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Biomedical subjects

Patrick Levallois

Publications and source records attributed to Patrick Levallois.

14 recordsLinked to original sources
PubMed2006

Use of a health information telephone line, Info-santé CLSC, for the surveillance of waterborne gastroenteritis.

The increasing frequency of waterborne outbreaks demonstrates that classic indicators used for the surveillance of the microbiological quality of drinking water have several gaps and that routine public health surveillance seems insufficient to allow for the rapid detection of these outbreaks. The main objective of this study was to evaluate the possibility of using a regional health information telephone line, 'Info-Santé CLSC' (Info-Health Local Community Health Centre), for the surveillance of waterborne gastroenteritis. This study measured the incidence rate of calls for acute gastrointestinal illness (AGI) placed to the Info-Santé CLSC line, investigated the relationship between the frequency of calls for AGI placed to the Info-Santé CLSC line and the turbidity of the treated water in the Quebec City drinking water plant and evaluated the relevance and the conditions of use of the Info-Santé CLSC system for the surveillance of waterborne enteric illness. A relationship between the turbidity and the calls for AGI placed to Info-Santé CLSC line was observed. Significant time lags (11, 15 and 17 days prior to the outcome) were identified in the final model derived from a Poisson model using generalized additive models (GAM) as a time series analysis. Some recommendations to improve the system were formulated even though the system already seems to be useful for the surveillance of waterborne enteric diseases.

Communicable Disease Control↗
PubMed2005

Chlorination disinfection by-products in drinking water and the risk of adult leukemia in Canada.

The authors conducted a population-based case-control study of 1,068 incident leukemia cases and 5,039 controls aged 20-74 years during 1994-1997 to examine the association between exposure to drinking water chlorination disinfection by-products and adult leukemia risk in Canada. Residence and drinking water source histories and data from municipal water supplies were used to estimate individual chlorination disinfection by-product exposure according to water source, chlorination status, and chlorination disinfection by-product levels during the 40-year period before the interview. The analysis included 686 cases and 3,420 controls for whom water quality information was available for at least 30 of these years. Increased risk of chronic myeloid leukemia was associated with increasing years of exposure to different chlorination disinfection by-product indexes, with an adjusted odds ratio of 1.72 (95% confidence interval: 1.01, 3.08) for the highest exposure duration to total trihalomethanes of more than 40 microg/liter. In contrast, the risk of the other studied leukemia subtypes was found to decrease with increasing years of exposure to chlorination disinfection by-products. A protective effect was noted for chronic lymphoid leukemia (odds ratio = 0.60, 95 percent confidence interval: 0.41, 0.87) associated with the highest exposure duration to total trihalomethanes of more than 40 microg/liter. More studies with long-term exposure measures and large enough to evaluate leukemia subtypes are needed to further understanding of the issue.

Adult↗
PubMed2005

Lifestyle factors and the risk of adult leukemia in Canada.

OBJECTIVES: To evaluate the impact of active smoking, obesity, and dietary intakes on the risk of adult leukemia. METHODS: We analysed data obtained from a population-based case-control study conducted in eight Canadian provinces. Risk estimates were generated by applying multivariate logistic regression methods to 1068 incident histologically confirmed leukemia cases and 5039 controls aged 20-74. RESULTS: We found a statistically significant increased risk for acute myeloid leukemia (AML) associated with active smoking, with a clear dose-response relationship and an adjusted odds ratio (OR) of 1.5 (95% confidence interval [CI]=1.1-2.0) for heavy smokers reporting more than 20 pack-years of cigarette smoking. We also observed positive associations with the highest body mass index (BMI) for AML, chronic myeloid leukemia, and chronic lymphoid leukemia with a significant dose-response relationship. No association with leukemia was observed for the intake of fruits and vegetables, and the effect of active smoking on adult leukemia risk was not modified by fruits and/or vegetables consumption or obesity. However, the positive risk for AML associated with active smoking disappeared among subjects with high BMI (> or =30 kg/m2). CONCLUSIONS: Our study contributes to the accumulating evidence linking AML and active smoking, and provides some evidence that obesity increases the risk of most of the adult leukemia subtypes.

