PubMed Health⌕ Search

Biomedical subjects

D Savitz

Publications and source records attributed to D Savitz.

17 recordsLinked to original sources
PubMed2001

Cohort studies of health effects among people exposed to estuarine waters: North Carolina, Virginia, and Maryland.

A variety of human symptoms have been associated with exposure to the dinoflagellate Pfiesteria and have been grouped together into a syndrome termed "possible estuary-associated syndrome." Prospective cohort studies of health effects associated with exposure to estuarine waters that may contain Pfiesteria spp. and related organisms are in progress in North Carolina, Virginia, and Maryland. The three studies recruited cohorts of 118-238 subjects who work or engaged in recreation in estuary waters. Baseline health and neuropsychological evaluations are conducted, and study subjects are followed prospectively for 2-5 years with periodic assessments of health and performance on a battery of neuropsychological tests. Health symptoms and estuary water exposure are recorded by telephone interviews or diaries every 1-2 weeks. Water quality information, including measurements of Pfiesteria spp., is collected in the areas where the subjects are working. Because it is not possible to measure individual exposure to Pfiesteria or a toxin produced by this organism, these studies examine surrogate exposure measures (e.g., time spent in estuary waters, in a fish kill area, or in waters where Pfiesteria DNA was detected by molecular amplification). Preliminary analyses of the first 2 years (1998-2000) of data indicate that none of the three ongoing cohorts have detected adverse health effects. However, there have not been any reported fish kills associated with Pfiesteria since the studies began, so it is possible that none of the study subjects have been exposed to toxin-producing Pfiesteria spp.

Animals↗
PubMed2001

Review of the epidemiologic literature on EMF and Health.

Exposures to extremely low-frequency electric and magnetic fields (EMF) emanating from the generation, transmission, and use of electricity are a ubiquitous part of modern life. Concern about potential adverse health effects was initially brought to prominence by an epidemiologic report two decades ago from Denver on childhood cancer. We reviewed the now voluminous epidemiologic literature on EMF and risks of chronic disease and conclude the following: a) The quality of epidemiologic studies on this topic has improved over time and several of the recent studies on childhood leukemia and on cancer associated with occupational exposure are close to the limit of what can realistically be achieved in terms of size of study and methodological rigor. b) Exposure assessment is a particular difficulty of EMF epidemiology, in several respects: i) The exposure is imperceptible, ubiquitous, has multiple sources, and can vary greatly over time and short distances. ii) The exposure period of relevance is before the date at which measurements can realistically be obtained and of unknown duration and induction period. iii) The appropriate exposure metric is not known and there are no biological data from which to impute it. c) In the absence of experimental evidence and given the methodological uncertainties in the epidemiologic literature, there is no chronic disease for which an etiological relation to EMF can be regarded as established. d) There has been a large body of high quality data for childhood cancer, and also for adult leukemia and brain tumor in relation to occupational exposure. Among all the outcomes evaluated in epidemiologic studies of EMF, childhood leukemia in relation to postnatal exposures above 0.4 microT is the one for which there is most evidence of an association. The relative risk has been estimated at 2.0 (95% confidence limit: 1.27-3.13) in a large pooled analysis. This is unlikely to be due to chance but, may be, in part, due to bias. This is difficult to interpret in the absence of a known mechanism or reproducible experimental support. In the large pooled analysis only 0.8% of all children were exposed above 0.4 microT. Further studies need to be designed to test specific hypotheses such as aspects of selection bias or exposure. On the basis of epidemiologic findings, evidence shows an association of amyotrophic lateral sclerosis with occupational EMF exposure although confounding is a potential explanation. Breast cancer, cardiovascular disease, and suicide and depression remain unresolved.

Adolescent↗
PubMed2001

Exposure to extremely low frequency magnetic fields among working women and homemakers.

Given concerns with potential health effects of exposure to magnetic fields, the goal of this study was to examine the magnitude and sources of occupational and residential exposure to extremely low frequency (primarily 60 Hz) magnetic fields among women. Exposure to 60 Hz magnetic fields was surveyed among cases and controls recruited for a study of breast cancer in 25 counties in North Carolina. The 273 women who participated wore an integrating personal magnetic-field exposure meter (AMEX 3-D) that measured their time-weighted average (TWA) exposure. A questionnaire was administered to determine the duration and frequency of electric appliance and machinery use. The geometric mean (GM) of the TWA exposure for employed women was 0.138 microT (range 0.022-3.636 microT) and for homemakers 0.113 microT (range 0.022-0.403 microT). Women working in manufacturing and industrial facilities had the highest exposure (GM 0.265 microT, range 0.054-3.436 microT), while nurses and health technicians (GM 0.134 microT, range 0.032-0.285 microT) and teachers and school administrators (GM 0.099 microT, range 0.035-0.673 microT) had the lowest exposures. Job titles, unless very limited in scope and/or environment, self-reported information about equipment use, potential exposure sources, time, and distance were not good predictors of magnetic-field exposure. Furthermore, the results show that occupations previously observed to have increased risk of breast cancer, such as teachers, nurses, administrative support, and housewives, did not have elevated average magnetic field exposures. Therefore, it is questionable whether exposure to power frequency magnetic fields is the cause of the increased breast cancer risk seen in these occupations.

