Peter J Franklin

University of Western Australia | UWA · School of Population Health

Despite their increasing popularity, and Australia’s unique regulatory environment, how and why Australian adults use e-cigarettes and their perceptions of their safety, efficacy and regulation have not been extensively reported before. In this study, we screened 2217 adult Australians with the aim of assessing these questions in a sample of curren...

Background and objective: Environmental exposure to phthalates and bisphenol A (BPA), chemicals used in the production of plastics, may increase risk for asthma and allergies. However, little is known about the long-term effects of early life exposure to these compounds. We investigated if prenatal exposure to these compounds was associated with a...

Background Landscape fires (LFs) are the main source of elevated particulate matter (PM 2.5 ) in Australian cities and towns. This study examined the associations between daily exposure to fine PM 2.5 during LF events and daily emergency department attendances (EDA) for all causes, respiratory and cardiovascular outcomes. Methods Daily PM 2.5 was...

Background A significant number of children attend Early Childhood Education and Care (ECEC). ECEC is an important environment and behaviour setting for young children. Time spent outdoors is positively associated with children's physical activity levels, yet increased time spent physically active outdoors may expose young children to traffic-relat...

Background Understanding the health effects of smoke from landscape fires (LFs), including wildfires and prescribed burns, is limited due to lack of adequate smoke exposure measures. Methods We used the reported LFs to determine smoke plume shapes from satellite images. Daily remotely sensed fire radiative power, aerosol optical depth, smoke plume...

Background Diesel engine exhaust (DEE) is classified as a potential carcinogen for bladder cancer in humans by the International Agency for Research on Cancer. We aimed to compare bladder cancer incidence in Western Australian miners against the general population and determine if there was an association with DEE, measured as Elemental Carbon. Me...

Background The use of low dose CT (LDCT) chest is becoming more widespread in occupationally exposed populations. There is a knowledge gap as to heterogeneity in severity and the natural course of asbestosis after low levels of exposure. This study reports the characteristics of LDCT‐detected interstitial lung abnormalities (ILA). Methods The Asbe...

Asbestos exposure is associated with many adverse health conditions including malignant mesothelioma and lung cancer as well as production of autoantibodies. Autoantibodies may serve as biomarkers for asbestos exposure in patients with cancer, and autoimmune dysfunction has been linked to increased rates of various cancers. The aim of this study wa...

Knowledge of asbestos-related diseases has been accumulating for over one hundred years as the industrial value of asbestos was recognised for the strength of its fibres and their resistance to destruction, resulting in increasing production and use until the multiple health effects have become apparent. Deposition in the lung parenchyma results in...

Previous studies have reported that miners (and other workers) exposed to high levels of diesel engine exhaust (DEE) have an increased risk of lung function decline. The main objective of this study was to evaluate associations between exposure to different components associated with DEE in relation to lung function across a 12-h working shift. Eig...

Introduction Asbestos exposure is recognised to raise the risk of lung cancer (with additive synergism combined with a tobacco smoking history). A significant asbestos-exposure history is not adequately considered in any current US lung cancer screening guidelines. The Western Australian (WA) Asbestos Review Program (ARP) has screened nearly five-t...

The Wittenoom crocidolite (blue asbestos) mine and mill ceased operating in 1966. The impact of this industry on asbestos-related disease in Western Australia has been immense. Use of the employment records of the Australian Blue Asbestos Company and records of the Wittenoom township residents has permitted two cohorts of people with virtually excl...

Rationale: Asbestos exposure is associated with a dose-dependent risk of lung cancer. The association between lung cancer and the presence of pleural plaques remains controversial. Objectives: To define the relationship between pleural plaques and lung cancer risk. Methods: Subjects were from two cohorts: (1) crocidolite mine and mill workers,...

Indigenous children have much higher rates of ear and lung disease than non-Indigenous children, which may be related to exposure to high levels of geogenic (earth-derived) particulate matter (PM). The aim of this study was to assess the relationship between dust levels and health in Indigenous children in Western Australia (W.A.). Data were from a...

Metabolites of polycyclic aromatic hydrocarbons measured in human samples are often used as biomarkers of exposure to diesel engine exhaust (DEE). The aim of this study was to assess the changes in urinary levels of 1-aminopyrene (1-AP) and 1-hydroxypyrene (1-OHP) and their relationship with Elemental Carbon (EC), as a component of diesel engine ex...

