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Biomedical subjects

P Boffetta

Publications and source records attributed to P Boffetta.

At least 271 records · Page 15Linked to original sources
PubMed1990

Alcohol drinking and mortality among men enrolled in an American Cancer Society prospective study.

We studied whether moderate alcohol drinkers have a lower total and coronary heart disease (CHD) mortality than nondrinkers. Among 276,802 U.S. men aged 40-59 enrolled in 1959 in an American Cancer Society prospective study, 42,756 deaths, 18,771 from CHD, occurred during the following 12 years (3% of the cohort was lost to follow-up). Using nondrinkers (55.3% of the cohort) as a reference category, age- and smoking-stratified relative risks (RR) of total mortality were 0.88 for occasional drinkers, 0.84 for those drinking 1 drink per day, 0.93, 1.02, 1.08, 1.22, and 1.38 for those drinking 2, 3, 4, 5, and 6 or more drinks per day, respectively. RRs of CHD mortality were 0.86, 0.79, 0.80, 0.83, 0.74, 0.85, and 0.92, respectively. Multivariate analysis failed to identify other confounders. No changes in RRs were introduced by excluding subjects with poor health or history of chronic disease at enrollment (32.8% of the cohort) or excluding subjects who died during the first 6 years of follow-up. These data indicate an apparent protective effect of moderate alcohol intake on CHD mortality that cannot be attributed to the inclusion of subjects with CHD or related diseases into the nondrinker category.

Adult↗
PubMed1990

[Carcinogenic risk of automobile exhaust: a review].

The increasing number of motor vehicles is associated with diffuse exposure to their exhausts, formed by mixtures of hundreds of chemical compounds. Some of these compounds cause chronic irritation of the respiratory mucosa, while others are carcinogenic in experimental animals, particularly polycyclic aromatic hydrocarbons and nitroarenes. This review aims to describe epidemiologic evidences of carcinogenicity of engine exhausts. The study of the effects in humans of the exposure at issue is impaired by several difficulties: widespread exposure of a large part of the population, with low levels of exposure; aspecific effects, shared with other exposures; concurrent exposures acting on the same targets, particularly the respiratory mucosa (smoking, occupational exposures); difficulties in the quantitation of exposure to exhaust. We review the epidemiologic studies concerning occupational exposures published up to June, 1988. Overall, excess risks for lung and bladder cancers and for hematolymphopoietic malignancies have been reported, particularly in people exposed to diesel exhaust. Excesses are modest, and their interpretation is often impaired by lacking or inadequate consideration of the effects of potential confounders. The review considers, for each study, enrollment procedures, information on exposure, and inclusion of potential confounders. In addition, aspects concerning internal coherence, such as a dose-response relationship, are considered. Particularly relevant are two studies on USA railroad workers, showing a relative risk of 1.4 among those exposed to diesel exhaust. The authors used, in the estimation of exposure, actual measurement of dose in recent years for some jobs and workplaces. Levels of exposure to respirable dusts were around 82-330 micrograms/m3, after allowing for cigarette smoking. According to the International Agency for Research on Cancer, these is limited evidence of carcinogenicity in humans of diesel exhaust, and inadequate evidence for gasoline exhaust.

Case-Control Studies↗
PubMed1990

[Influence of sociodemographic variables in the enrollment of subjects in a population case-control study].

Selection in representation of the study base was quantified in a case-control study of laryngeal cancer among residents of the City of Torino, Italy. Two-hundred-ninety-nine out of 408 eligible cases (73.3%) and 608 out of 1104 (55.1%) eligible controls were interviewed. All interviewed and non interviewed subjects were compared in a logistic regression model with respect to age, sex, educational level, civil status and area of birth. No large differential selection with respect to these variables was found between interviewed and non interviewed cases. Lower proportions of interviewed subjects were found among older controls and controls with lower education. These results suggest the possibility of selection bias in this case-control study. In particular, biased measures of effects might be estimated when analyzing variables related to educational level.

Adult↗
PubMed1989

Role of tobacco and alcoholic beverages in the etiology of cancer of the oral cavity/oropharynx in Torino, Italy.

