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De Matteis S. Occupational COVID-19: can we claim that compensation is causation? Occup Environ Med 2024; 81:169-170. [PMID: 38594071 DOI: 10.1136/oemed-2024-109460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 03/28/2024] [Indexed: 04/11/2024]
Affiliation(s)
- Sara De Matteis
- Department of Health Sciences, University of Milan, Milan, Italy
- NHLI, Imperial College London, London, UK
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Nafees AA, Ali Y, Sadia A, Shaukat N, Irfan M, Fatmi Z, Azam I, Matteis SD, Burney P, Cullinan P. Assessing the Feasibility of a Multifaceted Intervention Package for Improving Respiratory Health of Textile Workers: Findings From the MultiTex Pilot Study in Karachi, Pakistan. Asia Pac J Public Health 2024; 36:202-209. [PMID: 38247056 DOI: 10.1177/10105395231226273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
We piloted the development and implementation of a multifaceted intervention package for improving respiratory health among textile workers using a pre-post design at six mills in Karachi. The intervention, implemented following a baseline survey (n = 498), included health and safety training of workers and managers, promotion of cotton dust control measures, and the provision of facemasks. Follow-up surveys were conducted at 1, 6, and 12 months post-intervention. Knowledge, attitude, and practice (KAP) scores and respiratory symptoms were assessed through a questionnaire and spirometry was conducted. The intervention was provided to 230 workers and led to an improvement in KAP scores that was more likely among workers with a higher educational status, spinners, smokers, those with a permanent employment status, working in morning shifts, and with ⩾5 years of textile experience. We found the intervention acceptable and feasible in these textile mills henceforth, trials are required to determine its effectiveness.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Yousaf Ali
- Department of Community Medicine and Public Health, Khyber Medical College, Peshawar, Pakistan
| | - Afreen Sadia
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Natasha Shaukat
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Pulmonary and Critical Care Medicine, The Aga Khan University, Karachi, Pakistan
| | - Zafar Fatmi
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Iqbal Azam
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Paul Cullinan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
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Santo B, Bertini N, Cattaneo CG, De Matteis S, De Franco P, Grassi R, Iorio GC, Longo S, Boldrini L, Piras A, Desideri I, De Felice F, Salvestrini V. Nutritional counselling for head and neck cancer patients treated with (chemo)radiation therapy: why, how, when, and what? Front Oncol 2024; 13:1240913. [PMID: 38264757 PMCID: PMC10803628 DOI: 10.3389/fonc.2023.1240913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 12/14/2023] [Indexed: 01/25/2024] Open
Affiliation(s)
- Bianca Santo
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Niccolò Bertini
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Carlo Guglielmo Cattaneo
- Department of Radiotherapy, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Sara De Matteis
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Paola De Franco
- Radiation Oncology Unit, Dipartimento di Oncoematologia, Ospedale “Vito Fazzi”, Lecce, Italy
| | - Roberta Grassi
- Department of Precision Medicine, University of Campania “L. Vanvitelli”, Naples, Italy
| | | | - Silvia Longo
- Unità Operativa Complessa (UOC) Radioterapia Oncologica, Fondazione Policlinico Universitario Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “A. Gemelli”, Roma, Italy
| | - Luca Boldrini
- Unità Operativa Complessa (UOC) Radioterapia Oncologica, Fondazione Policlinico Universitario Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) “A. Gemelli”, Roma, Italy
| | - Antonio Piras
- Unità Operativa (UO) Radioterapia Oncologica, Villa Santa Teresa, Palermo, Italy
- Department of Biomedical Image Processing and Analysis, Ri.Med Foundation, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, Molecular and Clinical Medicine, University of Palermo, Palermo, Italy
| | - Isacco Desideri
- Radiation Oncology Unit, Azienda Ospedaliero-Universitaria Careggi, Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Francesca De Felice
- Department of Radiotherapy, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Rome, Italy
| | - Viola Salvestrini
- Radiation Oncology Unit, Centro Cyberknife, Istituto Fiorentino di Cura e Assistenza, Florence, Italy
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Nafees AA, Allana A, Kadir MM, Potts J, Minelli C, Semple S, De Matteis S, Burney P, Cullinan P. A cluster randomised controlled trial to reduce respiratory effects of cotton dust exposure among textile workers: the MultiTex RCT study. Eur Respir J 2024; 63:2301028. [PMID: 37857425 DOI: 10.1183/13993003.01028-2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/25/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND We determined the effectiveness of an intervention to reduce cotton dust-related respiratory symptoms and improve lung function of textile workers. METHODS We undertook a cluster randomised controlled trial at 38 textile mills in Karachi, Pakistan. The intervention comprised: training in occupational health for workers and managers, formation of workplace committees to promote a health and safety plan that included wet mopping and safe disposal of cotton dust, provision of simple face masks, and further publicity about the risks from cotton dust. Participating mills were randomised following baseline data collection. The impact of the intervention was measured through surveys at 3, 12 and 18 months using questionnaires, spirometry and dust measurements. The primary outcomes were 1) changes in prevalence of a composite respiratory symptom variable, 2) changes in post-bronchodilator percentage predicted forced expiratory volume in 1 s (FEV1) and 3) changes in cotton dust levels. These were assessed using two-level mixed effects linear and logistic regression. RESULTS Of 2031 participants recruited at baseline, 807 (40%) were available at the third follow-up. At that point, workers in the intervention arm were more likely to report an improvement in respiratory symptoms (OR 1.58, 95% CI 1.06-2.36) and lung function (FEV1 % pred: β 1.31%, 95% CI 0.04-2.57%). Personal dust levels decreased, more so in intervention mills, although we did not observe this in adjusted models due to the small number of samples. CONCLUSION We found the intervention to be effective in improving the respiratory health of textile workers and recommend scaling-up of such simple and feasible interventions in low- and middle-income countries.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Asad Allana
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | | | - James Potts
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Cosetta Minelli
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Sean Semple
- Institute for Social Marketing and Health, University of Stirling, Stirling, UK
| | - Sara De Matteis
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, London, UK
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De Matteis S. Indoor Air Pollution and Lung Function Decline: "Should I Stay or Should I Go?". Am J Respir Crit Care Med 2023; 208:1009-1012. [PMID: 37555744 PMCID: PMC10867922 DOI: 10.1164/rccm.202307-1262ed] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 08/08/2023] [Indexed: 08/10/2023] Open
Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health University of Cagliari Cagliari, Italy and National Heart and Lung Institute Imperial College London London, United Kingdom
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Veronesi G, Ferrario MM, Giusti EM, Borchini R, Cimmino L, Ghelli M, Banfi A, Luoni A, Persechino B, Di Tecco C, Ronchetti M, Gianfagna F, De Matteis S, Castelnuovo G, Iacoviello L. Systematic Violence Monitoring to Reduce Underreporting and to Better Inform Workplace Violence Prevention Among Health Care Workers: Before-and-After Prospective Study. JMIR Public Health Surveill 2023; 9:e47377. [PMID: 37955961 PMCID: PMC10682923 DOI: 10.2196/47377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 07/14/2023] [Accepted: 09/26/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND Monitoring workplace violence (WPV) against health care workers (HCWs) through incident reporting is crucial to drive prevention, but the actual implementation is spotty and experiences underreporting. OBJECTIVE This study aims to introduce a systematic WPV surveillance in 2 public referral hospitals in Italy and assess underreporting, WPV annual rates, and attributes "before" (2016-2020) and "after" its implementation (November 2021 to 2022). METHODS During 2016-2020, incident reporting was based on procedures and data collection forms that were neither standardized between hospitals nor specific for aggressions. We planned and implemented a standardized WPV surveillance based on (1) an incident report form for immediate and systematic event notification, adopting international standards for violence definitions; (2) second-level root cause analysis with a dedicated psychologist, assessing violence determinants and impacts and offering psychological counseling; (3) a web-based platform for centralized data collection; and (4) periodic training for workforce coordinators and newly hired workers. We used data from incident reports to estimate underreporting, defined as an observed-to-expected (from literature and the "before" period) WPV ratio less than 1, and the 12-month WPV rates (per 100 HCWs) in the "before" and "after" periods. During the latter period, we separately estimated WPV rates for first and recurrent events. RESULTS In the "before" period, the yearly observed-to-expected ratios were consistently below 1 and as low as 0.27, suggesting substantial violence underreporting of up to 73%. WPV annual rates declined in 1 hospital (from 1.92 in 2016 to 0.57 in 2020) and rose in the other (from 0.52 to 1.0), with the divergence being attributable to trends in underreporting. Available data were poorly informative to identify at-risk HCW subgroups. In the "after" period, the observed-to-expected ratio rose to 1.14 compared to literature and 1.91 compared to the "before" period, consistently in both hospitals. The 12-month WPV rate was 2.08 (95% CI 1.79-2.42; 1.52 and 2.35 in the 2 hospitals); one-fifth (0.41/2.08, 19.7%) was due to recurrences. Among HCWs, the youngest group (3.79; P<.001), nurses (3.19; P<.001), and male HCWs (2.62; P=.008) reported the highest rates. Emergency departments and psychiatric wards were the 2 areas at increased risk. Physical assaults were more likely in male than female HWCs (45/67, 67.2% vs 62/130, 47.7%; P=.01), but the latter experienced more mental health consequences (46/130, 35.4% vs 13/67, 19.4%; P=.02). Overall, 40.8% (53/130) of female HWCs recognized sociocultural (eg, linguistic or cultural) barriers as contributing factors for the aggression, and 30.8% (40/130) of WPV against female HCWs involved visitors as perpetrators. CONCLUSIONS A systematic WPV surveillance reduced underreporting. The identification of high-risk workers and characterization of violence patterns and attributes can better inform priorities and contents of preventive policies. Our evaluation provides useful information for the large-scale implementation of standardized WPV-monitoring programs.
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Affiliation(s)
- Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Marco Mario Ferrario
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Emanuele Maria Giusti
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Rossana Borchini
- Occupational and Preventive Medicine, Azienda Socio-Sanitaria Territoriale Lariana, Como, Italy
| | - Lisa Cimmino
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Monica Ghelli
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensations Authority (INAIL), Roma, Italy
| | - Alberto Banfi
- Struttura Complessa Qualità, Risk Management e Accreditamento, Azienda Socio-Sanitaria Territoriale dei Sette Laghi, Varese, Italy
| | - Alessandro Luoni
- School of Specialization in Occupational Medicine, University of Insubria, Varese, Italy
| | - Benedetta Persechino
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensations Authority (INAIL), Roma, Italy
| | - Cristina Di Tecco
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensations Authority (INAIL), Roma, Italy
| | - Matteo Ronchetti
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers Compensations Authority (INAIL), Roma, Italy
| | - Francesco Gianfagna
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Mediterranea Cardiocentro, Napoli, Italy
| | - Sara De Matteis
- Department of Health Sciences, University of Milan, Milan, Italy
| | - Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico, Milano, Italy
- Department of Psychology, Catholic University of the Sacred Heart, Milano, Italy
| | - Licia Iacoviello
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
- Department of Epidemiology and Prevention, Istituto di Ricovero e Cura a Carattere Scientifico Neuromed, Pozzilli, Italy
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Cocco P, Satta G, Cancedda V, Meloni F, Milia S, Pilia I, Zucca M, De Matteis S. Is a Good Sleep on Mosquito-Free Nights Worth the Risk of Lymphoma Associated with the Use of Household Insecticides? A Case-Control Study of Lymphoma Subtypes in Adults. Toxics 2023; 11:752. [PMID: 37755762 PMCID: PMC10537294 DOI: 10.3390/toxics11090752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Revised: 08/25/2023] [Accepted: 09/01/2023] [Indexed: 09/28/2023]
Abstract
BACKGROUND The evidence linking the use of household pesticides and the risk of lymphoma is scanty. METHODS We explored the hypothesis in a population-based case-control study on lymphoma conducted in Sardinia, Italy, in 1998-2004, including 325 cases and 465 population controls and data on lifetime frequency, seasonality, and years of use of household insecticides and potential confounders. We calculated the risk of lymphoma (all subtypes) and its major subtypes associated with using household insecticides in three time windows (up to 1978, from 1979-2001, and 2002 onwards) with unconditional logistic regression adjusting by age, sex, education, and occupational exposure to pesticides. RESULTS Household insecticides did not increase risk of lymphoma (all subtypes), Hodgkin's lymphoma, B-cell lymphoma, and the major B-cell lymphoma subtypes. The risk of multiple myeloma (MM) but not the other subtypes showed a non-significant upward trend (p = 0.203) with increasing quartiles of days of use in the time window when propoxur was the most popular household insecticide. CONCLUSIONS Our results suggest no association between the household use of insecticides and the risk of lymphoma. Further studies are warranted to confirm or discard an association between MM risk and the use of propoxur.
