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David B Thomas - One of the best experts on this subject based on the ideXlab platform.
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occupational exposures and parkinsonism among shanghai women Textile Workers
American Journal of Industrial Medicine, 2018Co-Authors: Harvey Checkoway, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, David B ThomasAbstract:BACKGROUND Endotoxin, a contaminant of cotton dust, is an experimental model for parkinsonism (PS). METHODS We investigated associations between exposures to endotoxin, solvents, magnetic fields, and night shift work, and neurologist-determined PS among Shanghai women Textile Workers, including 537 retired cotton factory Workers ages ≥50 years and an age-matched reference group of 286 retired Textile Workers not exposed to cotton dust. Repeat exams were conducted 2.5 years after enrollment among 467 cotton Workers and 229 reference Workers. RESULTS We identified 39 prevalent PS cases and 784 non-cases. No consistent or statistically significant associations were observed for endotoxin, solvents, magnetic fields, or shift work with PS risk, severity, or progression. CONCLUSIONS Despite the null findings, additional studies of endotoxin exposure and risk of PS in other well-characterized occupational cohorts are warranted in view of toxicological evidence that endotoxin is a pathogenic agent and its widespread occurrence in multiple industries worldwide.
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0442 occupational exposures and parkinsonism among women Textile Workers in shanghai china
Occupational and Environmental Medicine, 2017Co-Authors: David B Thomas, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, Sadie Costello, Harvey CheckowayAbstract:Objective To examine the association of endotoxin and other occupational exposures with parkinsonism (PS) severity and progression of PS signs. Methods Movement disorder specialists examined 823 retired female Textile Workers ages 51–86 in Shanghai, China for PS prevalence and assessment of Unified Parkinson Disease Rating Scale motor subsection part 3 (UPDRS3). Most (n=669) were re-evaluated two years later. Occupational exposures to endotoxin, metals, solvents, magnetic fields, and shiftwork during a mean of 24 years working in the Textile industry were assessed from detailed work histories and a job exposure matrix. We examined the association between each exposure and PS, severity (UPDRS3 score), and progression (annual change in UPDRS3) with multivariable regression models adjusting for age, smoking, and examiner. Results We observed 39 prevalent PS cases and 784 non-cases. No association was observed between endotoxin and PS prevalence, disease severity, or disease progression. The other chemical occupational exposures and magnetic fields also had had no associations with PS prevalence or disease severity. Shiftwork was marginally positively associated with disease progression. For each year of shiftwork as of the baseline exam, UPDRS3 score increased annually by an additional 0.047 (95% CI: −0.003, 0.097). Conclusions We observed little evidence for an association between endotoxin and other occupational exposures with PS in this cohort of Textile industry Workers, although we are unable to rule out the possibility of clinically modest increases in progression among Workers who had experienced several years of shiftwork.
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risk of pancreatic cancer in female Textile Workers in shanghai china exposed to metals solvents chemicals and endotoxin follow up to a nested case cohort study
Journal of Occupational and Environmental Medicine, 2016Co-Authors: Nicholas K Reul, David B Thomas, Roberta M Ray, Lisa G Gallagher, Dao Li Gao, Sverre Vedal, Megan E Romano, Harvey CheckowayAbstract:Objective We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female Textile Workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. Methods We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. Results We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. Conclusions Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.
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reply to comment on possible pro carcinogenic association of endotoxin on lung cancer among shanghai women Textile Workers
British Journal of Cancer, 2015Co-Authors: Harvey Checkoway, George Astrakianakis, Roberta M Ray, Dao Li Gao, Jessica I Lundin, Sadie Costello, Ellen A Eisen, Katie M Applebaum, David B ThomasAbstract:Reply to Comment on: ‘Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women Textile Workers’
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occupational exposures and risk of stomach and esophageal cancers update of a cohort of female Textile Workers in shanghai china
American Journal of Industrial Medicine, 2015Co-Authors: Lisa G Gallagher, David B Thomas, Karen J Wernli, Roberta M Ray, Megan E Romano, Dao L Gao, Harvey CheckowayAbstract:Background Associations between stomach and esophageal cancer and exposures to dusts, metals, chemicals, and endotoxin in the workplace are not very well understood, particularly in women. Methods We followed 267,400 female Textile Workers in Shanghai, China for cancer incidence from 1989 to 2006. Stomach (n = 1374) and esophageal (n = 190) cancer cases were identified and a comparison subcohort (n = 3187) was randomly selected. Cox proportional hazard modeling was used, adjusting for age and smoking. Results Increasing stomach cancer risk was observed with increasing duration of synthetic fiber dust exposure (p = 0.03), although the magnitude of effect was small (20 + years: HR = 1.2, 95% CI 1.1–1.4). Trends with endotoxin exposure were modestly inversed for esophageal cancer and increased for stomach cancer, but with little deviation from a null association. Conclusions Our findings demonstrate that long durations of synthetic fiber dust exposure can increase stomach cancer risk in women, but provide limited support for associations with other Textile industry exposures. Am. J. Ind. Med. 58:267–275, 2015. © 2015 Wiley Periodicals, Inc.
