Biomedical subjects

W Jedrychowski

Publications and source records attributed to W Jedrychowski.

At least 37 records · Page 2Linked to original sources

PubMed1999

The adverse effect of low levels of ambient air pollutants on lung function growth in preadolescent children.

The main purpose of our study was to assess the effect of low concentrations of ambient air pollution on lung function growth in preadolescent children. We accounted for height velocity over the follow-up period and also for other possible confounders such as baseline anthropometric and physiologic characteristics of children. In addition to outdoor air pollution, we considered the possible effects of social class and exposure to indoor pollutants such as gas stove fumes or environmental tobacco smoke. The cohort prospective study was carried out in 1,001 preadolescent children from two areas of Krakow, Poland, that differed in ambient air pollutants. In the city center (higher pollution area), the mean annual level [+/- standard deviation (SD)] of suspended particulate matter was 52.6 +/- 53.98 microg/m(3) and that of SO(2) was 43.87 +/- 32.69 microg/m(3); the corresponding values in the control area were 33.23 +/- 35.99 microg/m(3) and 31.77 +/- 21.93 microg/m(3). Mean lung function growth rate adjusted to height velocity and lung function level at the study entry was significantly lower in boys and girls living in the more polluted areas. Also, the proportion of children with the slower lung function growth (SLFG) was higher in the children from the more polluted area of the city. The analysis completed in the group of children after the exclusion of asthmatic subjects and those with asthmalike symptoms confirmed that, in boys, odds ratios (ORs) for SLFG [forced vital capacity (FVC)] and air pollution after adjustment to baseline FVC, height, and growth rate was significant [OR = 2.15; 95% confidence interval (CI), 1.25-3. 69)]. The analysis also confirmed that for SLFG(FEV(1)) the OR was 1. 90 (CI, 1.12-3.25). The corresponding OR values in girls were insignificant (OR = 1.50; CI, 0.84-2.68 and OR = 1.39; CI, 0.78-2. 44). The association between ambient pollutants and poorer gain of pulmonary volumes in children living in more polluted areas suggests that air pollution in the residence area may be a part of the causal chain of reactions leading to retardation in pulmonary function growth during the preadolescent years.

Air Pollution↗

PubMed1999

Molecular epidemiologic research on the effects of environmental pollutants on the fetus.

Evidence shows that fetuses and infants are more affected than adults by a variety of environmental toxicants because of differential exposure, physiologic immaturity, and a longer lifetime over which disease initiated in early life can develop. In this article we review data on the effects of in utero exposure to common environmental contaminants, including polycyclic aromatic hydrocarbons (PAH), particulate matter and environmental tobacco smoke (ETS). We then summarize results from our molecular epidemiologic study to assess risks from in utero exposures to ambient air pollution and ETS. This research study, conducted in Poland, used biomarkers to measure the internal and bioeffective dose of toxicants and individual susceptibility factors. The study included 160 mothers and 160 newborns. Ambient air pollution was significantly associated (p= 0.05) with the amount of PAH bound to DNA (PAH-DNA adducts) in both maternal and infant cord white blood cells (WBC). Newborns with elevated PAH-DNA adducts (greater than the median) had significantly decreased birth weight (p= 0.05), birth length (p= 0.02), and head circumference (p= 0.0005) compared to the newborns with lower adducts (n= 135). Maternal and infant cotinine levels were increased by active and passive cigarette smoke exposure of the mother (p= 0.01). An inverse correlation was seen between newborn plasma cotinine (nanograms per milliliter) and birth weight (p= 0.0001) and length (p= 0.003). Adducts were elevated in placental tissue and WBC of newborns who were heterozygous or homozygous for the cytochrome P4501A1 MspI restriction fragment length polymorphism (RFLP) compared to newborns without the RFLP. Levels of PAH-DNA and cotinine were higher in newborns than mothers. These results document that there is significant transplacental transfer of PAH and ETS constituents from mother to fetus; that PAH-DNA adduct levels in maternal and newborn WBC were increased with environmental exposure to PAH from ambient pollution; and that the fetus is more sensitive to genetic damage than the mother. The study also provided the first molecular evidence that transplacental PAH exposure to the fetus is compromising fetal development. If confirmed, these findings could have significant public health implications since a number of studies have found that reduction of head circumference at birth correlates with lower intelligence quotient as well as poorer cognitive functioning and school performance in childhood.

