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M. Jerrett,
K. B. Newbold,
R. T. Burnett,
G. Thurston,
R. Lall,
C. A. Pope,
R. Ma,
P. De Luca,
M. Thun,
J. Calle, D. Krewski
[show abstract]
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ABSTRACT: Assessing the long-term benefits of marginal improvements in air quality from regulatory intervention is methodologically
challenging. In this study, we explore how the relative risks (RRs) of mortality from air pollution exposure change over time
and whether patterns in the RRs can be attributed to air quality improvements. We employed two-stage multilevel Cox models
to describe the association between air pollution and mortality for 51 cities with data from the American Cancer Society (ACS)
cohort (N=264,299, deaths=69,819). New pollution data were computed through models that predict yearly average fine particle (PM2.5) concentrations throughout the follow-up (1982–2000). Average PM2.5 concentrations from 1999 to 2000 and sulfate concentrations from 1980 were also examined. We estimated the RRs of mortality
associated with air pollution separately for five time periods (1982–1986, 1987–1990, 1991–1994, 1995–1998, and 1999–2000).
Mobility models were implemented with a sub-sample of 100,557 subjects to assist with interpreting the RR estimates. Sulfate
RRs exhibit a large decline from the 1980s to the 1990s. In contrast, PM2.5 RRs follow the opposite pattern, with larger RRs later in the 1990s. The reduction in sulfate RR may have resulted from air
quality improvements that occurred through the 1980s and 1990s in response to the acid rain control program. PM2.5 concentrations also declined in many places, but toxic mobile sources are now the largest contributors to PM in urban areas.
This may account for the heightened RR of mortality associated with PM2.5 in the 1990s. The paper concludes with a three alternative explanations for the temporal pattern of RRs, each emphasizing
the uncertainty in ascribing health benefits to air quality improvements.
Stochastic Environmental Research and Risk Assessment 04/2012; 21(5):511-522. · 1.52 Impact Factor
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E Cardis,
B K Armstrong,
J D Bowman,
G G Giles,
M Hours, D Krewski,
M McBride,
M E Parent,
S Sadetzki,
A Woodward,
J Brown,
A Chetrit,
J Figuerola,
C Hoffmann,
A Jarus-Hakak,
L Montestruq,
L Nadon,
L Richardson,
R Villegas,
M Vrijheid
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ABSTRACT: The objective of this study was to examine the associations of brain tumours with radio frequency (RF) fields from mobile phones.
Patients with brain tumour from the Australian, Canadian, French, Israeli and New Zealand components of the Interphone Study, whose tumours were localised by neuroradiologists, were analysed. Controls were matched on age, sex and region and allocated the 'tumour location' of their matched case. Analyses included 553 glioma and 676 meningioma cases and 1762 and 1911 controls, respectively. RF dose was estimated as total cumulative specific energy (TCSE; J/kg) absorbed at the tumour's estimated centre taking into account multiple RF exposure determinants.
ORs with ever having been a regular mobile phone user were 0.93 (95% CI 0.73 to 1.18) for glioma and 0.80 (95% CI 0.66 to 0.96) for meningioma. ORs for glioma were below 1 in the first four quintiles of TCSE but above 1 in the highest quintile, 1.35 (95% CI 0.96 to 1.90). The OR increased with increasing TCSE 7+ years before diagnosis (p-trend 0.01; OR 1.91, 95% CI 1.05 to 3.47 in the highest quintile). A complementary analysis in which 44 glioma and 135 meningioma cases in the most exposed area of the brain were compared with gliomas and meningiomas located elsewhere in the brain showed increased ORs for tumours in the most exposed part of the brain in those with 10+ years of mobile phone use (OR 2.80, 95% CI 1.13 to 6.94 for glioma). Patterns for meningioma were similar, but ORs were lower, many below 1.0.
There were suggestions of an increased risk of glioma in long-term mobile phone users with high RF exposure and of similar, but apparently much smaller, increases in meningioma risk. The uncertainty of these results requires that they be replicated before a causal interpretation can be made.
Occupational and environmental medicine 06/2011; 68(9):631-40. · 3.64 Impact Factor
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Integrated Environmental Assessment and Management 10/2010; 6(4):782-3.
