ABSTRACT
An unusually high incidence of acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) concentrated in a specific locality of a region in Germany motivated a descriptive incidence study in that region which showed a near 10-fold increased risk of CML among males but not among females (Kolb G, Becker N, Scheller S, Zugmaier G, Pralle H, Wahrendorf J, Havemann K. Increased risk of acute myelogenous leukemia (AML) and chronic myelogenous leukemia (CML) in a County of Hesse, Germany, Soc Prev Med 1993;38:190-195). Since a serious environmental contamination of areas in this locality with armament wastes containing toluene-derivatives has been known for a long time, the hypothesis arose that TNT production and the related severe contamination of soil and water might be responsible for the observed higher risk. We carried out a case-control study within the cluster to test this hypothesis. Overall, the results do not confirm the hypothesis. There is an indication of a relationship of an increased odds ratio with the exposure for a small group of persons who lived at a particular site in one of the two communities involved during the peak phase of TNT production during the 1940s. However, this finding is spurious and cannot explain the large majority of cases which occurred in that area in the 1980s. At the moment, no other explanation can be given for the increased risk of leukemias in that area.
Subject(s)
Chemical Warfare Agents/adverse effects , Environmental Exposure/adverse effects , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/epidemiology , Leukemia, Myeloid, Acute/epidemiology , Trinitrotoluene/adverse effects , Adult , Case-Control Studies , Cause of Death , Female , Germany/epidemiology , Humans , Incidence , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/etiology , Leukemia, Myeloid, Acute/etiology , Male , Odds Ratio , Risk Factors , Soil Pollutants/adverse effectsABSTRACT
The concept of body image is thought to consist of two components: body size perception and attitudes towards the body. Correspondingly, two distinct modalities of body image dysfunction seem to be relevant for anorexia nervosa: perceptual body size distortion and cognitive-evaluative dissatisfaction. Consequently, various techniques to assess body image have been developed to assess body image disturbance in eating disorders, particularly anorexia nervosa. This review article compares the numerous methods of assessing body image used in recent studies on anorexia nervosa and discusses the various findings. The findings suggest that body image disturbance is not due to any perceptual deficit, but is based on cognitive-evaluative dissatisfaction. Although overestimation of body size is not a universal symptom in eating disorders, this issue is interesting in terms of prognostic and therapeutic implications. Thus, body size estimation remains a worthwhile approach to assessing body image disturbance in eating disorders. The identification of sensory and non-sensory factors in body image is considered a promising issue for further research.
