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Biomedical subjects

W Ahrens

Publications and source records attributed to W Ahrens.

67 records · Page 4Linked to original sources
PubMed1993

Retrospective assessment of asbestos exposure--II. At the job level: complementarity of job-specific questionnaire and job exposure matrices.

Retrospective assessment of asbestos exposure--II. At the job level: Complementarity of job-specific questionnaire and job exposure matrices. International Journal of Epidemiology 1993; 22 (Suppl. 2): S96-S105. The assessments of asbestos exposure by two a priori job exposure matrices (JEM) and by a job-specific questionnaire (SQ) are compared at job level. The data used for the comparison were generated by an ongoing case-control study on lung cancer in a region of northern Germany with a relatively high past prevalence of asbestos exposure. Among job periods assessed as unexposed by either JEM, 96% are recognized as such by the SQ. Discrepancies between the SQ and JEM were observed in jobs rated potentially exposed by the JEM. Despite varying estimates, the JEM and SQ were consistent as regards the relative classification of job periods by probability of exposure. The concordance of the methods, estimated by Kappa statistics, was stronger for the two JEM than for either of the JEM and the SQ. The identification of specific occupation/industry combinations in which discrepancies were most frequent and the comparison with expert ratings in some jobs yield insights into the sources of the disagreement between the methods. The misclassification of exposure by the JEM usually results in an overestimation of exposure. This is essentially related to loss of information due to the use of job codes as surrogates for job task descriptions and to the insufficiency of published data on asbestos exposure in different industries. As regards the SQ, two main sources of potential loss of sensitivity were identified: 1) possible omission of indirect sources of exposure by this method, 2) possible incompleteness of the SQ. The present comparison of methods of asbestos exposure assessment does not allow any one approach to be considered superior to another. Indeed, as proposed by Ahrens et al. in Part I of the study, both should be used to ensure optimal epidemiological performance.

Asbestos↗
PubMed1992

Occupational and environmental hazards associated with lung cancer.

In a hospital-based case-control study 194 lung cancer cases, 194 hospital controls, and 194 population controls were interviewed for their smoking, occupational, and residential history by trained interviewers, using a standardized questionnaire. In order to include many different environmental exposures, case ascertainment took place in seven different hospitals with catchment areas ranging from rural to highly industrialized. Lung cancer risk strongly increases with cumulative cigarette dose, reaching an odds ratio (OR) of 16.19 (95% confidence limits (CL): 5.10, 51.33) for male smokers of more than 40 pack-years and an OR of 19.99 (95% CL: 4.98, 80.24) for female smokers of more than 20 pack-years. For the quantification of occupational exposure to known carcinogens of the lung a novel approach was developed which accumulates exposure information obtained by supplemental questionnaires through an automatic procedure. The OR for the highest exposure group in males was 2.7 (95% CL: 1.23, 5.78). Significantly increased risks were observed in the metal industry, particularly in smelter and foundry workers (OR 4.8, 95% CL: 1.15, 20.16) and in turners (OR 2.2, 95% CL: 1.05, 4.75). In the construction industry the risks were particularly high in road construction workers (OR 3.7, 95% CL: 1.06, 13.20) and in unskilled construction workers (OR 2.7, 95% CL: 1.24, 5.76). The risks in these occupational groups increased with duration and with latency. Quantification of air pollution was done on a county basis by time period. An index based on emission data for sulphur dioxide was compared to a semiquantitative index, which included additional information on ambient air pollution. After adjustment for smoking and occupational exposures an OR of 1.01 (95% CL: 0.53, 1.91) for an emission index and of 1.16 (95% CL: 0.64, 2.13) for a semiquantitative index was obtained.

Adult↗
PubMed1991

Alcohol, smoking, and occupational factors in cancer of the larynx: a case-control study.