David C Christiani - One of the best experts on this subject based on the ideXlab platform.
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0025 conducting global occupational epidemiology research in a changing socio political climate case study of research among shanghai china Textile Workers
Occupational and Environmental Medicine, 2017Co-Authors: Harvey Checkoway, David C Christiani, David H WegmanAbstract:There is a long and continuing legacy of epidemiologists from high income countries conducting occupational health research in low and middle income countries. Opportunities to investigate occupational hazards in relatively high exposure settings and to develop multi-country research partnerships that can lead to disease prevention globally are the main motivations for this type of research. However, it should be appreciated that changes in the cultural, economic, and political environment of the country where the research is conducted can have profound influences on the likelihood of research success. Our research groups have long histories of conducting epidemiologic investigations among Textile Workers in Shanghai, China. The research includes studies of multiple different cancers and parkinsonism (HC) and respiratory disorders (DCC) in relation to exposures to Textile industry dusts and chemicals. Several gene/environment investigations have also been conducted. We present the historical background leading to the research, and the logistical challenges that have emerged over time as political, social, and economic conditions in Shanghai have changed. These challenges include reduced access to workplaces, reduced worker participation rates, and governmentally imposed restrictions on transporting bio-specimens outside of China. Based on our experiences, we can offer some recommendations that occupational epidemiologists in high and low/middle income countries might consider to facilitate collaborative research: being cognizant of national and regional political, social, and economic policy changes; maintaining flexibility in research protocols and budgetary allocations during the course of study conduct; and, keeping lines of communication open throughout the research design and implementation.
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exposure specific lung cancer risks in chinese chrysotile Textile Workers and mining Workers
Lung Cancer, 2014Co-Authors: Xiaorong Wang, Eiji Yano, Ignatius Taksun Yu, Midori N Courtice, David C ChristianiAbstract:Abstract Objective Whether there is a difference in the exposure–response slope for lung cancer between mining Workers and Textile Workers exposed to chrysotile has not been well documented. This study was carried out to evaluate exposure-specific lung cancer risks in Chinese chrysotile Textile Workers and mining Workers. Subjects and methods A chrysotile mining worker cohort and a chrysotile Textile worker cohort were observed concurrently for 26 years. Information on Workers’ vital status, occupational history and smoking habits were collected, and causes and dates of deaths were verified from death registries. Individual cumulative fiber exposures were estimated based on periodic dust/fiber measurements from different workshops, job title and duration, and categorized into four levels (Q1–Q4). Standardized mortality ratios (SMRs) for lung cancer were calculated and stratified by industry and job title with reference of the national rates. Cox proportional hazard models were fit to estimate the exposure-specific lung cancer risks upon adjustment for age and smoking, in which an external control cohort consisting of industrial Workers without asbestos exposure was used as reference group for both Textile and mining Workers. Results SMRs were almost consistent with exposure levels in terms of job titles and workshops. A clear exposure–response relationship between lung cancer mortality and exposure levels was observed in both cohorts. At low exposure levels (Q1 and Q2), Textile Workers displayed higher death risks of lung cancer than mining Workers. However, similarly considerably high risks were observed at higher exposure levels, with hazard ratios of over 8 and 11 at Q3 and Q4, respectively, for both Textile and mining Workers, after both age and smoking were adjusted. Conclusion The chrysotile Textile Workers appeared to have a higher risk of lung cancer than the mining Workers at a relatively low exposure level, but no difference was observed at a high exposure level, where both cohorts displayed a considerably high risk.
