TY  - JOUR
AB  - OBJECTIVES: The impact of occupational exposures on lung function impairments and quality of life (QoL) in patients with chronic obstructive pulmonary disease (COPD) was analysed and compared with that of smoking. METHODS: Data from 1283 men and 759 women (Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 1-4 or former grade 0, without alpha-1-antitrypsin deficiency) of the COPD and Systemic Consequences Comorbidities Network cohort were analysed. Cumulative exposure to gases/fumes, biological dust, mineral dust or the combination vapours/gases/dusts/fumes was assessed using the ALOHA job exposure matrix. The effect of both occupational and smoking exposure on lung function and disease-specific QoL (St George's Respiratory Questionnaire) was analysed using linear regression analysis adjusting for age, body mass index, diabetes, hypertension and coronary artery disease, stratified by sex. RESULTS: In men, exposure to gases/fumes showed the strongest effects among occupational exposures, being significantly associated with all lung function parameters and QoL; the effects were partially stronger than of smoking. Smoking had a larger effect than occupational exposure on lung diffusing capacity (transfer factor for carbon monoxide) but not on air trapping (residual volume/total lung capacity). In women, occupational exposures were not significantly associated with QoL or lung function, while the relationships between lung function parameters and smoking were comparable to men. CONCLUSIONS: In patients with COPD, cumulative occupational exposure, particularly to gases/fumes, showed effects on airway obstruction, air trapping, gas uptake capacity and disease-related QoL, some of which were larger than those of smoking. These findings suggest that lung air trapping and QoL should be considered as outcomes of occupational exposure to gases and fumes in patients with COPD. TRIAL REGISTRATION NUMBER: NCT01245933.
AU  - Gerlich, J.*
AU  - Ohlander, J.*
AU  - Kromhout, H.*
AU  - Vermeulen, R.*
AU  - Söhler, S.*
AU  - Radon, K.*
AU  - Nowak, D.*
AU  - Karrasch, S.
AU  - Adaskina, N.*
AU  - Vogelmeier, C.*
AU  - Ochmann, U.*
AU  - Jörres, R.A.*
C1  - 69022
C2  - 53807
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
SP  - 26-33
TI  - Cumulative occupational exposure to gases and fumes is associated with impairment in lung function and disease-related quality of life in a German COPD patient cohort.
JO  - Occup. Environ. Med.
VL  - 81
IS  - 1
PB  - Bmj Publishing Group
PY  - 2023
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Objectives: We evaluated the risk of lung cancer associated with ever working as a painter, duration of employment and type of painter by histological subtype as well as joint effects with smoking, within the SYNERGY project. Methods: Data were pooled from 16 participating case-control studies conducted internationally. Detailed individual occupational and smoking histories were available for 19 369 lung cancer cases (684 ever employed as painters) and 23 674 age-matched and sex-matched controls (532 painters). Multivariable unconditional logistic regression models were adjusted for age, sex, centre, cigarette pack-years, time-since-smoking cessation and lifetime work in other jobs that entailed exposure to lung carcinogens. Results: Ever having worked as a painter was associated with an increased risk of lung cancer in men (OR 1.30; 95% CI 1.13 to 1.50). The association was strongest for construction and repair painters and the risk was elevated for all histological subtypes, although more evident for small cell and squamous cell lung cancer than for adenocarcinoma and large cell carcinoma. There was evidence of interaction on the additive scale between smoking and employment as a painter (relative excess risk due to interaction >0). Conclusions: Our results by type/industry of painter may aid future identification of causative agents or exposure scenarios to develop evidence-based practices for reducing harmful exposures in painters.
AU  - Guha, N.*
AU  - Bouaoun, L.*
AU  - Kromhout, H.*
AU  - Vermeulen, R.*
AU  - Brüning, T.*
AU  - Behrens, T.*
AU  - Peters, S.*
AU  - Luzon, V.*
AU  - Siemiatycki, J.*
AU  - Xu, M.*
AU  - Kendzia, B.*
AU  - Guénel, P.*
AU  - Luce, D.*
AU  - Karrasch, S.
AU  - Wichmann, H.-E.
AU  - Consonni, D.*
AU  - Landi, M.T.*
AU  - Caporaso, N.E.*
AU  - Gustavsson, P.*
AU  - Plato, N.*
AU  - Merletti, F.*
AU  - Mirabelli, D.*
AU  - Richiardi, L.*
AU  - Jöckel, K.H.*
AU  - Ahrens, W.*
AU  - Pohlabeln, H.*
AU  - Tse, L.A.*
AU  - Yu, I.T.S.*
AU  - Tardón, A.*
AU  - Boffetta, P.*
AU  - Zaridze, D.*
AU  - Tmannetje, A.*
AU  - Pearce, N.*
AU  - Davies, M.P.A.*
AU  - Lissowska, J.*
AU  - Świątkowska, B.*
AU  - McLaughlin, J.*
AU  - Demers, P.A.*
AU  - Bencko, V.*
AU  - Foretova, L.*
AU  - Janout, V.*
AU  - Pándics, T.*
AU  - Fabianova, E.*
AU  - Mates, D.*
AU  - Forastiere, F.*
AU  - Bueno-de-Mesquita, B.*
AU  - Schüz, J.*
AU  - Straif, K.*
AU  - Olsson, A.*
C1  - 60553
C2  - 49492
CY  - British Med Assoc House, Tavistock Square, London Wc1h 9jr, England
SP  - 269-278
TI  - Lung cancer risk in painters: Results from the SYNERGY pooled case-control study consortium.
JO  - Occup. Environ. Med.
VL  - 78
IS  - 4
PB  - Bmj Publishing Group
PY  - 2021