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E. Cardis,
I. Deltour,
M. Vrijheid,
E. Combalot,
M. Moissonnier,
H. Tardy,
B. Armstrong,
G. Giles,
J. Brown,
J. Siemiatycki, [......],
K. G. Blaasaas,
L. Klaeboe,
M. Feychting,
S. Loenn,
A. Ahlbom,
P. A. McKinney,
S. J. Hepworth,
K. R. Muir,
A. J. Swerdlow,
M. J. Schoemaker
International Journal of Epidemiology 01/2010; 39(3):675. · 6.41 Impact Factor
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E. Cardis,
I. Deltour,
M. Vrijheid,
E. Combalot,
M. Moissonnier,
H. Tardy,
B. Armstrong,
G. Giles,
J. Brown,
J. Siemiatycki, [......],
K. G. Blaasaas,
L. Klaeboe,
M. Feychting,
S. Loenn,
A. Ahlbom,
P. A. McKinney,
S. J. Hepworth,
K. R. Muir,
A. J. Swerdlow,
M. J. Schoemaker
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ABSTRACT: Methods An interview-based case-control study with 2708 glioma and 2409 meningioma cases and matched controls was conducted in 13 countries using a common protocol. Results A reduced odds ratio (OR) related to ever having been a regular mobile phone user was seen for glioma [OR 0.81; 95% confidence interval (CI) 0.70-0.94] and meningioma (OR 0.79; 95% CI 0.68-0.91), possibly reflecting participation bias or other methodological limitations. No elevated OR was observed >= 10 years after first phone use (glioma: OR 0.98; 95% CI 0.76-1.26; meningioma: OR 0.83; 95% CI 0.61-1.14). ORs were < 1.0 for all deciles of lifetime number of phone calls and nine deciles of cumulative call time. In the 10th decile of recalled cumulative call time, >= 1640 h, the OR was 1.40 (95% CI 1.03-1.89) for glioma, and 1.15 (95% CI 0.81-1.62) for meningioma; but there are implausible values of reported use in this group. ORs for glioma tended to be greater in the temporal lobe than in other lobes of the brain, but the CIs around the lobe-specific estimates were wide. ORs for glioma tended to be greater in subjects who reported usual phone use on the same side of the head as their tumour than on the opposite side. Conclusions Overall, no increase in risk of glioma or meningioma was observed with use of mobile phones. There were suggestions of an increased risk of glioma at the highest exposure levels, but biases and error prevent a causal interpretation. The possible effects of long-term heavy use of mobile phones require further investigation.
International Journal of Epidemiology 01/2010; 39(3):675-694. · 6.41 Impact Factor
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M Vrijheid,
S Mann,
P Vecchia,
J Wiart,
M Taki,
L Ardoino,
B K Armstrong,
A Auvinen,
D Bédard,
G Berg-Beckhoff, [......],
S Lagorio,
S Lönn,
M McBride,
L Montestrucq,
R C Parslow,
S Sadetzki,
J Schüz,
T Tynes,
A Woodward,
E Cardis
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ABSTRACT: The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure for epidemiological studies, we assessed determinants of mobile phone output power in a multinational study.
More than 500 volunteers in 12 countries used Global System for Mobile communications software-modified phones (GSM SMPs) for approximately 1 month each. The SMPs recorded date, time, and duration of each call, and the frequency band and output power at fixed sampling intervals throughout each call. Questionnaires provided information on the typical circumstances of an individual's phone use. Linear regression models were used to analyse the influence of possible explanatory variables on the average output power and the percentage call time at maximum power for each call.
Measurements of over 60,000 phone calls showed that the average output power was approximately 50% of the maximum, and that output power varied by a factor of up to 2 to 3 between study centres and network operators. Maximum power was used during a considerable proportion of call time (39% on average). Output power decreased with increasing call duration, but showed little variation in relation to reported frequency of use while in a moving vehicle or inside buildings. Higher output powers for rural compared with urban use of the SMP were observed principally in Sweden where the study covered very sparsely populated areas.
Average power levels are substantially higher than the minimum levels theoretically achievable in GSM networks. Exposure indices could be improved by accounting for average power levels of different telecommunications systems. There appears to be little value in gathering information on circumstances of phone use other than use in very sparsely populated regions.
