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Park MY, Kim HR, Myong JP, Cho BS, Kim HJ, Kang MY. Case-Control Study of Occupational Acute Myeloid Leukemia in the Republic of Korea. Saf Health Work 2023; 14:451-456. [PMID: 38187196 PMCID: PMC10770274 DOI: 10.1016/j.shaw.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/01/2023] [Accepted: 10/22/2023] [Indexed: 01/09/2024] Open
Abstract
Background We conducted a case-control study to identify high-risk occupations and exposure to occupational hazards for acute myeloid leukemia (AML). Methods When patients with AML admitted to the Department of Hematology in the study hospital for the first time are referred to the Department of Occupational and Environmental Medicine, data on occupation are collected by investigators to evaluate work-relatedness. Community-based controls were recruited through an online survey agency, and four controls per case were matched. Occupational information was estimated using structured questionnaires covering 27 specific occupations and 32 exposure agents. Conditional logistic regression analysis was performed by pairing cases and controls. Results In the analysis of the risk of AML according to occupational classification, a significant association was found in paint manufacturing or painting work (OR = 2.22, 95% CI: 1.03-4.81) and aircrew (OR = 6.00, 95% CI: 1.00-35.91) in males, and in pesticide industry (OR = 6.89, 95% CI: 1.69-28.07) and cokes and steel industry (OR = 2.00, 95% CI: 1.18-22.06) in ≥60 years old. Moreover, the risk of AML increased significantly as the cumulative exposure to thinners increased. In the analyses stratified by sex and age, the association between pesticide exposure and AML was significant in males (OR = 3.28, 95% CI: 1.10-9.77) and in ≥60 years old (OR = 6.22, 95% CI: 1.48-26.08). Conclusion This case-control study identified high-risk occupational groups in the Republic of Korea including paint manufacturers and painters, aircrew, and those who are occupationally exposed to pesticides or paint thinners.
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Affiliation(s)
- Min Young Park
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyoung-Ryoul Kim
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jun-Pyo Myong
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Byung-Sik Cho
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hee-Je Kim
- Department of Hematology, Catholic Hematology Hospital, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Leukemia Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mo-Yeol Kang
- Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Minoretti P, Liaño Riera M, Santiago Sáez A, Gómez Serrano M, García Martín Á. Increased Peripheral Blood DNA Damage and Elevated Serum Levels of Melanoma Inhibitory Activity Protein: Clues to Excess Skin Cancer Risk in Airline Pilots? Cureus 2023; 15:e51077. [PMID: 38269211 PMCID: PMC10807821 DOI: 10.7759/cureus.51077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 12/24/2023] [Indexed: 01/26/2024] Open
Abstract
Background and objective The risk of malignant melanoma (MM) and other forms of skin cancer appears to be higher in airline pilots (APs), potentially due to their exposure to ionizing and ultraviolet (UV) radiation. We explored the possibility of increased peripheral blood DNA damage and elevated serum levels of the melanoma inhibitory activity (MIA) protein - a serological marker for MM known to be stimulated by UV radiation - in this professional group. Methods This was a case-control study involving 40 male APs, each of whom was age- and tenure-matched (≥5 years of service) with 40 male office workers (OWs). We assessed DNA damage in the two professional groups by performing comet and micronucleus (MN) assays on peripheral blood. Serum levels of MIA protein were quantified using an immunoassay. Results The comet tail lengths and the frequency of MN were significantly higher in APs (4.57 ± 0.79 µm and 2.05 ± 0.26 per 1000 cells, respectively) than in OWs (3.81 ± 0.60 µm and 1.76 ± 0.31 per 1000 cells, respectively, both p<0.001). Furthermore, serum MIA levels were also significantly higher in APs (7.45 ± 0.95 ng/mL) than in OWs (5.78 ± 0.54 ng/mL, p<0.001). A significant positive correlation was found between comet tail lengths in APs and their serum MIA concentrations (r=0.68, p<0.01). Conclusions The increased burden of DNA damage and elevated serum MIA levels in APs may offer an explanation for their higher susceptibility to MM and other types of skin cancers.
