Biomedical subjects

W Jedrychowski

Publications and source records attributed to W Jedrychowski.

At least 19 recordsLinked to original sources

PubMed1995

Review of recent studies from central and Eastern Europe associating respiratory health effects with high levels of exposure to "traditional" air pollutants.

The serious environmental problems caused by decades of Communist mismanagement of natural resources in countries of Central and Eastern Europe have been brought to light in recent years. All environmental media, including air, water, food, and soil have been burdened with toxic chemicals. Large segments of the population have been, and are now being exposed to air pollution levels exceeding guidelines established by western countries and by international health organizations. This review focuses on epidemiologic evidence regarding health effects of poor air quality in Central and Eastern Europe. It appears that short-term high levels of air pollutants (primarily particulates and SO2) may increase mortality in sensitive parts of the population. Associations were also seen between air pollution levels and prevalence of respiratory diseases as well as lung function disturbances in adults and children. One study indicated that urban air pollution increased the risk of lung cancer. Several investigations pointed to strong interactions between risk factors. The poor scientific standard of the studies often makes it difficult to evaluate the findings. Several steps should be taken to develop environmental epidemiology in Central and Eastern Europe, including international collaboration in research projects and training.

Air Pollutants↗

PubMed1995

[Prospective epidemiologic study on respiratory diseases in children in Cracow. Pilot study].

After introducing the main purpose of the project on the outdoor and indoor air quality and children's health in Cracow, the paper presents the results of the pilot study carried out in the higher polluted city area (suspended particulate matter: 51.5-74.5 micrograms/m3/year; SO2: 58.4-73.8 micrograms/m33/year) and in the less polluted area (suspended particulate matter: 31.7 micrograms/m3/year; SO2: 36.1 microgram/m3/year). The pilot study covered 171 children. There was an excess of chronic respiratory symptoms in children from the higher polluted area, but only the frequency of shortness of breath in boys and attacks of shortness of breath with wheezing in girls were significantly higher in those living in the polluted area. Spirometric indices were significantly lower in both boys and girls in the residence area with the higher air pollution level. The data on prevalence of respiratory diseases in the pilot study will be used to estimate the size of the sample needed in the other stages of the prospective study.

Air Pollution↗

PubMed1995

[Occupational exposure and histologic differentiation of lung cancer. Retrospective assessment in Cracow].

A population-based case-control study was performed in Cracow, Poland. Male cases and controls were identified from the Cracow Death Register. Information were obtained by mailed questionnaire from next-of-kin on smoking, occupational branch, occupational exposures and other pertinent variables. Response rates were 73.5% in cases and 72.0% in controls. For cases that underwent a bronchial biopsy or surgical excision the histological diagnosis of the tumor was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 small cell carcinomas and 106 adenocarcinomas. 27 cases showed other histological types (large cell carcinoma and not classifiable). Analysis was performed separately by histological type for occupational exposure variables adjusted for smoking. Long-term exposure to mineral dust and metal dust (20 years or more) was found to be a significant risk factor for small cell and squamous cell carcinoma. The effect was more pronounced if the analysis was restricted to the age groups "less than 70 years". The highest relative risk due to occupational exposures was found for squamous cell carcinoma and mineral dust exposure for more than 20 years (RR = 2.45, 95% CI 1.43-4.19). The estimated effect of mineral dust on small cell carcinoma and adenocarcinoma was slightly lower (RR = 2.29, 95% CI 1.16-4.53 and RR = 2.04, 95% CI 0.89-4.64, respectively). The effect of metal dust and fumes appeared to be about the same for squamous and small cell carcinoma.

Adenocarcinoma↗

PubMed1995

CYP1A1 messenger RNA levels in placental tissue as a biomarker of environmental exposure.

The human CYP1A1 gene codes for an inducible enzyme system involved in biotransformation of certain xenobiotics, including polycyclic aromatic hydrocarbons; some of the metabolites are carcinogenic and mutagenic. Effects of environmental exposures (smoking, air pollution, and diet) on CYP1A1 gene induction in placental tissue and the modulation of induction by the CYP1A1 MspI RFLP were evaluated in two groups from Poland: 70 mother-child pairs from Krakow, a city with elevated air pollution; and 90 pairs from Limanowa, a less polluted area. Compared to placentas from nonsmoking women, CYP1A1 mRNA levels were significantly increased in placentas from current smokers (P < 0.001). Ex-smokers also had significantly higher placental mRNA levels, including women who quit smoking prior to pregnancy (P < 0.01). A marginal increase in CYP1A1 mRNA with environmental tobacco smoke exposure was evident. Within Krakow, there was an increase in CYP1A1 mRNA with ambient pollution at the place of residence for each woman, which was significant among women who were not employed away from the home (P < 0.05 controlling for smoking status, diet, and use of coal for heating). Significant increases in mRNA were associated with dietary consumption of smoked meat, cheese, and fish (P < 0.01). The CYP1A1 MspI RFLP was not a significant determinant of CYP1A1 mRNA levels after controlling for smoking and other variables. Human placenta provides a readily available and responsive system that can serve as a model for evaluating environmental and genetic determinants of CYP1A1 induction.

