Firefighting and Cancer: A Meta-analysis of Cohort Studies in the Context of Cancer Hazard Identification

DeBono Nathan L.,Daniels Robert D.,Beane Freeman Laura E.,Graber Judith M.,Hansen Johnni,Teras Lauren R.,Driscoll Tim,Kjaerheim Kristina,Demers Paul A.,Glass Deborah C.,Kriebel David,Kirkham Tracy L. 한국산업안전보건공단 산업안전보건연구원 2023 Safety and health at work Vol.14 No.2

Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14–2.20, 8%) for mesothelioma, 1.16 (1.08–1.26, 0%) for bladder cancer, 1.21 (1.12–1.32, 81%) for prostate cancer, 1.37 (1.03–1.82, 56%) for testicular cancer, 1.19 (1.07–1.32, 37%) for colon cancer, 1.36 (1.15–1.62, 83%) for melanoma, 1.12 (1.01–1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02–1.61, 40%) for thyroid cancer, and 1.09 (0.92–1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.

Cancer incidence among paraquat exposed applicators in the agricultural health study: prospective cohort study.

Park, Sue K,Kang, Daehee,Beane-Freeman, Laura,Blair, Aaron,Hoppin, Jane A,Sandler, Dale P,Lynch, Charles F,Knott, Charles,Gwak, Jin,Alavanja, Michael Hanley Belfus 2009 International journal of occupational and environm Vol.15 No.3

<P>Paraquat (1,1'-dimethyl-4, 4'-bipyridinium dichloride) is a nonselective herbicide that is extremely toxic after acute exposure. It was once widely used in North America and is still used in some countries, including the United States. Although there is little firm evidence that paraquat is a carcinogen, previous studies have suggested a potential relationship with some cancers. This prospective cohort study was performed to evaluate the association between lifetime paraquat exposure and cancer incidence among licensed pesticide applicators with 9.1 years of median follow-up. The lifetime ever-use of paraquat was evaluated in 56,224 subjects at baseline and exposure-response relationship was evaluated in 24,667 subjects (44%) who provided detailed information on total life-time paraquat exposure in a second questionnaire. Among the total subjects, the risk for non-Hodgkin's lymphoma (NHL) in the exposed group was marginally elevated (Relative risk [RR], 1.47; 95% confidence interval [CI], 0.97-2.23) compared to the non-exposed group. However, among the 24,667 applicators who supplied total life-time exposure days, the highest tertile of lifetime exposure-days (LE) and intensity-weighted lifetime exposure-days (IWLE) was not significantly associated with NHL risk (RR, 1.57; 95%CI, 0.57-4.23 for LE; RR, 1.42; 95%CI, 0.40-4.71 for IWLE, respectively) and there was no significant exposure-response trend (p-trend > 0.1). There was some suggestion of a possible link between paraquat exposure and NHL risk in humans, but the inconsistency in exposure level trend suggests that this could be a chance finding.</P>

A Study of the Distribution of a Bacterial Community in Biological-Activated Carbon (BAC)

Hong-Ki Park(박홍기),Eun-Young Jung(정은영),Dong-Jin Cha(차동진),Jung-A Kim(김정아),Jae-Hoon Bean(빈재훈) 한국생명과학회 2012 생명과학회지 Vol.22 No.9

정수처리 공정에서 생물활성탄(BAC) 공정은 미생물의 유기물 제거능을 극대화시킨 일종의 생물여과 공정이다. 본 연구는 낙동강 원수를 이용하여 재질이 다른 생물활성탄을 사용하고 있는 정수장을 대상으로 세균 군집을 조사하였다. 실험결과 석탄계 재질의 BAC 부착세균 생체량 및 활성도가 각각 1.20~34.0×107 CFU/g, 0.61~1.10mg-C/m3ㆍh의 범위를 보여 세균 생체량과 DOC 제거율은 석탄계 재질이 가장 높은 것으로 나타났다. 부착세균을 동정한 결과 Pseudomonas 속이 우점하였으며, 그 다음으로 Chryseomonas 속, Flavobacterium 속, Alcaligenes 속, Acinetobacter 속, Sphingomonas 속 등의 순으로 동정되었다. 그리고 Pseudomonas cepacia는 석탄계 재질,Chryseomonas luteola는 목탄계 재질의 우점세균으로 조사되었다. The use of biological-activated carbon (BAC) processes in water treatment involves biofiltration, which maximizes the bacteria’s capabilities to remove organic matter. In this study, the distribution of the bacterial community was assessed in response to different types of BAC processes applied downstream in the Nakdong River. The bacterial biomass and activity were 1.20~34.0×107 CFU/g and 0.61~1.10 mg-C/m3ㆍhr in coal-based BAC, respectively. The attachment of the bacterial biomass and the removal efficiency of the organic carbon were greatest with the coal-based activated carbon. The bacteria attached to each activated carbon material were detected in the order of Pseudomonas genus, Chryseomonas genus, Flavobacterium genus, Alcaligenes genus, Acinetobacter genus, and Spingomona genus. Pseudomonas cepacia was the dominant species in the coal-based materials, and Chryseomonas luteola was the dominant species in the wood-based material.

