Spatial variations in ambient ultrafine particle concentrations and the risk of incident prostate cancer: A case-control study

Ambient air pollution and urological cancer risk: A systematic review and meta-analysis of epidemiological evidence

Exposure to ambient air pollution has significant adverse health effects; however, whether air pollution is associated with urological cancer is largely unknown. We conduct a systematic review and meta-analysis with epidemiological studies, showing that a 5 μg/m3 increase in PM2.5 exposure is associated with a 6%, 7%, and 9%, increased risk of overall urological, bladder, and kidney cancer, respectively; and a 10 μg/m3 increase in NO2 is linked to a 3%, 4%, and 4% higher risk of overall urological, bladder, and prostate cancer, respectively. Were these associations to reflect causal relationships, lowering PM2.5 levels to 5.8 μg/m3 could reduce the age-standardized rate of urological cancer by 1.5 ~ 27/100,000 across the 15 countries with the highest PM2.5 level from the top 30 countries with the highest urological cancer burden. Implementing global health policies that can improve air quality could potentially reduce the risk of urologic cancer and alleviate its burden.

Diesel Exhaust Exposure and Cause-Specific Mortality in the Diesel Exhaust in Miners Study II (DEMS II) Cohort

BACKGROUND

With the exception of lung cancer, the health effects associated with diesel exhaust for other cancers and nonmalignant health outcomes are not well understood.

OBJECTIVES

We extended the mortality follow-up of the Diesel Exhaust in Miners Study, a cohort study of 12,315 workers, by 18 y (ending 31 December 2015), more than doubling the number of observed deaths to n = 4,887 , to evaluate associations between mortality and diesel exhaust exposure.

METHODS

Quantitative estimates of historical exposure to respirable elemental carbon (REC), a surrogate for diesel exhaust, were created for all jobs, by year and facility, using measurements collected from each mine, as well as historical measurements. Standardized mortality ratios (SMRs) and hazard ratios (HRs) were estimated for the entire cohort and by worker location (surface, underground).

RESULTS

We observed an excess of death for cancers of the lung, trachea, and bronchus (n = 409 ; SMR = 1.24 ; 95% CI: 1.13, 1.37). Among workers who ever worked underground, where the majority of diesel exposure occurred, excess deaths were evident for lung, trachea, and bronchus cancers (n = 266 ; SMR = 1.26 ; 95% CI: 1.11, 1.42). Several nonmalignant diseases were associated with excess mortality among workers ever-employed underground, including ischemic heart disease (SMR = 1.08 ; 95% CI: 1.00, 1.16), cerebrovascular disease (SMR = 1.22 ; 95% CI: 1.04, 1.43), and nonmalignant diseases of the respiratory system (SMR = 1.13 ; 95% CI: 1.01, 1.26). Continuous 15-y lagged cumulative REC exposure < 1,280   μ g / m 3 -y was associated with increased lung cancer risk (HR = 1.93 ; 95% CI: 1.24, 3.03), but the risk declined at the highest exposures (HR = 1.29 ; 95% CI: 0.74, 2.26). We also observed a significant trend in non-Hodgkin lymphoma (NHL) risk with increasing 20-y lagged cumulative REC (HR Tertile 3  vs. Tertile 1 = 3.12 ; 95% CI: 1.00, 9.79; p -trend = 0.031 ).

DISCUSSION

Increased risks of lung cancer mortality observed in the original study were sustained. Observed associations between diesel exposure and risk of death from NHL and the excesses in deaths for diseases of the respiratory and cardiovascular system, including ischemic heart disease and cerebrovascular disease, warrant further study and provide evidence of the potential widespread public health impact of diesel exposure. https://doi.org/10.1289/EHP12840.

