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Hunt Valley, MD, United States

Zambelli-Weiner A.,Epidemiology International | Crews J.E.,Centers for Disease Control and Prevention | Friedman D.S.,Wilmer Eye Institute
American Journal of Ophthalmology | Year: 2012

Purpose: To review the existing knowledge on vision health disparities in major adult vision health outcomes (age-related macular degeneration, diabetic retinopathy, glaucoma, cataract, refractive errors) and visual impairment and to identify knowledge gaps as related to the development of enhanced vision health surveillance in the United States. Design: Literature review. Methods: Analysis of relevant publications in the peer-reviewed literature. Results: Prevalence data on vision health outcomes is limited to findings from a few key population-based studies. Study populations are not representative of all persons living in the United States. Vision loss and visual impairment are more common with age, and there is racial variation in the specific causes of vision loss (underlying health conditions). Women are at greater risk of vision loss than men (even after adjusting for age). Vision-related disability and disparities in visual outcomes are monitored poorly at present. Conclusions: Data to assess and monitor trends in vision health disparities in the United States are not collected presently in a systematic fashion. This lack of data limits public health efforts to overcome barriers to eye care use and to improve vision outcomes. © 2012 Elsevier Inc.

Kramer S.,Epidemiology International | Hikel S.M.,Epidemiology International | Adams K.,Epidemiology International | Hinds D.,Epidemiology International | Moon K.,Epidemiology International
Environmental Health Perspectives | Year: 2012

Background: Although case-control studies conducted to date have largely affirmed the relationship between polychlorinated biphenyls (PCBs) and non-Hodgkin lymphoma (NHL), occupational cohort studies of PCB-exposed workers have been generally interpreted as negative, thereby raising doubts about a potential causal association. A common theme of immune dysregulation unifies many of NHL's strongest risk factors, and several authors have posited that subclinical immune dysregulation may increase NHL risk by decreasing host resistance, reducing control of cellular proliferation and differentiation, and diminishing tumor surveillance mechanisms. Objectives: The goals of this review were a) to evaluate the epidemiological research examining the association between PCB exposure and NHL and discuss the contribution to the weight of evidence of case-control studies and occupational cohort studies; and b) to summarize the evidence for immune dysregulation as a means by which PCBs may cause NHL. Methods: We performed a literature search using PubMed and seven additional online biomedical and toxicological referencing libraries to identify literature published through August 2011. Discussion and Conclusions: Overall, we conclude that the weight of evidence supports a causal role of PCBs in lymphomagenesis. The strongest epidemiological evidence for the relationship between PCBs and NHL comes from case-control studies conducted among the general population. Epidemiological and toxicological data demonstrating immunosuppressive and inflammatory effects of PCBs further contribute to the weight of evidence by providing a plausible explanation for how PCBs can cause NHL through immune dysregulation.

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