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Biomedical subjects

A Anttila

Publications and source records attributed to A Anttila.

At least 37 records · Page 2Linked to original sources

Organised vs. spontaneous Pap-smear screening for cervical cancer: A case-control study.

To compare the effect of organised pap-smear screening for cervical cancer with that of the spontaneous one on the incidence of invasive cervical cancer, we performed a case-control study within the catchment area of the Helsinki University Hospital (Helsinki, Finland). The study material consisted of 179 incident cases of invasive cervical cancer and 1,507 population controls. Data on lifetime pap smears before the year of the cancer diagnosis were collected using a self-administered questionnaire. The questionnaire information was obtained for 82% of the cases and 73% of the controls. The main outcome measure was relative risk of invasive cervical cancer among those with history of organised or spontaneous screening compared with risk among those with no history of screening for cervical cancer, measured as odds ratios (OR) with 95% confidence intervals (CI) and computed with logistic regression. Odds ratio of invasive cervical cancer among those who participated in the organised screening programme was 0.38 (CI 0.26-0.56) whereas any lifetime spontaneous pap smear had an OR value of 0.82 (CI 0. 53-1.26), in terms of unit risk for those not subjected to any screening and adjusted for age and the other type of the screening activity. Our results indicate that the substantial decrease in the incidence of and mortality due to cervical cancer in Finland is mainly due to the organised mass-screening.

Adult↗

Effect of organised screening on cervical cancer incidence and mortality in Finland, 1963-1995: recent increase in cervical cancer incidence.

A nation-wide screening programme for cervical cancer started in Finland gradually from 1963 onwards. By the beginning of the 1990s, there had been a decrease of 80% both in the age-adjusted incidence of and mortality from cervical cancer. To describe the recent patterns in cervical cancer incidence and mortality and evaluate their differentials in relation with the organised screening activities, we have updated the material on the cervical cancer incidence and mortality as well as mass-screening activities up to the year 1995. Based on the files of the Finnish Cancer Registry, there is a striking increase of about 60% in the incidence of cervical cancer during the last 4 years of the study period among women below 55 years of age. The mortality rates are still decreasing. There is no overall decrease over recent years in the coverage of the programme invitations or smears taken. Incidence of invasive cancer and of moderate and severe dysplasia as detected in mass screening have increased. As to the interpretation, changes in the risk factors, such as in sexual behaviour and smoking habits, over the decades might partly explain increasing trends in cervical cancer incidence. As the change in incidence was relatively abrupt, inadequacies or changes in the effectiveness in the screening programme, particularly among young women, may also have contributed. Expanding the coverage of and attendance in the pap-screening programme among women in young target ages would still be effective. Increasing emphasis on quality assessment in screening is also needed.

Adult↗

Reduced fertility among female wood workers exposed to formaldehyde.

BACKGROUND: The aim of the study was to investigate whether exposure to formaldehyde, organic solvents or other chemicals in the wood-processing industry affects the fertility of women. METHODS: For this purpose, a retrospective study on time to pregnancy was conducted among female wood workers who had given birth during 1985-1995. Data on pregnancy history, time to pregnancy, occupational exposures, and potential confounders were collected by a questionnaire; 64% (699/1,094) participated. The exposure assessment was conducted by an occupational hygienist. The data on time to pregnancy were analyzed with the discrete proportional hazards regression. RESULTS: Exposure to formaldehyde was significantly associated with delayed conception: adjusted fecundability density ratio, FDR, was 0.64 (95% CI 0.43-0.92). At high exposure if no gloves were used, the FDR was 0.51 (% CI 0.28-0.92). Exposure to phenols, dusts, wood dusts, or organic solvents was not related to the time to pregnancy. Additionally, an association was observed between exposure to formaldehyde and an increased risk of spontaneous abortion (concerning previous spontaneous abortions, reported by the women). Associations between exposure to formaldehyde or to organic solvents and endometriosis, and between exposure to organic solvents or to dusts and salpingo-oophoritis were also suggested. CONCLUSIONS: The study suggests that a woman's occupational exposure to formaldehyde has an adverse effect on fertility.

