The New Zealand workforce survey II: occupational risk factors for asthma.

INTRODUCTION: We conducted a cross-sectional population-based survey in New Zealand that collected information on work history, current workplace exposures, and selected health outcomes. We report here the findings on occupational risk factors for asthma symptoms. METHODS: A random sample of men and women aged 20-64 years were selected from the New Zealand Electoral Roll and invited to take part in a telephone survey. Current asthma was defined as: (i) woken up by shortness of breath in the past 12 months; or (ii) an attack of asthma in the past 12 months; or (iii) currently taking asthma medication. Adult-onset asthma was defined as first attack of asthma at age 18 or over. Prevalence odds ratios (ORs) for all occupations were calculated using logistic regression adjusting for sex, age, smoking, and deprivation. RESULTS: Totally, 2903 participants were included in the analyses. The prevalence of current asthma was 17% and the prevalence of adult-onset asthma was 9%. Prevalence ORs for current asthma were elevated for ever working as a printer [OR = 2.26; 95% confidence interval (CI) = 1.09-4.66], baker (OR = 1.98; 95% CI = 1.02-3.85), sawmill labourer (OR = 3.26; 95% CI = 1.05-10.16), metal processing plant operator (OR = 2.48; 95% CI = 1.22-5.05), and cleaner (OR = 1.60; 95% CI = 1.09-2.35). Excess risks of adult-onset asthma were also found for ever working as a printer, baker, and sawmill labourer as well as ever-working as a market-oriented animal producer (OR = 1.66; 95% CI = 1.14-2.41), and other agricultural worker (OR = 2.08; 95% CI = 1.03-4.20). A number of occupations not previously considered at high risk for asthma were also identified, including teachers and certain sales professionals. CONCLUSION: This population-based study has confirmed findings of previous international studies showing elevated risks in a number of high-risk occupations. The strongest risks were consistently observed for printers, bakers, and sawmill labourers. Several occupations were also identified that have not been previously associated with asthma, suggesting that the risk of occupational asthma may be more widely spread across the workforce than previously assumed

An immunoassay for the measurement of (1→3)-β-D-glucans in the indoor environment

An inhibition enzyme immunoassay was developed for quantitation of (1→3)-β-D-glucans in the indoor environment. Immunospecific rabbit antibodies were produced by immunization with bovine serum albuminconjugated laminarin.The laminarin calibration curve ranged from 40 to 3000 ng/ml.Another (1→3)-β-D-glucan (curdlan) showed a similar inhibition curve, but was less reactive on a weight basis. Pustulan, presumed to be (1→3)-β-D-glucan, also showed immunoreactivity in the assay. Control experiments indicated that this was due to (1→3)-β-D-glucan structures. Other non-(1→3)-β-D-glucan polysaccharides did not react. (1→3)-β-Dglucan was detectable in dust from a variety of occupational and environmental settings. We conclude that the new assay offers a useful method for indoor (1→3)-β-Dglucan exposure assessment

Can selection explain the protective effects of farming on asthma?

INTRODUCTION AND OBJECTIVE: Reduced asthma and allergy risks in farmers have been ascribed to microbial exposures. However, selection may also play a role and this was assessed in two Scandinavian farming populations. MATERIALS AND METHODS: Asthma prevalence in 739 Danish farming students was compared to that of 1,105 siblings. 8,482 Norwegian farmers were also compared with 349 early retired farmers. RESULTS: The prevalence of ever-asthma was 5.4% in farming students and 5.2% in siblings (OR 1.1; 95%CI 0.73-1.7). Current asthma in farmers was 3.0% compared to 6.3% in farmers who had retired early (OR 1.8, 95%CI 1.1-2.9). Adjustments for early retirement increased the asthma prevalence by 0.3-0.6%. Farmers who had changed production were more likely to have asthma (OR 9.8, 95% CI 6.0-16). CONCLUSIONS: No healthy worker selection into farming was observed and changes in asthma prevalence due to early retirement were small. Selection effects are therefore unlikely to explain the protective effects of farming on asthma

Internet-Based Birth-Cohort Studies: Is This the Future for Epidemiology?

