Ingegerd Johansson

Adherence to the World Cancer Research Fund/American Institute for Cancer Research guidelines and risk of death in Europe: results from the European Prospective Investigation into Nutrition and Cancer cohort study

BACKGROUND In 2007, the World Cancer Research Fund (WCRF) and the American Institute for Cancer Research (AICR) issued recommendations on diet, physical activity, and weight management for cancer prevention on the basis of the most comprehensive collection of available evidence. OBJECTIVE We investigated whether concordance with WCRF/AICR recommendations is related to risk of death. DESIGN The current study included 378,864 participants from 9 European countries enrolled in the European Prospective Investigation into Cancer and Nutrition study. At recruitment (1992-1998), dietary, anthropometric, and lifestyle information was collected. A WCRF/AICR score, which incorporated 6 of the WCRF/AICR recommendations for men [regarding body fatness, physical activity, foods and drinks that promote weight gain, plant foods, animal foods, and alcoholic drinks (score range: 0-6)] and 7 WCRF/AICR recommendations for women [plus breastfeeding (score range: 0-7)], was constructed. Higher scores indicated greater concordance with WCRF/AICR recommendations. Associations between the WCRF/AICR score and risks of total and cause-specific death were estimated by using Cox regression analysis. RESULTS After a median follow-up time of 12.8 y, 23,828 deaths were identified. Participants within the highest category of the WCRF/AICR score (5-6 points in men; 6-7 points in women) had a 34% lower hazard of death (95% CI: 0.59, 0.75) compared with participants within the lowest category of the WCRF/AICR score (0-2 points in men; 0-3 points in women). Significant inverse associations were observed in all countries. The WCRF/AICR score was also significantly associated with a lower hazard of dying from cancer, circulatory disease, and respiratory disease. CONCLUSION Results of this study suggest that following WCRF/AICR recommendations could significantly increase longevity.

A longitudinal study of air contaminants in a newly built preschool

Abstract The air quality in a newly built preschool was investigated in a longitudinal study. Typical air contaminants emanating from building materials were determined, their variation over time (0–18 months) was measured, and the influence of the ventilation system (81%–91% recirculation of return air) on contaminant concentrations was studied. Volatile organic compounds were sampled by adsorption on porous polymer, analysed by a GC/FID system, and identified by MS. A spatial build-up in concentration (ppb or μg/m 3 levels) is evident for all the organic compounds, as well as for CO 2 , from the outdoor air, through the ventilation system, and through the rooms to the exhaust air. The longitudinal comparison over time shows that all the organic compounds decline in concentration mainly within the first 6 months of occupancy: 1-butanol 4–14 times, toluene and pentanal + hexanal 2–4 times, while formaldehyde remained at a constant low level of 90 ppb (110 μg/m 3 ). It is difficult to believe that the problems of poor air quality in 100 preschools in Stockholm are caused by the organic compounds alone unless interactions occur. A preschool building needs to be gassed off during the first 6 months after its construction with no recirculation of return air allowed (outdoor air rate approx 4–5 ach). During at least 1–2 additional years, it is desired that the recirculation rate of return air is restricted, perhaps to 50%.

Volatile organic compounds from used building materials in a simulated chamber study

Building materials emit volatile organic compounds (VOCs) indoors. They may also adsorb compounds so that an equilibrium with indoor air is reached. Samples were taken from the floor, walls, and ceiling of one room in a seven-year-old preschool building. They were placed in a small climate chamber for a period of 41 days. Samples from the air in the room and the chamber were analysed by gas chromatography and mass spectrometry, and about 60 compounds were identified. The composition of organics in the room air was reestablished in the chamber the first day. Since most of the compounds disappeared within 2 to 23 days, they are believed to have been adsorbed from the room air onto the material surfaces. During the last 10 days, 17 compounds remained at constant concentrations, implying that they are representative of the building material samples.

Joint representation of physical locations and volatile organic compounds in indoor air from a healthy and a sick building

Abstract Many modern, energy-efficient buildings have been labeled “sick”, in view of the fact that their occupants display an unusually large number of sensory symptoms (e.g. eye irritation, dry skin and perception of persistent odors). Air samples were taken from locations (17) in two Stockholm preschools, one considered healthy, the other, sick. The samples (170) were analyzed by gas chromatography/mass spectrometry (GC/MS) and 33 volatile organic compounds were identified and quantified by GC peak heights. The relationship between chemicals and locations in the two preschools was represented spatially by correspondence analysis and other statistical techniques. The analyses clearly distinguish among the buildings and among locations within each building, including whether the sample was collected outdoors or indoors. Within the sick preschool, concentrations of light aromatic hydrocarbons increased with distance from the air supply, but there was no similar gradient in the healthy preschool. The chief results obtained by the comparatively new method of correspondence analysis are supported further by a discriminant analysis and a principal components analysis.

