Elevated risk for male breast cancer after occupational exposure to gasoline and vehicular combustion products

BACKGROUND: Automotive gasoline contains benzene, 1,3-butadiene, 1, 2-dibromoethane and 1,2-dichloroethane, and the combustion products include certain polycyclic aromatic hydrocarbons, all of which have shown mammary gland carcinogenicity in long-term bioassays. It is the aim of this paper to investigate whether men occupationally exposed to gasoline and its combustion products have an elevated risk of breast cancer. METHODS: A nationwide register based case control study on male breast cancer morbidity was established among members of a pension fund, compulsory for all employees. Employment histories were reconstructed for each of 230 cases and 12,880 control subjects based on computerized records. The odds ratios, adjusted for socioeconomic status, were estimated by conditional logistic regression analysis. RESULTS: When a lag time of at least 10 years was included, the odds ratio for breast cancer among men with over three months of employment in trades with potential exposure to gasoline and combustion products was 2.5 (95% confidence interval: 1.3-4.5). Among men younger than 40 years at the time of first employment, the odds ratio was 5.4 (2.4-11.9). CONCLUSIONS: This study supports the hypothesis that occupational exposure to gasoline vapors and combustion products may play a role in the causation of male breast cancer. This hypothesis warrants further evaluation particularly in women.     

Past exposure to asbestos and combustion products and incidence of cancer among Finnish locomotive drivers.

Locomotive drivers in the steam engine era were exposed to asbestos during their vocational training for two years while training in workshops. Later in their career they had exposure to coal and diesel combustion products. To assess the level of earlier exposure historical working conditions were reconstructed and hygienic conditions were measured. The average exposure to asbestos (mainly anthophylline) fibres > 5 microns was 5.0 fibres/cm3. Incidence of cancer in a cohort of 8391 members of the Finnish Locomotive Drivers' Association, 1953-91, was analysed. The incidence of lung cancer and also total cancer was below the national average, probably due to the low prevalence of smoking among the drivers in the steam engine era. A four-fold risk of mesothelioma was found, most likely caused by exposure to asbestos. Also the observed 1.5-fold incidence of non-melanoma skin cancer and 1.7-fold risk of cancer of the oral cavity and pharynx may be related to occupation.     

Calculation of fractions of lung cancer incidence attributable to occupational exposure to asbestos and combustion products in Stockholm, Sweden

In a population-based case–referent study of lung cancer we wanted to estimate the over-all influence on the lung cancer incidence from several occupational exposures. Standard methods to do this are based on addition of separately estimated attributable fractions (AFs) by rather complex formulas. Although a simple and valid method for direct estimation of summary effects was published in 1990, it is not well known and has rarely been used. We here describe the method and apply it to the data from the case–referent study. The AF for withdrawal of occupational exposure to both asbestos and combustion products were nearly identical regardless of if it was calculated by an algorithm for summation of AF for the exposure factors separately (6.90%), by a bootstrap method (6.89%, 95% confidence interval, CI: 3.69, 10.04), or by the simple dichotomization-method (6.88%, 95%CI: 3.81, 9.84). The method is very easy to apply to population-based case–referent studies analyzed by logistic regression.     

Home endotoxin exposure and wheeze in infants: correction for bias due to exposure measurement error

Exposure to elevated levels of endotoxin in family-room dust was previously observed to be significantly associated with increased wheeze in the first year of life among a cohort of 404 children in the Boston, Massachusetts, metropolitan area. However, it is likely that family-room dust endotoxin was a surrogate for airborne endotoxin exposure. Therefore, a related substudy characterized the relationship between levels of airborne household endotoxin and the level of endotoxin present in house dust, in addition to identifying other significant predictors of airborne endotoxin in the home. We now reexamine the relationship between endotoxin exposure and wheeze under the assumption that the level of airborne endotoxin in the home is the exposure of interest and that the amount of endotoxin in household dust is a surrogate for this exposure. We applied a measurement error correction technique, using all available data to estimate the effect of endotoxin exposure in terms of airborne concentration and accounting for the measurement error induced by using house-dust endotoxin as a surrogate measure in the portion of the data in which airborne endotoxin could not be directly measured. After adjusting for confounding by lower respiratory infection status and race/ethnicity, endotoxin exposure was found to be significantly associated with a nearly 6-fold increase in prevalence of wheeze for a one interquartile range increase in airborne endotoxin (95% confidence interval, 1.2-26) among the 360 children in households with dust endotoxin levels between the 5th and 95th percentiles.     

