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Blot W.J.,Vanderbilt Epidemiology Center | Blot W.J.,International Epidemiology Institute | Cohen S.S.,International Epidemiology Institute | Aldrich M.,Vanderbilt University | And 5 more authors.
Journal of the National Cancer Institute | Year: 2011

Background Menthol cigarettes, preferred by African American smokers, have been conjectured to be harder to quit and to contribute to the excess lung cancer burden among black men in the Unites States. However, data showing an association between smoking menthol cigarettes and increased lung cancer risk compared with smoking nonmenthol cigarettes are limited. The Food and Drug Administration is currently considering whether to ban the sale of menthol cigarettes in the United States. Methods We conducted a prospective study among 85806 racially diverse adults enrolled in the Southern Community Cohort Study during March 2002 to September 2009 according to cigarette smoking status, with smokers classified by preference for menthol vs nonmenthol cigarettes. Among 12373 smokers who responded to a follow-up questionnaire, we compared rates of quitting between menthol and nonmenthol smokers. In a nested case-control analysis of 440 incident lung cancer case patients and 2213 matched control subjects, using logistic regression modeling we computed odds ratios (ORs) and accompanying 95% confidence intervals (CIs) of lung cancer incidence, and applied Cox proportional hazards modeling to estimate hazard ratios (HRs) of lung cancer mortality, according to menthol preference. Results Among both blacks and whites, menthol smokers reported smoking fewer cigarettes per day; an average of 1.6 (95% CI = 1.3 to 2.0) fewer for blacks and 1.8 (95% CI = 1.3 to 2.3) fewer for whites, compared with nonmenthol smokers. During an average of 4.3 years of follow-up, 21% of participants smoking at baseline had quit, with menthol and nonmenthol smokers having equal odds of quitting (OR = 1.02, 95% CI = 0.89 to 1.16). A lower lung cancer incidence was noted in menthol vs nonmenthol smokers (for smokers of <10, 10-19, and ≥20 cigarettes per day, compared with never smokers, OR = 5.0 vs 10.3, 8.7 vs 12.9, and 12.2 vs 21.1, respectively). These trends were mirrored for lung cancer mortality. In multivariable analyses adjusted for pack-years of smoking, menthol cigarettes were associated with a lower lung cancer incidence (OR = 0.65, 95% CI = 0.47 to 0.90) and mortality (hazard ratio of mortality = 0.69, 95% CI = 0.49 to 0.95) than nonmenthol cigarettes. Conclusion sThe findings suggest that menthol cigarettes are no more, and perhaps less, harmful than nonmenthol cigarettes. © The Author 2011. Published by Oxford University Press. All rights reserved.

Signorello L.B.,Harvard University | Cohen S.S.,International Epidemiology Institute | Williams D.R.,Harvard University | Munro H.M.,International Epidemiology Institute | And 2 more authors.
American Journal of Public Health | Year: 2014

Objectives. We evaluated the independent and joint effects of race, individual socioeconomic status (SES), and neighborhood SES on mortality risk.Methods. We conducted a prospective analysis involving 52 965 non-Hispanic Black and 23 592 non-Hispanic White adults taking part in the Southern Community Cohort Study. Cox proportional hazards modeling was used to determine associations of race and SES with all-cause and cause-specific mortality.Results. In our cohort, wherein Blacks and Whites had similar individual SES, Blacks were less likely than Whites to die during the follow-up period (hazard ratio [HR] = 0.78; 95% confidence interval [CI] = 0.73, 0.84). Low household income was a strong predictor of all-cause mortality among both Blacks and Whites (HR = 1.76; 95% CI = 1.45, 2.12). Being in the lowest (vs highest) category with respect to both individual and neighborhood SES was associated with a nearly 3-fold increase in all-cause mortality risk (HR = 2.76; 95% CI = 1.99, 3.84). There was no significant mortality-related interaction between individual SES and neighborhood SES among either Blacks or Whites.Conclusions. SES is a strong predictor of premature mortality, and the independent associations of individual SES and neighborhood SES with mortality risk are similar for Blacks and Whites. © 2013 American Public Health Association.