Adult↗

PubMed1999

Ambient air pollution and respiratory health in the east Baltic region.

Air pollutants of primary concern to human health in the east Baltic region include particulate matter and sulfur dioxide. Exposure to elevated levels of nitrogen dioxide and ozone is also widespread. Coal-fired power and heavy industrial plants not fitted with efficient air treatment equipment constitute major sources of air pollution. Domestic heating with coal causes high local levels in some areas. The rapid growth of motor vehicle traffic results in increased emissions, predominantly in densely populated areas. Several epidemiologic studies performed in the east Baltic region, mainly in Poland, have documented an association between air pollution exposure and adverse health effects, primarily in the respiratory tract. Short-term exposure to ambient air pollution has been related to an increase in mortality and hospital admissions for illnesses of the respiratory tract. The associations were mainly seen for particulates or sulfur dioxide, and thus they confirmed the findings from other parts of Europe and the United States.

Adolescent↗

PubMed1999

Effect of Helicobacter pylori infection, smoking and dietary habits on the occurrence of antrum intestinal metaplasia. Clinico-epidemiological study in Poland.

The purpose of the study was to assess risk factors for intestinal metaplasia arising from H. pylori-related chronic gastritis in a subset of the population referred to endoscopic examinations due to dyspeptic complaints. We aimed specifically to establish whether H. pylori itself may be responsible for the occurrence of intestinal metaplasia and to which extent the metaplasia may be associated with life style factors such as cigarette smoking, alcohol consumption or dietary habits. The study was carried out in a sample of 1290 outpatients referred for the first time to gastroenterologic outpatient clinics in 6 university centers in Poland. The study methods covered standardized health interviews, endoscopy and histology of gastric antral specimens taken at endoscopy. The interviews performed by trained interviewers sought information on tobacco and alcohol intake, diet, socioeconomic status, and other variables. In non-ulcer dyspepsia subjects there was 54.9% H. pylori related gastritis and 25.1% of non-H. pylori-related gastritis. The corresponding rates in the group of ulcer dyspepsia were 67.5% and 20.5%. The increased risk of chronic gastritis in antrum was associated with Helicobacter pylori infection (OR = 2.28; 95% CI:1.93-2.69), and with gastric peptic ulcer (OR = 1.88; 95% CI:1.20-2.94). In the non-ulcer dyspepsia the prevalence of metaplasia was 11.1% and in ulcer dyspepsia 19.7%. The risk of intestinal metaplasia within antrum depended greatly upon the presence of gastric peptic ulcer (OR = 3.85; 95% CI:2.35-6.32) and increased with age (OR = 1.05; 95% CI:1.04-1.07), smoking cigarettes currently or in the past (OR = 1.42; 95% CI:1.10-1.84), higher frequency of drinking vodka (OR = 1.32, 95% CI:1.01-1.75) and antral chronic gastritis (OR = 1.31; 95% CI:1.00-1.70), however, it was inversely related to daily consumption of fresh fruits or vegetables (OR = 0.59; 95% CI:0.38-0.93). The results of the study suggest that there is no sufficient evidence supporting the hypothesis about an association between H. pylori gastritis and intestinal metaplasia, however, the transition of gastritis to metaplasia depends greatly on life style factors such as cigarette smoking or vodka drinking and is impeded by daily consumption of fresh fruits or vegetables.

Alcohol Drinking↗

PubMed1998

Recent developments in molecular epidemiology: A study of the effects of environmental polycyclic aromatic hydrocarbons on birth outcomes in Poland.

