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J Heinrich

Publications and source records attributed to J Heinrich.

At least 91 records · Page 5Linked to original sources

Respiratory symptoms in relation to indoor exposure to mite and cat allergens and endotoxins. Indoor Factors and Genetics in Asthma (INGA) Study Group.

The authors investigated the relationship between respiratory symptoms in adults and exposure to mite and cat allergens, the role of endotoxins in house dust, the effects of mixtures of several allergens, and interactions between allergen exposure and allergic sensitization. Within a nested case-control study, 405 subjects aged 25-50 yrs from two German cities answered a standardized questionnaire. Allergen-specific immunoglobulin-E was measured. Dust samples were taken from the subjects' homes to determine exposure to mite (Dermatophagoides pteronyssinus antigen 1 Der p 1) and (D. farinae antigen 1 Der f l) and cat (cat antigen d1 Fel d 1) allergen and endotoxin content in settled house dust. Exposure to Der f 1 and Der p 1 plus Der f 1 >10 microg x g(-1) of mattress dust, respectively, increased the risk of wheeze and breathlessness (odds ratios (OR): 4.04, 95% confidence interval (CI): 1.53-10.64, OR: 2.78, 95% CI: 1.06-7.28). Fel d 1 >8 microg x g(-1) was positively associated with cough at night (OR: 2.74, 95%, CI: 1.22-.17), noteworthy also in the nonsensitized subjects. Subjects exposed to elevated concentrations of more than one allergen had an up to seven-fold increase in the risk of respiratory symptoms, compared to nonexposed subjects. Sensitized subjects exposed to elevated concentrations of Der f 1 or Fel d 1 were found to have the highest risk of asthma attacks and respiratory symptoms. No statistically significant association was found between exposure to endotoxins and respiratory health. Indoor exposure to Dermatophagoides farinae antigen 1 and cat antigen d1 is a risk factor for respiratory symptoms in adults, and for cat antigen d 1 even in nonsensitized subjects. The risk is increased if subjects are exposed to a mixture of allergens or if they are sensitized in addition to high exposure.

Adult↗

The European Community Respiratory Health Survey: what are the main results so far? European Community Respiratory Health Survey II.

The European Community Respiratory Health Survey (ECRHS) was the first study to assess the geographical variation in asthma and allergy in adults using the same instruments and definitions. The database of the ECRHS includes information from approximately 140,000 individuals from 22 countries. The aim of this review is to summarize the results of the ECRHS to date. The ECRHS has shown that there are large geographical differences in the prevalence of asthma, atopy and bronchial responsiveness, with high prevalence rates in English speaking countries and low prevalence rates in the Mediterranean region and Eastern Europe. Analyses of risk factors have highlighted the importance of occupational exposure for asthma in adulthood. The association between sensitization to individual allergens and bronchial responsiveness was strongest for indoor allergens (mite and cat). Analysis of treatment practices has confirmed that the treatment of asthma varies widely between countries and that asthma is often undertreated. In conclusion, the European Community Respiratory Health Survey has shown that the prevalence of asthma varies widely. The fact that the geographical pattern is consistent with the distribution of atopy and bronchial responsiveness supports the conclusion that the geographical variations in the prevalence of asthma are true and most likely due to environmental factors.

Asthma↗

Allergic sensitization and diet: ecological analysis in selected European cities.

It has been postulated that the prevalence of atopic diseases and their increase over time are associated with regional differences in diet and trends. The results of an ecological correlation study comparing the mean daily intake of selected dietary constituents and the prevalence of allergic sensitization in adults in Europe is presented. Prevalence data from the European Community Respiratory Health Survey (ECRHS) were used. For eight out of 37 ECRHS centres (including 3,872 subjects), comparable dietary data could be obtained. The effect for each dietary constituent was modelled using logistic regression analyses with a term for over dispersion. Inverse associations between the prevalence of allergic sensitization and the energy adjusted intake of fruit were found (odds ratio (OR) = 0.68, p = 0.034). Furthermore OR for energy adjusted intake of vitamin A (OR = 0.73, p = 0.057), vitamin C (OR = 0.83, p = 0.338) and riboflavin (OR = 0.72, p = 0.077) were consistently < 1, but confidence intervals were wider. Daily intake of monounsaturated fatty acids (energy adjusted) was positively associated with sensitization prevalence (OR = 1.59, p = 0.035). These results support the hypothesis that a high intake of monounsaturated fatty acids might promote the development of allergic sensitization.

