bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exposure-response analysis and risk assessment for silica and silicosis mortality in a pooled analysis of six cohorts
Authors: 't Mannetje A , Steenland K , Attfield M , Boffetta P , Checkoway H , DeKlerk N , Koskela R-S 
Published: October 2002

Aims:To study the relation between exposure to crystalline silica and silicosis mortality. Although mortality is an important endpoint for regulators, there have been no exposure-response studies for silicosis mortality, because of the relative rareness of silicosis as an underlying cause of death, and the limited availability of quantitative exposure estimates.Methods:Data from six occupational cohorts were pooled with good retrospective exposure data in which 170 deaths from silicosis were reported. Standard life table analyses, nested case-control analyses, and risk assessment were performed.Results:The rate of silicosis mortality in the combined data was 28/100 000 py, increasing in nearly monotonic fashion from 4.7/100 000 for exposure of 0–0.99 mg/m3-years to 233/100 000 for exposure of >28.1 mg/m3-years. The estimated risk of death up to age 65 from silicosis after 45 years of exposure at 0.1 mg/m3silica (the current standard in many countries) was 13 per 1000, while the estimated risk at an exposure of 0.05 mg/m3was 6 per 1000. Both of these risks are above the risk of 1 per 1000 typically deemed acceptable by the US OSHA.Conclusion:The findings from this pooled analysis add further support to the need to control silica exposure and to lower the occupational standards. Our estimates of lifetime silicosis mortality risk are probably underestimates as, in addition to exposure misclassification, our study might have suffered from outcome misclassification in that silicosis deaths might have been coded to other related causes, such as tuberculosis or chronic obstructive pulmonary disease.
Ineffective disability management by doctors is an obstacle for return-to-work: a cohort study on low back pain patients sicklisted for 3–4 months
Authors: Anema J R , van der Giezen A M , Buijs P C , van Mechelen W 
Published: October 2002

Aims:To determine obstacles for return-to-work in disability management of low back pain patients sicklisted for 3–4 months.Methods:A cohort of 467 low back pain patients sicklisted for 3–4 months was recruited. A questionnaire was sent to their occupational physicians (OPs) concerning the medical management, obstacles to return-to-work, and the communication with treating physicians.Results:The OPs of 300 of 467 patients participated in this study. In many cases OPs regarded the clinical waiting period (43%), duration of treatment (41%), and view (25%) of the treating physicians as obstacles for return-to-work. Psychosocial obstacles for return-to-work such as mental blocks, a lack of job motivation, personal problems, and conflicts at work were all mentioned much less frequently by OPs. In only 19% of the patients was there communication between OP and treating physician. Communication almost always entailed an exchange of information, and less frequently an attempt to harmonise the management policy. Surprisingly communication was also limited, when OPs felt that the waiting period (32%), duration of treatment (30%), and view (28%) of treating physicians inhibited return-to-work. Communication was significantly associated with the following obstacles for return-to-work: passivity with regard to return-to-work and clinical waiting period; adjusted odds ratios were 3.35 and 2.23, respectively.Conclusions:Medical management of treating physicians is often an obstacle for return to work regarding low back pain patients sicklisted for 3–4 months, in the opinion of OPs. Nevertheless communication between OPs and the treating physicians in disability management of these patients is limited. More attention to prevention of absenteeism and bilateral communication is needed in medical courses.
Lead induced increase of blood pressure in female lead workers
Authors: Nomiyama K , Nomiyama H , Liu S-J , Tao Y-X , Nomiyama T , Omae K 
Published: October 2002

Aims:Although lead exposure has, in the absence of mathematical modelling, been believed to elevate blood pressure in females, it is necessary to clarify the relation between lead and blood pressure by eliminating confounding factors in the analysis.Methods:Blood lead was measured in 193 female workers, including 123 lead exposed workers. Possible confounding factors were controlled by multiple regression analyses.Results and Conclusion:Blood lead above 40 μg/dl was found to be the most potent factor for elevating systolic/diastolic blood pressure. Aging, urine protein, and plasma triglyceride also contributed to systolic/diastolic/pulse pressure increase, but hypertensive heredity did not. Data suggested that lead induced changes in lipoprotein metabolism may play an important role in the lead induced blood pressure increase in female workers.
Different responses of Ross River virus to climate variability between coastline and inland cities in Queensland, Australia
Authors: Tong S , Hu W 
Published: October 2002

