Biomedical subjects

N Szeszenia-Dabrowska

Publications and source records attributed to N Szeszenia-Dabrowska.

At least 19 recordsLinked to original sources

PubMed2006

Established breast cancer risk factors by clinically important tumour characteristics.

Breast cancer is a morphologically and clinically heterogeneous disease; however, it is less clear how risk factors relate to tumour features. We evaluated risk factors by tumour characteristics (histopathologic type, grade, size, and nodal status) in a population-based case-control of 2386 breast cancers and 2502 controls in Poland. Use of a novel extension of the polytomous logistic regression permitted simultaneous modelling of multiple tumour characteristics. Late age at first full-term birth was associated with increased risk of large (> 2 cm) tumours (odds ratios (95% confidence intervals) 1.19 (1.07-1.33) for a 5-year increase in age), but not smaller tumours (P for heterogeneity adjusting for other tumour features (Phet) = 0.007). On the other hand, multiparity was associated with reduced risk for small tumours (0.76 (0.68-0.86) per additional birth; Phet = 0.004). Consideration of all tumour characteristics simultaneously revealed that current or recent use of combined hormone replacement therapy was associated with risk of small (2.29 (1.66-3.15)) and grade 1 (3.36 (2.22-5.08)) tumours (Phet = 0.05 for size and 0.0008 for grade 1 vs 3), rather than specific histopathologic types (Phet = 0.63 for ductal vs lobular). Finally, elevated body mass index was associated with larger tumour size among both pre- and postmenopausal women (Phet = 0.05 and 0.0001, respectively). None of these relationships were explained by hormone receptor status of the tumours. In conclusion, these data support distinctive risk factor relationships by tumour characteristics of prognostic relevance. These findings might be useful in developing targeted prevention efforts.

Breast Neoplasms↗

PubMed2005

A database of exposures in the rubber manufacturing industry: design and quality control.

The concerted action EXASRUB was initiated to create a database management system for information on occupational hygiene measurements that could be used to develop exposure models in the European rubber manufacturing industry. Quality of coding was assessed by calculating percentages of agreement and Cohen's kappa statistics (kappa) for an intra- and inter-centre recoding of randomly selected subsets of the measurements. In a 6-month period, 59 609 measurements from 523 surveys in 333 factories from as early as 1956 to 2003 were coded. The database consists primarily of measurements of N-nitrosamines (36%), rubber dust (23%), solvents (14%) and rubber fumes (10%). Coding of epidemiologically relevant information was done consistently with inter-centre kappa between 0.86 and 1.00. For occupational hygiene information, values of kappa were estimated to be between 0.67 and 1.00. The proposed method resulted in a large quantity of exposure measurements with auxiliary information of varying completeness and quality. Analyses showed that coding of epidemiologically relevant information in such a multi-centre, multi-country study was coded consistently. Larger errors however, occurred in coding of occupational hygiene information. This was primarily caused by lack of information in the primary records of measurements, emphasizing the importance of having a universal system in place to collect and store measurement information by occupational hygienists for future use.

Chemical Industry↗

PubMed2003

Oxidative-stress markers in blood of lung cancer patients occupationally exposed to carcinogens.

The study covered 152 lung cancer patients and 210 controls. The results of the study indicated decreased selenium (Se) concentrations and lowered activity of erythrocyte antioxidant enzymes (glutathione peroxidase, superoxide dismutase, glutathione-S-transferase) in the blood of lung cancer patients, as well as significantly increased concentrations of vitamin E in erythrocytes and thiobarbituric acid reactive substances in the plasma of the study population. Low plasma Se concentrations (< 45.7 microg/L) enhance the estimated risk of lung cancer (odds ratio = 3.047, p < 0.001). A more precise exposure assessment is required to identify the association between lung cancer incidence and occupational exposure to carcinogens.

Adult↗

PubMed2003

Glutathione S-transferase M1 and P1 metabolic polymorphism and lung cancer predisposition.