Incidence of cancer among Nordic police officers

Police work may expose officers to various circumstances that have potential for increasing their risk of cancer, including traffic-related air pollution, night shift work and radiation from radars. In this study, we examined the incidence of cancer among Nordic male and female police officers. We utilize data from the Nordic Occupational Cancer (NOCCA) project, which linked census data on occupations from Finland, Iceland, Norway and Sweden to national cancer registries for the period 1961 to 2005. We report standardized incidence ratios (SIR) and 95% confidence intervals (CI) of selected cancers for each country by sex, age and calendar period. The cohort included 38 523 male and 1998 female police officers. As compared with the general population, male police officers had a 7% (95% CI: 4-9%) excess cancer risk, with elevated SIRs for various cancer sites, including prostate (SIR 1.19, 1.14-1.25), breast (SIR 1.77, 1.05-2.80), colon (SIR 1.22, 1.12-1.32) and skin melanoma (SIR 1.44, 1.28-1.60). Conversely, male police officers had a lower risk of lung cancer than the general population (SIR 0.72, 0.66-0.77). In female police officers, the SIR for cancer overall was 1.15 (0.98-1.34), and there was a slight excess of cancers of the breast (SIR 1.25, 0.97-1.59) and colon (SIR 1.21, 0.55-2.30). In conclusion, cancer incidence among the police officers was slightly higher than in the general population. Notably, SIRs were elevated for cancer sites potentially related to night shift work, namely colon, breast and prostate cancer.

Mortality risk and long-term exposure to ultrafine particles and primary fine particle components in a national U.S. Cohort

The objective of this study was to estimate all-cause, cardiopulmonary, and cancer mortality associations for long-term exposure to ultrafine particles (UFP) and primary PM_2.5 components. We utilized high-resolution, national-scale exposure estimates for UFP (measured as particle number concentration; PNC) and three primary PM_2.5 components, namely black carbon (BC), traffic-emitted organic PM_2.5 (hereafter, hydrocarbon-like organic aerosols; HOA), and cooking-emitted organic PM_2.5 (cooking organic aerosols; COA). Two analytic cohorts were constructed from a nationally representative U.S. health survey. The larger cohort consisted of 617,997 adults with information on a broad set of individual-level risk factors; the smaller cohort was further restricted to those with information on physical activity (n = 396,470). In single-pollutant models, PNC was significantly associated with all-cause (larger cohort HR = 1.03, 95% CI [1.02, 1.04]; smaller cohort HR = 1.02, 95% CI [1.00, 1.04]) and cancer mortality (larger cohort HR = 1.05, 95% CI [1.02, 1.08]; smaller cohort HR = 1.06, 95% CI [1.02, 1.10]). In two-pollutant models, mortality associations varied based on co-pollutant adjustment; PNC mortality associations were generally robust to controlling for PM_10-2.5 and SO₂, but not PM_2.5. In contrast, we found some evidence that the HOA and COA mortality associations are independent of total PM_2.5 mass exposure. Nevertheless, PM_2.5 mass was the most robust predictor of air pollution related mortality, providing some support for current regulatory policies.

Ambient air pollution and prostate cancer risk in a population-based Canadian case-control study

Ambient air pollution is a human carcinogen and a possible risk factor for prostate cancer.

Within-city Spatial Variations in Ambient Ultrafine Particle Concentrations and Incident Brain Tumors in Adults

BACKGROUND

Ambient ultrafine particles (UFPs, <0.1 µm) can reach the human brain, but to our knowledge, epidemiologic studies have yet to evaluate the relation between UFPs and incident brain tumors.

METHODS

We conducted a cohort study of within-city spatial variations in ambient UFPs across Montreal and Toronto, Canada, among 1.9 million adults included in multiple cycles of the Canadian Census Health and Environment Cohorts (1991, 1996, 2001, and 2006). UFP exposures (3-year moving averages) were assigned to residential locations using land-use regression models with exposures updated to account for residential mobility within and between cities. We followed cohort members for malignant brain tumors (ICD-10 codes C71.0-C71.9) between 2001 and 2016; Cox proportional hazards models (stratified by age, sex, immigration status, and census cycle) were used to estimate hazard ratios (HRs) adjusting for fine particle mass concentrations (PM2.5), nitrogen dioxide (NO2), and various sociodemographic factors.

