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  • 1
    Keywords: CANCER ; Germany ; LUNG ; lung cancer ; LUNG-CANCER ; SYSTEM ; CANCER MORTALITY ; COHORT ; cohort studies ; cohort study ; cohort-studies ; DEATH ; DISEASE ; DISEASES ; DNA adducts ; EPIDEMIOLOGY ; EXPOSURE ; HEPATOCELLULAR-CARCINOMA ; HISTORY ; incidence ; iron foundry ; larynx ; liver ; LONG-TERM ; missing death certificates ; MORTALITY ; mouth ; NEW-YORK ; occupation ; PHARYNX ; POPULATION ; PRIMARY LIVER-CANCER ; RISK ; RISKS ; SITE ; SITES ; WORKERS
    Abstract: Background Observations of an increased incidence of cancers of the upper aero-digestive tract (pharynx, esophagus, larynx, lung) among workers of local German foundries gave rise to concern about a potentially elevated occupational risk of those cancer sites. The purpose of the study was to examine whether occupational exposure in iron foundries increases the risk of cancer. Methods A historical cohort study of 17,708 male German production workers in 37 iron foundries who were first employed in 1950-1985 with a minimum employment period of 1 year was initiated. Employment and occupational histories were collected. Mortality was compared with that of the German general population during 1950-1993 using a new method for computing the SMR when not all causes of death are available (called SMR*). Results Mortality from all causes was elevated to SMR = 115.4 (95% confidence interval (CI) = 111.9-119.1), as was for total cancer (SMR* = 123.8, CI = 102.1-152.6), especially cancers of the lung (SMR* = 163.9, CI = 123.9-223.0) and liver (SMR* = 322.5, CI = 149.5-844.8), and diseases of the respiratory system (SMR* = 147.6, CI = 100.4-221.5). Non- significant elevations of mortality were also found for cancers of the mouth and pharynx (SMR* = 153.5, CI = 82.3-359.8) and larynx (SMR* = 173.1, CI = 85.5-550.5). Mortality from various causes of death was higher among workers with shorter exposure periods than among long-term employees. The elevated mortality persisted for years and decades after termination of employment. Conclusions The results provide further evidence for an increased risk of lung cancer and possibly other cancers of the upper aero-digestive tract among foundry workers. Special attention should be paid to the strongly increased mortality from liver cancer and the mortality pattern among employees having terminated work. (C) 2003 Wiley-Liss, Inc
    Type of Publication: Journal article published
    PubMed ID: 12594777
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  • 2
    Keywords: CANCER ; Germany ; FOLLOW-UP ; LUNG-CANCER ; COHORT ; RISK ; MECHANISM ; mechanisms ; ASSOCIATION ; FREQUENCY ; ACID ; ACIDS ; WOMEN ; fatty acids ; FATTY-ACIDS ; DIETARY ; PREVALENCE ; OXIDATIVE STRESS ; ANTIOXIDANT ; European Prospective Investigation into Cancer and Nutrition ; nutrition ; QUESTIONNAIRE ; questionnaires ; SMOKERS ; antioxidants ; FOOD ; DIETARY-INTAKE ; WEST-GERMANY ; asthma ; antioxidants,diet,EPIC,fatty acids,hay fever ; ATOPY ; BETA-CAROTENE ; EAST-GERMANY ; EPIC-GERMANY ; FOOD FREQUENCY QUESTIONNAIRE ; FREQUENCY QUESTIONNAIRE ; NUTRIENTS ; VITAMIN-E
    Abstract: Background: The objective of the investigation was to explore in a prospective study the associations between dietary intake of fatty acids, antioxidants and hay fever manifestation in adulthood.Methods: Three hundred and thirty-four hay fever cases with adult onset of clinical symptoms from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Heidelberg cohort were identified during follow-up and matched with 1336 controls. Dietary intake data were obtained by means of validated food frequency questionnaires. The influence of dietary fatty acid and vitamin intake on hay fever risk was estimated by means of unconditional logistic regression.Results: High intake of oleic acid was positively associated with hay fever [odds ratio (OR): 2.86, 95% confidence intervals (95% CI): 1.22-6.70], whereas high intake of eicosapentaenoic acid was inversely related to hay fever (OR: 0.45, 95% CI: 0.22-0.93). Furthermore, high beta-carotene intake increased the risk of hay fever (OR: 1.69, 95% CI: 1.09-2.63) while increasing intake of vitamin E was a protective factor (OR: 0.38, 95% CI: 0.17-0.85). In grouped analyses, the effects of beta-carotene and vitamin E were mainly observed among women and ex-/current-smokers; in these subgroups, linoleic acid increased the risk of hay fever.Conclusions: In conclusion, the present results provide further evidence that dietary factors might affect the risk of clinical manifestation of hay fever. However, the effects in smokers and women may suggest different biological mechanisms for the investigated nutrients, which need further research