The authors briefly review the current potential and limitations of molecular epidemiology. This approach uses biomarkers to measure the internal and bioeffective dose of toxicants, early biologic effects likely to be predictive of cancer, and variations in individual susceptibility. The most frequent application of biomarkers has been in assessment of exposure/dose and susceptibility due to genetic and nongenetic factors. More research is needed to establish the predictive significance of biomarkers in terms of disease risk. To illustrate that molecular epidemiology has potential in identifying etiologic factors in disease, this article presents data from a recent study of the developmental effects of fetal exposure to polycyclic aromatic hydrocarbons (PAH) via ambient pollution. The study was carried out in an industrialized area of Poland with relatively high levels of PAH pollution from coal burning. PAH-DNA adducts in leukocytes and plasma cotinine were measured in umbilical cord blood as dosimeters of transplacental PAH and cigarette smoke, respectively. The study subjects were 70 newborns from the industrialized city of Krakow and 90 newborns from Limanowa, a rural town with far greater use of coal for home heating. Newborns whose levels of PAH-DNA adducts were above the median (3.85/10[8] nucleotides) had a significantly decreased birth length, weight, and head circumference. Cotinine was significantly inversely associated with birth weight and length. Although preliminary, these results provide a new molecular link between PAH exposure and developmental effects, generating initial data and hypotheses for further study.

Adult↗

PubMed1998

Predisposition to acute respiratory infections among overweight preadolescent children: an epidemiologic study in Poland.

This cross-sectional field health survey has as its subjects 1129 preadolescent children resident in Krakow. Trained health visitors interviewed the mothers at the children's schools or at the parents' homes in order to gather standardized information regarding the families' social background and the families' and children's respiratory health and episodes of respiratory infections. Predisposition to respiratory infections in children has been defined as frequent spells (3 or more) of acute respiratory infections experienced by a given child over the 12 months preceding the interview. Clinical examination of children consisted of anthropometric measurements and spirometric testing. Anthropometric measurements (weight and height) were used for calculation of the body mass index (kg/m2). A child whose BMI was 20 or higher was defined as overweight (90th percentile). Susceptibility to acute respiratory infections was related significantly to body mass index. The children with BMI > or = 20 experienced twice as high a risk for acute respiratory infections than children with low BMI (OR = 2.02, 95% CI: 1.13-3.59). Out of other potential factors possibly involved in the occurrence of respiratory infections only the presence of chronic respiratory symptoms (OR = 2.43, 95% CI: 1.64-3.59), allergy (OR = 1.89, 95% CI: 1.34-2.66), and Environmental Tobacco Smoke (OR = 1.54; 95% CI: 1.05-2.25) increased the susceptibility of children to acute respiratory infections. Central heating in the household was shown to have a protective effect (OR = 0.65, 95% CI: 0.43-1.00) when compared with children from households where coal or gas was used for home heating.

Acute Disease↗

PubMed1998

Polycyclic aromatic hydrocarbon-DNA adducts in human placenta and modulation by CYP1A1 induction and genotype.

This study investigated the relationship in human placenta between polycyclic aromatic hydrocabon (PAH)-DNA adduct levels and two biomarkers of cytochrome P4501A1 (CYP1A1): gene induction evidenced by CYP1A1 mRNA, and a genetic polymorphism, the CYP1A1 MspI RFLP. CYP1A1 codes for an inducible enzyme system that catalyzes the bioactivation of PAHs. Prior research found a high correlation in human lung tissue between CYP1A1 activity and DNA damage from PAHs. The CYP1A1 Mspi RFLP has been linked in some studies to risk of lung cancer. The relationships in human placenta between DNA damage, CYP1A1 activity and genotype have not been well characterized and may be relevant to risks from transplacental PAH exposure. The study cohort consisted of 70 newborns from Krakow, Poland, a city with elevated air pollution, and 90 newborns from nearby Limanowa, an area with lower air pollution but greater indoor coal use. Contrary to results seen previously in lung tissue, CYP1A1 mRNA was not significantly correlated with PAH-DNA adduct levels in the placenta. Smoking (self-reported maternal and infant plasma cotinine) was significantly associated with CYP1A1 mRNA levels (P < 0.01), but not with PAH-DNA adduct levels. Placental PAH-DNA adduct levels were significantly higher in infants with the CYP1A1 MspI restriction site compared with infants without the restriction site (P < 0.01), implicating a genetic factor in inter-individual variation in DNA damage in human placenta. Further studies are needed to determine the relevance of this finding to risk of transplacental carcinogenesis.

