Wireless phone use in childhood and adolescence and neuroepithelial brain tumours: Results from the international MOBI-Kids study.

In recent decades, the possibility that use of mobile communicating devices, particularly wireless (mobile and cordless) phones, may increase brain tumour risk, has been a concern, particularly given the considerable increase in their use by young people. MOBI-Kids, a 14-country (Australia, Austria, Canada, France, Germany, Greece, India, Israel, Italy, Japan, Korea, the Netherlands, New Zealand, Spain) case-control study, was conducted to evaluate whether wireless phone use (and particularly resulting exposure to radiofrequency (RF) and extremely low frequency (ELF) electromagnetic fields (EMF)) increases risk of brain tumours in young people. Between 2010 and 2015, the study recruited 899 people with brain tumours aged 10 to 24 years old and 1,910 controls (operated for appendicitis) matched to the cases on date of diagnosis, study region and age. Participation rates were 72% for cases and 54% for controls. The mean ages of cases and controls were 16.5 and 16.6 years, respectively; 57% were males. The vast majority of study participants were wireless phones users, even in the youngest age group, and the study included substantial numbers of long-term (over 10 years) users: 22% overall, 51% in the 20-24-year-olds. Most tumours were of the neuroepithelial type (NBT; n = 671), mainly glioma. The odds ratios (OR) of NBT appeared to decrease with increasing time since start of use of wireless phones, cumulative number of calls and cumulative call time, particularly in the 15-19 years old age group. A decreasing trend in ORs was also observed with increasing estimated cumulative RF specific energy and ELF induced current density at the location of the tumour. Further analyses suggest that the large number of ORs below 1 in this study is unlikely to represent an unknown causal preventive effect of mobile phone exposure: they can be at least partially explained by differential recall by proxies and prodromal symptoms affecting phone use before diagnosis of the cases. We cannot rule out, however, residual confounding from sources we did not measure. Overall, our study provides no evidence of a causal association between wireless phone use and brain tumours in young people. However, the sources of bias summarised above prevent us from ruling out a small increased risk.

The challenges posed by climate change to successful ageing.

Ever since the 2003 heat wave that caused 70,000 heat deaths, the dramatic consequences of climate change and rising temperatures in Europe have become an intensively researched topic. During heat waves, the older urban adult population is at highest risk. The STOPHOT project is the first investigation in Austria to establish a comprehensive knowledge base on heat perception, awareness of heat risks and adaptive/coping behaviours among older adults. The main research questions include: (1) Does climate change endanger the chances of successful ageing in urban areas? (2) How do age, social inequalities and the living environment intersect with environmental stressors in affecting successful ageing? (3) Which heat adaption strategies do older adults deploy and to what extent can they mediate heat stress in an effort to increase chances of successful ageing under the conditions of climate change? The results indicate that climate change and rising temperatures are in fact one important determinant of whether and how an older person can maintain well-being in later life. Older adults (> 65 years) with a low socio-economic status and poor health conditions, who tend to be socially isolated, are most at risk. However, no 'heat island effect' of the residential environment could be found. How much a person suffers from heat stress is highly dependent on the adaption strategies deployed. Adaption strategies of older urban residents mostly centred on body-related measures, such as drinking more or wearing lighter clothes, and indoor-centred measures, particularly avoiding the outdoors.

Urinary levoglucosan levels in Austrian communities differing in agrarian quota.

Levoglucosan is a sugar anhydride produced by combustion of carbohydrates. In ambient monitoring it serves as an indicator for wood smoke. Its use in human biomonitoring, however, is not yet widespread. This study investigated whether levoglucosan in urine is a suitable biomarker for regional differences in wood smoke exposure in the winter season. Within the first Austrian biomonitoring survey, pooled urine samples from mothers as well as children of five communities of different size (two-stage random stratified sampling) were analysed by HPLC. As an indicator of exposure to polycyclic aromatic hydrocarbons (PAH) that are also prevalent in wood smoke, 1-hydroxypyrene was determined. In each town levoglucosan was found in higher levels in the pooled children's samples than in the pooled mothers' samples. It correlated well with the agrarian quota. 1-Hydroxypyrene concentrations were higher in areas with higher population density. Correlation of urinary levoglucosan concentrations with the agrarian quota may be explained by higher wood smoke exposure in communities with higher agrarian quota. To our knowledge this study is the first investigation on this issue in Europe. It indicates that human biomonitoring of levoglucosan may be suitable to detect differences in regional exposure to wood smoke.