Heterocyclic aromatic amine pesticide use and human cancer risk: Results from the U.S. Agricultural Health Study

Koutros, Stella,Lynch, Charles F.,Ma, Xiaomei,Lee, Won Jin,Hoppin, Jane A.,Christensen, Carol H.,Andreotti, Gabriella,Freeman, Laura Beane,Rusiecki, Jennifer A.,Hou, Lifang,Sandler, Dale P.,Alavanja, Wiley Subscription Services, Inc., A Wiley Company 2009 International journal of cancer: Journal internati Vol.124 No.5

<P>Imazethapyr, a heterocyclic aromatic amine, is a widely used crop herbicide first registered for use in the United States in 1989. We evaluated cancer incidence among imazethapyr-exposed pesticide applicators enrolled in the Agricultural Health Study (AHS). The AHS is a prospective cohort of 57,311 licensed pesticide applicators in the U.S., enrolled from 1993–1997. Among the 49,398 licensed pesticide applicators eligible for analysis, 20,646 applicators reported use of imazethapyr and 2,907 incident cancers developed through 2004. Imazethapyr exposure was classified by intensity-weighted lifetime exposure days calculated as [years of use × days per year × intensity level]. Poisson regression analysis was used to evaluate the relationship between imazethapyr exposure and cancer incidence. We found significant trends in risk with increasing lifetime exposure for bladder cancer (p for trend 0.01) and colon cancer (p for trend 0.02). Rate ratios (RRs) were increased by 137% for bladder cancer and 78% for colon cancer when the highest exposed were compared to the nonexposed. The excess risk for colon cancer was limited to proximal cancers, (RR = 2.73, 95% confidence intervals 1.42, 5.25, p for trend 0.001). No association was observed for prostate, lung, rectum, kidney, oral, pancreas, lymphohematopoietic cancers or melanoma. These findings provide new evidence that exposure to aromatic amine pesticides may be an overlooked exposure in the etiology of bladder and colon cancer. The use of imazethapyr and other imidazolinone compounds should continue to be evaluated for potential risk to humans. Published 2008 Wiley-Liss, Inc.</P>

Infant Robotic Bilateral Upper Urinary Tract Surgery

Danesh Bansal,Christopher M Bean,Brian A Vanderbrink,Paul H Noh 대한비뇨의학회 2014 Investigative and Clinical Urology Vol.55 No.4

We describe a case of robot-assisted laparoscopic bilateral upper urinary tract surgeryin a 4-month-old infant for complex bilateral upper urinary tract duplication anomalies.

Clinical Characteristics of Nocardiosis: a Multicenter Retrospective Study in Korea

Kim Seulki,Shi Hye Jin,Jeon Cheon-Hoo,Kim Sun Bean,Yi Jongyoun,Kim A Reum,Kim Kye-Hyung,Lim Seungjin 대한감염학회 2023 Infection and Chemotherapy Vol.55 No.4

Background: Nocardiosis is a rare, but potentially life-threatening condition. It is difficult to diagnose, and bacterial culture identification can be time consuming. We investigated the characteristics of nocardiosis and the suitability of the treatment approach in Korea. Materials and Methods: This retrospective study was conducted at 5 medical institutions between 2011 and 2021. We reviewed the medical records of patients with microbiologically confirmed nocardiosis. Appropriate antibiotic selection was defined as follows: (1) selecting antibiotics according to the species, (2) if the species of Nocardia was unknown, trimethoprim-sulfamethoxazole-based therapy or linezolid-based therapy was administered, and (3) selection of antibiotics using the antibiotic susceptibility test. The appropriate treatment periods for antibiotics were defined as treatment maintained from 3 to 12 months, depending on involvement of the organs. Descriptive analysis and Fisher exact test were used. Statistical significance was set at P-values of <0.05. Results: Thirty patients were enrolled. Of these patients, 18 (60.0%) were male. The median age was 70.5 years. Among the diagnosed patients, 12 (40.0%) had an immunocompromised status. Eight (30.0%) patients received optimal treatment for the appropriate treatment period. Appropriate dosing duration was observed in 3 of the 12(25.0%) immunocompromised patients. There was no significant difference between the presence or absence of immunosuppression and the adequacy of treatment for nocardiosis (P = 1.000). Skin and soft tissue (14 patients) were most frequently involved in this study. Nocardia species (spp.) were isolated from culture at a median of 6.0 days. There were 7 cases with N. farcinica (23.3%). Conclusion: We found that 60.0% of the patients with nocardiosis did not have an immunocompromised status. Further, 26.7% of the total patients received adequate treatment for nocardiosis. The reasons for suboptimal management of nocardiosis in Korea are presumed to be diagnostic difficulties, lack of awareness about nocardiosis, and difficulties in selecting antibiotics for Nocardia spp. among clinicians. The lack of antibiotic susceptibility tests for Nocardia spp. could be the source of these problems. Nocardiosis should be suspected in cases of recurrent infections with skin and soft tissue, musculoskeletal, or respiratory system involvement with or without an immunocompromised status. Clinical microbiological support is required for the diagnosis and selection of antibiotics in Korea. High clinical index of suspicion and clinical microbiological support are required for the accurate diagnosis of nocardiosis in Korea.