The influence of ventilation on indoor/outdoor air contaminants in an office building

Abstract A modern energy-economized office building was studied in situ in a series of experiments with mobile laboratories connected on-line with the building. The investigation covered measurements of inorganic air contaminants (CO, CO 2 , NO x ). Off-line measurements were made of volatile organic contaminants which were analysed with a gas chromatograph using flame ionization detection in parallel with odor measurements. Samples were taken outdoors at street and roof levels, indoors at air intakes and outlets and in rooms. The building presented a sufficient protection against street pollution, provided the location of the air intake and the mixing of air indoors are adequate. The number and concentrations of most air pollutants increased from the air intake along the pathway of the ventilation air. The organic compounds that are generally found outdoors also seem to have indoor sources. Some aliphatic hydrocarbons (alcanes C 9 –C 11 ) were determined almost exclusively in the indoor air, probably originating from nonhuman indoor sources. Changes in recirculation of return air effect the concentration of indoor pollutants differently for different compounds. For CO and all organic compounds, a larger amount was transferred from the return air to supply air than was predicted from the transfer of CO 2 or from calculated flow rates. Saving energy by using a ventilation-by-demand principle cannot be generally recommended unless the effects of reduced ventilation on indoor air components other than CO 2 have been properly considered.

Dietary Flavonoid Intake and Esophageal Cancer Risk in the European Prospective Investigation into Cancer and Nutrition Cohort

We prospectively investigated dietary flavonoid intake and esophageal cancer risk in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. The study included 477,312 adult subjects from 10 European countries. At baseline, country-specific validated dietary questionnaires were used. During a mean follow-up of 11 years (1992-2010), there were 341 incident esophageal cancer cases, of which 142 were esophageal adenocarcinoma (EAC), 176 were esophageal squamous cell carcinoma (ESCC), and 23 were other types of esophageal cancer. In crude models, a doubling in total dietary flavonoid intake was inversely associated with esophageal cancer risk (hazard ratio (HR) (log₂) = 0.87, 95% confidence interval (CI): 0.78, 0.98) but not in multivariable models (HR (log₂) = 0.97, 95% CI: 0.86, 1.10). After covariate adjustment, no statistically significant association was found between any flavonoid subclass and esophageal cancer, EAC, or ESCC. However, among current smokers, flavonols were statistically significantly associated with a reduced esophageal cancer risk (HR (log₂) = 0.72, 95% CI: 0.56, 0.94), whereas total flavonoids, flavanols, and flavan-3-ol monomers tended to be inversely associated with esophageal cancer risk. No associations were found in either never or former smokers. These findings suggest that dietary flavonoid intake was not associated with overall esophageal cancer, EAC, or ESCC risk, although total flavonoids and some flavonoid subclasses, particularly flavonols, may reduce the esophageal cancer risk among current smokers.

Variation at ABO histo-blood group and FUT loci and diffuse and intestinal gastric cancer risk in a European population

ABO blood serotype A is known to be associated with risk of gastric cancer (GC), but little is known how ABO alleles and the fucosyltransferase (FUT) enzymes and genes which are involved in Lewis antigen formation [and in Helicobacter pylori (H. pylori) binding and pathogenicity] may be related to GC risk in a European population. The authors conducted an investigation of 32 variants at ABO and FUT1–7 loci and GC risk in a case–control study of 365 cases and 1,284 controls nested within the EPIC cohort (the EPIC‐Eurgast study). Four variants (including rs505922) in ABO, and allelic blood group A (AO+AA, odds ratio = 1.84, 95%CI = 1.20–2.80) were associated with diffuse‐type GC; however, conditional models with other ABO variants indicated that the associations were largely due to allelic blood group A. One variant in FUT5 was also associated with diffuse‐type GC, and four variants (and haplotypes) in FUT2 (Se), FUT3 (Le) and FUT6 with intestinal‐type GC. Further, one variant in ABO, two in FUT3 and two in FUT6 were associated with H. pylori infection status in controls, and two of these (in FUT3 and FUT6) were weakly associated with intestinal‐type GC risk. None of the individual variants surpassed a Bonferroni corrected p‐value cutoff of 0.0016; however, after a gene‐based permutation test, two loci [FUT3(Le)/FUT5/FUT6 and FUT2(Se)] were significantly associated with diffuse‐ and intestinal‐type GC, respectively. Replication and functional studies are therefore recommended to clarify the role of ABO and FUT alleles in H. pylori infection and subtype‐specific gastric carcinogenesis.

Research equipment for sensory air quality studies of nonindustrial environments

Abstract A mobile laboratory has been constructed consisting of three units, namely an environment chamber, an olfactometer, and sampling and HVAC equipment. The net yield of stimuli in the exposure hood of the olfactometer showed a high degree of correspondence with theoretical values. Only a small dispersion between concentrations in different points in the hood was shown. When dosing air from a study object into the environment chamber, the rise as well as the fall times are satisfactorily short and should permit the use of efficient and time-saving experimental designs for human whole-body exposures. Also in the chamber no differences in concentrations between different sites were found. There were only small losses in the sampling, dosing and exposure hood systems of the mobile laboratories.