Yueh-Ying Han

Increased urinary 8-hydroxy-2'-deoxyguanosine excretion in long-distance bus drivers in Taiwan.

Professional bus drivers are exposed to environments containing air pollution and reactive oxygen species (ROS) that can induce cellular oxidative stress and DNA damage. This study investigated environmental factors associated with oxidative DNA damage in a cohort of long-distance bus drivers. In a comparison study, urinary 8-hydroxydeoxyguanosine (8-OHdG), a biomarker of DNA oxidative damage, was examined in 120 male long-distance bus drivers and 58 male office workers in Taiwan. Multivariate logistic regression was used to analyze association between urinary 8-OHdG levels and environmental factors. Bus drivers had higher urinary 8-OHdG levels (adjusted odds ratio (aOR)=9.4, 95% confidence interval (CI)=3.5-28.2) compared with office workers. Increased urinary 8-OHdG level was significantly related to cigarette smoking (aOR=18.0, 95% CI=7.1-52.1), consumption of energy drinks (aOR=5.0, 95% CI=2.1-12.6), and regular exercise (aOR=3.8, 95% CI=1.5-10.2). A strong exposure-response relationship was found between urinary 8-OHdG and urinary cotinine (p<0.0001). Among nonsmokers, bus drivers (aOR=3.9, 95% CI=1.0-17.7) had higher urinary 8-OHdG than office workers. Among both bus drivers and office workers, those who drank energy drinks (aOR=3.7, 95% CI=1.2-12.2) had higher 8-OHdG levels than those who did not drink energy drinks. Adjusted for smoking, levels of 8-OHdG were increased in long-distance bus drivers exposed to traffic exhaust and ingested energy drinks. Future studies should explore what aspects of energy drinks may contribute to increased urinary 8-OHdG.

Cancer incidence among residents of the Three Mile Island accident area: 1982–1995 ☆

BACKGROUND The Pennsylvania Department of Health established a registry of the Three Mile Island (TMI) nuclear power plant accident in 1979. Over 93% of the population present on the day of the accident within a 5-mile radius was enrolled and interviewed. We used the registry to investigate the potential cancer risk from low-dose radiation exposure among the TMI population. METHODS Cancer incidence data among the TMI cohort were available from 1982 to 1995. Because more than 97% of the population were white and few cancer cases were reported for those younger than 18 years of age, we included whites of age 18 years and older (10,446 men and 11,048 women) for further analyses. Cox regression models were used to estimate the relative risk (RR) per 0.1 mSv and 95% confident interval (CI) of cancer by radiation-related exposures. The cancers of interest were all malignant neoplasms, cancer of bronchus, trachea, and lung, cancer of lymphatic and hematopoietic tissues, leukemia, and female breast. RESULTS Among men and women, there was no evidence of an increased risk for all malignant neoplasms among the TMI cohort exposed to higher maximum and likely γ radiation (RR=1.00, 95% CI=0.97, 1.01 and RR=0.99, 95% CI=0.94, 1.03, respectively) after adjusting for age, gender, education, smoking, and background radiation. Elevation in risk was noted for cancer of the bronchus, trachea, and lung in relation to higher background radiation exposure (RR=1.45, 95% CI=1.02-2.05 at 8.0-8.8 μR/h compared to 5.2-7.2 μR/h). An increased risk of leukemia was found among men exposed to higher maximum and likely γ radiation related to TMI exposure during the ten days following the accident (RR=1.15, 95% CI=1.04, 1.29 and RR=1.36, 95% CI=1.08, 1.71, respectively). This relationship was not found in women. CONCLUSION Increased cancer risks from low-level radiation exposure within the TMI cohort were small and mostly statistically non-significant. However, additional follow-up on this population is warranted, especially to explore the increased risk of leukemia found in men.

Trends in Acute Myocardial Infarction Hospitalization Rates for US States in the CDC Tracking Network

Objectives We examined temporal trends, spatial variation, and gender differences in rates of hospitalization due to acute myocardial infarction. Methods We used data from the Centers for Disease Control National Environmental Public Health Tracking Network to evaluate temporal trends, geographic variation, and gender differences in 20 Environmental Public Health Tracking Network states from 2000 to 2008. A longitudinal linear mixed effects model was fitted to the acute myocardial infarction hospitalization rates for the states and counties within each state to examine the overall temporal trend. Results There was a significant overall decrease in age-adjusted acute myocardial infarction hospitalization rates between 2000 and 2008, with most states showing over a 20% decline during the period. The ratio of male/female rates for acute myocardial infarction hospitalization rates remained relatively consistent over time, approximately two-fold higher in men compared to women. A large geographic variability was found for age-adjusted acute myocardial infarction hospitalization rates, with the highest rates found in the Northeastern states. Results of two ecological analyses revealed that the NE region remained significantly associated with increased AMI hospitalization rates after adjustment for socio-demographic factors. Conclusions This investigation is one of the first to explore geographic differences in AMI age adjusted hospital rates in individuals 35+ years of age for 2000–2008. We showed a decreasing trend in AMI hospitalization rates in men and women. A large geographic variability in rates was found with particularly higher rates in the New England/Mid-Atlantic region of the US and lower rates in the mountain and Pacific states of the tracking network. It appeared that over time this disparity in rates became less notable.

