Subtle excess in lifetime cancer risk related to CT scanning in Spanish young people

Background: CT scan is a life-saving medical diagnostic tool, entailing higher levels of ionising radiation exposure than conventional radiography, which may result in an increase in cancer risk, particularly in children. Information about the use and potential health effects of CT scan imaging among young people in Spain is scarce. Objective: This paper aims to estimate the number of radiation-related cancer cases which can be expected due to the use of CT scanning in Spanish children and young adults in a single year (2013). Methods: The 2013 distribution of number and types of CT scans performed in young people was obtained for Catalonia and extrapolated to the whole Spain. Organ doses were estimated based on the technical characteristics of 17,406 CT examinations extracted from radiology records. Age and sex-specific data on cancer incidence and life tables were obtained for the Spanish population. Age and sex-specific risk models developed by the Committee on Health Risks of Exposure to Low Levels of Ionizing Radiations (BEIR VII) and Berrington de Gonzalez were used, together, with the dose estimates to derive the lifetime attributable risks of cancer in Spain due to one year of CT scanning and project the number of future cancer cases to be expected. Results: In 2013, 105,802 CT scans were estimated to have been performed in people younger than age 21. It was estimated that a total of 168.6 cancer cases (95% CrI: 30.1-421.1) will arise over life due to the ionising radiation exposure received during these CTs. Lifetime attributable risks per 100,000 exposed patients were highest for breast and lung cancer. The largest proportion of CTs was to the head and neck and hence the highest numbers of projected cancer cases were of thyroid and oral cavity/pharynx. Conclusions: Despite the undeniable medical effectiveness of CT scans, this risk assessment suggests a small excess in cancer cases which underlines the need for justification and optimisation in paediatric scanning. Given the intrinsic uncertainties of these risk projection exercises, care should be taken when interpreting the predicted risks

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation

RING1B contributes to Ewing sarcoma development by repressing the Na(V)1.6 sodium channel and the NF-kappa B pathway, independently of the fusion oncoprotein

Ewing sarcoma (ES) is an aggressive tumor defined by EWSR1 gene fusions that behave as an oncogene. Here we demonstrate that RING1B is highly expressed in primary ES tumors, and its expression is independent of the fusion oncogene. RING1B-depleted ES cells display an expression profile enriched in genes functionally involved in hematological development but RING1B depletion does not induce cellular differentiation. In ES cells, RING1B directly binds the SCN8A sodium channel promoter and its depletion results in enhanced Nav1.6 expression and function. The signaling pathway most significantly modulated by RING1B is NF-κB. RING1B depletion results in enhanced p105/p50 expression, which sensitizes ES cells to apoptosis by FGFR/SHP2/STAT3 blockade. Reduced NaV1.6 function protects ES cells from apoptotic cell death by maintaining low NF-κB levels. Our findings identify RING1B as a trait of the cell-of-origin and provide a potential targetable vulnerability.Ministerio de Economía y Competitividad SAF2012-31089 and SAF2015-69762-RMEC FEDER RD12/0036/0017, PT13/0010/0056, RTC-2014- 2102-1, ISCIII Sara Borrell CD06/00001, PI12/03102, PI14/01466European FP7 Projects EuroSARC FP7- HEALTH-2011-two-stage, Project 278742 EUROSARCEuroewing FP7-HEALTH.2013.2.4.1-1, Project 60285

Lifetime occupational exposure to metals and welding fumes, and risk of glioma: a 7-country population-based case–control study

