action mechanism of slowly soluble uranium compounds, but need to be confirmed in larger studies with more detailed dose-response analyses.

• Reconstruction of radiation doses in a case-control study of thyroid cancer following the Chernobyl accident.

  Authors: Vladimir Drozdovitch, Valeri Khrouch, Evaldas Maceika, Irina Zvonova, Oleg Vlasov, Angelica Bratilova, Yury Gavrilin, Guennadi Goulko, Masaharu Hoshi, Ausrele Kesminiene, Sergey Shinkarev, Vanessa Tenet, Elisabeth Cardis, André Bouville

  Health physics. 07/2010; 99(1):1-16.

  A population-based case-control study of thyroid cancer was carried out in contaminated regions of Belarus and Russia among persons who were exposed during childhood and adolescence to fallout fromA population-based case-control study of thyroid cancer was carried out in contaminated regions of Belarus and Russia among persons who were exposed during childhood and adolescence to fallout from the Chernobyl accident. For each study subject, individual thyroid doses were reconstructed for the following pathways of exposure: (1) intake of 131I via inhalation and ingestion; (2) intake of short-lived radioiodines (132I, 133I, and 135I) and radiotelluriums (131mTe, 132Te) via inhalation and ingestion; (3) external dose from radionuclides deposited on the ground; and (4) ingestion of 134Cs and 137Cs. A series of intercomparison exercises validated the models used for reconstruction of average doses to populations of specific age groups as well as of individual doses. Median thyroid doses from all factors for study subjects were estimated to be 0.37 and 0.034 Gy in Belarus and Russia, respectively. The highest individual thyroid doses among the subjects were 10.2 Gy in Belarus and 5.3 Gy in Russia. Iodine-131 intake was the main pathway for thyroid exposure. Estimated doses from short-lived radioiodines and radiotelluriums ranged up to 0.53 Gy. Reconstructed individual thyroid doses from external exposure ranged up to 0.1 Gy, while those from internal exposure due to ingested cesium did not exceed 0.05 Gy. The uncertainty of the reconstructed individual thyroid doses, characterized by the geometric standard deviation, varies from 1.7 to 4.0 with a median of 2.2.

• Conduct of a personal radiofrequency electromagnetic field measurement study: proposed study protocol

  Authors: Martin Röösli, Patrizia Frei, John Bolte, Georg Neubauer, Elisabeth Cardis, Maria Feychting, Peter Gajsek, Sabine Heinrich, Wout Joseph, Simon Mann, Luc Martens, Evelyn Mohler, Roger Parslow, Aslak Poulsen, Katja Radon, Joachim Schüz, György Thuroczy, Jean-François Viel, Martine Vrijheid

  Environmental Health. 01/2010;

  Abstract Background The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposureAbstract Background The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposure distribution in the general population. Previous attempts to measure personal exposure to RF-EMF have used different measurement protocols and analysis methods making comparisons between exposure situations across different study populations very difficult. As a result, observed differences in exposure levels between study populations may not reflect real exposure differences but may be in part, or wholly due to methodological differences. Methods The aim of this paper is to develop a study protocol for future personal RF-EMF exposure studies based on experience drawn from previous research. Using the current knowledge base, we propose procedures for the measurement of personal exposure to RF-EMF, data collection, data management and analysis, and methods for the selection and instruction of study participants. Results We have identified two basic types of personal RF-EMF measurement studies: population surveys and microenvironmental measurements. In the case of a population survey, the unit of observation is the individual and a randomly selected representative sample of the population is needed to obtain reliable results. For microenvironmental measurements, study participants are selected in order to represent typical behaviours in different microenvironments. These two study types require different methods and procedures. Conclusion Applying our proposed common core procedures in future personal measurement studies will allow direct comparisons of personal RF-EMF exposures in different populations and study areas.

• Conduct of a personal radiofrequency electromagnetic field measurement study: proposed study protocol.