RESULTS

In total, we identified 1,400 incident brain tumors during the follow-up period. Each 10,000/cm increase in UFPs was positively associated with brain tumor incidence (HR = 1.112, 95% CI = 1.042, 1.188) after adjusting for PM2.5, NO2, and sociodemographic factors. Applying an indirect adjustment for cigarette smoking and body mass index strengthened this relation (HR = 1.133, 95% CI = 1.032, 1.245). PM2.5 and NO2 were not associated with an increased incidence of brain tumors.

CONCLUSIONS

Ambient UFPs may represent a previously unrecognized risk factor for incident brain tumors in adults. Future studies should aim to replicate these results given the high prevalence of UFP exposures in urban areas.

Distinct Ultrafine Particle Profiles Associated with Aircraft and Roadway Traffic

The Mobile ObserVations of Ultrafine Particles study was a two-year project to analyze potential air quality impacts of ultrafine particles (UFPs) from aircraft traffic for communities near an international airport. The study assessed UFP concentrations within 10 miles of the airport in the directions of aircraft flight. Over the course of four seasons, this study conducted a mobile sampling scheme to collect time-resolved measures of UFP, CO₂, and black carbon (BC) concentrations, as well as UFP size distributions. Primary findings were that UFPs were associated with both roadway traffic and aircraft sources, with the highest UFP counts found on the major roadway (I-5). Total concentrations of UFPs alone (10-1000 nm) did not distinguish roadway and aircraft features. However, key differences existed in the particle size distribution and the black carbon concentration for roadway and aircraft features. These differences can help distinguish between the spatial impact of roadway traffic and aircraft UFP emissions using a combination of mobile monitoring and standard statistical methods.

Associations between socioeconomic status and ultrafine particulate exposure in the school commute: An environmental inequality study for Toronto, Canada

Ultrafine particulate matter (UFP) air pollution is unevenly distributed across urban environments. Disparities in routine activity patterns, such as the exposure risk we face at work or on the commute, can contribute to chronic exposure-related health outcomes that place excess burdening on vulnerable population groups. In Canada, there is disagreement in the literature on the nature of these exposure-related inequalities, and our understanding of disparities associated with specific activity patterns such as commuting is limited. In the context of UFP specific exposure, these relationships are almost entirely unexplored in the environmental inequality literature. Our study presents an exploratory analysis of UFP exposure patterns in Toronto, Canada. We examined UFP dosage disparities experienced by children during routine school commutes. We estimated single trip dosages that accounted for variation in ambient UFP concentration, route morphology (distance, slope) and their effect on inhalation rate and trip duration. We aggregated these values at the dissemination-area level and collected socioeconomic status descriptors from the 2016 census. Our OLS model showed significant spatial autocorrelation (MI = 0.59, p < 0.001), and we instead applied a spatial error model to account for spatial effects in our dataset. We identified significant associations related to median income (β = -0.087, p < 0.05), government transfer dependence (β = -0.107, p < 0.005), immigration status (β = 0.119, p < 0.001), and education rates (β = -0.059, p < 0.05). Our results diverged from other pollutants in Toronto-based literature and could indicate that UFPs exhibit unique patterns of inequality. Our findings suggest a need to further study UFP dosage from an environmental inequality perspective.

Occupational exposure to unintentionally emitted nanoscale particles and risk of cancer: From lung to central nervous system - Results from three French case-control studies

OBJECTIVES

Nanoscale particles (1-100 nm) can be of natural origin, and either intentionally or unintentionally produced by human activities. Toxicological data have suggested a possible carcinogenic effect of such particles. The aim of this study was to estimate the association between occupational exposure to nanoscale particles and risk of lung cancer, pleural mesothelioma and brain tumors in adults.