Occupational and environmental medicine 06/2009; 66(10):664-71. · 3.64 Impact Factor
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Canadian Journal of Statistics 04/2009; 22(4):415 - 419. · 0.67 Impact Factor
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Canadian Journal of Statistics 12/2008; 21(4):448 - 459. · 0.67 Impact Factor
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[show abstract]
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ABSTRACT: To examine prescription Food and Drug Administration (FDA) C, D and X drugs in general obstetric population.
Historical cohort study.
A total of 18 575 women who gave a birth in Saskatchewan between January 1997 and December 2000 were included. Among them, 3604 (19.4%) received FDA C, D or X drugs at least once during pregnancy. The pregnancy exposure rates were 15.8, 5.2 and 3.9%, respectively, for category C, D and X drugs, and were 11.2, 7.3 and 8.2%, respectively, in the first, second and third trimesters. Salbutamol (albuterol), trimethoprim/sulfamethoxazole (co-trimoxazole), ibuprofen, naproxen and oral contraceptives were the most common C, D, X drugs used during pregnancy.
About one in every five women uses FDA C, D and X drugs at least once during pregnancy, and the most common prescription drugs in pregnancy are antiasthmatic, antibiotics, nonsteroid anti-inflammation drugs, antianxiety or antidepressants and oral contraceptives.
Journal of Perinatology 06/2008; 28(5):324-9. · 1.80 Impact Factor
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ABSTRACT: Radon is known to cause lung cancer in humans; however, there remain uncertainties about the effects associated with residential exposures. This case-control study of residential radon and lung cancer was conducted in five counties in New Jersey and involved 561 cases and 740 controls. A year long alpha-track detector measurement of radon was completed for approximately 93% of all residences lived in at the time of interview (a total of 2,063). While the odds ratios (ORs) for whole data were suggestive of an increased risk for exposures >75 Bq m(-3), these associations were not statistically significant. The adjusted excess OR (EOR) per 100 Bq m(-3) was -0.13 (95% CI: -0.30 to 0.44) for males, 0.29 (95% CI: -0.12 to 1.70) for females and 0.05 (95% CI: -0.14 to 0.56) for all subjects combined. An analysis of radon effects by histological type of lung cancer showed that the OR was strongest for small/oat cell carcinomas in both males and females. There was no statistical heterogeneity of radon effects by demographic factors (age at disease occurrence, education level and type of respondent). Analysis by categories of smoking status, frequency or duration did not modify the risk estimates of radon on lung cancer. The findings of this study are consistent with an earlier population-based study of radon and lung cancer among New Jersey women, and with the North American pooling of case control radon seven studies, including the previous New Jersey study. Several uncertainties regarding radon measurements and assumptions of exposure history may have resulted in underestimation of a true exposure-response relationship.
Radiation Protection Dosimetry 01/2008; 128(2):169-79. · 0.82 Impact Factor
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ABSTRACT: In this article, nonlinear regression models for correlated count data are examined. Correlation within clusters is modelled by a multivariate Gaussian mixing process on the log-expectation scale. The regression parameters and the variance-covariance parameters of the mixing process are estimated using quasi-likelihood methods. An example involving temporal trends in hospital admissions for respiratory disease is used to illustrate the methods proposed.
Environmetrics 11/2006; 3(2):211 - 222. · 1.06 Impact Factor
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ABSTRACT: To assess the risk of neonatal mortality and morbidity in vertex-vertex second twins according to mode of delivery and birth weight.
Data from a historical cohort study based on a twin registry in the US (1995-1997) were used. Multivariate logistic regression was used to control for maternal age, race, marital status, cigarette smoking during pregnancy, parity, medical complications, gestational age, and other confounders.
A total of 86 041 vertex-vertex second twins were classified into two groups: second twins delivered by cesarean section after cesarean delivery of first twin (C-C) (43.0%), second twins whose co-twins delivered vaginally (V-X) (57.0%). In infants of birth weight>or=2500 g group, the risks of noncongenital anomaly-related death (adjusted odds ratio (aOR): 4.64, 95% confidence interval (95% CI): 1.90, 13.92), low Apgar score (aOR: 2.39, 95% CI: 1.43, 4.14), and ventilation use (aOR: 1.31, 95% CI: 1.18, 1.47) were higher in the V-X group compared with the C-C group. No asphyxia-related neonatal deaths occurred in C-C group, whereas the incidence of this death was 0.04% in the V-X group.