Antioxidants↗

Beta(1-->3)-glucan in house dust of German homes: housing characteristics, occupant behavior, and relations with endotoxins, allergens, and molds.

beta(1-->3)-Glucans are potent proinflammatory agents that have been suggested to play a role in indoor-related respiratory health effects. The aim of this study was to assess whether beta(1-->3)-glucan concentrations in house dust are correlated with levels of endotoxins, allergens, and culturable mold spore counts in house dust. Further, the associations of beta(1-->3)-glucan with housing characteristics and occupant behavior were assessed. beta(1-->3)-Glucan was measured in settled house dust from living room floors of 395 homes of two German cities, Erfurt and Hamburg, with a specific enzyme immunoassay. Concentrations ranged from below the limit of detection to 19,013 microg/m(2) (22,588 microg/g dust). Concentrations per square meter were found to be correlated with endotoxins, mite and cat allergens, and culturable mold spores. Correlations were weaker when concentrations were expressed per gram of dust, indicating that variance in concentrations of all factors is largely determined by the amount of dust sampled. Associations between beta(1-->3)-glucan, housing characteristics, and occupant behavior were found for concentrations per square meter but not for concentrations per gram of dust. The following characteristics were associated with a significant increase in beta(1-->3)-glucan levels: carpets in the living room [means ratio (MR) = 1.9-2.1], keeping a dog inside (MR = 1.4), use of the home by four or more persons (MR = 1.4), use of the living room for > 180 hr/week (MR = 2.1), lower frequency of vacuum cleaning (MR = 1.6-3.0) and dust cleaning (MR = 1.2 and 1.4, respectively), and presence of mold spots during the past 12 months (MR = 1.4). We conclude that that the amount of dust sampled can be used as a proxy for hygiene and that beta(1-->3)-glucan concentrations per square meter are related to the amount of dust sampled.

Air Pollution, Indoor↗

Air quality in postunification Erfurt, East Germany: associating changes in pollutant concentrations with changes in emissions.

The unification of East and West Germany in 1990 resulted in sharp decreases in emissions of major air pollutants. This change in air quality has provided an opportunity for a natural experiment to evaluate the health impacts of air pollution. We evaluated airborne particle size distribution and gaseous co-pollutant data collected in Erfurt, Germany, throughout the 1990s and assessed the extent to which the observed changes are associated with changes in the two major emission sources: coal burning for power production and residential heating, and motor vehicles. Continuous data for sulfur dioxide, total suspended particulates (TSP), nitric oxide, carbon monoxide, and meteorologic parameters were available for 1990-1999, and size-selective particle number and mass concentration measurements were made during winters of 1991 and 1998. We used hourly profiles of pollutants and linear regression analyses, stratified by year, weekday/weekend, and hour, using NO and SO(2) as markers of traffic- and heating-related combustion sources, respectively, to study the patterns of various particle size fractions. Supplementary data on traffic and heating-related sources were gathered to support hypotheses linking these sources with observed changes in ambient air pollution levels. Substantially decreased (19-91%) concentrations were observed for all pollutants, with the exception of particles in the 0.01-0.03 microm size range (representing the smallest ultrafine particles that were measured). The number concentration for these particles increased by 115% between 1991 and 1998. The ratio of these ultrafine particles to TSP also increased by more than 500%, indicating a dramatic change in the size distribution of airborne particles. Analysis of hourly concentration patterns indicated that in 1991, concentrations of SO(2) and larger particle sizes were related to residential heating with coal. These peaks were no longer evident in 1998 due to decreases in coal consumption and consequent decreased emissions of SO(2) and larger particles. These decreases in coal combustion and the decreased concentrations of SO(2) and particles of larger size classes may have led to decreased particle scavenging and may be partially responsible for the observed increases in ultrafine particles. Traffic-related changes, such as increased numbers of trucks and increased use of diesel vehicles in Erfurt, were also associated with increased number concentrations of ultrafine particles. Morning particle peaks of all sizes were associated with NO and CO (markers for traffic) in both the 1991 and 1998 periods. There were significant differences in the ultrafine particle levels for morning hours between 1991 and 1998, suggesting that traffic was the cause of this increase.