Adult↗

PubMed1995

Relation between residential radon concentrations and housing characteristics. The Cracow Study.

The survey on indoor radon exposure was undertaken to explain whether the excess in lung cancer deaths in Cracow city center may be attributed to this particular exposure. A total of 310 detectors was placed in households randomly chosen from three homogenous strata of residential buildings. The first stratum included house in the old city center constructed predominantly out of the stone bricks. The second stratum covered area of the city with big apartment condominiums built out of concrete blocks. The third stratum consisted of single family houses located in a suburban area. From each of these residency strata a random sample of equal number of households has been chosen and the radon detectors were placed in households located at different levels of buildings. The three-month radon sampling data were used to determine the distribution of various levels of radon in the households. In the measurement of radon exposure the Landauer alpha-track samplers were used. The data collected show that the best single predictor of indoor radon concentrations was type of building. Other variables found to be associated significantly with indoor concentrations were household level in the building and house age. In general, residences with a concrete slabs and dwellings with rarely-opened windows were found to have slightly higher radon concentrations.

Air Pollution, Indoor↗

PubMed1994

[Ethanol as a risk factor in the pathogenesis of precancerous states and changes in the gastric mucous membrane].

The paper presents results of the epidemiological, clinical and experimental data regarding the link between alcohol abuse and cancer that demonstrate an important role of ethanol in stomach cancerogenesis. The role of ethanol is more evident in stomach as it is the organ exposed more directly and often to higher ethanol concentrations. Ethanol may develop its detrimental activity in carcinogenesis through several mechanisms: by its solvent effects, by inducing alimentary and immunological deficiencies, by acting as a vehicle for carcinogens, by facilitating their activation or by inhibiting DNA repair.

Alcoholism↗

PubMed1994

Ventilatory lung function level as a predictor of survival among the elderly.

During a population survey in 1986/1987 among community-dwelling elderly in Cracow, aged 65 yrs and over, measurements of ventilatory lung function were carried out on 698 males and 1,211 females. The main objective of the study was to assess the importance of forced expiratory volume in one second (FEV1) as a predictor of survival experienced in this population group over a 6 year follow-up, in comparison with that of sociodemographic variables, smoking habit, chronic respiratory symptoms, hypertension, obesity and self-assessment of health. Statistical analysis of the relationship between mortality and chosen predictors has been performed with Cox proportional hazards statistical model. It was found that in addition to age, the FEV1 level was the most relevant and independent of age survival predictor among the elderly. In males, a reduction of FEV1 by 100 ml after allowing for age, showed a significantly higher risk of dying by 4%, (relative risk (RR) = 1.04; 95% confidence interval (CI) 1.01-1.06), and in females by 5% (RR = 1.05; 95% CI 1.05-1.09). Male current or ex-smokers displayed a higher mortality risk due to reduction of FEV1 (RR = 1.05; 95% CI 1.01-1.09) compared to lifetime nonsmokers (RR = 1.04; 95% CI 1.00-1.07); the corresponding RR values in women were 1.12 (95% CI 1.02-1.23) and 1.04 (95% CI 1.00-1.08), respectively. However, the differences found between the smokers and nonsmokers were not significant in either gender group. Other potential predictors considered, such as education, chronic respiratory symptoms, hypertension, self-assessment of health, or obesity, appeared to have been irrelevant in the multivariate analysis.

Age Factors↗

PubMed1994

[Importance of ventilatory lung function for prediction of survival in elderly persons. Mortality cohort study in Cracow].