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Studies on exposure to respirable quartz dust at the workplace and the development of chronic obstructive pulmonary disease (COPD) were selected into a systematic review and meta-analysed to obtain an overall estimate of forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) reduction. PubMed and Embase were searched from 1970 to 2010. In total, 257 cross-sectional and longitudinal studies were identified that reported on inorganic dust exposure and had available lung function data. Of the 55 publications which met our inclusion criteria, 11 reported on associations with occupational exposure to respirable quartz dust. The combined average effect estimate of respirable quartz dust on spirometric parameters was obtained using a random effects model meta-analysis. Between-study heterogeneity was assessed via the I(2) statistic. Most studies found a significant negative association of FEV1 and FEV1/FVC related to increasing exposure to crystalline quartz at the workplace. One study found an effect only for smokers, and one did not observe such an effect at all. The meta-analysis of cross-sectional studies showed that the mean ratio FEV1 to FVC was reduced and FEV1 of workers exposed to respirable quartz dust was 4.6% less than predicted compared with workers with no/low exposure. Both results showed a statistically significant difference. Occupational exposure to respirable quartz dust was associated with a statistically significant decrease in FEV1 and FEV1/FVC, revealing airway obstruction consistent with COPD.
AU  - Brüske, I.
AU  - Thiering, E.
AU  - Heinrich, J.
AU  - Huster, K.M.*
AU  - Nowak, D.*
C1  - 31497
C2  - 34518
CY  - London
SP  - 583-589
TI  - Respirable quartz dust exposure and airway obstruction: A systematic review and meta-analysis.
JO  - Occup. Environ. Med.
VL  - 71
IS  - 8
PB  - Bmj Publishing Group
PY  - 2014
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - INTRODUCTION: Some studies have suggested increased lung cancer risks among bakers, however the results overall were inconsistent. The authors studied lung cancer risks among bakers and baking-related occupations in the SYNERGY pooled case-control database from 16 countries. METHODS: Occupation in a baking-related job was identified from the subjects' job histories. ORs adjusted for log(age), study centre, smoking behaviour and ever employment in a job with known exposure to occupational lung carcinogens were calculated by unconditional logistic regression. Findings were stratified by sex, histological subtype of lung cancer and smoking status. RESULTS: 19 366 cases (15 606 men) and 23 670 control subjects (18 528 men) were included. 473 cases (415 men, 58 women) and 501 controls (437 men, 64 women) had ever worked in baking or a related job. We did not observe an increased risk for men in baking (OR 1.01; 95% CI 0.86 to 1.18). No linear trends were observed for duration of employment. Some results suggested increased lung cancer risks for women, for example, for working as a baker for >30 years and in never-smokers, but after exclusion of one study these increased risks disappeared. DISCUSSION: The findings from this study do not suggest increased lung cancer risks in baking-related professions.
AU  - Behrens, T.*
AU  - Kendzia, B.*
AU  - Treppmann, T.*
AU  - Olsson, A.*
AU  - Jöckel, K.-H.*
AU  - Gustavsson, P.*
AU  - Pohlabeln, H.*
AU  - Ahrens, W.*
AU  - Brüske, I.
AU  - Wichmann, H.-E.
AU  - Merletti, F.*
AU  - Mirabelli, D.*
AU  - Richiardi, L.*
AU  - Simonato, L.*
AU  - Zaridze, D.*
AU  - Szeszenia-Dabrowska, N.*
AU  - Rudnai, P.*
AU  - Lissowska, J.*
AU  - Fabianova, E.*
AU  - Tardón, A.*
AU  - Field, J.*
AU  - Stanescu Dumitru, R.*
AU  - Bencko, V.*
AU  - Foretova, L.*
AU  - Janout, V.*
AU  - Siemiatycki, J.*
AU  - Parent, M.E.*
AU  - McLaughlin, J.*
AU  - Demers, P.*
AU  - Landi, M.T.*
AU  - Caporaso, N.*
AU  - Kromhout, H.*
AU  - Vermeulen, R.*
AU  - Peters, S.*
AU  - Benhamou, S.*
AU  - Stücker, I.*
AU  - Guida, F.*
AU  - Consonni, D.*
AU  - Bueno-de-Mesquita, H.B.*
AU  - 't Mannetje, A.*
AU  - Pearce, N.*
AU  - Tse, L.A.*
AU  - Yu, I.T.*
AU  - Plato, N.*
AU  - Boffetta, P.*
AU  - Straif, K.*
AU  - Schüz, J.*
AU  - Pesch, B.*
AU  - Brüning, T*
C1  - 26739
C2  - 32362
SP  - 810-814
TI  - Lung cancer risk among bakers, pastry cooks and confectionary makers: The SYNERGY study.
JO  - Occup. Environ. Med.
VL  - 70
IS  - 11
PB  - BMJ Publishing
PY  - 2013
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - We assessed whether long-term exposure to air pollution is associated with all-cause and cause-specific mortality during a period of declining particulate matter concentrations. Approximately 4800 women aged 55 years from North Rhine-Westphalia, Germany, were followed for up to 18 years. Exposure to air pollution was assessed in two ways: (1) using the distance between the residential address and the nearest major road, as calculated from Geographic Information System data and (2) calculating 1-year average particulate matter concentrations below 10 µm (PM(10)) and nitrogen dioxide (NO(2)) levels using data from the nearest air-monitoring station data to the subjects' residences. Ninety-two per cent of all subjects lived in the same community during the entire follow-up period. Associations between mortality and exposure were assessed using Cox's proportional hazards models, including confounder adjustment. Sixteen per cent of women passed away during the follow-up period. An increase of 7 μg/m(3) PM(10) (IQR) was associated with an increased HR for all-cause (HR 1.15, 95% CI (1.04 to 1.27)), cardiopulmonary (HR 1.39, 95% CI (1.17 to 1.64)), and lung cancer mortality (HR 1.84, 95% CI (1.23 to 2.74)). An increase of 16 μg/m(3) (IQR) NO(2) exposure was associated with all-cause (HR 1.18, 95% CI (1.07 to 1.30)) and cardiopulmonary mortality (HR 1.55, 95% CI (1.30 to 1.84)). The association between cardiopulmonary mortality and PM(10) was reduced for the extended follow-up period, during which PM(10) concentrations (but not NO(2) concentrations) were lower. Living close to a major road was associated with an increased relative risk for all-cause, cardiopulmonary and respiratory mortality. These associations were temporally stable. Long-term exposure to ambient PM(10) and NO(2) was associated with increased mortality rates.
AU  - Heinrich, J.
AU  - Thiering, E.
AU  - Rzehak, P.
AU  - Krämer, U.*
AU  - Hochadel, M.
AU  - Rauchfuss, K.M.*
AU  - Gehring, U.
AU  - Wichmann, H.-E.
C1  - 22990
C2  - 30973
SP  - 179-186
TI  - Long-term exposure to NO2 and PM10 and all-cause and cause-specific mortality in a prospective cohort of women.