  Authors: Martin Röösli, Patrizia Frei, John Bolte, Georg Neubauer, Elisabeth Cardis, Maria Feychting, Peter Gajsek, Sabine Heinrich, Wout Joseph, Simon Mann, Luc Martens, Evelyn Mohler, Roger C Parslow, Aslak Harbo Poulsen, Katja Radon, Joachim Schüz, György Thuroczy, Jean-François Viel, Martine Vrijheid

  Environmental health : a global access science source. 01/2010; 9:23.

  The development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposure distribution in theThe development of new wireless communication technologies that emit radio frequency electromagnetic fields (RF-EMF) is ongoing, but little is known about the RF-EMF exposure distribution in the general population. Previous attempts to measure personal exposure to RF-EMF have used different measurement protocols and analysis methods making comparisons between exposure situations across different study populations very difficult. As a result, observed differences in exposure levels between study populations may not reflect real exposure differences but may be in part, or wholly due to methodological differences. The aim of this paper is to develop a study protocol for future personal RF-EMF exposure studies based on experience drawn from previous research. Using the current knowledge base, we propose procedures for the measurement of personal exposure to RF-EMF, data collection, data management and analysis, and methods for the selection and instruction of study participants. We have identified two basic types of personal RF-EMF measurement studies: population surveys and microenvironmental measurements. In the case of a population survey, the unit of observation is the individual and a randomly selected representative sample of the population is needed to obtain reliable results. For microenvironmental measurements, study participants are selected in order to represent typical behaviours in different microenvironments. These two study types require different methods and procedures. Applying our proposed common core procedures in future personal measurement studies will allow direct comparisons of personal RF-EMF exposures in different populations and study areas.

• Radrue method for reconstruction of external photon doses for chernobyl liquidators in epidemiological studies.

  Authors: Victor Kryuchkov, Vadim Chumak, Evaldas Maceika, Lynn R Anspaugh, Elisabeth Cardis, Elena Bakhanova, Ivan Golovanov, Vladimir Drozdovitch, Nickolas Luckyanov, Ausrele Kesminiene, Paul Voillequé, André Bouville

  Health physics. 11/2009; 97(4):275-98.

  Between 1986 and 1990, several hundred thousand workers, called "liquidators" or "clean-up workers," took part in decontamination and recovery activities within the 30-km zone around the ChernobylBetween 1986 and 1990, several hundred thousand workers, called "liquidators" or "clean-up workers," took part in decontamination and recovery activities within the 30-km zone around the Chernobyl nuclear power plant in Ukraine, where a major accident occurred in April 1986. The Chernobyl liquidators were mainly exposed to external ionizing radiation levels that depended primarily on their work locations and the time after the accident when the work was performed. Because individual doses were often monitored inadequately or were not monitored at all for the majority of liquidators, a new method of photon (i.e., gamma and x rays) dose assessment, called "RADRUE" (Realistic Analytical Dose Reconstruction with Uncertainty Estimation), was developed to obtain unbiased and reasonably accurate estimates for use in three epidemiologic studies of hematological malignancies and thyroid cancer among liquidators. The RADRUE program implements a time-and-motion dose-reconstruction method that is flexible and conceptually easy to understand. It includes a large exposure rate database and interpolation and extrapolation techniques to calculate exposure rates at places where liquidators lived and worked within approximately 70 km of the destroyed reactor. The RADRUE technique relies on data collected from subjects' interviews conducted by trained interviewers, and on expert dosimetrists to interpret the information and provide supplementary information, when necessary, based upon their own Chernobyl experience. The RADRUE technique was used to estimate doses from external irradiation, as well as uncertainties, to the bone marrow for 929 subjects and to the thyroid gland for 530 subjects enrolled in epidemiologic studies. Individual bone marrow dose estimates were found to range from less than one muGy to 3,300 mGy, with an arithmetic mean of 71 mGy. Individual thyroid dose estimates were lower and ranged from 20 muGy to 507 mGy, with an arithmetic mean of 29 mGy. The uncertainties, expressed in terms of geometric standard deviations, ranged from 1.1 to 5.8, with an arithmetic mean of 1.9.