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0031 lung function improvement is sustained after work cessation in shanghai cotton and silk Textile Workers
Occupational and Environmental Medicine, 2014Co-Authors: Peggy S Lai, Ellen A Eisen, Jingqing Hang, Fengying Zhang, Buyong Zheng, Linda Valeri, David C ChristianiAbstract:Objectives Whether cessation of exposure to endotoxin containing organic dusts leads to transient vs. sustained improvement of lung function is unknown. Method The Shanghai Textile Workers study is a 30-year prospective cohort study of 447 cotton Workers exposed to endotoxin containing cotton dust and 472 control silk Workers unexposed to endotoxin. Spirometry and questionnaires were administered at 5 year intervals, and endotoxin sampling was performed to estimate individual cumulative exposures. The effect of work cessation on FEV1 was modelled with a generalised additive mixed effects (GAMM) model. Results When cessation was modelled as a smoothed term, adjusting for age, gender, height, and smoking history, cessation was associated with a significant FEV1 improvement in both cotton and silk Workers. Work cessation displayed a non-linear quadratic effect on FEV1, with an average adjusted +38.1, +220, +316 ml effect in silk and +26.3, +184.1, +264.1 ml effect in cotton Workers at 10, 20, and 25 years of work cessation. In a model allowing for a quadratic effect of cessation years as suggested by the GAMM model, the linear component of the interaction suggested that cessation of cotton work was associated with less FEV1 improvement than silk work (cotton*cessation year interaction s = -2.6 ml, p = 0.025). Conclusions Lung function improvement after work cessation was observed in both cotton and silk Workers, suggesting that non-endotoxin containing organic dust exposure has adverse respiratory effects. The greater improvement in FEV1 in silk compared to cotton Textile Workers suggests that the endotoxin component of cotton dust is associated with additional detrimental effects.
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cotton dust endotoxin and cancer mortality among the shanghai Textile Workers cohort a 30 year analysis
Occupational and Environmental Medicine, 2013Co-Authors: Shona C Fang, Ellen A Eisen, Hongxi Zhang, Helian Dai, Jingqing Hang, Amar J Mehta, David C ChristianiAbstract:Background Although occupational exposure to cotton dust and endotoxin is associated with adverse respiratory health, associations with cancer are unclear. We investigated cancer mortality in relation to cotton dust and endotoxin exposure in the Shanghai Textile Workers cohort. Methods We followed 444 cotton Textile and a reference group of 467 unexposed silk Workers for 30 years (26 777 person-years). HRs for all cancers combined (with and without lung cancer) and gastrointestinal cancer were estimated in Cox regression models as functions of cotton Textile work and categories of cumulative exposure (low, medium, high), after adjustment for covariates including pack-years smoked. Different lag years accounted for disease latency. Results Risks of mortality from gastrointestinal cancers and all cancers combined, with the exclusion of lung cancer, were increased in cotton Workers relative to silk Workers. When stratified by category of cumulative cotton exposure, in general, risks were greatest for 20-year lagged medium exposure (all cancers HR=2.7 (95% CI 1.4 to 5.2); cancer excluding lung cancer HR=3.4 (1.7–7.0); gastrointestinal cancer HR=4.1 (1.8–9.7)). With the exclusion of lung cancer, risks of cancer were more pronounced. When stratified by category of cumulative endotoxin exposure, consistent associations were not observed for all cancers combined. However, excluding lung cancer, medium endotoxin exposure was associated with all cancers and gastrointestinal cancer in almost all lag models. Conclusions Cotton dust may be associated with cancer mortality, especially gastrointestinal cancer, and endotoxin may play a causative role. Findings also indirectly support a protective effect of endotoxin on lung cancer.
