Influence of quartz exposure on lung cancer types in cases of lymph node–only silicosis and lung silicosis in German uranium miners

<p>Inhaled crystalline quartz is a carcinogen. Analyses show differences in the distribution of lung cancer types depending on the status of silicosis. Using 2,524 lung tumor cases from the WISMUT autopsy repository database, silicosis was differentiated into cases without silicosis in lung parenchyma and its lymph nodes, with lymph node–only silicosis, or with lung silicosis including lymph node silicosis. The proportions of adenocarcinoma, squamous cell carcinoma, and small-cell lung carcinoma mortality for increasing quartz exposures were estimated in a multinomial logistic regression model. The relative proportions of the lung cancer subtypes in lymph node–only silicosis were more similar to lung silicosis than without any silicosis. The results support the hypothesis that quartz-related carcinogenesis in case of lymph node–only silicosis is more similar to that in lung silicosis than in without silicosis.</p

Average number of the different kinds of examinations (3 years moving averages) considering all three birth cohorts separately for male and female subjects.

<p>The number of examinations rises continuously over lifetime. This rise with age has become significantly steeper in more recent birth cohorts. (NUK: nuclear medical examinations, CT: computed tomography).</p

Red bone marrow dose in association with age, calendar year and gender.

<p><b>A:</b> Red bone marrow dose per age and gender considering all subjects of the sample (N = 2811) independent of birth year. After a rise of dose in childhood the dose per calendar year shows no significant alteration until old age. <b>B:</b> Red bone marrow dose per calendar year considering all subjects of the sample independent of birth year and just separated by gender. A bimodal distribution of dose with an early rise followed by a drop and a second increase can be noticed. <b>A + B</b> In both graphics the dose were averaged over 10 years for smoothing random peaks.</p

Annual red bone marrow dose by age and calendar year for the three birth cohorts for A) Men, B) Women) based on the multivariate regression model (Table 3).

<p>Each line represents an age range of ten years, determined by the definition of the respective cohorts. Colours indicate calendar years restricted to 5-years intervals starting with 1925. All lines show an increase of annual dose with ten consecutive birth cohorts. Adjacent lines depict annual doses of the same birth cohorts for later calendar years in five year steps. This allows a comparison between the impact of increasing age and secular trend over calendar years. The increase of annual dose is faster over younger years and levels off later in life. The dynamics are basically similar over the three subsequent birth cohorts. The annual dose however with respect to age has considerably decreased over calendar time.</p

Distribution of the red bone marrow dose generated by the different categories of examinations for the three birth cohorts for male and female subjects.

<p>The distribution changed from a predominance of conventional and mass screening examinations to a dose generated mainly by technically advanced examinations like computed tomography and cardiac catheter examinations but also nuclear medicine and contrast medium examinations. The vertical dimension formation reflects similar calendar time. The diagrams of the birth cohorts show a similar distribution when compared at a given calendar time. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078027#pone-0078027-g005" target="_blank"><b>Figure 5a</b></a><b>:</b> Men. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078027#pone-0078027-g005" target="_blank"><b>Figure 5b</b></a><b>:</b> Women. (NUK: nuclear medical examinations, CT: computed tomography).</p

Point estimates and 95% confidence limits of the multivariate regression model.

<p>Point estimates and 95% confidence limits of the multivariate regression model.</p

Distribution of the number of different kinds of examinations considering all three birth cohorts separately for male and female subjects.

<p>The diagrams of the birth cohorts show a similar distribution when compared after an age shift of twenty years in such a way that the same time period is listed below one another. It can be noted that the number is generated mainly by conventional examinations. In the older subjects mass screening examinations are responsible for a considerable proportion of all examinations. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078027#pone-0078027-g002" target="_blank"><b>Figure 2a</b></a><b>:</b> Men. <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0078027#pone-0078027-g002" target="_blank"><b>Figure 2b</b></a><b>:</b> Women. (NUK: nuclear medical examinations, CT: computed tomography).</p

Absolute numbers of incident cases of MI in Mecklenburg-Western Pomerania in 2006 and 2017 with and without considering the changes in the prevalences of risk factors between 1997–2001 and 2008–2011.

<p>Absolute numbers of incident cases of MI in Mecklenburg-Western Pomerania in 2006 and 2017 with and without considering the changes in the prevalences of risk factors between 1997–2001 and 2008–2011.</p

Results of the Poisson regression model (dependent variable: MI incidence between SHIP baseline and 5-year-follow-up.

<p>CI: Confidence Interval</p><p>The coefficients of the risk factors of this model were used to compute the MI counts for the 5-year period following the baseline examination of SHIP-Trend.</p

Relative changes of the prevalences of risk factors from SHIP-Trend compared to SHIP prevalences, age- and sex-standardized on the population of from Mecklenburg-Western Pomerania in 2006.

<p>Abbreviations: WC, waist circumference; TG, triglyceride; HDL, high-density-lipoprotein; LDL, low-density-lipoprotein.</p