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Affiliation(s)
- Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Studies, Healthcare Research & Primary Care, Faculty of Health Sciences, University of Manchester, Manchester M13 9PL, UK
| | - Giannina Satta
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
| | - Valerio Cancedda
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
| | - Simone Milia
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
| | - Mariagrazia Zucca
- Unit of Laboratory Medicine, Sulcis Local Health Unit, 09013 Carbonia, Italy;
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, 09131 Cagliari, Italy; (G.S.); (V.C.); (F.M.); (S.M.); (I.P.); (S.D.M.)
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Broccia G, Carter J, Ozsin-Ozler C, De Matteis S, Cocco P. Epidemiology of Chronic Lymphocytic Leukemia in Sardinia, Italy (1974-2003). Exp Hematol 2023; 125-126:37-44. [PMID: 37567460 DOI: 10.1016/j.exphem.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/13/2023]
Abstract
Several reports have described a worldwide increasing incidence of chronic lymphocytic leukemia (CLL) dating back seven to eight decades. Although genetic susceptibility would be an implausible explanation, the determinants of this upward trend and its spatial coordinates are poorly understood. We explored CLL incidence in Sardinia, Italy, using a validated database including the 1700 CLL cases diagnosed during 1974-2003. We applied Bayesian methods to map the CLL probability by administrative unit and Poisson regression analysis to investigate socioeconomic and environmental determinants adjusting by possible confounders. The standardized (Standard European population) incidence rate for the Sardinian population over the study period was 5.1 per 100,000 (95% confidence interval [CI] 4.9-5.3), increased annually by 5.8% (95% CI 5.7-6.0) consistently by sex and age, and was more noticeable in urban areas. Five administrative units exceeded the 95% posterior probability of an elevated CLL incidence: these were rural areas spread over the regional territory, not suggestive of spatial clustering. The Poisson regression analysis showed that the risk was elevated in urban areas (RR = 1.11, 95% CI 1.05-1.17), among residents ≥ 30 km from the nearest hospital (RR = 1.09, 95% CI 1.06-1.12), and with the local prevalence of cork harvesting (RR = 1.62, 95% CI 1.12-2.34). Our results suggest that better access to health care facilities and improvements in diagnostic efficacy might have generated the observed upward trend in CLL incidence, along with contributing environmental factors.
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Affiliation(s)
- Giorgio Broccia
- Department of Haematology and Bone Marrow Transplants, Hospital A. Businco, Cagliari, Sardinia, Italy
| | | | - Cansu Ozsin-Ozler
- Department of Paediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Public Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK.
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De Matteis S. Respiratory effects of air pollution: time to stop this deadly trajectory. Thorax 2023; 78:635-636. [PMID: 36972978 DOI: 10.1136/thorax-2023-220030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 03/29/2023]
Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- National Heart & Lung Institute, Imperial College London, London, UK
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Lecca R, Figorilli M, Casaglia E, Cucca C, Meloni F, Loscerbo R, De Matteis S, Cocco P, Puligheddu M. Gender and Nightshift Work: A Cross Sectional Study on Sleep Quality and Daytime Somnolence. Brain Sci 2023; 13:brainsci13040607. [PMID: 37190572 DOI: 10.3390/brainsci13040607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Revised: 03/28/2023] [Accepted: 03/30/2023] [Indexed: 05/17/2023] Open
Abstract
A few studies suggested that female nightshift workers suffer more frequently from sleep deprivation and insomnia. We conducted a cross-sectional survey in two different occupational settings to address gender-related differences in nightshift work adaptation. We used the Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index questionnaires to quantify daytime sleepiness and sleep quality among 156 workers, 91 from a ceramic tile factory and 65 healthcare workers, including hospital doctors, nurses, and nurse assistants. Seventy-three percent of participants (40 women and 74 men) were engaged in nightshift work. We used logistic regression analysis to predict daytime sleepiness and poor sleep quality as a function of personal and lifestyle variables and nightshift work. The female gender showed a strong association with both daytime sleepiness and poor sleep quality. Results were also suggestive of an increase in the risk of daytime sleepiness associated with nightshift work and being married. Our results confirm that women are especially vulnerable to sleep disruption. Promoting adaptation to nightshift work requires special attention towards gender issues.
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Affiliation(s)
- Rosamaria Lecca
- Interdepartmental Sleep Research Centre, University of Cagliari, 09042 Cagliari, Italy
| | - Michela Figorilli
- Interdepartmental Sleep Research Centre, University of Cagliari, 09042 Cagliari, Italy
| | - Elisa Casaglia
- Interdepartmental Sleep Research Centre, University of Cagliari, 09042 Cagliari, Italy
| | - Carla Cucca
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Federico Meloni
- Interdepartmental Sleep Research Centre, University of Cagliari, 09042 Cagliari, Italy
| | - Roberto Loscerbo
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, 09042 Cagliari, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, University of Manchester, Manchester M13 9PT, UK
| | - Monica Puligheddu
- Interdepartmental Sleep Research Centre, University of Cagliari, 09042 Cagliari, Italy
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Cherchi R, Cusano R, Orrù S, Ferrari PA, Massidda M, Fotia G, De Matteis S, Cocco P. Next Generation Sequencing for miRNA Detection on the Exhaled Breath Condensate: A Pilot Study. Epigenet Insights 2023; 16:25168657231160985. [PMID: 37025420 PMCID: PMC10070752 DOI: 10.1177/25168657231160985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/14/2023] [Indexed: 04/05/2023] Open
Abstract
Introduction: Exhaled breath condensate (EBC) sampling has been suggested as a less-invasive and cost-effective method to detect biological macromolecules, including miRNA. To explore the feasibility of its use as a biomarker of early effects of asbestos exposure, we conducted a preliminary test on male volunteers by comparing the miRNA profile in the EBC and the plasma using 2 different sequencing platforms. Methods: Six male volunteers, all retired and unexposed to dust or fumes, participated in the test. RNA was extracted from 200 μL EBC samples and same-size plasma samples. Sample aliquots were processed in 2 laboratories using 2 different sequencing platforms: a MiSeq Illumina® platform and a more performing HiSeq Illumina® platform. Results: The HiSeq3000® sequencing platform identified twice as many unique molecular indexes (UMI)-validated miRNA as the MiSeq® platform. The Spearman’s correlation coefficient between EBC counts and plasma counts was significant in 5/6 subjects with either platform (MiSeq® = 0.128-0.508, P = .026-<.001; HiSeq® = 0.156-0.412, P = .001-<.001). The intraclass correlation coefficient confirmed the consistency of the miRNA profile over the 6 participants with both biospecimens. Exploring the agreement between the EBC and plasma samples with Bland-Altman plots showed that using the HiSeq3000® platform substantially improved the EBC miRNA detection rate. Conclusion: Our preliminary study confirms that, when using the HiSeq® sequencing platform, EBC sampling is a suitable, non-invasive method to detect the miRNA profile in healthy subjects.
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Affiliation(s)
- Roberto Cherchi
- Operative Unit of Thoracic Surgery, Hospital G. Brotzu, Cagliari, Italy
| | - Roberto Cusano
- CRS4-NGS Core, POLARIS Research Park, Pula—Cagliari, Italy
| | - Sandro Orrù
- Operative Unit of Medical Genetics, Health Agency of Sardinia, Hospital Binaghi, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato—Cagliari, Italy
- Orrù S, Unit of Medical Genetics, Health Agency of Sardinia, Hospital Binaghi, Via Is Guadazzonis 3, Cagliari 09126, Italy.
| | - Paolo A Ferrari
- Operative Unit of Thoracic Surgery, Hospital G. Brotzu, Cagliari, Italy
| | | | - Giorgio Fotia
- CRS4-NGS Core, POLARIS Research Park, Pula—Cagliari, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato—Cagliari, Italy
| | - Pierluigi Cocco
- Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research & Primary Care, University of Manchester, Manchester, UK
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Labate C, Panunzio A, De Carlo F, Zacheo F, De Matteis S, Barba MC, Carbonara U, Rizzo FL, Leo S, Forte S, Ditonno P, Tafuri A, Pagliarulo V. Current Knowledge on Radiation-Therapy-Induced Erectile Dysfunction in Prostate-Cancer Patients: A Narrative Review. Uro 2023. [DOI: 10.3390/uro3020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
Prostate cancer is the most frequently diagnosed cancer in men in the United States. Among the different available treatment options, radiation therapy is recommended for localized or even advanced disease. Erectile dysfunction (ED) often occurs after radiation therapy due to neurological, vascular, and endocrine mechanisms resulting in arterial tone alteration, pudendal-nerve neuropraxia, and lastly fibrosis. Considering the influence of quality of life on patients’ treatment choice, radiation-therapy-induced ED prevention and treatment are major issues. In this narrative review, we briefly summarize and discuss the current state of the art on radiation-therapy-induced ED in PCa patients in terms of pathophysiology and available treatment options.
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Affiliation(s)
- Connie Labate
- Department of Urology, “Vito Fazzi” Hospital, 73100 Lecce, Italy
- Department of Emergency and Organ Transplantation, Urology and Andrology Section, University of Bari, 70124 Bari, Italy
| | - Andrea Panunzio
- Department of Urology, “Vito Fazzi” Hospital, 73100 Lecce, Italy
| | | | - Federico Zacheo
- Department of Urology, “Vito Fazzi” Hospital, 73100 Lecce, Italy
| | - Sara De Matteis
- Department of Radiation Therapy, “Vito Fazzi” Hospital, 73100 Lecce, Italy
| | | | - Umberto Carbonara
- Department of Emergency and Organ Transplantation, Urology and Andrology Section, University of Bari, 70124 Bari, Italy
- Department of Urology, Royal Surrey NHS Trust, London NW3 2PS, UK
| | | | - Silvana Leo
- Department of Oncology, “Vito Fazzi” Hospital, 73100 Lecce, Italy
| | - Saverio Forte
- Department of Emergency and Organ Transplantation, Urology and Andrology Section, University of Bari, 70124 Bari, Italy
| | - Pasquale Ditonno
- Department of Emergency and Organ Transplantation, Urology and Andrology Section, University of Bari, 70124 Bari, Italy
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13
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Nafees AA, Muneer MZ, Irfan M, Kadir MM, Semple S, De Matteis S, Burney P, Cullinan P. Byssinosis and lung health among cotton textile workers: baseline findings of the MultiTex trial in Karachi, Pakistan. Occup Environ Med 2023; 80:129-136. [PMID: 36717255 PMCID: PMC9985716 DOI: 10.1136/oemed-2022-108533] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 12/14/2022] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To assess the association of exposure in cotton mills in Karachi with different definitions of byssinosis and lung health. METHODS This cross-sectional survey took place between June 2019 and October 2020 among 2031 workers across 38 spinning and weaving mills in Karachi. Data collection involved questionnaire-based interviews, spirometry and measurements of personal exposure to inhalable dust. Byssinosis was defined using both WHO symptoms-based (work-related chest tightness), and Schilling's criteria (symptoms with decreased forced expiratory volume in 1 s (FEV1). Values of FEV1/forced vital capacity ratio below the lower limit of normality on postbronchodilator test were considered as 'chronic airflow obstruction' (CAO). RESULTS 56% of participants had at least one respiratory symptom, while 43% had shortness of breath (grade 1). Prevalence of byssinosis according to WHO criteria was 3%, it was 4% according to Schilling's criteria, and likewise for CAO. We found low inhalable dust exposures (geometric mean: 610 µg/m3). Cigarette smoking (≥3.5 pack-years), increasing duration of employment in the textile industry and work in the spinning section were important factors found to be associated with several respiratory outcomes. CONCLUSION We found a high prevalence of respiratory symptoms but a low prevalence of byssinosis. Most respiratory outcomes were associated with duration of employment in textile industry. We have discussed the challenges faced in using current, standard guidelines for identifying byssinosis.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan .,National Heart & Lung Institute, Imperial College London, London, UK
| | - Muhammad Zia Muneer
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Muhammad Irfan
- Department of Pulmonary and Critical Care Medicine, Aga Khan University, Karachi, Pakistan
| | | | - Sean Semple
- Institute of Social Marketing, University of Stirling, Stirling, UK
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- National Heart & Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- National Heart & Lung Institute, Imperial College London, London, UK
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14
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Reynolds CJ, Sisodia R, Barber C, Moffatt M, Minelli C, De Matteis S, Cherrie JW, Newman Taylor A, Cullinan P. What role for asbestos in idiopathic pulmonary fibrosis? Findings from the IPF job exposures case-control study. Occup Environ Med 2023; 80:97-103. [PMID: 36635100 PMCID: PMC9887381 DOI: 10.1136/oemed-2022-108404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 12/05/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND Asbestos has been hypothesised as the cause of the recent global increase in the incidence of 'idiopathic' pulmonary fibrosis (IPF). Establishing this has important diagnostic and therapeutic implications. The association between occupational asbestos exposure and IPF, and interaction with a common (minor allele frequency of 9% in European populations) genetic variant associated with IPF, MUC5B rs35705950, is unknown. METHODS Multicentre, incident case-control study. Cases (n=494) were men diagnosed with IPF at 21 UK hospitals. Controls (n=466) were age-matched men who attended a hospital clinic in the same period. Asbestos exposure was assessed at interview using a validated job exposure matrix and a source-receptor model. The primary outcome was the association between asbestos exposure and IPF, estimated using logistic regression adjusted for age, smoking and centre. Interaction with MUC5B rs35705950 was investigated using a genetic dominant model. RESULTS 327 (66%) cases and 293 (63%) controls ever had a high or medium asbestos exposure risk job; 8% of both cases and controls had cumulative exposure estimates ≥25 fibre ml⁻¹ years. Occupational asbestos exposure was not associated with IPF, adjusted OR 1.1 (95% CI 0.8 to 1.4; p=0.6) and there was no gene-environment interaction (p=0.3). Ever smoking was associated with IPF, OR 1.4 (95% CI 1 to 1.9; p=0.04) and interacted with occupational asbestos exposure, OR 1.9 (95% CI 1 to 3.6; p=0.04). In a further non-specified analysis, when stratifying for genotype there was significant interaction between smoking and work in an exposed job (p<0.01) for carriers of the minor allele of MUC5B rs35705950. CONCLUSION Occupational asbestos exposure alone, or through interaction with MUC5B rs35705950 genotype, was not associated with IPF. Exposure to asbestos and smoking interact to increase IPF risk in carriers of a common genetic variant, the minor allele of MUC5B rs35705950. TRIAL REGISTRATION NUMBER NCT03211507.