Adult↗

PubMed1998

Effects of air quality on chronic respiratory symptoms adjusted for allergy among preadolescent children.

The aim of this study was to assess the respiratory effects of outdoor air pollution after correcting for allergy and indoor air quality. The respiratory health survey targeted 1,129 schoolchildren, 9 yrs of age, attending schools in Krakow located in city areas differing in outdoor air pollution levels. Chronic phlegm as a unique symptom was related neither to allergy nor to indoor variables, but was associated with the outdoor air pollution level (odds ratio (OR): 4.2; 95% confidence interval (CI): 1.1-16.9). The same relationship has been confirmed for the self-reported local sources of industrial air pollution in the area of residence (OR: 4.2; 95% CI: 1.5-11.7). Hay fever appeared to be related to outdoor air pollution level (OR: 1.43; 95% CI: 1.1-2.0) and self-reported heavy traffic (OR: 1.3; 95% CI: 1.0-1.7). In the total sample, wheezing was connected exclusively to allergy and parental atopy, while attacks of dyspnoea with wheezing and asthma diagnosed by physician only were associated with allergy. Since the effect of outdoor pollutants on chronic cough and wheezing (odds ratio: 1.85; 95% confidence interval: 1.03-3.33) was only shown to be significant in the subsample of children without allergy and parental atopy, it may be postulated that either allergy is predisposing to respiratory reactions, or outdoor air pollution is coinvolved in an allergization process of the preadolescent children. Consequently, allergy should be considered as an important confound in epidemiological studies on the respiratory effects of air pollution.

Air Pollution↗

PubMed1998

Relationship between ambient air pollution and DNA damage in Polish mothers and newborns.

Industrialized regions in Poland are characterized by high ambient pollution, including polycyclic aromatic hydrocarbons (PAHs) from coal burning for industry and home heating. In experimental bioassays, certain PAHs are transplacental carcinogens and developmental toxicants. Biologic markers can facilitate evaluation of effects of environmental PAHs on the developing infant. We measured the amount of PAHs bound to DNA (PAH-DNA adducts) in maternal and umbilical white blood cells. The cohort consisted of 70 mothers and newborns from Krakow, Poland, an industrialized city with elevated air pollution. Modulation of adduct levels by genotypes previously linked to risk of lung cancer, specifically glutathione S-transferase MI (GSTM1) and cytochrome P4501A1 (CYP1A1) Msp restriction fragment length polymorphism (RFLP), was also investigated. There was a dose-related increase in maternal and newborn adduct levels with ambient pollution at the women's place of residence among subjects who were not employed away from home (p < or = 0.05). Maternal smoking (active and passive) significantly increased maternal (p < or = 0.01) but not newborn adduct levels. Neither CYP1A1 Msp nor GSTM1 polymorphisms was associated with maternal adducts. However, adducts were significantly higher in newborns heterozygous or homozygous for the CYP1A1 Msp RFLP compared to newborns without the RFLP (p = 0.04). Results indicate that PAH-induced DNA damage in mothers and newborns is increased by ambient air pollution. In the fetus, this damage appears to be enhanced by the CYP1A1 Mspl polymorphism.

Adult↗

PubMed1998

[Occurrence of allergy in school-age children and their parents in relation to atmospheric air pollution. Prospective study in Cracow].

The main purpose of the study was to estimate unknown frequency of allergy in children and in their parents in Krakow and to check the hypothesis that allergy may be related to environmental urban factors. The three-year prospective study was carried out in two areas of the city with contrast air pollution levels and covered 1129 children. The occurrence of allergy in children was based on information from the parents that the disease had been diagnosed by a physician. Data on atopy in parents were supported by the information from parents that atopy-related diseases had been diagnosed by a physician. The prevalence of allergy in boys was much higher than in girls (28.1% vs 17.6%) but the inverse was observed in parents--more frequently it occurred in mothers (17.8%) than in fathers (12.9%). Among parents the prevalence and incidence of atopy was not related to air pollution levels in the place of residence. However, the prevalence odds ratio for allergy in children after accounting for potential confounders (parental atopy, environmental tobacco smoke, social class and household characteristics), was significantly higher among those who lived in streets with higher traffic (OR = 1.37, 95% CI: 1.0-1.9) or in vicinity of local industrial emission sources (OR = 1.70, 95% CI: 1.2-2.4) but it was not related to communal air pollutants (SO2/particulate matter). The similar analysis performed for new cases of allergy in children diagnosed over the three year period confirmed the conclusions gained from the prevalence data.