Aims:To examine the potential impact of climate variability on the transmission of Ross River virus (RRv) infection, and to assess the difference in the potential predictors of RRv incidence in coastline and inland regions, Queensland, Australia.Methods:Information on the RRv cases notified between 1985 to 1996 was obtained from the Queensland Department of Health. Climate and population data were supplied by the Australian Bureau of Meteorology and the Australia Bureau of Statistics, respectively. The function of cross correlations was used to compute a series of correlations between climate variables (rainfall, maximum temperature, minimum temperature, relative humidity, and high tide) and the monthly incidence of RRv disease over a range of time lags. Time series Poisson regression models were performed to adjust for the autocorrelations of the monthly incidences of RRv disease and the confounding effects of seasonality, the case notification time, and population sizes.Results:The cross correlation function shows rainfall, maximum temperature, minimum temperature, and relative humidity at a lag of 1–2 months and high tide in the current month were significantly associated with the monthly incidence of RRv in the coastline region. Relative humidity and rainfall at a lag of two months was also significantly associated with the monthly incidence of RRv in the inland region. The results of Poisson regressive models show that the incidence of RRv disease was significantly associated with rainfall, maximum temperature, minimum temperature, relative humidity, and high tide in the coastline region, and with rainfall and relative humidity in the inland region. There was a significant interaction between climate variables and locality in RRv transmission.Conclusions:Climate variability may have played a significant role in the transmission of RRv. There appeared to be different responses of RRv to climate variability between coastline and inland cities in Queensland, Australia. Maximum temperature appeared to exhibit a greater impact on the RRv transmission in coastline than in inland cities. Minimum temperature and relative humidity at 3 pm inland seemed to affect the RRv transmission more than at the coastline. However, the relation between climate variables and RRv needs to be viewed within a wider context of other social and environmental factors, and further research is needed.
Myocardial infarction risk and occupational categories in Kaunas 25–64 year old men
Authors: Malinauskiene V , Grazuleviciene R , Nieuwenhuijsen M J , Azaraviciene A 
Published: October 2002

Aims:To investigate the risk of a first time myocardial infarction (MI) among different occupational categories in 25–64 year old men in Kaunas, Lithuania, a country in a transition market economy.Methods:Case-control study among men aged 25–64 who were residents in Kaunas between 1997 and 2000. First time, non-fatal MI cases (n = 448) were identified from the MI hospital register (International Classification of Diseases, 10th revision, code I21). Controls (n = 1777) were selected and matched on age, gender, and city district of residence. Information was obtained on occupation, smoking, hypertension, psychosocial, and behavioural factors. The International Standard Classification of Occupations (ISCO) was used to code for occupational categories. The relation between MI and occupational categories was evaluated by logistic regression analysis, adjusting for a number of selected risk factors.Results:Legislators, senior officials, and managers (1st ISCO category) had a twofold increased risk for MI compared to craft and related trades workers (7th ISCO category) after adjustment for age, district, smoking, hypertension, obesity, stress, education, and employment duration. An increased risk for professionals (2nd ISCO category) and plant and machine operators and assemblers (8th ISCO category) was also observed. Employment duration in the last occupation for 20 years and more almost doubled the risk of MI in the whole population.We also found an increased risk for other traditional IHD risk factors such as smoking and arterial hypertension.Conclusions:Differences in first time MI risk among occupational categories were found. Legislators, senior officials, and managers (1st ISCO category), professionals (2nd ISCO category), and plant and machine operators and assemblers (8th ISCO category) were at an increased risk. Differences in psychosocial factors in transition market economy countries may contribute to observed results.
Mortality and cancer morbidity of production workers in the UK flexible polyurethane foam industry: updated findings, 1958–98
Authors: Sorahan T , Nichols L 
Published: October 2002