Air Pollutants↗

Synthesis, control of substitution pattern and phase transitions of 2,3-di-O-methylcellulose.

An improved heterogeneous procedure has been found for the regioselective introduction of trityl and 4-methoxytrityl groups at the primary positions of cellulose. The 6-O-tritylcelluloses produced were completely methylated by MeI-NaOH in Me2SO solution. The trityl groups were then completely removed to afford 2,3-di-O-methylcellulose without significant degradation of the polymer. 1H and 13C NMR spectroscopy and degradation analysis showed less than 5% deviation from the regular substitution pattern. Under optimum reaction conditions, almost perfectly regular cellulose derivatives could be obtained. Small changes in the substitution pattern had a strong effect on the phase transitions of the O-methylcelluloses in water. It was shown by DSC for the first time that perfect 2,3-di-O-methylcellulose does not undergo phase separation at elevated temperatures.

Magnetic Resonance Spectroscopy↗

Sources and concentrations of indoor nitrogen dioxide in Hamburg (west Germany) and Erfurt (east Germany).

Here we report indoor and outdoor concentrations of NO2 for Erfurt and Hamburg and assess the contribution of the most important indoor sources (e.g. the presence of gas cooking ranges, smoking) and outdoor sources (traffic exhaust emissions). We examined the relative contribution of the different sources of NO2 to the total indoor NO2 levels in Erfurt and Hamburg. NO2 indoor concentrations in Hamburg were slightly higher than those in Erfurt (i.e. living room: 15 microg m(-3) for Erfurt and 17 microg m(-3) for Hamburg). A linear regression model including the variables, place of residence, season and outdoor NO2 levels, location of the home within the city, housing and occupant characteristics accounted for 38% of the NO2 variance. The most important predictors of indoor NO2 concentrations were gas in cooking followed by other characteristics, such as ventilation or outdoor NO2 level. Residences in which gas was used for cooking, or in which occupants smoked, had substantially higher indoor NO2 concentrations (41 or 18% increase, respectively). An increase in the outdoor NO2 concentration from the 25th to the 75th-percentile (17 microg m(-3)) was associated with a 33% increase in the living room NO2 concentration. Multiple regression analysis for both cities separately illustrated that use of gas for cooking was the major indoor source of NO2. This variable caused a similar increase in the indoor NO2 levels in each city (43% in Erfurt and 47% in Hamburg). However, outdoor sources of NO2 (motor vehicle traffic) contributed more to indoor NO2 levels in Hamburg than in Erfurt.

Air Pollution, Indoor↗

[Daily mortality and air pollution in the northern Czech Republic].