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15
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Ratanachina J, Amaral AFS, De Matteis S, Lawin H, Mortimer K, Obaseki DO, Harrabi I, Denguezli M, Wouters EFM, Janson C, Nielsen R, Gulsvik A, Cherkaski HH, Mejza F, Mahesh PA, Elsony A, Ahmed R, Tan W, Loh LC, Rashid A, Studnicka M, Nafees AA, Seemungal T, Aquart-Stewart A, Al Ghobain M, Zheng J, Juvekar S, Salvi S, Jogi R, Mannino D, Gislason T, Buist AS, Cullinan P, Burney P. Association of respiratory symptoms and lung function with occupation in the multinational Burden of Obstructive Lung Disease (BOLD) study. Eur Respir J 2023; 61:2200469. [PMID: 36028253 PMCID: PMC9834632 DOI: 10.1183/13993003.00469-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 08/02/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Chronic obstructive pulmonary disease has been associated with exposures in the workplace. We aimed to assess the association of respiratory symptoms and lung function with occupation in the Burden of Obstructive Lung Disease study. METHODS We analysed cross-sectional data from 28 823 adults (≥40 years) in 34 countries. We considered 11 occupations and grouped them by likelihood of exposure to organic dusts, inorganic dusts and fumes. The association of chronic cough, chronic phlegm, wheeze, dyspnoea, forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1)/FVC with occupation was assessed, per study site, using multivariable regression. These estimates were then meta-analysed. Sensitivity analyses explored differences between sexes and gross national income. RESULTS Overall, working in settings with potentially high exposure to dusts or fumes was associated with respiratory symptoms but not lung function differences. The most common occupation was farming. Compared to people not working in any of the 11 considered occupations, those who were farmers for ≥20 years were more likely to have chronic cough (OR 1.52, 95% CI 1.19-1.94), wheeze (OR 1.37, 95% CI 1.16-1.63) and dyspnoea (OR 1.83, 95% CI 1.53-2.20), but not lower FVC (β=0.02 L, 95% CI -0.02-0.06 L) or lower FEV1/FVC (β=0.04%, 95% CI -0.49-0.58%). Some findings differed by sex and gross national income. CONCLUSION At a population level, the occupational exposures considered in this study do not appear to be major determinants of differences in lung function, although they are associated with more respiratory symptoms. Because not all work settings were included in this study, respiratory surveillance should still be encouraged among high-risk dusty and fume job workers, especially in low- and middle-income countries.
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Affiliation(s)
- Jate Ratanachina
- National Heart and Lung Institute, Imperial College London, London, UK
- Dept of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Bangkok, Thailand
- Dept of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Andre F S Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK
- Dept of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Herve Lawin
- Unit of Teaching and Research in Occupational and Environmental Health, Cotonou, Benin
| | - Kevin Mortimer
- University of Cambridge, Cambridge, UK
- Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
| | | | | | | | - Emiel F M Wouters
- Ludwig Boltzmann Institute for Lung Health, Vienna, Austria
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - Christer Janson
- Respiratory, Allergy and Sleep Research, Dept of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Rune Nielsen
- Dept of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Amund Gulsvik
- Dept of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Filip Mejza
- Center for Evidence Based Medicine, 2nd Department of Internal Medicine, Jagiellonian University Medical College, Kraków, Poland
| | | | - Asma Elsony
- The Epidemiological Laboratory, Khartoum, Sudan
| | - Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
| | - Wan Tan
- Centre for Heart Lung Innovation, University of British Columbia, Vancouver, BC, Canada
| | - Li Cher Loh
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
| | - Abdul Rashid
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Penang, Malaysia
| | - Michael Studnicka
- Dept of Pulmonary Medicine, Paracelsus Medical University, Salzburg, Austria
| | | | | | | | - Mohammed Al Ghobain
- College of Medicine, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City in Riyadh, Saudi Arabia
| | - Jinping Zheng
- State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical College, Guangzhou, China
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre Pune, Pune, India
| | - Sundeep Salvi
- Pulmocare Research and Education Foundation, Pune, India
| | - Rain Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | | | - Thorarinn Gislason
- Dept of Sleep, Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - A Sonia Buist
- Oregon Health and Science University, Portland, OR, USA
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
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16
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Broccia G, Carter J, Ozsin-Ozler C, De Matteis S, Cocco P. Incidence and Bayesian Mapping of Myeloid Hematologic Malignancies in Sardinia, Italy. Cancer Control 2023; 30:10732748231202906. [PMID: 37877513 PMCID: PMC10605662 DOI: 10.1177/10732748231202906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND The epidemiology of myeloid hematologic malignancies in Italy has been poorly investigated. METHODS We used a validated database of 1974-2003 incident cases of hematologic malignancies among the resident population (all ages) of Sardinia, Italy, to describe the incidence of myeloid malignancies overall (N = 4389 cases) and by subtype. We investigated the time trend of acute myeloid leukemia (N = 1227 cases), chronic myeloid leukemia (N = 613 cases), and myelodysplastic syndrome (N = 1296 cases), and used Bayesian methods to explore their geographic spread, and Poisson regression analysis to estimate their association with environmental and socio-economic factors. RESULTS The annual standardized (world population) incidence rate (IR) of myeloid malignancies over the study period was 6.5 per 100,000 (95% CI 6.2-6.7). Myelodysplastic syndromes were the most prevalent subgroup (IR = 1.7, 95% CI 1.5-1.8). Incidence of all myeloid malignancies combined increased sharply during the study period with an annual percent change (APC) of 10.06% (95% CI 9.51-10.61), 19.77% for myelodysplastic syndromes (95% CI 19.63-19.91), and 3.18% (95% CI 2.99-3.37) for acute myeloid leukemia. Chronic myeloid leukemia did not show an upward trend. Apart from sporadic excesses in small rural communities and the major urban area, there was no evidence of spatial clustering. The risk of myeloid malignancies increased with increasing prevalence of sheep breeding. CONCLUSIONS Our results might prompt further research on the local genetic and environmental determinants of myeloid hematologic malignancies.
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Affiliation(s)
- Giorgio Broccia
- Department of Haematology and Bone Marrow Transplants, Hospital A. Businco, Cagliari, Italy
| | | | - Cansu Ozsin-Ozler
- Department of Paediatric Dentistry, Faculty of Dentistry, Hacettepe University, Ankara, Turkey
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy
| | - Pierluigi Cocco
- Division of Public Health, Health Services Research & Primary Care, Centre for Occupational and Environmental Health, University of Manchester, Manchester, UK
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17
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De Matteis S, Cencedda V, Pilia I, Cocco P. COVID-19 incidence in a cohort of public transport workers. Med Lav 2022; 113:e2022039. [PMID: 36006092 PMCID: PMC9484285 DOI: 10.23749/mdl.v113i4.13478] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 08/05/2022] [Indexed: 11/17/2022]
Abstract
Background: Previous research has shown an excess risk of COVID-19 among several occupations, but data on public transport workers are scarce. To investigate the occupational risk posed by contact with the public, we followed up the incidence of COVID-19 in a cohort of public transport workers. Methods: We identified the incident cases of COVID-19 between 1 September 2020 - 6 May 2021 in a cohort of 2,052 employees of a public transport agency in Sardinia, Italy. The diagnosis of COVID-19 was based on a positive molecular test. To calculate the expected events, we applied the age- and gender-specific incidence rates in the regional population at the same time frame to the correspondent strata of the study cohort. We estimated the age- and gender-adjusted relative risk (RR) of COVID-19 as the ratio between the observed and the expected events and its 95% confidence interval (95% C.I.) among the total cohort and in two sub-cohorts: bus drivers and the rest of the personnel (administrative staff, train and metro drivers, workers in the mechanical shop, and in the railroad maintenance, and security). Results: Bus drivers run an elevated risk of COVID-19 (RR = 1.4, 95% C.I. 1.07 - 1.79). There was no excess risk among the rest of the personnel. Conclusions: Our study suggests an excess risk of COVID-19 among bus drivers even in a relatively low incidence area, which could imply inadequacy of the preventive measures put in place. Additional studies of larger size with detailed information on personal and lifestyle characteristics are warranted.
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Affiliation(s)
| | | | | | - Pierluigi Cocco
- Dipartimento di Sanità Pubblica, Medicina Clinica e Molecolare, Università di Cagliari.
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18
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Cocco P, De Matteis S. The determinants of the changing speed of spread of COVID-19 across Italy. Epidemiol Infect 2022; 150:1-26. [PMID: 35514091 PMCID: PMC9114753 DOI: 10.1017/s095026882200084x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/31/2022] [Accepted: 04/26/2022] [Indexed: 11/25/2022] Open
Abstract
The COVID-19 epidemic showed inter-regional differences in Italy. We used an ecological study design and publicly available data to compare the basic reproduction number (R 0), the doubling time of the infection (DT) and the COVID-19 cumulative incidence (CI), death rate, case fatality rate (CFR) and time lag to slow down up to a 50-days doubling time in the first and the second 2020 epidemic waves (δ DT50) by region. We also explored socio-economic, environmental and lifestyle variables with multiple regression analysis. COVID-19 CI and CFR changed in opposite directions in the second vs . the first wave: the CI increased sixfold with no evidence of a relationship with the testing rate; the CFR decreased in the regions where it was initially higher but increased where it was lower. The R 0 did not change; the initially mildly affected regions, but not those where the first wave had most severely hit, showed a greater δ DT50 amplitude. Vehicular traffic, average temperature, population density, average income, education and household size showed a correlation with COVID-19 outcomes. The deadly experience in the first epidemic wave and the varying preparedness of the local health systems might have contributed to the inter-regional differences in the second COVID-19 epidemic wave.