A population-based case-control study of cancer of oral cavity-oropharynx was conducted in the city of Torino, Italy, between 1982 and 1984. One hundred twenty-two cases (86 males and 36 females) and 606 controls (385 males and 221 females) were compared with respect to lifelong alcohol and tobacco consumption. A 4- to 6-fold increase in risk among subjects with medium or high tobacco consumption was observed, as well as a trend in increasing risk with duration and with earlier age at the start of smoking. Other findings included a sharp reduction in risk with cessation of smoking, no clear protective effect of usage of filter, no differences in risk according to color of tobacco, and a higher risk for cigar versus pipe/cigarette smokers. An effect of alcoholic beverages was found in subjects with an average daily consumption of 120 or more grams of alcohol, with a higher risk in beer drinkers. Among heavy consumers of alcohol and tobacco, risks of both oral and oropharyngeal cancer were very high. A positive association between oral cancer and low educational level, after adjustment for alcohol and tobacco, was found. Attributable risks for alcohol and tobacco in the population were 23% and 72% in men and 34% and 54% in women.

Age Factors↗
PubMed1989

Appearance, site of occurrence, and physical and clinical characteristics of oral carcinoma in Torino, Italy.

The appearance, site of occurrence, and selected physical and clinical characteristics are reported for 102 symptomatic carcinomas diagnosed during a 30-month period in Torino, Italy. Erythroplasia was a more significant visual component than leukoplakia, confirming the results of a previous study on asymptomatic cancer in a US population. Floor of the mouth, oral tongue, and soft palate complex accounted for 75% of all sites and 84% of sites if posterior pillar is excluded. Seventeen percent of the lesions were T1, 60% T2, and 23% larger than T2. Size of the lesion was associated with anterior or posterior position and the mobility of the structure, as well as with ulceration, bleeding, and lymphadenopathy (55% of cancers had no nodal involvement). Tumefaction, burning, and pain were the most frequently reported symptoms. About 50% of patients experienced a time lapse between onset of symptoms and final diagnosis of less than 3 months, and this proportion was higher among patients with T1 cancers.

Adult↗
PubMed1989

A case-control study of multiple myeloma nested in the American Cancer Society prospective study.

Among the subjects enrolled in the American Cancer Society Cancer Prevention Study II, a large nation-wide prospective study, 282 died from multiple myeloma (MM) during the first 4 years of follow-up. These were divided into incident cases who were initially free from disease and prevalent cases who reported MM or related symptoms at the time of enrollment. For each case, 4 controls matched for age, sex, ethnic group and residence were randomly selected. Previous history of diabetes [odds ratio (OR) = 2.0] and employment as farmer (OR = 2.7) were the risk factors consistently suggested by the results of the analysis. The risk associated with farming showed a linear trend with duration of exposure. Pesticide or herbicide exposure was not a risk factor per se but, when combined with farming, it increased the OR to 4.3. Low education, occupational exposure to dyes, and employment in a bank, on the railroad or as a maid were also suggested risk factors, but either they were not statistically significant or they were based on small numbers of exposed subjects. No association between MM and asbestos exposure was observed.

Adult↗
PubMed1989

Diesel exhaust exposure and lung cancer risk.

The association between lung cancer and occupations with probable exposure to diesel exhaust has been examined in several studies in the past with inconclusive results. We report a case-control study among 2,584 cases and 5,099 hospital controls. The crude odds ratio for probable exposure was 1.31 (95% Cl 1.09, 1.57), but adjustment for smoking and other confounders reduced the estimate to 0.95 (95% Cl 0.78, 1.16). Similar results were observed for truck drivers, the only occupational category large enough for separate analysis. Data on self-reported exposure for a subset of 477 cases and 946 controls revealed a crude odds ratio of 1.45 (95% Cl 0.93, 2.27) which was reduced to 1.21 (95% Cl 0.78, 2.02) after controlling for smoking and other confounders. A duration-response relationship was suggested (P less than 0.12) only for self-reported exposure. Cigarette smoking was the predominant confounder in the analysis. Problems arising from biases and confounding in the present and in other previously published reports on the association between diesel exhaust exposure and lung cancer risk are discussed, and a review on the evidence of human carcinogenicity of diesel exhaust exposure is presented.

Air Pollutants↗
PubMed1988

Perspectives of comparing risks of environmental carcinogens.

In 1987, investigators (Ames et al.) concluded that the risks of man-made industrial carcinogens and pesticides (outside of the workplace) are trivial compared with the risks of naturally occurring carcinogens found mostly in the diet. They used a ranking system based on human exposure and rodent potency (HERP) data to arrive at this conclusion. As a result, they recommend that regulatory agencies, such as the Environmental Protection Agency and the Food and Drug Administration, base their priorities in this area on their HERP system. We analyzed the assumptions and data set upon which the HERPs were based, concluding that such a simplified approach to set public health policy is inappropriate given the underlying uncertainties. However, we note that when comparisons are consistently based on estimates of average daily exposure to common carcinogens, the HERP scores of many man-made pollutants are comparable to those of naturally occurring carcinogens in the diet.

