Search PubMed⌕ Search

Biomedical subjects

P Boffetta

Publications and source records attributed to P Boffetta.

At least 145 records · Page 8Linked to original sources
PubMed1999

Cancer incidence among European man-made vitreous fiber production workers.

OBJECTIVES: This study analyzed cancer incidence among man-made vitreous fiber workers. METHODS: A cancer incidence follow-up was conducted among 3685 rock-slag wool (RSW) and 2611 glass wool (GW) production workers employed for > or =1 year in Denmark, Finland, Norway, or Sweden, and the standardized incidence ratios (SIR) were calculated on the basis of national incidence rates. RESULTS: Overall cancer incidence was close to expectation. Lung cancer incidence was increased among the RSW [SIR 1.08, 95% confidence interval (95% CI) 0.85-1.36] and GW (SIR 1.28, 95% CI 0.91-1.74) workers. For both subcohorts, a trend was suggested for time since first employment (P-value for linear trend 0.1 and 0.2, respectively). Neither subcohort showed an association with employment during the early technological phase, when fiber exposure was high. The incidence of oral, pharyngeal, and laryngeal cancer was increased among the RSW (SIR 1.46, 95% CI 0.99-2.07) and the GW (SIR 1.41, 95% CI 0.80-2.28) subcohorts. Despite a trend in risk for these neoplasms among the GW workers with time since first employment, the lack of a positive relation with other indirect indicators of fiber exposure points against a causal interpretation. No association between RSW or GW exposure and the risk of other neoplasms was suggested. CONCLUSIONS: These lung cancer results are similar to those of a mortality study that included a larger number of factories. For other cancers there was no suggestion of an association with RSW or GW exposure.

Humans↗
PubMed1999

Epidemiological studies on genetic polymorphism: study design issues and measures of occurrence and association.

As with other epidemiological studies, the design and analysis of a study including genetic polymorphisms generally involve relating a particular disease or health outcome to a particular exposure or genetic trait, while assessing the presence of systematic error, controlling random error and assessing effect modification (interaction) with other exposures or traits. In studies of determinants and mechanisms of disease, markers of genetic polymorphism are generally treated either as exposure variables or as effect modifiers. In epidemiological studies the study base can be completely enumerated, and the cases can be identified as either incident or prevalent cases (incidence and prevalence studies). Alternatively, the study may involve cases of the disease (or condition) under investigation and a control group sampled from the study base that generated the cases (incidence and prevalence case-control studies). Most available studies on metabolic polymorphism and cancer risk are incidence case-control studies. Their major methodological problem is the selection of controls, which may be an important source of bias. Another important limitation of many available studies is the small sample size, which may be inadequate for assessing statistical interaction when the metabolic polymorphism is treated as an effect modifier.

Case-Control Studies↗
PubMed1998

Classic Kaposi's sarcoma in Jews living in Israel, 1961-1989: a population-based incidence study.

BACKGROUND: The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations, mostly born in Eastern Europe. OBJECTIVE: To describe the incidence on CKS in Israeli Jews and to determine differences in incidence according to their geography origin. DESIGN: We analysed data on 1098 incident CKS cases with known country of origin occurring between 1961 and 1989 in the Jewish Israeli population. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of HIV-seropositive patients. Patients who were seropositive for HIV were excluded from the study population. Population figures for groups of migrants and natives were derived from census surveys (1961, 1972, 1983) and inter-census estimates based on the population registry. RESULTS: The overall age-standardized rate of CKS was 16.9 per million in men and 6.3 per million in women. The ratio between genders remained stable during the study period. In both genders, there was a steep increase in CKS incidence between the late 1960s (age-standardized rates per million: 8.0 in men and 2.2 in women) and the early 1970s (17.9 in men and 6.7 in women). No further increase was present after 1971. Overall, immigrants experienced a relative risk (RR) of 1.17 [95% confidence interval (CI) 0.90-1.521 compared with Jews born in Israel. Immigrants from Morocco, Algeria and Tunisia had the highest incidence (RR 2.01; 95% CI 1.52-2.65) compared with Jews born in Israel, followed by those born in Iraq (RR 1.74; CI 95% 1.27-2.37). The lowest incidence was experienced by immigrants from Iran (RR 0.37; CI 95% 0.18-0.77) and from Central European countries (RR 0.45; CI 95% 0.30-0.66). Immigrants from other countries in Asia, Africa, the Americas and Europe had similar rates as Jews born in Israel. CONCLUSIONS: Israeli Jews present one of the highest incidences of CKS reported from developed countries. The incidence varies according to geographical origin. Countries surrounding the Mediterranean sea represent the area of highest CKS incidence.

