Canadian male farm residents, pesticide safety handling practices, exposure to animals and non-Hodgkin's lymphoma (NHL).

BACKGROUND: A majority of published studies indicate that farmers have an elevated risk of developing non-Hodgkin's lymphoma (NHL) compared to other workers. METHODS: We evaluated accidental exposure to pesticides, the use of personal protective equipment, and exposure to animals among male farm residents in a Canadian population-based, multi-centre, NHL-control questionnaire study. RESULTS: In a multivariate model, the following variables had statistically significant adjusted odds ratios (OR) using 95% confidence intervals (95% CI) (a) higher risk: having more than 13 head of swine, raising bison, elk or ostriches, a personal history of cancer, > 4 and < or = 15 years of farm residence and occupational exposure to diesel fuel and exhaust; (b) lower risk: raising cattle and a personal history of measles. CONCLUSIONS: Future multidisciplinary studies of NHL should include a comprehensive review of exposure to animals in sufficient detail to assess etiological mechanisms to explain the putative associations between exposure to farm animals and NHL.

Non-Hodgkin's lymphoma and specific pesticide exposures in men: cross-Canada study of pesticides and health.

Our objective in the study was to investigate the putative associations of specific pesticides with non-Hodgkin's Lymphoma [NHL; International Classification of Diseases, version 9 (ICD-9) 200, 202]. We conducted a Canadian multicenter population-based incident, case (n = 517)-control (n = 1506) study among men in a diversity of occupations using an initial postal questionnaire followed by a telephone interview for those reporting pesticide exposure of 10 h/year or more, and a 15% random sample of the remainder. Adjusted odds ratios (ORs) were computed using conditional logistic regression stratified by the matching variables of age and province of residence, and subsequently adjusted for statistically significant medical variables (history of measles, mumps, cancer, allergy desensitization treatment, and a positive history of cancer in first-degree relatives). We found that among major chemical classes of herbicides, the risk of NHL was statistically significantly increased by exposure to phenoxyherbicides [OR, 1.38; 95% confidence interval (CI), 1.06-1.81] and to dicamba (OR, 1.88; 95% CI, 1.32-2.68). Exposure to carbamate (OR, 1.92; 95% CI, 1.22-3.04) and to organophosphorus insecticides (OR, 1.73; 95% CI, 1.27-2.36), amide fungicides, and the fumigant carbon tetrachloride (OR, 2.42; 95% CI, 1.19-5.14) statistically significantly increased risk. Among individual compounds, in multivariate analyses, the risk of NHL was statistically significantly increased by exposure to the herbicides 2,4-dichlorophenoxyacetic acid (2,4-D; OR, 1.32; 95% CI, 1.01-1.73), mecoprop (OR, 2.33; 95% CI, 1.58-3.44), and dicamba (OR, 1.68; 95% CI, 1.00-2.81); to the insecticides malathion (OR, 1.83; 95% CI, 1.31-2.55), 1,1,1-trichloro-2,2-bis (4-chlorophenyl) ethane (DDT), carbaryl (OR, 2.11; 95% CI, 1.21-3.69), aldrin, and lindane; and to the fungicides captan and sulfur compounds. In additional multivariate models, which included exposure to other major chemical classes or individual pesticides, personal antecedent cancer, a history of cancer among first-degree relatives, and exposure to mixtures containing dicamba (OR, 1.96; 95% CI, 1.40-2.75) or to mecoprop (OR, 2.22; 95% CI, 1.49-3.29) and to aldrin (OR, 3.42; 95% CI, 1.18-9.95) were significant independent predictors of an increased risk for NHL, whereas a personal history of measles and of allergy desensitization treatments lowered the risk. We concluded that NHL was associated with specific pesticides after adjustment for other independent predictors.

Socioeconomic status and lung cancer risk in Canada.