News Article | November 17, 2016

Dozens of classic snack foods, from Doritos and Cheerios to Oreos and Fritos, may contain traces of glyphosate — the active ingredient in Monsanto's RoundUp herbicide. A new study by Food Democracy Now! found that 29 treats tested in a lab showed levels of glyphosate between 8.02 and 1,123.5 parts per billion. SEE ALSO: 'Erin Brockovich' chemical found in more than 200 million Americans' tap water Food Democracy Now! and bloggers like FoodBabe will tell you yes, drop those Cool Ranch Doritos immediately, because they could give you cancer. But outside experts say the findings are no cause for alarm and stoke more fear than scientific understanding. "None of these [results] strike me as particularly worrisome," said David Eastmond, a toxicologist at the University of California, Riverside, who chairs the school's cell biology and neuroscience department. Glyphosate is the world's most widely used herbicide in agriculture and gardening. Several global scientific agencies have found the chemical is unlikely to cause cancer in people exposed to it through food. Food Democracy Now!, a non-governmental organization, enlisted Anresco Laboratories to carry out the study. The food safety testing lab is registered with the U.S. Food and Drug Administration. Researchers found original Cheerios had the highest level of glyphosate compared to other foods tested, at about 1,123.5 parts per billion — or 1.125 milligrams of glyphosate per 1 kilogram of cereal. Say you weighed 50 kilograms, or 110 pounds, and ate a kilogram of Cheerios. That means you would ingest about 0.022 milligrams of glyphosate per kilogram of body weight. That would be ok, since the U.N. agency estimates show you could ingest between 0 and 1 milligrams per kilogram of body weight every day, over a lifetime, with no substantial risk to your health. To hit that daily upper limit, a 110-pound person would have to eat about 45.5 kilograms of Cheerios per day. That's equal to nearly 130 boxes of 12.5-ounce Cheerios every day, over the course of years. On their own, those numbers seem meaningless. Who will realistically eat that much cereal in 24 hours, and do so day after day? However, since most people regularly eat a range of cereals and snack foods, their total exposure to glyphosate may be higher than results for a single item suggest. And the less you weigh, the more glyphosate you consume relative to your body weight, so toddlers munching on Cheerios have much higher exposure. Still, the results are "nothing to be alarmed by," Eastmond told Mashable.  While he didn't dismiss the study outright, he said its conclusions are far from certain. The research must be replicated, scrutinized and tested in various settings before scientists can determine whether residue on snack foods is actually a health threat. In May, two United Nations agencies, the Food and Agriculture Organization and the World Health Organization, concluded that glyphosate is unlikely to cause cancer in people via their diets. The joint safety assessment looked at the chemical's cancer risk — that is, whether it could cause cancer or damage cells in real-life conditions and at current levels. The agencies assessed about 20 studies in rats, and found there was no convincing evidence of cancer. Studies on mice did suggest some evidence of cancer, but at doses so high they were not considered relevant to human exposure. The EU-backed European Food Safety Authority last fall similarly found that glyphosate is unlikely to be carcinogenic in humans. A farmer in Bunceton, Missouri holds up Roundup-resistant soybeans at his family farm, July 5, 2008. In its report, Food Democracy Now! said glyphosate is "unsafe on any plate" and pointed to rodent studies that other agencies found were not proof of a cancer risk. A recent finding by the International Agency for Research on Cancer (IARC) has further confused the public. The agency, part of the World Health Organization, found in 2015 that glyphosate may pose a cancer "hazard," meaning that at some unknown, possibly very high level, glyphosate could potentially cause cancer in humans. Other scientists have disputed IARC's approach, given that hazards do not reflect real-world conditions. Monsanto's Roundup is stocked at a store in Frederick, Maryland, March 28, 2015. Robert Tarone, a biostatistician formerly with the U.S. National Cancer Institute and the International Epidemiology Institute, said the IARC's cancer finding was the result of a "flawed and incomplete summary of the experimental evidence" from animal studies, according to his May paper in the European Journal of Cancer Prevention.  But the public is clearly still worried.  Blog posts featured on FoodBabe and the Huffington Post about the report earned enough attention this week to prompt Monsanto to issue a rare response on its Facebook page. The U.S. agrochemical giant called the report a "scare tactic." Tarone, the retired biostatistician, agreed that studies making wholesale claims on limited evidence produce more confusion than proof. "The average person has no idea how to interpret the exposure levels," he told Mashable. BONUS: 7 benefits of matcha: Why everyone's talking about this green tea powder

Lipworth L.,International Epidemiology Institute | Lipworth L.,Vanderbilt University | Holmich L.R.,Herlev Hospital | McLaughlin J.K.,International Epidemiology Institute | McLaughlin J.K.,Vanderbilt University
Seminars in Immunopathology | Year: 2011