Adolescent↗
PubMed1998

Multicenter case-control study of exposure to environmental tobacco smoke and lung cancer in Europe.

BACKGROUND: An association between exposure to environmental tobacco smoke (ETS) and lung cancer risk has been suggested. To evaluate this possible association better, researchers need more precise estimates of risk, the relative contribution of different sources of ETS, and the effect of ETS exposure on different histologic types of lung cancer. To address these issues, we have conducted a case-control study of lung cancer and exposure to ETS in 12 centers from seven European countries. METHODS: A total of 650 patients with lung cancer and 1542 control subjects up to 74 years of age were interviewed about exposure to ETS. Neither case subjects nor control subjects had smoked more than 400 cigarettes in their lifetime. RESULTS: ETS exposure during childhood was not associated with an increased risk of lung cancer (odds ratio [OR] for ever exposure = 0.78; 95% confidence interval [CI] = 0.64-0.96). The OR for ever exposure to spousal ETS was 1.16 (95% CI = 0.93-1.44). No clear dose-response relationship could be demonstrated for cumulative spousal ETS exposure. The OR for ever exposure to workplace ETS was 1.17 (95% CI = 0.94-1.45), with possible evidence of increasing risk for increasing duration of exposure. No increase in risk was detected in subjects whose exposure to spousal or workplace ETS ended more than 15 years earlier. Ever exposure to ETS from other sources was not associated with lung cancer risk. Risks from combined exposure to spousal and workplace ETS were higher for squamous cell carcinoma and small-cell carcinoma than for adenocarcinoma, but the differences were not statistically significant. CONCLUSIONS: Our results indicate no association between childhood exposure to ETS and lung cancer risk. We did find weak evidence of a dose-response relationship between risk of lung cancer and exposure to spousal and workplace ETS. There was no detectable risk after cessation of exposure.

Aged↗
PubMed1998

Classic Kaposi's sarcoma in Arabs living in Israel, 1970-1993: a population-based incidence study.

The incidence of classic Kaposi's sarcoma (CKS) has been reported to be high in Jewish populations living in Israel and in immigrants originating from the Mediterranean basin. No population-based reports are available on the incidence of CKS in Israeli Arabs. We analyzed the incidence of CKS cases occurring between 1970 and 1993 among Arabs living in Israel. Reporting systems were the Israel Cancer Registry, the medical documentation of all-Kaposi's sarcoma cases and the registry of human immunodeficiency virus-seropositive patients. Population figures were derived for census surveys (1972 and 1983) and inter-census data based on annual updating of demographic characteristics. Age-standardized incidence rates (ASR) were 6.87 per million in men and 2.18 per million in women. The ASR did not increase between 1970 and 1993 in either men or women. The age-adjusted male to female ratio was 2.0 below 50 years of age and 3.5 above it. The observation of a stable and relatively high incidence of CKS in Israel-born Arabs, comparable to other populations living in the Mediterranean basin, suggests that risk is related to geographical origin. CKS incidence, however, is lower than that in Israel-born Jews.

Adult↗
PubMed1998

Second follow-up of a Dutch cohort occupationally exposed to phenoxy herbicides, chlorophenols, and contaminants.