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Affiliation(s)
- Pierluigi Cocco
- Division of Population Health, Centre for Occupational and Environmental Health, University of Manchester, Manchester M13 9PL, UK
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, 09047 Monserrato, Italy
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19
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Nafees AA, Iqbal AR, Cullinan P, De Matteis S, Burney P, Semple S. Use of Low-Cost Particle Counters for Cotton Dust Exposure Assessment in Textile Mills in Low- and Middle-Income Countries. Ann Work Expo Health 2022; 66:537-542. [PMID: 34791042 PMCID: PMC9030129 DOI: 10.1093/annweh/wxab102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 10/25/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE There is a lack of consensus on methods for cotton dust measurement in the textile industry, and techniques vary between countries-relying mostly on cumbersome, traditional approaches. We undertook comparisons of standard, gravimetric methods with low-cost optical particle counters for personal and area dust measurements in textile mills in Pakistan. METHODS We included male textile workers from the weaving sections of seven cotton mills in Karachi. We used the Institute of Occupational Medicine (IOM) sampler with a Casella Apex 2 standard pump and the Purple Air (PA-II-SD) for measuring personal exposures to inhalable airborne particles (n = 31). We used the Dylos DC1700 particle counter, in addition to the two above, for area-level measurements (n = 29). RESULTS There were no significant correlations between the IOM and PA for personal dust measurements using the original (r = -0.15, P = 0.4) or log-transformed data (r = -0.32, P = 0.07). Similarly, there were no significant correlations when comparing the IOM with either of the particle counters (PA and Dylos) for area dust measurements, using the original (r = -0.07, P = 0.7; r = 0.10, P = 0.6) or log-transformed data (r = -0.09, P = 0.6; r = 0.07, P = 0.7). CONCLUSION Our findings show a lack of correlation between the gravimetric method and the use of particle counters in both personal and area measurements of cotton dust, precluding their use for measuring occupational exposures to airborne dust in textile mills. There continues to be a need to develop low-cost instruments to help textile industries in low- and middle-income countries to perform cotton dust exposure assessment.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Abdul Rehman Iqbal
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Paul Cullinan
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Peter Burney
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Sean Semple
- Institute for Social Marketing and Health Research, University of Stirling, Stirling, Scotland, UK
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20
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Abstract
PURPOSE OF REVIEW This brief narrative review aims to highlight relevant recent updates on occupational causes of chronic obstructive pulmonary disease (COPD). RECENT FINDINGS The most recent literature has been searched for any new relevant association between occupational exposures and COPD. Only large epidemiological studies of high quality have been included. Beyond the more traditional exposures, such as mineral or organic dusts, new chemicals have emerged as potential occupational causal agents for COPD. In particular, pesticides and cleaning products, including disinfectants, that have shown also positive exposure-response trends. For cleaning products, some specific chemicals have been identified, but for pesticides the identification of specific causal compounds is more challenging. The biological underlying mechanisms are still under study. SUMMARY In the recent literature, occupational exposure to pesticides and cleaning products has emerged as potential cause of COPD. Awareness on occupational causes of COPD should increase among all stakeholders, from health professionals to public to prevent the associated public health burden. More studies on identifying the specific causal agents and mechanisms are needed to focus preventive strategies.
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Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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21
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Veronesi G, De Matteis S, Calori G, Pepe N, Ferrario MM. Long-term exposure to air pollution and COVID-19 incidence: a prospective study of residents in the city of Varese, Northern Italy. Occup Environ Med 2022; 79:192-199. [PMID: 35012995 PMCID: PMC8764713 DOI: 10.1136/oemed-2021-107833] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVES To investigate the association between long-term exposure to airborne pollutants and the incidence of SARS-CoV-2 up to March 2021 in a prospective study of residents in Varese city. METHODS Citizens of Varese aged ≥18 years as of 31 December 2019 were linked by residential address to 2018 average annual exposure to outdoor concentrations of PM2.5, PM10, NO2, NO and ozone modelled using the Flexible Air quality Regional Model (FARM) chemical transport model. Citizens were further linked to regional datasets for COVID-19 case ascertainment (positive nasopharyngeal swab specimens) and to define age, sex, living in a residential care home, population density and comorbidities. We estimated rate ratios and additional numbers of cases per 1 µg/m3 increase in air pollutants from single- and bi-pollutant Poisson regression models. RESULTS The 62 848 residents generated 4408 cases. Yearly average PM2.5 exposure was 12.5 µg/m3. Age, living in a residential care home, history of stroke and medications for diabetes, hypertension and obstructive airway diseases were independently associated with COVID-19. In single-pollutant multivariate models, PM2.5 was associated with a 5.1% increase in the rate of COVID-19 (95% CI 2.7% to 7.5%), corresponding to 294 additional cases per 100 000 person-years. The association was confirmed in bi-pollutant models; excluding subjects in residential care homes; and further adjusting for area-based indicators of socioeconomic level and use of public transportation. Similar findings were observed for PM10, NO2 and NO. Ozone was associated with a 2% decrease in disease rate, the association being reversed in bi-pollutant models. CONCLUSIONS Long-term exposure to low levels of air pollutants, especially PM2.5, increased the incidence of COVID-19. The causality warrants confirmation in future studies; meanwhile, government efforts to further reduce air pollution should continue.
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Affiliation(s)
- Giovanni Veronesi
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- National Heart and Lung Institute, Imperial College London, London, UK
| | | | | | - Marco M Ferrario
- Research Center in Epidemiology and Preventive Medicine, Department of Medicine and Surgery, University of Insubria, Varese, Italy
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22
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De Matteis S, Jarvis D, Darnton L, Consonni D, Kromhout H, Hutchings S, Sadhra SS, Fishwick D, Vermeulen R, Rushton L, Cullinan P. Lifetime occupational exposures and chronic obstructive pulmonary disease risk in the UK Biobank cohort. Thorax 2022; 77:997-1005. [PMID: 35082144 DOI: 10.1136/thoraxjnl-2020-216523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 11/04/2021] [Indexed: 11/03/2022]
Abstract
BACKGROUND AND AIM Occupational exposures are important, preventable causes of COPD. We previously found an increased risk of COPD among six occupations by analysing lifetime job histories and lung function data in the population-based UK Biobank cohort. We aimed to build on these findings and elucidate the underlying potential causal agents to focus preventive strategies. METHODS We applied the ALOHA+job exposure matrix (JEM) based on the International Standard Classification of Occupations V.1988 codes, where exposure to 12 selected agents was rated as 0 (no exposure), 1 (low) or 2 (high). COPD was spirometrically defined as FEV1/FVC less than the lower limit of normal. We calculated semiquantitative cumulative exposure estimates for each agent by multiplying the duration of exposure and squared intensity. Prevalence ratio (PR) and 95% CI for COPD were estimated using robust Poisson regression adjusted for centre, sex, age, smoking and coexposure to JEM agents. Only associations confirmed among never-smokers and never-asthmatics were considered reliable. RESULTS Out of 116 375 participants with complete job histories, 94 514 had acceptable/repeatable spirometry and smoking data and were included in the analysis. Pesticide exposure showed increased risk of COPD for ever exposure (PR=1.13, 95% CI 1.01 to 1.28) and high cumulative exposure (PR=1.32, 95% CI 1.12 to 1.56), with positive exposure-response trends (p trend=0.004), which were confirmed among never-smokers (p trend=0.005) and never-asthmatics (p trend=0.001). CONCLUSION In a large population-based study, occupational exposure to pesticides was associated with risk of COPD. Focused preventive strategies for workers exposed to pesticides can prevent the associated COPD burden.
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Affiliation(s)
- Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK .,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Debbie Jarvis
- National Heart and Lung Institute, Imperial College London, London, UK.,MRC Centre for Environment and Health, Imperial College, London, UK
| | - Lucy Darnton
- Science Division, Health and Safety Executive, Harpur Hill Buxton, UK
| | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Sally Hutchings
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Steven S Sadhra
- Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK
| | - David Fishwick
- Science Division, Health and Safety Executive, Harpur Hill Buxton, UK
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, University of Utrecht, Utrecht, The Netherlands
| | - Lesley Rushton
- MRC Centre for Environment and Health, Imperial College, London, UK.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
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Nafees AA, Matteis SD, Burney P, Cullinan P. Contemporary Prevalence of Byssinosis in Low- and Middle-Income Countries: A Systematic Review. Asia Pac J Public Health 2022; 34:483-492. [DOI: 10.1177/10105395211073051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We aimed to identify the contemporary prevalence of byssinosis through a systematic review. We used Medline, Web of Science, Embase, and Global Health databases to identify studies published in any language between 2000 and 2019, reporting primary data on byssinosis among adults. We used the Joanna Briggs Institute checklist to estimate the risk of bias in studies and undertook a qualitative, narrative data analysis. The review considered the prevalence of byssinosis, chest tightness, and airflow obstruction in textile workers in low- and middle-income countries (LMICs). We found 26 relevant studies that included 6930 workers across 12 countries. Most of the studies (n = 19) were from Asia, and 7 from African countries. Twenty-five studies were cross-sectional surveys while 1 was a cohort study. The prevalence of byssinosis was reported by 18 studies, and ranged from 8% to 38%, without any clear associations, at the group level, between the prevalence of byssinosis and durations of workers’ exposures. Prevalence of chest tightness ranged between 4% and 58% and that of airflow obstruction between 10% and 30%. We found a strong correlation ( r = 0.72) between prevalence of byssinosis and cotton dust levels. Our findings indicate that byssinosis remains a significant, contemporary problem in some parts of the textile sector in LMICs.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Sara De Matteis
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Peter Burney
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
| | - Paul Cullinan
- Genomic and Environmental Medicine, National Heart and Lung Institute, Imperial College London, UK
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24
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Cocco P, Piro S, Meloni F, Montagna A, Pani M, Pilia I, Padoan M, Miligi L, Magnani C, Gambelunghe A, Muzi G, Ferri GM, Vimercati L, Zanotti R, Scarpa A, Zucca M, Latte GC, Angelucci E, De Matteis S, Puligheddu M. Night shift work and lymphoma: results from an Italian multicentre case-control study. Occup Environ Med 2022; 79:452-459. [PMID: 35027441 DOI: 10.1136/oemed-2021-107845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/22/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Night shift work can disrupt circadian rhythm and cause chronic sleep deprivation, which might increase the risk of lymphoma through immunosuppression and oxidative stress. MATERIAL AND METHODS We investigated the association between night shift work and risk of lymphoma subtypes in 867 incident cases and 774 controls, who participated in a multicentre Italian study between 2011 and 2017. Based on questionnaire information, occupational experts assessed the lifetime probability of night shift work, the total number of night shifts and years of night shift work among study participants. OR and 95% CI for lymphoma and its major subtypes associated with night shift work was calculated with logistic regression, adjusting by age, gender, education, study area, marital status and family history of haemolymphatic cancer. RESULTS Ever working night shifts was associated with an increase in the risk of chronic lymphocytic leukaemia (CLL) (OR 1.9, 95% CI 1.14 to 3.32), which was highest after a 15-34 years latency. However, there was not a linear increase in risk by probability of exposure, years of night shift work, nor lifetime number of night shifts whether under rotating or permanent work schedules. Risk of lymphoma overall, B cell lymphoma (BCL), its major subtypes other than CLL, and other less prevalent BCL subtypes combined did not show an association. CONCLUSIONS We found conflicting evidence of an association between night shift work and the risk of CLL. We did not observe an association with other lymphoma subtypes.