BACKGROUND: Several epidemiological studies have found that lung cancer is inversely related to socioeconomic status (SES) and suggest it as a possible risk factor for lung cancer. This study examines SES and lung cancer risk in Canada. METHODS: Mailed questionnaires with telephone follow-up were used to obtain data on 3280 newly diagnosed, histologically confirmed lung cancer cases and 5073 population controls, between 1994 and 1997, in eight Canadian provinces. Measurement included information on SES, smoking habits, alcohol use, diet, residential and occupational histories and both residential and occupational exposure to environmental tobacco smoke (ETS). Odds ratios (OR) and 95% CI were derived from unconditional logistic regression analysis. RESULTS: Compared with high income adequacy, an increased risk was found among low income males and females, with adjusted OR of 1.7 (95% CI : 1.3-2.2) and 1.5 (95% CI : 1.1-2.0), respectively. Compared with < or = 8 years of education, the adjusted OR were 0.6 (95% CI : 0.5-0.7) and 0.6 (95% CI : 0.5-0.8) for > or = 14 years education among males and females, respectively. Lung cancer risk was significantly increased for males of some social classes. The population attributable risk for income adequacy, education and social class was 24%, 25% and 21% among males, respectively, and 14% and 19% for income adequacy and education among females, respectively, in this Canadian population. CONCLUSIONS: A statistically significant association between income adequacy, education social class and lung cancer risk was found.

Is occupation a risk factor for thyroid cancer? Canadian Cancer Registries Epidemiology Research Group.

A Canadian case-control study explored the etiology of thyroid cancer, including occupational exposure. Analysis of job history from 1272 thyroid cancer patients and 2666 controls revealed statistically significant risks among the following occupations: Wood Processing, Pulp and Papermaking (odds ratio [OR] = 2.54, 95% confidence interval [CI] = 1.11-5.83); Sales and Service (OR = 1.26, 95% CI = 1.05-1.52); and Clerical (OR = 0.81, 95% CI = 0.67-0.97). ORs were adjusted for age, sex, province, cigarette smoking, education, self-reported exposure to radiation at work, and duration of employment. Exposure to ionizing radiation or electromagnetic fields at work (inferred from job histories) did not affect risk, nor did socioeconomic status, measured by education, income, or occupational prestige. Possible explanations for the results and further investigations are discussed.

Equine macrophage identification with an antibody (Ki-M6) to human CD68 and a new monoclonal antibody (JB10).

Monoclonal antibodies (mAbs) recognizing equine macrophages are scarce. The present study compared the immunocytochemical staining of various equine tissues (lymphoid tissue, lung, liver, small intestine, skin and blood leucocytes) by an antibody, Ki-M6, which detects CD68 in human macrophages and dendritic cells, and by a new anti-equine mAb, JB10, with staining produced by two previously described anti-equine macrophage mAbs, CZ2.2 and CZ3.3. Ki-M6 was shown to identify equine macrophages, which had a distribution different from those identified by CZ2.2 and CZ3.3. JB10 identified equine macrophages with a distribution similar to those identified by Ki-M6, but additionally bound to polymorphonuclear leucocytes. Flow cytometry of peripheral blood leucocyte subpopulations and tissue immunocytochemistry were used to compare staining by JB10 with that of CZ2.2 and CVS19; the latter identifies the myeloid antigen, EqCD13, found on polymorphonuclear leucocytes. The staining by JB10 differed from that of both CZ2.2 and CVS19, suggesting that JB10 detects a different molecule. These additional mAbs should prove useful for the future study of new, defined, populations of macrophages in equine immune responses and pathology, and, in the case of Ki-M6 antibody, may make possible an analysis of the structure, distribution and function of the CD68 molecule in the horse.

Power-frequency electric and magnetic fields and risk of childhood leukemia in Canada.