The objective of the study undertaken among elderly was to assess the strength and importance of biologic predictors of mortality (blood pressure, ventilatory lung function) in comparison with that of sociodemographic variables (age, sex, education), smoking habit, obesity and health self-assessment. The study covered a sample of elderly (698 males and 1211 females), inhabitants of Cracow city center who attended the mass screening x-ray clinic. The sample examined did not include patients of houses for elderly or geriatric wards. At the occasion of the x-ray examination an epidemiologic interview has been taken from each person and basic clinical measurements (anthropometry, blood pressure and ventilatory lung function) have been performed. Statistical analysis of relation between mortality over 5-year period and chosen predictors has been carried out with Cox proportional hazards model and PC BMDP programs. It was found that beside age FEV1 level is the strongest survival predictor among the elderly. Subjects who had better FEV1 by 500 ml showed significantly lower death risk, by 18% in males and 27% in females after allowing for age and height. The results obtained confirmed the expectation that ventilatory lung function is one of the strongest predictor of survival in elderly. In the sample studied the impact of education, smoking habit, obesity, health self-assessment on the mortality experience was not significant. The effect of hypertension appeared to be relevant only in the female group.

Aged↗

PubMed1993

Vodka consumption, tobacco smoking and risk of gastric cancer in Poland.

A multicentre hospital-based incident case-control study with 520 male gastric cancer cases aged < 75 years and an equal number of age- and sex-matched controls without cancer has been carried out in Poland to assess potential risks due to smoking and alcohol consumption. It was shown that after adjusting for socio-demographic and dietary confounders and vodka drinking, smoking cigarettes had no significant effect on risk. The estimated relative risk (RR) increased to 2.27 (95% confidence interval [CI] : 0.97-5.28) for intestinal cardia cancer for those who smoked cigarettes without filters. The RR for stomach cancer grew as the frequency and amount of vodka drunk increased. People drinking vodka at least once a week had about a threefold higher risk compared to non-drinkers (RR = 3.06, 95% CI : 1.90-4.95). The effect of vodka drinking on risk was particularly strong for non-cardia cancers of the intestinal type. Those who usually drank vodka before breakfast had an elevated risk (RR = 2.98, 95% CI : 1.60-5.53) which was also present in all the subgroups investigated. Cardia and non-cardia cancer showed differences with respect to the interaction between tobacco smoking and vodka drinking. For cancers of the cardia region the risk was low for non-smokers or those who drank small amounts of vodka. The risk for cardia cancer increased considerably for smokers of cigarettes without filters and vodka drinkers who consumed large amounts (RR = 3.70, 95% CI : 1.13-12.06). For the non-cardia region a uniform increase could be observed for vodka drinking regardless of cigarette smoking status.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1993

Effect of occupational air pollutants on various histological types of lung cancer: a population based case-control study.

A population based case-control study was performed in Cracow, Poland, to determine the effect of occupational air pollutants on various histological types of lung cancer. Male cases and controls were identified from the Cracow Death Register. Information was obtained by mailed questionnaire from next of kin on smoking, occupational branch, occupational exposures, and other pertinent variables. Response rates were 73.5% in cases and 72.0% in controls. For cases that underwent a bronchial biopsy or surgical excision the histological diagnosis of the tumour was obtained from clinical records. The case group contained 343 subjects with squamous cell carcinomas, 151 with small cell carcinomas, and 106 with adenocarcinomas. Twenty seven cases showed other histological types (large cell carcinoma and not classifiable). Analysis was performed separately by histological type for occupational exposure variables adjusted for smoking. Long term exposure to mineral dust and metal dust (20 years or more) was found to be a significant risk factor for small cell and squamous cell carcinoma. The effect was more pronounced if the analysis was restricted to those aged less than 70 years. The highest relative risk (RR) due to occupational exposures was found for squamous cell carcinoma and exposure to mineral dust for more than 20 years (RR = 2.45, 95% CI 1.43-4.19). The estimated effect of mineral dust on small cell carcinoma and adenocarcinoma was smaller (RR = 2.29, 95% CI 1.16-4.53 and RR = 2.04, 95% CI 0.89-4.64 respectively). The effect of metal dust and fumes seemed about the same for squamous and small cell carcinoma. No specific agent could be identified as particularly important for a specific histological type; it rather seemed that the effects of the substances considered were similar for lung cancers in general.

Adenocarcinoma↗

PubMed1993

[On the need for training in environmental epidemiology].

The growing awareness and understanding of the fact that the maintenance of the health status of population is affected by environment, implements new objectives in undergraduate and postgraduate training of medical doctors and a necessity in producing a new generation of epidemiologists being able to solve environment health--related problems. While in Western European countries an intensive training in environmental epidemiology takes place, not much is done in this respect in our country. The training programs in environmental epidemiology should be based on the good recognition of the nature of the environmental hazards and local health needs. These requirements are urgent as one expects from medical doctors to-day, not only a proper understanding of relations between environment and health status of population, but also certain skills and ability to use epidemiologic methods in everyday clinical practice.

Curriculum↗

PubMed1992

Effect of tobacco smoking on various histological types of lung cancer.