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Affiliation(s)
- Pierluigi Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy .,Centre for Occupational and Environmental Health, Division of Population Health, The University of Manchester, Manchester, UK
| | - Sara Piro
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, ISPRO - Institute for Prevention, Research, and Cancer Network, Florence, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Montagna
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Michele Pani
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marina Padoan
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, ISPRO - Institute for Prevention, Research, and Cancer Network, Florence, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Italy
| | - Angela Gambelunghe
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giacomo Muzi
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Roberta Zanotti
- Department of Haematology, University of Verona, Verona, Italy
| | - Aldo Scarpa
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Mariagrazia Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Emanuele Angelucci
- Deaprtment of Haematology, IST - National Institute for Cancer Research, Genova, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Puligheddu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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25
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Nafees AA, Muneer MZ, De Matteis S, Amaral A, Burney P, Cullinan P. Impact of using different predictive equations on the prevalence of chronic byssinosis in textile workers in Pakistan. Occup Environ Med 2021; 79:242-244. [PMID: 34799440 PMCID: PMC7613213 DOI: 10.1136/oemed-2021-107680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022]
Abstract
Objective byssinosis remains a significant problem among textile workers in low- and middle-income countries. Here we share our experience of using different prediction equations for assessing ‘chronic’ byssinosis according to the standard WHO classification using measurements of FEV1. Methods we enrolled 1910 workers in a randomized controlled trial of an intervention to improve the health of textile workers in Pakistan. We included in analyses the 1724 (90%) men who performed pre-bronchodilator spirometry tests of acceptable quality. We compared four different equations for deriving lung function percentage predicted values among those with symptoms-based byssinosis: the third US National Health and Nutrition Examination Survey (NHANES-III, with “N. Indian and Pakistani” conversion factor); the Global Lung Function Initiative (GLI, “other or mixed ethnicities”); a recent equation derived from survey of a western Indian population; and one based on an older and smaller survey of Karachi residents. Results 58 men (3.4%) had symptoms-based byssinosis according to WHO criteria. Of these, the proportions with a reduced FEV1 (< 80% predicted) identified using NHANES, GLI, Indian and Pakistani reference equations were 40%, 41%, 14% and 12%, respectively. Much of this variation was eliminated when we substituted FEV1/FVC ratio (<LLN) as a measure of airway obstruction. Conclusion accurate measures of occupational disease frequency and distribution require approaches that are both standardised and meaningful. We should reconsider the WHO definition of ‘chronic’ byssinosis based on changes in FEV1, and instead use the FEV1/FVC.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan .,National Heart and Lung Institute, Imperial College London, London, UK
| | - Muhammad Zia Muneer
- Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK.,Department of Medical Sceinces and Public Health, University of Cagliari, Cagliari, Italy
| | - Andre Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
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26
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Andersen ZJ, Gehring U, De Matteis S, Melen E, Vicedo-Cabrera AM, Katsouyanni K, Yorgancioglu A, Ulrik CS, Medina S, Hansen K, Powell P, Ward B, Hoffmann B. Clean air for healthy lungs - an urgent call to action: European Respiratory Society position on the launch of the WHO 2021 Air Quality Guidelines. Eur Respir J 2021; 58:13993003.02447-2021. [PMID: 34561297 DOI: 10.1183/13993003.02447-2021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Zorana Jovanovic Andersen
- Dept of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Sara De Matteis
- Dept of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Heart and Lung Institute, Imperial College London, London, UK
| | - Erik Melen
- Dept of Clinical Sciences and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Ana Maria Vicedo-Cabrera
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Oeschger Center for Climate Change Research, University of Bern, Bern, Switzerland
| | - Klea Katsouyanni
- National and Kapodistrian University of Athens, Medical School, Athens, Greece.,Environmental Research Group, School of Public Health, Imperial College London, London, UK
| | - Arzu Yorgancioglu
- Medical Faculty, Dept of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - Charlotte Suppli Ulrik
- Dept of Respiratory Medicine, Copenhagen University Hospital-Hvidovre, Hvidovre, Denmark.,Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Sylvia Medina
- Direction of Environmental and Occupational Health, Santé Publique France, Saint Maurice, France
| | - Kjeld Hansen
- European Lung Foundation, Sheffield, UK.,Kristiania University College, Technology, Oslo, Norway
| | | | - Brian Ward
- European Respiratory Society, Brussels, Belgium
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
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27
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De Matteis S, Facondo G, Valeriani M, Vullo G, De Sanctis V, Ascolese AM, Campanella B, Scalabrino G, Osti MF. Hypofractionated Radiation Therapy (HFRT) of Breast/Chest Wall and Regional Nodes in Locally Advanced Breast Cancer: Toxicity Profile and Survival Outcomes in Retrospective Monoistitutional Study. Clin Breast Cancer 2021; 22:e332-e340. [PMID: 34670727 DOI: 10.1016/j.clbc.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 09/07/2021] [Accepted: 09/20/2021] [Indexed: 11/03/2022]
Abstract
AIM To evaluate the efficacy and safety of hypofractionated radiation therapy (HFRT) of the breast/chest wall and regional nodes in patients with locally advanced breast cancer and positive lymph nodes. MATERIALS AND METHODS One hundred and twenty-two patients treated between October 2016 and March 2020 with HFRT were retrospectively reviewed. A total dose of 42.4 Gy was delivered to the chest wall and lymph nodes in 16 fractions of 2.65 Gy each, using the IMRT technique. Patients treated with breast-conserving surgery received an overdose (concomitant boost of 3 Gy daily) with the SIB (Simultaneous Integrated Boost) technique. RESULTS Median age at diagnosis was 58 years (range 34-86 years) and median follow-up was 22 months (range 6-48 months). Overall survival (OS) at 1, 2 and 3 years was 100%, 97.3% and 90%, respectively. Disease-free survival (DFS) at 1, 2, and 3 years was 91.4%, 87%, and 84.8%, respectively. Distant metastasis-free survival (MFS) at 1, 2 and 3 years was 93.1%, 88% and 85.7%, respectively. Two patients (1.6%) experienced local recurrence on the chest wall during FUP. Twenty-one patients (17%) showed a grade 2 dermal toxicity, no grade 3 acute skin toxicity was found. Sixteen patients (13%) showed early-stage arm lymphedema (grade ≤ 2). Twenty-three patients (19%) showed a grade 2 late skin toxicity. Twenty patients (16%) had grade ≤ 2 late arm lymphedema. CONCLUSION Given the excellent local control, survival rates and the low toxicity profile demonstrated, HFRT could be considered a valid therapeutic option in patients with locally advanced breast cancer.
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Affiliation(s)
- Sara De Matteis
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Giuseppe Facondo
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Maurizio Valeriani
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Gianluca Vullo
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy.
| | - Vitaliana De Sanctis
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Anna Maria Ascolese
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Barbara Campanella
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Giovanna Scalabrino
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
| | - Mattia Falchetto Osti
- Department of Medicine and Surgery and Translational Medicine, Sapienza University of Rome, Radiotherapy Oncology, St. Andrea Hospital, Rome, Italy
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Andersen ZJ, Hoffmann B, Morawska L, Adams M, Furman E, Yorgancioglu A, Greenbaum D, Neira M, Brunekreef B, Forastiere F, Rice MB, Wakenhut F, Coleen E, Boogaard H, Gehring U, Melén E, Ward B, De Matteis S. Air pollution and COVID-19: clearing the air and charting a post-pandemic course: a joint workshop report of ERS, ISEE, HEI and WHO. Eur Respir J 2021; 58:2101063. [PMID: 34385271 PMCID: PMC8361303 DOI: 10.1183/13993003.01063-2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/26/2021] [Indexed: 01/07/2023]
Abstract
Air pollution is now recognised by governments, international institutions and civil society as a major global public health risk factor. The health burden of air pollution is large: 509 000 premature deaths every year in Europe [1] and serious aggravations of heart and lung diseases that affect millions of patients, both children and adults. The European Environmental Agency estimated that in 2018 there were 417 000 premature deaths attributable to particulate matter with diameter <2.5 µm (PM2.5), 55 000 to NO2, and 20 600 to O3 in Europe (table 10.1 in EEA Report 9/2020 [2]). In addition, 4 805 800 years of life lost could be attributed to PM2.5, 623 600 to NO2, and 246 700 to O3 (table 10.2 in [2]). This “silent killer” is one the most important determinants of health, surpassed only by high blood pressure, tobacco use and poor diet. The coronavirus disease 2019 (COVID-19) pandemic has raised concerns about whether air pollution can increase the severity of disease and risk of death after infection, as well as facilitate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Chronic lung disease patients are in the epicentre of the current crisis, as they are more vulnerable to both the adverse effects of a SARS-CoV-2 infection and air pollution exposure, as well as their possible interactions. At the same time, the lockdown measures to control the spread of COVID-19 brought historical short-term reductions in air pollution levels around the globe, and increasing general public interest and demand for clean air policies [3]. The COVID-19 pandemic, an emerging infectious disease probably caused by a spill over from animals, and its possible interactions with air pollution, is an existential reminder that we are a part of a larger ecosystem, and that human health is closely connected with the health of our environment and planet. Here we provide a short summary on the potential role of air pollution in the spread and worsening of health impacts of COVID-19, and on the influence of the pandemic on air pollution levels in Europe. Moreover, we outline the major lessons learned to chart a healthy post-pandemic course. This work summarises the key messages from a workshop that took place on 2 December, 2020, organised by the European Respiratory Society (ERS), the International Society for Environmental Epidemiology (ISEE) and the Health Effects Institute (HEI), endorsed by the World Health Organization (WHO), and hosted by the European Parliament Lung Health Group and the European Commission (table 1). The potential role of air pollution in the worsening of health impacts of COVID-19, and the influence of the pandemic on air pollution levels in Europe is explored. This editorial outlines the major lessons learned to chart a healthy post-pandemic course. https://bit.ly/3hmbaya
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Affiliation(s)
- Zorana J Andersen
- Environmental Epidemiology Group, Section of Environmental Health, Dept of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Barbara Hoffmann
- Institute for Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Lidia Morawska
- International Laboratory for Air Quality and Health (ILAQH), School of Earth and Atmospheric Sciences, Queensland University of Technology, Brisbane, Australia
| | - Martin Adams
- European Environment Agency, Copenhagen, Denmark
| | - Eeva Furman
- Finnish Environment Institute, Helsinki, Finland
| | - Arzu Yorgancioglu
- Celal Bayar University Medical Faculty, Dept of Pulmonology, Manisa, Turkey
| | | | - Maria Neira
- World Health Organization, Geneva, Switzerland
| | - Bert Brunekreef
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | | | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - François Wakenhut
- Clean Air Unit, Directorate-General Environment, European Commission, Brussels, Belgium
| | - Erika Coleen
- Belgian Asthma and Allergy Association, Brussels, Belgium
| | | | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
| | - Erik Melén
- Dept of Clinical Sciences and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | - Brian Ward
- European Respiratory Society, Brussels, Belgium
| | - Sara De Matteis
- Dept of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- National Heart and Lung Institute, Imperial College London, London, UK
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29
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Ratanachina J, Amaral A, De Matteis S, Cullinan P, Burney P. Farming, pesticide exposure and respiratory health: a cross-sectional study in Thailand. Occup Environ Med 2021; 79:38-45. [PMID: 34162719 DOI: 10.1136/oemed-2020-107325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/09/2021] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To assess the association of lung function and respiratory symptoms with farming, particularly pesticide use, in an agricultural province in Thailand. METHODS We undertook a cross-sectional survey of adults aged 40-65 in Nan province, Thailand, between May and August 2019. We randomly recruited 345 villagers and enriched the sample with 82 government employees. All participants performed post-bronchodilator spirometry and completed a questionnaire covering information on respiratory symptoms, farming activities, pesticide use and known risk factors for respiratory disease. Associations of respiratory outcomes with farming and pesticide exposures were examined by multivariable regression analysis. RESULTS The response rate was 94%. The prevalence of chronic airflow obstruction among villagers was 5.5%. Villagers had, on average, a lower percent predicted post-bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) than government employees (98.3% vs 100.3%; p=0.04). There was no evidence of association of lung function with farming activities, the use of specific herbicides (glyphosate and paraquat), insecticides (organophosphates and pyrethroids) or fungicides. The exceptions were poultry farming, associated with chronic cough and an increase of FEV1/FVC, and atrazine, for which duration (p-trend <0.01), intensity (p-trend <0.01) and cumulative hours (p-trend=0.01) of use were all associated with higher FEV1/FVC in an exposure-response manner. Cumulative hours (-280 mL/hour), low duration (-270 mL/year) and intensity (-270 mL/hour/year) of atrazine use were associated with lower FVC. CONCLUSIONS Chronic airflow obstruction is uncommon among villagers of an agricultural province in Nan, Thailand. Farming and pesticide use are unlikely to be major causes of respiratory problems there.
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Affiliation(s)
- Jate Ratanachina
- National Heart and Lung Institute, Imperial College London, London, UK .,Department of Preventive and Social Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Andre Amaral
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Sardegna, Italy
| | - Paul Cullinan
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Peter Burney
- National Heart and Lung Institute, Imperial College London, London, UK
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30
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Meloni F, Satta G, Padoan M, Montagna A, Pilia I, Argiolas A, Piro S, Magnani C, Gambelunghe A, Muzi G, Ferri GM, Vimercati L, Zanotti R, Scarpa A, Zucca M, De Matteis S, Campagna M, Miligi L, Cocco P. Occupational exposure to glyphosate and risk of lymphoma:results of an Italian multicenter case-control study. Environ Health 2021; 20:49. [PMID: 33910586 PMCID: PMC8082925 DOI: 10.1186/s12940-021-00729-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 04/14/2021] [Indexed: 05/30/2023]
Abstract
BACKGROUND The International Agency for Research on Cancer (IARC) recently classified glyphosate, the most used herbicide worldwide, as a probable human carcinogen. We inquired into the association between occupational exposure to glyphosate and risk of lymphoma subtypes in a multicenter case-control study conducted in Italy. METHODS The Italian Gene-Environment Interactions in Lymphoma Etiology (ItGxE) study took place in 2011-17 in six Italian centres. Overall, 867 incident lymphoma cases and 774 controls participated in the study. Based on detailed questionnaire information, occupational experts classified duration, confidence, frequency, and intensity of exposure to glyphosate for each study subject. Using unconditional regression analysis, we modelled risk of major lymphoma subtypes associated with exposure to glyphosate adjusted by age, gender, education, and study centre. RESULTS Very few study subjects (2.2%) were classified as ever exposed to glyphosate. Risk of follicular lymphoma (FL) was elevated 7-fold in subjects classified as ever exposed to glyphosate with medium-high confidence, 4.5-fold in association with medium-high cumulative exposure level, 12-fold with medium-high exposure intensity, and 6-fold with exposure for 10 days or more per year. Significant upward trends were detected with all the exposure metrics, but duration. The overall p-value for an upward trend with four independent metrics was 1.88 × 10- 4. There was no association with risk of lymphoma (any subtype), Non Hodgkin Lymphoma, B-cell lymphoma, or the major lymphoma subtypes other than FL. CONCLUSIONS Our findings provide limited support to the IARC decision to classify glyphosate as Group 2A human carcinogen.