In a case-control study of childhood leukemia in relation to exposure to power-frequency electric and magnetic fields (EMF), 399 children resident in five Canadian provinces who were diagnosed at ages 0-14 years between 1990 and 1994 (June 1995 in British Columbia and Quebec) were enrolled, along with 399 controls. Exposure assessment included 48-hour personal EMF measurement, wire coding and magnetic field measurements for subjects' residences from conception to diagnosis/reference date, and a 24-hour magnetic field bedroom measurement. Personal magnetic fields were not related to risk of leukemia (adjusted odds ratio (OR) = 0.95, p for trend = 0.73) or acute lymphatic leukemia (OR = 0.93, p for trend = 0.64). There were no clear associations with predicted magnetic field exposure 2 years before the diagnosis/reference date or over the subject's lifetime or with personal electric field exposure. A statistically nonsignificant elevated risk of acute lymphatic leukemia was observed with very high wiring configurations among residences of subjects 2 years before the diagnosis/reference date (OR = 1.72 compared with underground wiring, 95% confidence interval 0.54-5.45). These results provide little support for a relation between power-frequency EMF exposure and risk of childhood leukemia.

Occupational exposure to chemical and biological agents in the nonproduction departments of pulp, paper, and paper product mills: an international study.

As part of an international epidemiological study of workers in the pulp and paper industry, previously unpublished exposure measurements were assembled in a database. This article describes 7293 measurements in nonproduction departments from 147 mills in 11 countries. The greatest variety of agents was measured in the maintenance, construction, and cleaning department, where high exposures to asbestos, chromium [VI] compounds, copper, mercury in urine, nitrogen dioxide, ozone, styrene, sulfur dioxide, trichloroethylene, and welding fumes were observed. Measurements in the storage, yard, loading, and shipping department indicated high exposures to asbestos, carbon monoxide, fungal spores, nitrogen oxides, sulfur dioxide, and total dust. The steam and power generation department had high exposures to methyl mercaptan, silica, and total dust. Measurements in process and effluent water treatment, laboratory and research, engineering, and office, administration, and cafeteria areas had few elevated exposures. Throughout the nonproduction departments, measurements of pulp-production chemicals such as chlorine and sulfur compounds tended to be low, with many below detection limits. There were some problems with the available data; in particular, detection limits were often not specified, and the data tended to be clustered in such a way that sources of exposure variability could not be distinguished. Despite these problems, the data provide new insight into the exposures of nonproduction pulp and paper industry personnel.

Sunlight exposure, hat use, and squamous cell skin cancer on the head and neck.

BACKGROUND: Sunlight is the environmental exposure most often associated with squamous cell cancer (SCC) of the skin. It can be difficult to quantify the sunlight exposure of the skin because of the different types of clothing that may be worn. The problem is simplified for studies of SCC on the skin of the head and neck, where a hat is the only type of clothing that needs to be considered. OBJECTIVE: The purpose of the study was to determine the risk for SCC of sunlight exposure on the skin of the head and neck, and the protective effect, if any, associated with wearing a hat. METHODS: A case-control study of squamous cell carcinoma of the skin was conducted amongst men in the province of Alberta, Canada. Analysis was restricted to only those cases where cancer occurred on the head or neck, and their age and sex matched controls. RESULTS: Ethnicity, non-sunexposed skin colour, and hair colour each significantly affected the SCC risk. An increased SCC risk was also associated with greater cumulative sunlight exposure and with sunburns experienced during the ages 5 to 15 years. The risk associated with sunlight exposure was significantly elevated in men who reported that they had always or usually worn a hat. CONCLUSION: As observed in previous studies, SCC on the skin of the head and neck is associated with host pigmentation, sunburns occurring in childhood, and sunlight exposure during adulthood. The risk observed for wearing a hat may be due to bias or confounding; however, hats remain an unproven means of protection against SCC on the skin of the head and neck.

Chemical exposures, medical history, and risk of squamous and basal cell carcinoma of the skin.