Background: Brain tumor etiology is poorly understood. Based on their ability to pass through the blood–brain barrier, it has been hypothesized that exposure to metals may increase the risk of brain cancer. Results from the few epidemiological studies on this issue are limited and inconsistent. Methods: We investigated the relationship between glioma risk and occupational exposure to five metals - lead, cadmium, nickel, chromium and iron- as well as to welding fumes, using data from the seven-country INTEROCC study. A total of 1800 incident glioma cases and 5160 controls aged 30–69 years were included in the analysis. Lifetime occupational exposure to the agents was assessed using the INTEROCC JEM, a modified version of the Finnish job exposure matrix FINJEM. Results: In general, cases had a slightly higher prevalence of exposure to the various metals and welding fumes than did controls, with the prevalence among ever exposed ranging between 1.7 and 2.2% for cadmium to 10.2 and 13.6% for iron among controls and cases, respectively. However, in multivariable logistic regression analyses, there was no association between ever exposure to any of the agents and risk of glioma with odds ratios (95% confidence intervals) ranging from 0.8 (0.7–1.0) for lead to 1.1 (0.7–1.6) for cadmium. Results were consistent across models considering cumulative exposure or duration, as well as in all sensitivity analyses conducted. Conclusions: Findings from this large-scale international study provide no evidence for an association between occupational exposure to any of the metals under scrutiny or welding fumes, and risk of glioma

Risk of lung cancer mortality in nuclear workers from internal exposure to alpha particle-emitting radionuclides

BACKGROUND: Carcinogenic risks of internal exposures to alpha-emitters (except radon) are poorly understood. Since exposure to alpha particles-particularly through inhalation-occurs in a range of settings, understanding consequent risks is a public health priority. We aimed to quantify dose-response relationships between lung dose from alpha-emitters and lung cancer in nuclear workers. METHODS: We conducted a case-control study, nested within Belgian, French, and UK cohorts of uranium and plutonium workers. Cases were workers who died from lung cancer; one to three controls were matched to each. Lung doses from alpha-emitters were assessed using bioassay data. We estimated excess odds ratio (OR) of lung cancer per gray (Gy) of lung dose. RESULTS: The study comprised 553 cases and 1,333 controls. Median positive total alpha lung dose was 2.42 mGy (mean: 8.13 mGy; maximum: 316 mGy); for plutonium the median was 1.27 mGy and for uranium 2.17 mGy. Excess OR/Gy (90% confidence interval)-adjusted for external radiation, socioeconomic status, and smoking-was 11 (2.6, 24) for total alpha dose, 50 (17, 106) for plutonium, and 5.3 (-1.9, 18) for uranium. CONCLUSIONS: We found strong evidence for associations between low doses from alpha-emitters and lung cancer risk. The excess OR/Gy was greater for plutonium than uranium, though confidence intervals overlap. Risk estimates were similar to those estimated previously in plutonium workers, and in uranium miners exposed to radon and its progeny. Expressed as risk/equivalent dose in sieverts (Sv), our estimates are somewhat larger than but consistent with those for atomic bomb survivors.See video abstract at, http://links.lww.com/EDE/B232

Occupational exposure to extremely low frequency magnetic fields and brain tumour risks in the INTEROCC study

BACKGROUND: Occupational exposure to extremely low frequency magnetic fields (ELF) is a suspected risk factor for brain tumours, however the literature is inconsistent. Few studies have assessed whether ELF in different time windows of exposure may be associated with specific histologic types of brain tumours. This study examines the association between ELF and brain tumours in the large-scale INTEROCC study. METHODS: Cases of adult primary glioma and meningioma were recruited in seven countries (Australia, Canada, France, Germany, Israel, New Zealand, United Kingdom) between 2000 and 2004. Estimates of mean workday ELF exposure based on a job exposure matrix assigned. Estimates of cumulative exposure, average exposure, maximum exposure, and exposure duration were calculated for the lifetime, and 1-4, 5-9, and 10+ years prior to the diagnosis/reference date. RESULTS: There were 3,761 included brain tumour cases (1,939 glioma, 1,822 meningioma) and 5,404 population controls. There was no association between lifetime cumulative ELF exposure and glioma or meningioma risk. However, there were positive associations between cumulative ELF 1-4 years prior to the diagnosis/reference date and glioma (odds ratio (OR) ≥ 90th percentile vs < 25th percentile = 1.67, 95% confidence interval (CI) 1.36-2.07, p < 0.0001 linear trend), and, somewhat weaker associations with meningioma (OR ≥ 90th percentile vs < 25th percentile = 1.23, 95% CI 0.97-1.57, p = 0.02 linear trend). CONCLUSIONS: Results showed positive associations between ELF in the recent past and glioma. IMPACT: Occupational ELF exposure may play a role in the later stages (promotion and progression) of brain tumourigenesis.Keywords: glioma, meningioma, occupation, case control study, extremely low frequency magnetic field