Aims:To describe cause specific mortality and site specific cancer morbidity among workers employed in factories that produce polyurethane foams, and to determine if any part of the experience may be caused by occupation, in particular to investigate any association between respiratory disease (malignant and non-malignant) and exposure to diisocyanates.Methods:The mortality (1958–98) and cancer morbidity (1971–94) experienced by a cohort of 8288 male and female employees from 11 factories in England and Wales engaged in the manufacture of flexible polyurethane foams were investigated. All employees were employed for at least six months with some period of employment in the period 1958–79. Two analytical approaches were used, indirect standardisation and Poisson regression.Results:Compared with the general population of England and Wales, mortality from lung cancer in female employees was significantly increased (observed (Obs) 35, expected (Exp) 19.4, standardised mortality ratio (SMR) 181). A similar excess was not found for male employees (Obs 134, Exp 125.0, SMR 107). There were no significantly increased cause specific SMRs among the subcohort (n = 1782) with some period of isocyanate exposed employment. No significant positive trends were found between risks of lung cancer or risks of non-malignant diseases of the respiratory system and durations of “lower” or “higher” exposures to diisocyanates.Conclusions:The study has been unable to link isocyanate exposed employment either with risks of lung cancer or with risks of non-malignant diseases of the respiratory system. The increased SMR for female lung cancer is most likely caused by factors unrelated to the industry under study.
Are women more sensitive than men to 2-propanol andm-xylene vapours?
Authors: Ernstgård L , Gullstrand E , Löf A , Johanson G 
Published: October 2002

Aims:To evaluate possible differences between men and women in acute health effects after controlled short term chamber exposure to vapours of two common organic solvents.Methods:Fifty six healthy volunteers (28 per sex) were exposed to 150 ppm 2-propanol, 50 ppmm-xylene, and clean air for two hours at rest. The subjects rated symptoms on a visual analogue scale before, during, and after the exposure. Blinking frequency was measured continuously during exposure. Pulmonary function, nasal swelling, inflammatory markers (lysozyme, eosinophilic cationic potein, myeloperoxidase, albumin) in nasal lavage and colour vision (Lanthony D-15 desaturated panel) were measured before and at 0 and 3 hours after the exposure.Results:There were no significant sex differences in response to solvent exposure with respect to blinking frequency, lung diffusing capacity, nasal area and volume, inflammatory markers in nasal lavage, and colour vision. Increased symptoms were rated by both sexes for nearly all 10 questions during exposure to 2-propanol orm-xylene, most increases being significant at one time point at least. The rating of “discomfort in the throat or airways” increased more in women during exposure to 2-propanol orm-xylene. During exposure to 2-propanol the rating of “fatigue” was more increased in men after one hour, but more increased in women after two hours of exposure. With regard to pulmonary function, women had small but significant decreases in FVC, FEV1/FVC, and FEF75three hours after exposure tom-xylene, but only the decrease in FVC was significantly different from that in men.Conclusion:Our results suggest that women are slightly more sensitive than men to the acute irritative effects of 2-propanol andm-xylene vapours.
Hazard potential ranking of hazardous waste landfill sites and risk of congenital anomalies
Authors: Vrijheid M , Dolk H , Armstrong B , Boschi G , Busby A , Jorgensen T , Pointer P 
Published: October 2002