• The estimation of 3D SAR distributions in the human head from mobile phone compliance testing data for epidemiological studies.

  Authors: Kanako Wake, Nadège Varsier, Soichi Watanabe, Masao Taki, Joe Wiart, Simon Mann, Isabelle Deltour, Elisabeth Cardis

  Physics in medicine and biology. 10/2009; 54(19):5695-5706.

  A worldwide epidemiological study called 'INTERPHONE' has been conducted to estimate the hypothetical relationship between brain tumors and mobile phone use. In this study, we proposed a method toA worldwide epidemiological study called 'INTERPHONE' has been conducted to estimate the hypothetical relationship between brain tumors and mobile phone use. In this study, we proposed a method to estimate 3D distribution of the specific absorption rate (SAR) in the human head due to mobile phone use to provide the exposure gradient for epidemiological studies. 3D SAR distributions due to exposure to an electromagnetic field from mobile phones are estimated from mobile phone compliance testing data for actual devices. The data for compliance testing are measured only on the surface in the region near the device and in a small 3D region around the maximum on the surface in a homogeneous phantom with a specific shape. The method includes an interpolation/extrapolation and a head shape conversion. With the interpolation/extrapolation, SAR distributions in the whole head are estimated from the limited measured data. 3D SAR distributions in the numerical head models, where the tumor location is identified in the epidemiological studies, are obtained from measured SAR data with the head shape conversion by projection. Validation of the proposed method was performed experimentally and numerically. It was confirmed that the proposed method provided good estimation of 3D SAR distribution in the head, especially in the brain, which is the tissue of major interest in epidemiological studies. We conclude that it is possible to estimate 3D SAR distributions in a realistic head model from the data obtained by compliance testing measurements to provide a measure for the exposure gradient in specific locations of the brain for the purpose of exposure assessment in epidemiological studies. The proposed method has been used in several studies in the INTERPHONE.

• French cohort of the uranium processing workers: mortality pattern after 30-year follow-up.

  Authors: Irina Guseva Canu, Elisabeth Cardis, Camille Metz-Flamant, Sylvaine Caër-Lorho, Bernard Auriol, Pascal Wild, Dominique Laurier, Margot Tirmarche

  International archives of occupational and environmental health. 09/2009;

  OBJECTIVE: To investigate mortality among nuclear workers with potential internal exposure to uranium. METHODS: The cohort included 2,709 workers employed at the AREVA NC Pierrelatte plant for atOBJECTIVE: To investigate mortality among nuclear workers with potential internal exposure to uranium. METHODS: The cohort included 2,709 workers employed at the AREVA NC Pierrelatte plant for at least 6 months (72,787 person-years). This plant processed uranium enrichment during the period 1960-1996 and chemical conversion since 1980. Mortality was compared to the national and regional mortality rates available for the period 1968-2005. For causes of death of interest with respect to occupational exposure, mortality trends according to occupational characteristics were assessed. RESULTS: As expected, an important healthy worker effect (all causes SMR = 0.55 (95% CI: 0.50-0.61), n = 411; all cancers SMR = 0.70 (95% CI: 0.60-0.81), n = 193) was observed. Among cancer sites a priori related to uranium exposure, only mortality for lymphatic cancer was increased among potentially exposed workers (SMR = 1.49 (95% CI: 0.68-2.82); n = 9). An important increase in mortality from pleural cancer was observed (SMR = 2.85 (95% CI: 0.93-6.66), n = 5); none of the deceased workers were exposed to radiation whereas all handled asbestos. CONCLUSION: In spite of limited statistical power, results show consistency with previous studies of nuclear workers potentially exposed to uranium. Further investigation based on more precise uranium exposure data should allow the estimation of uranium hazard effects among this cohort.

• Human exposure to high natural background radiation: what can it teach us about radiation risks?