In a population-based case/control study the differential lung cancer risk patterns due to tobacco smoking habits of various histological types have been investigated. The cases were 1432 deaths from lung cancer in the years 1980-1987, of which the histological type was known for 627 individuals. There was 54% squamous cell carcinoma, 24% small-cell carcinoma and 17% adenocarcinoma. Controls were 1343 deaths from other causes. Next-of-kin interviews were performed. The results of the study confirmed that cigarette smoking is associated with all histological types of lung cancer; however, the dose/response relationship between smoking and adenocarcinoma differed clearly from that observed in squamous and small-cell carcinomas. In the latter histological types the gradient of risk was much stronger as the number of cigarettes smoked or duration of smoking increased. The overall relative risk for smoking in small-cell and squamous cell carcinoma was 15.4 and 13.5 respectively, whereas that for adenocarcinoma was weaker (relative risk = 3.1). An interesting difference between squamous and small-cell carcinomas was found also for patients who gave up smoking. The effect of stopping was more pronounced in squamous cell carcinoma. The attributable risks for smoking in squamous and small-cell carcinoma were much higher (90% and 88% respectively) than for adenocarcinoma (64%). The data suggest that adenocarcinoma is likely to be related to other factors than tobacco smoking to a greater extent than are squamous or small cell carcinoma. Possible sources of bias, such as missing histological diagnoses, are discussed in detail.

Adenocarcinoma↗

PubMed1992

Dietary practices in households as risk factors for stomach cancer: a familial study in Poland.

In the framework of a nationwide case-control study of risk factors for stomach cancer, a household survey was conducted on those food habits at the family level which were considered relevant for stomach cancer. The practices of 741 case and 741 control households were compared and relative risks calculated by the unconditional maximum likelihood method. For each household, the person responsible for cooking completed the survey. Respondents to the household survey were 35% of the cases and 40% of the controls of the case-control study and otherwise other household members. Case households relied more frequently on their own gardens as a major source of vegetables and fruit, and they cooked their vegetables more often than control households. The vegetable and fruit consumption during the summer period per family member was significantly less in case households compared to control households. The difference in per capita vegetable and fruit consumption between case and control households persisted, but was considerably less pronounced when the consumption of the index person (case or control) was subtracted from the household consumption. The consumption of mainly wholemeal bread showed a relative risk (RR) of 0.18 (95% CI 0.07-0.44) compared with mainly white bread consumption, whereas frequent frying and stewing of meat was associated with an increased risk compared to boiling of meat (RR = 2.06, 95% CI 1.48-2.87). No association with risk was found for long-term refrigerator use or other storage modalities.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗

PubMed1992

[Tobacco smoking and alcohol consumption as risk factors for stomach cancer in different locations and histologic types].

A multicancer hospital based case-control study involving interviews with 741 incident male and female gastric cancer cases under the age of 75 years and an equal number of age and sex matched controls has been carried out in Poland. Smoking cigarettes without filter increased the risk for intestinal cancer in the cardia part of the stomach (OR = 3.72, 95% CI: 1.35-10.23). Relative risk of the intestinal type of cancer in the distal part of the stomach was augmented with the increasing frequency and amount of vodka drinking. Subjects who drank vodka at least once a week had about 4.5 times the risk of intestinal cancer of the gastric corpus compared to non-drinkers (RR = 4.45, CI: 2.26-8.75). The relative risk of intestinal carcinoma in the distal stomach due to vodka drinking among those who used to drink vodka on an empty stomach was also elevated (RR = 3.28, CI: 1.33-8.13), but the effect of years of vodka drinking habit failed to show significant association with gastric cancer. A weak interaction effect between smoking and vodka drinking was found for intestinal cardia cancer. Diffuse type gastric carcinoma or mixed type carcinoma were not significantly related to smoking or vodka drinking habits.

Aged↗

PubMed1992

[Effect of smoking on the development of various histological types of lung cancer].

The aim of this clinically controlled trial was to assess the effect of different smoking patterns on development of different histological types of lung cancer. The study group consisted of 1,432 subjects that died due to lung cancer in the years 1980-1987. 627 of these had the histological type of the cancer determined; 54% had squamous cell cancer, 24% small cell lung cancer (SCLC), 17% adenocarcinoma. The control group consisted of 1,343 subjects that died due to other causes. Medical and social history was taken from the families of the deceased. The results of the analysis demonstrate that lung cancer development is related to smoking although differences were seen in the different types of cancer. The calculated risk of a smoker developing lung cancer-squamous cell and SCLC was respectively 15.4 and 13.5 while for adenocarcinoma it was much lower--3.1. Important differences were seen in ex-smokers developing squamous cell lung cancer and SCLC. The risk of developing squamous cell lung cancer and SCLC in this group was 89% and 88%, and adenocarcinoma only 64%. This suggests that adenocarcinoma is related more to environmental factors than the other two types of lung cancer.