    Type of Publication: Journal article published
    PubMed ID: 14616103
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  • 3
    Keywords: CANCER ; Germany ; COHORT ; DISEASES ; TIME ; ASSOCIATION ; PATTERNS ; AGE ; WOMEN ; MEN ; smoking ; PREVALENCE ; cigarette smoking ; EPIC ; TRENDS ; education ; BIRTH COHORT ; birth cohorts
    Abstract: Background. Several studies in Germany and other European countries have already shown smoking prevalence to be related to education. This study was aimed to investigate time trends in smoking habits in the German cohorts Heidelberg and Potsdam of the European Prospective Investigation into Cancer and Nutrition (EPIC) according to sex, birth cohort, and level of education. Methods. Within EPIC, 25,546 and 27,548 participants were recruited in Heidelberg and Potsdam, respectively. Data on smoking were collected by means of a computer-guided interview during the baseline examination between 1994 and 1998. For each birth cohort smoking prevalence and mean number of cigarettes smoked per day at different ages were calculated. Odds ratios and 95% confidence interval for associations between smoking prevalence and educational level were computed by using logistic regression. Results. Smoking prevalence was higher among men than among women, with a smaller difference in younger birth cohorts. Between 1950 and 1960, smoking prevalence among women in the Heidelberg cohort rose sharply (from 12.8% to 51.8% in the least educated group). This strong increase was delayed by 10 years in the Potsdam cohort. Men and women in Heidelberg smoked more cigarettes per day than their counterparts in Potsdam, but in both study centers less educated subjects smoked more than subjects with a higher education. Conclusions. Smoking patterns in the Potsdam and Heidelberg cohorts are quite similar with respect to prevalence and years of lifetime smoking. Since an increasing difference between smoking prevalence of less and high educated individuals is observable, programs on smoking cessation should especially concentrate on persons of lower educational level. (C) 2003 American Health Foundation and Elsevier Science (USA). All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 12649053
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  • 4
    Keywords: CANCER ; CELLS ; Germany ; SYSTEM ; DISEASES ; HISTORY ; RISK ; ASSOCIATION ; LYMPHOMA ; MALIGNANCIES ; NUMBER ; AGE ; CHILDREN ; non-hodgkin's lymphoma ; Hodgkin's lymphoma ; FOLLICULAR LYMPHOMA ; NON-HODGKINS-LYMPHOMA ; multiple myeloma ; MALIGNANCY ; ADULT ; ADULTS ; case-control study ; CHILDHOOD ; HYGIENE HYPOTHESIS ; SAN-FRANCISCO ; RE ; RHEUMATOID-ARTHRITIS ; allergy ; B-CLL ; case control studies ; diffuse large B-cell lymphoma ; ACUTE-LEUKEMIA ; B-NHL ; LYMPHOMAS ; MALT lymphoma ; T-NHL ; urticaria
    Abstract: Since lymphomas are malignancies of cells of the immune system, associations with disorders characterised by impaired immune functions can be assumed. We investigated the relationship between a history of selected medical conditions and the risk for lymphoma including specified subentities within our population-based case-control study of lymphoma among adults conducted in Germany between 1999 and 2002. Overall, we found decreased risks for a history of repeated diarrhoea, warts, arthrosis, allergies, and appendectomy (at a younger age). Elevated risks for lymphoma correlated with tonsillectomy (at a younger age), whereas null results were found for selected auto-immune disorders in adulthood. Although the numbers are small, most of the results for the subentities corresponded with these findings. These results are compatible with the notion that persistent immunological alterations contribute to the aetiology of lymphoma, but partially inconsistent with the Th1/Th2-shift paradigm. (C) 2004 Elsevier Ltd. All rights reserved
    Type of Publication: Journal article published