METHODS

Three French population-based case-control studies were analyzed: 1) the ICARE study including 2029 lung cancer cases and 2591 controls; 2) the PNSM study including 371 pleural mesothelioma cases and 730 controls and 3) the CERENAT study including 257 brain tumor cases and 511 controls. Occupational exposure to unintentionally emitted nanoscale particles (UNPs) was retrospectively assessed by a job exposure matrix providing a probability and a frequency of exposure.

RESULTS

In adjusted analyses among men, significant associations between occupational exposure to UNPs and lung cancer (OR = 1.51; 95% CI: 1.22-1.86 and brain tumors (OR = 1.69; 95% CI: 1.17-2.44) were observed. No increased OR was observed for pleural mesothelioma (OR = 0.78; 95% CI: 0.46-1.33).

CONCLUSION

This is the first study showing positive associations between occupational exposure to UNPs and increased risk of lung cancer and brain tumors. These preliminary results should encourage further epidemiological research.

Nanotoxicity: a challenge for future medicine

Background/aim

Due to nanomaterials’ potential benefits for diagnosis and treatment, they are widely used in medical applications and personal care products. Interaction of nanomaterials, which are very small in size, with tissue, cell and microenvironment, can reveal harmful effects that cannot be created with chemically identical and larger counterparts in biological organisms. In this review, a challenge for future medicine, nanotoxicity of nanomaterials is discussed.

Materials and methods

A detailed review of related literature was performed and evaluated as per medical applications of nanomaterials their toxicity.

Results and conclusion

Most authors state “the only valid technology will be nanotechnology in the next era”; however, there is no consensus on the impact of this technology on humankind, environment and ecological balance. Studies dealing with the toxic effect of nanomaterials on human health have also varied with developing technology. Nanotoxicology studies such as in vivo-like on 3D human organs, cells, advanced genetic studies, and -omic approaches begin to replace conventional methods. Nanotoxicity and adverse effects of nanomaterials in exposed producers, industry workers, and patients make nanomaterials a double-edged sword for future medicine. In order to control and tackle related risks, regulation and legislations should be implemented, and researchers have to conduct joint multidisciplinary studies in various fields of medical sciences, nanotechnology, nanomedicine, and biomedical engineering.

Preexisting coronary heart disease and susceptibility to long-term effects of traffic-related air pollution: A matched cohort analysis

BACKGROUND

Individuals with coronary heart disease are considered susceptible to traffic-related air pollution exposure. Yet, cohort-based evidence on whether preexisting coronary heart disease modifies the association of traffic-related air pollution with health outcomes is lacking.

AIM

Using data of four Israeli cohorts, we compared associations of traffic-related air pollution with mortality and cancer between coronary heart disease patients and matched controls from the general population.

METHODS

Subjects hospitalized with acute coronary syndrome from two patient cohorts (inception years: 1992-1993 and 2006-2014) were age- and sex-matched to coronary heart disease-free participants of two cycles of the Israeli National Health and Nutrition Surveys (inception years: 1999-2001 and 2005-2006). Ambient concentrations of nitrogen oxides at the residential place served as a proxy for traffic-related air pollution exposure across all cohorts, based on a high-resolution national land use regression model (50 m). Data on all-cause mortality (last update: 2018) and cancer incidence (last update: 2016) were retrieved from national registries. Cox-derived stratum-specific hazard ratios with 95% confidence intervals were calculated, adjusted for harmonized covariates across cohorts, including age, sex, ethnicity, neighborhood socioeconomic status, smoking, diabetes, hypertension, prior stroke and prior malignancy (the latter only in the mortality analysis). Effect-modification was examined by testing nitrogen oxides-by-coronary heart disease interaction term in the entire matched cohort.