JO  - Occup. Environ. Med.
VL  - 70
IS  - 3
PB  - BMJ Publishing
PY  - 2013
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Objective To quantify the relationship between death from non-malignant respiratory diseases (NMRD) and exposure to silica dust or radon in a cohort of 58690 former German uranium miners. Methods In the follow-up period from 1946 to 2008, a total of 2336 underlying deaths from NMRDs occurred, including 715 deaths from chronic obstructive pulmonary diseases (COPD) and 975 deaths from silicosis or other pneumoconiosis. Exposure to respirable crystalline silica and radon was individually assessed by means of a comprehensive job-exposure matrix. Risk analyses were based on a linear Poisson regression model with the baseline stratified by age, calendar year and duration of employment. Results There was no increase in risk of death from COPDs or any other NMRDs in relation to cumulative exposure to silica (mean=5.9, max=56mg/m(3)-years), except in the group of deaths from silicosis or other pneumoconiosis. Here, a strong non-linear increase in risk was observed. Cumulative radon exposure (mean=280; max=3224 Working Level Months) was not related to death from COPDs or any other NMRDs. Conclusions The present findings do not indicate a relationship between mortality from COPD with silica dust or radon. However, validity of cause of death and lack of control for smoking remain potential sources of bias.
AU  - Kreuzer, M.*
AU  - Sogl, M.*
AU  - Brüske, I.
AU  - Möhner, M.*
AU  - Nowak, D.*
AU  - Schnelzer, M.*
AU  - Walsh, L.*
C1  - 28695
C2  - 33523
SP  - 869-875
TI  - Silica dust, radon and death from non-malignant respiratory diseases in German uranium miners.
JO  - Occup. Environ. Med.
VL  - 70
IS  - 12
PB  - BMJ Publishing
PY  - 2013
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - OBJECTIVES: To study new onset of adult asthma in relation to dampness and moulds in dwelling places. METHODS: Totally, 7104 young adults from 13 countries who participated in the European Community Respiratory Health Survey (ECRHS I and II) who did not report respiratory symptoms or asthma at baseline were followed prospectively for 9 years. Asthma was assessed by questionnaire data on asthmatic symptoms and a positive metacholine challenge test at follow-up. Data on the current dwelling was collected at the beginning and at the end of the follow-up period by means of an interviewer-led questionnaire, and by inspection. Relative risks (RR) for new onset asthma were calculated with log-binomial models adjusted for age, sex, smoking and study centre. RESULTS: There was an excess of new asthma in subjects in homes with reports on water damage (RR 1.46; 95% CI 1.09 to 1.94) and indoor moulds (RR=1.30; 95% CI 1.00 to 1.68) at baseline. A dose-response effect was observed. The effect was stronger in those with multisensitisation and in those sensitised to moulds. Observed damp spots were related to new asthma (RR=1.49; 95% CI 1.00 to 2.22). The population-attributable risk was 3-10% for reported, and 3-14% for observed dampness/moulds. CONCLUSIONS: Dampness and mould are common in dwellings, and contribute to asthma incidence in adults.
AU  - Norbäck, D.*
AU  - Zock, J.P.*
AU  - Plana, E.*
AU  - Heinrich, J.
AU  - Svanes, C.*
AU  - Sunyer, J.*
AU  - Künzli, N.*
AU  - Villani, S.*
AU  - Olivieri, M.*
AU  - Soon, A.*
AU  - Jarvis, D.*
C1  - 24386
C2  - 31534
SP  - 325-331
TI  - Mould and dampness in dwelling places, and onset of asthma: The population-based cohort ECRHS.
JO  - Occup. Environ. Med.
VL  - 70
IS  - 5
PB  - BMJ Publishing
PY  - 2013
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Objectives Elevated ozone levels have been associated with cardiovascular morbidity and mortality. We investigated the effects of ozone on heart rate (HR) and repolarisation parameters in potentially susceptible populations. Methods Between March 2007 and December 2008, 363 ECG recordings including >2000 1 h intervals were measured in 64 individuals with type 2 diabetes or impaired glucose tolerance and in 46 healthy individuals with a potential genetic predisposition on the detoxification pathways from Augsburg, Germany. Associations between 1 h averages of ozone and HR, Bazett-corrected QT-interval (QTc), T-wave amplitude and T-wave complexity were analysed using additive mixed models. A variable indicating season and participants' location during the 1 h ECG recordings (summer and outdoors vs winter or indoors) was used as a potential ozone effect modifier. Results We observed concurrent and 1-4 h lagged increases in HR of 0.5-0.7% for each 20 μg/m(3) increase in ozone. These effects were stronger (1.0-1.2%) when participants were outdoors during the summer. We detected in all participants a concurrent (-1.31%; 95% CI -2.19% to -0.42%) and 1 h lagged (-1.32%; -2.19% to -0.45%) T-wave flattening. Elevated ozone levels were associated with 1 h (2.12%; 0.81 to 3.52) and 2 h lagged (1.89%; 0.55% to 3.26%) increases in T-wave complexity. However, no effects were seen for QTc. Ozone effects were generally more pronounced in individuals with metabolic disorders than a potential genetic predisposition. Conclusions Changes in repolarisation might contribute to underlying pathophysiological changes associated with the link between elevated ozone levels and reported adverse cardiovascular outcomes.
AU  - Hampel, R.
AU  - Breitner-Busch, S.
AU  - Zareba, W.*
AU  - Kraus, U.
AU  - Pitz, M.
AU  - Geruschkat, U.
AU  - Belcredi, P.
AU  - Peters, A.
AU  - Schneider, A.E.
AU  - KORA Study Group (Wichmann, H.-E.
AU  - Holle, R.
AU  - John, J.
AU  - Illig, T.
AU  - Meisinger, C.
AU  - Peters, A.)
C1  - 7491
C2  - 29751
SP  - 428-436
TI  - Immediate ozone effects on heart rate and repolarisation parameters in potentially susceptible individuals.
JO  - Occup. Environ. Med.
VL  - 69
IS  - 6
PB  - BMJ Publishing Group
PY  - 2012