The risks of neonatal mortality and morbidity are increased in vertex-vertex second twins with birth weight>or=2500 g whose co-twins delivered vaginally compared with second twins delivered by cesarean section after cesarean delivery of first twin.
Journal of Perinatology 01/2006; 26(1):3-10. · 1.80 Impact Factor
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ABSTRACT: The possible association of specific fatty acid (FA) intake and pancreatic cancer risk was investigated in a population-based case-control study of 462 histologically confirmed cases and 4721 frequency-matched controls in eight Canadian provinces between 1994 and 1997. Dietary intake was assessed by means of a self-administered food frequency questionnaire. Unconditional logistic regression was used to assess associations between dietary FAs and pancreatic cancer risk. After adjustment for age, province, body mass index, smoking, educational attainment, fat and total energy intake, statistically significant inverse associations were observed between pancreatic cancer risk and palmitate (odds ratios (ORs)=0.73; 95% confidence intervals (CIs) 0.56-0.96; P-trend=0.02), stearate (OR=0.70; 95% CI 0.51-0.94; P-trend=0.04), oleate (OR=0.75; 95% CI 0.55-1.02; P-trend=0.04), saturated FAs (OR=0.67; 95% CI 0.50-0.91; P-trend=0.01), and monounsaturated FAs (OR=0.72; 95% CI 0.53-0.98; P-trend=0.02), when comparing the highest quartile of intake to the lowest. Significant interactions were detected between body mass index and both saturated and monounsaturated FAs, with a markedly reduced risk associated with intake of stearate (OR=0.36; 95% CI 0.18-0.70; P-trend=0.001), oleate (OR=0.36; 95% CI 0.19-0.72; P-trend=0.002), saturated FAs (OR=0.35; 95% CI 0.18-0.67; P-trend=0.002), and monounsaturated FAs (OR=0.32; 95% CI 0.16-0.63; P-trend<0.0001) among subjects who are obese. The results suggest that substituting polyunsaturated FAs with saturated or monounsaturated FAs may reduce pancreatic cancer risk, independently of total energy intake, particularly among obese subjects.
British Journal of Cancer 04/2005; 92(5):971-7. · 5.04 Impact Factor
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ABSTRACT: Biologically based risk projection models for radiation carcinogenesis seek to describe the fundamental biological processes involved in neoplastic transformation of somatic cells into malignant cancer cells. A validated biologically based model, whose parameters have a direct biological interpretation, can also be used to extrapolate cancer risks to different exposure conditions with some confidence. In this article biologically based models for radiation carcinogenesis, including the two-stage clonal expansion (TSCE) model and its extensions, are reviewed. The biological and mathematical bases for such models are described, and the implications of key model parameters for cancer risk assessment examined. Specific applications of versions of the TSCE model to important epidemiological datasets are discussed, including the Colorado uranium miners' cohort; a cohort of Chinese tin miners; the lifespan cohort of atomic bomb survivors in Hiroshima and Nagasaki; and a cohort of over 200,000 workers included in the National Dose Registry (NDR) of Canada.
Radiation Protection Dosimetry 02/2003; 104(4):367-76. · 0.82 Impact Factor
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ABSTRACT: The incidence of pancreatic cancer worldwide appears to correlate with increasing age, and it is slightly more common among men and Jewish people. There is evidence that the incidence rate is higher among blacks than among whites.
The published literature was reviewed for preparation of an overview on epidemiology of pancreatic cancer.