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evidence of a paradoxical relationship between endotoxin and lung cancer after accounting for left truncation in a study of chinese female Textile Workers
Occupational and Environmental Medicine, 2013Co-Authors: Katie M Applebaum, David C Christiani, George Astrakianakis, David B Thomas, Harvey Checkoway, Roberta M Ray, Dao Li Gao, Michael P Lavalley, Ellen A EisenAbstract:Introduction Occupational exposure to endotoxin, found in Gram-negative bacteria in organic material, has been associated predominantly with a reduced risk of lung cancer among Workers. An inverse exposure–response gradient among women Textile Workers in Shanghai, China, has been reported previously. In this case–cohort study, we investigated the influence of left truncation, which can itself induce a downward trend, on the observed association. Methods Subjects were enrolled between 1989 and 1991 and followed until 1998. The data were left-truncated as all subjects were hired before baseline. An analysis was performed with 3038 subcohort members and 602 cases of incident lung cancer. To evaluate left truncation, we compared lung cancer rates in those hired longer ago with those hired more recently among unexposed subjects. Cox proportional hazards modelling was used to estimate incident rate ratios (IRRs) and 95% CIs. Results Among those who were never exposed to workplace endotoxin, we compared lung cancer rates in those hired >35 years before enrolment with Workers hired ≤35 years before enrolment and observed a reduced risk in the former group, IRR=0.74, 95% CI (0.51 to 1.07). After accounting for this downward bias from left truncation, the reduced risk associated with endotoxin remained among those hired ≤50 years before enrolment. In contrast, there was suggestion of an increased risk of lung cancer among those hired >50 years ago. Conclusions After examination of left truncation bias, an inverse dose–response between endotoxin and lung cancer remained for all subjects except those hired longest ago.
Harvey Checkoway - One of the best experts on this subject based on the ideXlab platform.
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occupational exposures and parkinsonism among shanghai women Textile Workers
American Journal of Industrial Medicine, 2018Co-Authors: Harvey Checkoway, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, David B ThomasAbstract:BACKGROUND Endotoxin, a contaminant of cotton dust, is an experimental model for parkinsonism (PS). METHODS We investigated associations between exposures to endotoxin, solvents, magnetic fields, and night shift work, and neurologist-determined PS among Shanghai women Textile Workers, including 537 retired cotton factory Workers ages ≥50 years and an age-matched reference group of 286 retired Textile Workers not exposed to cotton dust. Repeat exams were conducted 2.5 years after enrollment among 467 cotton Workers and 229 reference Workers. RESULTS We identified 39 prevalent PS cases and 784 non-cases. No consistent or statistically significant associations were observed for endotoxin, solvents, magnetic fields, or shift work with PS risk, severity, or progression. CONCLUSIONS Despite the null findings, additional studies of endotoxin exposure and risk of PS in other well-characterized occupational cohorts are warranted in view of toxicological evidence that endotoxin is a pathogenic agent and its widespread occurrence in multiple industries worldwide.
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0442 occupational exposures and parkinsonism among women Textile Workers in shanghai china
Occupational and Environmental Medicine, 2017Co-Authors: David B Thomas, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, Sadie Costello, Harvey CheckowayAbstract:Objective To examine the association of endotoxin and other occupational exposures with parkinsonism (PS) severity and progression of PS signs. Methods Movement disorder specialists examined 823 retired female Textile Workers ages 51–86 in Shanghai, China for PS prevalence and assessment of Unified Parkinson Disease Rating Scale motor subsection part 3 (UPDRS3). Most (n=669) were re-evaluated two years later. Occupational exposures to endotoxin, metals, solvents, magnetic fields, and shiftwork during a mean of 24 years working in the Textile industry were assessed from detailed work histories and a job exposure matrix. We examined the association between each exposure and PS, severity (UPDRS3 score), and progression (annual change in UPDRS3) with multivariable regression models adjusting for age, smoking, and examiner. Results We observed 39 prevalent PS cases and 784 non-cases. No association was observed between endotoxin and PS prevalence, disease severity, or disease progression. The other chemical occupational exposures and magnetic fields also had had no associations with PS prevalence or disease severity. Shiftwork was marginally positively associated with disease progression. For each year of shiftwork as of the baseline exam, UPDRS3 score increased annually by an additional 0.047 (95% CI: −0.003, 0.097). Conclusions We observed little evidence for an association between endotoxin and other occupational exposures with PS in this cohort of Textile industry Workers, although we are unable to rule out the possibility of clinically modest increases in progression among Workers who had experienced several years of shiftwork.