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Objectives Changes in air temperature are associated with an increase in cardiovascular events, but the role of procoagulant and proinflammatory blood markers is still poorly understood. The authors investigated the association between air temperature and fibrinogen, plasminogen activator inhibitor type 1, interleukin-6 and high-sensitivity C reactive protein in two potentially susceptible groups. Methods This prospective panel study was conducted between March 2007 and December 2008 in Augsburg, Germany. The study population comprised 187 participants with type 2 diabetes mellitus or impaired glucose tolerance and 87 participants with genetic polymorphisms on the detoxification and inflammation pathways. Overall, 1766 repeated blood measurements were collected. Hourly meteorology data were available from a central measurement site. The association between temperature and blood markers was analysed with additive mixed models. Results For type 2 diabetes mellitus and impaired glucose tolerance participants, the authors observed immediate, lagged and cumulative increases in fibrinogen (range of percentage changes in geometric mean: 0.6%-0.8%) and plasminogen activator inhibitor type 1 (6.0%-10.1%) in association with a 5 degrees C temperature decrement. Participants with a body mass index above 30 kg/m(2) as well as females showed particularly strong fibrinogen effects. In participants with the special genetic background, 5 degrees C decreases in the 5-day average of temperature led to a change of 8.0% (95% CI 0.5% to 16.2%) in interleukin-6 and of -8.4% (95% CI - 15.8% to -0.3%) in high-sensitivity C reactive protein, the latter driven by physically active individuals. Conclusions The authors observed different temperature effects on blood markers in two potentially susceptible groups probably indicating varying underlying biological mechanisms. This study results might provide a link between temperature and cardiovascular events.
AU  - Schäuble, C.L.
AU  - Hampel, R.
AU  - Breitner-Busch, S.
AU  - Rückerl, R.
AU  - Phipps, R.*
AU  - Diaz-Sanchez, D.*
AU  - Devlin, R.B.*
AU  - Carter, J.D.*
AU  - Soukup, J.*
AU  - Silbajoris, R.*
AU  - Dailey, L.*
AU  - Koenig, W.*
AU  - Cyrys, J.
AU  - Geruschkat, U.
AU  - Belcredi, P.
AU  - Kraus, U.
AU  - Peters, A.
AU  - Schneider, A.E.
C1  - 10407
C2  - 30254
SP  - 670-678
TI  - Short-term effects of air temperature on blood markers of coagulation and inflammation in potentially susceptible individuals.
JO  - Occup. Environ. Med.
VL  - 69
IS  - 9
PB  - BMJ Publishing Group
PY  - 2012
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - BACKGROUND AND OBJECTIVE: Air temperature changes are associated with increased cardiovascular and respiratory risk, but the roles of inflammatory and coagulation markers are not well understood. We investigated the associations between temperature and several blood markers in patients with coronary heart disease (CHD) and pulmonary disease (PD). METHODS: Two studies were conducted in Erfurt, Germany, over two successive winters. 578 and 381 repeated blood measurements were collected from 57 CHD and 38 PD patients, respectively. Data on patient characteristics and disease history were gathered at baseline. Meteorological data were collected from existing networks. Associations were analysed using additive mixed models with random patient effects. Effect modification by diabetes status was investigated only in CHD patients, as only two PD patients had diabetes. RESULTS: Mean daily air temperature varied between -13 degrees C and 16 degrees C in both study periods. A 10 degrees C decrease in the 5-day temperature average before blood withdrawal led to an increase in platelet counts (% change from the mean: 3.0%, 95% CI 0.6% to 5.5%) and fibrinogen (5.5%, 1.3% to 9.7%), no change in C-reactive protein in PD patients, and a decrease in C-reactive protein in CHD patients. A 2-day delayed increase in factor VII associated with temperature decrease was seen in CHD patients (4.9%; 0.7% to 9.2%), while PD patients showed no effect. 'Effects in CHD patients without diabetes' into 'Effects on factor VII in CHD patients without diabetes'. CONCLUSIONS: This study suggests that temperature decrease is associated with change in several blood parameters. The complex interplay of blood markers at low temperature may contribute to the observed association between cold and cardiovascular mortality and morbidity.
AU  - Hampel, R.
AU  - Breitner-Busch, S.
AU  - Rückerl, R.
AU  - Frampton, M.W.*
AU  - Koenig, W.*
AU  - Phipps, R.P.*
AU  - Wichmann, H.-E.
AU  - Peters, A.E.
AU  - Schneider, A.
C1  - 1668
C2  - 27356
SP  - 408-416
TI  - Air temperature and inflammatory and coagulation responses in men with coronary or pulmonary disease during the winter season.
JO  - Occup. Environ. Med.
VL  - 67
IS  - 6
PB  - BMJ Publishing Group
PY  - 2010
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - OBJECTIVES: Traffic-related pollution is associated with cardiovascular disease in general, but previous studies suggested that low socioeconomic status (SES) groups might be more susceptible towards a negative impact. We examined whether the association between long-term exposure to high traffic and early signs of coronary artery disease is modified by SES. METHODS: Individual-level medical and social data from a population-based study were linked with census information on neighbourhood socioeconomic characteristics. Residential exposure to traffic was defined as proximity to major roads using a geographical information system. We studied associations between high traffic and coronary artery calcification (CAC) within strata of SES to examine effect modification. Data stem from an epidemiological study in Germany including 2264 women and 2037 men (45-75 years). RESULTS: High traffic and low SES were both associated with higher amounts of calcification (>or=75th age-specific percentile). More participants with low SES lived close to major roads while stratified analyses did not indicate higher susceptibility in low SES groups. Participants with low SES and simultaneous exposure to high traffic had highest levels of CAC. For example, the prevalence of high calcification was 23.9% in better-educated men with low traffic exposure but 37.7% in lower-educated men with high traffic exposure (women: 22.0% vs 28.1%). CONCLUSIONS: High traffic exposure was associated with coronary calcification in all social groups, but as low SES individuals had higher calcification in general and were also more often exposed to traffic, existing inequalities could be further shaped by traffic exposure.