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Affiliation(s)
| | - Miryam Liaño Riera
- Legal Medicine, Psychiatry, and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Andrés Santiago Sáez
- Legal Medicine, Hospital Clinico San Carlos, Madrid, ESP
- Legal Medicine, Psychiatry, and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Manuel Gómez Serrano
- Legal Medicine, Psychiatry, and Pathology, Complutense University of Madrid, Madrid, ESP
| | - Ángel García Martín
- Legal Medicine, Psychiatry, and Pathology, Complutense University of Madrid, Madrid, ESP
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Minoretti P, Sáez ASS, Martín ÁFG, Riera ML, Serrano MG, Emanuele E. Skin biophysical parameters and serum dermokine levels in airline pilots: a comparative study with office workers. Postepy Dermatol Alergol 2023; 40:757-761. [PMID: 38282882 PMCID: PMC10809828 DOI: 10.5114/ada.2023.132262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 08/08/2023] [Indexed: 01/30/2024] Open
Abstract
Introduction Concerns are growing in the aviation industry about occupational skin diseases like malignant melanoma (MM) among airline pilots (APs), due to the unique working environment that exposes them to various skin stressors. Aim To compare five skin biophysical parameters in a group of 40 male APs, each matched in terms of age and service tenure (minimum of 5 years) with a control group of 40 male office workers (OWs). Considering the potential role of dermokine (DMKN) in skin barrier dysfunction and the pathogenesis of MM, we further analyzed the serum levels of this molecule and correlated them with the measured skin parameters. Material and methods Stratum corneum skin hydration, transepidermal water loss (TEWL), sebum content, erythema index (EI), and melanin index (MI) were quantified by non-invasive instruments in the cheek region. Serum DMKN levels were measured using a commercially available enzyme-linked immunosorbent assay kit. Results Compared with OWs, the skin of APs exhibited a decrease in hydration levels in the stratum corneum, coinciding with a higher TEWL. However, there was no significant variance in sebum content between the groups. MI was notably higher in APs than in OWs, as was EI. In APs, serum DMKN levels were independently associated with MI (β = 0.56, p < 0.05). Conclusions We found a significant link between the profession of an airline pilot and changes in skin biophysical parameters. Further research into the interplay between serum DMKN levels and the risk of MM in APs is warranted.
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Affiliation(s)
- Piercarlo Minoretti
- Studio Minoretti, Oggiono, Italy
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Andrés S. Santiago Sáez
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Ángel F. García Martín
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Miryam Liańo Riera
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Manuel Gómez Serrano
- Department of Legal Medicine, Psychiatry and Pathology, School of Medicine, Complutense University of Madrid, Madrid, Spain
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Scheibler C, Toprani SM, Mordukhovich I, Schaefer M, Staffa S, Nagel ZD, McNeely E. Cancer risks from cosmic radiation exposure in flight: A review. Front Public Health 2022; 10:947068. [PMID: 36483259 PMCID: PMC9723364 DOI: 10.3389/fpubh.2022.947068] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 10/12/2022] [Indexed: 12/13/2022] Open
Abstract
Aircrew (consisting of flight attendants, pilots, or flight engineers/navigators) are exposed to cosmic ionizing radiation (CIR) at flight altitude, which originates from solar activity and galactic sources. These exposures accumulate over time and are considerably higher for aircrew compared to the general population, and even higher compared to U.S. radiation workers. Many epidemiological studies on aircrew have observed higher rates of specific cancers compared to the general population. Despite high levels of CIR exposure and elevated rates of cancer in aircrew, a causal link between CIR and cancer has yet to be established. Many challenges still exist in effectively studying this relationship, not the least of which is evaluating CIR exposure separately from the constellation of factors that occur as part of the flight environment. This review concentrates on cancer incidence and mortality observed among aircrew in epidemiologic studies in relation to CIR exposure and limitation trends observed across the literature. The aim of this review is to provide an updated comprehensive summary of the literature that will support future research by identifying epidemiological challenges and highlighting existing increased cancer concerns in an occupation where CIR exposure is anticipated to increase in the future.