    PubMed ID: 15617998
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  • 5
    Keywords: CANCER ; EXPRESSION ; Germany ; FOLLOW-UP ; DISEASE ; RISK ; ACTIVATION ; ASSOCIATION ; LYMPHOMA ; AGE ; CIGARETTE-SMOKING ; smoking ; DOSE-RESPONSE ; case-control studies ; TOBACCO ; ALCOHOL ; SMOKERS ; EUROPE ; INTERVIEW ; Hodgkin's lymphoma ; DRINKING ; ONCOLOGY ; case-control study ; RE ; alcohol drinking ; case control studies ; INTERVAL ; NEVER SMOKERS ; odds ratio ; HEMATOLYMPHOPOIETIC MALIGNANCIES ; STERNBERG CELLS
    Abstract: We analysed the effects of tobacco and alcohol in the aetiology of Hodgkin's lymphoma (HL), based on 340 cases and 2465 controls enrolled in Spain, France, Italy, Germany, Ireland and Czech Republic, between 1998 and 2004. Current smokers showed a significantly increased odds ratio (OR) of HL of 1.39 (95% confidence interval (CI) = 1.04-1.87). Analyses were also conducted separately for subjects younger than 35 years (179 cases) and for older subjects (161 cases). For subjects below age 35, no association was observed between tobacco and HL, whereas for older subjects, ever-smokers experienced a doubled risk of HL as compared to never smokers and the OR of HL for current smoking was 2.35 (95% CI = 1.52-3.61), with suggestion of a dose response relationship. A protective effect of alcohol was observed in both age groups. The OR for ever-regular drinking was 0.58 (95% CI = 0.38-0.89) for younger subjects and 0.50 (95% CI = 0.34-0.74) for older subjects. There was no evidence of interaction between tobacco and alcohol. Our results are consistent with previous studies, suggesting a protective effect of alcohol on HL. An effect of tobacco was suggested for HL occurring in middle and late age, although this finding might have occurred by chance
    Type of Publication: Journal article published
    PubMed ID: 16819547
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  • 6
    Keywords: CANCER ; SURVIVAL ; Germany ; neoplasms ; DIAGNOSIS ; COHORT ; DISEASE ; DISEASES ; MORTALITY ; POPULATION ; RISK ; RISKS ; PATIENT ; RISK-FACTORS ; BREAST ; LYMPHOMA ; NUMBER ; CLINICAL-TRIALS ; risk factors ; case-control studies ; INHIBITORS ; case-control study ; case control studies ; INTERVAL ; DRUGS ; RISK-FACTOR ; PRAVASTATIN ; PROTEIN GERANYLGERANYLATION
    Abstract: Background: Statins, drugs used to treat dyslipidemia, may have anticancer properties. We have evaluated lymphoma risk associated with regular statin use in an international case-control study. Methods: This case-control study included 2,362 cases of incident B- and T-cell lymphoma from Czech Republic, France, Germany, Ireland, Italy, and Spain and 2,206 hospital or population controls. Information on drug use, diagnosis at admission (for hospital controls), and putative risk factors for lymphoma was collected with personal interviews. Hospital controls admitted for diseases possibly entailing use of statins were excluded from the analysis. Results: The odds ratio for regular statin use was 0.61 (95% confidence interval, 0.45-0.84); all major lymphoma subtypes showed similarly decreased risks. Decreased risks were observed in all centers. Duration of statin use was not associated with a greater reduction in the risk of lymphoma. Use of other lipid lowering drugs, such as fibrates, did not significantly modify the risk of lymphoma (odds ratio, 0.75; 95% confidence interval, 0.44-1.27). Conclusion: Statin use was associated with an important reduction in lymphoma risk, adding to the growing evidence of anticancer properties of this group of drugs. These results are reassuring for the increasing number of patients taking statins on a regular basis
    Type of Publication: Journal article published
    PubMed ID: 16702371
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  • 7
    Keywords: CANCER ; Germany ; human ; neoplasms ; RISK ; TIME ; ASSOCIATION ; LYMPHOMA ; MALIGNANCIES ; WOMEN ; MEN ; leukemia ; cancer risk ; CARCINOGENS ; hair dyes ; case-control studies ; NON-HODGKINS-LYMPHOMA ; MALIGNANCY ; PRODUCTS ; HUMAN CANCER ; INCREASE ; INTERVAL ; odds ratio ; population-based ; CANCER-RISK ; lymphatic system
