Showing papers by "Rodolfo Saracci published in 1990"

Exposure of nonsmoking women to environmental tobacco smoke: a 10-country collaborative study.

Abstract: The interpretation and interpretability of epidemiologic studies of environmental tobacco smoke (ETS) depend largely on the validity of self-reported exposure. To investigate to what extent questionnaires can indicate exposure levels to ETS, an international study was conducted in 13 centers located in 10 countries, and 1,369 nonsmoking women were interviewed. The present paper describes the results of the analysis of self-reported recent exposure to ETS from any source in relation to urinary concentrations of cotinine. Of the total, 19.7 percent of the subjects had nondetectable cotinine levels, the median value was 6 ng/mg, and the cut-point of the highest decile was 24 ng/mg. The proportion of subjects misreporting their active smoking habit was estimated at between 1.9 and 3.4 percent, depending on whether cut-points of 50 or 100 ng/mg creatinine were used. Large and statistically significant differences were observed between centers, with the lowest values in Honolulu, Shanghai, and Chandigarh, and the highest in Trieste, Los Angeles, and Athens. Mean cotinine/creatinine levels showed a clear linear increase from the group of women not exposed either at home or at work, to the group of those exposed both at home and at work. Values were significantly higher for women exposed to ETS from the husband but not at work, than for those exposed at work but not from the husband. The results of linear regression analysis indicated that duration of exposure and number of cigarettes to which the subject reported being exposed were strongly related to urinary cotinine. ETS exposure from the husband was best measured by the number of cigarettes, while exposure at work was more strongly related to duration of exposure. After adjustment of number of cigarettes for volume of indoor places, a similar increase in cotinine (5 ng/mg) was predicted by the exposure to 7.2 cigarettes/8 h/40 m3 from the husband and 17.9 cigarettes/8 h/40 m3 at work. The results indicate that, when appropriately questioned, nonsmoking women can provide a reasonably accurate description of ETS exposure. Assessment of individual exposure to ETS should focus on daily duration and volume of indoor places where exposure occurred.

Epidemiologic evidence on the relationship between formaldehyde exposure and cancer.

Abstract: Over 30 epidemiologic studies have evaluated cancer risks associated with formaldehyde exposure. Excesses were reported for several sites, leukemia and cancers of the nasal cavities, nasopharynx, lung, and brain generating the greatest interest. The excesses of leukemia and brain and colon cancer found among professionals may not be related to formaldehyde exposure, since similar excesses were not observed among industrial workers. Inconsistencies among and within studies impede assigning formaldehyde a convincing causal role for the excesses of lung cancer found among industrial workers. A causal role for formaldehyde is the most probable for cancers of the nasopharynx and, to a less extent, the nasal cavities. Evidence of exposure-response relationships, the fact that direct contact with formaldehyde may occur at these upper respiratory sites, and the consistency of these findings with experimental studies make this assumption highly probable.

Passive smoking and diet in the etiology of lung cancer among non-smokers.

Abstract: A case-control study was undertaken in Athens to explore the role of passive smoking and diet in the causation of lung cancer, by histologic type, in non-smoking women. Among 160 women with lung cancer admitted to one of seven major hospitats in Greater Athens between 1987 and 1989, 154 were interviewed in person; of those interviewed, 91 were life-long non-smokers. Among 160 identified controls with fractures or other orthopedic conditions, 145 were interviewed in person; of those interviewed, 120 were life-long non-smokers. Marriage of a non-smoking woman to a smoket was associated with a relative risk for lung cancer of 2.1 (95% confidence interval [CI] 1.1–4.1); number of cigarettes smoked daily by the husband and years of exposure to husband's smoking were positively, but not significantly, related to lung cancer risk. There was no evidence of any association with exposure to smoking of other household members, and the association with exposure to passive smoking at work was small and not statistically significant. Dietary data collected through a semi-quantitative food-frequency questionnaire indicated that high consumption of fruits was inversely related to the risk of lung cancer (the relative risk between extreme quartiles was 0.27 (CI 0.10–0.74)). Neither vegetables nor any other food group had an additional protective effect; futthermore, the apparent protective effect of vegetables was not due to carotenoid vitamin A content and was only partly explained in terms of vitamin C. The associations of lung cancer risk with passive smoking and reduced fruit intake were independent and did not confound each other. Passive smoking was associated with an increase of the risk of all histologic types of cancer, although the elevation was more modest for adenocarcinoma.

