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Gallagher L.G.,University of Washington | Davis L.B.,University of Washington | Ray R.M.,Fred Hutchinson Cancer Research Center | Psaty B.M.,University of Washington | And 5 more authors.
International Journal of Epidemiology | Year: 2011

Background: Few studies have examined the possible effects of reproductive factors on cardiovascular disease (CVD) risks in Asian women. Methods: A cohort of 267 400 female textile workers in Shanghai, China, was administered a questionnaire at enrolment (1989-91) and followed for mortality through 2000. Relative risks (hazard ratios) for ischaemic heart disease (IHD), ischaemic stroke and haemorrhagic stroke were calculated using Cox proportional hazards modelling, adjusting for relevant co-variates. Results: Risks were not consistently associated with age at menopause, parity, stillbirths, miscarriages or duration of lactation. An increasing trend in IHD mortality risk, but not stroke, was observed with decreasing age at menarche. There was no evidence of increased CVD mortality risk by oral or injectable contraceptive use or induced abortions. As expected, greater mortality rates from CVD and increased CVD risks were also observed with smoking. Conclusions: Use of steroid contraceptives, induced abortions and reduced parity from China's one-child-per-family policy has not had an adverse effect on risk of CVD mortality in this cohort. Published by Oxford University Press on behalf of the International Epidemiological Association. © The Author 2011; all rights reserved.


Nelson Z.C.,Centers for Disease Control and Prevention | Ray R.M.,Fred Hutchinson Cancer Research Center | Wu C.,Fred Hutchinson Cancer Research Center | Stalsberg H.,University of Tromso | And 9 more authors.
Journal of Nutrition | Year: 2010

Fibroadenomas are common benign breast conditions among women and account for ∼50% of breast biopsies performed. Dietary factors are known to influence benign breast conditions in the aggregate, but little is known of their association specifically with fibroadenoma. Our objective in this study was to evaluate the association between dietary and other factors and fibroadenoma risk. A case-control study, nested in a randomized trial of breast self-examination (BSE) in Chinese textile workers in Shanghai, China, was conducted between 1989 and 2000. The study sample included 327 affected women and 1070 controls. Women were administered a FFQ and a questionnaire that elicited reproductive and gynecological history and other information. Odds ratios, as estimates of relative risks, were calculated using multivariate conditional logistic regression. Significant decreasing trends in risk of fibroadenoma were observed with intake of fruits and vegetables and with number of live births, and a reduced risk was also associated with natural menopause, oral contraceptive use, and moderate exercise (walking and gardening). Increased risk of fibroadenoma was associated with heavy physical activity in one's 20s, breast cancer in a first-degree relative, and a history of prior benign breast lumps; and significant increasing trends in risk were observed with numbers of BSE per year and years of education. In conclusion, a diet rich in fruits and vegetables and the use of oral contraceptives may reduce risk of fibroadenoma. © 2010 American Society for Nutrition.


Gallagher L.G.,University of Washington | Rosenblatt K.A.,University of Illinois at Urbana - Champaign | Ray R.M.,Fred Hutchinson Cancer Research Center | Li W.,Fred Hutchinson Cancer Research Center | And 5 more authors.
Cancer Causes and Control | Year: 2013

Purpose: Hormonal factors may play a role in the development of lung cancer in women. This study examined the relationship between lung cancer and reproductive factors in a large cohort of women, most of whom never smoked (97 %). Methods: A cohort of 267,400 female textile workers in Shanghai, China, enrolled in a trial of breast self-examination provided information on reproductive history, demographical factors, and cigarette smoking at enrollment in 1989-91. The cohort was followed until July of 2000 for incidence of lung cancer; 824 cases were identified. Hazard ratios (HR) and 95 % confidence intervals (CI) associated with selected reproductive factors were calculated using Cox proportional hazards modeling, adjusting for smoking, age, and also parity when relevant. Results: Nulliparous women were at increased risk compared to parous women (HR = 1.33, 95 % CI 1.00-1.77). Women who had gone through menopause at baseline were at increased risk compared to women of the same age who were still menstruating. Risk was higher in women with a surgical menopause (HR = 1.64, 95 % CI 0.96-2.79) than in those with a natural menopause (HR = 1.35, 95 % CI 0.84-2.18), and risk was highest in those postmenopausal women with a hysterectomy and bilateral oophorectomy at baseline (HR = 1.39, 95 % CI 0.96-2.00), although the risk estimates were not statistically significant. Conclusions: These results support experimental data that demonstrate a biological role for hormones in lung carcinogenesis. © 2013 Springer Science+Business Media Dordrecht.


Gallagher L.G.,University of Washington | Li W.,Fred Hutchinson Cancer Research Center | Ray R.M.,Fred Hutchinson Cancer Research Center | Romano M.E.,Brown University | And 5 more authors.
American Journal of Industrial Medicine | Year: 2015

Background: Associations between stomach and esophageal cancer and exposures to dusts, metals, chemicals, and endotoxin in the workplace are not very well understood, particularly in women. Methods: We followed 267,400 female textile workers in Shanghai, China for cancer incidence from 1989 to 2006. Stomach (n=1374) and esophageal (n=190) cancer cases were identified and a comparison subcohort (n=3187) was randomly selected. Cox proportional hazard modeling was used, adjusting for age and smoking. Results: Increasing stomach cancer risk was observed with increasing duration of synthetic fiber dust exposure (p=0.03), although the magnitude of effect was small (20 + years: HR=1.2, 95% CI 1.1-1.4). Trends with endotoxin exposure were modestly inversed for esophageal cancer and increased for stomach cancer, but with little deviation from a null association. Conclusions: Our findings demonstrate that long durations of synthetic fiber dust exposure can increase stomach cancer risk in women, but provide limited support for associations with other textile industry exposures. Am. J. Ind. Med. 58:267-275, 2015. © 2015 Wiley Periodicals, Inc.


Gallagher L.G.,University of Washington | Ray R.M.,Fred Hutchinson Cancer Research Center | Li W.,Fred Hutchinson Cancer Research Center | Psaty B.M.,University of Washington | And 5 more authors.
American Journal of Industrial Medicine | Year: 2012

Background: Exposure to textile fiber dusts, like particulate air pollution, may be associated with cardiovascular disease (CVD) mortality. Bacterial endotoxin, a potent inflammagen found in cotton dust, may be a specific risk factor. Methods: Female textile workers (N=267,400) in Shanghai, China were followed for CVD mortality (1989-2000). Factory exposures were approximated by sector classifications based on materials and processes. Quantitative endotoxin and cotton dust measures were available for a subcohort (n=3,188). Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence interval (CI). Results: Slightly elevated mortality risk for the cotton sector was seen for ischemic stroke (HR=1.12, 95% CI: 0.97-1.31) and hemorrhagic stroke (HR=1.12, 95% CI: 1.02-1.23). Similar hemorrhagic stroke mortality risk was observed in high dust sectors (HR=1.12, 95% CI: 1.02-1.24). No association was observed for ischemic heart disease. Conclusions: Exposures in textile factories may have contributed to CVD mortality among this cohort. The specific components of these exposures that may be harmful are not clear and should be further investigated. © 2012 Wiley Periodicals, Inc.

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