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0025 conducting global occupational epidemiology research in a changing socio political climate case study of research among shanghai china Textile Workers
Occupational and Environmental Medicine, 2017Co-Authors: Harvey Checkoway, David C Christiani, David H WegmanAbstract:There is a long and continuing legacy of epidemiologists from high income countries conducting occupational health research in low and middle income countries. Opportunities to investigate occupational hazards in relatively high exposure settings and to develop multi-country research partnerships that can lead to disease prevention globally are the main motivations for this type of research. However, it should be appreciated that changes in the cultural, economic, and political environment of the country where the research is conducted can have profound influences on the likelihood of research success. Our research groups have long histories of conducting epidemiologic investigations among Textile Workers in Shanghai, China. The research includes studies of multiple different cancers and parkinsonism (HC) and respiratory disorders (DCC) in relation to exposures to Textile industry dusts and chemicals. Several gene/environment investigations have also been conducted. We present the historical background leading to the research, and the logistical challenges that have emerged over time as political, social, and economic conditions in Shanghai have changed. These challenges include reduced access to workplaces, reduced worker participation rates, and governmentally imposed restrictions on transporting bio-specimens outside of China. Based on our experiences, we can offer some recommendations that occupational epidemiologists in high and low/middle income countries might consider to facilitate collaborative research: being cognizant of national and regional political, social, and economic policy changes; maintaining flexibility in research protocols and budgetary allocations during the course of study conduct; and, keeping lines of communication open throughout the research design and implementation.
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risk of pancreatic cancer in female Textile Workers in shanghai china exposed to metals solvents chemicals and endotoxin follow up to a nested case cohort study
Journal of Occupational and Environmental Medicine, 2016Co-Authors: Nicholas K Reul, David B Thomas, Roberta M Ray, Lisa G Gallagher, Dao Li Gao, Sverre Vedal, Megan E Romano, Harvey CheckowayAbstract:Objective We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female Textile Workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. Methods We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. Results We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. Conclusions Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.
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reply to comment on possible pro carcinogenic association of endotoxin on lung cancer among shanghai women Textile Workers
British Journal of Cancer, 2015Co-Authors: Harvey Checkoway, George Astrakianakis, Roberta M Ray, Dao Li Gao, Jessica I Lundin, Sadie Costello, Ellen A Eisen, Katie M Applebaum, David B ThomasAbstract:Reply to Comment on: ‘Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women Textile Workers’
Dao Li Gao - One of the best experts on this subject based on the ideXlab platform.
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occupational exposures and parkinsonism among shanghai women Textile Workers
American Journal of Industrial Medicine, 2018Co-Authors: Harvey Checkoway, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, David B ThomasAbstract:BACKGROUND Endotoxin, a contaminant of cotton dust, is an experimental model for parkinsonism (PS). METHODS We investigated associations between exposures to endotoxin, solvents, magnetic fields, and night shift work, and neurologist-determined PS among Shanghai women Textile Workers, including 537 retired cotton factory Workers ages ≥50 years and an age-matched reference group of 286 retired Textile Workers not exposed to cotton dust. Repeat exams were conducted 2.5 years after enrollment among 467 cotton Workers and 229 reference Workers. RESULTS We identified 39 prevalent PS cases and 784 non-cases. No consistent or statistically significant associations were observed for endotoxin, solvents, magnetic fields, or shift work with PS risk, severity, or progression. CONCLUSIONS Despite the null findings, additional studies of endotoxin exposure and risk of PS in other well-characterized occupational cohorts are warranted in view of toxicological evidence that endotoxin is a pathogenic agent and its widespread occurrence in multiple industries worldwide.
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0442 occupational exposures and parkinsonism among women Textile Workers in shanghai china
Occupational and Environmental Medicine, 2017Co-Authors: David B Thomas, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, Sadie Costello, Harvey CheckowayAbstract:Objective To examine the association of endotoxin and other occupational exposures with parkinsonism (PS) severity and progression of PS signs. Methods Movement disorder specialists examined 823 retired female Textile Workers ages 51–86 in Shanghai, China for PS prevalence and assessment of Unified Parkinson Disease Rating Scale motor subsection part 3 (UPDRS3). Most (n=669) were re-evaluated two years later. Occupational exposures to endotoxin, metals, solvents, magnetic fields, and shiftwork during a mean of 24 years working in the Textile industry were assessed from detailed work histories and a job exposure matrix. We examined the association between each exposure and PS, severity (UPDRS3 score), and progression (annual change in UPDRS3) with multivariable regression models adjusting for age, smoking, and examiner. Results We observed 39 prevalent PS cases and 784 non-cases. No association was observed between endotoxin and PS prevalence, disease severity, or disease progression. The other chemical occupational exposures and magnetic fields also had had no associations with PS prevalence or disease severity. Shiftwork was marginally positively associated with disease progression. For each year of shiftwork as of the baseline exam, UPDRS3 score increased annually by an additional 0.047 (95% CI: −0.003, 0.097). Conclusions We observed little evidence for an association between endotoxin and other occupational exposures with PS in this cohort of Textile industry Workers, although we are unable to rule out the possibility of clinically modest increases in progression among Workers who had experienced several years of shiftwork.