Carcinogens, Environmental↗
PubMed1988

Cancer of the larynx/hypopharynx, tobacco and alcohol: IARC international case-control study in Turin and Varese (Italy), Zaragoza and Navarra (Spain), Geneva (Switzerland) and Calvados (France).

A case-control study on larynx and hypopharynx cancer was carried out in 6 populations including the city of Turin and the province of Varese (Italy), the provinces of Navarra and Zaragoza (Spain), the canton of Geneva (Switzerland), and the département of Calvados (France). This report presents an analysis of the risk associated with alcohol and tobacco consumption based on 1,147 male cases and 3,057 male population controls. Special attention was given to the study of the risk at various sites of larynx and hypopharynx. The effect of tobacco is similar for all sites and the risk associated with ever smoking is on the order of 10. The risks from alcohol drinking depend on site. They are similar for epilarynx and hypopharynx (RR = 4.3, for more than 80 g/day) and lower for endolarynx (RR = 2.1, for more than 80 g/day). For all sites the risk decreases after quitting (RR = 0.3 after 10 years); exclusive use of filter cigarettes is protective (RR = 0.5 relative to smokers of plain cigarettes only) as is exclusive use of blond tobacco (RR = 0.5 relative to smokers of black tobacco only). Inhalation increases the risk of endolaryngeal cancer but not that of hypopharynx or epilarynx. The relative risks for joint exposure to alcohol and tobacco are consistent with a multiplicative model.

Adult↗
PubMed1988

Smoking habits of 800,000 American men and women in relation to their occupations.

The distribution of cigarette smoking (as well as of cigar and pipe smoking in men) by occupation was examined in over 800,000 men and women age 45-70 who were enrolled in the American Cancer Society's prospective study in 1982. Striking variations were seen for men--less striking variations for women. Smoking rates were significantly higher in groups exposed to a number of occupational hazards, compared to groups not so exposed. A considerable amount of variation is related to social class, but some individual occupations exhibit notably high (law enforcement) or low (clergy) smoking rates. This information can be quite useful in planning morbidity or mortality studies of specific occupational groups or in analyzing data from existing studies.

Aged↗
PubMed1988

Diesel exhaust exposure and mortality among males in the American Cancer Society prospective study.

In 1982, the American Cancer Society enrolled over 1.2 million American men and women in a prospective mortality study of cancer and other causes in relation to different risk factors. The 2-year mortality of 461,981 males aged 40-79 years with known smoking habit has been analyzed in relation to exposure to diesel exhaust (DE) and to employment in selected occupations related to DE exposure. The relative risk (RR) for all causes of death for those exposed was 1.05 (95% confidence interval [CI]: 0.97-1.13). For lung cancer, the RR was 1.18 (95% CI: 0.97-1.44). A dose-response effect was present. Railroad workers, heavy equipment operators, miners, and truck drivers had a higher mortality both for all causes and for lung cancer when compared with subjects with other occupations and no exposure to DE. Truck drivers exposed to DE were not at excess risk of lung cancer if compared with truck drivers unexposed to DE, but a trend of increasing risk with duration of exposure was suggested. DE exposure was also associated with increase in mortality for accidents, cerebrovascular disease, arteriosclerosis, and cirrhosis of the liver. An association based on small numbers was also present for Hodgkin's disease and lymphoid leukemia. No association with chronic non-neoplastic pulmonary diseases or with bladder cancer was found.

Adult↗
PubMed1988

Alcohol and breast cancer: a cohort study.

The relation between alcohol consumption and several causes of death, including breast cancer, was examined in a population of 581, 321 women enrolled in a prospective study in 1959 and followed for 12 years. Women who drank occasionally had about the same breast cancer mortality rate as nondrinkers; those who drank one to four drinks per day had SMRs 7-26% higher; five drinks per day, 1.89; and six or more drinks per day, 1.65. The two highest-consumption groups' risks were significantly higher than those of nondrinkers after multivariate adjustment for several breast cancer risk factors. Distinctive dose-response relationships were observed for two known alcohol-related conditions: cirrhosis of the liver and cancer of the aero-digestive tract, suggesting that results for other causes are not seriously biased by misclassification of drinking habits. Death rates from all causes combined were elevated for drinkers of three or more drinks per day. Whether or not the association of elevated breast cancer death rates ultimately turns out to be causal, there is ample reason to continue to warn the public against excessive drinking.

Adult↗
PubMed1988

A comparative study of smoking, drinking and dietary habits in population samples in France, Italy, Spain and Switzerland. I. Study design and dietary habits.