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Affiliation(s)
- Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Giannina Satta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marina Padoan
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, Novara, Italy
| | - Andrea Montagna
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Ilaria Pilia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessandra Argiolas
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Piro
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Corrado Magnani
- Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont, Novara, Italy
| | - Angela Gambelunghe
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giacomo Muzi
- Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
| | - Giovanni Maria Ferri
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Luigi Vimercati
- Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
| | - Roberta Zanotti
- Department of Medicine, Haematology Unit, and Department of Diagnostics and Public Health-Section of Pathology, Verona University Hospital, Verona, Italy
| | - Aldo Scarpa
- Department of Medicine, Haematology Unit, and Department of Diagnostics and Public Health-Section of Pathology, Verona University Hospital, Verona, Italy
| | - Mariagrazia Zucca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPRO), Florence, Italy
| | - Pierluigi Cocco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy .,National Heart and Lung Institute, Imperial College London, London, UK
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Abstract
There is consistent and growing evidence of an epidemic of "asthma-like" symptoms among professional cleaners. Questions include how big is this problem worldwide, which cleaning agents are dangerous, how do they affect the lungs, and is it really asthma? This issue is important to public health because of the increasing number of professional cleaners, many from vulnerable categories. There are implications for anybody exposed to cleaning products during housekeeping, including children. This article uses available evidence to give a broad but concise overview on what we know so far and how we can prevent the cleaning-associated respiratory public health burden.
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Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; NHLI, Imperial College London, London, United Kingdom.
| | - Steven Ronsmans
- Clinic for Occupational and Environmental Medicine, Department of Pulmonary Medicine, University Hospitals Leuven, Leuven, Belgium; Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
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Cocco P, Satta G, Meloni F, Pilia I, Ahmed F, Becker N, Casabonne D, de Sanjosé S, Foretova L, Maynadié M, Nieters A, Staines A, 't Mannetje A, Zucca M, Ennas MG, Campagna M, De Matteis S, Benavente Y. Occupational exposure to organic dust and risk of lymphoma subtypes in the EPILYMPH case-control study. Scand J Work Environ Health 2021; 47:42-51. [PMID: 33103203 PMCID: PMC7801142 DOI: 10.5271/sjweh.3925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to estimate the risk of lymphoma and its major subtypes in relation to occupational exposure to specific organic dusts. Methods We explored the association in 1853 cases and 1997 controls who participated in the EpiLymph case-control study, conducted in six European countries in 1998-2004. Based on expert assessment of lifetime occupational exposures, we calculated the risk of the major lymphoma subtypes associated with exposure to six specific organic dusts, namely, flour, hardwood, softwood, natural textile, synthetic textile, and leather, and two generic (any types) groups: wood and textile dusts. Risk was predicted with unconditional regression modeling, adjusted by age, gender, study center, and education. Results We observed a 2.1-fold increase in risk of follicular lymphoma associated with ever exposure to leather dust [95% confidence interval (CI) 1.01-4.20]. After excluding subjects who ever worked in a farm or had ever been exposed to solvents, risk of B-cell lymphoma was elevated in relation to ever exposure to leather dust [odd ratio (OR) 2.2, 95% CI 1.00-4.78], but it was not supported by increasing trends with the exposure metrics. Risk of Hodgkin lymphoma was elevated (OR 2.0, 95% CI 0.95-4.30) for exposure to textile dust, with consistent upward trends by cumulative exposure and three independent exposure metrics combined (P=0.023, and P=0.0068, respectively). Conclusions Future, larger studies might provide further insights into the nature of the association we observed between exposure to textile dust and risk of Hodgkin lymphoma.
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Affiliation(s)
- Pierluigi Cocco
- Department of Medical Sciences and Public Health, Occupational Medicine unit, University of Cagliari, Monserrato (Cagliari) Italy.
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De Matteis S, Pira E, Mutti A. The COVID-19 pandemic and Occupational Medicine: impact and opportunities. LA MEDICINA DEL LAVORO 2021; 112:411-413. [PMID: 34939613 PMCID: PMC8759048 DOI: 10.23749/mdl.v112i6.12627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 11/29/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari
| | - Enrico Pira
- Department of Occupational Medicine, University Hospital Città della Salute e della Scienza of Turin
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Archangelidi O, Sathiyajit S, Consonni D, Jarvis D, De Matteis S. Cleaning products and respiratory health outcomes in occupational cleaners: a systematic review and meta-analysis. Occup Environ Med 2020; 78:oemed-2020-106776. [PMID: 33234692 DOI: 10.1136/oemed-2020-106776] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/25/2020] [Accepted: 10/30/2020] [Indexed: 01/07/2023]
Abstract
There is consistent evidence of increased respiratory symptoms in occupational cleaners; however, uncertainty remains on type of respiratory health effects, underlying causal agents, mechanisms and respiratory phenotypes. We aimed to conduct a systematic review and if possible, a meta-analysis of the available literature to characterise and quantify the cleaning-related respiratory health effects. We searched MEDLINE and EMBASE databases and included studies that evaluated the association of any respiratory health outcome with exposure to cleaning occupation or products in occupational cleaners. A modified GRADE was used to appraise the quality of included studies. We retrieved 1124 articles, and after applying our inclusion criteria, 39 were selected for the systematic review. We performed a meta-analysis of the 21 studies evaluating asthma which showed a 50% increased pooled relative risk in cleaners (meta-relative risk (RR)=1.50; 95% CI 1.44 to 1.56). Population-based cross-sectional studies showed more stable associations with asthma risk. No evidence of atopic asthma as dominant phenotype emerged. Also, we estimated a 43% increased risk (meta-RR=1.43; 95% CI 1.31 to 1.56) of chronic obstructive pulmonary disease. Evidence for associations with bronchial-hyper-responsiveness, lung function decline, rhinitis, upper and lower respiratory tract symptoms was weaker. In our systematic review and meta-analysis, we found that working as a cleaner is associated with an increased risk of reversible and even irreversible obstructive airway diseases. All studies lacked quantitative exposure assessment to cleaning products; this would help elucidate underlying causal agents and mechanisms. Exposure control and respiratory surveillance among cleaners is warranted to prevent the associated respiratory health burden. Trial registration number: CRD4201705915.
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Affiliation(s)
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sara De Matteis
- NHLI, Imperial College London, London, UK
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Sardegna, Italy
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van der Plaat D, De Matteis S, Sadhra S, Jarvis D, Cullinan P, Minelli C. Interaction between VGDF exposure and antioxidant genes on COPD in UK Biobank. Genes Environ 2020. [DOI: 10.1183/13993003.congress-2020.4921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Jennings N, Fecht D, De Matteis S. Mapping the co-benefits of climate change action to issues of public concern in the UK: a narrative review. Lancet Planet Health 2020; 4:e424-e433. [PMID: 32918888 PMCID: PMC7494843 DOI: 10.1016/s2542-5196(20)30167-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 06/24/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
To avoid a 1·5°C rise in global temperatures above preindustrial levels, the next phase of reductions in greenhouse gas emissions will need to be comparatively rapid. Linking the co-benefits of climate action to wider issues that the public are concerned about can help decision makers to prioritise decarbonisation options that increase the chance of public support for such changes, while ensuring that a just transition is delivered. We identified key issues of concern to the UK public by use of Ipsos MORI public opinion data from 2007 to 2020 and used these data to guide a narrative review of academic and grey literature on the co-benefits of climate change action for the UK. Correspondence with civil servants, third sector organisations, and relevant academics allowed us to identify omissions and to ensure policy relevance of the recommendations. This evidence-based Review of the various co-benefits of climate change action for the UK identifies four main areas: health and the National Health Service; security; economy and unemployment; and poverty, housing, and inequality. Associated trade-offs are also discussed. City-level and regional-level governments are particularly well placed to incorporate co-benefits into their decision making because it is at this scale that co-benefits most clearly manifest, and where interventions can have the most immediate effects.
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Affiliation(s)
- Neil Jennings
- Grantham Institute-Climate Change and the Environment, Imperial College London, London, UK.
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, Medical Research Council Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
| | - Sara De Matteis
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; National Heart and Lung Institute, Imperial College London, London, UK
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Sadhra SS, Mohammed N, Kurmi OP, Fishwick D, De Matteis S, Hutchings S, Jarvis D, Ayres JG, Rushton L. Occupational exposure to inhaled pollutants and risk of airflow obstruction: a large UK population-based UK Biobank cohort. Thorax 2020; 75:468-475. [DOI: 10.1136/thoraxjnl-2019-213407] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 02/17/2020] [Accepted: 02/26/2020] [Indexed: 11/04/2022]
Abstract
BackgroundAlthough around 10% to 15% of COPD burden can be attributed to workplace exposures, little is known about the role of different airborne occupational pollutants (AOP). The main aim of the study was to assess the effect size of the relationship between various AOP, their level and duration of exposure with airflow obstruction (AFO).MethodsA cross-sectional analysis was conducted in 228 614 participants from the UK Biobank study who were assigned occupational exposure using a job exposure matrix blinded to health outcome. Adjusted prevalence ratios (PRs) and 95% CI for the risk of AFO for ever and years of exposure to AOPs were estimated using robust Poisson model. Sensitivity analyses were conducted for never-smokers, non-asthmatic and bi-pollutant model.ResultsOf 228 614 participants, 77 027 (33.7%) were exposed to at least one AOP form. 35.5% of the AFO cases were exposed to vapours, gases, dusts or fumes (VGDF) and 28.3% to dusts. High exposure to vapours increased the risk of occupational AFO by 26%. Exposure to dusts (adjusted PR=1.05; 95% CI 1.01 to 1.08), biological dusts (1.05; 1.01 to 1.10) and VGDF (1.04; 1.01 to 1.07) showed a significantly increased risk of AFO, however, statistically not significant following multiple testing. There was no significant increase in risk of AFO by duration (years) of exposure in current job. The results were null when restricted to never-smokers and when a bi-pollutant model was used. However, when data was analysed based on the level of exposure (low, medium and high) compared with no exposure, directionally there was increase in risk for those with high exposure to vapours, gases, fumes, mists and VGDF but statistically significant only for vapours.ConclusionHigh exposure (in current job) to airborne occupational pollutants was suggestive of higher risk of AFO. Future studies should investigate the relationship between lifetime occupational exposures and COPD.
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Consonni D, De Matteis S, Dallari B, Pesatori AC, Riboldi L, Mensi C. Impact of an asbestos cement factory on mesothelioma incidence in a community in Italy. Environ Res 2020; 183:108968. [PMID: 31812249 DOI: 10.1016/j.envres.2019.108968] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/25/2019] [Accepted: 11/27/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Broni is a small town (9000 inhabitants) in the province of Pavia, Lombardy, north-west Italy, where the second largest Italian asbestos cement factory (Fibronit) was in operation between 1932 and 1993. Based on Lombardy Mesothelioma Registry (RML) data (2000-2011), we previously showed a high impact of asbestos exposure on malignant mesothelioma (MM) incidence among Fibronit workers, their families, and people living in Broni and in the nearby town of Stradella (11,000 residents). Given the great concern of the community, we have recently updated the data regarding 5 more years (2012-2016). METHODS From the RML database we extracted subjects who ever worked in Fibronit, their family members, ever residents in Broni, and subjects living in Stradella and nearby towns at the time of diagnosis. For each type of exposure we calculated standardized incidence ratios (SIR = observed/expected cases). RESULTS In the period 2000-2016 we registered 56 cases (2.52 expected, SIR = 22.2), 49 men (41 pleural, 8 peritoneal MM), 7 women (5 pleural, 2 peritoneal MM) with past occupational exposure in Fibronit. Among subjects never occupationally exposed and never exposed to extra-occupational sources unrelated to Fibronit, we counted 39 cases (4.24 expected, SIR = 9.2), 10 men (all pleural MM), 29 women (28 pleural, 1 peritoneal MM) in Fibronit workers' families, 91 pleural mesothelioma cases (7.43 expected, SIR = 12.2, 31 men, 60 women), ever residents in Broni, and 25 pleural mesothelioma cases (3.05 expected, SIR = 8.2, 6 men, 19 women) living in Stradella at the time of diagnosis. The overall number of excess cases was about 194 (211 against 17.24 expected). In the remaining adjacent (No. 8) and surrounding (No. 17) municipalities (32,000 people) there were 7 cases (1 men, 6 women, 8.85 expected). CONCLUSION The mesothelioma burden related to the asbestos cement factory is still high on factory workers, their families, and residents in Broni and Stradella towns.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK.