The role of non-sunlight-related risk factors for squamous cell carcinoma (SCC) and basal cell carcinoma (BCC) of the skin was investigated in a population-based, case-control study conducted among males in Alberta, Canada. In total, 180 SCC and 226 BCC cases and 406 randomly selected male controls, frequency matched by 5-year age groups to the cases, were interviewed by trained personnel using a standardized etiological questionnaire. Data were analyzed using conditional logistic regression techniques. After adjustment for age, skin and hair color, mother's ethnic origin, and sunlight exposure, elevated risks for SCC were seen in subjects exposed to insecticides [odds ratio (OR), highest tertile, 2.8; 95% confidence interval (CI), 1.4-5.6], herbicides (OR, highest tertile, 3.9; 95% CI, 2.2-6.9), and fungicides and seed treatments (OR, highest tertile, 2.4; 95% CI, 1.4-4.0), as well petroleum products, grease, and several other exposures. Elevated risks of BCC were seen in subjects exposed to fiberglass dust (OR, 2.0; 95% CI, 1.0-3.9) and dry cleaning agents (OR, 4.6 95% CI, 1.1-19.7). Prior nondiagnostic X-ray treatment for skin conditions increased risk of both cancers. Although solar UV radiation is known to be the major environmental exposure causing nonmelanocytic skin cancer, results of this study suggest that nonsolar factors may also be important.

Non-solar ultraviolet radiation and the risk of basal and squamous cell skin cancer.

A case-control study of non-melanocytic skin cancer was conducted among men in the province of Alberta, Canada. Two hundred and twenty-six cases of basal cell carcinoma (BCC), 180 cases of squamous cell carcinoma (SCC) and 406 age-matched controls provided information concerning skin pigmentation, occupational history, recreational activity, exposure to sunlight and sources of non-solar ultraviolet radiation (NSUVR) and other potential risk factors. Our analyses show no evidence of elevated risk for BCC or SCC among subjects exposed to various types of NSUVR. This is in opposition to studies of melanoma that have shown elevated risks for exposure to fluorescent lighting, sunlamps and sunbeds.

Sunlight exposure, pigmentary factors, and risk of nonmelanocytic skin cancer. I. Basal cell carcinoma.

BACKGROUND AND DESIGN: Basal cell carcinoma (BCC) of the skin is the most common neoplasm in white populations, and solar radiation is generally accepted to be the dominant environmental risk factor for this disease. However, little information is available on the nature of the relationship between BCC and sunlight. The purpose of this study was to evaluate the nature of the relationship between sunlight exposure, pigmentary factors, and BCC of the skin. A population-based case-control study of 226 male patients with BCC diagnosed from January 1, 1983, through December 31, 1984, and 406 randomly selected male control subjects was conducted in Alberta, Canada. The study was conducted using a standardized questionnaire, administered in person by trained interviewers. Data were analyzed using conditional logistic regression methods. RESULTS: After controlling for other host and pigmentary factors, the risk of BCC was increased in subjects with light skin color and those who freckled in childhood. A history of severe sunburn in childhood also increased risk. Subjects of southern European ethnic origin were at significantly lower risk of BCC. Surprisingly, no association was seen between mean annual cumulative summer sunlight exposure and risk of BCC. A significantly increased risk of BCC was seen in subjects with increased recreational sunlight exposure in adolescence and childhood (age, 0 to 19 years), although an inverse relationship was seen with lifetime recreation exposure. The relationship with childhood sun exposure was most pronounced among sun-sensitive subjects whose skin tended to burn rather than tan in the sun. CONCLUSIONS: The lack of association between cumulative sun exposure and BCC contradicts conventional wisdom about the cause of this tumor, and the increased risk with sun exposure at age 0 to 19 years suggests that childhood and adolescence may be critical periods for establishing adult risk for BCC.

Sunlight exposure, pigmentation factors, and risk of nonmelanocytic skin cancer. II. Squamous cell carcinoma.