RESULTS

The cohort (mean (standard deviation) age 61.5 (14) years; 44% women) included 2393 matched pairs, among them 2040 were cancer-free at baseline. During a median (25th-75th percentiles) follow-up of 13 (10-19) and 11 (7-17) years, 1458 deaths and 536 new cancer cases were identified, respectively. In multivariable-adjusted models, a 10-parts per billion nitrogen oxides increment was positively associated with all-cause mortality among coronary heart disease patients (hazard ratio = 1.13, 95% confidence interval 1.05-1.22), but not among controls (hazard ratio = 1.00, 0.93-1.08) (pinteraction = 0.003). A similar pattern was seen for all-cancer incidence (hazard ratioCHD = 1.19 (1.03-1.37), hazard ratioCHD-Free = 0.93 (0.84-1.04) (pinteraction = 0.01)). Associations were robust to multiple sensitivity analyses.

CONCLUSIONS

Coronary heart disease patients might be at increased risk for traffic-related air pollution-associated mortality and cancer, irrespective of their age and sex. Patients and clinicians should be more aware of the adverse health effects on coronary heart disease patients of chronic exposure to vehicle emissions.

An overview of selected emerging outdoor airborne pollutants and air quality issues: The need to reduce uncertainty about environmental and human impacts

According to the literature, it is estimated that outdoor air pollution is responsible for the premature death in a range from 3.7 to 8.9 million persons on an annual basis across the world. Although there is uncertainty on this figure, outdoor air pollution represents one of the greatest global risks to human health. In North America, the rapid evolution of technologies (e.g., nanotechnology, unconventional oil and gas rapid development, higher demand for fertilizers in agriculture) and growing demand for ground, marine and air transportation may result in significant increases of emissions of pollutants that have not been carefully studied so far. As a result, these atmospheric pollutants insufficiently addressed by science in Canada and elsewhere are becoming a growing issue with likely human and environmental impacts in the near future. Here, an emerging pollutant is defined as one that meets the following criteria: 1) potential or demonstrated risk for humans or the environment, 2) absence of Canada-wide national standard, 3) insufficient routine monitoring, 4) yearly emissions greater than one ton in Canada, 5) insufficient data concerning significant sources, fate, and detection limit, and 6) insufficiently addressed by epidemiological studies. A new methodology to rank emerging pollutants is proposed here based on weighting multiple criteria. Some selected emerging issues are also discussed here and include the growing concern of ultrafine or nanoparticles, growing ammonia emissions (due to rapid expansion of the agriculture), increased methane/ethane/propane emissions (due to the expanding hydraulic fracturing in the oil and gas sector) and the growing transportation sector. Finally, the interaction between biological and anthropogenic pollution has been found to be a double threat for public health. Here, a multidisciplinary and critical overview of selected emerging pollutants and related critical issues is presented with a focus in Canada.Implications: This overview paper provides a selection methodology for emerging pollutants in the atmospheric environment. It also provides a critical discussion of some related issues. The ultimate objective is to inform about the need to 1) address emerging issues through adequate surface monitoring and modeling in order to inform the development of regulations, 2) reduce uncertainties by geographically mapping emerging pollutants (e.g., through data fusion, data assimilation of observations into air quality models) which can improve the scientific support of epidemiological studies and policies. This review also highlights some of the difficulties with the management of these emerging pollutants, and the need for an integrated approach.

Statistical modelling of roadside and urban background ultrafine and accumulation mode particle number concentrations using generalized additive models

Quantification of the exposure of urban residents to ultrafine particle number concentrations (UFP) is challenging due to its high spatial and temporal variability. Hence, statistical models, e.g. generalized additive models (GAM), may be used to estimate time series or spatial characteristics of UFP. The GAM approach allows the representation of non-linear relations of a response variable with explanatory variables without the need to pre-define model functions. Up to now, GAMs were usually fitted to UFP data from a single site or from mobile measurement campaigns with limited temporal coverage. In this study, GAMs were used to determine UFP, accumulation mode particle (ACC) and total number concentration (TNC) at five urban sites in the cities of Leipzig and Dresden, Germany for the period 2011-2013. As explanatory variables, reanalysis data sets of meteorological quantities, urban geometry and traffic volume data were evaluated. Variables causing concurvity, which is the equivalent to collinearity in non-linear model approaches, were neglected to guarantee the interpretability of the final models. The models were then validated in a ten-fold cross-validation approach. The final models contained smooth functions for the building surface fraction, planetary boundary layer height, traffic volume, air temperature, wind direction, atmospheric pressure, relative humidity, global radiation and precipitation. Adjusted coefficients of determination (R²_adj.) for the final models were R²_adj. = 0.44 for UFP, R²_adj. = 0.51 for ACC and R²_adj. = 0.48 for TNC. Coefficients of determination of the cross-validation were in a similar range (0.44 for UFP, 0.51 for ACC, 0.49 for TNC). Finally, our study shows that GAMs are able to represent important processes that contribute to the particle number concentration from the smooth functions, i.e. emission, dilution, nucleation, deposition and long-range transport.