Procedimiento para la propagación in vitro del espárrago

Procedimiento para la propagación in vitro del espárrago. Procedimiento de propagación de espárrago (del género Asparagus) mediante técnicas de cultivo de tejidos vegetales. Se describe un procedimiento de propagación in vitro del espárrago enfocado hacia el acortamiento del proceso de micropropagación conforme y hacia la obtención de un método eficaz y consistente, que nos permita obtener unos altos porcentajes de éxito en la clonación para una mayoría de genotipos, y reducir el tiempo necesario para la obtención de copias clónales de genotipos agronómicamente interesantes.El procedimiento de propagación in vitro del espárrago objeto de la presente invención consiste en el cultivo y desarrollo de estructuras gemantes ya preexistentes en el rizoma, cultivándose yemas axilares que ofrecen por ello una mejor garantía de estabilidad somacional, asimismo las raíces se forman a partir de un tejido de parénquima que se conserva en la parte basal de la zona gemante del rizoma que se utiliza como explanto. El procedimiento objeto de la presente invención, probado en genotipos muy diferentes incluyendo incluso una especie silvestre de espárrago A. maritimus, una variedad población (“Morado de Huétor”) y varios cultivares de Asparagus officinalis (“UC-157”, “Baitoru”, y “Atlas”) funciona bien en todos los genotipos evaluados y alcanza además unos rendimientos de enraizado bastante altos en todos los genotipos ensayados y en un periodo de tiempo bastante corto, obteniéndose plántulas de 3-4 semanas y en 6-8 semanas plantas de calidad y características idóneas para su trasplante y aclimatación, con un elevado rendimiento en la recuperación de plántulas de calidad al final del proceso de micropropagación.Peer reviewedConsejo Superior de Investigaciones Científicas (España)A1 Solicitud de patente con informe sobre el estado de la técnic

CT scan exposure in Spanish children and young adults by socioeconomic status: Cross-sectional analysis of cohort data

Recent publications reported that children in disadvantaged areas undergo more CT scanning than others. The present study is aimed to assess the potential differences in CT imaging by socioeconomic status (SES) in Spanish young scanned subjects and if such differences vary with different indicators or different time point SES measurements. The associations between CT scanning and SES, and between the CT scan rate per patient and SES were investigated in the Spanish EPI-CT subcohort. Various SES indicators were studied to determine whether particular SES dimensions were more closely related to the probability of undergoing one or multiple CTs. Comparisons were made with indices based on 2001 and 2011 censuses. We found evidence of socio-economic variation among young people, mainly related to autonomous communities of residence. A slightly higher rate of scans per patient of multiple body parts in the less affluent categories was observed, possibly reflecting a higher rate of accidents and violence in these groups. The number of CT scans per patient was higher both in the most affluent and the most deprived categories and somewhat lower in the intermediate groups. This relation varied with the SES indicator used, with lower CT scans per patients in categories of high unemployment and temporary work, but not depending on categories of unskilled work or illiteracy. The relationship between these indicators and number of CTs in 2011 was different than that seen with the 2001 census, with the number of CTs increasing with higher unemployment. Overall we observed some differences in the SES distribution of scanned patients by Autonomous Community in Spain. There was, however, no major differences in the frequency of CT scans per patient by SES overall, based on the 2001 census. The use of different indicators and of SES data collected at different time points led to different relations between SES and frequency of CT scans, outlining the difficulty of adequately capturing the social and economic dimensions which may affect health and health service utilisation