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Nafees AA, De Matteis S, Kadir MM, Burney P, Coggon D, Semple S, Cullinan P. MultiTex RCT - a multifaceted intervention package for protection against cotton dust exposure among textile workers - a cluster randomized controlled trial in Pakistan: study protocol. Trials 2019; 20:722. [PMID: 31842937 PMCID: PMC6913022 DOI: 10.1186/s13063-019-3743-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 09/23/2019] [Indexed: 12/04/2022] Open
Abstract
Background In the Pakistani textile industry the prevalence of workplace respiratory illnesses, including byssinosis, is high. The MultiTex RCT study aims to determine the effectiveness of a multifaceted intervention package in reducing dust levels in cotton mills, decreasing the frequency of respiratory symptoms among cotton textile workers, and improving their lung function. Methods/design We will conduct a cluster-randomized controlled trial at 28 textile mills in Karachi. The intervention will comprise: training in occupational health for all workers and managers reinforced by regular refresher sessions; the formation of workplace committees to draw up, agree and promote a health and safety plan that includes wet mopping, safe disposal of cotton dust, and the use of simple face-masks, as well as further publicity about the risks from cotton dust; and provision of adequate supplies of face-masks to support the health and safety plan. Participating mills will be randomized to intervention and control arms following a baseline survey. The impact of the intervention will be determined through follow-up surveys conducted at 3, 12 and 18 months. Data collection in the surveys will include spirometry, questionnaire-based interviews and cotton-dust measurements. Discussion If successful, the study may pave the way for simple, low-cost interventions that can help reduce cotton-dust levels in textile mills, and improve the respiratory health of textile workers in developing countries such as Pakistan. Trial registration ClinicalTrials.gov, ID: NCT03738202. Registered on 12 November 2018.
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Affiliation(s)
- Asaad Ahmed Nafees
- Department of Community Health Sciences, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan. .,Population Health and Occupational Disease, National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
| | - Sara De Matteis
- Population Health and Occupational Disease, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Muhammad Masood Kadir
- Department of Community Health Sciences, Aga Khan University, Stadium Road, PO Box 3500, Karachi, 74800, Pakistan
| | - Peter Burney
- Population Health and Occupational Disease, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - David Coggon
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Sean Semple
- Institute for Social Marketing and Health Research, University of Stirling, Stirling, Scotland, UK
| | - Paul Cullinan
- Population Health and Occupational Disease, National Heart and Lung Institute (NHLI), Imperial College London, London, UK
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Consonni D, Migliore E, Barone-Adesi F, Dallari B, De Matteis S, Oddone E, Pesatori AC, Riboldi L, Mirabelli D, Mensi C. Gender differences in pleural mesothelioma occurrence in Lombardy and Piedmont, Italy. Environ Res 2019; 177:108636. [PMID: 31419715 DOI: 10.1016/j.envres.2019.108636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/05/2019] [Accepted: 08/06/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Higher mesothelioma rates in men (vs women) reflect more frequent and more intense asbestos exposure. We assessed the impact of exposure difference between genders on age-specific rates of pleural mesothelioma (PM) occurrence using data from two Italian regions. METHODS We used data from the Lombardy and Piedmont mesothelioma registries (period 2000-2016, age 45-74 years) to compare rates of PM in men and women and to estimate the rate advancement period (RAP). RESULTS Based on 3384 cases (2405 men, 979 women) in Lombardy and 2042 (1389 men, 653 women) in Piedmont, the rate ratio was 2.81 (90% confidence interval: 2.61-3.03) in Lombardy and 2.39 (2.17-2.62) in Piedmont. In both regions RAP ranged from 7 to 10 years (at age 45 and 63 in men, respectively). CONCLUSION Men showed more than twofold increased PM rates and reached the same incidence as women 7-10 years earlier. RAP can be a useful measure of exposure impact on premature disease occurrence.
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | | | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, UK and Humanitas University, Milan, Italy.
| | - Enrico Oddone
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, and ICS Maugeri IRCCS, Pavia, Italy.
| | - Angela C Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, Università Degli Studi di Milano, Milan, Italy.
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| | | | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Consonni D, Calvi C, De Matteis S, Mirabelli D, Landi MT, Caporaso NE, Peters S, Vermeulen R, Kromhout H, Dallari B, Pesatori AC, Riboldi L, Mensi C. Peritoneal mesothelioma and asbestos exposure: a population-based case-control study in Lombardy, Italy. Occup Environ Med 2019; 76:545-553. [PMID: 31285358 PMCID: PMC6703122 DOI: 10.1136/oemed-2019-105826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Asbestos is the main risk factor for peritoneal mesothelioma (PeM). However, due to its rarity, PeM has rarely been investigated in community-based studies. We examined the association between asbestos exposure and PeM risk in a general population in Lombardy, Italy. METHODS From the regional mesothelioma registry, we selected PeM cases diagnosed in 2000-2015. Population controls (matched by area, gender and age) came from two case-control studies in Lombardy on lung cancer (2002-2004) and pleural mesothelioma (2014). Assessment of exposure to asbestos was performed through a quantitative job-exposure matrix (SYN-JEM) and expert evaluation based on a standardised questionnaire. We calculated period-specific and gender-specific OR and 90% CI using conditional logistic regression adjusted for age, province of residence and education. RESULTS We selected 68 cases and 2116 controls (2000-2007) and 159 cases and 205 controls (2008-2015). The ORs for ever asbestos exposure (expert-based, 2008-2015 only) were 5.78 (90% CI 3.03 to 11.0) in men and 8.00 (2.56 to 25.0) in women; the ORs for definite occupational exposure were 12.3 (5.62 to 26.7) in men and 14.3 (3.16 to 65.0) in women. The ORs for ever versus never occupational asbestos exposure based on SYN-JEM (both periods) were 2.05 (90% CI 1.39 to 3.01) in men and 1.62 (0.79 to 3.27) in women. In men, clear positive associations were found for duration, cumulative exposure (OR 1.33 (1.19 to 1.48) per fibres/mL-years) and latency. CONCLUSIONS Using two different methods of exposure assessment we provided evidence of a clear association between asbestos exposure and PeM risk in the general population.
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Grants
- Intramural Research Program of the National Institutes of Health, the National Cancer Institute, Division of Cancer Epidemiology and Genetics, Bethesda, Maryland, USA
- Associazione Italiana per la Ricerca sul Cancro (AIRC), Milan, Italy
- Ministry of Health, CCM (Centro Nazionale per la Prevenzione e il Controllo delle Malattie), Rome, Italy
- Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro (INAIL), Rome, Italy
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Affiliation(s)
- Dario Consonni
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Sara De Matteis
- National Heart and Lung Institute, Imperial College, London, UK
- Medical School, Humanitas University, Milan, Italy
| | - Dario Mirabelli
- Cancer Epidemiology, CPO and University of Turin, Turin, Italy
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Neil E Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Susan Peters
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Roel Vermeulen
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Hans Kromhout
- Department of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Barbara Dallari
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | - Angela Cecilia Pesatori
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, University of Milan, Milano, Italy
| | - Luciano Riboldi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
| | - Carolina Mensi
- Occupational Health Unit, Fondazione IRCCS Ca’ Granda – Ospedale Maggiore Policlinico, Milan, Italy
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43
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Doiron D, de Hoogh K, Probst-Hensch N, Fortier I, Cai Y, De Matteis S, Hansell AL. Air pollution, lung function and COPD: results from the population-based UK Biobank study. Eur Respir J 2019; 54:13993003.02140-2018. [PMID: 31285306 DOI: 10.1183/13993003.02140-2018] [Citation(s) in RCA: 215] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 04/22/2019] [Indexed: 01/01/2023]
Abstract
Ambient air pollution increases the risk of respiratory mortality, but evidence for impacts on lung function and chronic obstructive pulmonary disease (COPD) is less well established. The aim was to evaluate whether ambient air pollution is associated with lung function and COPD, and explore potential vulnerability factors.We used UK Biobank data on 303 887 individuals aged 40-69 years, with complete covariate data and valid lung function measures. Cross-sectional analyses examined associations of land use regression-based estimates of particulate matter (particles with a 50% cut-off aerodynamic diameter of 2.5 and 10 µm: PM2.5 and PM10, respectively; and coarse particles with diameter between 2.5 μm and 10 μm: PMcoarse) and nitrogen dioxide (NO2) concentrations with forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), the FEV1/FVC ratio and COPD (FEV1/FVC <lower limit of normal). Effect modification was investigated for sex, age, obesity, smoking status, household income, asthma status and occupations previously linked to COPD.Higher exposures to each pollutant were significantly associated with lower lung function. A 5 µg·m-3 increase in PM2.5 concentration was associated with lower FEV1 (-83.13 mL, 95% CI -92.50- -73.75 mL) and FVC (-62.62 mL, 95% CI -73.91- -51.32 mL). COPD prevalence was associated with higher concentrations of PM2.5 (OR 1.52, 95% CI 1.42-1.62, per 5 µg·m-3), PM10 (OR 1.08, 95% CI 1.00-1.16, per 5 µg·m-3) and NO2 (OR 1.12, 95% CI 1.10-1.14, per 10 µg·m-3), but not with PMcoarse Stronger lung function associations were seen for males, individuals from lower income households, and "at-risk" occupations, and higher COPD associations were seen for obese, lower income, and non-asthmatic participants.Ambient air pollution was associated with lower lung function and increased COPD prevalence in this large study.
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Affiliation(s)
- Dany Doiron
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada .,Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Nicole Probst-Hensch
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
| | - Isabel Fortier
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Yutong Cai
- Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Dept of Analytical, Environmental and Forensic Sciences, School of Population Health and Environmental Sciences, King's College London, London, UK
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, UK
| | - Anna L Hansell
- Dept of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.,Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
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De Matteis S, Jarvis D, Darnton A, Hutchings S, Sadhra S, Fishwick D, Rushton L, Cullinan P. The occupations at increased risk of COPD: analysis of lifetime job-histories in the population-based UK Biobank Cohort. Eur Respir J 2019; 54:13993003.00186-2019. [DOI: 10.1183/13993003.00186-2019] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/21/2019] [Indexed: 11/05/2022]
Abstract
Occupational exposures are important, preventable causes of chronic obstructive pulmonary disease (COPD). Identification of COPD high-risk jobs is key to focus preventive strategies, but a definitive job-list is unavailable.We addressed this issue by evaluating the association of lifetime job-histories and lung function data in the population-based UK Biobank cohort, whose unprecedented sample size allowed analyses restricted to never-smokers to rule out the most important confounder, tobacco smoking. COPD was spirometrically defined as forced expiratory volume in 1 s/forced vital capacity ratio below the lower limit of normal. Lifetime job-histories were collected via OSCAR (Occupations Self-Coding Automatic Recording), a new validated online tool that automatically codes jobs into the UK Standard Occupational Classification v.2000. Prevalence ratios for COPD by employment duration in each job compared to lifetime office workers were estimated using robust Poisson regression adjusted for age, sex, centre and smoking. Only associations confirmed among never-smokers and never-asthmatics were considered reliable.From the 116 375 participants with complete job-histories, 94 551 had acceptable/repeatable spirometry data and smoking information and were included in the analysis. Six occupations showed an increased COPD risk among never-smokers and never-asthmatics; most of these also with positive exposure-response trends. Interesting new findings included sculptors, gardeners and warehouse workers.COPD patients, especially never-smokers, should be asked about their job-history for better disease management. Focussed preventive strategies in COPD high-risk jobs are warranted.
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de Vries M, Axson EL, Ratanachina J, Dumas O, De Matteis S, Bédard A, Roda C, Moitra S, Dagli E, Dimanti A, Dilektasli AG, Ravara S, Amaral AF. European Respiratory Society International Congress 2018: four shades of epidemiology and tobacco control. ERJ Open Res 2019; 5:00217-2018. [PMID: 30847352 PMCID: PMC6397917 DOI: 10.1183/23120541.00217-2018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/16/2019] [Indexed: 12/27/2022] Open
Abstract
In this article, early career members and experienced members of the Epidemiology and Environment Assembly of the European Respiratory Society highlight and summarise a selection of six sessions from the Society's annual congress, which in 2018 was held in Paris, France. The topics covered in these sessions span from cutting-edge molecular epidemiology of lung function to clinical, occupational and environmental epidemiology of respiratory disease, and from emergent tobacco products to tobacco control.