Land use regression models for ultrafine particles, fine particles, and black carbon in Southern California

Exposure models are needed to evaluate health effects of long-term exposure to ambient ultrafine particles (UFP; <0.1 μm) and to disentangle their association from other pollutants, particularly PM_2.5 (<2.5 μm). We developed land use regression (LUR) models to support UFP exposure assessment in the Los Angeles Ultrafines Study, a cohort in Southern California. We conducted a short-term measurement campaign in Los Angeles and parts of Riverside and Orange counties to measure UFP, PM_2.5, and black carbon (BC), collecting three 30-minute average measurements at 215 sites across three seasons. We averaged concentrations for each site and evaluated geographic predictors including traffic intensity, distance to airports, land use, and population and building density by supervised stepwise selection to develop models. UFP and PM_2.5 measurements (r = 0.001) and predictions (r = 0.05) were uncorrelated at the sites. UFP model explained variance was robust (R² = 0.66) and 10-fold cross-validation indicated good performance (R² = 0.59). Explained variation was moderate for PM_2.5 (R² = 0.47) and BC (R² = 0.38). In the cohort, we predicted a 2.3-fold exposure contrast from the 5^th to 95^th percentiles for all three pollutants. The correlation between modeled UFP and PM_2.5 at cohort residences was weak (r = 0.28), although higher than between measured levels. LUR models, particularly for UFP, were successfully developed and predicted reasonable exposure contrasts.

A link between environmental pollution and civilization disorders: a mini review

Most civilization disorders have a complex etiology, involving factors such as genetics, lifestyle, and environmental pollution (EP) due to different chemicals. Among harmful chemicals, the major ones include particulate matter (PM), nitrogen oxides, polycyclic aromatic hydrocarbons (PAHs), heavy metals, pesticides, plasticizers, polychlorinated biphenyls (PCBs), dioxins, furans, some food additives, hormones, and antibiotics. In fact, potential pollutants are countless and most of them have never been evaluated in terms of their toxicity and health risks, especially that new chemicals emerge all the time due to interactions between the existing ones. It is almost impossible to determine the effects of these new compounds on health. Previous studies have revealed a broad spectrum of diseases related to pollution. EP has been associated with an increased incidence of some malignancies, an increased rate of all-cause mortality, development or exacerbation of cardiovascular diseases, recurrent infections, impairment of intellectual and psychomotor development in children, development of type 2 diabetes, respiratory and immune system diseases, and also brain degenerative disorders. EP is an important cause of morbidity and mortality worldwide, generating high health care costs. Global pollution questions the common recommendation to eat vegetables, fruit, and fish regularly as part of a healthy diet, if they do not have ecological certification. Research in the fields of ecology, biology, and toxicology is needed to determine which environmental contaminants are the most hazardous to wildlife and humans and at what levels. Only an interdisciplinary cooperation and measures to raise public awareness could help improve environmental protection.