  Authors: Jolyon H Hendry, Steven L Simon, Andrzej Wojcik, Mehdi Sohrabi, Werner Burkart, Elisabeth Cardis, Dominique Laurier, Margot Tirmarche, Isamu Hayata

  Journal of radiological protection : official journal of the Society for Radiological Protection. 07/2009; 29(2):A29-42.

  Natural radiation is the major source of human exposure to ionising radiation, and its largest contributing component to effective dose arises from inhalation of (222)Rn and its radioactive progeny.Natural radiation is the major source of human exposure to ionising radiation, and its largest contributing component to effective dose arises from inhalation of (222)Rn and its radioactive progeny. However, despite extensive knowledge of radiation risks gained through epidemiologic investigations and mechanistic considerations, the health effects of chronic low-level radiation exposure are still poorly understood. The present paper reviews the possible contribution of studies of populations living in high natural background radiation (HNBR) areas (Guarapari, Brazil; Kerala, India; Ramsar, Iran; Yangjiang, China), including radon-prone areas, to low dose risk estimation. Much of the direct information about risk related to HNBR comes from case-control studies of radon and lung cancer, which provide convincing evidence of an association between long-term protracted radiation exposures in the general population and disease incidence. The success of these studies is mainly due to the careful organ dose reconstruction (with relatively high doses to the lung), and to the fact that large-scale collaborative studies have been conducted to maximise the statistical power and to ensure the systematic collection of information on potential confounding factors. In contrast, studies in other (non-radon) HNBR areas have provided little information, relying mainly on ecological designs and very rough effective dose categorisations. Recent steps taken in China and India to establish cohorts for follow-up and to conduct nested case-control studies may provide useful information about risks in the future, provided that careful organ dose reconstruction is possible and information is collected on potential confounding factors.

• Can loud noise cause acoustic neuroma? Analysis of the INTERPHONE study in France.

  Authors: Martine Hours, Marlene Bernard, Marie T Arslan, Lucile Montestrucq, Lesley Richardson, Isabelle Deltour, Elisabeth Cardis

  Occupational and environmental medicine. 04/2009;

  OBJECTIVES: To investigate possible associations between risk of acoustic neuroma and exposure to loud noise in leisure and occupational settings. METHODS: A case-control study was conducted inOBJECTIVES: To investigate possible associations between risk of acoustic neuroma and exposure to loud noise in leisure and occupational settings. METHODS: A case-control study was conducted in France within the international INTERPHONE study. The cases were the 108 subjects diagnosed with acoustic neuroma between June 1st 2000 and August 31st 2003. Two controls per case were selected from the electoral rolls and individually matched for gender, age (+/- 5 years) and area (local authority district) of residence at the time of the case diagnosis. Multivariate analyses were conducted using conditional logistic regression. Adjustment was made for socio-economic status. RESULTS: Acoustic neuroma was found to be associated with loud noise exposure [Odds-Ratio (OR) = 2.55; 95% Confidence Interval (CI) = 1.35-4.82], both in leisure settings, particularly when listening to loud music [OR = 3.88; 95% CI = 1.48-10.17] and at work [OR = 2.26; 95% CI = 1.08-4.72]. This risk increased with exposure duration (> 6 years leisure exposure: OR = 3.15; 95% CI = 1.07-9.24). Risk varied according to the type of noise (continuous or explosive, versus intermittent). CONCLUSION: The present results agree with other recent reports implicating loud noise in the risk of acoustic neuroma.

• Residential exposure to radiofrequency fields from mobile-phone base stations, and broadcast transmitters: a population-based survey with personal meter.