AU  - Dragano, N.*
AU  - Hoffmann, B.*
AU  - Moebus, S.*
AU  - Möhlenkamp, S.*
AU  - Stang, A.*
AU  - Verde, P.E.*
AU  - Jöckel, K.-H.*
AU  - Erbel, R.*
AU  - Siegrist, J.*
AU  - Heinz Nixdorf Recall Study Investigative Group (Löwel, H.)
C1  - 32351
C2  - 34980
SP  - 628-635
TI  - Traffic exposure and subclinical cardiovascular disease: Is the association modified by socioeconomic characteristics of individuals and neighbourhoods? Results from a multilevel study in an urban region.
JO  - Occup. Environ. Med.
VL  - 66
IS  - 9
PY  - 2009
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Occupational exposures to ionising radiation mainly occur at low-dose rates and may accumulate effective doses of up to several hundred milligray. The objective of the present study is to evaluate the evidence of cancer risks from such low-dose-rate, moderate-dose (LDRMD) exposures. Our literature search for primary epidemiological studies on cancer incidence and mortality risks from LDRMD exposures included publications from 2002 to 2007, and an update of the UK National Registry for Radiation Workers study. For each (LDRMD) study we calculated the risk for the same types of cancer among the atomic bomb survivors with the same gender proportion and matched quantities for dose, mean age attained and mean age at exposure. A combined estimator of the ratio of the excess relative risk per dose from the LDRMD study to the corresponding value for the atomic bomb survivors was 1.21 (90% CI 0.51 to 1.90). The present analysis does not confirm that the cancer risk per dose for LDRMD exposures is lower than for the atomic bomb survivors. This result challenges the cancer risk values currently assumed for occupational exposures.
AU  - Jacob, P.
AU  - Rühm, W.
AU  - Walsh, L.*
AU  - Blettner, M.*
AU  - Hammer, G.*
AU  - Zeeb, H.*
C1  - 1316
C2  - 26704
SP  - 789-796
TI  - Is cancer risk of radiation workers larger than expected?
JO  - Occup. Environ. Med.
VL  - 66
IS  - 12
PY  - 2009
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - OBJECTIVES: We modelled exposure to traffic particles using a latent variable approach and investigated whether long-term exposure to traffic particles is associated with an increase in the occurrence of acute myocardial infarction (AMI) using data from a population-based coronary disease registry. METHODS: Cases of individually validated AMI were identified between 1995 and 2003 as part of the Worcester Heart Attack Study. Population controls were selected from Massachusetts, USA, resident lists. NO(2) and PM(2.5) filter absorbance were measured at 36 locations throughout the study area. The air pollution data were used to estimate exposure to traffic particles using a semiparametric latent variable regression model. Conditional logistic models were used to estimate the association between exposure to traffic particles and occurrence of AMI. RESULTS: Modelled exposure to traffic particles was highest near the city of Worcester. Cases of AMI were more exposed to traffic and traffic particles compared to controls. An interquartile range increase in modelled traffic particles was associated with a 10% (95% CI 4% to 16%) increase in the odds of AMI. Accounting for spatial dependence at the census tract, but not block group, scale substantially attenuated this association. CONCLUSIONS: These results provide some support for an association between long-term exposure to traffic particles and risk of AMI. The results were sensitive to the scale selected for the analysis of spatial dependence, an issue that requires further investigation. The latent variable model captured variation in exposure, although on a relatively large spatial scale.
AU  - Tonne, C.*
AU  - Yanosky, J.*
AU  - Gryparis, A.*
AU  - Melly, S.*
AU  - Mittleman, M.*
AU  - Goldberg, R.*
AU  - von Klot, S.
AU  - Schwartz, J.*
C1  - 28
C2  - 27053
SP  - 797-804
TI  - Traffic particles and occurrence of acute myocardial infarction: A case-control analysis.
JO  - Occup. Environ. Med.
VL  - 66
IS  - 12
PB  - BMJ Publishing Group
PY  - 2009
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Objectives: To evaluate whether hourly changes in fine particle (PM2.5, diameter, <2.5 mu m) exposure or outdoor particle concentrations are associated with rapid ischaemic responses. Methods: 41 non-smoking elderly people with coronary heart disease were followed up with biweekly clinic visits in Helsinki, Finland. The occurrence of ST segment depressions >0.1 mV was recorded during submaximal exercise tests. Hourly variations in personal PM2.5 exposure and outdoor levels of PM2.5 and ultrafine particles (<0.1 mu m) were recorded for 24 h before a clinic visit. Associations between particulate air pollution and ST segment depressions were evaluated using logistic regression. Results: Both personal and outdoor PM2.5 concentrations, but not outdoor ultrafine particle counts, were associated with ST segment depressions. The odds ratio (per 10 mu g/m(3)) for personal PM2.5 concentration during the hour preceding a clinic visit was 3.26 (95% CI 1.07 to 9.99) and for 4 h average outdoor PM2.5 it was 2.47 (95% CI 1.05 to 5.85). Conclusions: Even very short-term elevations in fine particle exposure might increase the risk of myocardial ischaemia. The precise mechanism is still unknown but could involve changes in autonomic nervous control of the heart.