Individual susceptibility to different environmental agents is expected to be associated with alterations in metabolism of xenobiotics. Thus, genetic polymorphism of glutathione S-transferase (GST) can be recognized as a potential risk modifier in lung cancer development. The distribution of GSTM1 and GSTP1 genotypes was studied in a group of 138 diagnosed lung cancer patients and in 165 controls living in central Poland and RFLP-PCR technique was applied. The frequency of GSTM1 null genotype and GSTP1 Val single and duplicated alleles was similar among patients and controls. GSTM1 homozygous deletion was most prevalent in small-cell carcinoma groups (adjusted odds ratio (OR): 2.32, 95% confidence interval (CI): 0.98-5.52). In patients and controls, GSTM1A genotype was most frequent (34.1% vs. 37.0%). The estimated lung cancer risk for GSTM1 null, GSTP1 Ile/Val and GSTP1 Val/Val combined genotype was 1.44 (95% CI: 0.73-2.83), suggesting the absence of modifying effect of defective GSTM1 and GSTP1 alleles on lung cancer predisposition.

Adenocarcinoma↗

PubMed2001

[Occupational monitoring of lung cancer in epidemiologic studies].

This paper addresses the problem of diagnosing occupational lung cancer faced in different countries. The risks of lung cancer attributed to occupational exposure in selected epidemiological studies are presented. Evidenced and probable lung carcinogens, as well as occupations and industries responsible for the increased risk for the incidence of this pathology are discussed in the light of epidemiological studies.

Carcinogens↗

PubMed2001

Cancer mortality in rubber tire workers in Poland.

The study aimed at assessing cancer risk in a cohort of workers employed in the rubber tire production. The cohort consisted of 17,747 workers (11,660 men and 6087 women) employed in a rubber tire plant for at least three months during the years 1950-1995. The cohort follow-up was completed on December 31, 1995. Deaths by causes were analyzed using standardized mortality ratio (SMR) calculated by the person-years method. The mortality pattern of the general population of Poland was used as the reference. The study indicated significantly lower total mortality in the cohort (men: SMR = 72; women: SMR = 62) as compared to the general population, which is an example of a well known "healthy worker effect". The number of deaths from malignant neoplasms was also lower than expected (men: SMR = 67; women: SMR = 64). Only in a very small sub-cohort of men involved in dosing and mixing of raw material for the production of rubber, an excess of total mortality (SMR = 104) and from all cancers (SMR = 115) was found. Mortality from all neoplasms was enhanced (SMR = 108) in the sub-cohort of women employed in the technical service work area. When analyzing individual cancer sites in men of the whole cohort or sub-cohorts, the observed number of deaths from cancers of the lip, tongue, pharynx, stomach, gallbladder, pancreas, peritoneum, articular cartilage, connective tissue, skin, testis, prostate, bladder, kidney, brain, as well as from Hodgkin's disease, multiple myeloma and leukemia was larger than the expected number. Among women the excess mortality was due to cancers of the large myeloma and leukemia. The SMR calculated for these sites were statistically insignificant. The cohort under study was "young" and thus relatively small numbers of deaths were recorded. The excess mortality, based quite frequently on single cases of selected cancer sites, cannot be regarded as a basis for final conclusions. Nevertheless, the fact that these observations are in agreement with the findings of other authors who carried out studies in the rubber industry of other countries justifies the need to follow-up this cohort in the future.

Adult↗

PubMed2001

Mortality pattern in the cohort of workers exposed to carbon disulfide.

The objective of the study was to assess mortality in the cohort of the viscose factory workers occupationally and environmentally exposed to carbon disulfide. Male workers employed for at least one year during 1950-1985 in the production or maintenance departments, living in the vicinity of the plant, were enrolled into the study. Of the 2,878 workers in the cohort, 2,762 were successfully traced, yielding 76,465 person-years. Mortality assessment was based on the standardized mortality ratio using a person-years method. The general male population of Poland was considered as a reference group. Total mortality in the cohort was higher than in the general male population in Poland (SMR = 108). A significantly increased risk of deaths was observed for all cardiovascular (SMR = 114) and cerebrovascular (SMR = 208) diseases. Analyses showed a significantly elevated risk of death from the circulatory system diseases in the men of the "highly exposed" group, spinners and those who were first employed before 1974. A statistically significant trend of mortality from all cardiovascular diseases in relation to the level of exposure (assessed qualitatively) was evident. No clear relationship between duration of exposure and the risk of death was found.

Adult↗

PubMed2001

[Occupational exposure to chemicals in the manufacture of rubber tires].