Airborne, Vehicle-Derived Fe-Bearing Nanoparticles in the Urban Environment: A Review

Airborne particulate matter poses a serious threat to human health. Exposure to nanosized (<0.1 μm), vehicle-derived particulates may be hazardous due to their bioreactivity, their ability to penetrate every organ, including the brain, and their abundance in the urban atmosphere. Fe-bearing nanoparticles (<0.1 μm) in urban environments may be especially important because of their pathogenicity and possible association with neurodegenerative diseases, such as Alzheimer's and Parkinson's diseases. This review examines current knowledge regarding the sources of vehicle-derived Fe-bearing nanoparticles, their chemical and mineralogical compositions, grain size distribution and potential hazard to human health. We focus on data reported for the following sources of Fe-bearing nanoparticles: exhaust emissions (both diesel and gasoline), brake wear, tire and road surface wear, resuspension of roadside dust, underground, train and tram emissions, and aircraft and shipping emissions. We identify limitations and gaps in existing knowledge as well as future challenges and perspectives for studies of airborne Fe-bearing nanoparticles.

Cancer and mortality in relation to traffic-related air pollution among coronary patients: Using an ensemble of exposure estimates to identify high-risk individuals

BACKGROUND

Moderate correlations were previously observed between individual estimates of traffic-related air pollution (TRAP) produced by different exposure modeling approaches. This induces exposure misclassification for a substantial fraction of subjects.

AIM

We used an ensemble of well-established modeling approaches to increase certainty of exposure classification and reevaluated the association with cancers previously linked to TRAP (lung, breast and prostate), other cancers, and all-cause mortality in a cohort of coronary patients.

METHODS

Patients undergoing percutaneous coronary interventions in a major Israeli medical center from 2004 to 2014 (n = 10,627) were followed for cancer (through 2015) and mortality (through 2017) via national registries. Residential exposure to nitrogen oxides (NO_x) -a proxy for TRAP- was estimated by optimized dispersion model (ODM) and land use regression (LUR) (r_Pearson = 0.50). Mutually exclusive groups of subjects classified as exposed by none of the methods (high-certainty low-exposed), ODM alone, LUR alone, or both methods (high-certainty high-exposed) were created. Associations were examined using Cox regression models.

RESULTS

During follow-up, 741 incident cancer cases were diagnosed and 3051 deaths occurred. Using a ≥25 ppb cutoff, compared with high-certainty low exposed, the multivariable-adjusted hazard ratios (95% confidence intervals) for lung, breast and prostate cancer were 1.56 (1.13-2.15) in high-certainty exposed, 1.27 (0.86-1.86) in LUR-exposed alone, and 1.13 (0.77-1.65) in ODM-exposed alone. The association of the former category was strengthened using more extreme NO_x cutoffs. A similar pattern, albeit less strong, was observed for mortality, whereas no association was shown for cancers not previously linked to TRAP.

CONCLUSIONS

Use of an ensemble of TRAP exposure estimates may improve classification, resulting in a stronger association with outcomes.

Extending the spatial scale of land use regression models for ambient ultrafine particles using satellite images and deep convolutional neural networks

We paired existing land use regression (LUR) models for ambient ultrafine particles in Montreal and Toronto, Canada with satellite images and deep convolutional neural networks as a means of extending the spatial coverage of these models. Our findings demonstrate that this method can be used to expand the spatial scale of LUR models, thus providing exposure estimates for larger populations. The cost of this approach is a small loss in precision as the training data are themselves modelled values.

Detection of Pathogenic Viruses in the Ambient Air in Seoul, Korea

The possible transport of pathogenic microorganisms during Asian dust events could be an important concern for health workers; however, this is still uncertain owing to a lack of supporting evidence. The present study aimed to investigate the presence of pathogenic microorganisms in air samples collected during the Asian and non-Asian dust periods. Between March and September 2016, air samples were collected at three weather observation stations in Seoul using a high-volume air sampler. Multiplex PCR was performed using the Allplex™ respiratory and gastrointestinal panel assay kits to detect 46 microorganisms. RT-PCR was performed for klassevirus, Aichivirus, and human parechovirus (HPeV) detection. In total, 71 air samples were collected during the Asian (8 samples) and non-Asian (63 samples) dust events. During an Asian dust event, only one human rhinovirus (HRV)-positive air sample was collected on April 23. During the non-Asian dust period, HRV, HPeV, norovirus (NoV), enteroaggregative Escherichia coli (EAEC), enterotoxigenic E. coli (ETEC), and Blastocystis hominis were detected in four, two, one, one, one, and one air samples, respectively. Pathogenic viruses were mostly detected in ambient air samples during the non-Asian dust period, which suggests a possible air-borne transmission of viral pathogens; however, the role of Asian dust in epidemics caused by pathogenic viruses is unclear.