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Affiliation(s)
- Christopher Scheibler
- Environmental and Occupational Medicine and Epidemiology Program, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Sneh M. Toprani
- John B. Little Center for Radiation Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Irina Mordukhovich
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Matthew Schaefer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Steven Staffa
- Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Zachary D. Nagel
- John B. Little Center for Radiation Sciences, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Eileen McNeely
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Yong SS, Han WH, Faheem NAA, Puvan N, Tan LL, Wong SM, Kwan Z. Predictive factors of sun protection behaviour among global airline pilots. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2022; 38:541-547. [PMID: 35324018 DOI: 10.1111/phpp.12787] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Airline pilots face significant ultraviolet radiation exposure resulting in an increased risk of sun damage and skin cancers. We aimed to evaluate sun-protective practices and associated factors among airline pilots. METHODS We disseminated an online questionnaire evaluating the use of sunscreen, sunglasses, hats and protective clothing during daytime hours in the cockpit and during outdoor activities to 346 global commercial airline pilots, and we received 220 completed responses. The Pearson chi-squared test or Fisher's exact test where necessary were used to determine possible factors associated with the use of sun-protective practices. Potential confounders were adjusted for using multivariate analyses. RESULTS The most common sun protective behaviour was the wearing of sunglasses during daytime flights (89.5%), followed by the use of caps during outdoor activities (47.7%). More pilots applied sunscreen during daytime flights (14.1%) compared with walk-arounds (8.2%). Males were less likely to use sunscreen during flights (adjusted odds ratio, aOR = 0.76), use sunscreen for walk-arounds (aOR = 0.175) and wear long sleeves (aOR = 0.013). Pilots who flew less than 30 h a month in high latitude regions were less likely to use a cap or hat outdoors (aOR = 0.419) or use sunscreen during walk-arounds (aOR = 0.241). Younger pilots were also less likely to use caps or hats outdoors (aOR = 0.446). CONCLUSION Male pilots and those who spent less time in high latitudes were less likely to practice sun protection. Targeted educational efforts may be implemented to reduce occupational ultraviolet exposure.
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Affiliation(s)
- Shin Shen Yong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Winn Hui Han
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nik Aimee Azizah Faheem
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nisha Puvan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Leng Leng Tan
- Thomson Hospital Kota Damansara, Petaling Jaya, Malaysia
| | - Su-Ming Wong
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Zhenli Kwan
- Division of Dermatology, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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Dasari SS, Archer M, Mohamed NE, Tewari AK, Figueiro MG, Kyprianou N. Circadian Rhythm Disruption as a Contributor to Racial Disparities in Prostate Cancer. Cancers (Basel) 2022; 14:cancers14205116. [PMID: 36291899 PMCID: PMC9600368 DOI: 10.3390/cancers14205116] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/08/2022] [Accepted: 10/15/2022] [Indexed: 01/27/2023] Open
Abstract
In the United States, African American (AA) men have a 2.4 times higher mortality rate due to prostate cancer than White men. The multifactorial causes of the racial disparities in prostate cancer involve various social determinants of health, socioeconomic status, and access to healthcare. However, emerging evidence also suggests that circadian rhythm disruption (CRD) contributes to prostate cancer, and AA men may be more susceptible to developing CRDs. Circadian rhythms play a significant role in metabolism, hormone secretion, and sleep/wake cycles. Disruption in these circadian rhythms can be caused by airplane travel/jetlag, night shift work, exposure to light, and neighborhood noise levels, which can contribute to sleep disorders and chronic conditions such as obesity, diabetes, cardiovascular disease, and depression. The drivers of the racial disparities in CRD include night shift work, racial discrimination, elevated stress, and residing in poor neighborhoods characterized by high noise pollution. Given the increased vulnerability of AA men to CRDs, and the role that CRDs play in prostate cancer, elucidating the clock-related prostate cancer pathways and their behavior and environmental covariates may be critical to better understanding and reducing the racial disparities in prostate cancer.
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Affiliation(s)
- Sonali S. Dasari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Maddison Archer
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Mariana G. Figueiro
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Tisch Cancer Institute, Mount Sinai Health, New York, NY 10029, USA
- Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Correspondence: (M.G.F.); (N.K.)
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Kim JS, Han BS, Kwon YH, Lim J. A 5-Year Analysis of Aviation Medical Examinations in South Korea. Aerosp Med Hum Perform 2022; 93:499-506. [DOI: 10.3357/amhp.5973.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION: Little has been studied to promote aviation health in South Korea. The aim of this study was to analyze the results of aviation medical examinations conducted in South Korea over the past 5 yr and, in doing so, provide evidence for establishing a health promotion,
disease prevention plan.METHODS: Subjects of the study consisted of applicants who underwent aviation medical examinations from January 1, 2016, to December 31, 2020.RESULTS: Over the past 5 yr, the total number of aviation medical examinations in South Korea has shown
an annual increase of more than 10%. In the presence of the COVID-19 pandemic in 2020, the number of aviation medical examinations, both renewal and initial, for all types of licenses, except renewal aviation medical examinations for the ATCL, decreased. Disqualification rates were generally
higher in initial examinations than in renewal examinations. The examination results for license renewal showed the ATPL disqualification rate to be the highest at 3.5 per 1000 pilots per year in their 50s, with cardiology cases being the most common reason for disqualification, followed by
ophthalmology cases and psychiatry cases. Diagnostic categories for those disqualified after initial aviation medical examinations were similar, though ophthalmological causes were most common, followed by cases of psychiatry and neurology.CONCLUSION: Main causes of disqualification
in airmen and air traffic controllers were identified as the presence of cardiovascular, ophthalmic, and psychiatric diseases. The results of this study provide evidence for improving health promotion activity plans to manage risk factors of such diseases for aviation workers.Kim JS,
Han BS, Kwon YH, Lim J. A 5-yr analysis of aviation medical examinations in South Korea. Aerosp Med Hum Perform. 2022; 93(6):499–506.
