Effects of Deomestic Gas Cooking and Passive Smoking on Chronic Respiratory Symptoms and Asthma in Elderly Women.

The purpose of the study was to assess the effect of indoor air pollution resulting from the use of gas stoves for cooking on women more than 65 years old, who may be more susceptible than younger women to the harmful effects of pollutants. A total of 1,544 women living in Cracow took part in a survey. The data were collected to standardized interviews dealing with respiratory symptoms (coughing, phlegm production, dyspnea on exertion), chronic chest diseases diagnosed by a doctor, active and passive smoking, educational level, type of cooking fuel used, and average time spent daily in cooking. Lung function was tested with a spirometer. Comparison of the prevalence of respiratory symptoms by daily duration of cooking of smokers with that of never-smokers showed more symptoms in smokers even in the low-exposure category. In multivariate analysis, the effects of duration of cooking with gas on asthma for the highest exposure category in terms of odds ratios (ORs) were 2.8 for the never-smokers and 2.4 for the smokers; however, passive smoking had no significant effect. As regards dyspnea on exertion, both gas cooking and passive smoking had significant effects in never-smokers (OR for gas cooking 7.2, for passive smoking 2.2). The OR for dyspnea due to cooking with gas in smokers was 3.1. Mean FVC and FEV&inf1; levels were not decreased among passive smokers or those who were subject to high levels of gas-cooking exposure.

[Occupational exposure and histologic differentiation of lung cancer. Retrospective assessment in Cracow]. / Ekspozycja zawodowa a zróznicowanie histologiczne raka pluca. Badanie retrospektywne w Krakowie.

A population-based case-control study was performed in Cracow, Poland. Male cases and controls were identified from the Cracow Death Register. Information were 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 tumor was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 small cell carcinomas and 106 adenocarcinomas. 27 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 the age groups "less than 70 years". The highest relative risk due to occupational exposures was found for squamous cell carcinoma and mineral dust exposure 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 slightly lower (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 appeared to be about the same for squamous and small cell carcinoma.

Ventilatory lung function level as a predictor of survival among the elderly.

During a population survey in 1986/1987 among community-dwelling elderly in Cracow, aged 65 yrs and over, measurements of ventilatory lung function were carried out on 698 males and 1,211 females. The main objective of the study was to assess the importance of forced expiratory volume in one second (FEV1) as a predictor of survival experienced in this population group over a 6 year follow-up, in comparison with that of sociodemographic variables, smoking habit, chronic respiratory symptoms, hypertension, obesity and self-assessment of health. Statistical analysis of the relationship between mortality and chosen predictors has been performed with Cox proportional hazards statistical model. It was found that in addition to age, the FEV1 level was the most relevant and independent of age survival predictor among the elderly. In males, a reduction of FEV1 by 100 ml after allowing for age, showed a significantly higher risk of dying by 4%, (relative risk (RR) = 1.04; 95% confidence interval (CI) 1.01-1.06), and in females by 5% (RR = 1.05; 95% CI 1.05-1.09). Male current or ex-smokers displayed a higher mortality risk due to reduction of FEV1 (RR = 1.05; 95% CI 1.01-1.09) compared to lifetime nonsmokers (RR = 1.04; 95% CI 1.00-1.07); the corresponding RR values in women were 1.12 (95% CI 1.02-1.23) and 1.04 (95% CI 1.00-1.08), respectively. However, the differences found between the smokers and nonsmokers were not significant in either gender group. Other potential predictors considered, such as education, chronic respiratory symptoms, hypertension, self-assessment of health, or obesity, appeared to have been irrelevant in the multivariate analysis.

Lung function level as a valuable predictor of survival among the elderly. A 5-year community-based mortality study in Cracow.

The objective of the study undertaken among the elderly was to assess the strength and importance of health variable predictors (ventilatory lung function, blood pressure) in comparison with that of sociodemographic variables (age, sex, education), smoking habit, obesity and health self-assessment. The study covered a sample of elderly inhabitants of Cracow (698 males and 1211 females) who attended the mass screening X-ray clinic. The sample examined did not include patients of old people's homes or geriatric wards. Statistical analysis of the relation between mortality over a 5-year period and chosen predictors was carried out with Cox proportional hazards model. It was found that besides age, forced expiratory volume in 1 s (FEV(1)) level is the strongest survival predictor among the elderly. Subjects who had better FEV(1) by 500 ml showed significantly lower death risk, by 18% in males and 27% in females after allowing for age and height. The results obtained confirmed the expectation that ventilatory lung function is one of the strongest predictors of survival in the elderly. In the sample studied, the impact of education, smoking habit, obesity, health self-assessment on mortality was not significant. The effect of hypertension appeared to be relevant only in the female group.

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 tobacco smoking on various histological types of lung cancer.