[Lung function of dust-exposed workers]. / Lungenfunktion staubexponierter Arbeitnehmer.

Workers exposed to dust have to undergo medical check-ups every 2 years including lung function testing. Here we report on the routine lung function data (FVC, FEV1, MEF50) of 994 workers from Austria. Lung function data were compared to the Austrian standard values that are based on routine testing of healthy volunteers. For all parameters the workers' values were significantly poorer than the Austrian standards (FVC: -0.4 l; FEV1: -0.5 l; MEF50: -0.9 l/s). The difference from the standard increased with increasing duration of the dust exposure. This increase was significant for the total group for MEF50 even after controlling for smoking. About half of the workers were exposed to quartz dust and had poorer lung function values (p = 0.02 for MEF50) than the other workers. Smoking significantly reduced all 3 lung function parameters with a significant interaction between strong smoking (compared to non-smokers) and quartz exposure (compared to all other exposures). Current Austrian limit values are not protective against chronic damage of the respiratory system. The combined impact of cigarette smoke and high concentration of mineral dust (quartz) is especially dangerous.

Higher blood concentrations of synthetic musks in women above fifty years than in younger women.

Synthetic musk compounds are widely used as fragrance ingredients in many consumer products. Little is known about their accumulation in humans and especially in older persons. In this study, we determined concentrations of 11 synthetic musks in women above fifty years and compared the results with earlier results from samples of young females. Blood was taken from 53 women above 50 years of age, visiting outpatients of the Department of Angiology at the Hanusch-Krankenhaus in Vienna, Austria. The used analytical methods consist of an extraction and clean-up step and a chromatographic analysis by GC/MS. Tonalide-D3 was used as recovery standard in all samples. Hexachlorobenzene (13)C(6) was used as internal standard. Study participants also completed a questionnaire on the use of cosmetics, about nutrition and other life-style aspects. The two substances which could be detected in higher percentages of the blood plasma samples were galaxolide (89 percent, maximum concentration 6900 ng/L) and musk xylene (62 percent, maximum concentration 190 ng/L). Regression analysis revealed a significant association of galaxolide concentration with frequent use of perfumes, deodorants and shampoos. Frequent use of soaps and fabric softener was associated with higher plasma concentrations of musk xylene. Nutrition habits, skin type, body mass index or surface area were not related to plasma concentration of these musk compounds. From the study group investigated older persons showed higher plasma concentrations. These findings could be due to the higher use of lotions and crèmes on face and hands and a more frequent use of skin care products because older persons reported more frequently dry skin. In addition, physiological aging related changes might be responsible for higher dermal absorption of synthetic musks. These results indicate that more focus on aging tissues is needed.

Synthetic musks in blood of healthy young adults: relationship to cosmetics use.

Production of polycyclic musk compounds is increasing accompanied by a decline in nitro musk production. Although it can be assumed that due to this reduction nitro musks are less prevalent in human body fluids, there are no data available from the last decade. This study examined the concentrations of five nitro musks and six polycyclic musks in blood samples from young healthy volunteers. Blood was taken from 100 healthy students of the Medical University of Vienna. The lipophilic fraction was extracted and after purification analyzed by GC-MS. Study participants also completed a questionnaire on the use of cosmetics, about nutrition and other life-style aspects. Highest percentages of synthetic musks in blood plasma samples were found for galaxolide (91%, median 420 ng L(-1)) and musk xylene (79%, median 11 ng L(-1)). Both musk ketone and tonalide were found in 17%. In two cases musk ambrette was detected. In a multivariate approach only younger age, use of lotion and perfumes did significantly predict blood concentrations of polycyclic musks. For nitro musks except body surface area no significant predictor could be found. High percentage of the population is still exposed to nitro musk compounds although blood concentrations of nitro musks are generally lower than those of polycyclic musks. Compared to earlier investigations performed in the 1990s nitro musks were detected in lower percentages and concentrations. There seems to be no dominant source of nitro musk uptake although relationship to body surface area indicates cosmetic products applied to the skin as the likely origin of plasma concentrations.

Persistent sciatic artery: an uncommon cause of intermittent claudication.

