Search

Objectives/hypothesis: To evaluate survival for nasopharyngeal carcinoma in relation to socioeconomic status., Study Design: Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) Census Tract-level Socioeconomic Status Database (2000-2016)., Methods: Patients with nasopharyngeal carcinoma diagnosed between 2000 and 2016 were identified. Data were stratified based on socioeconomic status, divided into three groups: group 1 being the poorest and group 3 the wealthiest. Univariate analysis as well as multivariate Cox regression analysis adjusted for individual variables was performed., Results: A total of 5,527 patients were included in the study, with 33% in group 1, 34% in group 2, and 33% in group 3. There was a significant difference between groups in regard to age at diagnosis, race, histologic subtype, overall stage, tumor stage, nodal stage, and whether or not they received radiation. Patients in group 1, the poorest socioeconomic status, were more likely to be young (P = .003), black (P < .0001), present with higher overall stage (P = .009), tumor stage (P = .01), and nodal stage (P = .02), and less likely to receive radiation (P = .005). In multivariate analysis, there was a significant difference in survival between the groups, with group 1 patients less likely to survive compared to group 3 (hazard ratio = 1.28; 95% CI 1.07-1.57)., Conclusions: Patients in the poorest socioeconomic status presented with more advanced nasopharyngeal cancer and were less likely to receive radiation when compared with individuals of higher socioeconomic status. The poorest socioeconomic status groups were less likely to survive from their disease when controlling for other variables., Level of Evidence: NA Laryngoscope, 131:2719-2723, 2021., (© 2021 The American Laryngological, Rhinological and Otological Society, Inc..)

Background: A 5-year longitudinal study examined nonmalignant respiratory effects of wood processing dust exposure., Methods: Ten study plants, investigator selected from 447 candidate plants, included 1 sawmill-planing-plywood, 1 plywood, 1 milling, 3 cabinet and 4 furniture facilities. Personal dust samples (2363) were divided into three size fractions (extrathoracic, tracheobronchial, and respirable) which were apportioned into wood solids (WS) and residual particulate matter (RPM), and used to compute each individuals TWA exposure for the 6 exposure types. Serial spirometric tests and medical, smoking and occupational questionnaires were collected with 1,164 subjects having adequate follow-up (minimum 3 datapoints over at least 2.5 years) for analyses. Forward selection regression was used to evaluate the effect of exposure on annual change in FEV(1), FVC, FEF(25-75), and FEV(1)/FVC., Results: There were no significant adverse effects of WS exposures (overall means were 0.66, 0.32, and 0.05 mg/m(3), for extrathoracic, tracheobronchial, and respirable fractions, respectively). Statistically significant effects were only to respirable RPM in the milling facility (mean exposures of 0.147 mg/m(3) associated with changes in FEV(1) = -32 ml/year, FEV(1)/FVC = -0.48%/year, and FEF(25-75) = -0.11 l/s/year) and in the sawmill-planing-plywood facility (mean exposures of 0.255 mg/m(3) associated with changes in FEV(1) = -59 ml/year and FVC = -103 ml/year)., Conclusion: Exposure to WS was not associated with significant adverse effects. Respirable RPM was associated with an obstructive effect in the milling facility, and respirable RPM was also associated with a restrictive effect in the sawmill-planing plywood facility. Finally, this study does not exclude the possibility that other exposures common to this industry can cause respiratory effects, only that none were noted in this population for wood solids for the exposure levels and durations studied.

Background: The aim was to investigate the respiratory response of HDI-based paint aerosol within the context of the protection afforded by current exposure guidelines., Methods: A cross-sectional study of 240 painters spraying polyurethane enamels was undertaken at four aircraft maintenance plants. Questionnaire and spirometric data were related to gravimetric measures of cumulative total and respirable paint aerosol (TPA and RPA) and estimated isocyanate in total and respirable aerosols (TIA and RIA)., Results: Average cumulative exposures in mg/m(3)-years +/- SD were 159.0 +/- 115.2 TPA, 19.1 +/- 13.8 RPA, 15.8 +/- 11.5 TIA, and 1.9 +/- 1.4 RIA. After adjusting for smoking and asthma symptoms, higher exposures were associated with statistically significant reduction in expiratory flowrates. Significant smoking-related reductions were also observed, without exposure interactions., Conclusions: These results suggest important respiratory effects from exposures to spray paint aerosols at levels generally in compliance with existing standards for otherwise unregulated particulates and for the isocyanate component of the paint.