AU  - Lanki, T.*
AU  - Hoek, G.*
AU  - Timonen, K. L.*
AU  - Peters, A.
AU  - Tiittanen, P.*
AU  - Vanninen, E.*
AU  - Pekkanen, J.*
C1  - 2301
C2  - 25843
SP  - 782-786
TI  - Hourly variation in fine particle exposure is associated with transiently increased risk of ST segment depression.
JO  - Occup. Environ. Med.
VL  - 65
IS  - 11
PB  - BMJ Publ. Group
PY  - 2008
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Occupational exposures have been associated with an increased risk of new-onset rhinitis in apprentices. However, population-based prospective data are scarce and do not cover new onset of rhinitis later in life. The authors studied the association between occupational exposure and adult onset of rhinitis prospectively. METHODS: The data of 4994 participants (age at follow-up 28-57 years) from 27 centres of the European Community Respiratory Health Survey II who were symptom-free at baseline were analysed. As outcome at follow-up self-reported (a) nasal allergies ("allergic rhinitis") and (b) runny, blocked nose for 12 months a year ("perennial rhinitis") were used. Occupational exposures at any time during follow-up were defined by job title. RESULTS: The cumulative incidence of allergic rhinitis, perennial rhinitis and both conditions was 12%, 11% and 3%, respectively. Compared to office workers, male medical professionals were at increased risk of new onset of allergic rhinitis (OR 3.0; 95% CI 1.4 to 6.4). Odds ratios were reduced in metal workers not involved in metal making or treating (0.3; 95% CI 0.1 to 0.7). For perennial rhinitis ORs were significantly increased in cleaners (1.4; 95% CI 1.0 to 2.1). CONCLUSIONS: Cleaners and medical professionals may be at increased risk for adult-onset rhinitis.
AU  - Radon, K.*
AU  - Gerhardinger, U.*
AU  - Schulze, A.
AU  - Zock, J.P.*
AU  - Norbäck, D.*
AU  - Torén, K.*
AU  - Jarvis, D.*
AU  - Held, L.*
AU  - Heinrich, J.
AU  - Leynaert, B.*
AU  - Nowak, D.*
AU  - Kogevinas, M*
AU  - ECRHS Study Group (*)
C1  - 1988
C2  - 25177
SP  - 38-43
TI  - Occupation and adult onset of rhinitis in the general population.
JO  - Occup. Environ. Med.
VL  - 65
IS  - 1
PB  - BMJ Publ. Group
PY  - 2008
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - In their Education article in the March issue (Occup Environ Med 2007;64:202–10), Koh and Koh interestingly propose that measurements of heavy metals (for example, lead and cadmium) in saliva may be a novel and promising approach to occupational health, revealing the patient’s risk of systemic exposure to toxicants. We would like to share our experience regarding the assessment of metals …
AU  - Minoia, C.*
AU  - Ronchi, A.*
AU  - Veronese, I.*
AU  - Giussani, A.
AU  - Guzzi, G.*
C1  - 2380
C2  - 24932
SP  - S. 856
TI  - The confounding effects of intraoral metals in salivary biomarkers.
JO  - Occup. Environ. Med.
VL  - 64
PB  - BMJ Publ. Group
PY  - 2007
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - OBJECTIVES: To estimate long-term exposure to traffic-related air pollutants on an individual basis and to assess adverse health effects using a combination of air pollution measurement data, data from geographical information systems (GIS) and questionnaire data. METHODS: 40 measurement sites in the city of Munich, Germany were selected at which to collect particulate matter with a 50% cut-off aerodynamic diameter of 2.5 microm (PM2.5) and to measure PM2.5 absorbance and nitrogen dioxide (NO2). A pool of GIS variables (information about street length, household and population density and land use) was collected for the Munich metropolitan area and was used in multiple linear regression models to predict traffic-related air pollutants. These models were also applied to the birth addresses of two birth cohorts (German Infant Nutritional Intervention Study (GINI) and Influence of Life-style factors on the development of the Immune System and Allergies in East and West Germany (LISA)) in the Munich metropolitan area. Associations between air pollution concentrations at birth address and 1-year and 2-year incidences of respiratory symptoms were analysed. RESULTS: The following means for the estimated exposures to PM2.5, PM2.5 absorbance and NO2 were obtained: 12.8 microg/m3, 1.7x10(-5) m(-1) and 35.3 mug/m3, respectively. Adjusted odds ratios (ORs) for wheezing, cough without infection, dry cough at night, bronchial asthma, bronchitis and respiratory infections indicated positive associations with traffic-related air pollutants. After controlling for individual confounders, significant associations were found between the pollutant PM2.5 and sneezing, runny/stuffed nose during the first year of life (OR 1.16, 95% confidence interval 1.01 to 1.34) Similar effects were observed for the second year of life. These findings are similar to those from our previous analysis that were restricted to a subcohort in Munich city. The extended study also showed significant effects for sneezing, running/stuffed nose. Additionally, significant associations were found between NO2 and dry cough at night (or bronchitis) during the first year of life. The variable "living close to major roads" (<50 m), which was not analysed for the previous inner city cohort with birth addresses in the city of Munich, turned out to increase the risk of wheezing and asthmatic/spastic/obstructive bronchitis. CONCLUSIONS: Effects on asthma and hay fever are subject to confirmation at older ages, when these outcomes can be more validly assessed.
AU  - Morgenstern, V.
AU  - Zutavern, A.
AU  - Cyrys, J.
AU  - Brockow, I.*
AU  - Gehring, U.
AU  - Koletzko, S.*
AU  - Bauer, C.P.*
AU  - Reinhardt, D.*
AU  - Wichmann, H.-E.
AU  - Heinrich, J.
C1  - 1517
C2  - 24393
SP  - 8-16
TI  - Respiratory health and individual estimated exposure to traffic-related air pollutants in a cohort of young children.
JO  - Occup. Environ. Med.
VL  - 64
IS  - 1
PB  - BMJ Publ. Group
PY  - 2007
SN  - 1351-0711
ER  - 