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risk of pancreatic cancer in female Textile Workers in shanghai china exposed to metals solvents chemicals and endotoxin follow up to a nested case cohort study
Journal of Occupational and Environmental Medicine, 2016Co-Authors: Nicholas K Reul, David B Thomas, Roberta M Ray, Lisa G Gallagher, Dao Li Gao, Sverre Vedal, Megan E Romano, Harvey CheckowayAbstract:Objective We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female Textile Workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. Methods We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. Results We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. Conclusions Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.
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reply to comment on possible pro carcinogenic association of endotoxin on lung cancer among shanghai women Textile Workers
British Journal of Cancer, 2015Co-Authors: Harvey Checkoway, George Astrakianakis, Roberta M Ray, Dao Li Gao, Jessica I Lundin, Sadie Costello, Ellen A Eisen, Katie M Applebaum, David B ThomasAbstract:Reply to Comment on: ‘Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women Textile Workers’
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night shift work and lung cancer risk among female Textile Workers in shanghai china
Journal of Occupational and Environmental Hygiene, 2015Co-Authors: Paul Kwon, David B Thomas, Roberta M Ray, Dao Li Gao, Jessica Lundin, Christopher T Littell, Harvey CheckowayAbstract:In 2007, the International Agency for Research on Cancer classified shift work that involves circadian disruption as a probable human carcinogen. Suppression of the anti-neoplastic hormone, melatonin, is a presumed mechanism of action. We conducted a case-cohort study nested within a cohort of 267,400 female Textile Workers in Shanghai, China. Newly diagnosed lung cancer cases (n = 1451) identified during the study period (1989–2006) were compared with an age-stratified subcohort (n = 3040). Adjusting for age, smoking, parity, and endotoxin exposure, relative risks [hazard ratios (HRs)] were estimated by Cox regression modeling to assess associations with cumulative years and nights of rotating shift work. Results did not consistently reveal any increased risk of lung cancer among rotating shift work or statistically significant trends for both cumulative years (HR 0.82, 95% CI 0.66 to 1.02; Ptrend = 0.294) and nights (HR 0.81, 95% CI 0.65 to 1.00; Ptrend = 0.415). Further analyses imposing 10- and 20-yea...
Roberta M Ray - One of the best experts on this subject based on the ideXlab platform.
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occupational exposures and parkinsonism among shanghai women Textile Workers
American Journal of Industrial Medicine, 2018Co-Authors: Harvey Checkoway, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, David B ThomasAbstract:BACKGROUND Endotoxin, a contaminant of cotton dust, is an experimental model for parkinsonism (PS). METHODS We investigated associations between exposures to endotoxin, solvents, magnetic fields, and night shift work, and neurologist-determined PS among Shanghai women Textile Workers, including 537 retired cotton factory Workers ages ≥50 years and an age-matched reference group of 286 retired Textile Workers not exposed to cotton dust. Repeat exams were conducted 2.5 years after enrollment among 467 cotton Workers and 229 reference Workers. RESULTS We identified 39 prevalent PS cases and 784 non-cases. No consistent or statistically significant associations were observed for endotoxin, solvents, magnetic fields, or shift work with PS risk, severity, or progression. CONCLUSIONS Despite the null findings, additional studies of endotoxin exposure and risk of PS in other well-characterized occupational cohorts are warranted in view of toxicological evidence that endotoxin is a pathogenic agent and its widespread occurrence in multiple industries worldwide.