Diet, tobacco and alcohol consumption, and occupational histories have been investigated in stratified random samples of the adult population in 6 areas in France (departement of Calvados), Italy (province of Varese and city of Torino), Spain (provinces of Navarra and Zaragoza) and Switzerland (canton of Geneva), to be used as a reference group in a case-control study on cancer of the larynx and hypopharynx. Out of a total of 8,074 sampled subjects, 5,564 could be interviewed. Sampling procedures are described, and reasons for non-response are analysed. Everywhere the intake of the 4 energy providing nutrients (particularly alcohol) was much greater in men than in women. In both sexes, total caloric intake was higher in Calvados and in Italy than elsewhere. There were wide inter-area variations in the consumption of butter + milk products and oils, resulting in a polyunsaturated/saturated fatty acid ratio ranging from 0.27 in Calvados to 0.54-0.65 in Spain. Among nutrients suggested to be involved in cancer aetiology, inter-area differences in daily intake were up to 3-fold for carotene and smaller for vitamin C and fibre. The proportion of lipids, fibres, vitamin C and carotene provided by different foods varied widely between areas, thus suggesting that in etiological cancer studies consideration should be given not only to nutrients but also to foods providing them.

Adult↗
PubMed1987

Incidence of breast cancer in Piedmont: 1979-1981.

A population-based survey of histologically diagnosed breast cancer was carried out among residents in Piedmont. A total of 5267 incident cases occurring in 1979-1981 was collected, corresponding to an age-standardized (on the world population) incidence rate of 49.5/100,000 per year. Rates (standardized on the population of Piedmont in 1981) were highest in the city of Torino (112.4/100,000 per year) and lowest in the province of Cuneo (67.5), whereas in the other provinces they ranged between 85.3 and 90.0. Estimation of rates in the 54 Local Health Authorities of Piedmont detected up to 2-fold differences between adjacent areas. A correlation was found between rates and size of the population of town of residence. Comparison with age-specific incidence rates from the Cancer Registry of the nearby province of Varese suggested a loss of nonhistologically confirmed cases selectively in older age groups. The distribution of cases diagnosed in 1979 by histologic type is presented. The proportion of diagnoses reported in terms which were consistent with the 1978 WHO Histological Typing of Breast Tumours was 61.3%. It was highest among cases identified in Pathology Services located in University Hospitals and/or diagnosing more than 50 breast cancers per year.

Adolescent↗
PubMedDate not supplied

Occupational exposure to chemical and biological agents in the nonproduction departments of pulp, paper, and paper product mills: an international study.

As part of an international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article describes 7293 measurements in nonproduction departments from 147 mills in 11 countries. The greatest variety of agents was measured in the maintenance, construction, and cleaning department, where high exposures to asbestos, chromium [VI] compounds, copper, mercury in urine, nitrogen dioxide, ozone, styrene, sulfur dioxide, trichloroethylene, and welding fumes were observed. Measurements in the storage, yard, loading, and shipping department indicated high exposures to asbestos, carbon monoxide, fungal spores, nitrogen oxides, sulfur dioxide, and total dust. The steam and power generation department had high exposures to methyl mercaptan, silica, and total dust. Measurements in process and effluent water treatment, laboratory and research, engineering, and office, administration, and cafeteria areas had few elevated exposures. Throughout the nonproduction departments, measurements of pulp-production chemicals such as chlorine and sulfur compounds tended to be low, with many below detection limits. There were some problems with the available data; in particular, detection limits were often not specified, and the data tended to be clustered in such a way that sources of exposure variability could not be distinguished. Despite these problems, the data provide new insight into the exposures of nonproduction pulp and paper industry personnel.

Databases, Factual↗
PubMedDate not supplied

Literature review of levels and determinants of exposure to potential carcinogens and other agents in the road construction industry.

Workers in the road construction industry include asphalt plant, ground construction, and road paving workers. These individuals can be exposed to a wide range of potentially hazardous substances. A summary of levels of exposure to different substances measured during road construction is presented. In modern road paving, workers typically are exposed to 0.1 to 2 mg/m3 of bitumen fume, which includes 10 to 200 ng/m3 of benzo(a)pyrene. Sampling strategies and analytical methods employed in each reviewed survey are described briefly. The published reports provide some insight into the identity of factors that influence exposure to bitumen among road construction workers: type of work performed, meteorological conditions, temperature of paved asphalt. However, there is a lack of (a) comprehensive and well-designed studies that evaluate determinants of exposure to bitumen in road construction, and (b) standard methods for bitumen sampling and analysis. Information on determinants of other exposures in road construction is either absent or limited. It is concluded that data available through published reports have limited value in assessing historical exposure levels in the road construction industry.

Carcinogens↗