The association of silicone breast implants with connective tissue diseases (CTDs), including systemic sclerosis, systemic lupus erythematosus, rheumatoid arthritis, and fibromyalgia, as well as a hypothesized new "atypical" disease, which does not meet established diagnostic criteria for any known CTD, has been extensively studied. We have reviewed the epidemiologic literature regarding an association between cosmetic breast implants and CTDs, with particular emphasis on results drawn from the most recent investigations, many of which are large cohort studies with long-term follow-up, as well as on those studies that address some of the misinformation and historically widespread claims regarding an association between breast implants and CTDs. These claims have been unequivocally refuted by the remarkably consistent evidence from published studies, as well as numerous independent meta-analyses and critical reviews, which have demonstrated that cosmetic breast implants are not associated with a subsequent increased occurrence of individual CTDs or all CTDs combined, including fibromyalgia. Moreover, there is no credible evidence for the conjectured excess of "atypical" CTD among women with cosmetic breast implants, or of a rheumatic symptom profile unique to these women. No increased risk of CTDs is evident in women with extracapsular ruptures in two studies, which evaluated risk by implant rupture status, and no consistent association has been observed between silicone breast implants and a variety of serologic markers or autoantibodies. Thus, any claims that remain regarding an association between cosmetic breast implants and CTDs are not supported by the scientific literature but rather are a residual byproduct of the unprecedented large-scale product liability litigation in the USA. © Springer-Verlag 2011.

Conway B.N.,Vanderbilt University | Conway B.N.,West Virginia University | May M.E.,Vanderbilt University | Blot W.J.,Vanderbilt University | Blot W.J.,International Epidemiology Institute
Diabetes Care | Year: 2012

OBJECTIVE - To estimate mortality rates and risk factors for mortality in a low-socioeconomic status (SES) population of African Americans and whites with diabetes. RESEARCH DESIGN AND METHODS - We determined mortality among African Americans and whites aged 40-79 years with (n = 12,498) and without (n = 49,914) diabetes at entry into a cohort of participants recruited from government-funded community health centers. Multivariable Cox analysis was used to estimate mortality hazard ratios (HRs) (95% CI) among those with versus those without diabetes and among those with diabetes according to patient characteristics. RESULTS - During follow-up (mean 5.9 years), 13.5% of those with and 7.3% of those without diabetes died. All-cause mortality risk was higher among those with versus without diabetes for both African Americans (HR 1.84 [95% CI 1.71- 1.99]) and whites (1.80 [1.58-2.04]), although among those with diabetes, mortality was lower among African Americans than whites (0.78 [0.69-0.87]). Mortality risk increased with duration of diabetes and was greater among patients on insulin therapy and reporting histories of cardiovascular disease (CVD), hypertension, and stroke. The HRs associated with these multiple risk factors tended to be similar by sex and race, with the exception of a differentially higher impact of prevalent CVD on mortality among African Americans (interaction P value = 0.03), despite a lower baseline prevalence of CVD. CONCLUSIONS - In this population with similarly low SES and access to health care, strong and generally similar predictors of mortality were identi fied for African Americans and whites with diabetes, with African Americans at a moderately but significantly lower mortality risk. © 2012 by the American Diabetes Association.

Sonderman J.S.,International Epidemiology Institute | Munro H.M.,International Epidemiology Institute | Blot W.J.,International Epidemiology Institute | Blot W.J.,Vanderbilt University | And 2 more authors.
American Journal of Epidemiology | Year: 2012

Prospective epidemiologic studies generally rely on 1 baseline biologic sample from participants for measurement of prediagnostic biomarkers, assuming that 1 measurement adequately represents the participant's "typical" level. The body of work assessing the reproducibility of circulating serum 25-hydroxyvitamin D (25(OH)D) levels over time focuses almost exclusively on populations of European descent, and data for vitamin D-binding protein (VDBP) are virtually nonexistent. Thus, the authors measured levels of serum 25(OH)D and VDBP twice in samples collected between 2005 and 2008 from 225 participants (155 black, 70 white) in the Southern Community Cohort Study. Reproducibility for 25(OH)D was uniformly high, with adjusted intraclass correlation coefficients (ICCs) of 0.84 (95 confidence interval (CI): 0.79, 0.88) for blacks and 0.92 (95 CI: 0.87, 0.95) for whites, and there was substantial agreement for assignment of 25(OH)D quartile (κ 0.83, 95 CI: 0.78, 0.87) and vitamin D adequacy status (κ 0.76, 95 CI: 0.69, 0.83). VDBP levels were highly stable over time, with adjusted ICCs of 0.97 (95 CI: 0.96, 0.98) for blacks and 0.96 (95 CI: 0.93, 0.97) for whites. These findings suggest that single, baseline 25(OH)D and VDBP serum measurements provide reasonably representative measures of these compounds for both white and black adults, demonstrating their utility as epidemiologic biomarkers in prospective studies. © 2012 The Author.