Background:A 33% increase in the risk of congenital anomalies has been found among residents near hazardous waste landfill sites in a European collaborative study (EUROHAZCON).Aims:To develop and evaluate an expert panel scoring method of the hazard potential of EUROHAZCON landfill sites, and to investigate whether sites classified as posing a greater potential hazard are those with a greater risk of congenital anomaly among nearby residents relative to more distant residents.Methods:A total of 1270 cases of congenital anomaly and 2308 non-malformed control births were selected in 14 study areas around 20 landfill sites. An expert panel of four landfill specialists scored each site in three categories—overall, water, and air hazard—based on readily available, documented data on site characteristics. Tertiles of the average ranking scores defined low, medium, and high hazard sites. Calculation of odds ratios was based on distance of residence from the sites, comparing a 0–3 km “proximate” with a 3–7 km “distant” zone.Results:Agreement between experts measured by intraclass correlation coefficients was 0.50, 0.44, and 0.20 for overall, water, and air hazard before a consensus meeting and 0.60, 0.56, and 0.53 respectively after this meeting. There was no evidence for a trend of increasing odds ratios with increasing overall hazard or air hazard. For non-chromosomal anomalies, odds ratios by water hazard category showed an increasing trend of borderline statistical significance (p = 0.06) from 0.79 in the low hazard category, 1.43 in the medium, to 1.60 in the high water hazard category.Conclusions:There is little evidence for a relation between risk of congenital anomaly in proximate relative to distant zones and hazard potential of landfill sites as classified by the expert panel, but without external validation of the hazard potential scoring method interpretation is difficult. Potential misclassification of sites may have reduced our ability to detect any true dose–response effect.
When reciprocity fails: effort–reward imbalance in relation to coronary heart disease and health functioning within the Whitehall II study
Authors: Kuper H , Singh-Manoux A , Siegrist J , Marmot M 
Published: October 2002

Background:A deleterious psychosocial work environment, as defined by high efforts expended in relation to few rewards reaped, is hypothesised to increase the risk of future poor health outcomes.Aims:To test this hypothesis within a cohort of London based civil servants.Methods:Effort–reward imbalance (ERI) was measured among 6895 male and 3413 female civil servants aged 35–55 during the first phase of the Whitehall II study (1985–88). Participants were followed until the end of phase 5 (1997–2000), with a mean length of follow up of 11 years. Baseline ERI was used to predict incident validated coronary heart disease (CHD) events during follow up and poor mental and physical functioning at phase 5.Results:A high ratio of efforts in relation to rewards was related to an increased incidence of all CHD (hazard ratio (HR) = 1.36, 95% CI 1.12 to 1.65) and fatal CHD/non-fatal myocardial infarction (HR = 1.28, 95% CI 0.89 to 1.84) during follow up, as well as poor physical (odds ratio (OR) = 1.47, 95% CI 1.24 to 1.74) and mental (OR = 2.24, 95% CI 1.89 to 2.65) functioning at phase 5, net of employment grade. A one item measure of high intrinsic effort also significantly increased the risk of these health outcomes, net of grade. ERI may be particularly deleterious with respect to CHD risk among those with low social support at work or in the lowest employment grades.Discussion:Within the Whitehall II study, a ratio of high efforts to rewards predicted higher risk of CHD and poor physical and mental health functioning during follow up. Although the increased risk associated with ERI was relatively small, as ERI is common it could be of considerable public health importance.
Fever and neutrophilic alveolitis caused by a vanadium based catalyst
Authors: Vandenplas O , Binard-Van Cangh F , Gregoire J , Brumagne A , Larbanois A 
Published: October 2002

Aims:To investigate a worker who experienced systemic and respiratory symptoms when exposed to a vanadium containing powder used as a catalyst in the production of maleic anhydride.Methods:The investigation included inhalation challenge with the suspected compound combined with monitoring of lung function tests and post-challenge bronchoalveolar lavage.Results:Exposure to the vanadium containing catalyst for 120 minutes resulted in a sustained decline in forced vital capacity and forced expiratory volume in one second, while the transfer factor for carbon monoxide did not change significantly. The subject developed fever and peripheral blood neutrophilia. Bronchoalveolar lavage performed 48 hours after the end of challenge exposure showed a marked increase in neutrophils (60% of total cell count).Conclusions:Exposure to vanadium can cause a metal fume fever-like syndrome associated with neutrophilic alveolitis.
Epidermal growth factor receptor and bladder cancer
Authors: Colquhoun A J , Mellon J K 
Published: November 2002

