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Olav Axelson

Publications and source records attributed to Olav Axelson.

10 recordsLinked to original sources

Residential radon exposure, diet and lung cancer: a case-control study in a Mediterranean region.

We performed a case-control study in Lazio, a region in central Italy characterized by high levels of indoor radon, Mediterranean climate and diet. Cases (384) and controls (404) aged 35-90 years were recruited in the hospital. Detailed information regarding smoking, diet and other risk factors were collected by direct interview. Residential history during the 30-year period ending 5 years before enrollment was ascertained. In each dwelling, radon detectors were placed in both the main bedroom and the living room for 2 consecutive 6-month periods. We computed odds ratios (ORs) and 95% confidence intervals (CIs) for time-weighted radon concentrations using both categorical and continuous unconditional logistic regression analysis and adjusting for smoking, diet and other variables. Radon measurements were available from 89% and 91% of the time period for cases and controls, respectively. The adjusted ORs were 1.30 (1.03-1.64), 1.48 (1.08-2.02), 1.49 (0.82-2.71) and 2.89 (0.45-18.6) for 50-99, 100-199, 200-399 and 400+ Bq/m(3), respectively, compared with 0-49 Bq/m(3) (OR = 1; 0.56-1.79). The excess odds ratio (EOR) per 100 Bq/m(3) was 0.14 (-0.11, 0.46) for all subjects, 0.24 (-0.09, 0.70) for subjects with complete radon measurements and 0.30 (-0.08, 0.82) for subjects who had lived in 1 or 2 dwellings. There was a tendency of higher risk estimates among subjects with low-medium consumption of dietary antioxidants (EOR = 0.32; -0.19, 1.16) and for adenocarcinoma, small cell and epidermoid cancers. This study indicates an association, although generally not statistically significant, between residential radon and lung cancer with both categorical and continuous analyses. Subjects with presumably lower uncertainty in the exposure assessment showed a higher risk. Dietary antioxidants may act as an effect modifier.

Adult↗

On the use of different measures of exposure-experiences from a case-control study on testicular cancer and PVC exposure.

Associations between exposure to PVC plastics and testicular cancer have been reported. To improve the exposure-response analysis in a matched case-control study on testicular cancer and occupational exposures, a self-administered exposure questionnaire and expert assessment was applied and different exposure measures were developed. The questionnaires regarding work histories and employment in PVC production, manufacturing, and handling of PVC products were completed by 1582 subjects (90%). By expert assessment, 360 subjects were considered exposed, and the exposure intensity to PVC plastics for different working periods was determined. Different exposure measures to PVC plastics were then developed, such as ever/never exposed, duration, maximum intensity, median intensity, and cumulative median intensity. The correlation between the different measures of exposure was high for exposure duration and the cumulative median exposure intensity (Spearman rank coefficient r(s) = 0.94), as was the correlation between the maximum intensity and the median intensity (r(s) = 0.94). The agreement between the answers in the questionnaire and the expert assessments was moderate, Kappa value 0.56. The odds ratio for "ever" exposed based on the exposure as reported in the questionnaire was 1.1 (95%, CI 0.82-1.56), and as determined by expert assessment 1.3 (CI 1.05-1.69). The odds ratios for all four different categories of exposure measures varied between 0.86 and 2.6 but decreased by increasing exposure. An overall excess of testicular cancer for the PVC exposed vs. the unexposed was not supported by the pattern seen in a standard exposure-response analysis based on several exposure measures. The findings stress the importance of using several exposure measures as dose surrogates when the underlying toxic mechanisms are unknown and when there are indications of an overall effect.

Adult↗

Using environmental concentrations of cadmium and lead to assess human exposure and dose.