Ioannidis J.P.A.,Stanford University | Tarone R.,International Epidemiology Institute | McLaughlin J.K.,Stanford University
Epidemiology | Year: 2011

The ratio of false-positive to false-negative findings (FP:FN ratio) is an informative metric that warrants further evaluation. The FP:FN ratio varies greatly across different epidemiologic areas. In genetic epidemiology, it has varied from very high values (possibly even >100:1) for associations reported in candidate-gene studies to very low values (1:100 or lower) for associations with genome-wide significance. The substantial reduction over time in the FP:FN ratio in human genome epidemiology has corresponded to the routine adoption of stringent inferential criteria and comprehensive, agnostic reporting of all analyses. Most traditional fields of epidemiologic research more closely follow the practices of past candidate gene epidemiology, and thus have high FP:FN ratios. Further, FP and FN results do not necessarily entail the same consequences, and their relative importance may vary in different settings. This ultimately has implications for what is the acceptable FP:FN ratio and for how the results of published epidemiologic studies should be presented and interpreted. © 2011 by Lippincott Williams & Wilkins.

Lipworth L.,International Epidemiology Institute | McLaughlin J.K.,International Epidemiology Institute
Current Psychiatry Reports | Year: 2010

Five large epidemiologic mortality studies of women with cosmetic breast implants have consistently reported a two- to threefold higher rate of suicide compared with the general female population. Overall, 135 suicides have been observed, compared with 66.9 expected, yielding a significantly elevated standardized mortality ratio of 2.0 (95% CI, 1.5-2.6). In addition to suicides, excesses from other external causes of death related to drug and alcohol abuse/dependence, atypical motor vehicle accidents, and other self-harm causes have been consistently reported. These observations, together with limited but direct epidemiologic evidence of preimplant psychiatric hospitalization, as well as self-reports of preimplant psychiatric disorders, including depression, eating disorders, and body image dissatisfaction, among implant women raise the possibility of significant underlying psychiatric morbidity for a subgroup of implant patients. Research into the psychiatric profiles and history of the women who have committed suicide in the investigated cohorts appears warranted. © Springer Science+Business Media, LLC 2010.

McLaughlin J.K.,International Epidemiology Institute | Tarone R.E.,International Epidemiology Institute
Cancer Epidemiology Biomarkers and Prevention | Year: 2013

Background: A recent attempt to estimate the false-positive rate for cancer epidemiology studies is based on agents in International Agency for Research on Cancer (IARC) category 3 (agent not classifiable as to its carcinogenicity to humans) in the IARC Monographs Program. Methods: The estimation method is critiqued regarding biases caused by its reliance on the IARC classification criteria for assessing carcinogenic potential. Results: The privileged position given to epidemiologic studies by the IARC criteria ensures that the percentage of positive epidemiologic studies for an agent will depend strongly on the IARC category to which the agent is assigned. Because IARC category 3 is composed of agents with the lowest-assessed carcinogenic potential to which the estimation approach in question could be applied, a spuriously low estimated false-positive rate was necessarily the outcome of this approach. Conclusions: Tendentious estimation approaches like that employed will by necessity produce spuriously low and misleading false positive rates. Impact: The recently reported estimates of the false-positive rate in cancer epidemiology are seriously biased and contribute nothing substantive to the literature on the very real problems related to false-positive findings in epidemiology. ©2012 AACR.

Boice Jr. J.D.,International Epidemiology Institute | Boice Jr. J.D.,Vanderbilt Epidemiology Center
Health Physics | Year: 2011

Epidemiology is the study of the distribution and causes of disease in humans. Studies of human populations exposed to ionizing radiation have been conducted for nearly 100 y during the "Golden Age of Radiation Epidemiology." Radiation epidemiology is now so sophisticated that human studies are the basis for radiation protection standards and for compensation schemes in response to claims of ill health from prior exposures. The studies of exposed human populations are very broad and include not only the Japanese atomic bomb survivors, but also patients given radiotherapy for cancer, patients treated with radiation for nonmalignant disease, patients given diagnostic radiation, persons with intakes of radionuclides, workers exposed to occupational radiation, and communities exposed to environmental sources of radiation. But there is more to be learned, and future knowledge may be advanced from new and continued occupational studies of the early radiation workers, atomic veterans, medically exposed patients, and populations living in areas of high natural background radiation. The interaction between radiation and underlying genetic susceptibilities is an important emerging area of research. It is indeed an honor to be included among the Lauriston S. Taylor Lecturers. Health Phys. 100(1):59 -76; 2011 © 2010 Health Physics Society.

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