Adult↗

PubMed1998

[Allergy and lung function in school children].

In order to measure the effect of allergy on the lung function among schoolchildren a cross-sectional study has been performed in 1048 children of 10-11 year age who attended the grammar schools in Krakow. The lung function was assessed by the following spirometric indices: VC, FVC, FEV0.5, FEV0.75, FEV1, FEF25-75%, FEF0.2-1.2, PEFR while the data on allergy diagnosed clinically by physician was obtained by self-administered questionnaires from the parents of children. For those of the children who had the allergic skin test performed a search in medical records has been carried out. The frequency of allergy diagnosed clinically (without skin tests) was higher in boys (22.3%) than in girls (18.4%) and the same differences have been found for allergy confirmed by skin testing (15.7% vs. 9.3%). Except for VC and FVC, all adjusted mean values of spirometric indices were significantly lower in allergic than in non-allergic group of children. Regression coefficient of spirometric indices were related inversely with the presence of allergy. The greatest effects of allergy (without skin tests) have been observed on PEFR (-180 ml), FEF0.2-1.2 (-171 ml), FEF25-75% (-121 ml) and for FEV0.75 (-69 ml) and FEV1 (-68 ml). The smallest differences were found for VC and FVC. The additional series of analysis done in the subgroup of children without attacks of dyspnea with wheezing or wheezing independent from colds or respiratory infections confirmed the results obtained in the total study sample. The prevalence of obstructive syndrome, defined as FEV1/FVC < 80%, was 4.5% in the total sample, however, only 2.9% in non-allergic children, 7.2% in children in whom allergy was diagnosed by physicians and 8.5% among those children among whom allergy was diagnosed by allergic skin tests.

Catchment Area, Health↗

PubMed1998

Separate and combined effects of the outdoor and indoor air quality on chronic respiratory symptoms adjusted for allergy among preadolescent children.

The purpose of the study was (a) to assess whether the respiratory effects of outdoor air pollutants may be replicated after correcting for indoor air quality (environmental tobacco smoke, home heating and damp or mold houses), (b) to evaluate whether the extent of the allergic status of children modifies the respiratory health due to air pollution, and (c) to determine whether the higher prevalence of respiratory symptoms in more polluted areas of the city may be explained by excess in allergy. The survey targeted 1,129 school children, nine years of age, attending schools in Cracow, located in the areas with different levels of the outdoor air pollution. Based on the measurements obtained from the air pollution monitoring stations and the information provided by parents on the sources of local emission of air pollutants, four categories of air pollution areas have been defined. Chronic phlegm as a single symptom was unrelated to allergy but associated with the outdoor air pollution score. The prevalence odds ratio (OR) for this symptom between the contrasting areas of outdoor air pollution, i.e. very high pollution versus very low, was 5.85 (95% CI: 1.05-32.6). Except for chronic phlegm, the outdoor air pollution score was associated only with hay fever when adjusted for indoor characteristics and allergy. After adjustment for air pollution and allergy, the presence of molds or dampness in the house was significantly related to hay fever (OR = 2.1, 95% CI: 1.5-3.0), wheezing (OR = 1.6, 95% CI: 1.1-2.5), and difficulty in breathing (OR = 2.0, 95% CI: 1.2-3.3). In terms of attributable fraction (AF(pop)), the effect of outdoor air pollution on the occurrence of allergy in children was significant (AF(pop) = 22.3%). The impact of allergy on the occurrence of respiratory symptoms (two or more respiratory symptoms) was stronger (AF(pop) = 52.1%) than that of the outdoor air pollution level (AF(pop) = 21.6%) or that of molds/dampness at home (AF(pop) = 14.1%).