INTRODUCTION AND DESIGN: Squamous cell carcinoma of the skin (SCC), a common cancer in white populations, is related to sunshine exposure; however, relatively little information is available on how timing and character of exposure affect the relationship. The purpose of this study was to investigate the nature of the relationship of SCC to individual solar UV exposure after control for phenotype and pigmentary factors. All newly diagnosed cases of SCC were in men aged 25 through 79 years, ascertained in the province of Alberta from January 1, 1983, through December 31, 1984, who were approached for participation; 80% completed a standardized etiologic interview that was conducted in their homes by a trained interviewer. Control subjects were chosen at random from the Alberta Health Care Insurance Plan subscribers list, matched only by sex (male) and age (within a 5-year age group). The response rate among controls was 71%. RESULTS: Subjects with pale skin and red hair had an elevated risk of SCC. Subjects whose mother was of southern European ancestry had a reduced risk of SCC. After accounting for pigmentary factors, no association was seen between risk of SCC and cumulative lifetime sun exposure. However, a strong trend toward increasing risk was seen with increasing chronic occupational sun exposure in the 10 years prior to diagnosis. CONCLUSION: The results suggest that recent sun exposure (in the 10 years prior to diagnosis) may be important in accounting for individual risk of SCC.

Community health promotion programs.

The theory behind several community-based health promotion/disease prevention programs was reviewed, together with the way theory was put into practice and the outcomes of various interventions. Much has been published on theoretical bases and mechanics of these programs, but evidence linking theory, practice and outcome is limited. Conceptual overlap between theories and models make it difficult to test them with scientific rigour. More basic research is needed to evaluate the relations between the process of change, the target of change and both short- and long-term outcomes.

Patterns and risks of cancer in farmers in Alberta.

Data on occupations and life styles of patients with cancer have been collected since 1983. To investigate cancer patterns and risks in farmers in Alberta, all farmers were abstracted and compared with nonfarmers in the data base, using case-control analysis. Controls were patients with cancer at any site except the index site. Significantly elevated odds ratio (OR), adjusted for age and smoking, were found among the farmers for cancers of the lip (OR = 3.22, 95% confidence interval [CI] = 2.14 to 4.84) and prostate (OR = 1.31, 95% CI = 1.11 to 1.55). Crude risk for lung cancer was significantly lower in farmers, but statistical significance disappeared when risk was adjusted for smoking (OR = 0.81, 95% CI = 0.65 to 1.02). Farmers were at considerably lower risk of malignant melanoma of the skin, compared with nonfarmers (OR = 0.57, 95% CI = 0.36 to 0.91).

Epidemiology of prostatic cancer: a case-control study.

A population-based case-control study of prostatic cancer in Alberta was undertaken to determine the risk factors associated with the disease. Cases were 382 newly diagnosed prostatic cancer patients and 625 controls, group-matched to the anticipated age distribution of the cases, chosen at random from the health insurance roster. Subjects were interviewed in their homes by using a pre-tested questionnaire including questions related to ethnic group, education, puberty, marital history, family history, residence, water supply, smoking, and diet. Factors significantly related to the risk of developing prostatic cancer included ethnic group (British high, Ukrainian low), education (elementary high, university low), age at first marriage (early high, late low), family history (high risk for those with relatives with prostatic cancer), and increased masculinity among the children of cases. The results with respect to smoking, occupation, medical history, birthplace, residence, water supply, and diet were generally negative.

Socioeconomic status, sunlight exposure, and risk of malignant melanoma: the Western Canada Melanoma Study.

In a study of 261 male melanoma patients and age-and sex-matched controls, a strong positive univariate association between socioeconomic status, as determined by usual occupation, and risk of melanoma was detected. This association, however, was substantially explained by host constitutional factors and occupational, recreational, and vacation sunlight exposure. The study demonstrated an increased risk of melanoma in draftsmen and surveyors and a reduced risk of melanoma in construction workers and individuals employed in the finance, insurance, and real estate industry even after control for the effect of host factors and sunlight exposure.

Sex ratio of offspring of patients with prostatic cancer.

We have examined the fertility of 354 patients with prostatic cancer and 597 controls who had married at least once and formed part of a population-based case-control study in Alberta. Considering offspring of both sexes, the mean fertility of the patients was 3.17, not significantly different from the mean of 3.11 for the controls. However, the sex ratios were significantly different, 56.5% of the patients' offspring being sons, compared with 50.1% of the controls' offspring. The difference in sex ratio persisted after adjustment for ethnic group, level of education and age at first marriage, which were found to be risk factors for prostatic cancer.