OBJECTIVES: Using environmental concentrations and Geographic Information Systems (GIS) to model human exposure is an emerging tool in environmental epidemiology. To evaluate the usefulness of this, we investigated to what extent cadmium and lead concentrations in soil and moss could be used as potential determinants for cadmium and lead exposure for a population living near a battery plant. METHODS: Cadmium in urine and blood and lead in blood, as well as food, smoking habits, places of residence, occupations and health, were determined for 512 individuals living near a closed down battery factory in Sweden. Cadmium and lead contents in moss were available through previous assessments by the Geological Survey of Sweden. Soil samples had been collected at various distances from the factory, and analyzed for cadmium and lead contents in 1990. Kriging technique in GIS was used to create areas with different metal concentrations based on these measurements. By linking individual address coordinates to mapped concentration levels, each study subject home address received a value of cadmium and lead in moss and soil. RESULTS: We found a statistically significant association between lead in soil and lead in blood, for female subjects eating homegrown vegetables regularly. No significant association was found between cadmium in soil and cadmium in urine for either gender in the study population. No clear associations were found for either gender regarding lead and cadmium in moss and lead in blood or cadmium in urine or in blood. CONCLUSION: In general, environmental concentrations may not be useful surrogates for assessing human exposure to lead and cadmium, but concentrations of metals in soil around emitting point sources can be a complement for estimating the exposure in certain subgroups.

Adolescent↗

Increase of regional total cancer incidence in north Sweden due to the Chernobyl accident?

STUDY OBJECTIVE: Is there any epidemiologically visible influence on the cancer incidence after the Chernobyl fallout in Sweden? DESIGN: A cohort study was focused on the fallout of caesium-137 in relation to cancer incidence 1988-1996. SETTING: In northern Sweden, affected by the Chernobyl accident in 1986, 450 parishes were categorised by caesium-137 deposition: < 3 (reference), 3-29, 30-39, 40-59, 60-79, and 80-120 kiloBecquerel/m(2). PARTICIPANTS: All people 0-60 years living in these parishes in 1986 to 1987 were identified and enrolled in a cohort of 1 143 182 persons. In the follow up 22 409 incident cancer cases were retrieved in 1988-1996. A further analysis focused on the secular trend. MAIN RESULTS: Taking age and population density as confounding factors, and lung cancer incidence in 1988-1996 and total cancer incidence in 1986-1987 by municipality as proxy confounders for smoking and time trends, respectively, the adjusted relative risks for the deposition categories were 1.00 (reference < 3 kiloBecquerel/m(2)), 1.05, 1.03, 1.08, 1.10, and 1.21. The excess relative risk was 0.11 per 100 kiloBecquerel/m(2) (95% CI 0.03 to 0.20). Considering the secular trend, directly age standardised cancer incidence rate differences per 100 000 person years between 1988 to 1996 and the reference period 1986-1987, were 30.3 (indicating a time trend in the reference category), 36.8, 42.0, 45.8, 50.1, and 56.4. No clear excess occurred for leukaemia or thyroid cancer. CONCLUSIONS: Unless attributable to chance or remaining uncontrolled confounding, a slight exposure related increase in total cancer incidence has occurred in northern Sweden after the Chernobyl accident.

Adolescent↗

Negative and non-positive epidemiological studies.

The aim of this study was to identify and discuss validity aspects on so called negative and non-positive studies. Arguments and examples are drawn from experiences in occupational health epidemiology regarding the interpretation of more or less equivocal study results. A negative study may be defined as showing a result that goes against the investigated hypothesis of an increased (or prevented) risk. Traditionally, studies with a risk estimate (relative risk or odds ratio) above, but close to unity are also referred to as negative, given a narrow confidence interval (CI) that includes unity. A risk estimate above unity with the CI including unity is non-positive, however, but an estimate below unity with upper CI bond exceeding unity might be seen as possibly negative or non-negative. A weaker "significance" than usually required should perhaps be accepted when evaluating serious hazards. In contrast to positive studies, the negative and non-positive studies tend to escape criticism in spite of questionable validity that may have obscured existing risks (or preventive effects). Even stronger arguments can be made in criticising negative and non-positive studies than positive studies, for example, regarding selection phenomena, and observational problems regarding exposure and outcome. Negative confounding should be considered although usually weak. In case-control studies, so called over-matching may obscure an existing risk as could the "healthy worker effect" in cohort studies. Small scale non-positive studies should be made available for meta-analyses and when considering studies that do not convincingly show a risk; those who are exposed should be given the "benefit of the doubt".

Case-Control Studies↗

Prostate cancer and exposure to pesticides in agricultural settings.