Abstract
Muscle-invasive bladder cancer is a disease which causes significant morbidity and mortality. The two main forms of treatment for this disease include radical cystectomy and radical radiotherapy, but five year survival after treatment remains low at 40%. Many clinical and molecular risk factors have been shown to be associated with poor prognosis. One such factor is the expression of epidermal growth factor receptor (EGFR), which is overexpressed by many epithelial tumours, including bladder cancers. There are several methods of inhibiting the activity of EGFR and it may be that use of an anti-EGFR therapy, in combination with more conventional treatment, provides a method of improving the prognosis for muscle-invasive bladder cancer.
Use of complementary therapies and non-prescribed medication in patients with Parkinson’s disease
Authors: Ferry P , Johnson M , Wallis P 
Published: November 2002

Abstract
Patients with Parkinson’s disease resort to complementary therapy and non-prescribed medication in the hope of improving their quality of life. In the US 40% of patients with Parkinson’s disease reported the use of at least one form of complementary therapy for Parkinson’s disease. Data for the UK are limited. A structured questionnaire was administered to consecutive patients attending a Parkinson’s disease clinic. Patients were excluded if they were cognitively impaired, if they were living in an institution, or if they declined to take part. The participants were asked about current and previous use of complementary therapy in general and Parkinson’s disease in particular and were presented with an extensive list of complementary therapies and non-prescribed medications. The response rate was 90% and 80 patients met the inclusion criteria.
Fifty four per cent (n=44) reported the use of at least one form of complementary therapy or non-prescribed medication either for Parkinson’s disease or for some other indication, of whom 31 (38.7% of the total sample) used it solely for the treatment of Parkinson’s disease. The most commonly used complementary therapies for Parkinson’s disease were massage (n=9) and aromatherapy (n=8). Non-prescribed medication was mainly used for indications other than Parkinson’s disease and the commonest drugs used were simple analgesics (n=7), cod liver oil (n=5), and multivitamins (n=4). The use of complementary therapy for Parkinson’s disease correlated significantly (Pearson’s r=0.44, p=0.01) with a younger age at diagnosis of Parkinson’s disease. Comorbidity correlated significantly with complementary therapy use for indications other than Parkinson’s disease (Pearson’s r=0.29, p= 0.01).
The use of complementary therapy for Parkinson’s disease in this UK based clinic closely mimics that in the US. Non-pharmacological complementary therapy is mainly used for Parkinson’s disease, while non-prescribed medication is more commonly used for other indications.
Randomized Trial of Influenza Vaccine With Granulocyte-Macrophage Colony-Stimulating Factor or Placebo in Cancer Patients
Authors: Ramanathan Ramesh K. , Potter Douglas M. , Belani Chandra P. , Jacobs Samuel A. , Gravenstein Stefan , Lim Felix , Kim Hyoung , Savona Steven , Evans Terry , Buchbarker Dianne , Simon Mary B. , Depee Jane K. , Trump Donald L. 
Published: October 2002

PURPOSE: To determine whether granulocyte-macrophage colony-stimulating factor (GM-CSF) would improve response to influenza vaccination in cancer patients. PATIENTS AND METHODS: In a randomized, patient-blinded, placebo-controlled trial carried out in 1997 to 2000, 133 patients were stratified into five groups of treatment and disease. Single doses of standard split trivalent influenza vaccine and either placebo or 250 μg of GM-CSF were administered at the same time. Hemagglutination inhibition assay titers were measured before and 4 weeks after vaccination. RESULTS: Standard analyses, which define response as at least a four-fold increase in titers, detect no effect of GM-CSF for any of the three influenza subtypes in the trivalent vaccines (P ≥ .12). Analysis that includes the magnitude of the change in titers and combines responses of the subtypes suggests that the placebo group had the greater response (P = .051), thus indicating that GM-CSF does not improve response. Ancillary analyses show that response declines both with increasing age and with higher initial titers. The fraction of patients with at least a four-fold increase in titers was 0.36 (95% confidence interval, 0.29 to 0.42) CONCLUSION: A single 250-μg dose of GM-CSF administered with the influenza vaccine does not improve response to vaccination. Response in cancer patients is low and declines as age and initial titer increase.