Environmental Asthma Reduction Potential Estimates for Selected Mitigation Actions in Finland Using a Life Table Approach

Aims: To quantify the reduction potential of asthma in Finland achievable by adjusting exposures to selected environmental factors. Methods: A life table model for the Finnish population for 1986–2040 was developed and Years Lived with Disability caused by asthma and attributable to the following selected exposures were estimated: tobacco smoke (smoking and second hand tobacco smoke), ambient fine particles, indoor dampness and mould, and pets. Results: At baseline (2011) about 25% of the total asthma burden was attributable to the selected exposures. Banning tobacco was the most efficient mitigation action, leading to 6% reduction of the asthma burden. A 50% reduction in exposure to dampness and mould as well as a doubling in exposure to pets lead each to a 2% reduction. Ban of urban small scale wood combustion, chosen as a mitigation action to reduce exposure to fine particles, leads to a reduction of less than 1% of the total asthma burden. Combination of the most efficient mitigation actions reduces the total asthma burden by 10%. A more feasible combination of mitigation actions leads to 6% reduction of the asthma burden. Conclusions: The adjustment of environmental exposures can reduce the asthma burden in Finland by up to 10%

Maternal Smoking and the Risk of Cancer in Early Life – A Meta-Analysis

<div><p>Background</p><p>In spite of the well-known harmful effects on the fetus, many women continue smoking during pregnancy. Smoking as an important source of toxic chemicals may contribute to the developmental origin of diseases.</p><p>Objectives</p><p>The aim of this work was to pursue the possible association between maternal smoking and cancer in early life. Specifically, we wanted to identify the associated early life cancer types, and to quantify the associations.</p><p>Methods</p><p>In a systematic literature search 825 articles were identified in PubMed and Web of Science, and 55 more through the reference lists. Of these 62 fulfilled the criteria for inclusion in meta-analyses. Using Mantel-Haenszel or DerSimonian and Laird method, depending on heterogeneity of the studies, pooled estimates and 95% confidence intervals for eight cancer types were calculated.</p><p>Results</p><p>Smoking during pregnancy was associated with an increased risk for for brain and central nervous system tumors (OR = 1.09; 95% CI = 1.02–1.17). Although the risk for lymphoma was also associated (OR = 1.21; 95% CI = 1.05–1.34), it did not hold up in subgroup analyses. Leukemia was not found to be associated with maternal smoking. Five other cancer types (bone, soft tissue, renal, hepatic, and germ cell cancer) were also examined, but the number of studies was too limited to exclude the possibility of maternal smoking as a risk factor for cancer in offspring.</p><p>Conclusions</p><p>According to our meta-analyses, maternal smoking is associated with nervous system cancers, but not with leukemia in early life. Confirming or rejecting associations of maternal smoking with lymphoma and the five other cancer types requires further studies.</p></div

Cancer (sub)types which were analyzed according to exposure time window and exposure amount.

<p>Sensitivity analyses were conducted for nine study characteristics using studies reporting “any” smoking “during pregnancy”. Exposure amount is given in cigarettes per day (CPD). PNET = primitive neuroectodermal tumor; ALL = acute lymphoblastic leukemia; AML = acute myeloblastic leukemia.</p

Planned subgroup analyses and number of identified articles for each analysis.

<p>Each row corresponds to one cancer (sub)type as listed in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165040#pone.0165040.g002" target="_blank">Fig 2</a>. For column definition see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165040#pone.0165040.t001" target="_blank">Table 1</a>.</p

Systematic literature search.

<p>PubMed and Web of Science results and reference lists of the papers produced a total of 880 unique hits. Finally, 62 original research papers covering eight types of cancer, and 12 of their subtypes, were available for the meta-analyses (Tables A-C in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0165040#pone.0165040.s001" target="_blank">S1 File</a>). NS: nervous system; c.: cancer.</p