Adenocarcinoma↗

PubMed1991

Dietary risk factors in intestinal and diffuse types of stomach cancer: a multicenter case-control study in Poland.

A hospital-based, multicenter, case-control study has been performed in Poland covering 741 incident stomach-cancer cases (520 males and 221 females) and the same number of controls. All stomach-cancer diagnoses were evaluated for histologic type according to the Lauren criteria. Fifty-one percent were of the intestinal type, 35 percent of the diffuse type, and 8.5 percent of the mixed type. The frequency of consumption of individual food items and several food groups was analyzed and the association of various foods with stomach cancer risk was evaluated after controlling for sex, age, occupation, education, and residency. Increased consumption of sausages was related significantly to gastric cancer risk, whereas increased consumption of cheese products, nonwhite bread, vegetables, and fruit was associated with decreased risk. A particularly strong decrease in risk was associated with consumption of radishes and onions. When consumption of fruits and vegetables, sausages, nonwhite bread, and cheese were introduced simultaneously in a multivariate model, independent effects were found only for fruit and vegetables, sausages, and nonwhite bread. The use of table salt, the frequency of eating hot meals, and an irregular eating pattern were also associated with increased risk, while additional consumption of fruit between meals showed reduced risk. If a reduction in vegetable and fruit consumption took place after marriage, an increased risk for stomach cancer was found, whereas augmented consumption of these food items after marriage decreased the risk. Separate risk models were calculated for stomach cancer of the intestinal and diffuse types, but both histologic varieties showed the same pattern of associations with dietary risk factors.

Adenocarcinoma↗

PubMed1990

The effect of acute broncho-pulmonary infections on the FEV1 change in 13-year follow-up. The Cracow Study.

The aim of this study was to assess the effect of acute bronchitis and pneumonia on the FEV1 decline rate in a random sample of Cracow inhabitants followed over a 13-year period. A total of 718 males and 1029 females completed the spirometric testing and interview in 13-year follow-up period. Acute chest diseases diagnosed and treated by doctors and reported by respondents in surveys were the source of data on broncho-pulmonary infections. The rate of FEV1 change, expressed in ml per year was estimated for each person in 13-year follow-up period. Persons who reported recurrent bronchitis and pneumonia had significantly lower initial FEV1 levels than those without infections. The effect was controlled for confounders like age, height, smoking and chronic chest symptoms. The initial low ventilatory function by itself was not a predisposing factor for chest infections, unless they were associated with chronic respiratory symptoms. Lung function in men decreased steeply after pneumonia infection, but the effect appeared to be reversible. This effect was not limited to people with pre-existing chronic respiratory disease. The data indicated that in some subjects who reported new symptoms of dyspnea on effort, the acceleration of FEV1 decline due to pneumonia was greater than in people without the symptoms. This may result from the fact that in lower respiratory infection, bacterial or viral agents can produce serious dysfunction of small airways.

Acute Disease↗

PubMed1990

Occupational exposure and incidence of chronic respiratory symptoms among residents of Cracow followed for 13 years.

We analyzed the relationship between incidence rates of chronic respiratory symptoms over 13 years and occupational exposure during the first five years of follow-up. The study group contained 1132 males and 1598 females, 19 to 60 years of age, randomly selected from residents of Cracow, Poland. The data was collected in three surveys conducted in 1968, five and 13 years later. Prolonged occupational exposure (i.e. reported in the initial survey and 5 years later) to dusts doubled the odds for the appearance of chronic phlegm and attacks of breathlessness in all men, and of chronic bronchitis in men aged 41 to 50, initially free of the symptom. In women, this exposure doubled the odds for new chronic cough and for chronic bronchitis. Prolonged exposure to chemicals doubled the incidence rates of attacks of breathlessness and dyspnea in all women and of chronic bronchitis in women with the lowest level of education. Prolonged work in variable temperatures doubled the risk of wheeze in women. The effects of discontinuation or start of exposure during the initial 5 years of the study were also seen on the incidence rates of the symptoms but were less pronounced. The detected effects of occupational exposure were not modified by cigarette smoking or living in areas of the city with various levels of air pollution. This longitudinal analysis confirms the results of cross-sectional studies which have indicated deleterious effects of even moderate occupational exposures on respiratory symptoms.

Adult↗