BACKGROUND: Several studies have demonstrated that the increase of air pollutants is related to the increase of the diurnal mortality. The aim of the work was to find correlation among the diurnal mortality and changes in the concentration of SO2, total suspended particles (TSP), and dust particles with aerodynamic diameter smaller than 10 microns (PM10) and smaller than 2.5 microns (PM2.5) in the external air of the North Bohemian brown-coal basin. METHODS AND RESULTS: All that died in 1982-1994 in coal-basin districts of the North Bohemia region were included into the data set. Method of long time series and the model of logistic regression were applied with correction to long-term trends, seasons, respiratory diseases and meteorological condition. Investigating the described relation regardless to age and sex, the increase of TSP by 100 micrograms/m3 was connected with significant increase of the total diurnal mortality by 3.4%. Significant differences between males and females were found. Meanwhile the mortality of males younger than 65 years increased, that of equally old females decreased. Contrary to it, in population of females older than 65 mortality increased and that males significantly decreased. CONCLUSION: Monitoring of the diurnal mortality and air pollution in relation to the sex reveals important for the identification of sensitive and vulnerable population subgroups. Illogic and difficult to explain is the decrease of mortality in conditions of increased air pollutants. Authors recommend repeating the analysis also in different epidemiological studies in order to distinguish whether the presented results are accidental or have a more general significance.

Adolescent↗

MSL1 plays a central role in assembly of the MSL complex, essential for dosage compensation in Drosophila.

In male Drosophila, histone H4 acetylated at Lys16 is enriched on the X chromosome, and most X-linked genes are transcribed at a higher rate than in females (thus achieving dosage compensation). Five proteins, collectively called the MSLs, are required for dosage compensation and male viability. Here we show that one of these proteins, MSL1, interacts with three others, MSL2, MSL3 and MOF. The latter is a putative histone acetyl transferase. Overexpression of either the N- or C-terminal domain of MSL1 has dominant-negative effects, i.e. causes male-specific lethality. The lethality due to expression of the N-terminal domain is reduced if msl2 is co-overexpressed. MSL2 co-purifies over a FLAG affinity column with the tagged region of MSL1, and both MSL3 and MOF co-purify with the FLAG-tagged MSL1 C-terminal domain. Furthermore, the MSL1 C-terminal domain binds specifically to a GST-MOF fusion protein and co-immunoprecipitates with HA-tagged MSL3. The MSL1 C-terminal domain shows similarity to a region of mouse CBP, a transcription co-activator. We conclude that a main role of MSL1 is to serve as the backbone for assembly of the MSL complex.

Amino Acid Sequence↗

The effect of low-level blood lead on hematologic parameters in children.

A health survey of school children living in polluted regions of eastern Germany provided us with data necessary to examine the effects of lead on the blood system at levels below current standards for blood lead content. Data collected for 797 children, aged 5-14 years, with low blood lead levels (GM, 33.3 microg Pb/L; range, 7.5-239 microg Pb/L) allowed us to examine the relationship between blood lead content and hematological parameters. Using linear regression analyses and controlling for a number of potential confounding factors, we found that increasing blood lead levels by 10 microg/L were associated with a small increase in the number of red blood cells and in girls with reduced MCV and MCH. The reasons for our observation, especially the gender difference, are still uncertain. In conclusion the morphology and function of erythrocytes might be sensitive parameters of low dose lead toxicity.

Adolescent↗

Social inequality and environmentally-related diseases in Germany: review of empirical results.

A literature search was conducted aiming at all empirical studies from Germany till mid 1997 containing data on the association between environmentally-related diseases and the socio-economic status (education, occupation, income, social class) and/or on the association between the exposure to harmful substances and the socio-economic status. With respect to the exposures, a clear picture becomes visible: the concentration of harmful substances in the ambient air as well as indoors is considerably higher with regard to the lower social class as compared with the higher social class. This applies to children as well as to adults and to West Germany as well as to East Germany. However, with respect to environmentally-related diseases, no such clear picture becomes visible. For example, several studies indicate that allergies, atopic eczema and croup occur less frequently in the lower social class than in the higher social class. Malignant tumours (lung cancer, kidney cancer or bladder cancer), however, seem to occur more frequently in the lower social class than in the higher social class. Environmental-epidemiological studies should increasingly integrate socio-epidemiological study approaches and explicitly present their results.

Adolescent↗

Induction of putative tumor-suppressing genes in Rat-1 fibroblasts by oncogenic Raf-1 as evidenced by robot-assisted complex hybridization.