    Abstract: Hair dyes have been evaluated as possibly being mutagenic and carcinogenic in animals. Studies of the association between human cancer risk and use of hair dyes have yielded inconsistent results. The authors evaluated the risk of lymphoid malignancies associated with personal use of hair dyes. The analysis included 2,302 incident cases of lymphoid neoplasms and 2,417 hospital- or population-based controls from the Czech Republic, France, Germany, Ireland, Italy, and Spain (1998-2003). Use of hair dyes was reported by 74% of women and 7% of men. Lymphoma risk among dye users was significantly increased by 19% in comparison with never use (odds ratio (OR) = 1.19, 95% confidence interval (CI): 1.00, 1.41) and by 26% among persons who used hair dyes 12 or more times per year (OR = 1.26, 95% CI: 1.00, 1.60; p for linear trend = 0.414). Lymphoma risk was significantly higher among persons who had started coloring their hair before 1980 (OR = 1.37, 95% CI: 1.09, 1.72) and persons who had used hair dyes only before 1980 (OR = 1.62, 95% CI: 1.10, 2.40). Personal use of hair dyes is associated with a moderate increase in lymphoma risk, particularly among women and persons who used dyes before 1980. Specific compounds associated with this risk remain to be elucidated
    Type of Publication: Journal article published
    PubMed ID: 16731576
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  • 8
    Keywords: CANCER ; evaluation ; Germany ; LUNG-CANCER ; screening ; COHORT ; cohort studies ; cohort study ; DISEASE ; DISEASES ; EPIDEMIOLOGY ; RISK ; TIME ; CONTRAST ; ASSOCIATION ; ACID ; NO ; cancer prevention ; lifestyle ; DIFFERENCE ; AGE ; WOMEN ; MEN ; COUNTRIES ; PRODUCT ; RECRUITMENT ; DIET ; DIETARY ; FAT ; UNITED-STATES ; PREVALENCE ; CONSUMPTION ; meat ; nutrition ; BETA-CAROTENE ; FOOD FREQUENCY QUESTIONNAIRE ; LEISURE-TIME ; ASSOCIATIONS ; RE ; PRODUCTS ; SUPPLEMENT ; HIGH PREVALENCE ; SUPPLEMENTATION ; PHYSICAL-ACTIVITY ; EPIC PROJECT ; RELATIVE VALIDITY ; LEVEL ; methods ; VITAMIN-C ; VITAMINS ; NO ASSOCIATION ; EPIC-Heidelberg ; PEOPLE ; - ; German ; milk ; FRENCH-WOMEN ; MINERAL SUPPLEMENTS ; nutrient supplements
    Abstract: Background The use of dietary supplements is often associated with a healthy lifestyle. Due to high variation in supplementation practice by country, these associations will be investigated in a large German cohort study. Aim of the study To describe the prevalence of dietary supplement use in the EPIC-Heidelberg cohort and to illuminate differences in health-relevant characteristics between regular users and non-users. Methods At cohort recruitment, 13,615 women aged 35-65 and 11,929 men aged 40-65 were asked for regular dietary supplementation over the past year. Results Regular use of any supplement was reported by 47% of the women and 41% of the men, vitamin or mineral supplements were taken by 40% and 33%, respectively. The use of vitamin and/or mineral supplements was significantly associated with higher age, being non- or ex-smoker, lower BMI, higher physical leisure time activity, and higher educational level. After adjustment for these factors, we observed positive associations between supplement use and the consumption of milk, milk products, and fish as well as the intake of vitamin C and beta-carotene. In contrast, the supplement use was related to lower meat and meat product consumption, saturated fat intake, and n6/n3-fatty acid ratio in the diet, both in women and men. Except for Hemoccult((R)) testing in women, no association with participation in cancer screening was observed. Conclusion The high prevalence of supplement use in EPIC-Heidelberg was associated with several presumably healthier lifestyle and diet characteristics. This needs to be considered in further evaluations of the risk of chronic diseases
    Type of Publication: Journal article published
    PubMed ID: 17377829
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  • 9
    Keywords: CANCER ; CELLS ; CELL ; Germany ; MODEL ; MODELS ; FOLLOW-UP ; SYSTEM ; cohort study ; DISEASE ; DISEASES ; EPIDEMIOLOGY ; RISK ; RISK-FACTORS ; ASSOCIATION ; NO ; LYMPHOMA ; HEALTH ; WOMEN ; etiology ; risk factors ; DIETARY ; UNITED-STATES ; ALCOHOL-CONSUMPTION ; CONSUMPTION ; FRUIT ; nutrition ; VEGETABLES ; CALIBRATION ; B-CELL LYMPHOMA ; MULTIPLE-MYELOMA ; NON-HODGKINS-LYMPHOMA ; ONCOLOGY ; DIETARY FACTORS ; ASSOCIATIONS ; IMMUNE-SYSTEM ; non-Hodgkin lymphoma ; INTERVAL ; FRUITS ; methods ; function ; prospective ; prospective study ; RISK-FACTOR ; HODGKIN LYMPHOMA ; B-CELL ; N-NITROSO COMPOUNDS ; DRINKING-WATER NITRATE