The work environment of the rubber industry company, producing various types of tires, was assessed and the workers of the plant were included in a cohort study of mortality. Concentrations of twenty chemical substances at 137 workposts were measured by employees of the plant laboratory and the sanitary and epidemiological station in 1981-1996. The mean values and concentration ranges were determined by departments and workposts. The excess of threshold limit values was analyzed. The workposts with exposure to agents possibly carcinogenic to humans were identified. The analysis performed will render it possible to calculate doses of cumulative exposure to given compounds among workers covered by the epidemiological study.

Carcinogens↗

PubMed2001

[Occupational risk factors for breast cancer in the epidemiological studies].

The paper reviews data on the occupational risk factors, which role in the etiology of breast cancer in women has been analyzed and estimated in the epidemiological studies. The results of the studies are presented and discussed. An increased incidence or risk of death from breast cancer was observed in some studies among teachers, nurses and physicians, managerial occupations, beauticians and hairdressers, chemists, telephone and telegraph operators, workers of the pharmaceutical and chemical industry. Some epidemiological studies indicate that breast cancer incidence might be related to occupational exposure to electromagnetic fields, ionizing radiation, low physical activity, organic solvents, selected pesticides. However, owing to inconsistency of the study results and methodological weaknesses (imprecise classification of exposure, low response rate, uncontrolled confounding) no definite conclusion can be drawn.

Breast Neoplasms↗

PubMed2000

Mortality of workers at two asbestos-cement plants in Poland.

To assess mortality rate among workers occupationally exposed to asbestos, cohort studies were carried out in two asbestos cement plants operating since the 1960s. Asbestos cement sheets for roofing and siding have been manufactured there, using mostly chrisotile, and since 1985 also crocidolite for pressure pipes. In all, the cohort comprised 3,220 workers, including 2,616 male workers. Subject to consideration were the workers employed for at least three months in the period between the onset of the production and 1980. The vital status of the subjects was traced up to 31 December 1991. The availability of the cohort was 96.8%. Workers' mortality was analysed using standardized mortality ratio (SMR). The reference group was the general population of Poland. In the male cohort, 385 cases of death were recorded. Statistically significant excess of mortality from large intestine cancer (7 cases, SMR = 264) and pleural mesothelioma (5 cases, SMR = 2846) was found. In male workers who died from pleural mesothelioma the work history ranged from 12 to 26 years. An excess mortality from pleural mesothelioma was also noted among the female workers (2 cases, SMR = 11,275). No malignant neoplasms of other locations produced significant excess mortality either in the male or female workers.

Adult↗

PubMed2000

[Mortality in the tire plant workers].

This paper describes a cohort study of the mortality among workers employed in one of Polish tyre plants. The scope of the study was limited to the analysis of mortality from main disease categories. Mortality from particular cancer sites will be discussed in a separate publication. The cohort comprised 17,747 workers (11,660 men and 6,087 women) employed during the years 1950-95 for at least three months in the tyre plant. As of 31 December 1995, the follow-up of the cohort was completed. A detailed analysis of mortality by causes was carried out using standardised mortality ratio (SMR) calculated by the person-years method. The general population of Poland was used as the reference. The results indicated general mortality significantly lower in the cohort (men: SMR = 72; women: SMR = 62), than in the reference population. The number of observed deaths from main disease categories was also lower than those expected. The analysis by specific causes revealed significant excess of deaths, due to hypertensive disease among men (36 deaths, SMR = 142; 95% CI: 99-197). SMRs were also calculated in sub-cohorts identified by activities performed (preparatory works: production of tyres and inner tubes; maintenance; storage; others). General mortality in sub-cohorts was similar to that in the total cohort. After analysis by causes of death, some non-significant excess mortality could be observed. It was very small or it applied only to single cases of death. Excess mortality from hypertensive disease in male maintenance workers (21 deaths, SMR = 262; 95% CI: 162-400) was the only exception. The absence of adverse health effects pronounced by significant excess mortality should be attributed to a relatively short period of exposure among the majority of the followed-up workers (over 58% of workers in the cohort employed in the plant for a period shorter than five years) and to their young age. Almost 56% of workers in the cohort were born in the 1950s or later which means that at the end of the follow-up they were not older than 45 years. In order to complete the final mortality assessment the follow-up should continue.