A retrospective cohort study of workers exposed to phenoxy herbicides, chlorophenols, and contaminants (2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and other polychlorinated dioxins and furans) has been conducted in a chemical factory in the Netherlands. Male workers exposed to phenoxy herbicides or chlorophenols showed increased relative risks (adjusted for age, calendar period at end of follow-up, and time since first exposure/employment) for total mortality (relative risk (RR)=1.8, 95% confidence interval (CI) 1.2-2.5), cancer mortality (RR=4.1, 95% CI 1.8-9.0), respiratory cancer (RR=7.5, 95% CI 1.0-56.1), non-Hodgkin's lymphoma (RR=1.7, 95% CI 0.2-16.5), and ischemic heart diseases (RR=1.8, 95% CI 0.9-3.6) compared with an internal referent group of nonexposed workers. By using TCDD levels (predicted at the time of maximum exposure), based on extrapolated TCDD levels that were measured in a subset of the cohort, estimated relative risks for workers with medium and high TCDD levels were comparable with risks derived from the simple and earlier applied dichotomous exposure classification. In general, relative risks were highest in the highest category, indicating exposure-related increases in risk with TCDD level. In conclusion, results of this cohort study support the evidence of a high cancer risk in workers exposed to phenoxy herbicides, chlorophenols, and contaminants.

Adult↗
PubMed1998

Exposure to environmental tobacco smoke and risk of lung cancer in non-smoking women from Moscow, Russia.

The association between exposure to ETS and the risk of lung cancer in life-time non-smoking women was investigated by means of a hospital based case-control study in Moscow, Russia. The main importance of our study is that it was conducted on a population with a specific smoking pattern from which no information is available on health effects of ETS. A total of 189 incident cases of histologically confirmed lung cancer were identified in 2 principal cancer treatment hospitals in Moscow. A total of 358 female oncology patients from the same hospitals were selected as controls. The controls matched by the hospitals to the cases were similarly restricted to never-smokers. Women diagnosed with cancer of the upper respiratory organs were ineligible for selection as controls. Personal interviews of cases and controls were conducted in the hospital wards, using a closed-form structured questionnaire. An elevated risk of lung cancer was observed in women whose husbands smoked. The odds ratio (OR) adjusted by age and education for husband's smoking was 1.53 (95% CI, 1.06-2.21). Smoking by other members of the family, by colleague's, or by fathers in the women's childhood do not affect the risk of lung cancer. The risk is higher for women whose husbands smoke "papirosy" (OR 2.12; 95% CI, 1.32-3.40), a special Russian type of cigarettes with a long mouthpiece, and usually very high levels of tar (> 30 mg/cig) and nicotine (> 1.8 mg/cig). Our study suggests that the association between exposure to ETS of the spouse and risk of lung cancer in non-smoking women is somewhat stronger for squamous-cell carcinoma (OR, 1.94; 95% CI, 0.99-3.81) than for adenocarcinoma (OR, 1.52; 95% CI, 0.96-2.39).

Adenocarcinoma↗
PubMed1998

A meta-analysis of epidemiological studies on the combined effect of hepatitis B and C virus infections in causing hepatocellular carcinoma.

The aim of the study was to assess whether co-infection by hepatitis-B virus (HBV) and hepatitis-C virus (HCV) is associated with a higher risk of developing hepatocellular carcinoma (HCC) than each infection alone. A meta-analysis of data published up to June 1997 was performed. HBsAg and anti-HCV antibodies or HCV RNA (anti-HCV/HCV RNA) were considered as serological markers of current HBV and HCV infection respectively. A total of 32 case-control studies were suitable for a quantitative overview. The summary odds ratios (OR) were 13.7 for HBsAg positivity and 11.5 for anti-HCV/HCV RNA positivity. The OR for anti-HCV was lower among studies using second- or third-generation anti-HCV or HCV RNA (OR, 8.2) with respect to studies with first-generation anti-HCV test (OR, 19.1). When combining data from the studies with second- or third-generation anti-HCV or HCV RNA, the OR for HBsAg positivity and anti-HCV/HCV RNA negativity was 22.5 (95% confidence interval (CI), 19.5-26.0), the OR for anti-HCV/HCV RNA positivity and HBsAg negativity was 17.3 (95% CI, 13.9-21.6), and the OR for both markers positivity was 165 (95% CI: 81.2-374, based on 191 cases and 8 controls exposed). A synergism was found between HBV and HCV infections, the OR for co-infection being greater than the sum and lower than the product of those for each infection alone. The interaction was therefore negative according to the multiplicative model, providing epidemiological evidence both of an independent effect and of interference between the 2 viruses in the carcinogenic process.