Persistent sciatic artery (PSA) is a rarely seen variation of the lower limb vessels. Anatomically the PSA is the continuation of internal iliac arteries. It follows the sciatic nerve from the sciatic foramen to the level of the knee. We report our experience with conservative therapy in a patient with complete occlusion of a PSA. A 54-year-old man with typical symptoms of intermittent claudication on the left limb was referred to our Department. After clinical examination Doppler and duplex sonography were performed. Angiography showed bilateral PSA. On the left side the PSA was occluded. The patient received 20 intravenous courses of prostaglandin E1 for 4 weeks, followed by oral anticoagulation with phenprocoumon for life (INR: 2.5-3.5). After 3 years therapy he does not show any typical symptoms of intermittent claudication or limb ischemia. This case shows that conservative therapy may be effective. However, it has to be emphasised that this approach requires frequent clinical and duplex sonography follow-up every 3 to 6 months with oral anticoagulation.

Subjective symptoms, sleeping problems, and cognitive performance in subjects living near mobile phone base stations.

BACKGROUND: The erection of mobile telephone base stations in inhabited areas has raised concerns about possible health effects caused by emitted microwaves. METHODS: In a cross-sectional study of randomly selected inhabitants living in urban and rural areas for more than one year near to 10 selected base stations, 365 subjects were investigated. Several cognitive tests were performed, and wellbeing and sleep quality were assessed. Field strength of high-frequency electromagnetic fields (HF-EMF) was measured in the bedrooms of 336 households. RESULTS: Total HF-EMF and exposure related to mobile telecommunication were far below recommended levels (max. 4.1 mW/m2). Distance from antennae was 24-600 m in the rural area and 20-250 m in the urban area. Average power density was slightly higher in the rural area (0.05 mW/m2) than in the urban area (0.02 mW/m2). Despite the influence of confounding variables, including fear of adverse effects from exposure to HF-EMF from the base station, there was a significant relation of some symptoms to measured power density; this was highest for headaches. Perceptual speed increased, while accuracy decreased insignificantly with increasing exposure levels. There was no significant effect on sleep quality. CONCLUSION: Despite very low exposure to HF-EMF, effects on wellbeing and performance cannot be ruled out, as shown by recently obtained experimental results; however, mechanisms of action at these low levels are unknown.

Low levels of air pollution induce changes of lung function in a panel of schoolchildren.

In search of sensitive screening parameters for assessing acute effects of ambient air pollutants in young schoolchildren, the impact of 8-h average air pollution before lung function testing was investigated by oscillatory measurements of resistance and spirometry with flow-volume loops. At a central elementary school in Linz, the capital of Upper Austria, 163 children aged 7-10 yrs underwent repeated examinations at the same time of day during 1 school year, yielding a total of 11-12 lung function tests per child. Associations to mass concentrations of particulate matter and nitrogen dioxide (NO(2)) measured continuously at a nearby monitoring station were tested, applying the Generalised Estimating Equations model. Reductions per 10 microg.m(-3) (both for particles and for NO(2)) were in the magnitude of 1% for most lung function parameters. The most sensitive indicator for acute effects of combustion-related pollutants was a change in maximal expiratory flow in small airways. NO(2) at concentrations below current standards reduced (in the multipollutant model) the forced expiratory volume in one second by 1.01%, maximal instantaneous forced flow when 50% of the forced vital capacity remains to be exhaled (MEF(50%)) by 1.99% and MEF(25%) by 1.96%. Peripheral resistance increased by 1.03% per 10 microg.m(-3) of particulate matter with a 50% cut-off aerodynamic diameter of 2.5 mum (PM(2.5)). Resistance is less influenced by the child's cooperation and should be utilised more often in environmental epidemiology when screening for early signs of small airway dysfunction from urban air pollution, but cannot replace the measurement of MEF(50%) and MEF(25%). In the basic model, the reduction of these parameters per 10 microg.m(-3) was highest for NO(2), followed by PM(1), PM(2.5) and PM(10), while exposure to coarse dust (PM(10)-PM(2.5)) did not change end-expiratory flow significantly. All acute effects of urban air pollution found on the lung function of healthy pupils were evident at levels below current European limit values for nitrogen dioxide. Thus, planned reduction of nitrogen dioxide emission (Euro 5; vehicles that comply with the emission limits as defined in Directive 99/96/EC) of 20% in 2010 would seem to be insufficient.

Blood concentrations of polycyclic musks in healthy young adults.