Cell phone use and acoustic neuroma: the need for standardized questionnaires and access to industry data.

BACKGROUND The capacity of radiofrequency from cell phones to be absorbed into the brain has prompted concerns that regular cell phone use may increase the risk of acoustic neuroma (AN) and other brain tumors. This article critically evaluates current literature on cell phone use and AN risks and proposes additional studies to clarify any possible linkage. METHODS Through a PubMed search, we identified and reviewed 10 case-control studies and 1 cohort study of AN risks associated with cell phone use and a meta-analysis of long-term mobile phone use and its association with AN and other brain tumors. RESULTS Most studies did not find association between the development of AN and cell phone use, but some studies that followed cases for 10 years or more did show an association. Among 10 case-control studies, odds ratios for AN associated with regular cell phone use ranged from 0.5 (95% confidence interval [CI], 0.2-1.0) to 4.2 (95% CI, 1.8-10). Cell phone use was not associated with increased risk for AN in the Danish cohort study, which excluded business users from their study. The meta-analysis, which included 3 case-control studies, found that subjects who used cell phones for at least 10 years had a 2.4-fold greater risk of developing ipsilateral AN. In general, retrospective studies are limited in the ability to assess cell phone exposure because of recall bias and misclassification. CONCLUSIONS The evaluation of AN risk factors is challenging due to its long latency. Some studies of longer term cell phone use have found an increased risk of ipsilateral AN. Adopting a prospective approach to acquire data on cell phone use, obtaining retrospective billing records that provide independent evaluations of exposures, and incorporating information on other key potential risk factors from questionnaires could markedly advance the capacity of studies to evaluate the impact of cell phones on AN.

Generational Risks for Cancers not Related to Tobacco, Screening, or Treatment in the United States

To assess trends in cancer, the authors evaluated the risk of 1 generation compared with that 25 years earlier (generational risk) for 3 groupings of cancers: those related to tobacco; those that reflect advances in screening or treatment; and a residual category of all other cancers.

Age-period-cohort analysis of cancers not related to tobacco, screening, or HIV: sex and race differences

ObjectiveTo identify trends in a residual category of cancers not typically associated with tobacco, screening, or human immunodeficiency virus (HIV) infection.MethodsFor persons aged 20–84, we used sex- and race-specific age-period-cohort (APC) models to describe temporal patterns of incidence (1975–2004) and mortality (1970–2004) in the U.S. for a residual cancer category that excluded non-Hodgkin lymphoma, Kaposi sarcoma, and cancer of the oral cavity and pharynx, esophagus, pancreas, larynx, lung and bronchus, urinary bladder, kidney and renal pelvis, colon and rectum, prostate, female breast, and cervix uteri.ResultsAge-specific incidence rose (0.1–0.9% per year, on average) in every sex-race group, with factors related to both time period and birth cohort membership appearing to accelerate the increases in women. Age-specific mortality fell (0.6–0.9% per year, on average) for black and white men and women, with the declines decelerating in white women but accelerating in the other sex-race groups. Extrapolations of APC models predicted higher age-adjusted incidence rates in white women (11%), black women (5%), and white men (4%) in 2005–2009, relative to 2000–2004, and lower rates in black men (−3%), accompanied by lower age-adjusted mortality rates in every sex-race group (−8% in black men, −3% in black women, −1% in white men, and −1% in white women).ConclusionsThe possibility that increased incidence in women over time reflects changes in underlying risks, diagnostic practices, or better case ascertainment should be actively explored. Declining mortality may signify improvements in cancer care.

Temporal and Demographic Patterns of Non-Hodgkin's Lymphoma Incidence in Pennsylvania

Abstract Our study analyzed temporal and demographic patterns of non-Hodgkins lymphoma (NHL) incidence in Pennsylvania and compared Pennsylvania time trends with national trends. Joinpoint and age-period-cohort analyses summarized sex- and race-specific NHL incidence time trends between 1985 and 2004. Ecologic analysis identified demographic factors associated with age-adjusted county-specific NHL incidence. NHL incidence in Pennsylvania increased annually: 1.6% and 2.5% in white and black men and 1.6% and 3.2% in white and black women. National trends were similar, except for smaller increases in white men. Diffuse lymphoma appeared to be the major contributor to the increases. NHL incidence was higher in Pennsylvania counties with greater percentages of urban residents. NHL incidence patterns in Pennsylvania were parallel to those seen nationally, with the highest rates occurring in white men and in persons residing in urban areas.

Gamma Knife Radiosurgery for Vestibular Schwannomas and Quality of Life Evaluation.