Adult↗

The counterface, surface smoothness, tolerances, and coatings in total joint prostheses.

Proper counterface material combinations, surface finish, and tolerances of contact surfaces are important issues in minimizing friction, wear, and corrosion of total joint prostheses. In the current study, the potential of novel amorphous diamond coatings to solve some present problems in total joint prostheses was studied by using tribological tests with a hip joint simulator and pin-on-disk testers. Based on the tests, the wear of amorphous diamond is negligible compared with conventional hip joint materials (10,000 to 1,000,000 times lower). The coefficient of friction of diamond-coated artificial hip joint was 0.03 to 0.06 when tested in saline solution with loads from 200 to 1000 kg for as many as two million cycles. The friction remained stable throughout the tests. Methylmethacrylate (bone cement) is a typical source of third body wear particles in cemented total hip replacements. The wear tests showed that bone cement (containing hard ceramic particles of barium sulfate or zirconia) severely scratched cobalt chromium molybdenum alloy samples. These scratches enhance the wear of softer counterpart materials, such as polyethylene or bone cement, whereas diamond-coated surfaces remained undamaged. High quality amorphous diamond coatings offer superior stability (minimal wear debris release in surrounding tissues) and good biomechanical performance.

Acetabulum↗

Biocompatibility of silicon carbide in colony formation test in vitro. A promising new ceramic THR implant coating material.

We studied the possible use of silicon carbide (SiC) as a ceramic coating material of titanium-based total hip replacement (THR) implants. The idea is to prevent wear debris formation from the soft titanium surface. SiC is a hard and tightly bonding ceramic surface material, and because of these physical properties it is not easily degradable, as is the case with hydroxyapatite. Our previous in vivo and in vitro studies have indicated that SiC and hydroxyapatite are equally biocompatible regarding particle size for phagocytosis. The present cytotoxicity test using JCRB0603 cells showed that 5 microns SiC particles inhibited colony outgrowth by one-third (67% + 10% vs control), while SiC-coated pins did not cause any inhibition and acted similarly to uncoated titanium pins. The results support the hypothesis that SiC is a promising ceramic THR implant coating material.

Carbon Compounds, Inorganic↗

Cancer incidence among Finnish workers exposed to aromatic hydrocarbons.

OBJECTIVES: To assess whether occupational exposure to aromatic hydrocarbons increases carcinogenic risk. METHODS: We followed cancer incidence among 3,922 male and 1,379 female workers monitored for exposure to styrene, toluene, or xylene. The follow-up after the first personal measurement comprised 66,500 person-years at risk over the period 1973-1992. We computed the indirectly standardized incidence ratios (SIR) with 95% confidence interval (CI) with regard to age-, gender-, and period-specific incidence rates of cancer in the Finnish general population. RESULTS: The overall rate of cancer incidence for the total cohort was fairly similar to that of the general population. The risk for nervous system tumors was increased at 10 years after the first personal measurement (SIR 2.80, CI 1.03-6.08). For styrene there was an excess risk for rectal cancer (SIR 3.11, CI 1.14-6.77), and risks for pancreatic and nervous system tumors were increased nonsignificantly. For toluene and xylene, no clear increase in cancer risk was found. CONCLUSIONS: The data are not supportive of an overall increase in the cancer risk for these solvents, even though we cannot rule out site-specific associations with the rectum, pancreas, and nervous system. There is supporting evidence in the epidemiology literature for pancreatic cancer risk and heavy exposure to styrene. More studies are warranted on solvents, with detailed information on lifetime exposures and habits being collected whenever possible.

Adult↗

Update of cancer incidence among workers at a copper/nickel smelter and nickel refinery.