The growth factor receptor-dependent protein kinase Raf-1 is activated by GTP-bound Ras, thereby activating the mitogen-activated protein kinase pathway. To study the role of Raf in transformation we transduced Rat-1 cells with a tetracycline-regulatable retroviral vector encoding the constitutively active oncogenic C-terminal fragment of the human Raf-1 protein. Using subtractive hybridization of mRNAs from induced and noninduced cells and robot-assisted screening by complex hybridization, Raf-induced genes with various different characteristics of induction were investigated. Among the strongly induced genes were those involved in carcinogenesis such as metalloproteinases 3, 10 and 13, cathepsin L, ornithine decarboxylase, and putative tumor-suppressing genes such as monocyte chemoattracting protein 1, interferon-induced protein 10, a recently identified 2'-5' oligoadenylate synthetase-like protein, and plasminogen activator inhibitor type 2. Other components of the plasminogen activator system were not induced. Plasminogen activator inhibitor type 2 is a down-regulator of the proteolytic cascade consisting of various metalloproteinases, some of which are induced by a carboxy-terminal Raf mutant (RafCT). In conclusion, RafCT induces factors which act in a conflicting manner in respect of carcinogenesis, especially within the proteolytic system of the extracellular matrix.

Animals↗

Indoor viable mold spores--a comparison between two cities, Erfurt (eastern Germany) and Hamburg (western Germany).

BACKGROUND: In eastern Germany, the prevalence of allergies is lower than in western Germany for both children and adults. Several reasons for this fact have been discussed, although it is still not completely understood. One purpose of the epidemiologic study "Indoor and genetic factors in asthma and allergy" (INGA) is to compare exposure to mold spores in two German cities. Therefore, 405 homes in Erfurt (east) and Hamburg (west) were visited twice by trained investigators between June 1995 and May 1997. METHODS: Samples of settled dust were taken by vacuuming from the carpet in the living room. Sieved house dust was diluted and plated on DG18 agar. The analyses were carried out in duplicate in the same laboratory. RESULTS: No significant difference could be shown for the total and for single genera (Alternaria, Aspergillus, Cladosporium, and Penicillium) in concentration of spores of viable fungi in settled house dust between Erfurt and Hamburg. Seasonal variation of the mold picture, with highest values in August, could be identified both indoors and outdoors. CONCLUSIONS: Because outdoor concentration is the main influence on indoor concentration of mold spores from June to October, we recommend sampling from November to May to evaluate exposure to indoor mold spores.

Adult↗

Indoor determinants of Der p 1 and Der f 1 concentrations in house dust are different.

BACKGROUND: Exposure to mite allergens is a major risk factor for sensitization and the development of asthma. Der p 1 and Der f 1 content in homes and probably the proportion of both antigens is highly variable even in the same geographical area. OBJECTIVE: We investigated specific indoor determinants of Der p 1 and Der f 1 concentrations in house dust of two German cities, Erfurt and Hamburg (n = 405 homes). METHODS: Mite allergen levels were determined using monoclonal antibodies against Der p 1 and Der f 1 by the ELISA method. Indoor relative humidity and temperature were monitored continuously in the homes over 1 week. The characteristics of homes and occupants were assessed by questionnaire to obtain information on factors which may have an impact on the mite antigen concentration in house dust. These determinants were studied by multivariate regression analysis. RESULTS: The correlation between concentrations of Der p 1 and Der f 1 inside the homes was weak (r = 0.29-0.35), indicating that different determinants are relevant. Concentrations of the allergens were significantly higher on lower floors (ratios 2-8 times, Der p 1, Der f 1), on old mattresses (ratios 3-13 times, Der p 1, Der f 1), in post-war buildings (ratio 6 times, Der p 1), for non-central heating (ratio 2 times, Der p 1), for old carpets (ratio 3 times, Der p 1) and for the presence of a dog in the house (ratio 3 times, Der f 1). Furthermore, mite concentration increases with raising relative humidity (ratio 1.03 per 1%, Der p 1) and with decreasing temperature (ratio 0.86 per 1 degrees C, Der p 1) indoors. CONCLUSION: Both Der p 1 and Der f 1 concentrations should be measured in house dust, since they are only weakly correlated and have different determinants.