In a population-based case/control study the differential lung cancer risk patterns due to tobacco smoking habits of various histological types have been investigated. The cases were 1432 deaths from lung cancer in the years 1980-1987, of which the histological type was known for 627 individuals. There was 54% squamous cell carcinoma, 24% small-cell carcinoma and 17% adenocarcinoma. Controls were 1343 deaths from other causes. Next-of-kin interviews were performed. The results of the study confirmed that cigarette smoking is associated with all histological types of lung cancer; however, the dose/response relationship between smoking and adenocarcinoma differed clearly from that observed in squamous and small-cell carcinomas. In the latter histological types the gradient of risk was much stronger as the number of cigarettes smoked or duration of smoking increased. The overall relative risk for smoking in small-cell and squamous cell carcinoma was 15.4 and 13.5 respectively, whereas that for adenocarcinoma was weaker (relative risk = 3.1). An interesting difference between squamous and small-cell carcinomas was found also for patients who gave up smoking. The effect of stopping was more pronounced in squamous cell carcinoma. The attributable risks for smoking in squamous and small-cell carcinoma were much higher (90% and 88% respectively) than for adenocarcinoma (64%). The data suggest that adenocarcinoma is likely to be related to other factors than tobacco smoking to a greater extent than are squamous or small cell carcinoma. Possible sources of bias, such as missing histological diagnoses, are discussed in detail.

[Effect of smoking on the development of various histological types of lung cancer]. / Wplyw palenia tytoniu na powstawanie róznych typów histologicznych raka pluca.

The aim of this clinically controlled trial was to assess the effect of different smoking patterns on development of different histological types of lung cancer. The study group consisted of 1,432 subjects that died due to lung cancer in the years 1980-1987. 627 of these had the histological type of the cancer determined; 54% had squamous cell cancer, 24% small cell lung cancer (SCLC), 17% adenocarcinoma. The control group consisted of 1,343 subjects that died due to other causes. Medical and social history was taken from the families of the deceased. The results of the analysis demonstrate that lung cancer development is related to smoking although differences were seen in the different types of cancer. The calculated risk of a smoker developing lung cancer-squamous cell and SCLC was respectively 15.4 and 13.5 while for adenocarcinoma it was much lower--3.1. Important differences were seen in ex-smokers developing squamous cell lung cancer and SCLC. The risk of developing squamous cell lung cancer and SCLC in this group was 89% and 88%, and adenocarcinoma only 64%. This suggests that adenocarcinoma is related more to environmental factors than the other two types of lung cancer.

The analytic epidemiologic study on occupational factors and stomach cancer occurrence.

A multicenter hospital based case-control study involving 562 incident male gastric cancer caused under the age of 75 years and an equal number of age matched controls has been carried out. The study aimed at examining occupational factors in the development of stomach cancer after accounting for confounding variables such as dietary habits and alcohol consumption. The interviews with case and control series covered detailed questions on frequency of consumption of various dietary items and socio-demographic characteristics. The results of the study showed that manual workers in industry and farmers run the higher risk of stomach cancer compared with non-exposed clerical workers. Some job categories like painters, tanners and millers displayed the highest relative risk (RR: 3.4) and this higher risk could not be explained by differences in dietary habits or alcohol consumption. The results of the study are discussed against background of possible occupational hazards present in particular environmental settings.

Lung cancer, smoking, and employment in foundries.

A case-referent study on lung cancer was conducted in Cracow, Poland. Men dying of lung cancer within a 6-year period (1980-1985) formed the case group. The reference series was selected from death registers and was frequency-matched with the cases by sex and age. Deaths due to other respiratory diseases were excluded. Information on the occupation, smoking habits, and residency of 901 cases and 875 referents was collected from their next-of-kin. The combined effect of smoking and industrial exposure, in particular employment in steel or iron foundries, was investigated by multivariate analyses and was very well fitted by a multiplicative model. Foundry employment, in particular in the younger age (less than 70 years) group, occupational exposure to known carcinogens in other industries for more than 20 years, and smoking were found to be risk factors.

[Clinical and control studies of cancer of the lungs. Smoking and employment in metallurgy]. / Badania kliniczno-kontrolne nad rakiem pluc. Palenie tytoniu i zatrudnienie w przemysle metalurgicznym.

Deaths due to the lung cancer has been investigated among the Cracow inhabitants in years 1980-1985. The control group consisted of men died to other causes than diseases and neoplasms of the respiratory tract. Data on smoking habits and habitation place of the investigated and the control group were received from family members of subjects studied. It has been stated that relative risk of death due to the lung cancer in subjects working in metallurgical industry increases parallely to the time of work and the class of workers employed more than 30 years and in these groups the relative risk of death to above cancer was equal to 2.66 (95% PU 1.37-5.42). The relative risk associated with occupational exposure has also been significant in subject working more than 20 years in other industry branches. The cigarette smoking has been determined as most significant etiologic factor of the lung cancer.