Activity-dependent silencing reveals functionally distinct itch-generating sensory neurons

Roberson, David P,Gudes, Sagi,Sprague, Jared M,Patoski, Haley A W,Robson, Victoria K,Blasl, Felix,Duan, Bo,Oh, Seog Bae,Bean, Bruce P,Ma, Qiufu,Binshtok, Alexander M,Woolf, Clifford J Nature Publishing Group, a division of Macmillan P 2013 NATURE NEUROSCIENCE Vol.16 No.7

The peripheral terminals of primary sensory neurons detect histamine and non-histamine itch-provoking ligands through molecularly distinct transduction mechanisms. It remains unclear, however, whether these distinct pruritogens activate the same or different afferent fibers. Using a strategy of reversibly silencing specific subsets of murine pruritogen-sensitive sensory axons by targeted delivery of a charged sodium-channel blocker, we found that functional blockade of histamine itch did not affect the itch evoked by chloroquine or SLIGRL-NH2, and vice versa. Notably, blocking itch-generating fibers did not reduce pain-associated behavior. However, silencing TRPV1<SUP>+</SUP> or TRPA1<SUP>+</SUP> neurons allowed allyl isothiocyanate or capsaicin, respectively, to evoke itch, implying that certain peripheral afferents may normally indirectly inhibit algogens from eliciting itch. These findings support the presence of functionally distinct sets of itch-generating neurons and suggest that targeted silencing of activated sensory fibers may represent a clinically useful anti-pruritic therapeutic approach for histaminergic and non-histaminergic pruritus.

Coapplication of Lidocaine and the Permanently Charged Sodium Channel Blocker QX-314 Produces a Long-lasting Nociceptive Blockade in Rodents

Binshtok, Alexander M.,Gerner, Peter,Oh, Seog Bae,Puopolo, Michelino,Suzuki, Suzuko,Roberson, David P.,Herbert, Teri,Wang, Chi-Fei,Kim, Donghoon,Chung, Gehoon,Mitani, Aya A.,Wang, Ging Kuo,Bean, Bruce American Society of Anesthesiologists, Inc. 2009 Anesthesiology Vol.111 No.1

BACKGROUND:: Nociceptive-selective local anesthesia is produced by entry of the permanently charged lidocaine-derivative QX-314 into nociceptors when coadministered with capsaicin, a transient receptor potential vanilloid 1 (TRPV1) channel agonist. However, the pain evoked by capsaicin before establishment of the QX-314–mediated block would limit clinical utility. Because TRPV1 channels are also activated by lidocaine, the authors tested whether lidocaine can substitute for capsaicin to introduce QX-314 into nociceptors through TRPV1 channels and produce selective analgesia. METHODS:: Lidocaine (0.5% [17.5 mm], 1% [35 mm], and 2% [70 mm]) alone, QX-314 (0.2% [5.8 mm]) alone, and a combination of the two were injected subcutaneously and adjacent to the sciatic nerve in rats and mice. Mechanical and thermal responsiveness were measured, as was motor block. RESULTS:: Coapplication of 0.2% QX-314 with lidocaine prolonged the nociceptive block relative to lidocaine alone, an effect attenuated in TRPV1 knockout mice. The 0.2% QX-314 alone had no effect when injected intraplantary or perineurally, and it produced only weak short-lasting inhibition of the cutaneous trunci muscle reflex. Perisciatic nerve injection of lidocaine with QX-314 produced a differential nociceptive block much longer than the transient motor block, lasting 2 h (for 1% lidocaine) to 9 h (2% lidocaine). Triple application of lidocaine, QX-314, and capsaicin further increased the duration of the differential block. CONCLUSIONS:: Coapplication of lidocaine and its quaternary derivative QX-314 produces a long-lasting, predominantly nociceptor-selective block, likely by facilitating QX-314 entry through TRPV1 channels. Delivery of QX-314 into nociceptors by using lidocaine instead of capsaicin produces sustained regional analgesia without nocifensive behavior.

Permeation and block of TRPV1 channels by the cationic lidocaine derivative QX-314

Puopolo, M.,Binshtok, A.M.,Yao, G.-L.,Oh, S.B.,Woolf, C.J.,Bean, B.P. AMERICAN PHYSIOLOGICAL SOCIETY 2013 journal of neurophysiology Vol.109 No.4

Alachlor Use and Cancer Incidence in the Agricultural Health Study: An Updated Analysis

Lerro, C. C.,Andreotti, G.,Koutros, S.,Lee, W. J.,Hofmann, J. N.,Sandler, D. P.,Parks, C. G.,Blair, A.,Lubin, J. H.,Beane Freeman, L. E. U.S. Dept. of Health, Education, and Welfare, Publ 2018 Journal of the National Cancer Institute Vol.110 No.9