Global burden of disease due to smokeless tobacco consumption in adults : analysis of data from 113 countries

BACKGROUND: Smokeless tobacco is consumed in most countries in the world. In view of its widespread use and increasing awareness of the associated risks, there is a need for a detailed assessment of its impact on health. We present the first global estimates of the burden of disease due to consumption of smokeless tobacco by adults. METHODS: The burden attributable to smokeless tobacco use in adults was estimated as a proportion of the disability-adjusted life-years (DALYs) lost and deaths reported in the 2010 Global Burden of Disease study. We used the comparative risk assessment method, which evaluates changes in population health that result from modifying a population's exposure to a risk factor. Population exposure was extrapolated from country-specific prevalence of smokeless tobacco consumption, and changes in population health were estimated using disease-specific risk estimates (relative risks/odds ratios) associated with it. Country-specific prevalence estimates were obtained through systematically searching for all relevant studies. Disease-specific risks were estimated by conducting systematic reviews and meta-analyses based on epidemiological studies. RESULTS: We found adult smokeless tobacco consumption figures for 115 countries and estimated burden of disease figures for 113 of these countries. Our estimates indicate that in 2010, smokeless tobacco use led to 1.7 million DALYs lost and 62,283 deaths due to cancers of mouth, pharynx and oesophagus and, based on data from the benchmark 52 country INTERHEART study, 4.7 million DALYs lost and 204,309 deaths from ischaemic heart disease. Over 85 % of this burden was in South-East Asia. CONCLUSIONS: Smokeless tobacco results in considerable, potentially preventable, global morbidity and mortality from cancer; estimates in relation to ischaemic heart disease need to be interpreted with more caution, but nonetheless suggest that the likely burden of disease is also substantial. The World Health Organization needs to consider incorporating regulation of smokeless tobacco into its Framework Convention for Tobacco Control

Oral and pharyngeal cancer risk associated with occupational carcinogenic substances: A systematic review

Background: Oral and pharyngeal cancers (OPC) represent the seventh most common type of cancer and the seventh leading cause of deaths by cancer worldwide. Few studies have assessed the occupational exposure risks associated with OPC and in many cases the results are conflicting. The aim of this study was to determine, through a systematic review, the association of OPC and exposure to different occupational carcinogenic substances.Methods: The addressed focused question was “Is there an association of occupational carcinogenic substances with OPC?” PubMed, MEDLINE, EMBASE, and ISI Web of Science databases were searched between January 1995 up to and including July 2016 using the keywords “oral cancer,” “pharyngeal cancer,” “pharyngeal neoplasms,” “oral neoplasms,” “occupational disease,” “occupational exposure,” and “occupational risk factor” in various combinations. Letters to the Editor, review articles, case reports, and unpublished articles were excluded.Results: Fourteen original articles were included. Majority of the studies were conducted in European countries and used a case-control design. The results showed a significant association between formaldehyde, wood dust, coal dust, asbestos, welding fumes, and risk of developing OPC, while marginal association was observed with metal and leather dust. No associated risk was observed for textile fibers.Conclusion: There is some evidence to suggest associations of occupational substances with OPC, particularly in the pharynx. Future well-designed studies are required to confirm or rule out with confidence the associated exposure risk of these substances

The Diana project: pioneering women studying pioneering women

The 2007 winner of the International Award for Entrepreneurship and Small Business Research is the Diana Project team (Candida Brush, Nancy Carter, Elizabeth Gatewood, Patricia Greene and Myra Hart). The Diana Project builds on the vast experience of the team in the field of entrepreneurship in general and women entrepreneurship, business growth and venture capital in particular. The Diana Project has investigated the supply and demand side of growth capital for women entrepreneurs. The research contributes to entrepreneurship theory as well as to practice, filling a void in knowledge on growth-oriented women entrepreneurship. In this article we present and discuss the research contribution of the Diana Project, in the areas of entrepreneurship, women entrepreneurship and venture capital. We specifically discuss the value of researching a specific group of women entrepreneurs, those who want to grow their businesses, that very clearly demonstrates the positive potential of female entrepreneurship. The Diana Project has also moved research on women's entrepreneurship forward since its framework does not treat women entrepreneurs as 'other,' i.e., the project does not presuppose that women's entrepreneurship is similar to or different from men's entrepreneurship. It assumes that women's entrepreneurship is entrepreneurship and studies it from that point of view