OBJECTIVES: To assess cancer risk among nickel-exposed workers. METHODS: We updated cancer incidence among 1388 workers employed for at least 3 months at a copper/nickel smelter and nickel refinery in Harjavalta, Finland. There were 1155 workers exposed to nickel during the period 1960-1985 in the smelter (566 workers), repair shop (239 workers), or refinery (418 workers). Cancer incidence was followed through the files of the Finnish Cancer Registry up to 31 December 1995. For overall cancer and for a priori selected specific cancer types the ratio of observed to expected numbers of cases was computed as a standardized incidence ratio (SIR), controlled for age, gender, and calendar period and using the region-specific rates as a reference. RESULTS: The overall cancer incidence among both nickel-exposed and unexposed subcohorts was at the expected level. A small increase in lung cancer incidence, which reached statistical significance among workers with a latency exceeding 20 years, was observed among the smelter workers exposed to insoluble nickel compounds. Among workers in the refinery, who were exposed primarily to nickel sulfate at levels below 0.5 mg/m3 as well as to low concentrations of other nickel compounds, there was an increased risk for nasal cancer (SIR 41.1, 95% CI 4.97-148), positively associated with latency and duration of employment, and an excess risk for stomach (SIR 4.98, 95% CI 1.62-11.6) and lung (SIR 2.61, 95% CI 0.96-5.67) cancers. CONCLUSIONS: Since elevated nasal and lung cancer risks were confined to the refinery, where the primary exposure was to nickel sulfate, it is likely that nickel sulfate is mainly responsible for the elevated respiratory cancer risk. We cannot rule out whether the excess stomach cancer risk is a chance finding, or related to the working environment.

Adult↗

Time to pregnancy among the wives of men exposed to organic solvents.

OBJECTIVES: To assess whether paternal exposure to organic solvents is associated with decreased fertility. METHODS: A retrospective time to pregnancy study was conducted among men biologically monitored for organic solvents. The workers were classified into exposure categories on the basis of work description and the use of solvents as reported in the questionnaires, and on biological exposure measurements. The relative fecundability density ratios (FDR--an analogue of incidence density ratio of clinically recognised pregnancies) were calculated with discrete proportional hazards regression. RESULTS: After three mailings 316 (72.1%) wives of the monitored men participated. The final study population consisted of 282 couples who did not use contraception at the beginning of pregnancy. The FDRs, adjusted for potential confounders, were 0.80 (95% confidence interval (95% CI) 0.57 to 1.11) and 0.74 (95% CI 0.51 to 1.06) for high or frequent and low or intermediate exposure, respectively. High or frequent and low or intermediate exposure were related to decreased fecundability among primigravida (FDRs 0.36; 95% CI 0.19 to 0.66 and 0.53; 95% CI 0.27 to 1.04) but not among couples with at least one previous pregnancy (FDRs 0.96; 95% CI 0.62 to 1.49 and 0.77; 95% CI 0.47 to 1.24). CONCLUSIONS: The findings of the study provide limited support for the hypothesis that paternal exposure to organic solvents might be associated with decreased fertility. Further studies with careful design are warranted.

Adolescent↗

Diamond coated total hip replacements.

Diamond has many superior, desired characteristics of implant materials such as low friction, high wear and corrosion resistance, and well bonding surface to bone. The potential of diamond for total hip replacement implants was studied in the form of amorphous diamond coatings on conventional metal implant materials. Amorphous diamond coatings (sp3 bonding fraction 80%, thickness 0.2 to 10 microns) were deposited on stainless steel AISI316L, Ti6A14V, and CoCrMo alloys using filtered pulsed plasma are discharge method. Superior attachment of coatings to the implant materials was achieved by using high energy plasma beams to deposit amorphous diamond and proper intermediate layers. Previously it was shown that these coatings are biocompatible causing no local tissue reactions. Tribologic studies using a pin on disk apparatus with coated or uncoated implant materials in 1 wt.% NaCl distilled water were performed. A simplified hip joint simulator was used for preliminary testing of metal on polyethylene and metal on metal artificial hip joints modified with amorphous diamond coating. The average coefficients of friction were typically in the range of 0.03 to 0.11 for amorphous diamond coated materials. In the case of metal on metal hip implants, the average friction during initial running in period was improved (coefficient of friction = 0.07) compared with the same metal on metal pair (coefficient of friction = 0.22) and sliding was significantly smoother. In pin on disk wear tests, the average wear factors obtained were 140.10(-6), 5.0.10(-6), and << 0.1.10(-6) mm3/Nm for the pairs of AISI316L, CoCrMo, and the same materials with amorphous diamond coating. The corrosion rates of these implant materials in 10 wt.% HCl solution were decreased by a factor of 10,000 to 15,000 and any damage of the coatings was not observed in 6 months. The results of the tests show that in all the combinations studied, amorphous diamond coating improved definitely the wear and corrosion resistance compared with the uncoated materials.