Objectives: An asbestos job-exposure matrix (AsbJEM) has been developed to systematically and cost-effectively evaluate occupational exposures in population-based studies. The primary aim of this study was to examine the accuracy of the AsbJEM in determining exposure-response relationships between asbestos exposure estimates and malignant mesothel...

There is a growing body of research on the association between ambient air pollution and adverse birth outcomes. However, people in high income countries spend most of their time indoors. Pregnant women spend much of that time at home. The aim of this study was to investigate if indoor air pollutants were associated with poor birth outcomes. Pregna...

Objectives Mining is associated with exposures to various lung carcinogens such as diesel engine exhaust (DEE) and respirable crystalline silica (RCS). We aimed to determine if lung cancer incidence was higher in Western Australian (WA) miners than the general population and if risk varied within the cohort according to exposures and work or job ty...

Introduction: The diagnosis of lung disease in asbestos-exposed individuals is a process that not only requires a detailed occupational and tobacco smoking history, but correlation with physical signs, appropriate imaging, detailed lung function assessment and histology/cytology when required. Worldwide, the total quantity of asbestos mined is stat...

Objectives The presence of asbestos in public buildings is a legacy of past asbestos use in many developed countries. Of particular concern is the amount and current condition in schools and the vulnerability of children to mesothelioma. Our aim was to compare the risk of mesothelioma between those exposed to blue asbestos as children and as adults...

Background Studies comparing different forms of asbestos are rare, and limited by the failure to compare results with unexposed populations. We compare autoimmune responses among former workers and residents of the crocidolite mining and milling town of Wittenoom, Western Australia, with an unexposed population. Methods ANA testing using indirect...

Detection of Lung Cancer in an asbestos exposed population in Western Australia by Low dose CT scanning

Background Crocidolite is known to be the most carcinogenic form of asbestos for mesothelioma. This study aimed to assess if there was a difference between crocidolite and mixed asbestos fibre exposure for rates of lung cancer incidence and mortality after adjusting for smoking. Methods Administrative datasets were used to identify lung cancer inc...

Objectives Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5%–10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. Methods Cases with no kno...

Objectives Three hundred and thirty thousand Italians arrived in Australia between 1945 and 1966, many on assisted passage schemes where the worker agreed to a 2-year unskilled employment contract. Italians were the largest of 52 migrant groups employed at the Wittenoom blue asbestos mining and milling operation. We compare mortality from asbestos-...

Electronic cigarette usage is increasing worldwide, yet there is a paucity of information on the respiratory health effects of electronic cigarette aerosol exposure. This study aimed to assess whether exposure to electronic-cigarette (e-cigarette) aerosol would alter lung function and pulmonary inflammation in mice, and to compare the severity of a...

Background: Survival with the epithelioid subtype of malignant mesothelioma (MM) is longer than the biphasic or sarcomatoid subtypes. There is concern that cytology-diagnosed epithelioid MM may underdiagnose the biphasic subtype. This study examines survival differences between patients with epithelioid MM diagnosed by cytology only and other subt...

The environmental factors which may affect children’s respiratory health are complex, and the influence and significance of factors such as traffic, industry and presence of vegetation is still being determined. We undertook a cross-sectional study of 360 school children aged 5 to 12 years who lived on the outskirts of a heavy industrial area in We...

Objectives: Malignant mesothelioma (MM) is a rare and generally fatal cancer, usually caused by asbestos, although about 5-10% of cases report no asbestos exposure. This study aimed to identify sources whereby people in Western Australia (WA) may be unknowingly exposed to asbestos or to other exposures which may cause MM. Methods: Cases with no...

Objectives: The correlation between ultra low dose computed tomography (ULDCT)-detected parenchymal lung changes and pulmonary function abnormalities is not well described. This study aimed to determine the relationship between ULDCT-detected interstitial lung disease (ILD) and measures of pulmonary function in an asbestos-exposed population. Met...

Background: While there is evidence of an association between caesarean birth and increased asthma in children in high-income countries, it is unknown whether this association exists in low-to-middle-income countries (LMICs). We investigated whether children born through caesarean in India and Vietnam are at increased risk of caregiver-reported as...

Background Malignant mesothelioma (MM) has distinct histological subtypes (epithelioid, sarcomatoid and biphasic) with variable behaviour and prognoses. It is well recognised that survival time varies with the histological subtype of MM. It is not known, however, if asbestos exposure characteristics (type of asbestos, degree of exposure) are associ...