A possible role of diabetes in the etiology of pancreatic cancer has been suggested by different epidemiological studies. Several investigations indicate that a history of pancreatitis may increase the risk of pancreas cancer, and it appears that people with a history of pernicious anemia or partial gastrectomy for ulcer as well as cholecystectomy may be at higher risk. Individuals with familial adenomatous polyposis (FAP) also have a high risk of developing this cancer. Pancreatic cancer is seen in some breast cancer families with BRCA1 and BRCA2 mutations. Epidemiological studies have confirmed that relatives of individuals with pancreatic cancer have an increased risk of this malignancy. Affected family members of the familial atypical multiple-mole melanoma (FAMMM) as well as those with a positive family history of ataxia-telangiectasia (AT) have much higher risk of developing pancreatic cancer, compared with the general population. A positive association has been reported between pancreatic cancer risk and dietary intake such as fat and oil, meat, and dairy products, as well as with high intake of energy, fried foods, carbohydrates, cholesterol, and salt. The risk is found to decrease with increased consumption of fresh fruits and vegetables, fiber, natural foods, and Vitamin C. Cigarette smoking has shown the strongest positive association with risk of pancreatic cancer.
Some diseases and medical conditions such as diabetes, chronic pancreatitis, AP, family aggregation of pancreatic cancer, FAMMM, AT, as well as nutrition and lifestyle factors, like smoking may play important role in the etiology of pancreatic cancer.
Cancer Detection and Prevention 02/2003; 27(2):87-93. · 2.52 Impact Factor
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ABSTRACT: Assess associations between short-term exposure to gaseous pollutants and asthma hospitalisation among boys and girls 6 to12 years of age.
A bi-directional case-crossover analysis was used. Conditional logistic regression models were fitted to the data for boys and girls separately. Exposures averaged over periods ranging from one to seven days were used to assess the effects of gaseous pollutants on asthma hospitalisation. Estimated relative risks for asthma hospitalisation were calculated for an incremental exposure corresponding to the interquartile range in pollutant levels, adjusted for daily weather conditions and concomitant exposure to particulate matter.
Toronto, Ontario, Canada.
A total of 7319 asthma hospitalisations for children 6 to 12 years of age (4629 for boys and 2690 for girls) in Toronto between 1981 and 1993.
A significant acute effect of carbon monoxide on asthma hospitalisation was found in boys, and sulphur dioxide showed significant effects of prolonged exposure in girls. Nitrogen dioxide was positively associated with asthma admissions in both sexes. The lag time for certain gaseous pollutant effects seemed to be shorter in boys (around two to three days for carbon monoxide and nitrogen dioxide), as compared with girls (about six to seven days for sulphur dioxide and nitrogen dioxide). The effects of gaseous pollutants on asthma hospitalisation remained after adjustment of particulate matter. The data showed no association between ozone and asthma hospitalisation in children.
The study showed positive relations between gaseous pollutants (carbon monoxide, sulphur dioxide, and nitrogen dioxide) at comparatively low levels and asthma hospitalisation in children, using bi-directional case-crossover analyses. Though, the effects of certain specific gaseous pollutants were found to vary in boys and girls.
Journal of Epidemiology & Community Health 02/2003; 57(1):50-5. · 3.19 Impact Factor
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ABSTRACT: The authors examined the interactive effect of smoking and pets at home on the incidence of asthma and the difference between sexes. The longitudinal data from the first two cycles of the National Population Health Survey, conducted in Canada, were used. A total of 12,636 subjects who reported no asthma at baseline were included in the analysis. The 2-yr cumulative incidence of asthma was higher in females than in males. Female sex and household pets demonstrated a significant interaction in the development of asthma. After adjustment for age, immigration and history of allergy, the odds ratio for smoking in relation to the asthma incidence was 2.50 (95% confidence interval: 1.24-5.05) for females who had pets at home and close to unity for those who had no pets. The incidence of asthma was not associated with smoking status and household pets in males. These results indicate that smoking, having pets at home and other environmental factors can partly explain asthma morbidity among female Canadians.
European Respiratory Journal 12/2002; 20(5):1162-6. · 5.89 Impact Factor
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ABSTRACT: The Harvard Six Cities Study (Dockery et al.) was the first large-scale cohort study to demonstrate an association between long-term exposure to fine particulate matter less than 2.5 microns in aerodynamic diameter (PM2.5) and mortality in urban centres in the United States. Because of the pivotal role of this study in the establishment of the first U.S. national ambient air quality objective for PM2.5 in 1997 (Greenbaum et al.), the results of this study were subjected to an independent detailed re-analysis to test the robustness of the findings to alternative analytic methods (Krewski et al.), including an assessment of the effect of exposure measurement error on estimates of risk based on the Cox proportional hazards model. It is well-known that random measurement error leads to downward bias in estimates of risk, and overstatement of the precision of such estimates.