Automobiles↗

PubMed1999

Occupational cancer in central European countries.

The countries of central Europe, including Poland, the Czech Republic, Slovakia, Hungary, Romania, and Bulgaria, suffer from environmental and occupational health problems created during the political system in place until the late 1980s. This situation is reflected by data on workplace exposure to hazardous agents. Such data have been systematically collected in Skovakia and the Czech Republic since 1977. The data presented describe mainly the situation in the early 1990s. The number of workers exposed to risk factors at the workplace represent about 10% of the working population in Slovakia and 30% in Poland. In Slovakia in 1992 the percentage of persons exposed to chemical substances was 16.4%, to ionizing radiation 4.3%, and to carcinogens 3.3% of all workers exposed to risk factors. The total number of persons exposed to substances proven to be carcinogens in Poland was 1.3% of the employees; 2.2% were exposed to the suspected carcinogens. The incidence of all certified occupational diseases in the Slovak Republic was 53 per 100,000 insured employees in 1992. Cancers certified as occupational cancers are skin cancer caused by occupational exposure to carcinogens, lung cancer caused by ionizing radiation, and asbestosis together with lung cancer. Specific information on occupational cancers from Romania and Bulgaria was not available for this paper. It is difficult to predict a trend for future incidences of occupational cancer. Improved control technology, governmental regulatory activity to reduce exposure, surveillance of diseases and risk factors, and vigilant use of preventive measures should, however, ultimately reduce occupational cancer.

Carcinogens↗

PubMed1999

Mortality in the cotton industry workers: results of a cohort study.

The cohort consisted of persons found on the payroll of one of the Lódź cotton plants in 1964-1993 who were employed in the plant for at least 10 years. Death risk by causes was analysed using standardised mortality ratios (SMRs) calculated by the person-years method. The general population of Poland was used as the reference. In all, 7892 people were observed. As of December 31, 1995, the follow-up was completed for 7545 people (2852 men and 4693 women), i.e. the availability of the cohort was 95.6%. A total of 2069 deaths were recorded; the information on the cause of death was available for 97% of the subjects. In the male cohort, the level of the general mortality was the same as in the general population (SMR = 99). However, there was a significant increase in the number of deaths from diseases of the digestive system (SMR = 142) and larynx cancer (SMR = 188). The analysis of the results by production departments revealed in the weaving department significantly higher mortality from atherosclerosis (SMR = 141), peritoneal carcinoma (SMR = 1057) and melanoma (SMR = 677); and in the spinning department the increased risk of the hypertensive disease (SMR = 239), atherosclerosis (SMR = 175), and Hodgkin's disease (SMR = 768). Mortality in the female cohort was lower than that in the general population (SMR = 88). None of the disease groups or tumour sites caused statistically significant excess deaths either in the total cohort or in subcohorts selected according to departments. Special attention was paid to the chemical processing departments where chemicals used could contribute to the increased risk of death from cancer. Our analysis did not reveal any significant increase either in the total cohort of the workers employed in those departments or in the cohorts analyzed by duration of employment. Our results confirm the lower risk of lung cancer in the analysed group as compared with that in the general population. The numerous, but statistically insignificant increases in the incidence of malignant tumours at some specific sites detected in the subcohorts, distinguished according to the duration of employment or department, confirm the reported findings on the incidence of oral cavity, nose, throat, and larynx tumours among people exposed to harmful agents in the cotton industry.

Adult↗

PubMed1999

[Incidence of occupational diseases in Poland].