TY  - JOUR
AU  - Gehring, U.
AU  - Leaderer, B.P.*
AU  - Heinrich, J.
AU  - Oldenwening, M.*
AU  - Giovannangelo, M.E.C.A.*
AU  - Nordling, E.*
AU  - Merkel, G.*
AU  - Hoek, G.*
AU  - Bellander, T.*
AU  - Brunekreef, B.
C1  - 5799
C2  - 24255
SP  - 766-772
TI  - Comparison of parental reports of smoking and residential air nicotine concentrations in children.
JO  - Occup. Environ. Med.
VL  - 63
PB  - BMJ Publ. Group
PY  - 2006
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - Background: Acute myocardial infarction (AMI) is the leading cause of death attributed to cardiovascular diseases. An association between traffic related air pollution and AMI has been suggested, but the evidence is still limited. Objectives: To evaluate in a multicentre study association between hospitalisation for first AMI and daily levels of traffic related air pollution. Methods: The authors collected data on first AMI hospitalisations in five European cities. AMI registers were available in Augsburg and Barcelona; hospital discharge registers (HDRs) were used in Helsinki, Rome and Stockholm. NO2, CO, PM10 (particles <10 μm), and O3 were measured at central monitoring sites. Particle number concentration (PNC), a proxy for ultrafine particles (<0.1 μm), was measured for a year in each centre, and then modelled retrospectively for the whole study period. Generalised additive models were used for statistical analyses. Age and 28 day fatality and season were considered as potential effect modifiers in the three HDR centres. Results: Nearly 27 000 cases of first AMI were recorded. There was a suggestion of an association of the same day CO and PNC levels with AMI: RR = 1.005 (95% CI 1.000 to 1.010) per 0.2 mg/m3 and RR = 1.005 (95% CI 0.996 to 1.015) per 10000 particles/cm3, respectively. However, associations were only observed in the three cities with HDR, where power for city-specific analyses was higher. The authors observed in these cities the most consistent associations among fatal cases aged <75 years: RR at 1 day lag for CO = 1.021 (95% CI 1.000 to 1.048) per 0.2 mg/m3, for PNC = 1.058 (95% CI 1.012 to 1.107) per 10000 particles/cm3, and for NO 2 = 1.032 (95% CI 0.998 to 1.066) per 8 μg/m3. Effects of air pollution were more pronounced during the warm than the cold season. Conclusions: The authors found support for the hypothesis that exposure to traffic related air pollution increases the risk of AMI. Most consistent associations were observed among fatal cases aged <75 years and in the warm season.
AU  - Lanki, T.*
AU  - Pekkanen, J.*
AU  - Aalto, P.*
AU  - Elosua, R.*
AU  - Berglind, N.*
AU  - D'Ippoliti, D.*
AU  - Kulmala, M.*
AU  - Nyberg, F.*
AU  - Peters, A.
AU  - Picciotto, S.*
AU  - Salomaa, V.*
AU  - Sunyer, J.*
AU  - Tiittanen, P.*
AU  - von Klot, S.
AU  - Forastiere, F.*
C1  - 5103
C2  - 24211
SP  - 844-851
TI  - Associations of traffic related air pollutants with hospitalisation for first acute myocardial infarction: The HEAPSS study.
JO  - Occup. Environ. Med.
VL  - 63
IS  - 12
PB  - BMJ Publ. Group
PY  - 2006
SN  - 1351-0711
ER  - 