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Biomaterials for human space exploration: A review of their untapped potential. Acta Biomater 2021; 128:77-99. [PMID: 33962071 DOI: 10.1016/j.actbio.2021.04.033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 04/01/2021] [Accepted: 04/15/2021] [Indexed: 02/08/2023]
Abstract
As biomaterial advances make headway into lightweight radiation protection, wound healing dressings, and microbe resistant surfaces, a relevance to human space exploration manifests itself. To address the needs of the human in space, a knowledge of the space environment becomes necessary. Both an understanding of the environment itself and an understanding of the physiological adaptations to that environment must inform design parameters. The space environment permits the fabrication of novel biomaterials that cannot be produced on Earth, but benefit Earth. Similarly, designing a biomaterial to address a space-based challenge may lead to novel biomaterials that will ultimately benefit Earth. This review describes several persistent challenges to human space exploration, a variety of biomaterials that might mitigate those challenges, and considers a special category of space biomaterial. STATEMENT OF SIGNIFICANCE: This work is a review of the major human and environmental challenges facing human spaceflight, and where biomaterials may mitigate some of those challenges. The work is significant because a broad range of biomaterials are applicable to the human space program, but the overlap is not widely known amongst biomaterials researchers who are unfamiliar with the challenges to human spaceflight. Additionaly, there are adaptations to microgravity that mimic the pathology of certain disease states ("terrestrial analogs") where treatments that help the overwhelmingly healthy astronauts can be applied to help those with the desease. Advances in space technology have furthered the technology in that field on Earth. By outlining ways that biomaterials can promote human space exploration, space-driven advances in biomaterials will further biomaterials technology.
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Abstract
Exposure of aircrew to cosmic radiation has been recognized as an occupational health risk for several decades. Based on the recommendations by the International Commission on Radiological Protection (ICRP), many countries and their aviation authorities, respectively have either stipulated legal radiation protection regulations, e.g., in the European Union or issued corresponding advisory circulars, e.g., in the United States of America. Additional sources of ionizing and non-ionizing radiation, e.g., due to weather phenomena have been identified and discussed in the scientific literature in recent years. This article gives an overview of the different generally recognized sources due to weather as well as space weather phenomena that contribute to radiation exposure in the atmosphere and the associated radiation effects that might pose a risk to aviation safety at large, including effects on human health and avionics. Furthermore, potential mitigation measures for several radiation sources and the prerequisites for their use are discussed.
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Pariollaud M, Lamia KA. Cancer in the Fourth Dimension: What Is the Impact of Circadian Disruption? Cancer Discov 2020; 10:1455-1464. [PMID: 32934020 PMCID: PMC7541588 DOI: 10.1158/2159-8290.cd-20-0413] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/08/2020] [Accepted: 07/01/2020] [Indexed: 11/16/2022]
Abstract
Circadian rhythms integrate many physiological pathways, helping organisms to align the timing of various internal processes to daily cycles in the external environment. Disrupted circadian rhythmicity is a prominent feature of modern society, and has been designated as a probable carcinogen. Here, we review multiple studies, in humans and animal models, that suggest a causal effect between circadian disruption and increased risk of cancer. We also discuss the complexity of this connection, which may depend on the cellular context. SIGNIFICANCE: Accumulating evidence points to an adverse effect of circadian disruption on cancer incidence and progression, indicating that time of day could influence the effectiveness of interventions targeting cancer prevention and management.
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Affiliation(s)
- Marie Pariollaud
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, California
| | - Katja A Lamia
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, California.