  Authors: Jean-Francois Viel, Stephanie Clerc, Coralie Barrera, Raouchan Rymzhanova, Monika Moissonnier, Martine Hours, Elisabeth Cardis

  Occupational and environmental medicine. 04/2009;

  OBJECTIVES: Both the public perceptions, and most published epidemiologic studies, rely on the assumption that the distance of a particular residence from a base station or a broadcast transmitter isOBJECTIVES: Both the public perceptions, and most published epidemiologic studies, rely on the assumption that the distance of a particular residence from a base station or a broadcast transmitter is an appropriate surrogate for exposure to radiofrequency fields, although complex propagation characteristics affect the beams from antennas. The main goal of this study was to characterise the distribution of residential exposure from antennas using personal exposure meters. METHODS: A total of 200 randomly selected people was enrolled. Each participant was supplied with a personal exposure meter for 24 hour measurements, and kept a time-location-activity diary. Two exposure metrics for each radiofrequency were then calculated: the proportion of measurements above the detection limit (0.05 V/m), and the maximum electric field strength. Residential address was geocoded, and distance from each antenna was calculated. RESULTS: Much of the time the recorded field strength was below the detection level (0.05 V/m), the FM band standing apart with a proportion above the detection threshold of 12.3%. The maximum electric field strength was always lower than 1.5 V/m. Exposure to GSM and DCS waves peaked around 280 m and 1000 m from the antennas. A downward trend was found within a 10 km range for FM. Conversely, UMTS, TV 3, and TV 4&5 signals did not vary with distance. CONCLUSIONS: Despite numerous limiting factors entailing a high variability in RF exposure assessment, but owing to a sound statistical technique, we found that exposures from GSM and DCS base stations increase with distance in the near source zone, to a maximum where the main beam intersects the ground. We believe these results will contribute to the on-going public debate over the siting of base stations and their associated emissions.

• Quantifying the Impact of Selection Bias Caused by Nonparticipation in a Case-Control Study of Mobile Phone Use.

  Authors: Martine Vrijheid, Lesley Richardson, Bruce K Armstrong, Anssi Auvinen, Gabriele Berg, Matthew Carroll, Angela Chetrit, Isabelle Deltour, Maria Feychting, Graham G Giles [......] Siegal Sadetzki, Tina Salminen, Marie Sanchez, Birgitte Schlehofer, Joachim Schüz, Jack Siemiatycki, Tore Tynes, Alistair Woodward, Naohito Yamaguchi, Elisabeth Cardis

  Annals of epidemiology. 02/2009; 19(1):33-41.e1.

  PURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-responsePURPOSE: To quantitatively assess the impact of selection bias caused by nonparticipation in a multinational case-control study of mobile phone use and brain tumor. METHODS: Non-response questionnaires (NRQ) were completed by a sub-set of nonparticipants. Selection bias factors were calculated based on the prevalence of mobile phone use reported by nonparticipants with NRQ data, and on scenarios of hypothetical exposure prevalence for other nonparticipants. RESULTS: Regular mobile phone use was reported less frequently by controls and cases who completed the NRQ (controls, 56%; cases, 50%) than by those who completed the full interview (controls, 69%; cases, 66%). This relationship was consistent across study centers, sex, and age groups. Lower education and more recent start of mobile phone use were associated with refusal to participate. Bias factors varied between 0.87 and 0.92 in the most plausible scenarios. CONCLUSIONS: Refusal to participate in brain tumor case-control studies seems to be related to less prevalent use of mobile phones, and this could result in a downward bias of around 10% in odds ratios for regular mobile phone use. The use of simple selection bias estimation methods in case-control studies can give important insights into the extent of any bias, even when nonparticipant information is incomplete.

• Risk of Hematological Malignancies among Chernobyl Liquidators.

  Authors: Ausrele Kesminiene, Anne-Sophie Evrard, Viktor K Ivanov, Irina V Malakhova, Juozas Kurtinaitis, Aivars Stengrevics, Mare Tekkel, Lynn R Anspaugh, André Bouville, Sergei Chekin [......] Evaldas Maceika, Marat Maksyoutov, Anatoly K Mirkhaidarov, Semion Polyakov, Natalia Shchukina, Vanessa Tenet, Tatyana I Tserakhovich, Aleksandr Tsykalo, Aleksandr R Tukov, Elisabeth Cardis

  Radiation research. 01/2009; 170(6):721-35.