Selenium depletion and its correction in a child with homocystinuria

A child of 10 months with proven homocystinuria was found to be selenium depleted and we report the serial monitoring of replacement therapy. Selenium, as an enriched yeast preparation, equivalent to 50 mug on alternate days was required for maintenance. Indices of selenium status returned to normal in varying times. The child initially demonstrated an abnormality of an in vitro challenge by hydrogen peroxide to her erythrocytes, that returned to within normal limits with selenium therapy alone, the serum vitamin E concentration being normal.     

Asthma onset after exposure to fluorinated hydrocarbons in the presence of combustion

Fluorinated hydrocarbons, which can thermally degrade into toxic hydrofluoric acid, are widely used as, for example, cooling agents in refrigerators and air conditioning systems and as medical aerosol propellants. Hydrofluoric acid is a known causative agent of irritant-induced asthma. We report on two patients with asthma initiation shortly after exposure to fluorinated hydrocarbon-based cooling agents while welding or smoking cigarettes in a confined space. Both cases developed respiratory symptoms and headache and later demonstrated nonspecific bronchial hyperresponsiveness. In follow-up, asthma was persistent and responded poorly to asthma medication. Exposure to the fluorinated hydrocarbons themselves is unlikely to have caused asthma due to their low toxicity. Instead, exposure to small amounts of hydrofluoric acid via the thermal degradation of the fluorinated hydrocarbons was considered the most likely cause of asthma onset. This is supported by the typical clinical picture of irritant-induced asthma and acute symptoms resembling hydrofluoric acid poisoning. When fluorinated hydrocarbons are used in the presence of combustion, thermal degradation may lead to the formation of hydrofluoric acid. In confined spaces, this exposure may induce asthma via irritation. Welding, smoking, and other sources of combustion in confined spaces may be a risk in workplaces and other places in which fluorinated hydrocarbons are used.     

Postgraduate educational possibilities for young surgeons in the United Kingdom]

The authors describe the surgical training opportunities provided by the ODTS since 1986. These posts offer excellent postgraduate training. Hungarians may apply for ODTS posts after they have passed the Hungarian General Surgical examination, but preferably before the age of 35. The applications should be supported by Home Sponsors. The applicants must pass a high standard English Language examination.     

Driver exposure to combustion particles in the U.S. Trucking industry

A large study of combustion particle exposures for drivers of diesel-powered trucks was conducted in collaboration with an epidemiologic study of lung cancer outcomes for workers in the trucking industry. Three components of diesel exhaust combustion particles (PM(2.5), elemental carbon, and organic carbon) were measured inside the driver cabs of diesel-powered trucks from 36 different trucking terminals across the United States between 2001 and 2005. In-cab particle exposures for drivers assigned to both short and long distance trips were observed, as well as information on the smoking status of the driver, truck characteristics such as age and model, and weather conditions during the sampling session. This article summarizes these findings and describes the relationship between exhaust particles and various determinants of exposure. The results suggest that in-cab particle exposures are positively related to smoking, ambient particle concentrations, truck age, and open windows, with other significant modifying factors such as weather. This study represents the largest and most comprehensive exposure assessment of drivers in the trucking industry, encompassing a 4-year period of observations on diesel and exhaust particle exposures nationwide. The results are relevant not only to the occupational group of truck drivers being examined but also to the general population that live, commute, or work within proximity to diesel-fueled traffic or trucking terminals.     

Human exposure to mercury in the Brazilian Amazon: a historical perspective]

The objective of the present article was to present the most important data generated by a multicentric study carried out by Brazilian researchers who, with the support of national and international institutions, worked during the 1990s to describe human exposure to mercury in gold mining areas in the Brazilian Amazon. Three sets of procedures were followed with residents of the Tocantins and Xingu river basins: (1) clinical examination, based on a standardized protocol and performed by a single researcher, in order to identify five basic levels of contamination; (2) determination of mercury levels in blood, hair, and urine, using atomic absorption spectrophotometry (Xingu Project); and (3) investigation of genotoxicity by using four cytogenetic indicators. During the first stage, 41 individuals were studied. Mercury was found in miners and their family members. Contamination was significantly associated with occupation and showed a differential correlation with genotoxicity indicators. After that, the Xingu project, which encompassed 625 individuals, focused on 417 Kayapó natives from the Gorotire and Djudjetiktire villages; 142 miners; and 66 riverine individuals (ribeirinhos). The highest levels of methylmercury in hair and total mercury in blood and urine were found among the Indian population. Contamination with inorganic forms of mercury was also observed in the blood, hair, and urine of Indians. Following a specific recommendation from the World Health Organization, special attention was given to pregnant Gorotire and Djudjetiktire women, who, although not directly exposed to mercury vapors, showed considerable levels of mercury intoxication. Despite this worrisome scenario, a number of social achievements in the 1990s point to new standards of dignity in health care and of social ethics in Brazil that could benefit everyone, including the victims of environmental injury.