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Robbins AS, Pathak SR, Webber BJ, Erich RA, Escobar JD, Simon AA, Stahlman SL, Gambino-Shirley KJ. Malignancy in U.S. Air Force fighter pilots and other officers, 1986-2017: A retrospective cohort study. PLoS One 2020; 15:e0239437. [PMID: 32960918 PMCID: PMC7508357 DOI: 10.1371/journal.pone.0239437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 09/05/2020] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE This study sought to determine the incidence rates of cancer, overall and by site, among active component U.S. Air Force fighter pilots, and to compare the rates with those in other active component Air Force officers. METHODS Using a matched retrospective cohort design, U.S. Air Force fighter pilots were compared with other commissioned officers who entered active component service between 1 January 1986 and 31 December 2006. The cohort was followed for cancer diagnoses in TRICARE and the Veterans Health Administration from 1 October 1995 through 31 December 2017. Fighter pilots and non-fighter pilot officers were compared after matching on sex, age at first observation (15 age groups), and age at last observation (15 age groups). Sex-stratified overall and site-specific cancer rates were compared with matched Poisson regression to determine incidence rate ratios with 95% confidence intervals. RESULTS During 1,412,590 person-years of follow-up, among the study population of 88,432 service members (4,949 fighter pilots and 83,483 matched officers), 977 incident cancer cases were diagnosed (86 in fighter pilots and 891 in matched officers). Male fighter pilots and matched officers had similar rates of all malignant cancers (RR = 1.04; 95% CI: 0.83-1.31) and of each cancer site. Female fighter pilots and matched officers also had similar rates of all malignant cancers (RR = 0.99; 95% CI: 0.25-4.04). DISCUSSION In the active component U.S. Air Force, fighter pilots and their officer peers had similar overall and site-specific cancer rates.
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Affiliation(s)
- Anthony S Robbins
- Public Health and Preventive Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
| | - Sonal R Pathak
- DataRev LLC, Atlanta, Georgia, United States of America.,Solutions Through Innovative Technologies, Inc., Fairborn, Ohio, United States of America
| | - Bryant J Webber
- Public Health and Preventive Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
| | - Roger A Erich
- Aerospace Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
| | - James D Escobar
- Public Health and Preventive Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
| | - Alisa A Simon
- Public Health and Preventive Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
| | - Shauna L Stahlman
- Armed Forces Health Surveillance Branch, Silver Spring, Maryland, United States of America
| | - Kelly J Gambino-Shirley
- Public Health and Preventive Medicine Department, U.S. Air Force School of Aerospace Medicine, Wright-Patterson Air Force Base, Ohio, United States of America
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Dreger S, Wollschläger D, Schafft T, Hammer GP, Blettner M, Zeeb H. Cohort study of occupational cosmic radiation dose and cancer mortality in German aircrew, 1960–2014. Occup Environ Med 2020; 77:285-291. [DOI: 10.1136/oemed-2019-106165] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Revised: 12/12/2019] [Accepted: 01/13/2020] [Indexed: 11/03/2022]
Abstract
ObjectivesTo determine cancer mortality compared with the general population and to examine dose-response relationships between cumulative occupational radiation dose and specific cancer outcomes in the German aircrew cohort.MethodsFor a cohort of 26 846 aircrew personnel, standardised mortality ratios (SMR) were calculated. Dose-response analyses were carried out using Poisson regression to assess dose-related cancer risks for the period 1960–2014. Exposure assessment comprises recently available dose register data for all cohort members and newly estimated retrospective cabin crew doses for 1960–2003.ResultsSMR for all-cause, specific cancer groups and most individual cancers were reduced in all aircrew groups. The only increases were seen for brain cancer in pilots (n=23, SMR 2.01, 95% CI 1.15 to 3.28) and for malignant melanoma (n=10, SMR 1.88, 95% CI 0.78 to 3.85). Breast cancer mortality among female cabin crew was similar to the general population (n=71, SMR 1.06, 95% CI 0.77 to 1.44). Overall median cumulative effective dose was 34.2 mSv (max: 116 mSv) for 1960–2014. No dose-response associations were seen in any of the models. For brain cancer, relative risks were elevated across dose categories. An indicative negative trend with increasing dose category was seen for large intestine cancer in female cabin crew (n=23).ConclusionsThere was no evidence for significant dose-response patterns for the considered cancer types. Interpretation of results remains difficult as cumulative dose is closely related to age. Future work should focus on investigating radiation jointly with other risk factors that may contribute to risks for specific cancers among aircrew.