  Kesminiene, A., Evrard, A-S., Ivanov, V. K., Malakhova, I. V., Kurtinaitis, J., Stengrevics, A., Tekkel, M., Anspaugh, L. R., Bouville, A., Chekin, S., Chumak, V. V., Drozdovitch, V., Gapanovich, V.,Kesminiene, A., Evrard, A-S., Ivanov, V. K., Malakhova, I. V., Kurtinaitis, J., Stengrevics, A., Tekkel, M., Anspaugh, L. R., Bouville, A., Chekin, S., Chumak, V. V., Drozdovitch, V., Gapanovich, V., Golovanov, I., Hubert, P., Illichev, S. V., Khait, S. E., Kryuchkov, V. P., Maceika, E., Maksyoutov, M., Mirkhaidarov, A. K., Polyakov, S., Shchukina, N., Tenet, V., Tserakhovich, T. I., Tsykalo, A., Tukov, A. R. and Cardis, E. Risk of Hematological Malignancies among Chernobyl Liquidators. Radiat. Res. 170, 721-735 (2008).A case-control study of hematological malignancies was conducted among Chernobyl liquidators (accident recovery workers) from Belarus, Russia and Baltic countries to assess the effect of low- to medium-dose protracted radiation exposures on the relative risk of these diseases. The study was nested within cohorts of liquidators who had worked around the Chernobyl plant in 1986-1987. A total of 117 cases [69 leukemia, 34 non-Hodgkin lymphoma (NHL) and 14 other malignancies of lymphoid and hematopoietic tissue] and 481 matched controls were included in the study. Individual dose to the bone marrow and uncertainties were estimated for each subject. The main analyses were restricted to 70 cases (40 leukemia, 20 NHL and 10 other) and their 287 matched controls with reliable information on work in the Chernobyl area. Most subjects received very low doses (median 13 mGy). For all diagnoses combined, a significantly elevated OR was seen at doses of 200 mGy and above. The excess relative risk (ERR) per 100 mGy was 0.60 [90% confidence interval (CI) -0.02, 2.35]. The corresponding estimate for leukemia excluding chronic lymphoid leukemia (CLL) was 0.50 (90% CI -0.38, 5.7). It is slightly higher than but statistically compatible with those estimated from A-bomb survivors and recent low-dose-rate studies. Although sensitivity analyses showed generally similar results, we cannot rule out the possibility that biases and uncertainties could have led to over- or underestimation of the risk in this study.

• Ionizing radiation and risk of chronic lymphocytic leukemia in the 15-country study of nuclear industry workers.

  Authors: Martine Vrijheid, Elisabeth Cardis, Patrick Ashmore, Anssi Auvinen, Ethel Gilbert, Rima R Habib, Hans Malker, Colin R Muirhead, David B Richardson, Agnes Rogel, Mary Schubauer-Berigan, Hélène Tardy, Maylis Telle-Lamberton

  Radiation research. 12/2008; 170(5):661-5.

  In contrast to other types of leukemia, chronic lymphocytic leukemia (CLL) has long been regarded as non-radiogenic, i.e. not caused by ionizing radiation. However, the justification for this viewIn contrast to other types of leukemia, chronic lymphocytic leukemia (CLL) has long been regarded as non-radiogenic, i.e. not caused by ionizing radiation. However, the justification for this view has been challenged. We therefore report on the relationship between CLL mortality and external ionizing radiation dose within the 15-country nuclear workers cohort study. The analyses included, in seven countries with CLL deaths, a total of 295,963 workers with more than 4.5 million person-years of follow-up and an average cumulative bone marrow dose of 15 mSv; there were 65 CLL deaths in this cohort. The relative risk (RR) at an occupational dose of 100 mSv compared to 0 mSv was 0.84 (95% CI 0.39, 1.48) under the assumption of a 10-year exposure lag. Analyses of longer lag periods showed little variation in the RR, but they included very small numbers of cases with relatively high doses. In conclusion, the largest nuclear workers cohort study to date finds little evidence for an association between low doses of external ionizing radiation and CLL mortality. This study had little power due to low doses, short follow-up periods, and uncertainties in CLL ascertainment from death certificates; an extended follow-up of the cohorts is merited and would ideally include incident cancer cases.