Adult↗
PubMed1998

Catechol-O-methyltransferase and breast cancer risk.

Recent studies suggest that a polymorphism in catechol-O-methyltransferase (COMT) is associated with increased risk of breast cancer. Methylation by COMT is the principal pathway for inactivation of catechol estrogens, which are hypothesized to participate in estrogen-induced carcinogenesis. We examined the association of COMT genotype and breast cancer risk in a population-based, case-control study of invasive breast cancer in North Carolina. The study population consisted of 654 cases and 642 controls, with approximately equal numbers of African-American and white women and women under the age of 50 and aged 50 or over. Contrary to previous reports, we did not observe an association between one or more copies of the low activity COMT allele (COMT-L) and breast cancer risk. Multivariate relative risks (RRs) were 0.8 (95% confidence interval: 0.6-1.1) for COMT-HL and 0.8 (0.6-1.1) for COMT-LL, compared with the COMT-HH genotype. RRs for COMT did not differ among African-American and white women and we did not observe strong modification of RR estimates by menopausal status, body mass index, physical activity or other covariates. Our results suggest that COMT genotype is not related to breast cancer risk.

Adult↗
PubMed1998

Cigarette smoking, N-acetyltransferases 1 and 2, and breast cancer risk.

To examine the effects of smoking and N-acetylation genetics on breast cancer risk, we analyzed data from an ongoing, population-based, case-control study of invasive breast cancer in North Carolina. The study population consisted of 498 cases and 473 controls, with approximately equal numbers of African-American and white women, and women under the age of 50 and age 50 years or older. Among premenopausal women, there was no association between current smoking [odds ratio (OR), 0.9; 95% confidence interval (CI), 0.5-1.5] or past smoking (OR, 1.0; 95% CI, 0.6-1.6) and breast cancer risk. Among postmenopausal women, there was also no association with current smoking (OR, 1.2; 95% CI, 0.7-2.0); however, a small increase in risk was observed for past smoking (OR, 1.5; 95% CI, 1.0-2.4). For postmenopausal women who smoked in the past, ORs and 95% CIs were 3.4 (1.4-8.1) for smoking within the past 3 years, 3.0 (1.3-6.7) for smoking 4-9 years ago, and 0.6 (0.3-1.4) for smoking 10-19 years ago. Neither N-acetyltransferase 1 (NAT1) nor N-acetyltransferase 2 (NAT2) genotype alone was associated with increased breast cancer risk. There was little evidence for modification of smoking effects according to genotype, except among postmenopausal women. Among postmenopausal women, ORs for smoking within the past 3 years were greater for women with the NAT1*10 genotype (OR, 9.0; 95% CI, 1.9-41.8) than NAT1-non*10 (OR, 2.5; 95% CI, 0.9-7.2) and greater for NAT2-rapid genotype (OR, 7.4; 95% CI, 1.6-32.6) than NAT2-slow (OR, 2.8; 95% CI, 0.4-8.0). Future studies of NAT genotypes and breast cancer should investigate the effects of environmental tobacco smoke, diet, and other exposures.

Acetyltransferases↗
PubMed1995

Guidelines for application of meta-analysis in environmental epidemiology. ISLI Risk Science Institute.

The use of meta-analysis in environmental epidemiology can enhance the value of epidemiologic data in debates about environmental health risks. Meta-analysis may be particularly useful to formally examine sources of heterogeneity, to clarify the relationship between environmental exposures and health effects, and to generate information beyond that provided by individual studies or a narrative review. However, meta-analysis may not be useful when the relationship between exposure and disease is obvious, when there are only a few studies of the key health outcomes, or when there is substantial confounding or other biases which cannot be adjusted for in the analysis. Recent increases in the use of meta-analysis in environmental epidemiology have highlighted the need for guidelines for the application of the technique. Guidelines, in the form of desirable and undesirable attributes, are presented in this paper for various components of a meta-analysis including study identification and selection; data extraction and analysis; and interpretation, presentation, and communication of results. Also discussed are the appropriateness of the use of meta-analysis in environmental health studies and when meta-analysis should or should not be used.

Environmental Exposure↗
PubMed1995

Studying environmental influences and breast cancer risk: suggestions for an integrated population-based approach.