TY  - JOUR
AB  - OBJECTIVES:
      	
      		The chronic effects of urban air pollution are not well known. The authors' aim was to investigate the association between the prevalence and new onset of chronic bronchitis and urban air pollution.
      	
      		METHODS:
      	
      		Subjects from the general population randomly selected for the European Community Respiratory Health Survey (ECRHS I) during 1991-93 in 21 centres in 10 countries were followed up from the years 2000 to 2002 (n = 3232 males and 3592 females; average response rate = 65.3%). PM2.5 and elements, with the same equipment at centre level, and home outdoor NO2 in 1634 individuals were measured. Hierarchical models were used.
      	
      		RESULTS:
      	
      		The prevalence and new onset of chronic phlegm during follow up were 6.9% and 4.5%, respectively, 5.3% in males and 3.5% in females. Smoking, rhinitis, poor education, and low social class were associated with (prevalence and new onset of) chronic phlegm in both genders, and occupational exposures in males and traffic intensity (adjusted odds ratio for constant traffic, OR = 1.86; 95% CI 1.24 to 2.77) as well as home outdoor NO2 (OR > 50 microg/m3v < 20 microg3 = 2.71; 95% CI 1.03 to 7.16) among females. PM2.5 and S content at centre level did not show any association with prevalence or new onset of chronic phlegm. Similar results were obtained with chronic productive cough.
      	
      		CONCLUSION:
      	
      		Individual markers of traffic at household level such as reported intensity and outdoor NO2 were risk factors for chronic bronchitis among females.
      
      
      	 
AU  - Sunyer, J.*
AU  - Jarvis, D.*
AU  - Götschi, T.*
AU  - García-Esteban, R.*
AU  - Jacquemin, B.*
AU  - Aguilera, I.*
AU  - Ackerman, U.*
AU  - de Marco, R.*
AU  - Forsberg, B.*
AU  - Gislason, T.*
AU  - Heinrich, J.
AU  - Norbäck, D.*
AU  - Villani, S.*
AU  - Künzli, N.*
C1  - 4348
C2  - 24249
SP  - 836-843
TI  - Chronic bronchitis and urban air pollution in an international study.
JO  - Occup. Environ. Med.
VL  - 63
IS  - 12
PB  - BMJ Publ. Group
PY  - 2006
SN  - 1351-0711
ER  - 

TY  - JOUR
AU  - Heinrich, J.
AU  - Gehring, U.*
AU  - Cyrys, J.
AU  - Brauer, M.*
AU  - Hoek, G.*
AU  - Fischer, P.*
AU  - Bellander, T.*
AU  - Brunekreef, B.*
C1  - 5520
C2  - 22985
SP  - 517-523
TI  - Exposure to traffic related air pollutants : Self reported traffic intensity versus GIS modelled exposure.
JO  - Occup. Environ. Med.
VL  - 62
PB  - BMJ Publ. Group
PY  - 2005
SN  - 1351-0711
ER  - 

TY  - JOUR
AU  - Donaldson, K.*
AU  - Stone, V.*
AU  - Tran, C.L.*
AU  - Kreyling, W.G.
AU  - Borm, P.J.A.*
C1  - 3040
C2  - 21955
SP  - 727-728
TI  - Nanotoxicology.
JO  - Occup. Environ. Med.
VL  - 61
PB  - BMJ Publ. Group
PY  - 2004
SN  - 1351-0711
ER  - 

TY  - JOUR
AU  - Timonen, K.L.*
AU  - Hoek, G.*
AU  - Heinrich, J.
AU  - Bernard, A.*
AU  - Brunekreef, B.*
AU  - de Hartog, J.*
AU  - Hämeri, K.*
AU  - Ibald-Mulli, A.
AU  - Mirme, A.*
AU  - Peters, A.
AU  - Tiittanen, P.*
C1  - 535
C2  - 22075
SP  - 908-914
TI  - Daily variation in fine and ultrafine particulate air pollution and urinary concentrations of lung Clara cell protein CC16.
JO  - Occup. Environ. Med.
VL  - 61
PB  - BMJ Publ. Group
PY  - 2004
SN  - 1351-0711
ER  - 

TY  - JOUR
AU  - Kraus, T.*
AU  - Schramel, P.
AU  - Schaller, K.H.*
AU  - Zöbelein, P.*
AU  - Weber, A.*
AU  - Angerer, J.*
C1  - 21719
C2  - 19912
SP  - 631-634
TI  - Exposure assessment in the hard metal manufacturing industry with special regard to tungsten and its compounds.
JO  - Occup. Environ. Med.
VL  - 58
PY  - 2001
SN  - 1351-0711
ER  -