Age Distribution↗
PubMed2005

Environmental tobacco smoke and risk of adult leukemia.

BACKGROUND: The role of environmental tobacco smoke (ETS) in the causation of lung and breast cancer has been repeatedly evaluated over recent years. In contrast, its impact on the risk of adult leukemia has received little attention. METHODS: We used the lifetime residential and occupational ETS exposure histories from a population-based sample of 1068 incident and histologically confirmed adult leukemia cases and 5039 population controls age 20 to 74 years to evaluate the relationship between ETS exposure and adult leukemia risk among nonsmokers in Canada. The duration of exposure and smoker-years index were used as indices of ETS exposure. We restricted our analysis to the 266 case and 1326 control subjects who reported being lifetime nonsmokers and provided residential ETS exposure history for at least 75% of their lifetime. RESULTS: No association was found for most leukemia subtypes, and in particular for acute myeloid leukemia. In contrast, the risk for chronic lymphocytic leukemia was clearly associated with ETS exposure, with an adjusted odds ratio of 2.3 (95% confidence interval = 1.2-4.5) for more than 83 smoker-years of residential exposure and 2.4 (1.3-4.3) for more than 72 smoker-years of occupational exposure. There was a dose-response relationship for chronic lymphocytic leukemia with both indices of exposure. Risk was not higher with recent exposure, using time-window-exposure analyses. CONCLUSIONS: Regular long-term ETS exposure may be a risk factor for chronic lymphocytic leukemia.

Adult↗
PubMed2005

Workgroup report: Drinking-water nitrate and health--recent findings and research needs.

Human alteration of the nitrogen cycle has resulted in steadily accumulating nitrate in our water resources. The U.S. maximum contaminant level and World Health Organization guidelines for nitrate in drinking water were promulgated to protect infants from developing methemoglobinemia, an acute condition. Some scientists have recently suggested that the regulatory limit for nitrate is overly conservative; however, they have not thoroughly considered chronic health outcomes. In August 2004, a symposium on drinking-water nitrate and health was held at the International Society for Environmental Epidemiology meeting to evaluate nitrate exposures and associated health effects in relation to the current regulatory limit. The contribution of drinking-water nitrate toward endogenous formation of N-nitroso compounds was evaluated with a focus toward identifying subpopulations with increased rates of nitrosation. Adverse health effects may be the result of a complex interaction of the amount of nitrate ingested, the concomitant ingestion of nitrosation cofactors and precursors, and specific medical conditions that increase nitrosation. Workshop participants concluded that more experimental studies are needed and that a particularly fruitful approach may be to conduct epidemiologic studies among susceptible subgroups with increased endogenous nitrosation. The few epidemiologic studies that have evaluated intake of nitrosation precursors and/or nitrosation inhibitors have observed elevated risks for colon cancer and neural tube defects associated with drinking-water nitrate concentrations below the regulatory limit. The role of drinking-water nitrate exposure as a risk factor for specific cancers, reproductive outcomes, and other chronic health effects must be studied more thoroughly before changes to the regulatory level for nitrate in drinking water can be considered.

Drinking↗
PubMed2004

Experimental validation of a statistical model for evaluating the past or future magnetic field exposures of a population living near power lines.

This study was designed to provide an experimental validation for a statistical model predicting past or future exposures to magnetic fields (MF) from power lines. The model estimates exposure, combining the distribution of ambient MF in the absence of power lines with the distribution of past or future MF produced by power lines. In the study, validation is carried out by comparing exposures predicted by the model with the actual measurements obtained from a large-scale epidemiological study. The comparison was made for a group of 220 women living near a 735 kV power line. Knowing that the individual arithmetic means of MF exposures follow a log-normal distribution, the Pearson correlation between the log-transformed measured means and the calculated ones was determined and found to be 0.77. Predicted values of MF exposures were slightly lower than measured values. The calculated geometric mean of the group was 0.33 microT, compared to 0.38 microT for the measured geometric mean. The present study shows good agreement between the measured MF exposure of an individual inside a house near a 735 kV line and the MF exposure calculated using a statistical model.

Adult↗
PubMed2004

Perception of drinking water in the Quebec City region (Canada): the influence of water quality and consumer location in the distribution system.

