Effect of occupational air pollutants on various histological types of lung cancer: a population based case-control study.

A population based case-control study was performed in Cracow, Poland, to determine the effect of occupational air pollutants on various histological types of lung cancer. Male cases and controls were identified from the Cracow Death Register. Information was obtained by mailed questionnaire from next of kin on smoking, occupational branch, occupational exposures, and other pertinent variables. Response rates were 73.5% in cases and 72.0% in controls. For cases that underwent a bronchial biopsy or surgical excision the histological diagnosis of the tumour was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 with small cell carcinomas, and 106 with adenocarcinomas. Twenty seven cases showed other histological types (large cell carcinoma and not classifiable). Analysis was performed separately by histological type for occupational exposure variables adjusted for smoking. Long term exposure to mineral dust and metal dust (20 years or more) was found to be a significant risk factor for small cell and squamous cell carcinoma. The effect was more pronounced if the analysis was restricted to those aged less than 70 years. The highest relative risk (RR) due to occupational exposures was found for squamous cell carcinoma and exposure to mineral dust for more than 20 years (RR = 2.45, 95% CI 1.43-4.19). The estimated effect of mineral dust on small cell carcinoma and adenocarcinoma was smaller (RR = 2.29, 95% CI 1.16-4.53 and RR = 2.04, 95% CI 0.89-4.64 respectively). The effect of metal dust and fumes seemed about the same for squamous and small cell carcinoma. No specific agent could be identified as particularly important for a specific histological type; it rather seemed that the effects of the substances considered were similar for lung cancers in general.     

Effect of indoor air quality in the postnatal period on lung function in pre-adolescent children: a retrospective cohort study in Poland

The purpose of this study was to determine the association between level of lung function in pre-adolescence and indoor air quality in the postnatal period. The retrospective cohort study was carried out in a sample of 1036 pre-adolescent children (9 years of age) attending schools in two residential areas of Krakow, Poland. Measurement of health outcomes considered lung function together with height and weight. Indoor air quality was based on environmental tobacco smoke and type of household heating. In addition, the number of winter months that occurred during the first 6 months of life was included as a key independent variable. Multivariate linear regression of lung function measured by forced expiratory volume in 1s (FEV1) and forced vital capacity (FVC), and postnatal exposure to indoor pollution in the heating season (PEIP score) was adjusted for potential confounders such as maternal smoking during pregnancy and parental education as a proxy of social class. In the total study sample, the adjusted beta coefficient for FEV1 per unit of the PEIP score was -0.06 (P=0.02), while that for FVC was -0.05 (P=0.04). The analysis carried out in the more polluted area found that children living in households heated with gas or coal had a PEIP score that was strongly inversely related to lung function (adjusted beta coefficient for FEV1=-0.13; P=0.03; for FVC=-0.15, P=0.01), whereas regression coefficients were not significant in the group of children living in households with central heating. This study suggests that a lower level of lung function in pre-adolescent children can be related to postnatal exposure to indoor emissions in the winter.     

Multidetector CT angiography of the aortoiliac system and lower extremities: a prospective comparison with digital subtraction angiography

OBJECTIVE: Our objective was to determine whether multidetector CT (MDCT) angiography is an accurate and reliable method of revealing atheroocclusive disease of the aortoiliac system and the lower extremities compared with digital subtraction angiography (DSA). SUBJECTS AND METHODS: Forty-one patients with ischemic legs underwent both MDCT angiography and DSA of the aortoiliac system and the legs. The arterial supply of the legs was divided into 35 segments. Three independent observers rated each segment according to the maximal degree of arterial stenosis. Consensus interpretation was used to calculate the sensitivity and specificity of MDCT angiography in showing arterial occlusions and stenoses of at least 75%. Intertechnique agreement was measured for each anatomic segment, and interobserver agreement was calculated for both techniques. Agreement was quantified using the kappa statistic. RESULTS: The sensitivity and specificity of MDCT angiography for depicting arterial occlusions and stenoses of at least 75% were 88.6% and 97.7%, and 92.2% and 96.8%, respectively. Substantial intertechnique agreement (kappa > 0.4) was present in 102 (97.1%) of 105 arterial segments. Substantial interobserver agreement was present in 104 (99.0%) of 105 comparisons for both MDCT angiography and DSA with an average kappa value of 0.84 for CT and 0.78 for DSA. MDCT angiography showed more patent segments than DSA (1192 vs 1091). All nine segments seen on DSA and not seen on MDCT angiography were in the calves. Of 110 segments seen on MDCT angiography and not seen on DSA, 100 (90.9%) were in the calves. CONCLUSION: MDCT angiography was accurate in showing arterial atheroocclusive disease with reliability similar to DSA. MDCT angiography showed more vascular segments than DSA, particularly within calf vessels.     

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.     

Male and female nurses in intensive-care wards in The Netherlands

This article presents the results of a national survey among intensive-care nurses, establishing whether male nurses and female nurses can be distinguished with respect to issues such as professionalization, career orientation and their preference for technical departments. The study showed that there is an over-representation of men in technical wards. At IC/CC-units the percentage of male nurses is twice as large as in the hospital as a whole (IC/CCU included). The distribution of labour among male and female nurses is taking place according to traditional sex-specific role patterns. Male nurses are more oriented towards professionalization than female nurses. Male IC-nurses see their jobs more in a medical perspective and they also show a higher frequency in the performance of medically reserved activities. Male IC-nurses seem to be particularly directed at upgrading their own profession. The differences between male and female nurses can also be explained by culturally determined differences between men and women regarding their own career perspective and career development, as well as by internal staff policy.     

白木通多糖的研究

用碱液从白木通(Akebia trifoliate)茎中提取所得的粗多糖ATB经DEAE-Celulose及SephadexG-200柱层析后得到一多糖纯品ATBB 2,其分子量为2.3×10⁵。糖组分分析ATBB-2中各糖残基的摩尔比为Rha∶Ara∶Xyl∶Gal∶Glc∶GalA=1.22∶1.00∶1.10∶0.85∶0.24∶0.82。经甲基化,高碘酸氧化,Smith降解,部分酸水解,¹H和¹³CNMR谱的分析揭示ATBB-2是一个结构复杂的杂多糖。