BACKGROUND: International collaborative cohorts the NINFEA and the ELF studies are mother-child cohorts that use the internet for recruitment and follow-up of their members. The cohorts investigated the association of early life exposures and a wide range of non-communicable diseases. OBJECTIVE: The objective is to report the research methodology, with emphasis on the advantages and limitations offered by an Internet-based design. These studies were conducted in Turin, Italy and Wellington, New Zealand. METHODS: The cohorts utilized various online/offline methods to recruit participants. Pregnant women who became aware volunteered, completed an online questionnaire, thus obtaining baseline information. RESULTS: The NINFEA study has recruited 7003 pregnant women, while the ELF study has recruited 2197 women. The cohorts targeted the whole country, utilizing a range of support processes to reduce the attrition rate of the participants. For the NINFEA and ELF cohorts, online participants were predominantly older (35% and 28.9%, respectively), highly educated (55.6% and 84.9%, respectively), and were in their final trimester of pregnancy (48.5% and 53.6%, respectively). CONCLUSIONS: Internet-based cohort epidemiological studies are feasible, however, it is clear that participants are self-selective samples, as is the case for many birth cohorts. Internet-based cohort studies are potentially cost-effective and novel methodology for conducting long-term epidemiology research. However, from our experience, participants tend to be self-selective. In marked time, if the cohorts are to form part of a larger research program they require further use and exploration to address biases and overcome limitations

The fecal microbiotas of women of Pacific and New Zealand European ethnicities are characterized by distinctive enterotypes that reflect dietary intakes and fecal water content

Obesity is a complex, multifactorial condition that is an important risk factor for noncommunicable diseases including cardiovascular disease and type 2 diabetes. While prevention and management require a healthy and energy balanced diet and adequate physical activity, the taxonomic composition and functional attributes of the colonic microbiota may have a supplementary role in the development of obesity. The taxonomic composition and metabolic capacity of the fecal microbiota of 286 women, resident in Auckland New Zealand, was determined by metagenomic analysis. Associations with BMI (obese, nonobese), body fat composition, and ethnicity (Pacific, n = 125; NZ European women [NZE], n = 161) were assessed using regression analyses. The fecal microbiotas were characterized by the presence of three distinctive enterotypes, with enterotype 1 represented in both Pacific and NZE women (39 and 61%, respectively), enterotype 2 mainly in Pacific women (84 and 16%) and enterotype 3 mainly in NZE women (13 and 87%). Enterotype 1 was characterized mainly by the relative abundances of butyrate producing species, Eubacterium rectale and Faecalibacterium prausnitzii, enterotype 2 by the relative abundances of lactic acid producing species, Bifidobacterium adolescentis, Bifidobacterium bifidum, and Lactobacillus ruminis, and enterotype 3 by the relative abundances of Subdoligranulum sp., Akkermansia muciniphila, Ruminococcus bromii, and Methanobrevibacter smithii. Enterotypes were also associated with BMI, visceral fat %, and blood cholesterol. Habitual food group intake was estimated using a 5 day nonconsecutive estimated food record and a 30 day, 220 item semi-quantitative Food Frequency Questionnaire. Higher intake of 'egg' and 'dairy' products was associated with enterotype 3, whereas 'non-starchy vegetables', 'nuts and seeds' and 'plant-based fats' were positively associated with enterotype 1. In contrast, these same food groups were inversely associated with enterotype 2. Fecal water content, as a proxy for stool consistency/colonic transit time, was associated with microbiota taxonomic composition and gene pools reflective of particular bacterial biochemical pathways. The fecal microbiotas of women of Pacific and New Zealand European ethnicities are characterized by distinctive enterotypes, most likely due to differential dietary intake and fecal consistency/colonic transit time. These parameters need to be considered in future analyses of human fecal microbiotas.Peer reviewe

Determinants of hand dermatitis, urticaria and loss of skin barrier function in professional cleaners in New Zealand.