Development of a source-exposure matrix for occupational exposure assessment of electromagnetic fields in the INTEROCC study

To estimate occupational exposures to electromagnetic fields (EMF) for the INTEROCC study, a database of source-based measurements extracted from published and unpublished literature resources had been previously constructed. The aim of the current work was to summarize these measurements into a source-exposure matrix (SEM), accounting for their quality and relevance. A novel methodology for combining available measurements was developed, based on order statistics and log-normal distribution characteristics. Arithmetic and geometric means, and estimates of variability and maximum exposure were calculated by EMF source, frequency band and dosimetry type. The mean estimates were weighted by our confidence in the pooled measurements. The SEM contains confidence-weighted mean and maximum estimates for 312 EMF exposure sources (from 0 Hz to 300 GHz). Operator position geometric mean electric field levels for radiofrequency (RF) sources ranged between 0.8 V/m (plasma etcher) and 320 V/m (RF sealer), while magnetic fields ranged from 0.02 A/m (speed radar) to 0.6 A/m (microwave heating). For extremely low frequency sources, electric fields ranged between 0.2 V/m (electric forklift) and 11,700 V/m (high-voltage transmission line-hotsticks), whereas magnetic fields ranged between 0.14 μT (visual display terminals) and 17 μT (tungsten inert gas welding). The methodology developed allowed the construction of the first EMF-SEM and may be used to summarize similar exposure data for other physical or chemical agents.This work was funded by the National Institutes for Health (NIH) Grant No. 1R01CA124759-01. Coding of the French occupational data was in part funded by AFSSET (Convention N° ST-2005-004). The INTERPHONE study was supported by funding from the European Fifth Framework Program, ‘Quality of Life and Management of Living Resources’ (contract 100 QLK4-CT-1999901563) and the International Union against Cancer (UICC). The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. Provision of funds to the INTERPHONE study investigators via the UICC was governed by agreements that guaranteed INTERPHONE’s complete scientific independence (http://interphone.iarc.fr/ interphone_funding.php). In Australia, funding was received from the Australian National Health and Medical Research 5 Council (EME Grant 219129) with funds originally derived from mobile phone service licence fees; a University of Sydney Medical Foundation Program; the Cancer Council NSW and The Cancer Council Victoria. In Montreal, Canada, funding was received from the Canadian Institutes of Health Research (project MOP-42525); the Canada Research Chair programme; the Guzzo-CRS Chair in Environment and Cancer; the Fonds de la recherche en sante du Quebec; the Société de recherché sur le cancer; in Ottawa and Vancouver, Canada, from the Canadian Institutes of Health Research (CIHR), the latter including partial support from the Canadian Wireless Telecommunications Association; the NSERC/SSHRC/McLaughlin Chair in Population Health Risk Assessment at the University of Ottawa. In France, funding was received by l’Association pour la Recherche sur le Cancer (ARC) (Contrat N85142) and three network operators (Orange, SFR, Bouygues Telecom). In Germany, funding was received from the German Mobile Phone Research Program (Deutsches Mobilfunkforschungsprogramm) of the German Federal Ministry for the Environment, Nuclear 45 Safety, and Nature Protection; the Ministry for the Environment and Traffic of the state of Baden- Wurttemberg; the Ministry for the Environment of the state of North Rhine-Westphalia; the MAIFOR Program (Mainzer Forschungsforderungsprogramm) of the University of Mainz. In New Zealand, funding was provided by the Health Research Council, Hawkes Bay Medical Research Foundation, the Wellington Medical Research Foundation, the Waikato Medical Research Foundation and the Cancer Society of New Zealand. Additional funding for the UK study was received from the Mobile Telecommunications, Health and Research (MTHR) program, funding from the Health and Safety Executive, the Department of Health, the UK Network Operators (O2, Orange, T-Mobile, Vodafone, ‘3’) and the Scottish Executive. All industry funding was governed by contracts guaranteeing the complete scientific independence of the investigator