Objectives: To describe the incidence of malignant mesothelioma (MM) in Aboriginal people in Western Australia (WA) and determine the main routes of exposure to asbestos in this population. Methods: All MM cases in Western Australia, as well as the primary source of asbestos exposure, are recorded in the WA Mesothelioma Register. Aboriginal case...

Background and objective: Computed tomography (CT)-based studies of asbestos-exposed individuals report a high prevalence of lung cancer, but the utility of low dose CT (LDCT) to screen asbestos-exposed populations is not established. We aimed to describe the prevalence of indeterminate pulmonary nodules and incidental findings on chest LDCT of as...

Introduction: The Australian Aboriginal population experiences significantly poorer health than the non-Aboriginal population. The contribution of environmental risk factors in remote communities to this health disparity is poorly understood. Objective: To describe and quantify major environmental risk factors and associated health outcomes in r...

Background: Multiple breath washout (MBW) testing with SF6 gas mixture is routinely used to assess ventilation distribution in infants. It is currently unknown whether SF6 changes tidal breathing parameters during MBW in infants. We investigated if SF6 does change tidal breathing parameters in infants and whether a separate tidal breathing trace p...

Many of the pathological consequences in the lung following inhalation of asbestos fibres arise as a consequence of persistent oxidative stress and inflammation. Inflammatory responses can be observed in asymptomatic asbestos-exposed individuals. There are currently no interventions to reduce inflammatory or oxidative responses to asbestos before d...

Occupational exposure data on asbestos are limited and poorly integrated in Australia so that estimates of disease risk and attribution of disease causation are usually calculated from data that are not specific for local conditions. To develop a job-exposure matrix (AsbJEM) to estimate occupational asbestos exposure levels in Australia, making opt...

Objective: A considerable health disparity exists between Aboriginal and non-Aboriginal Australians, including a higher incidence and severity of cardiovascular and respiratory diseases.The burden of these diseases appears to be greatest in communities located in the remote regions of Australia. Unique environmental challenges in these regions may...

Rationale: Pulmonary inflammation, infection, and structural lung disease occur early in life in children with cystic fibrosis. Objectives: We hypothesized that the presence of these markers of cystic fibrosis lung disease in the first 2 years of life would be associated with reduced lung function in childhood. Methods: Lung function (forced e...

Purpose: To examine the effect of knowledge of radiographic abnormalities on the mental health of asbestos-exposed people with and without pleural abnormalities. Methods: Subjects were former asbestos mine and mill workers and residents of the mining town who had participated in an annual health review program. Pleural abnormalities (pleural pla...

Background: Parental exposures to chemicals, and the interplay between chemical exposures in utero and in infancy leading to respiratory disease in childhood, are not yet fully understood. In this study we investigated the impact of chemical exposures to the parent in occupational settings and to the child in the home and children's respiratory he...

This study presents detailed indoor air chemistry model simulations of the impacts of ambient air quality (AQ) on reactive indoor air chemistry in two cities with very different ambient AQ profiles; Hong Kong; a city of known high ambient air pollution and Perth, Western Australia; a city of generally low ambient air pollution. The models are const...

This study of indoor air quality reports VOC concentrations in 386 suburban homes located in Perth Western Australia, a city of low ambient pollution and temperate climate. Details of indoor VOC concentrations, temperature, relative humidity, and information on house characteristics and occupant activities were collected during the sampling periods...

Studies have linked air pollution with the incidence of acute coronary artery events and cardiovascular mortality but the association with out-of-hospital cardiac arrest (OHCA) is less clear. To examine the association of air pollution with the occurrence of OHCA. Electronic bibliographic databases (until February 2013) were searched. Search terms...

Mould in schools has been associated with increased upper airway obstruction in adults. In this study, we investigated the relationship between school indoor mould spore exposure and nasal patency in children. Airborne mould samples were collected in 32 classrooms from 4 primary schools during both summer and winter using a single-stage Anderson sa...

Background: The forced oscillation technique (FOT) can be used in children as young as 2 years of age and in those unable to perform routine spirometry. There is limited information on changes in FOT outcomes in healthy children beyond the preschool years and the level of bronchodilator responsiveness (BDR) in healthy children. We aimed to create...

Introduction: Smoking and asbestos exposure are known to cause lung cancer (LC). However, the precise combined effect of smoking and asbestos on LC risk remains ill-defi ned. Some studies have suggested a multiplicative effect while others an additive effect. Aims: (i) To investigate the LC incidence in crocidolite exposed subjects from Wittenoom t...