This study assessed the risk of dermatitis, urticaria and loss of skin barrier function in 425 cleaners and 281 reference workers (retail workers and bus drivers). Symptoms, atopy and skin barrier function were assessed by questionnaire, skin prick tests, and measurement of transepidermal water loss. Cleaners had an increased risk of current (past 3 months) hand/arm dermatitis (14.8% vs. 10.0%; OR = 1.9, p < 0.05) and urticaria (11% vs. 5.3%; OR = 2.4, p < 0.05) and were more likely to have dermatitis as adults (17.6% vs. 11.4%; OR = 1.8, p < 0.05). The risk of atopy was not increased, but associations with symptoms were more pronounced in atopics. Transepidermal water loss was significantly higher in cleaners. Wet-work was a significant risk factor for dermatitis and hand washing and drying significantly reduced the risk of urticaria. In conclusion, cleaners have an increased risk of hand/arm dermatitis, urticaria and loss of skin barrier function

Pleural Mesothelioma in New Caledonia: Associations with Environmental Risk Factors

International audienceBackground: High incidences of malignant mesothelioma (MM) have been observed in New Caledonia. Previous work has shown an association between MM and soil containing serpentinite. Objectives: We studied the spatial and temporal variation of MM and its association with environmental factors. Methods: We investigated the 109 MM cases recorded in the Cancer Registry of New Caledonia between 1984 and 2008 and performed spatial, temporal, and space-time cluster analyses. We conducted an ecological analysis involving 100 tribes over a large area including those with the highest incidence rates. Associations with environmental factors were assessed using logistic and Poisson regression analyses. Results: The highest incidence was observed in the Houaïlou area with a world age-standardized rate of 128.7 per 100,000 person-years [95% confidence interval (CI), 70.41-137.84]. A significant spatial cluster grouped 18 tribes (31 observed cases vs. 8 expected cases; p = 0.001), but no significant temporal clusters were identified. The ecological analyses identified serpentinite on roads as the greatest environmental risk factor (odds ratio = 495.0; 95% CI, 46.2-4679.7; multivariate incidence rate ratio = 13.0; 95% CI, 10.2-16.6). The risk increased with serpentinite surface, proximity to serpentinite quarries and distance to the peridotite massif. The association with serpentines was stronger than with amphiboles. Living on a slope and close to dense vegetation appeared protective. The use of whitewash, previously suggested to be a risk factor, was not associated with MM incidence. Conclusions: Presence of serpentinite on roads is a major environmental risk factor for mesothelioma in New Caledonia

Acceptability of human papillomavirus self-sampling for cervical-cancer screening in under-screened Māori and Pasifika women: a pilot study.

AIM: To assess whether self-sampling for cervical-cancer screening is acceptable to New Zealand women. METHODS: Māori, Pacific and Asian un- or under-screened women aged 30-69 years were asked to: 1) examine three self-sampling devices; 2) complete a questionnaire on demographics and experiences with the devices; and 3) take a self-sample. Samples were tested 'off-label' using the cobas® 4800 human papillomavirus (HPV) test (Roche Diagnostics NZ). RESULTS: Thirty-one Pacific, 12 Māori, nine Asian and four women of other ethnicities participated (mean age, 39.5 years). Before trying any devices, 78% indicated a preference to self-sample, compared to 22% who preferred a physician-collected sample (PCS). After trying a device (HerSwab™, 91%; Delphi Screener™, 14%; cobas Swab, 13%; 12.5% used >1 device), fewer women (66%) preferred to self-sample next time, fewer (16%) preferred a PCS, while 18% expressed no preference. One of 32 samples with valid results (35 were tested) was positive for HPV 'other' oncogenic types. CONCLUSIONS: This was the first New Zealand study to invite women, including Māori women, to take a self-sample for cervical-cancer screening. The pilot study suggests that un- and under-screened women generally find self-sampling acceptable and all sample types are suitable for use with the cobas HPV test