The Po River Delta epidemiological study of obstructive lung disease: sampling methods, environmental and population characteristics

Abstract: A longitudinal study on chronic obstructive lung disease (AOD) has been started in the Po River Delta in northern Italy. The first cross-sectional study was conducted in this previously unpolluted rural area before the start of operation of a large thermoelectric power plant (2,649 megawatt). A significant output of air pollutants is expected. This will permit us to carry out a "natural experiment" to study the effects of air pollutants (SO2 and suspended particulates). A multistage stratified cluster design was chosen. Stratification was based on age and socio-economic characteristics (SES) of households, and was performed in two steps, using the different indices computed from the census data. Geographic zones represented four areas of different predicted pollution exposure, once the plant started operating. There were 3,289 subjects in the selected age group (8-64) who agreed to participate (78%); only 11% refused to participate. The participants were representative of the clusters and SES. Participants had slightly fewer employed males, who did not participate due to work. The stratification and staging method allowed us to keep an acceptable level of precision and efficiency in the sample. In fact age-related differences were not found among the SES strata and geographic zones; various socio-economic characteristics, verified from the questionnaire information, were consistent with the SES stratification. Differences between geographic zones were related to the number of households of different SES within clusters; however this reflects the characteristics of the general population in the area.

The effect of involuntary smoking on the occurence of chronic obstructive pulmonary disease

Abstract: One hundred and three ever-married women with newly diagnosed Chronic Obstructive Pulmonary Disease (COPD), who have never smoked, and 179 ever-married women who were visiting friends or relatives at the same hospital during the same period and have never smoked, were interviewed regarding the smoking habits of their husbands. There was statistically marginally significant difference between the COPD cases and the controls with respect to their husband's smoking habits. The association was irregular with respect to daily number of cigarettes smoked but there was a smooth dose response curve with respect to life long total number of cigarettes smoked, with women whose husband smoked more that 300 thousand cigarettes having a relative risk of 1.8 (90% confidence interval of 0.9–3.6) compared to women whose husband has never smoked. These findings, and converging related evidence, indicate that exposure to environmental tobacco smoke may be a risk factor for the development of COPD.

Possible prognostic value of pulmonary AH-locus-linked enzymes in patients with tobacco-related lung cancer.

Abstract: As prognosis in breast cancer patients has been related to the AHH activity in their breast tissue, we have conducted a similar analysis on pulmonary drug metabolizing enzymes as prognostic markers for male lung cancer patients, primarily investigated for other reasons. A subset of 50 patients with lung cancer related to tobacco use, who had undergone thoracic surgery, was re-analyzed. The activity of parenchymal aryl hydrocarbon hydroxylase (AHH) and epoxide hydrolase (EH) that had been determined previously in homogenates of non-neoplastic surgical lung specimens, was used for comparisons of the patients' survival after surgery. When the crude mortality percentages at 1 and 2 years by AHH or EH activity, subdivided into quarters of the distribution, were calculated, a lower mortality was related to lower enzyme levels. Subjects in the 1st and 4th quarters of the distribution showed significant differences in their 1-year survival for AHH (p = 0.05) and EH (p less than 0.01) activities. This relationship could not be accounted for by age, cumulative lifetime smoking, recent or continuing smoking, stage or histological type of disease. Thus, the levels of pulmonary AHH and EH may have some prognostic significance in tobacco-related lung cancer.

The diet and cancer hypothesis: current trends.

Abstract: The current decade has witnessed an increasing interest in the diet-cancer issue as a central one for public health. Notwithstanding a substantial amount of epidemiological investigations, firm evidence of carcinogenicity exists only for alcoholic beverages with respect to cancers at several sites, and for aflatoxin with respect to liver cancer; also, the relation is established between diet related excess of energy intake, as translated into obesity, and cancer of endometrium and gallbladder. For a number of other dietary factors the evidence for a causal or protective role still remains at a presumptive level (e.g. intake of fresh vegetables and fruits with respect to cancers at several sites), or is still frankly open to debate (e.g. fat with respect to breast and colon cancer). Methodological inadequacies in past studies have been identified and clearer results should derive in the coming decade from epidemiological investigations substantially improved in methodology, particularly from the longterm prospective studies as now planned by the International Agency for Research on Cancer. Fortunately for cancer prevention, such dietary advice as can be derived from the highly incomplete and unsatisfactory knowledge on the role of dietary factors on cancer, turns out to be in broad agreement with the advice aimed at preventing other major diseases such as ischaemic heart disease and hypertension. This allows the issuing of a set of simple but important ‘prudent diet’ recommendations.