Knowledge on the concentration of polycyclic musk fragrance compounds in human blood is sparse. This study examined the concentrations of six polycyclic musks in blood samples from healthy volunteers. Blood was taken from hundred healthy students of the Medical University of Vienna. The lipophilic fraction was extracted and after purification analyzed by GC-MS. Study participants also completed a questionnaire on the use of cosmetics, about nutrition and other life-style aspects. Two compounds -- galaxolide and tonalide -- were identified in higher percentages of the blood plasma samples. Maximum plasma levels over 100 ng/l were also only found for galaxolide (4100 ng/l) and tonalide (800 ng/l). Women showed significantly higher levels than men. In a statistical multivariate approach only use of body lotion and age were predictive of positive galaxolide concentrations. For tonalide no significant predictor could be found. The findings mirror the replacement of nitro musk fragrances by polycyclic musks, mainly galaxolide. The high concentrations of galaxolide in human blood raise concern since few toxicological data are available.

Moulds in housing: visual inspection and spore counts comparison--implications for future strategies in the public health setting.

OBJECTIVES: Among the problems of health related to living conditions presented to a public consulting centre for environmental medicine in Vienna, the main point at issue was damp housing and mould growth. On answering this demand indoor exposure to fungal spores was identified by visual semi-quantitative assessment of fungal growth on the one hand and quantitative measurement of viable spores on the other hand. The validity and practicability of this approach was investigated. METHOD: We applied these two simple methods in a standardised form and compared the results in a field study, which has been conducted between 1995 and 1999. In 197 rooms in Viennese flats (183 of which were claimed to be "mouldy") fungal spore concentrations were measured by RCS-impactor and Rose-Bengal-agar. Outdoor measurements were taken simultaneously outside the buildings and were used for reference. RESULTS: Independent classification of visible growth of mould in flats correlated significantly (r = 0.635; p < 0.0001) with the ratio of indoor/ outdoor concentration of fungal spores. CONCLUSIONS: It is usually possible to classify the severity of the problem just by local inspection. Visible plaques should always be an indication for sanitary measures. However, spore counting is indicated for quantifying health relevant exposures, for scientific comparisons and in documentation and follow up such as for litigation purposes. Quantitative data bear more credibility and so help to prove the need of sanitation.

[Toxicologically determined indoor air guidelines values]. / Zur toxikologischen Ableitung von Richtwerten für Luftschadstoffe in Innenräumen.

At the Austrian Ministry for Environment (now: Federal Ministry for agriculture and forestry, environment and water management) a working group was established to propose indoor air guideline values. This consists of representatives of different disciplines, such as physicians, toxicologists, engineers and lawyers. Already in the constituent meeting it was decided to employ a set pattern for establishing toxicologically sound guideline values. It was then agreed to use the pattern proposed by the German ad-hoc-working team. The interdisciplinary discussions, however, demonstrated the need for additional clarification, since representatives of different disciplines obviously interpret the various terms and principles differently. In particular, there is a need for discussing in detail the relation between the guideline values for indoor air to other air quality standards (outdoor air and workplace) and to specify their scope and application, especially the need to describe in greater detail what should be done in case either guideline value I or II was exceeded.

[Determinants of patient satisfaction with services of the Vienna environmental medicine counseling center]. / Determinanten der Zufriedenheit von Patienten mit der Betreuung durch die Umweltmedizinische Beratungsstelle der Stadt Wien.

Client satisfaction is a relevant aspect for assessing the efficiency of a Medical Advisory Board. The study presented here aimed at determining the factors that guarantee satisfaction. These findings are essential for the further development of the service of the Advisory Board of the City of Vienna for Environmental Medicine ("UMB"). To this end a brief anonymous questionnaire was sent to 245 clients. This comprised elements evaluating the degree of satisfaction with the consultant service of the Advisory Board, fulfillment rate of expectations, solutions offered for various problems, and whether--if necessary--the "UMB" Advisory Board would be consulted again. A satisfactory response rate of 43% was obtained. The results show a high degree of satisfaction among the clients with the consultations (= 78%) despite unresolved or only partly resolved problems (71%) and questions that remained open for discussion (38%). Approximately 90% of the clients would again consult "UMB" for advice. The reasons for consultation did not show any significant influence on the client satisfaction. However, satisfaction of clients depended on whether or not a solution was found in respect of their problem and on the action taken by "UMB" to solve it. Summarising the findings, the analyses show that apart from on-the-spot assessment and detailed inspection, comprehensive case histories and interviews are an important basis for further clarification of problems caused by environmental factors.