    Abstract: Introduction Lymphomas are a heterogeneous group of malignant diseases of cells of the immune system. The best-established risk factors are related to dys-regulation of immune function, and evidence suggests that factors such as dietary or lifestyle habits may be involved in the etiology. Material and methods In the European Prospective Investigation into Cancer and Nutrition (EPIC), 849 lymphoma cases were identified in a median follow-up period of 6.4 years. Fruit and vegetable consumption was estimated from validated dietary questionnaires. Cox proportional hazard models were used to examine the association between fruit and vegetable intake with the risk of lymphomas overall and subentities. Results There was no overall association between total fruit and vegetable consumption and risk of lymphoma [hazard ratio (HR) = 0.95, 95% confidence interval (CI) 0.78-1.15 comparing highest with lowest quartile]. However, the risk of diffuse large B-cell lymphomas (DLBCL) tended to be lower in participants with a high intake of total vegetables (HR = 0.49, 95% CI 0.23-1.02). Conclusion In this large prospective study, an inverse associations between fruit and vegetable consumption and risk of lymphomas overall could not be confirmed. Associations with lymphoma subentities such as DLBCL warrant further investigation
    Type of Publication: Journal article published
    PubMed ID: 17443415
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  • 10
    Keywords: Germany ; DIAGNOSIS ; SUPPORT ; EXPOSURE ; HISTORY ; POPULATION ; RISK ; PATIENT ; ASSOCIATION ; CARBON ; LYMPHOMA ; HEALTH ; AGE ; smoking ; REGION ; REGIONS ; SAFETY ; case-control studies ; ALCOHOL ; ALCOHOL-CONSUMPTION ; CONSUMPTION ; FOLLICULAR LYMPHOMA ; AROMATIC-HYDROCARBONS ; case control study ; case-control study ; REGRESSION ; INCREASE ; case control studies ; INTERVAL ; analysis ; methods ; POWER ; female ; Male ; odds ratio ; population-based ; E ; case control ; LOGISTIC-REGRESSION ; POINT ; case-control ; CLICK ; PERSONAL INTERVIEW
    Abstract: To analyze the relationship between exposure to chlorinated and aromatic organic solvents and malignant lymphoma in a multi-centre, population-based case-control study. METHODS: Male and female patients with malignant lymphoma (n = 710) between 18 and 80 years of age were prospectively recruited in six study regions in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/Gütersloh, and Munich). For each newly recruited lymphoma case, a gender, region and age-matched (+/- 1 year of birth) population control was drawn from the population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least one year. On the basis of job task-specific supplementary questionnaires, a trained occupational physician assessed the exposure to chlorinated hydrocarbons (trichloroethylene, tetrachloroethylene, dichloromethane, carbon tetrachloride) and aromatic hydrocarbons (benzene, toluene, xylene, styrene). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression analysis, adjusted for smoking (in pack years) and alcohol consumption. To increase the statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. RESULTS: We observed a statistically significant association between high exposure to chlorinated hydrocarbons and malignant lymphoma (Odds ratio = 2.1; 95% confidence interval 1.1-4.3). In the analysis of lymphoma subentities, a pronounced risk elevation was found for follicular lymphoma and marginal zone lymphoma. When specific substances were considered, the association between trichloroethylene and malignant lymphoma was of borderline statistical significance. Aromatic hydrocarbons were not significantly associated with the lymphoma diagnosis. CONCLUSION: In accordance with the literature, this data point to a potential etiologic role of chlorinated hydrocarbons (particularly trichloroethylene) and malignant lymphoma. Chlorinated hydrocarbons might affect specific lymphoma subentities differentially. Our study does not support a strong association between aromatic hydrocarbons (benzene, toluene, xylene, or styrene) and the diagnosis of a malignant lymphoma.
    Type of Publication: Journal article published
    PubMed ID: 17407545
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