Biocompatible Materials↗

Organic solvents and cancer.

Epidemiologic evidence on the relationship between organic solvents and cancer is reviewed. In the 1980s, more than a million persons were potentially exposed to some specific solvents in the United States; in Canada, 40 percent of male cancer patients in Montreal had experienced exposure to solvents; in the Finnish population, one percent was regularly exposed. There is evidence for increased risks of cancer following exposure to: trichloroethylene (for the liver and biliary tract and for non-Hodgkin's lymphomas); tetrachloroethylene (for the esophagus and cervix--although confounding by smoking, alcohol, and sexual habits cannot be excluded--and non-Hodgkin's lymphoma); and carbon tetrachloride (lymphohematopoietic malignancies). An excess risk of liver and biliary tract cancers was suggested in the cohort with the high exposure to methylene chloride, but not found in the other cohorts where an excess risk of pancreatic cancer was suggested. 1,1,1-trichloroethane has been used widely, but only a few studies have been done suggesting a risk of multiple myeloma. A causal association between exposure to benzene and an increased risk of leukemia is well-established, as well as a suggested risk of lung and nasopharynx cancer in a Chinese cohort. Increased risks of various gastrointestinal cancers have been suggested following exposure to toluene. Two informative studies indicated an increased risk of lung cancer, not supported by other studies. Increased risks of lymphohematopoietic malignancies have been reported in some studies of persons exposed to toluene or xylene, but not in the two most informative studies on toluene. Occupation as a painter has consistently been associated with a 40 percent increased risk of lung cancer. (With the mixed exposures, however, it is not possible to identify the specific causative agent[s].) A large number of studies of workers exposed to styrene have evidenced no consistent excess risk of all lymphohematopoietic malignancies, although the most sensitive study suggested an excess risk of leukemia among workers with a high exposure.

Alcohol Drinking↗

Benign response to particles of diamond and SiC: bone chamber studies of new joint replacement coating materials in rabbits.

Wear particles from total joint replacements are thought to accelerate prosthetic loosening. Diamond coating may improve the smoothness and wear characteristics of the femoral head component of total hip replacements, and thus increase their longevity. The brittleness of a thin diamond coat may be overcome by using an SiC-whisker diamond composite. This study describes the reactions of regenerating bone tissue to phagocytosable particles of diamond and SiC, using implanted bone harvest chambers in rabbits. The particles were dispersed in hyaluronan and introduced into a canal transversing the implant. The tissue that entered the canal during the following 3 weeks was then harvested. In previous studies using this model, particles of high density polyethylene, bone cement and chromium-cobalt all caused an inflammatory reaction and a marked decrease in the amount of ingrown bone. In the present study, neither the diamond nor the SiC particles caused any decrease in bone formation. It appears that particles of diamond and SiC are comparatively harmless.

Animals↗

Risk of nervous system cancer among workers exposed to lead.

Experimental animal studies suggest that lead compounds may increase the risk of gliomas. To study whether occupational exposure to lead increases the risk, we followed nervous system cancer incidence among 20,741 employees biologically monitored for their blood lead (B-Pb) concentrations. We also performed a nested case-referent study, comprising 26 male cases of nervous system cancer (16 of which had gliomas). Those cases a B-Pb > or = 1.4 mumol/L had a twofold increase in the odds ratio of nervous system cancer as compared with those employees whose B-Pb had not exceeded 0.7 mumol/L. The excess was confined to gliomas (odds ratio 11, 95% confidence interval 1.0 to 630 for B-Pb > or = 1.4 mumol/L; overall P value for trend, 0.037). We obtained lifetime information on exposure and potential confounders for 58% of the cases. The odds ratio of glioma was associated with indices of lifetime exposure to lead, and potential confounders seemed not to explain the effects. The results suggest that there may be an association between occupational lead exposure and the risk of gliomas. No firm conclusions can be drawn because of the small number of cases and loss of material.