Adult↗
PubMed1998

Occupation and the risk of laryngeal cancer in Uruguay.

In a case-control analysis involving 112 patients afflicted by laryngeal cancer and 509 controls diagnosed with cancers not related to tobacco and alcohol exposures, we studied the effects of type of employment and of substances present in the workplace on laryngeal cancer risk. Effects were measured relative to those never employed or never exposed to the substances. All analyses were controlled for age, tobacco smoking, and alcohol drinking through unconditional logistic regression and stratified analysis. Among job titles, butchers, vintners, bakers, and car assemblers presented elevated risks of laryngeal cancer (OR for butchers 2.8, 95% CL 1.1-7.2). Similarly, asbestos, mists from strong inorganic acids and pesticide exposures were associated with increased risks of laryngeal cancer (OR for strong acids 1.8, 95% 1.1-2.9).

Adult↗
PubMed1998

Cancer mortality and wood dust exposure among participants in the American Cancer Society Cancer Prevention Study-II (CPS-II).

In 1994, the International Agency for Research on Cancer (IARC) classified wood duct as a human carcinogen, based on very strong evidence of a carcinogenic risk of sino-nasal cancer. Excesses of other cancers, including lung and stomach, have been reported among persons employed in wood industries or occupationally exposed to wood dust, but not as consistently. We investigated such possible associations using the mortality experience of 362,823 men enrolled in the American Cancer Society's Cancer Prevention Study-II in 1982 and followed up for 6 years. Within this group, 45,399 men (12.5%) reported either employment in a wood-related occupation or exposure to wood dust or both. Among woodworkers, a small but significant excess risk was found for all cases of death (RR 1.17 (95% CI 1.11-1.24)) and for total malignancies (RR 1.17 (1.05-1.30)). Among men who reported exposure to wood dust, there was an elevated risk of total mortality (Rr 1.07 (1.03-1.11)), total malignancies (RR 1.08 (1.01-1.15)), and lung cancer (RR 1.17 (1.04-1.31)). Among woodworkers, a significant trend (P = 0.02) of increasing risk of lung cancer with increasing duration of exposure was observed. An unexpected, significantly increased mortality from prostate cancer was observed in both wood-employed and wood-exposed, and a twofold increased risk of fatal brain cancer was seen among the former. Lung cancer mortality was especially high among woodworkers who also reported exposure to asbestos or formaldehyde, and it appears that exposure to these known carcinogens may partly explain the observed increased risks. Excess sino-nasal cancer was not observed, but the number of cases was small.

Cause of Death↗
PubMed1998

Nonmalignant respiratory disease mortality among woodworkers participating in the American Cancer Society Cancer Prevention Study-II (CPS-II).

Nonmalignant respiratory disease (NMRD) mortality was examined among woodworkers participating in the American Cancer Society's CPS-II cohort study. During the 6-year prospective follow-up there were 97 NMRD death's among 11,541 men reporting employment in wood-related occupations and 1,338 NMRD deaths among 317,424 men reporting no exposure to wood dust or wood-related jobs. Relative risks, adjusted for age and smoking, were calculated using Poisson regression. A small excess of NMRD was observed among woodworkers. However, the relative risk was higher among woodworkers who did not report exposure to wood dust (RR = 1.52, 95% CI = 1.18-1.97) than those who did (RR = 1.27, 95% CI = 0.91-1.77), and no clear trend with duration of exposure was observed. An excess of NMRD was observed among woodworkers reporting exposure to asbestos (RR = 1.59, 95% CI = 0.85-2.96), as well as the small number of woodworkers reporting exposure to formaldehyde (RR = 1.95, 95% CI = 0.63-6.06), but men not reporting exposure to these substances also had an excess risk. Although limited by a short follow-up period and crude indicators of exposure, the strengths of this analysis were the ability to compare woodworkers to a similar, healthy population and to adjust for the effects of smoking. Cohort studies with better exposure information are needed to examine the role of occupational exposures among woodworkers in the etiology of respiratory disease.