The purpose of every water utility is to provide consumers with drinking water that is aesthetically acceptable and presents no risk to public health. Several studies have been carried out to analyze people's perception and attitude about the drinking water coming from their water distribution systems. The goal of the present study is to investigate the influence of water quality and the geographic location of consumers within a distribution system on consumer perception of tap water. The study is based on the data obtained from two surveys carried out in municipalities of the Quebec City area (Canada). Three perception variables were used to study consumer perception: general satisfaction, taste satisfaction and risk perception. Data analysis based on logistic regression indicates that water quality variations and geographic location in the distribution system have a significant impact on the consumer perception. This impact appears to be strongly associated with residual chlorine levels. The study also confirms the importance of socio-economic characteristics of consumers on their perception of drinking water quality.

Adolescent↗
PubMed2004

Behavior of trihalomethanes and haloacetic acids in a drinking water distribution system.

This investigation focused on the seasonal variation and spatial fate of chlorination disinfection by-products (CDBPs) in a drinking water distribution system located in a region where very significant seasonal variations in water temperature and surface water quality occur. The analysis of a large number of collected samples showed that the seasonal and geographical variations of both groups of CDBPs under study--trihalomethanes (THMs) and haloacetic acids (HAAs)--were particularly important in this region. THM levels in summer and fall were, on average, about five times higher than in winter, whereas average HAAs in spring were about four times higher than in winter. THMs increased and stabilized in the extremities of the distribution system, whereas HAAs begin to increase, and then decrease (mainly due to a reduction of dichloroacetic acid). This decrease was significantly higher in warm waters than in cold waters, which led to the hypothesis of microbial degradation of HAAs as water approaches the system extremities. In fact, regression models for the occurrence of both CDBPs showed that the residence time of water was one important parameter in explaining the fate of both CDBPs. The spatio-temporal portrait of both groups of CDBPs that was generated demonstrates that, due to their high intra-seasonal changes, the calculation of average annual levels of these substances for compliance with regulations can vary widely. The results used in the portrait of CDBP behavior are also relevant in terms of exposure assessment for future epidemiological studies on human reproductive outcomes in the region.

Acetates↗
PubMed2004

Exposure of a Cree population living near mine tailings in northern Quebec (Canada) to metals and metalloids.

The authors investigated the effect of residues from copper- and gold-mining on the Cree population of Oujé-Bougoumou, located 560 km north of Quebec City, Canada. Subjects (225) from Oujé-Bougoumou and a control population (100) completed a questionnaire on lifestyle and dietary habits and provided blood and urine samples for analysis. Geometric means of arsenic, lead, cadmium, and copper concentrations were not significantly different for subjects or controls 15 yr and older or children (8-14 yr old). However, blood zinc was higher and selenium was lower in Oujé-Bougoumou samples. Mean blood lead level was higher in children from Oujé-Bougoumou, but lower in adults aged 40 yr and older. For adults (15 yr and older) blood lead level increased with age and was higher in men, those who hunted, and consumed wild meat (R2 = 0.43). Blood cadmium increased with age and smoking (R2 = 0.61). No influence of mine residues was observed among residents of Oujé-Bougoumou, but lifestyle exposure associations were noted for both communities.

Adolescent↗
PubMed2004

Thyroid function of newborns and exposure to chlorine dioxide by-products.

In this study, the authors compared thyroid function of newborns from 11 municipalities where drinking water was disinfected by chlorine dioxide (ClO2) with that of newborns from 15 municipalities using chlorine disinfection. They estimated the mean neonatal blood thyroid stimulating hormone (TSH) levels and proportion of congenital hypothyroidism cases using the results of the Quebec neonatal screening for congenital hypothyroidism for 32,978 newborns over the period 1993-1999. There was no significant increase in the TSH level and no excess of congenital hypothyroidism when all newborns exposed to ClO2 were considered. However, for newborns with low birth weight, mean TSH level was significantly higher among those exposed to ClO2 than for those in the reference group.

Child, Preschool↗
PubMed2002

Cancer risk associated with household exposure to chloroform.