Our study evaluates the association between prostate cancer and exposure to pesticides in agricultural settings in Italy. The data were derived from a hospital-based multi-site case-control study carried out in 5 rural areas between 1990-92. In our study, 124 new cases of prostate cancer were ascertained and interviewed, along with 659 cancer controls. A team of agronomists assessed past exposure to pesticides by using a checklist of 100 chemical families and 217 compounds applied from 1950-85 in the areas considered. The association between prostate cancer and different occupational risk factors was measured by maximum likelihood estimation of the odds ratio, controlling for potential confounders. "Ever been employed in agriculture" was associated with a 40% increased risk (OR = 1.4, 95% CI = 0.9-2.0). Prostate cancer was also related positively to food and tobacco (OR= 2.1, 95% CI = 1.1-4.1), and chemical products (OR = 2.2, 95% CI = 0.7-7.2) industries. The analyses carried out to estimate the association between different types of pesticides and prostate cancer showed increased risks among farmers exposed to organochlorine insecticides and acaricides (OR = 2.5, 95% CI = 1.4-4.2), more specifically to the often contemporary used compounds DDT (OR = 2.1, 95% CI = 1.2-3.8), and dicofol (OR = 2.8, 95% CI = 1.5-5.0), whose effects could not be well separated.

Aged↗

Leukemia in childhood and adolescence and exposure to ionizing radiation in homes built from uranium-containing alum shale concrete.

Concerns in Sweden about indoor radon around 1980 prompted measurements of gamma-radiation from the facades of houses to identify those constructed of uranium-containing alum shale concrete, with potentially high radon concentrations. To evaluate any possible risk of acute lymphocytic leukemia from exposure to elevated gamma-radiation in these homes, we identified the acute lymphocytic leukemia cases less than 20 years of age in Sweden during 1980-1989 as well as eight controls per case from the population registry, matching on age, gender, and county. Using the existing measurements, exposure was assessable for 312 cases and 1,418 controls from 151 properly measured municipalities. A conditional logistic odds ratio of 1.4 (95% confidence interval = 1.0-1.9) was obtained for those ever having lived in alum shale concrete houses, with the average exposure exceeding 0.10 microsieverts per hour. Comparing those who ever lived in alum shale concrete houses (divided by higher and lower annual average exposure) with those who never lived in such houses, we found a weak dose-response relation. The results suggest some risk of acute lymphocytic leukemia from indoor ionizing radiation among children and young adults.

Carcinogens, Environmental↗

Alternative for estimating the burden of lung cancer from occupational exposures--some calculations based on data from Swedish men.

OBJECTIVES: This study attempts to demonstrate a calculation of the occupational lung cancer burden using economically active men in Sweden as an example. METHODS: Estimates were calculated using Swedish register data on occupation in 1970, lung cancer incidence in 1971-1989, smoking frequencies in 1963, and the formula I = RI0F + I0(1-F), where I is the overall incidence, R is the relative risk associated with a factor (here smoking), F is the fraction of persons at risk (smokers), and I0 is the incidence among those not at risk (nonsmokers). RESULTS: Farmers, gardeners, forestry workers, and fishermen had the lowest lung cancer risk (42.1 per 100,000 person-years) and a smoking frequency of 44.7%. Their I0 was 12.6 or 8.4 per 100,000 person-years, taking R for smoking as 6 or 10, respectively. From these I0 estimates, the expected rates for white- and blue-collar workers (smoking frequencies 52.7 and 57.7%, respectively) were 45.8 and 49.1 per 100,000 person-years, as compared with the 22% and 57% higher observed rates, respectively. Weighing these excesses proportionally according to the sizes of the three occupational categories gave, respectively for R equal to 6 and 10, occupation-related excesses of 39% and 32% and population-attributable risks of 28% and 24%. CONCLUSIONS: About one-fourth of the lung cancers that occur among economically active Swedish men seem to have been related to occupation. This figure agrees with estimates made by other methods in Nordic countries. Due to interaction, the population-attributable risk from smoking is still high, 73% and 83% at relative risk values of 6 and 10, respectively.

Adult↗