Cohort Studies↗
PubMed1998

Historical exposure to inorganic mercury at the smelter works of Abbadia San Salvatore, Italy.

Metallic mercury production from cinnabar ore may result in high exposures to inorganic mercury, that are difficult to assess separately from the exposures originating from underground extraction, and previously have only been scantily described. We retrieved and analysed the air and biological mercury determinations on workers involved in the smelting process of the Abbadia San Salvatore mine (Monte Amiata, Italy). Native mercury was not present in the ore, and the exposure in the underground extraction was low. The smelter operated from 1897 to 1983. Blood and urine (24/h urine collections and concentration samples) had been sampled in 1968 to 1982, and analysed for mercury by atomic absorption spectrophotometry, and relate to all subjects. Exposure to mercury in air had been determined in a small set of personal samples in 1982. The data relate to all jobs in the smelter process, and all jobs entailed substantial exposure to mercury. The overall distribution of breathing zone air, blood and urinary levels is right-skewed and similar to the log-normal distribution (air, median 48 micrograms/m3, n = 49; blood, arithmetic mean AM 49 micrograms/L; geometric mean GM 26 micrograms/L, n = 192; urinary excretion, AM 140 micrograms/24 h, GM 78 micrograms/24 h, n = 839; and urinary concentration, AM 160 micrograms/L, GM 83 micrograms/L, n = 632). Air, blood and urinary values show a high ratio of the between- and within-job variance, indicating differences in exposure by job. Cinnabar pigment production, of which the exposure has not been characterised previously, was the job with the highest air (AM 160 micrograms/m3) and urinary levels (excretion AM 690 micrograms/24 h; concentration AM 1100 micrograms/L). Other jobs with high urinary levels were soot purification, laboratory work, and bottling. Cleaning of condensers showed the highest blood level (AM 280 micrograms/L). There is a downwards time trend in mercury concentration in blood and in urine. The corresponding trend is not seen for urinary excretion levels, the reason for this being unclear. Roasters, which is the most frequently monitored group, show however a decreasing trend in all sets of data (e.g. the mean of urinary excretion decreased from 300 micrograms/24 h in 1968/69 to 50 micrograms/24 h in 1980/81). The mercury exposure experienced by the smelters of Abbadia San Salvatore is in line with the few available data on workers from other mercury mines and smelters, and our data confirm the high exposure levels in this occupational group, in particular at cinnabar pigment production, soot purification, and condenser cleaning.

Aerosols↗
PubMed1998

Lung cancer and smoking: a case-control study in Buenos Aires, Argentina.

The objective of this study was to examine the risks for lung cancer associated with lifestyle characteristics of smoking in a developing country where lung cancer is the first cause of mortality by cancer in men, tobacco propaganda is freely allowed, and there are no restrictions operating for smoking. The design was a case-control and hospital-based study. Two hundred men with lung cancer and 397 hospital controls were interviewed. Odds ratio (OR) for current smokers was 8.5, whereas former smokers displayed an OR of 5.3. The risk increased with duration of smoking and with the number of cigarettes smoked per day. The attributable risk for smoking was 85%. Smokers of black tobacco and more than 24 cigarettes/day showed a risk of 12.9 regarding non-smokers, and of 15.5 for 40 or more years duration of smoking. The proportion of cases diagnosed as adenocarcinoma was higher than the proportion of squamous cell carcinoma.

Adult↗