• Recall bias in the assessment of exposure to mobile phones.

  Authors: Martine Vrijheid, Bruce K Armstrong, Daniel Bédard, Julianne Brown, Isabelle Deltour, Ivano Iavarone, Daniel Krewski, Susanna Lagorio, Stephen Moore, Lesley Richardson, Graham G Giles, Mary McBride, Marie-Elise Parent, Jack Siemiatycki, Elisabeth Cardis

  Journal of exposure science & environmental epidemiology. 06/2008;

  Most studies of mobile phone use are case-control studies that rely on participants' reports of past phone use for their exposure assessment. Differential errors in recalled phone use are a majorMost studies of mobile phone use are case-control studies that rely on participants' reports of past phone use for their exposure assessment. Differential errors in recalled phone use are a major concern in such studies. INTERPHONE, a multinational case-control study of brain tumour risk and mobile phone use, included validation studies to quantify such errors and evaluate the potential for recall bias. Mobile phone records of 212 cases and 296 controls were collected from network operators in three INTERPHONE countries over an average of 2 years, and compared with mobile phone use reported at interview. The ratio of reported to recorded phone use was analysed as measure of agreement. Mean ratios were virtually the same for cases and controls: both underestimated number of calls by a factor of 0.81 and overestimated call duration by a factor of 1.4. For cases, but not controls, ratios increased with increasing time before the interview; however, these trends were based on few subjects with long-term data. Ratios increased by level of use. Random recall errors were large. In conclusion, there was little evidence for differential recall errors overall or in recent time periods. However, apparent overestimation by cases in more distant time periods could cause positive bias in estimates of disease risk associated with mobile phone use.Journal of Exposure Science and Environmental Epidemiology advance online publication, 21 May 2008; doi:10.1038/jes.2008.27.

• Smoking and risk of parotid gland tumors: a nationwide case-control study.

  Authors: Siegal Sadetzki, Bernice Oberman, Lori Mandelzweig, Angela Chetrit, Tehila Ben-Tal, Avital Jarus-Hakak, Shay Duvdevani, Elisabeth Cardis, Michael Wolf

  Cancer. 06/2008; 112(9):1974-82.

  BACKGROUND: Because existing data regarding the relation between smoking and salivary gland tumors are sparse, tobacco is currently not classified as a salivary gland carcinogen. The objective of theBACKGROUND: Because existing data regarding the relation between smoking and salivary gland tumors are sparse, tobacco is currently not classified as a salivary gland carcinogen. The objective of the current study was to assess the association between smoking and benign and malignant parotid gland tumors (PGTs) in a nationwide study. METHODS: The sample included 459 patients with incident PGT, aged > or =18 years, who were diagnosed between 2001 and 2003 and a group of 1265 individually matched, population-based controls. Analyses of the risk of PGT associated with various smoking variables were performed by using conditional logistic regression. Data also were stratified by histologic type; statistical significance tests were 2-sided. RESULTS: Ever smoking cigarettes was associated with an odds ratio (OR) of 1.66 (95% confidence interval [95% CI], 1.31-2.11) for developing a PGT. The risk was strongest for early ages at smoking initiation, and trends of increasing risk were observed with increasing smoking intensity, pack-years, latent period, and smoking duration (P for trend <.001 for each). Analysis by histologic type indicated remarkably high risks for Warthin tumor (OR for ever cigarette smokers: 15.3; 95% CI, 6.1-38.5). For pleomorphic adenomas and malignant tumors, the risks associated with ever smoking were 1.01 (95% CI, 0.75-1.37) and 1.69 (95% CI, 0.81-3.51), respectively. CONCLUSIONS: Smoking plays an important role in the development of Warthin tumor. Although no association was observed for pleomorphic adenoma, the possible indication of increased risk of malignant tumors requires further investigation in larger studies.