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0442 occupational exposures and parkinsonism among women Textile Workers in shanghai china
Occupational and Environmental Medicine, 2017Co-Authors: David B Thomas, Roberta M Ray, Dao Li Gao, Sindana D Ilango, Caroline M Tanner, Xin Wang, Susan Searles Nielsen, Sadie Costello, Harvey CheckowayAbstract:Objective To examine the association of endotoxin and other occupational exposures with parkinsonism (PS) severity and progression of PS signs. Methods Movement disorder specialists examined 823 retired female Textile Workers ages 51–86 in Shanghai, China for PS prevalence and assessment of Unified Parkinson Disease Rating Scale motor subsection part 3 (UPDRS3). Most (n=669) were re-evaluated two years later. Occupational exposures to endotoxin, metals, solvents, magnetic fields, and shiftwork during a mean of 24 years working in the Textile industry were assessed from detailed work histories and a job exposure matrix. We examined the association between each exposure and PS, severity (UPDRS3 score), and progression (annual change in UPDRS3) with multivariable regression models adjusting for age, smoking, and examiner. Results We observed 39 prevalent PS cases and 784 non-cases. No association was observed between endotoxin and PS prevalence, disease severity, or disease progression. The other chemical occupational exposures and magnetic fields also had had no associations with PS prevalence or disease severity. Shiftwork was marginally positively associated with disease progression. For each year of shiftwork as of the baseline exam, UPDRS3 score increased annually by an additional 0.047 (95% CI: −0.003, 0.097). Conclusions We observed little evidence for an association between endotoxin and other occupational exposures with PS in this cohort of Textile industry Workers, although we are unable to rule out the possibility of clinically modest increases in progression among Workers who had experienced several years of shiftwork.
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risk of pancreatic cancer in female Textile Workers in shanghai china exposed to metals solvents chemicals and endotoxin follow up to a nested case cohort study
Journal of Occupational and Environmental Medicine, 2016Co-Authors: Nicholas K Reul, David B Thomas, Roberta M Ray, Lisa G Gallagher, Dao Li Gao, Sverre Vedal, Megan E Romano, Harvey CheckowayAbstract:Objective We studied associations between pancreatic cancer and occupational exposures to metals, solvents, chemicals, and endotoxin in a cohort of female Textile Workers in Shanghai, China. To assess the longer-term influences of these agents on pancreatic cancer we extended follow-up of this previously studied cohort. Methods We utilized a job exposure matrix to assess occupational exposures for 481 pancreatic cancer cases and a randomly selected sub-cohort of 3191 non-cases. We calculated hazard ratios and 95% confidence intervals using Cox proportional hazards modeling adapted for the case-cohort design. Results We observed a statistically significant trend of increasing hazard ratios associated with solvent exposure, but no associations with any of the remaining occupational exposures, including endotoxin and metals. Conclusions Our findings of increasing risk of pancreatic cancer with solvent exposures are consistent with published literature.
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reply to comment on possible pro carcinogenic association of endotoxin on lung cancer among shanghai women Textile Workers
British Journal of Cancer, 2015Co-Authors: Harvey Checkoway, George Astrakianakis, Roberta M Ray, Dao Li Gao, Jessica I Lundin, Sadie Costello, Ellen A Eisen, Katie M Applebaum, David B ThomasAbstract:Reply to Comment on: ‘Possible pro-carcinogenic association of endotoxin on lung cancer among Shanghai women Textile Workers’
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occupational exposures and risk of stomach and esophageal cancers update of a cohort of female Textile Workers in shanghai china
American Journal of Industrial Medicine, 2015Co-Authors: Lisa G Gallagher, David B Thomas, Karen J Wernli, Roberta M Ray, Megan E Romano, Dao L Gao, Harvey CheckowayAbstract:Background Associations between stomach and esophageal cancer and exposures to dusts, metals, chemicals, and endotoxin in the workplace are not very well understood, particularly in women. Methods We followed 267,400 female Textile Workers in Shanghai, China for cancer incidence from 1989 to 2006. Stomach (n = 1374) and esophageal (n = 190) cancer cases were identified and a comparison subcohort (n = 3187) was randomly selected. Cox proportional hazard modeling was used, adjusting for age and smoking. Results Increasing stomach cancer risk was observed with increasing duration of synthetic fiber dust exposure (p = 0.03), although the magnitude of effect was small (20 + years: HR = 1.2, 95% CI 1.1–1.4). Trends with endotoxin exposure were modestly inversed for esophageal cancer and increased for stomach cancer, but with little deviation from a null association. Conclusions Our findings demonstrate that long durations of synthetic fiber dust exposure can increase stomach cancer risk in women, but provide limited support for associations with other Textile industry exposures. Am. J. Ind. Med. 58:267–275, 2015. © 2015 Wiley Periodicals, Inc.