Background: Further investigation is needed to look at the impact of vestibular schwannoma (VS) on the health-related quality of life (QOL) of participants who undergo Gamma Knife® radiosurgery (GKRS). Objectives: Investigators compared the QOL for VS participants to reported US population norms in order to evaluate disease burden and long-term QOL several years after GKRS. Methods: This cross-sectional study surveyed participants to assess hearing status, tinnitus, imbalance, vertigo, as well as the Short-Form 36-item Health Questionnaire (SF-36). The data were normalized, age adjusted, and functional status was correlated to determine clinically significant differences. Results: A total of 353 participants who underwent GKRS between 1997 and 2007 were included in this study with a median postoperative period of 5 years. SF-36 scores were very similar to population norms, and age-adjusted scores for participants followed the US population curve. Frequent vertigo and balance problems had the largest statistically and clinically significant effect on physical and mental component summary scores followed by nonuseful hearing in the tumor ear. Conclusions: Participants reported a good long-term QOL that was very similar to the QOL of US population norms. Of the common VS symptoms, vertigo had the greatest impact on QOL followed by imbalance and then hearing loss.

Abstract A130: Spatial and temporal patterns in female breast carcinoma incidence in Pennsylvania, 1985–2004

Objective: The assessment of spatial and temporal trends in breast carcinoma incidence can signal changes in ascertainment, changes in risk, and possibly point to changes in underlying risk factors. It is important to develop geographic maps to identify hot spots where cancer rates, by race and by histologic type, are elevated to better appreciate changes in cancer risk. Methods: Incidence data for breast carcinoma, 1985–2004, was requested from the Pennsylvania Cancer Registry (PCR). Joinpoint regression model was applied to characterize age‐, race‐ and histologic type‐specific breast tumor incidence time trends in Pennsylvania (PA). Geographic Information System methods and spatial analysis is also being applied to these data to detect spatial clusters of diagnosed breast carcinoma in PA. Results: Among whites, age‐adjusted incidence for ductal carcinoma in situ (DCIS) increased significantly from 1985 to 1999 and incidence for lobular carcinoma in situ (LCIS) slightly increased from 1994 to 2004, although this increase was not significant. Among blacks, age‐adjusted incidence for DCIS and LCIS increased significantly over the entire study period. Age‐adjusted incidence for malignant breast carcinoma slightly decreased from 1997–2004 among blacks but more recently since 2001 has shown a sharp decrease among whites (annual percent change = −3.0). Between 1985 to 2004, for women under age of 40, age‐adjusted incidence of breast carcinoma in situ (DCIS, LCIS, mixed) significantly increased 4.5% and 10.0% annually for whites and blacks, respectively. Incidence for malignant breast carcinoma slightly decreased over the study period. To better define invasive breast cancer risk in PA, spatial clustering analysis performed to identify county‐specific changes in malignant breast carcinoma incidence. This analysis showed significant spatial clustering in Pennsylvania (P=0.024) and the region of increased invasive breast cancer was clustered in seven southeastern counties. Conclusion: Incidence for breast carcinoma in situ increased significantly among women in PA. An increase in invasive breast cancer was identified in seven southeastern counties. Factors responsible for the state‐wide increase in breast carcinoma in situ and the elevated invasive breast cancer incidence in southeastern Pennsylvania should be carefully assessed. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A130.

Abstract A12: Increased urinary 8‐hydroxy‐2′‐deoxyguanosine excretion in long‐distance bus drivers in Taiwan

Objective: Professional bus drivers are exposed to environments containing air pollution and reactive oxygen species (ROS) that can induce cellular oxidative stress and DNA damage. This study investigated environmental factors associated with oxidative DNA damage in a cohort of long distance bus drivers. Methods: In a comparison study, urinary 8‐hydroxydeoxyguanosine (8‐OHdG), a biomarker of DNA oxidative damage, was examined in 120 male long distance bus drivers and 58 male office workers in Taiwan. Multivariate logistic regression was used to analyze association between urinary 8‐OHdG levels and environmental factors. Results: Bus drivers had higher urinary 8‐OHdG levels (adjusted odds ratio (aOR) = 9.4, 95% confidence interval (CI) = 3.5–28.2) compared with office workers. Increased urinary 8‐OHdG level was significantly related to cigarette smoking (aOR = 18.0, 95% CI = 7.1–52.1), consumption of energy drinks (aOR = 5.0, 95% CI = 2.1–12.6), and regular exercise (aOR = 3.8, 95% CI = 1.5–10.2). A strong exposure‐response relationship was found between urinary 8‐OHdG and urinary cotinine (p Conclusion: Adjusted for smoking, levels of 8‐OHdG were increased in long‐distance bus drivers exposed to traffic exhaust and ingested energy drinks. Future studies should explore what aspects of energy drinks may contribute to increased urinary 8‐OHdG. Citation Information: Cancer Prev Res 2010;3(1 Suppl):A12.