Increased attention has focused in recent years on environmental exposures which may elevate risk of human breast cancer. Following a brief introduction to the topic, we present a summary of recent evidence regarding the role of chlorinated hydrocarbons (e.g. pesticides), occupational exposures (e.g. electromagnetic fields), dietary factors, and other hydrocarbons (e.g. tobacco). Next, we present suggestions for additional measurements which may help to clarify the contribution of environmental factors, including individual and ecologic level exposure histories, polymorphisms in carcinogen-metabolizing enzymes, and interactions among environmental exposures, breast tumor characteristics, and other risk factors for breast cancer. Finally, we discuss how a population-based approach may be used to integrate these sources of information and could provide new clues regarding the role of environmental influences in breast cancer.

Breast Neoplasms↗
PubMed1993

Farming and prostate cancer mortality.

Although farmers appear to be at an increased risk of prostate cancer, the specific exposures which produce the excess risk remain unexplained. This study was based on a retrospectively assembled cohort of male Manitoba, Saskatchewan, and Alberta, Canada, farmers age 45 years or older identified in the 1971 Canadian censuses of population and agriculture. The cohort was linked to the Canadian National Mortality Database using an iterative computer record linkage system for the period June 1971 to the end of 1987. A total of 1,148 prostate cancer deaths and 2,213,478 person-years were observed. Using Poisson regression, the study examined the relation between the risk of dying from prostate cancer and various farm practices as identified on the 1971 Census of Agriculture, including exposure to chickens, cattle, pesticides, and fuels. A weak, but statistically significant, association was found between number of acres sprayed with herbicides in 1970 and risk of prostate cancer mortality. When the analysis was restricted to farmers believed to be subject to the least amount of misclassification, the risk associated with acres sprayed with herbicides increased (rate ratio (RR) = 2.23 for 250 or more acres sprayed; 95% confidence interval (CI) 1.30-3.84; test for trend, p < 0.01). No other farm exposure examined was associated with any detectable pattern of increased or decreased risk. These findings encourage further research to examine the effects of herbicides on prostate cancer.

Aged↗
PubMed1993

Cigarette smoking and preeclampsia.

OBJECTIVE: To examine the relationship between cigarette smoking during pregnancy and the development of preeclampsia. METHODS: A case-control study compared the smoking histories of 110 nulliparous preeclamptic women and 115 healthy nulliparas aged 15-35 years who delivered at North Carolina Memorial Hospital. RESULTS: Unconditioned logistic regression relating smoking during pregnancy to preeclampsia yielded an odds ratio of 0.71 (95% confidence interval 0.33-1.50) when adjusting for working during pregnancy, alcohol use, medication use, contraceptive choices with the father of the index pregnancy, and family history of preeclampsia. There was no evidence of a dose-response effect of reduced risk for heavier smokers. CONCLUSIONS: Despite major methodologic improvements from previous studies, including rigorous diagnostic criteria for preeclampsia, a negative, non-statistically significant association persisted between cigarette smoking during pregnancy and preeclampsia, similar in magnitude to that of previous reports.

Adolescent↗
PubMed1991

Modification of the 1979 "Denver wire code" for different wire or plumbing types.

This article examines "wire configuration coding" as used to estimate relative residential AC magnetic field exposure in epidemiological studies--and the need to alter such coding for time or locations other than those in which the code was developed. Effects of different secondary wire practices are particularly examined.

Colorado↗
PubMed1989

Use of wiring configuration and wiring codes for estimating externally generated electric and magnetic fields.

The relative locations and characteristics of the distribution lines feeding 434 residences in the Denver metropolitan area were recorded and classified according to the Wertheimer-Leeper code (WL code) as a part of an epidemiological study of the incidence of childhood cancer. The WL code was found to place the mean values of the fields in rank order. However, the standard deviations were approximately the same size as the means. Theoretical calculations indicate that a significant fraction of the low-power magnetic fields can be generated by the distribution lines, especially in the cases where the distribution lines are within 50 feet of the residence. Thus, the wiring code was shown to be a useful method for making a first-order approximation to predict long-term, low-level magnetic fields in residences.

Building Codes↗
PubMed1971

Tracer determinations of human red cell membrane permeability to small nonelectrolytes.

A flow system has been used to determine the permeability of human red cell membranes to four small nonelectrolytes labeled with (14)C. The permeability coefficients, omega, in units of mol dyne(-1) sec(-1) x 10(15), are: ethylene glycol, 6; urea, 13; formamide, 22; and methanol, 131. The values for urea and formamide are in good agreement with values obtained by Sha'afi, Gary-Bobo, and Solomon by the minimum method. The unusually high value for omega for methanol is ascribed to its solubility in the red cell membrane since its ether: water partition coefficient is 0.14, higher by more than an order of magnitude than the ether: water partition coefficient for water. The other three solutes are hydrophilic and are characterized by values of omega which behave consistently with those of other hydrophilic amides and ureas. The values of omega for the three hydrophilic solutes measured are also consistent with an equivalent pore radius of about 3.5 A in agreement with previous estimates made on the basis of other types of studies.

Amides↗