Adult↗

Glycophorin A somatic cell mutation frequencies in Finnish reinforced plastics workers exposed to styrene.

We have used the glycophorin A (GPA) in vivo somatic cell mutation assay to assess the genotoxic potential of styrene exposure in 47 reinforced plastics workers occupationally exposed to styrene and 47 unexposed controls matched for age, gender, and active smoking status. GPA variant erythrocyte frequencies (Vf), reflecting GPA allele loss (phi/N) and allele loss and duplication (N/N) somatic mutations arising in vivo in the erythroid progenitor cells of individuals of GPA M/N heterozygous genotype, were flow cytometrically determined in peripheral blood samples from these subjects. Measurements of styrene exposure of the workers at the time of blood sampling showed a mean 8-h time-weighted average (TWA8-h) styrene concentration of 155 mg/m3 (37 ppm) in the breathing zone. Mean urinary concentrations of the styrene metabolites mandelic acid (MA) and mandelic acid plus phenyl glyoxylic acid (MA+PGA) were 4.4 mmol/liter (after workshift) and 2.1 mmol/liter (next morning), respectively. Multivariate analysis of covariance on log-transformed GPA Vf data with models allowing adjustment for age, gender, smoking status, and styrene exposure showed that N/N Vf were nearly significantly increased among all of the exposed workers (adjusted geometric mean, 6.3 per million versus 5.0 in the controls; P = 0.058) and were statistically significantly elevated (adjusted geometric mean, 6.8 versus 5.0 in the controls; P = 0.036) among workers classified into a high-exposure group according to personal TWA8-h concentration of styrene in the breathing zone of > or = 85 mg/m3 (20 ppm; Finnish threshold limit value). Women in this high exposure group showed especially elevated N/N Vf (adjusted geometric mean 8.5 versus 5.3 in control women; P = 0.020); this elevation was also significant if urinary MA+PGA of > or = 1.2 mmol/liter was used as the basis of classification (adjusted geometric mean, 8.3; P = 0.030). The occupational exposure could not be shown to influence phi/N Vf. Cigarette smoking was associated with significantly elevated GPA Vf among active smokers (P = 0.042 for phi/N and P = 0.020 for N/N) and among active and ex-smokers combined (P = 0.014 for N/N). Its influence on phi/N Vf was especially clear among active smokers in the control group (P = 0.005). An effect of smoking, nearly statistically significant, was also observed for the phi/N Vf of control ex-smokers (P = 0.055) and of all active and ex-smokers combined (P = 0.050). Thus, the two characterized chemical exposures experienced by this group of workers and controls appear to produce differential effects on the two independent classes of GPA variants enumerated in the assay. This result suggests that the genotoxicity of these agents is mediated, at least in part, by different genetic mechanisms. Styrene exposure is associated with a specific increase in GPA N/N Vf; these allele loss and duplication variants reflect predominantly somatic recombination mechanisms in erythroid progenitor cells. Tobacco smoke exposure in active and ex-smokers is also associated not only with an increase in N/N Vf but also with an increase in phi/N Vf, reflecting the induction of GPA gene-inactivating mutations, including point mutations and deletions. This finding is consistent with a broad mechanistic spectrum of tobacco smoke genotoxicity associated with this complex mixture of chemical mutagens. Finally, there was no detectable effect of age on phi/N Vf; however, a highly significant (P = 0.0002) increase in N/N Vf with age, even after adjustment for other variables, was observed.

Adult↗

Reduced fertility among women exposed to organic solvents.