• Reconstruction of individual radiation doses for a case-control study of thyroid cancer in French Polynesia.

  Authors: Vladimir Drozdovitch, André Bouville, Françoise Doyon, Pauline Brindel, Elisabeth Cardis, Florent de Vathaire

  Health physics. 06/2008; 94(5):418-33.

  Forty-one atmospheric nuclear weapons tests (plus five safety tests) were conducted in French Polynesia between 1966 and 1974. To evaluate the potential role of atmospheric nuclear weapons testing onForty-one atmospheric nuclear weapons tests (plus five safety tests) were conducted in French Polynesia between 1966 and 1974. To evaluate the potential role of atmospheric nuclear weapons testing on a high incidence of thyroid cancer observed since 1985 in French Polynesia, a population-based case-control study was performed. The study included 602 subjects, either cases or controls, all aged less than 40 y at the end of nuclear weapons testing in 1974. Radiation doses to the thyroids of the study subjects were assessed based on the available historical results of radiation measurements. These were mainly found in the annual reports on the radiological situation in French Polynesia that had been sent to the UNSCEAR Secretariat. For each atmospheric nuclear weapons test that contributed substantially to the local deposition of radionuclides, the radiation dose to the thyroid from I intake was estimated. In addition, thyroid doses from the intake of short-lived radioiodines (132I, 133I, 135I) and 132Te, external exposure from gamma-emitted radionuclides deposited on the ground, and ingestion of long-lived Cs were reconstructed. The mean thyroid dose among the study subjects was found to be around 3 mGy while the highest dose was estimated to be around 40 mGy. Doses from short-lived iodine and tellurium isotopes ranged up to 10 mGy. Thyroid doses from external exposure ranged up to 3 mGy, while those from internal exposure due to cesium ingestion did not exceed 1 mGy. The dose estimates that have been obtained are based on a rather limited number of radiation measurements performed on a limited number of islands and are highly uncertain. A thorough compilation of the results of all radiation monitoring that was performed in French Polynesia in 1966-1974 would be likely to greatly improve the reliability and the precision of the dose estimates.

• Cellular phone use and risk of benign and malignant parotid gland tumors--a nationwide case-control study.

  Authors: Siegal Sadetzki, Angela Chetrit, Avital Jarus-Hakak, Elisabeth Cardis, Yonit Deutch, Shay Duvdevani, Ahuva Zultan, Ilya Novikov, Laurence Freedman, Michael Wolf

  American journal of epidemiology. 03/2008; 167(4):457-67.

  The objective of this nationwide study was to assess the association between cellular phone use and development of parotid gland tumors (PGTs). The methods were based on the international INTERPHONEThe objective of this nationwide study was to assess the association between cellular phone use and development of parotid gland tumors (PGTs). The methods were based on the international INTERPHONE study that aimed to evaluate possible adverse effects of cellular phone use. The study included 402 benign and 58 malignant incident cases of PGTs diagnosed in Israel at age 18 years or more, in 2001-2003, and 1,266 population individually matched controls. For the entire group, no increased risk of PGTs was observed for ever having been a regular cellular phone user (odds ratio = 0.87; p = 0.3) or for any other measure of exposure investigated. However, analysis restricted to regular users or to conditions that may yield higher levels of exposure (e.g., heavy use in rural areas) showed consistently elevated risks. For ipsilateral use, the odds ratios in the highest category of cumulative number of calls and call time without use of hands-free devices were 1.58 (95% confidence interval: 1.11, 2.24) and 1.49 (95% confidence interval: 1.05, 2.13), respectively. The risk for contralateral use was not significantly different from 1. A positive dose-response trend was found for these measurements. Based on the largest number of benign PGT patients reported to date, our results suggest an association between cellular phone use and PGTs.