Soft-tissue sarcoma.
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Agricultural Workers' Diseases↗
Biomedical subjects
M Kogevinas
Publications and source records attributed to M Kogevinas.
Cancer mortality in workers exposed to chlorophenoxy herbicides and chlorophenols.
Epidemiological studies have revealed an increased risk of cancer, notably soft-tissue sarcomas and non-Hodgkin's lymphomas, in people occupationally exposed to chlorophenoxy herbicides, including those contaminated by 2, 3, 7, 8-tetrachlorodibenzo-p-dioxin (TCDD). We report here a historical cohort study of mortality in an international register of 18,910 production workers or sprayers from ten countries. Exposure was reconstructed through questionnaires, factory or spraying records, and job histories. Cause-specific national death rates were used as reference. No excess was observed in all-cause mortality, for all neoplasms, for the most common epithelial cancers, or for lymphomas. A statistically non-significant two-fold excess risk, based on 4 observed deaths, was noted for soft-tissue sarcoma with a standardised mortality ratio (SMR) of 196 and 95% confidence interval (Cl) 53-502; this was concentrated as a six-fold statistically significant excess, occurring 10-19 years from first exposure in the cohort as a whole (SMR = 606 [165-1552]) and, for the same time period, as a nine-fold excess among sprayers (SMR = 882 [182-2579]). Risks appeared to be increased for cancers of the testicle, thyroid, other endocrine glands, and nose and nasal cavity, based on small numbers of deaths. The excess of soft-tissue sarcomas among sprayers is compatible with a causal role of chlorophenoxy herbicides but the excess does not seem to be specifically associated with those herbicides probably contaminated by TCDD.
2,4,5-Trichlorophenoxyacetic Acid↗
Cancer risks related to electricity production.
The International Agency for Research on Cancer has previously evaluated the cancer risks associated with fossil fuel-based industrial processes such as coal gastification and coke production, substances and mixtures such as coal tars, coal tar pitch and mineral oils, and a number of substances emitted from fossil-fuelled plants such as benzo[a]pyrene and other polycyclic aromatic hydrocarbons, arsenic, beryllium, cadmium, chromium, nickel, lead and formaldehyde. Based on these evaluations and other evidence from the literature, the carcinogenic risks to the general population and occupational groups from the fossil fuel cycle, the nuclear fuel cycle and renewable cycles are reviewed. Cancer risks from waste disposal, accidents and misuses, and electricity distribution are also considered. No cycle appears to be totally free from cancer risk, but the quantification of the effects of such exposures (in particular of those involving potential exposure to large amounts of carcinogens, such as coal, oil and nuclear) requires the application of methods which are subject to considerable margins of error. Uncertainties due to inadequate data and unconfirmed assumptions are discussed. Cancer risks related to the operation of renewable energy sources are negligible, although there may be some risks from construction of such installations. The elements of knowledge at our disposal do not encourage any attempt toward a quantitative comparative risk assessment. However, even in the absence of an accurate quantification of risk, qualitative indication of carcinogenic hazards should lead to preventive measures.
Accidents, Occupational↗
Socioeconomic differences in cancer survival.
STUDY OBJECTIVE: The aim was to investigate the relationship between socioeconomic status and cancer survival. DESIGN: This was a prospective study, linking census and vital registration records for an approximate 1% representative sample of those enumerated in England and Wales in the 1971 census. SETTING: The study population is nationwide. PARTICIPANTS: The study sample consists of 250,588 men and 262,484 women. During 1971-81, 17,844 cases of cancer were registered, and of those registered, 13,532 died during 1971-1983. MEASUREMENTS AND MAIN RESULTS: Socioeconomic status was assessed in terms of housing tenure. Council tenants, the low socioeconomic group, had poorer survival than owner occupiers, the high socioeconomic group, for the combined group of all neoplasms, and for 11 out of 13 neoplasms examined in males, and 12 out of 15 neoplasms examined in females. Differences were found irrespective of age, cause of death and prognosis of the cancer. Survival analysis by length of follow up indicated that council tenants were more likely to present at a later stage than owner occupiers. CONCLUSIONS: Wide survival differentials were observed between socioeconomic groups. Differences in survival for cancers of poor prognosis (eg, oesophagus, pancreas, lung) where treatment has little effect, cannot be attributed to socioeconomic differences in treatment. The survival differences for cancers of good prognosis (eg, corpus uteri, bladder, skin) could, in part, be due to differences in treatment. It is probable that delay in seeking care is one of the major contributing causes.
Adult↗
A cohort mortality study and a case-control study of workers potentially exposed to styrene in the reinforced plastics and composites industry.
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Case-Control Studies↗
Socioeconomic status and disease.
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Cause of Death↗
Regional differences in maternal mortality in Greece, 1973-1982.
Maternal mortality in the ten regions of Greece during the period 1973-82 is examined. In Greece as a whole, maternal mortality declined from 27.2 per 100,000 livebirths in 1973, to 12.0 in 1982. During these ten years, the age standardized maternal mortality ratios (SMRs) of two regions was significantly raised, Thrace (SMR = 295, 95% CL = 187-443) and the Aegean Islands (SMR = 197, 95% CL = 117-311). Greater Athens was the only region with significantly reduced maternal mortality (SMR = 77, 95% CL = 59-99). In two regions, Thrace and Epirus, maternal mortality increased during the ten years studied. To explore the possible reasons for the observed geographical differences in maternal mortality, data on three sociodemographic and three obstetric service indicators are presented. Regions with the highest proportion of hospital births had the lowest SMRs (p less than 0.05); and it is suggested that cultural factors in the case of Thrace, mainly emanating from the Muslim minority living in this region, and topographical factors, in the case of the Aegean Islands and Epirus, may have influenced maternal mortality by adversely affecting maternity service usage and availability.
Female↗
Social/economic status and disease.
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Culture↗
Earthquake-related stress and cardiac mortality.
The acute effects of earthquake-related psychological stress on total and cardiac mortality were investigated using mortality data from the city of Thessaloniki (Greece) which was hit on 19 and 20 June 1978, by two strong earthquakes, measuring 5.2 and 6.4 degrees on the Richter scale, respectively. During the a priori specified three-day period of 19, 20 and 21 June, mortality from cardiac and 'all other' pathological causes increased significantly. The estimated relative risks (and 95% confidence intervals) were 3.0 (1.5-5.9) for atherosclerotic heart disease, and 1.6 (1.1-2.3) for 'all other' diseases (excluding external causes) as underlying conditions. Stress-related cardiac deaths (proximate cause) were more common when atherosclerotic heart disease was the underlying condition (p approximately 0.10), but there was no evidence of any age or sex predilection.
Analysis of Variance↗