There are few data on the long-term health outcomes of exposure to asbestos in childhood. This study investigated cancer and mortality of adults exposed to blue asbestos as children. Data linkage to relevant health registries was used to identify cancers and mortality in a cohort of adults (n = 2,460) that had lived in an asbestos mining town durin...

Despite the well publicised health effects of passive smoking, many young children are still exposed to cigarette smoke in the home. Exposure to environmental tobacco smoke (ETS) often begins in-utero, due to maternal smoking, and continues during childhood if parents or regular visitors smoke. Worldwide, the prevalence of smoking during pregnancy...

Residential concentrations of formaldehyde have been associated with poor respiratory health in children, where formaldehyde has been measured using stationary monitors inside homes. Although children spend most of their time indoors at home, there are few studies of children's personal exposure to formaldehyde. The aim of this study was to investi...

Introduction: Exposure to asbestos causes radiographic abnormalities such as pleural plaque (PP), diffuse pleural thickening (DPT) and asbestosis. Knowledge of presence of these radiographic abnormalities may affect individuals’ mental health (MH). Aim: To examine the effect of radiographic abnormalities on the MH of people exposed to crocidolite....

To report the number of malignant pleural and peritoneal mesotheliomas that have occurred in former Wittenoom crocidolite workers to the end of 2008, to compare this with earlier predictions, and to relate the mesothelioma rate to amount of exposure. A group of 6489 men and 419 women who had worked for the company operating the former Wittenoom cro...

Unflued gas heaters (UFGHs) and cookers are a major contributor to air pollution in homes. Gas appliances have been associated with adverse respiratory outcomes in children and, less consistently, adults. There have been very few studies on the effects of gas appliances on the respiratory health of older people. This study investigated the daily lu...

A detailed chemical box model utilizing the reaction framework of the Master Chemical Mechanism (MCM) has been developed for simulating the photochemical degradation of volatile organic compounds (VOC) inside residential properties. The models are tailored for the indoor environs of metropolitan homes in Perth, Western Australia, based on air sampl...

Childhood asthma is a condition characterized by airflow obstruction that varies in time spontaneously, in response to various environmental stimuli and in response to treatment. Asthma is more common in childhood than in adulthood and is more correctly thought of as a syndrome than as a discrete condition. Asthma can be thought of a failure of dev...

To determine trends in incidence of malignant mesothelioma (MM) caused by exposure to asbestos during home maintenance and renovation. Using the Western Australian Mesothelioma Register, we reviewed all cases of MM diagnosed in WA from 1960 to the end of 2008, and determined the primary source of exposure to asbestos. Categories of exposure were co...

Malignant mesothelioma (MM) of the pleura or peritoneum is a universally fatal disease attracting an increasing range of medical interventions and escalating healthcare costs. Changes in survival and the factors affecting survival of all patients ever diagnosed with MM in Western Australia over the past five decades and confirmed by the Western Aus...

Respiratory function impacts on musical expression for wind/brass (W/B) musicians. Investigation of musicians' respiratory health to date has rarely progressed further than assessments of flow limitation through spirometry. This study aimed to compare W/B musicians' respiratory function to a non-wind/brass (NW/B) group with a comprehensive respirat...

The fast growing economies and continued urbanization in Asian countries have increased the demand for mobility and energy in the region, resulting in high levels of air pollution in cities from mobile and stationary sources. In contrast, low level of urbanization in Australia produces low level of urban air pollution. The World Health Organization...

Playing a wind or brass (W/B) instrument is considered a strenuous activity for the respiratory system. Exhaled nitric oxide (FeNO) is a potential marker of airway inflammation, and the aim of this study was to compare levels of FeNO between W/B musicians to a group of people who did not play these instruments. Eighty-three (41 male) nonsmoking, no...

There are moves to ban smoking in outdoor areas of pubs, restaurants and cafes. Some argue that this is unnecessary as exposure to second hand smoke (SHS) is minimal. The aim of this study was to determine potential exposure of patrons to SHS in outdoor areas of eating and drinking venues. Concentrations of fine particulate matter (PM2.5) were meas...

Control of respiration is important in wind/brass instrument playing. Although respiratory diseases, such as asthma, may affect breathing control, little is known about the prevalence of asthma among wind and brass musicians. The aim of this study was to compare the prevalence of self-reported asthma between wind/brass musicians and non-wind/brass...