Employing incidence data from the Quebec Tumor Registry, we examined the relative risks of cancer of all sites for the years 1969-73 in the asbestos-mining, rural, and metropolitan counties of Quebec Province, Canada. Generally, rates for males exceeded those for females, and the relative risks in the asbestos-mining counties for 7-10 different sites of cancer, all of low incidence, were from 1.50 to 8.08 times those of other rural counties of the Province for both sexes. Metropolitan counties exhibited equally high risk for many of these sites. We discovered higher risks among males in asbestos-mining counties for cancer of the pleura, peritoneum, lip, tongue, salivary gland, mouth, and small intestine and higher risks among females for cancer of the pleura, lip, kidney, salivary gland, and for melanoma. Because of the likelihood of a long latent period for asbestos-related cancers, the risks we observed were possibly the product of since-altered occupational and environmental conditions existing 20-30 years ago in the asbestos-mining areas. The similarities in risks for most cancers in asbestos-mining and urban areas were noteworthy.
The aim of this study was to investigate the incidence of cancer among 318 male employees of a niobium mining company which was only operated between 1951 and 1965. Many of the workers, especially underground miners, were exposed to the daughters of radon and thoron and also to thorium. The accumulated doses to the workers from short-lived radon and thoron daughters in the mine atmosphere were assessed to be relatively low; up to 300 working-level months. During the follow-up period 1953-1981, 24 new cases of cancer were observed compared to an expected number of 22.8. Twelve cases of lung cancer had occurred versus 3.0 expected. Among the 77 miners, 9 cases of lung cancer were observed against 0.8 expected. Associations between the occurrence of lung cancer and exposure to alpha radiation and smoking were found. For the radon and thoron daughter exposure, about 50 excess cases per million person-years at risk per working-level month were observed.
The association between cumulative radon exposure and coronary heart disease mortality was studied in a retrospective cohort investigation of Newfoundland fluorspar miners.
Multivariate Poisson regression techniques were used to estimate relative risks of coronary heart disease mortality by level of radon exposure. Relative risks (RR) were adjusted by attained age, calendar period, duration of exposure, and smoking status. Death from coronary heart disease was the outcome measure of interest and was identified by record linkage to the Canadian Mortality Database.
An elevated risk of mortality from coronary heart disease was observed among miners with a cumulative radon exposure exceeding 1000 working-level months [RR 1.5, 95% confidence interval (95% CI) 0.77-2.75]. The association between radon exposure and coronary heart disease was not statistically significant according to a test for trend across exposure categories (P = 0.09). The smokers were 1.8 times more likely than the nonsmokers to die from coronary heart disease (95% CI 1.1-2.8).
These results suggest a positive association between coronary heart disease and radon exposure. However, these findings should be interpreted cautiously due to the inability to control for the confounding influence of other known risk factors of coronary heart disease.
This article contrasts two case definitions for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). We compared the empiric CFS case definition (Reeves et al., 2005) and the Canadian ME/CFS clinical case definition (Carruthers et al., 2003) with a sample of individuals with CFS versus those without. Data mining with decision trees was used to identify the best items to identify patients with CFS. Data mining is a statistical technique that was used to help determine which of the survey questions were most effective for accurately classifying cases. The empiric criteria identified about 79% of patients with CFS and the Canadian criteria identified 87% of patients. Items identified by the Canadian criteria had more construct validity. The implications of these findings are discussed.
This paper reviews the epidemiology of lung cancer in uranium miners in northern Ontario whose cumulative exposure was relatively low and who were exposed only for a short period of time. The development of the "epidemic" is demonstrated chronologically and in terms of latency. An apparent difference between the effects of short-term and of more prolonged radiation is shown. A dose-response effect is demonstrated at all levels. Analysis of tumor type suggests that there may be a difference in dose-response between the two principal types encountered. The relationship of the geographic location of exposure to the final residence at death is reviewed.
A high mortality from lung cancer among miners was reported from Central Europe already in the 19th century. In the 60s and 70s several reports have indicated an increased lung cancer mortality among uranium miners and other metal-miners, e.g. in the US, UK, France and Sweden, but also among fluorspar miners in Canada. The cause is supposed to be the decay products of radon as emanating from the rocks, i.e. the alpha-radiation from short-lived radon daughters. Radon and radon daughter exposure in dwellings have more recently attracted interest as a potential hazard to the general population, especially since radon daughter concentrations seem to have increased due to more effective insulation for energy saving. In many Swedish houses the radon daughter exposures amount to levels similar to that of mines. Some epidemiological evaluations of the relationship between lung cancer and exposure to radon daughters, i.e. residency in stone houses versus wooden houses (with and without consideration of the contribution of radon from the ground underneath the houses), seem to indicate a risk also to the general population and, moreover, the risk of smoking seems to be several times greater in stone houses than in wooden houses, the latter usually having less radon daughters on the average.
While multiplicative (log-linear and logistic) models have a firmly established place in epidemiologic methodology, additive and other more general model structures are needed also. The authors propose a parametric family of relative risk functions ranging from subadditive to supramultiplicative that is generated by varying the exponent in a power transform for the log relative risk. The choice of model is facilitated by graphic analysis of goodness-of-fit statistics computed for various values of the exponent. Intermediate quantities available as by-products of the fit are useful for checking the influence of particular observations on the estimated regression coefficients. Three examples illustrate the applications of these methods to random, stratified, and matched samples of cases and controls. Computer software is available for each of these situations. Even though different relative risk models may have markedly different implications for the multifactorial nature of the disease process, it may be difficult to distinguish between them unless the data are quite extensive.