A retrospective time-to-pregnancy study was performed among women biologically monitored for exposure to organic solvents. The women were participants in a previous study on spontaneous abortion. They were classified into exposure categories on the basis of work description and the use of solvents as reported in the questionnaires and on biological exposure measurements. Daily or high solvent exposure, adjusted for potential confounders, was significantly associated with reduced fecundability in the discrete proportional hazards analysis (incidence density ratio of clinical pregnancies 0.41; 95% confidence interval [CI] 0.27-0.62). The incidence density ratios were decreased also among workers who were exposed to organic solvents in shoe factories (0.28; CI 0.11-0.71), dry cleaning shops (0.44; CI 0.22-0.86), and in the metal industry (0.58; CI 0.34-0.98). The possible effects of various biases are discussed. The results of the study support the hypothesis that daily or high exposure to organic solvents is associated with reduced fertility. There is a need for safer working methods in industries where organic solvents still are used.

Abortion, Spontaneous↗

Cancer incidence among Finnish workers exposed to halogenated hydrocarbons.

Epidemiologic studies and long-term carcinogenicity studies in experimental animals suggest that some halogenated hydrocarbons are carcinogenic. To investigate whether exposure to trichloroethylene, tetrachloroethylene, or 1,1,1-trichloroethane increases carcinogenic risk, a cohort of 2050 male and 1924 female workers monitored for occupational exposure to these agents was followed up for cancer incidence in 1967 to 1992. The overall cancer incidence within the cohort was similar to that of the Finnish population. There was an excess of cancers of the cervix uteri and lymphohematopoietic tissues, however. Excess of pancreatic cancer and non-Hodgkin lymphoma was seen after 10 years from the first personal measurement. Among those exposed to trichloroethylene, the overall cancer incidence was increased for a follow-up period of more than 20 years. There was an excess of cancers of the stomach, liver, prostate, and lymphohematopoietic tissues combined. Workers exposed to 1,1,1-trichloroethane had increased risk of multiple myeloma and cancer of the nervous system. The study provides support to the hypothesis that trichloroethylene and other halogenated hydrocarbons are carcinogenic for the liver and lymphohematopoietic tissues, especially for non-Hodgkin lymphoma. The study also documents excess of cancers of the stomach, pancreas, cervix uteri, prostate, and the nervous system among workers exposed to solvents.

Adult↗

Effects of parental occupational exposure to lead and other metals on spontaneous abortion.

The aim of this article was to summarize the epidemiologic studies on the possible impact of parental occupational exposure to lead or other metals on spontaneous abortion. For paternal exposure, the total number of abortions in the studies with adequate exposure contrast were 340 for lead, 240 for mercury, and 90 for unspecified metals and, correspondingly, for maternal exposure, about 80 for lead, 80 for mercury, 70 for nickel, and 130 for exposure to unspecified metals. Epidemiologic studies indicate that paternal exposure to lead or mercury might be associated with the risk of spontaneous abortion. For maternal exposure, no clear conclusion could be reached. In particular, paternal occupational exposure levels to metals were substantial compared with population values. Even though there are shortcomings in the present knowledge, protective goals for paternal exposure to lead and mercury are warranted. More well-designed studies on metals are needed.

Abortion, Spontaneous↗

Time to pregnancy among women occupationally exposed to lead.

A retrospective time-to-pregnancy study was conducted among women biologically monitored for exposure to lead. The women were participants of a previous study on spontaneous abortion. They were classified into exposure categories on the basis of questionnaire information, and individual blood lead (B-Pb) measurements. The adjusted incidence density ratios (IDR) of clinically recognized pregnancies were .93 (95% confidence interval [CI] .56 to 1.57) for very low (B-Pb < .5 mumol/L), .84 (CI .48 to 1.45) for low (B-Pb .5 to .9 mumol/L), and .80 (CI 0.42 to 1.54) for higher (B-Pb > or = 1.0 mumol/L) exposure compared with no exposure, in the discrete proportional hazards analysis. Exposure to inorganic lead was not associated with fecundability at current, low-exposure levels. The suggestive finding among the eight most heavily exposed women (B-Pb 1.4 to 2.4 mumol/L, IDR .53; CI .19 to 1.52) should be confirmed or refuted in a larger study.

Abortion, Spontaneous↗