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Affiliation(s)
- Maaike de Vries
- University of Groningen, University Medical Centre Groningen, Dept of Epidemiology, Groningen, The Netherlands
- University of Groningen, University Medical Centre Groningen, Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands
| | - Eleanor L. Axson
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Jate Ratanachina
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
- King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand
- Dept of Preventive and Social Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Orianne Dumas
- INSERM, U1168, VIMA: Aging and chronic diseases, Epidemiological and Public Health Approaches, Villejuif, France
- Universite de Versailles St-Quentin-en-Yvelines, UMR-S 1168, Montigny le Bretonneux, France
| | - Sara De Matteis
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
| | - Annabelle Bédard
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Célina Roda
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- INSERM U1153, HERA team: Health Environmental Risk Assessment, Paris Descartes University, Paris Faculty of Pharmacy, Paris, France
| | - Subhabrata Moitra
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Athina Dimanti
- Midwifery Department of University of West Attica, Athens, Greece
- Dept of Critical Care and Pulmonary Services, University of Athens Medical School, Evangelismos Hospital, Athens, Greece
| | | | - Sofia Ravara
- Health Sciences Research Centre (CICS-UBI), Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
- Public Health Research Centre, National School of Public Health, NOVA University, Lisbon, Portugal
- CHUCB, University Hospital, Covilha, Portugal
| | - André F.S. Amaral
- Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, UK
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Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, Perez-Padilla R, Rice MB, Riojas-Rodriguez H, Sood A, Thurston GD, To T, Vanker A, Wuebbles DJ. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 2: Air Pollution and Organ Systems. Chest 2018; 155:417-426. [PMID: 30419237 DOI: 10.1016/j.chest.2018.10.041] [Citation(s) in RCA: 339] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 12/30/2022] Open
Abstract
Although air pollution is well known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million COPD deaths can be attributed to air pollution, but air pollution may also account for 19% of all cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults. Air pollution is associated with reduced cognitive function and increased risk of dementia. Particulate matter in the air (particulate matter with an aerodynamic diameter < 2.5 μm) is associated with delayed psychomotor development and lower child intelligence. Studies link air pollution with diabetes mellitus prevalence, morbidity, and mortality. Pollution affects the immune system and is associated with allergic rhinitis, allergic sensitization, and autoimmunity. It is also associated with osteoporosis and bone fractures, conjunctivitis, dry eye disease, blepharitis, inflammatory bowel disease, increased intravascular coagulation, and decreased glomerular filtration rate. Atopic and urticarial skin disease, acne, and skin aging are linked to air pollution. Air pollution is controllable and, therefore, many of these adverse health effects can be prevented.
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Affiliation(s)
- Dean E Schraufnagel
- Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL.
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA
| | - Clayton T Cowl
- Divisions of Preventive, Occupational, and Aerospace Medicine and Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Sara De Matteis
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Soon-Hee Jung
- Department of Pathology, Wonju Colleage of Medicine, Yonsei University, Seoul, South Korea
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Akshay Sood
- Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, NM
| | - George D Thurston
- Departments of Environmental Medicine and Population Health, New York University School of Medicine, New York, NY
| | - Teresa To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anessa Vanker
- Department of Paediatrics and Child Health & MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Donald J Wuebbles
- School of Earth, Society, and Environment, Department of Atmospheric Sciences, University of Illinois, Urbana, IL
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Schraufnagel DE, Balmes JR, Cowl CT, De Matteis S, Jung SH, Mortimer K, Perez-Padilla R, Rice MB, Riojas-Rodriguez H, Sood A, Thurston GD, To T, Vanker A, Wuebbles DJ. Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 1: The Damaging Effects of Air Pollution. Chest 2018; 155:409-416. [PMID: 30419235 DOI: 10.1016/j.chest.2018.10.042] [Citation(s) in RCA: 249] [Impact Index Per Article: 41.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 10/28/2018] [Accepted: 10/31/2018] [Indexed: 11/24/2022] Open
Abstract
Air pollution poses a great environmental risk to health. Outdoor fine particulate matter (particulate matter with an aerodynamic diameter < 2.5 μm) exposure is the fifth leading risk factor for death in the world, accounting for 4.2 million deaths and > 103 million disability-adjusted life years lost according to the Global Burden of Disease Report. The World Health Organization attributes 3.8 million additional deaths to indoor air pollution. Air pollution can harm acutely, usually manifested by respiratory or cardiac symptoms, as well as chronically, potentially affecting every organ in the body. It can cause, complicate, or exacerbate many adverse health conditions. Tissue damage may result directly from pollutant toxicity because fine and ultrafine particles can gain access to organs, or indirectly through systemic inflammatory processes. Susceptibility is partly under genetic and epigenetic regulation. Although air pollution affects people of all regions, ages, and social groups, it is likely to cause greater illness in those with heavy exposure and greater susceptibility. Persons are more vulnerable to air pollution if they have other illnesses or less social support. Harmful effects occur on a continuum of dosage and even at levels below air quality standards previously considered to be safe.
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Affiliation(s)
- Dean E Schraufnagel
- Pulmonary, Critical Care, Sleep and Allergy, University of Illinois at Chicago, Chicago, IL.
| | - John R Balmes
- Department of Medicine, University of California, San Francisco, Division of Environmental Health Sciences, School of Public Health, University of California, Berkeley, CA
| | - Clayton T Cowl
- Divisions of Preventive, Occupational, and Aerospace Medicine, and Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Soon-Hee Jung
- Department of Pathology, Wonju Colleage of Medicine Yonsei University, Seoul, South Korea
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | | | - Mary B Rice
- Division of Pulmonary, Critical Care and Sleep Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | | | - Akshay Sood
- Pulmonary, Critical Care, and Sleep Medicine, University of New Mexico School of Medicine, Albuquerque, NM
| | - George D Thurston
- Departments of Environmental Medicine and Population Health, New York University School of Medicine, New York, NY
| | - Teresa To
- The Hospital for Sick Children, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Anessa Vanker
- Department of Paediatrics and Child Health & MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - Donald J Wuebbles
- School of Earth, Society, and Environment, Department of Atmospheric Sciences, University of Illinois, Urbana, IL
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Consonni D, Carugno M, De Matteis S, Nordio F, Randi G, Bazzano M, Caporaso NE, Tucker MA, Bertazzi PA, Pesatori AC, Lubin JH, Landi MT. Outdoor particulate matter (PM10) exposure and lung cancer risk in the EAGLE study. PLoS One 2018; 13:e0203539. [PMID: 30216350 PMCID: PMC6157824 DOI: 10.1371/journal.pone.0203539] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/22/2018] [Indexed: 12/27/2022] Open
Abstract
Objective Cohort studies in Europe, but not in North-America, showed an association between exposure to outdoor particulate matter with aerodynamic diameter ≤10 μm (PM10) and lung cancer risk. Only a case-control study on lung cancer and PM10 in South Korea has so far been performed. For the first time in Europe we analyzed quantitatively this association using a case-control study design in highly polluted areas in Italy. Methods The Environment And Genetics in Lung cancer Etiology (EAGLE) study, a population-based case-control study performed in the period 2002–2005 in the Lombardy Region, north-west Italy, enrolled 2099 cases and 2120 controls frequency-matched for area of residence, gender, and age. For this study we selected subjects with complete active and passive smoking history living in the same municipality since 1980 until study enrollment. Fine resolution annual PM10 estimates obtained by applying land use regression modeling to satellite data calibrated with fixed site monitor measurements were used. We assigned each subject the PM10 average estimates for year 2000 based on enrollment address. We used logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI) adjusted for matching variables, education, smoking, and dietary and occupational variables. Results We included 3473 subjects, 1665 cases (1318 men, 347 women) and 1808 controls (1368 men, 440 women), with PM10 individual levels ranging from 2.3 to 53.8 μg/m3 (mean: 46.3). We found increasing lung cancer risk with increasing PM10 category (P-value for trend: 0.04). The OR per 10 μg/m3 was 1.28 (95% CI: 0.95–1.72). The association appeared stronger for squamous cell carcinoma (OR 1.44, 95% CI: 0.90–2.29). Conclusion In a population living in highly polluted areas in Italy, our study added suggestive evidence of a positive association between PM10 exposure and lung cancer risk. This study emphasizes the need to strengthen policies to reduce airborne pollution.
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Affiliation(s)
- Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- * E-mail:
| | - Michele Carugno
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Sara De Matteis
- National Heart & Lung Institute, Imperial College London, London, United Kingdom
| | - Francesco Nordio
- TIMI Study Group, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States of America
| | - Giorgia Randi
- European Commission, DG Joint Research Centre, Ispra, Varese, Italy
| | - Martina Bazzano
- Master Program in Cognitive Sciences and Decision Making, Università degli Studi di Milano, Milan, Italy
| | - Neil E. Caporaso
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America
| | - Margaret A. Tucker
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America
| | - Pier Alberto Bertazzi
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Angela C. Pesatori
- Epidemiology Unit, Fondazione IRCCS Ca’ Granda—Ospedale Maggiore Policlinico, Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Jay H. Lubin
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States of America
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Caivano D, Valeriani M, De Matteis S, Bonome P, Russo I, De Sanctis V, Minniti G, Osti MF. Re-irradiation in lung disease by SBRT: a retrospective, single institutional study. Radiat Oncol 2018; 13:87. [PMID: 29739436 PMCID: PMC5941638 DOI: 10.1186/s13014-018-1041-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/30/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The loco regional relapse is frequent in the lung disease. The aim of this study was to evaluate the outcomes of re-irradiation by SBRT in terms of Local Control (LC) and toxicities. METHODS From April 2011 to December 2016, twenty-two patients received a re-irradiation by SBRT. Twenty- seven lesions were treated. The medium BED(10) of re-irradiation was 100.6 Gy (range: 48-151.2 Gy) and the medium EQD2(10) was 93.8 Gy (range: 40-126 Gy). In the previous treatment the medium BED(10) was 97.2 Gy (range: 40-120 Gy), the medium EQD2(10) was 81 Gy (range: 32.5-100 Gy). The median time between the first and the second treatment was 18 months. RESULTS Local Control was reached in 18 out of 27 (66%) re-irradiated lesions, with rates of 67 and 54% at 1- year and 2- years respectively. The treatment was well tolerated; the maximum recorded toxicity was Grade 3. CONCLUSIONS Re- irradiation by SBRT may represent an option for the treatment of lung disease with good results in terms of LC and toxicity.
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Affiliation(s)
- Donatella Caivano
- Departement of Radiation Oncology, CNAO (National Centre of Oncological Hadrontherapy), Str. Campeggi, 53, 27100, Pavia, Italy.
| | - Maurizio Valeriani
- Department of Radiation Oncology, Faculty of "Medicina e Psicologia", University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - Sara De Matteis
- Department of Radiation Oncology, Faculty of "Medicina e Psicologia", University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - Paolo Bonome
- Department of Radiation Oncology, Faculty of "Medicina e Psicologia", University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - Ivana Russo
- UPMC San Pietro FBF, Centro di Radioterapia ad alta specializzazione, Via Cassia 600, 00189, Roma, Italia
| | - Vitaliana De Sanctis
- Department of Radiation Oncology, Faculty of "Medicina e Psicologia", University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy
| | - Giuseppe Minniti
- Neuromed - Mediterranean Neurological Institute, Via Atinense, 18, 86077, Pozzilli, (IS), Italy
| | - Mattia Falchetto Osti
- Department of Radiation Oncology, Faculty of "Medicina e Psicologia", University of Rome "Sapienza", Sant'Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy
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Thurston GD, De Matteis S, Murray K, Scheelbeek P, Scovronick N, Budolfson M, Spears D, Vineis P. Maximizing the Public Health Benefits from Climate Action. Environ Sci Technol 2018; 52:3852-3853. [PMID: 29512384 DOI: 10.1021/acs.est.8b00859] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- George D Thurston
- Nelson Institute of Environmental Medicine , New York University School of Medicine , Tuxedo , New York 10987 , United States
| | - Sara De Matteis
- National Heart and Lung Institute , Royal Brompton Hospital, Imperial College London , Chelsea, London , SW3 6NP , U.K
| | - Kris Murray
- Grantham Institute - Climate Change and the Environment and Dept. of Infectious Disease Epidemiology , Imperial College London , London , W2 1PG , U.K
| | - Pauline Scheelbeek
- London School of Hygiene and Tropical Medicine , London , WC1E 7HT , U.K
| | - Noah Scovronick
- Princeton University , Princeton , New Jersey 08544 , United States
| | - Mark Budolfson
- Department of Philosophy , University of Vermont , Burlington , Vermont 05405 , United States
| | - Dean Spears
- Indian Statistical Unit , Delhi 78712 , India
- Department of Economics , University of Texas at Austin , Austin , Texas 78712 , United States
| | - Paolo Vineis
- MRC-PHE Centre for Environment and Health , Imperial College London , London , W2 1PG , U.K
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