The paper is aimed at presenting the incidence of occupational diseases in Poland. The analysis was performed on the basis of the information included in 'occupational disease certificates'. All sanitary and epidemiological stations throughout the country are committed to send these certificates to the Central Register of Occupational Medicine in The Nofer Institute of Occupational Medicine in Lódź. The incidence of occupational diseases during the three recent years (1996-97-98) was the subject of a thorough analysis. In all, 11,318, 11,685 and 12,017 cases of occupational diseases, respectively were registered over those three years. The corresponding rates were 116.0, 116.9 and 117.3, respectively per 100,000 people employed. In 1998, diseases of the voice organ predominated (30.4%) of all occupational diseases) and they were followed by hearing impairment (28.2%), infectious and parasitic diseases (9.9%), pneumoconioses (8.2%), dermatoses (6.4%), vibratory syndrome (2.9%) and poisoning (2.5%). These disease categories constituted over 88% of all occupational diseases registered in that year. Diseases of the voice organ which showed the greatest growth dynamic were mainly diagnosed among teachers. Neither in the United States nor in the member states of the European Union, this pathology is included into the list of occupational diseases. In view of high rates of its incidence in our country it has become one of essential problems of occupational medicine. In Poland, particular attention is paid to infectious and parasitic diseases among which hepatitis occupies the first place (65%), mostly among health service workers. The decrease in hepatitis incidence observed in the 1990s has been due to an intensive vaccination programme in this group of workers. The incidence of occupational hepatitis became rather stable and accounted for 940 cases per year, however the incidence of hepatitic C increased at the same time. Lower rates of incidence of 'classic' occupational diseases, such as poisoning, pneumoconioses or vibratory syndrome are a positive observation. It is also interesting to note that the rate of occupational diseases diagnosed in advanced stage has also diminished. When analyzing occupational diseases one should bear in mind that the majority of pathologies already diagnosed result from long-term effect of exposure to harmful factors. In all, 93% of cases of occupational diseases emerged after a ten-year exposure. The highest rates, taking account of sections of activity, were found in mining and quarrying, health service, agriculture, hunting and forestry.

Adult↗

PubMed1998

[The effect of systemic changes on sick-day absenteeism in the workplace. II. Causes of work disability among persons under termination of employment].

During the period of transformations and restructuring of workplaces in Poland, the reduction of employment becomes quite common, what seems to make a considerable impact on sick absenteeism. The analysis presented aimed at defining how far the risk of sick absenteeism increases among workers under termination of employment because of different reasons, and indicating morbidity causes in case of which sick absenteeism is most extensive. The study was carried out in one of the largest plants of the motor car industry (before the process of restructuring), and it covered a cohort of 5,373 men and 3,215 women employed during the years 1989-94. The workers who terminated their employment during those years made 77% of the whole cohort under study. The case index, calculated as the ratio of the number of cases to the number of man-days under observation, was taken as an analysis parameter. Poisson regression model involving a number of variables (age, departments, current workers, workers discharged according to particular reasons, and the period preceding the termination of employment) was used in the statistical analysis. The study indicated an increased risk of sick absenteeism in the group of workers approaching the termination of employment in comparison with that among current workers. The highest risk of work disability, both among men and women, was observed in persons leaving their jobs because of long-lasting illness or disability pension. The highest risk indices were noted in men whose sick absenteeism was caused by neoplasms (RR = 14.42); endocrine secretion disorders (RR = 4.83); cardiovascular disorders (RR = 3.60); mental disorders (RR = 3.04); and diseases of the musculoskeletal system (RR = 2.95); and in women with neoplasms (R = 6.42); diseases of the musculoskeletal system (RR = 4.01); and cardiovascular diseases (RR = 3.99). Risk of sick absenteeism was over 50% higher among retiring workers than among current workers (RR = 1.50 for men; and RR = 1.53 for women). Among workers discharged because of economic reasons, statistically significant risk of sick absenteeism was also observed (RR = 1.51 for men; and RR = 1.37 for women). In the group of workers leaving their jobs, following the agreement of the parties, an increased risk of sick absenteeism was noted in men (RR = 1.45). The economy transformation processes make a considerable impact on the occurrence of sick absenteeism in workplaces. Workers leaving their jobs because of health problems or of their own accord, as well as those discharged because of economic reasons belong to the highest risk groups.

Absenteeism↗

PubMed1998

[Mortality of men with occupational lead poisoning in Poland].