Data from the Harvard Six Cities Study were used to evaluate the potential impact of measurement error on estimates of risk. After introducing a known amount of measurement error into the original data, estimates of risk were calculated using two methods for adjusting for measurement error: regression calibration (RCAL) and simulation extrapolation (SIMEX). With RCAL, the observed value of PM2.5 is replaced by its expected value with respect to the measurement error distribution. SIMEX adjusts for measurement error by adding progressively larger errors to the data and then extrapolating back to the case of no measurement error. Computer simulation was used to evaluate the accuracy and precision of both RCAL and SIMEX, and to assess the robustness of RCAL to mis-specification of the measurement error distribution.
When the measurement error distribution was correctly specified, RCAL greatly reduced the downward bias in risk estimates induced by random measurement error, even when the degree of measurement error was relatively large. SIMEX, on the other hand, failed to adequately adjust for the effects of random measurement error in the Cox model, even in the presence of a moderate degree of measurement error. Although RCAL is thus preferable to SIMEX, RCAL was not robust against mis-specification of the measurement error distribution, seriously overestimating (underestimating) risk when the measurement error was overstated (understated).
Journal of cancer epidemiology and prevention 02/2002; 7(4):155-64.
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ABSTRACT: We present a new statistical model for linking spatial variation in ambient air pollution to mortality. The model incorporates risk factors measured at the individual level, such as smoking, and at the spatial level, such as air pollution. We demonstrate that the spatial autocorrelation in community mortality rates, an indication of not fully characterizing potentially confounding risk factors to the air pollution-mortality association, can be accounted for through the inclusion of location in the model assessing the effects of air pollution on mortality. Our methods are illustrated with an analysis of the American Cancer Society cohort to determine whether all cause mortality is associated with concentrations of sulfate particles. The relative risk associated with a 4.2 microg/m(3) interquartile range of sulfate distribution for all causes of death was 1.051 (95% confidence interval 1.036-1.066) based on the Cox proportional hazards survival model, assuming subjects were statistically independent. Inclusion of community-based random effects yielded a relative risk of 1.055 (1.033, 1.077), which represented a doubling in the residual variance compared to that estimated by the Cox model. Residuals from the random-effects model displayed strong evidence of spatial autocorrelation (p = 0.0052). Further inclusion of a location surface reduced the sulfate relative risk and the evidence for autocorrelation as the complexity of the location surface increased, with a range in relative risks of 1.055-1.035. We conclude that these data display both extravariation and spatial autocorrelation, characteristics not captured by the Cox survival model. Failure to account for extravariation and spatial autocorrelation can lead to an understatement of the uncertainty of the air pollution association with mortality.
Environmental Health Perspectives 07/2001; 109 Suppl 3:375-80. · 7.04 Impact Factor
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ABSTRACT: A study was conducted to investigate cancer risks in a cohort of pulp and paper workers.
All male workers with > or =1 years of employment in 14 pulp and paper mills in 1950-1992 were studied. Standardized incidence ratios (SIR) were used to compare the cancer incidence of the cohort with that of the Canadian male population. Record linkage with the National Cancer Registry was performed using the generalized iterative record linkage method.
Altogether 1756 cancer cases were observed in the entire cohort. For > or =15 years of work, the entire cohort had significantly increased SIR values for pleural and prostate cancer and skin melanoma; there was also a significantly increased risk for skin melanoma among workers in the kraft process only, rectal cancer among workers in the sulfite process only, and stomach and prostate cancer and all leukemias combined among workers in both the kraft and sulfite processes. A separate analysis comparing workers in pulping and papermaking with those in the pulping process only did not reveal any difference in cancer risk and hence did not modify the results. The SIR values for skin melanoma were not significantly increased in a comparison using the British Columbia male population. Nine of 10 pleural cancers were mesotheliomas, which likely reflect past asbestos exposure.
The results suggest that long-term work in the pulp and paper industry is associated with excess risks of prostate and stomach cancers and all leukemias for work in both kraft and sulfite processes and of rectal cancer for work in the sulfite process only.
Scandinavian journal of work, environment & health 04/2001; 27(2):113-9. · 3.12 Impact Factor