A hospital-based case-control study of laryngeal cancer was conducted in Bremen in 1986 and 1987 with 100 prevalent male laryngeal cancer patients and 100 male hospital controls with diseases not considered to be related to smoking, alcohol, or occupational exposures, who were frequency matched by age. The odds ratio for heavy smoking (more than 30 pack-years) reached a value of 3.5 (95% confidence limits (CL) 1.1, 7.9). Ex-smokers showed a significant decrease in risk; this reached the level of those who had never smoked about 15 years after smoking cessation. For daily consumers of alcohol an odds ratio of 3.2 (95% CL 1.4, 7.5) was observed. Among the 17 occupations in which at least ten subjects had worked, excess risks were observed for stock keeping and transportation workers, and for leather and textile workers. The odds ratio was significantly increased for the latter (p less than 0.05). Among all those persons ever employed in a priori defined-risk occupations, an odds ratio of 2.74 (95% CL 1.23, 6.06) was observed. Considering responses to an exposure check-list, no increased risks could be shown for exposure to asbestos, coal tar, or welding fumes. On the other hand, excess risks were observed for exposures to diesel oil, gasoline, and mineral oil, controlling for smoking and alcohol. The findings in occupational and exposure subgroups were based on small numbers of cases and controls and, consequently, were subject to large sampling errors. Many of the results are consistent, however, with occupational risk factors reported from other studies.

Adult↗
PubMed1991

ELISA screening of staphylococcal enterotoxins by means of a specially developed test kit.

The development of a new test kit for the detection of staphylococcal enterotoxins is described. This polyclonal antibody-based enzyme-linked immunosorbent assay (ELISA) is designed for qualitative and quantitative rapid detection of toxin serotypes A, B, C (subgroup 1), D and E in one test system. Results are obtained in 60 min. The lower limit of detection is 0.5 ng/ml; the precision is 90%.

Antibodies, Bacterial↗
PubMed1990

[Results of the epidemiology of lung cancer in females].

In the context with an extensive pilot study investigating risk factors for lung cancer, aetiological and clinical questions were analysed for lung cancer mortality in women. In a first step all available data sources about the prevalence of smoking in the FRG were used to determine the correlation between the prevalence of smoking and lung cancer mortality. 88% of the variance (R2) of lung cancer mortality for women could be explained by smoking. In a second step medical records of 133 female lung cancer patients from three hospitals were analysed with regard to the histological types of lung cancer and smoking. Small cell lung cancers were more frequent among female smokers while adenocarcinoma was more prevalent among non-smokers. Survival analysis for 421 men and 97 women showed a significantly longer survival time for women as compared to men, taking into account other relevant prognostic factors. The association between smoking and lung cancer is discussed and analysed in greater detail.

Cause of Death↗
PubMed1976

Infants of very low birthweight: a follow-up study.

The survival, growth and neurodevelopmental status of a group of non-White infants of very low birthweight, who were managed in the Neonatal Intensive Care Unit of Groote Schuur Hospital, is reported. The effect of certain high-risk perinatal factors on this status is assessed.

Birth Weight↗
PubMedDate not supplied

Pediatric death: managing the aftermath in the emergency department.

Managing the family conference in the emergency department after the sudden death of a child is difficult and, when mishandled, can be deleterious to the patient's family. We surveyed parents of children who died in an emergency department setting in an effort to elicit information that will help emergency physicians tell parents that their child has died. A 24-question survey was distributed to 60 parents identified by the Illinois chapter of the Sudden Infant Death Syndrome Alliance. Results were included if the parents indicated that their child was pronounced dead on arrival or died in an emergency department. If the victim was over 16 years of age, had a terminal illness, or died after hospitalization, results were excluded. Thirty-seven parents completed the survey. Seventy-six percent felt that it was the attending physician's responsibility to inform the family that the child had died. Holding the dead child was helpful for 88%. Seventy-six percent felt that being asked about organ donation would not be offensive. For most parents, having the child's clothes returned was important. Fully 92% of the respondents would have liked a physical memento of the child, such as a print or mold of the child's hand or a lock of hair. Most parents felt that a follow-up telephone call would be helpful, although only a small minority received such a call. Parents whose child died in an emergency department provided some concrete suggestions for emergency physicians regarding informing parents that their child died. Although the majority of children died of sudden infant death syndrome, the results may be applicable to other pediatric deaths.

Attitude to Death↗
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

A standard tool for the analysis of occupational lung cancer in epidemiologic studies.

A standard tool for the analysis of known and suspected causes of occupational lung cancer in population-based studies is proposed in order to allow comparable definitions of exposure or of categorizations of occupations. It is based on a list of occupations and industries known (list A) or suspected (list B) to be associated with lung cancer. The lists were translated into codes of the International Standard Classification of Occupations (1968) and the International Standard Industrial Classification (1971). The specificity of the categorization is compromised for some groups that are defined by highly specific production processes or exposures. Nevertheless, the grouping is based on a highly valid source of information in population-based studies. It is proposed for use in the assessment of the public health impact of occupational lung cancer.

Carcinogens↗