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Hassan S, Bhatti J, Poulos C, Mahmoud A, Mohammed TO, Hoenig LJ. Celestial effects on the skin. Clin Dermatol 2019; 38:485-488. [PMID: 32972607 DOI: 10.1016/j.clindermatol.2019.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Many factors affect the health and physiology of human skin, with some of them arising from outer space. This contribution explores four celestial influences on the skin: (1) the sun's ultraviolet light, which has both beneficial and deleterious dermatologic effects, (2) meteorite injuries, (3) possible lunar effects on the body's health, and (4) cosmic radiation as a risk factor for skin cancer and pregnancy-related complications. Some of these extraterrestrial influences on skin health have taken on added significance as human beings increasingly spend more time at higher altitudes in aircraft, spaceships, and space stations.
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Affiliation(s)
- Shahzeb Hassan
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Junaid Bhatti
- University of Maryland School of Medicine, Baltimore, Maryland, USA
| | - Christian Poulos
- University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Ali Mahmoud
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Charlier P, Kluger N. Work‐related skin diseases of Santa Claus. J Eur Acad Dermatol Venereol 2019; 33:e437-e438. [DOI: 10.1111/jdv.15381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- P. Charlier
- UFR of Health Sciences (UVSQ DANTE Laboratory EA4498) 2 avenue de la Source de la Bièvre 78180 Montigny‐Le‐Bretonneux France
- Museum of Quai Branly 222 rue de l’ Université 75007 Paris France
| | - N. Kluger
- Dermatology Department, Allergology, and Venereology University of Helsinki and Helsinki University Central Hospital Helsinki Finland
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15
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Miura K, Olsen C, Rea S, Marsden J, Green A. Do airline pilots and cabin crew have raised risks of melanoma and other skin cancers? Systematic review and meta‐analysis. Br J Dermatol 2019; 181:55-64. [DOI: 10.1111/bjd.17586] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2018] [Indexed: 11/28/2022]
Affiliation(s)
- K. Miura
- Population Health Department QIMR Berghofer Medical Research Institute 300 Herston Road Herston QLD 4006 Australia
| | - C.M. Olsen
- Population Health Department QIMR Berghofer Medical Research Institute 300 Herston Road Herston QLD 4006 Australia
| | - S. Rea
- Population Health Department QIMR Berghofer Medical Research Institute 300 Herston Road Herston QLD 4006 Australia
| | - J. Marsden
- Queen Elizabeth Hospital Birmingham B15 2GW U.K
| | - A.C. Green
- Population Health Department QIMR Berghofer Medical Research Institute 300 Herston Road Herston QLD 4006 Australia
- CRUK Manchester Institute and Faculty of Biology, Medicine and Health University of Manchester Manchester Academic Health Science Centre Manchester U.K
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16
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Patel AS, El-Sayed T, Cho JS, Kelly JA, Ludwinski FE, Saha P, Lyons OT, Smith A, Modarai B. Response by Patel et al to Letter Regarding Article, "Radiation Induced DNA Damage in Operators Performing Endovascular Aortic Repair". Circulation 2018; 137:2680-2681. [PMID: 29891634 DOI: 10.1161/circulationaha.118.034639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ashish S Patel
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Tamer El-Sayed
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Jun S Cho
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - James A Kelly
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Francesca E Ludwinski
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Prakash Saha
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Oliver T Lyons
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Alberto Smith
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
| | - Bijan Modarai
- Department of Vascular Surgery, School of Cardiovascular Medicine and Sciences, King's College London, British Heart Foundation Centre of Excellence at Guy's & St Thomas' NHS Foundation Trust, United Kingdom
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17
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Mortazavi SMJ. Comments on "Incidence of cancer among licensed commercial pilots flying North Atlantic routes". Environ Health 2017; 16:125. [PMID: 29149894 PMCID: PMC5693704 DOI: 10.1186/s12940-017-0333-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Accepted: 11/01/2017] [Indexed: 06/07/2023]
Abstract
Gudmundsdottir et al. in their paper entitled "Incidence of cancer among licensed commercial pilots flying North Atlantic routes" published in Environmental Health have evaluated the effects of exposure to higher levels of cosmic radiation on cancer incidence in the pilots of commercial flights. Despite its remarkable strengths, the paper authored by Gudmundsdottir et al. has some shortcomings. The shortcomings of this paper such as not determining the shape of dose-response relationship for radiation-induced cancers, limitations in flight dose calculations, the weaknesses of CARI-6 as the program used by Gudmundsdottir et al. to estimate the effective dose of galactic cosmic rays, and the problems associated with unpredictable nature of the magnitude and duration of solar particle events are discussed.
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Affiliation(s)
- S M J Mortazavi
- Diagnostic Imaging Center, Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA, 19111, USA.
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