Chronic exposure to traffic-related air pollution and cancer incidence among 10,000 patients undergoing percutaneous coronary interventions: A historical prospective study

Background Exposure to traffic-related air pollution (TRAP) is considered to have a carcinogenic effect. The authors previously reported a nonsignificant association between TRAP and cancer risk in a relatively small cohort of myocardial infarction survivors. This study assessed whether TRAP exposure is associated with subsequent cancer in a large cohort of coronary patients. Methods & results Consecutive patients undergoing percutaneous coronary interventions in a major medical centre in central Israel from 2004 to 2014 were followed for cancer through 2015. Residential levels of nitrogen oxides (NO_x) - a proxy for TRAP - were estimated based on a high-resolution national land use regression model. Cox proportional hazards models were constructed to study relationships with cancer. Among 12,784 candidate patients, 9816 had available exposure data and no history of cancer (mean age, 68 years; 77% men). During a median (25th-75th percentiles) follow-up of 7.0 (3.9-9.3) years, 773 incident cases of cancer (8%) were diagnosed. In a multivariable-adjusted model, a 10-ppb increase in mean NO_x exposure was associated with hazard ratios (HRs) of 1.07 (95% confidence interval [CI] 1.00-1.15) for all-site cancer and 1.16 (95% CI 1.05-1.28) for cancers previously linked to TRAP (lung, breast, prostate, kidney and bladder). A stronger association was observed for breast cancer (HR = 1.43; 95% CI 1.12-1.83). Associations were slightly strengthened after limiting the cohort to patients with more precise exposure assessment. Conclusion Coronary patients exposed to TRAP are at increased risk of several types of cancer, particularly lung, prostate and breast. As these cancers are amenable to prevention strategies, identifying highly exposed patients may provide an opportunity to improve clinical care.

Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies

OBJECTIVES

We conducted a systematic review and meta-analysis to evaluate potential associations between firefighting and police occupations, and prostate cancer incidence and mortality.

METHODS

Original epidemiological studies published from 1980 to 2017 were identified through PubMed and Web of Science. Studies were included if they contained specific job titles for ever/never firefighting and police work and associated prostate cancer risk estimates with 95% confidence intervals (CI). Study quality was assessed using a 20-point checklist. Prostate cancer meta-risk estimates (mRE) and corresponding 95% CIs were calculated for firefighting and police work separately and by various study characteristics using random effects models. Between-study heterogeneity was evaluated using the I² score. Publication bias was assessed using Begg's and Egger's tests.

RESULTS

A total of 26 firefighter and 12 police studies were included in the meta-analysis, with quality assessment scores ranging from 7 to 19 points. For firefighter studies, the prostate cancer incidence mRE was 1.17 (95% CI = 1.08-1.28, I² = 72%) and the mortality mRE was 1.12 (95% CI = 0.92-1.36, I² = 50%). The mRE for police incidence studies was 1.14 (95% CI = 1.02-1.28; I² = 33%); for mortality studies, the mRE was 1.08 (95% CI = 0.80-1.45; I² = 0%). By study design, mREs for both firefighter and police studies were similar to estimates of incidence and mortality.

CONCLUSION

Small excess risks of prostate cancer were observed from firefighter studies with moderate to substantial heterogeneity and a relatively small number of police studies, respectively. There is a need for further studies to examine police occupations and to assess unique and shared exposures in firefighting and police work.