Air Pollution↗

PubMed1998

[Chronic respiratory symptoms and lung function in children related to air pollution in the residential areas].

The main purpose of the paper was to answer the question whether the various respiratory symptoms are related to type of air pollution in the residential areas and to which extent the worse lung function in children could have been explained by the air pollutants. Cross-sectional field study has been carried out in 1048 children aged 11 years attending grammar schools in Krakow. The results of the study provided the evidence that the current level of communal air pollutants (SPM and SO2) is not related to an excessive risk of respiratory symptoms in children, provided it is not combined with other sources of air pollution such as heavy traffic or local low point industrial emission. The risk of obstructive ventilation disorders (FEV1/FVC% 85) was significantly higher in children from the residential areas with higher air pollution (RR = 1.71; 95% CI: 1.19-2.47).

Air Pollution↗

PubMed1997

Maternal smoking during pregnancy and postnatal exposure to environmental tobacco smoke as predisposition factors to acute respiratory infections.

This study compared susceptibility to respiratory morbidity in a cohort of 9-year-old children exposed congenitally and postnatally to environmental tobacco smoke (ETS) to susceptibility in a cohort of unexposed children. The epidemiologic study included 1129 children: 594 boys and 535 girls attending the second grade of grammar schools in Kraków, Poland. We found strong evidence that children exposed to ETS in their homes were more susceptible to acute respiratory tract illnesses than unexposed children. A dose-response relationship between degree of exposure [for lower ETS exposure, odds ratio (OR) = 1.32; for higher ETS exposure, OR = 1.74] supports a causal explanation for the association observed. The significant trend of increased risk of respiratory infections due to ETS level in nonatopic children whose mothers did not smoke cigarettes during pregnancy suggests a direct effect of ETS exposure on the child's respiratory health. ETS combined with allergy nearly tripled the risk of acute respiratory tract illness (OR = 3.39; 95% CI, 1.93-5.93), and maternal smoking during pregnancy had a modifying effect on the risk of respiratory illnesses due to ETS after accounting for atopy. The stronger effect of ETS in atopic children and in those whose mothers smoked during pregnancy may be result of biologic interaction of endogenous and environmental factors. The results of this study are of relevance to public health policy, as children with higher risk of respiratory infections may be more susceptible to environmental hazards later in adolescence or in adulthood. Respiratory infections also increase demands for medical interventions in terms of outpatient services and hospital administrations. In addition, respiratory illnesses cause missed school days, and caring for a sick child may lead to absenteeism from work.

Acute Disease↗

PubMed1997

[Atmospheric air pollution as a factor potentiating the risk of asthma in school children. Epidemiologic studies in Krakow].

The purpose of this study was to assess the prevalence of asthma in schoolchildren in relation to residency in areas with higher urban air pollution in Krakow. The material consisted of 1129 children aged 9 years among whom health survey based on standardized interviews with parents, together with anthropometry and spirometry has been carried out in 1995. In the asthmatic children allergy diagnosed by doctor was 4 times more prevalent (83.3% vs 20.2%) and asthma or allergy was twofold more prevalent in their biologic parents (42.6% vs 29.3%). The children with asthma resided more frequently in the city areas with the higher air pollution level (62.5% vs 46.2%). Mean spirometric values of FVC, FEV1, FEF25-75% I PEFR did not differ across the groups, however, FEV1/FVC% was significantly higher in nonasthmatic than in asthmatic groups (corresponding values in boys 90.9% vs 88.7%, in girls 92.7% vs 89.8%). After accounting for potential confounders (child's gender, education level of parents, environmental tobacco smoke, cigarette smoking of mothers in pregnancy and household standard) it was estimated from the multiple logistic regression that the separate effect of air pollution category was relatively small (OR = 2.27; 95%, CI = 1.11-3.93) in comparison with that of allergy (20.5; 95% CI = 9.40-44.7), however, combined effect of both risk factors on the occurrence of asthma in children was multiplicative.