Adult↗

Quantification of group 5 grass pollen allergens in house dust.

BACKGROUND: It is widely known and accepted that grass pollen is a major outdoor cause of hay fever. However, it is of virtual importance for grass pollen allergic patients with symptoms all the year round to know the concentration of grass pollen allergens in their homes. OBJECTIVE: The main objective of this study was to quantify the amount of grass pollen allergen in mass units (microg Phl p 5) in dust settled indoors and to detect the distribution of allergenic activity in different sampling locations of homes. Furthermore, we studied the seasonal fluctuation of allergen content in dust samples. METHODS: We adapted the two site binding assay for detection of group 5 grass pollen allergens in samples from randomly selected homes in Hamburg (n = 371), Erfurt (n = 396), Hettstedt (n = 353), Zerbst (n = 289) and Bitterfeld (n = 226), Germany. Dust samples were collected from floor of living room (LR), bedroom (BR) or children's room (CR) and mattress (MA) during period of June 1995 to August 1998. The amount of the major grass group 5 allergens was detected in microg/g dust. RESULTS: Phl p 5 was detected in 67% of the samples analysed (n = 4760). The range was between undetectable (< 0.03 microg/g dust) and 81 microg/g dust. Phl p 5 levels were significantly higher in the dust from LR (geometric mean 0.117 microg/g dust) or BR/CR floors (geometric mean 0.098 microg/g dust) than in mattresses (geometric mean 0.043 microg/g dust). We observed seasonal fluctuation of indoor Phl p 5 levels with peak in June but also annual differences. Thus Phl p 5 content indoors reflects also the different quantities of pollen counts of annual courses. During pollination period we found two times higher Phl p 5 levels (0.172 microg/g dust, P < 0.001) than outside of grass pollination season (0.095 microg/g dust). The indoor Phl p 5 levels outside of season seem to be independent of pollination before. We suppose that settled pollen grains or allergenic material from outdoor particles carried indoors via footwear and clothes accumulates in house dust. CONCLUSION: Although we not known how the allergens in settled dust are equilibrated with those in the air, the considerable high level of Phl p 5 in indoor dust even during periods when no grass pollen is present in the atmosphere may be an important cause of pollen-allergy symptoms outside of season.

Air Pollution, Indoor↗

C-reactive protein and the severity of atherosclerosis in myocardial infarction patients with stable angina pectoris.

BACKGROUND: Recent findings provide evidence for the importance of inflammatory processes in the pathogenesis of atherosclerosis. C-reactive protein was elevated in patients with peripheral artery disease, coronary heart disease and myocardial infarction compared to normal subjects. METHODS: In 1112 male and 299 female survivors of myocardial infarction (mean age +/- SD, men, 50.4 +/- 9.5, women, 56.1 +/- 9.3), we investigated whether plasma C-reactive protein concentration is associated with the severity of coronary heart disease and generalized pre-clinical or clinically manifest arteriopathy. The control group consisted of 326 male and 138 female individuals matched for age without clinical symptoms of coronary disease. The severity of arteriosclerotic changes was determined for the extra-cranial brain-supplying arteries, abdominal aorta, pelvis and leg arteries. In myocardial infarction patients coronary angiography was performed. Laboratory analyses included determination of C-reactive protein, fibrinogen, D-dimer, HDL-cholesterol, LDL-cholesterol and triglycerides. RESULTS: The following ranking of C-reactive protein concentrations was found: controls < or = patients after myocardial infarction without atherosclerosis < or = patients with myocardial infarction and pre-clinical atherosclerosis < or = patients with myocardial infarction and clinically manifest atherosclerosis. Additionally, our data showed a significant association between C-reactive protein concentrations and the angiographically detected degree of coronary heart disease. CONCLUSIONS: As C-reactive protein is a marker of inflammatory processes, our results in patients with clinically manifest and early pre-clinical atherosclerosis support the hypothesis that inflammatory processes in the vessel wall participate in atherogenesis. Moreover, they support the hypothesis of a causal relationship between an acute phase reaction and the pathogenesis of atherosclerosis in coronary arteries and other parts of the arterial vessel system.

