[Porphyria and liver cancer--a commentary].
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Biomedical subjects
Publications and source records attributed to L Hardell.
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In a case-control study including 237 cases with soft tissue sarcoma and 237 controls, previous jobs and exposures to different agents, including pesticides, were assessed. Exposure to phenoxyacetic acids or chlorophenols gave a statistically significant increased rate ratio (RR) of 1.80 [95% confidence interval (CI) = 1.02-3.18] for soft tissue sarcoma. Exposure to phenoxyacetic acids of all types gave a nonsignificantly increased RR of 1.34 (95% CI = 0.70-2.56). During the 1950s, exposure to 2,4,5-trichlorophenoxyacetic acid gave a threefold significantly increased risk. High-grade exposure to chlorophenols, which are also contaminated by dioxins, gave an RR of 5.25 (95% CI = 1.69-16.34). The increased risk was thus attributed to dioxin-contaminated phenoxyacetic acids or chlorophenols that gave an RR of 2.43 (95% CI = 1.30-4.54).
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A case-control study on colon cancer was conducted encompassing 329 cases and 658 controls. Occupations and various exposures were assessed by questionnaires. A decreased risk was found in persons with physically active occupations. This effect was most pronounced in colon descendens and sigmoideum with an odds ratio (OR) of 0.49 whereas no reduced risk was found for right-sided colon cancer. Regarding specific jobs, reduced ORs were found for agricultural, forestry, and saw mill workers and increased OR for railway employees. High-grade exposure to asbestos or to organic solvents gave a two-fold increased risk. Regarding exposure to trichloroethylene in general, a slightly increased risk was found whereas such exposure among dry cleaners gave a seven-fold increase of the risk.
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A case-referent study on soft tissue sarcomas (STS) was conducted, to see if previous findings regarding an association between exposure to phenoxyacetic acids or chlorophenols and this tumor type could be reproduced. Fifty-five male STS patients were thereby compared with 220 living and 110 dead population-based referents. Furthermore, another referent group consisting of 190 patients with another type of malignant disease was used in order to evaluate any influence of recall bias on the results. To obtain information about exposure to the studied chemicals, as well as about any other exposures that might be of interest, questionnaires were used, and if necessary these were completed over the phone by an interviewer who had no information regarding case-referent status. All analysis and interpretation of exposure data were done in a blinded manner. Exposure to phenoxyacetic acids gave a roughly three-fold increased risk for STS, thereby confirming previous findings, whereas exposure to chlorophenols was not associated with STS in this study.
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Fifty male AIDS patients with Kaposi sarcoma and 50 matched controls were interviewed about occupation, exposure to pesticides, Vietnam service, smoking habits, etc. No difference in use of pesticides was seen. One case but no control had served in Vietnam and was thereby exposed to agent orange. Dioxins are known to be immunosuppressive in animals. No significant difference in exposure to dioxin-containing products was found between cases and controls, however. Of interest was the fact that four cases but no control were occupationally exposed to hair dyes, some of which have been reported to be carcinogenic.
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Some environmental factors of possible aetiological importance for primary liver carcinoma (PLC) in males were analysed in a case-control study including 83 cases of hepatocellular carcinoma (HCC), 15 cases of intrahepatic cholangiocellular carcinoma (CC), 3 cases of haemangiosarcoma and 1 case of unspecified sarcoma in the liver--102 cases in total. Two matched controls were used in each case. One case with haemangiosarcoma was exposed to polyvinyl chloride. The case with unspecified soft-tissue sarcoma was exposed to phenoxy acids. A 4-fold increase in the risk of HCC was seen in alcoholics, and regular drinking gave a 3-fold increase in the risk. Exposure to organic solvents gave a 2-fold increase in the risk of HCC. No increased risk was observed for cases exposed to various other chemicals. Three cases of HCC had a previous diagnosis of porphyria acuta intermittens (PAI), versus no control. Six cases of HCC had a previous diagnosis of porphyria acuta intermittens (PAI), versus no control. Six cases with PLC had polyphyria cutanea tarda (PCT) which in 4 cases was related to alcoholism and in one case to haemochromatosis.