Air Pollution↗

PubMed1997

[Classification exposure error in studies on tobacco smoke in pregnancy and birth weight of newborns].

The purpose of the paper was to assess the validity of the self-reported tobacco smoke exposure in pregnancy against plasma cotinine measurements. A total of 158 patients from obstetrical wards was included in the cotinine study. Biochemical smokers were defined as persons with serum cotinine levels greater than 25 ng/ml. The data showed that the exposure classification based on self-reported smoking habit status confronted with cotinine values was of low sensitivity (52%) but of high specificity (98%). To assess the effect of this exposure classification error on the association between the low birth weight (LBW) and smoking in pregnancy, the data from the recent survey in Cracow children have been used. It was shown that RR estimates for smoking and LBW after adjustment for misclassification error were substantially higher than that not adjusted (crude RR = 2.9, corrected RR = 5.1). Due to the exposure misclassification error the attributable fraction (AF) of LBW due to mother's smoking was heavily biased as well. Estimated attributable fraction AF(pop) based on crude RR amounted to 22%, however, after adjustment reached 50%. The corresponding values for attributable fraction in exposed group AF(exp) were 66% and 80%.

Environmental Exposure↗

PubMed1997

A topographic analysis of atrophic gastritis and stomach cancer risk. A clinicoepidemiological study in Poland.

The purpose of this cross-sectional study was to assess the relation between intestinal and diffuse stomach cancer at its various locations with topography of atrophic gastritis. The study population consisted of 3435 patients who reported over the period of 1991-1994 for the first time to gastroenterological outpatient clinics of 7 university medical centers in Poland. Among these subjects there were 131 histologically proved consecutive cases of gastric carcinoma. The reference group consisted of 1540 patients among whom endoscopic examination did not reveal peptic ulcers, polyps, deformations of antrum or bulbus duodenum and mucosa erosions. Gastroscopy on gastric cancer patients and the reference group was performed and biopsy specimens were obtained from the tumour and from the antrum and stomach corpus distant from the tumour. Among the gastric cancer cases there was a higher prevalence of atrophic gastritis in the intestinal than in the diffuse type. The highest prevalence of atrophic gastritis irrespective of its degree and stomach area was observed in the tumour-area of intestinal cancer located distally (78.9%), and the lowest in the tumour-free area in diffuse proximal cancer (18.5%). Prevalence of atrophic pangastritis (atrophic gastritis present both in the corpus and antrum) was also highest in intestinal distal cancer (69.2%) and lowest in diffuse proximal cancer (21.7%). The age-adjusted correlation coefficients between gastritis score in the tumour-area and tumour-free area were highly significant. It was shown that only atrophic pangastritis was significantly associated with gastric cancer irrespective of its histology and location (OR = 3.8, 95% CI:2.4-6.0), however, it was much stronger related to the intestinal gastric cancer (OR = 5.9, 95% CI: 3.1-11.0), than to the diffuse carcinoma (OR = 2.2, 95% CI: 1.1-4.3).

Adult↗

PubMed1997

[Respiratory system reactions in children with allergies exposed to air pollution at home. Epidemiologic studies in Cracow].

The purpose of the paper was to check the hypothesis whether the domestic air quality together with level of outdoor air pollution increases the risk of allergy and whether allergy determines the occurrence of respiratory symptoms. The results of the study have shown that chronic cough was related mainly to allergy, however, chronic phlegm was linked with air quality. Wheezing independent from respiratory infections was associated in the strongest way with allergy (RR = 7.7; 4.7-12.7) and much weaker related to air quality score (RR = 1.3; 1.1-1.5). The occurrence of attacks of breathlessness was confirmed only in allergic children. Allergic rhinitis, similarly to wheezing, was related stronger to allergy (RR = 3.3; 2.5-4.4) than to air quality score (RR = 1; 1.0-1.2). Pulmonary volumes (FVC, FEV1) were not associated with air quality score, but the lower indices of FEV1/FVC and FEF25 - 75% were observed in those who were exposed to poor air quality. The results are in favor of the hypothesis, that air pollutants bring about spasm of smaller airways and it is independent from respiratory symptoms.

Air Pollutants↗