Chloroform (CHCl3) the trihalomethane most prevalent in drinking water, is a proven animal carcinogen and a suspected human carcinogen. Consequently, standards have been issued by health authorities to limit its concentration in drinking water. These limits are based solely on ingestion, without taking into account inhalation and skin contact. Exposure to CHCl3 was assessed for 18 men (age: mean 38 years; range 23-51) following a 10-min shower in their respective residences located in the Quebec City region (Canada). CHCl3 concentration was measured in alveolar air samples collected before, immediately after, and 15 min and 30 min following the shower. Indoor air and water concentrations were determined concomitantly. Mean CHCl3 concentrations in the air of the shower stall and in water were respectively 147 microg/m3 (SD = 56.2 microg/m3) and 20.1 microg/L (SD = 9.0 microg/L). Water concentrations were comparable to those documented in a large proportion of distribution networks in Canada. The mean increase in alveolar air CHCl3 concentration (deltaCHCIALV) at the end of the shower was 33 microg/m3 (SD = 14.7 microg/m3). A multiple-regression analysis revealed that deltaCHCl3ALV values were only associated with chloroform concentration in air of the shower stall. DeltaCHCl3ALV were described using a physiologically based pharmacokinetic (PBPK) model. This model was then used to estimate concentrations of CHCl3 metabolites bound to liver and kidney macromolecules following a shower, and also according to exposure scenarios that integrate drinking-water ingestion and air inhalation. The concentration predicted in the liver following a worst-case exposure scenario was 0.41 microg CHCl3 equivalents/kg of tissue, some 6,000 times lower than the lowest concentration that did not increase the incidence of hepatic tumors in laboratory animals. Data indicate that for this range of exposure the safety margin appears therefore considerable with respect to the potential carcinogenic effect of household exposure to CHCl3.

Adult↗
PubMed2002

Hypersensitivity of human subjects to environmental electric and magnetic field exposure: a review of the literature.

Hypersensitivity to exposure to electric and magnetic fields (EMFs) has been reported for nearly 20 years; however, the literature on the subject is still very limited. Nearly all the literature published concerns a dermatological syndrome that consists of mainly subjective symptoms (itching, burning, dryness) and a few objective symptoms (redness, dryness) appearing after individuals begin working with video display units and decreasing during absence from work. Case-control studies as well as some good but limited double-blind trials have not found any clear relationship between this syndrome and exposure to EMFs. A "general syndrome" with more general symptoms has been rarely described but seems to have a worse prognosis. The symptoms often associated with skin disorders are mainly of neurasthenic type and can cover a lot of nonspecific symptoms present in other atypical syndromes such as multiple chemical sensitivity or chronic fatigue. Most of these symptoms are allegedly triggered by exposure to different sources of EMFs, but there have been no valid etiological studies published on this more general syndrome. It appears that the so-called hypersensitivity to environmental electric and magnetic fields is an unclear health problem whose nature has yet to be determined.

Case-Control Studies↗
PubMed2002

Study of self-reported hypersensitivity to electromagnetic fields in California.

Cases of alleged hypersensitivity to electromagnetic fields (EMFs) have been reported for more than 20 years, and some authors have suggested some connection with the "multiple chemical sensitivity" illness. We report the results of a telephone survey among a sample of 2,072 Californians. Being "allergic or very sensitive" to being near electrical devices was reported by 68 subjects, resulting in an adjusted prevalence of 3.2% (95% confidence interval = 2.8, 3.7). Twenty-seven subjects (1.3%) reported sensitivity to electrical devices but no sensitivity to chemicals. Characteristics of the people reporting hypersensitivity to EMFs were generally different from those of people reporting being allergic to everyday chemicals. Alleging environmental illness or multiple chemical sensitivity diagnosed by a doctor was the strongest predictor of reporting being hypersensitive to EMFs in this population. Other predictive factors apart from self-reporting chemical sensitivity were race/ethnicity other than White, Black, or Hispanic; having low income; and being unable to work. The perception of risk of exposure to EMFs through the use of hair dryers (vs. exposure to power and distribution lines) was the factor the most associated with self-reporting about hypersensitivity to EMFs. However, risk perception was not sufficient to explain the characteristics of people reporting this disorder.

Adolescent↗