Adult↗

Trends in bronchial hyperresponsiveness, respiratory symptoms and lung function among adults: West and East Germany. INGA Study Group. Indoor Factors and Genetics in Asthma.

Previous studies have shown higher prevalences of bronchial hyperresponsiveness (BHR), respiratory symptoms and atopic sensitization among adults in Western Germany than in Eastern Germany. One of the aims of the joint project INGA (INdoor Factors and Genetics in Asthma) is to assess incidence, prevalence and trends for asthma, BHR and atopic diseases over a time period of 11 years (1990-2001) in the former West (Hamburg) and East Germany (Erfurt), with special reference to indoor exposure. INGA was designed as a case-control study following a cross-sectional study performed from 1990 to 1992 within the European Community Respiratory Health Survey (ECRHS). The database consisted of 1159 subjects in Hamburg and 731 subjects in Erfurt from the ECRHS (age 20-44). In 1995-1996, 107 cases (diagnosed asthma, positive specific serum IgE, positive skin prick or PD20FEV1< or =2.0 mg methacholine at ECRHS) and 106 controls (none of the previous findings) participated in Hamburg (115 cases and 109 controls in Erfurt). The methodology was identical to the ECRHS and dose-response slopes (DRS) of the methacholine challenge were calculated as an index of responsiveness. In the control group, median values of DRS were 0.028% mg(-1) (1990-1992) and 0.044 (1995-1996) (P<0.01) in Erfurt. Corresponding values for Hamburg were 0.028 and 0.022 (NS). Corresponding values within the case groups were 0.041 and 0.049 (NS) for Erfurt, and 0.069 and 0.052 (P<0.05) for Hamburg. Thus, 4 years after the first survey, we found an increased BHR in the Erfurt control group while the bronchial responsiveness remained unchanged for the Hamburg group. These trends in BHR, which indicate the expected converging tendency between East and West Germany, have to be confirmed within the next INGA-survey in 2000-2001.

Adult↗

Gender differences in lung cancer risk by smoking: a multicentre case-control study in Germany and Italy.

Several studies in the past have shown appreciably higher lung cancer risk estimates associated with smoking exposure among men than among women, while more recent studies in the USA report just the opposite. To evaluate this topic in a European population we conducted a case-control study of lung cancer in three German and three Italian centres. Personal interviews and standardized questionnaires were used to obtain detailed life-long smoking and occupational histories from 3723 male and 900 female cases and 4075 male and 1094 female controls. Lung cancer risk comparing ever-smokers with never-smokers was higher among men (odds ratios (OR) adjusted for age and centre = 16.1, 95% confidence interval (CI) 12.8-20.3) than among women (OR = 4.2, CI 3.5-5.1). Because the smoking habits of women were different from men, we conducted more detailed analyses using comparable levels of smoking exposure. After restriction to smokers and adjustment for other smoking variables, risk estimates did not differ appreciably between genders. The analysis of duration of smoking (0-19, 20-39, 40+ years) adjusted for cigarette consumption and time since quitting smoking revealed similar risk estimates in men (OR = 1.0, 3.3 [CI 2.6-4.2], 4.1 [CI 3.1-5.6]) and women (OR = 1.0, 2.7 [CI 1.7-4.1], 3.3 [CI 1.9-5.8]). The same was true of the analysis of average or cumulative smoking consumption, and also of analyses stratified by different histological types. We conclude that for comparable exposure to tobacco smoke, the risk of lung cancer is comparable in women and men.

Adenocarcinoma↗