The cohort method was used in the study. A retrospective observation covered 4.556 males with occupational disease, manifested by lead poisoning, diagnosed during the years 1970-1992. Mortality risk analysis by causes was based on standardized mortality ratios (SMRs) calculated by person-years method. Their statistical significance was assessed by means of the test based on Poisson distribution. The general adult male population was adopted as the reference population. The state of the cohort as of 31 December 1992 was considered. The cohort accessibility was 95.6%. The study revealed increased total mortality among lead poisoned males (670 deaths; SMR = 108; 95% CI: 100-116). Significant excess mortality was observed in diseases of the digestive system (37 deaths; SMR = 148; 95% CI: 104-204), including chronic hepatitis and cirrhosis (19 deaths; SMR = 173; 95% CI: 104-270); malignant neoplasms of respiratory and intrathoracic organs (82 deaths; SMR = 135; 95% CI: 107-168), including malignant neoplasm of larynx (13 deaths; SMR = 213; 95% CI: 113-364). In the subcohort with high exposure, death risk was significantly enhanced in comparison to the general population (153 deaths; SMR = 129; 95% CI: 109-151). In addition, significant excess of malignant neoplasms was observed (43 deaths; SMR = 151; 95% CI: 109-203) including liver (4 deaths; SMR = 419; 95% CI: 114-1073) and respiratory and intrathoracic organs tumors (21 deaths; SMR = 175; 95% CI: 108-268).

Adult↗

PubMed1998

Environmental exposure to asbestos in asbestos cement workers: a case of additional exposure from indiscriminate use of industrial wastes.

The paper presents data on cancer risk, especially pleural mesothelioma and lung cancer, among the workers of asbestos cement plant who living in the vicinity of the plant, were also environmentally exposed to asbestos. In 1959 an asbestos cement factory was founded in the rural area of south-eastern Poland. Apart from chrysotile asbestos, crocidolite was used till 1985 chiefly for the manufacture of pressure pipes. The blue asbestos made up 15% of the mean annual tonnage of the processed asbestos. It was found that soon after asbestos production had started the process wastes were made available to local community, particularly to the workers of that factory. For over twenty years asbestos wastes of all kinds, both wet (process sludge) and dry (from pipe and sheet grinding) were exploited for the hardening of roads, paths, farmyards and sports fields and as construction material components. For the evaluation of cancer risk due to occupational exposure to asbestos a cohort of 1,526 workers employed in this factory was observed till the end of 1996. The cohort availability was 95.6%. Standardized mortality ratio (SMR) was calculated using the man-years method. The reference population was the general population of Poland. The results of the study demonstrated a statistically significant increase in the risk of a) pleural mesothelioma--over an 80-fold excess among males and over a 200-fold one among females; b) lung cancer in females--over a 6-fold excess; c) colon cancer in males--over a 3-fold excess. In the 1990 ten new cases of pleural mesothelioma in the cohort were reported. As compared to other asbestos-cement cohorts in Poland, observed at the same time, this cohort presented a very high risk of pleural mesothelioma. The analysis of 16 cases of pleural mesothelioma found in the cohort from 1987 to 1997 revealed 4 cases with very short employment period (3.5 months-5 years) including two cases with relatively short latency period (11-12 years). In order to find explanation of these findings, additional investigations were made. The epidemiological study indicated that all these persons were at the same time subject to non-occupational exposure associated with massive utilization of commonly available asbestos-cement wastes as road surface material.

Adult↗

PubMed1998

Sickness absence in a rubber plant in Poland.

The disease-related temporary incapacity for work, its causes and duration are essential factors in the assessment of health status of the occupationally active population. The aim of the present study was to investigate the main causes of work disability among the rubber industry workers, with special regard to sickness absence among workers directly enganged in manufacture. The study was performed in 1995 on a sample of 973 workers (456 males and 517 females) at a plant producing rubber footware. The number of days of work disability from a particular disease, frequency and duration per year were examined. The analysis concerned such parameters of sickness absence as the lost time rate, average duration of absence, and percentage of workers on a sick-leave. The results revealed that during the period under study the main medical causes of the sickness absence included: a) for males--cardiovascular diseases (48% of the total sickness absence), respiratory diseases (18%), gastrointestinal disease (8%) and the nervous system and sense organs diseases (8%); b) for females--cardiovascular diseases (24%), respiratory diseases (16%), pregnancy, childbirth and puerperium complications (11%) and neoplasms (10%). The sickness absence of workers directly involved in the manufacture appeared to be by 72% higher than that noted for workers of other departments, with the age- and gender-standardized lost time rate of 4.74. The differences can be related mainly to a higher percentage of the sick in the group of 'production workers' (43%) as compared to the 'non-production' ones (28%). The findings of our study indicate that in the rubber industry workers a high rate of absence due to some groups of diseases may be associated with exposure to hazardous agents in their work environment.

Absenteeism↗