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OBJECTIVE: To examine the risk of lung cancer among men associated with exposure to diesel engine emissions incurred in a wide range of occupations and industries. METHODOLOGY: 2 population-based lung cancer case-control studies were conducted in Montreal. Study I (1979-1986) comprised 857 cases and 533 population controls; study II (1996-2001) comprised 736 cases and 894 population controls. A detailed job history was obtained, from which we inferred lifetime occupational exposure to 294 agents, including diesel engine emissions. ORs were estimated for each study and in the pooled data set, adjusting for socio-demographic factors, smoking history and selected occupational carcinogens. While it proved impossible to retrospectively estimate absolute exposure concentrations, there were estimates and analyses by relative measures of cumulative exposure. RESULTS: Increased risks of lung cancer were found in both studies. The pooled analysis showed an OR of lung cancer associated with substantial exposure to diesel exhaust of 1.80 (95% CI 1.3 to 2.6). The risk associated with substantial exposure was higher for squamous cell carcinomas (OR 2.09; 95% CI 1.3 to 3.2) than other histological types. Joint effects between diesel exhaust exposure and tobacco smoking are compatible with a multiplicative synergistic effect. DISCUSSION: Our findings provide further evidence supporting a causal link between diesel engine emissions and risk of lung cancer. The risk is stronger for the development of squamous cell carcinomas than for small cell tumours or adenocarcinomas. [ABSTRACT FROM AUTHOR]

Context Retrospective exposure assessment in population-based case-control studies poses a major challenge due to the wide range of occupations and industries involved. The FINJEM is a generic job-exposure matrix (JEM) developed in Finland, which represents a potentially cost-effective exposure assessment tool. While FINJEM has been used in several studies outside Finland, little is known of its applicability in other countries. Methods We compared prevalence and intensity of exposure in FINJEM with a JEM developed from expert assessments of occupational histories obtained in a population-based case-control study in Montreal. Agreement for prevalence of exposure was measured by weighted [kappa] coefficients between prevalence categories. Agreement for exposure intensity was measured by Spearman correlation coefficients between cells with non-null exposure. Results The comparison involved 27 chemicals, the time period 1945-1995 and included 4743 jobs initially assessed by the Montreal experts. 4293 combinations of agent, occupational title and period were available for comparison of prevalence. Agent-specific prevalence was consistently higher in the Montreal JEM (median difference 1.7%). Agent-specific [kappa] values between prevalence categories varied from 0.89 (welding fumes) to 0.07 (flour dust). The comparison of exposure levels involved 14 agents and 198 cells with non-null exposure in both sources. Agent-specific Spearman correlation varied from 0.89 (flour dust) to -0.35 (benzo(a)pyrene). Conclusion Our observations suggest that information concerning several agents (eg, metals, welding fumes) can be successfully transported from Finland to Canada and probably other countries. However, for other agents, there was considerable disagreement, and hence, transportability of FINJEM cannot be assumed by default. [ABSTRACT FROM AUTHOR]

Rationale: Diesel motor exhaust is classified by the International Agency for Research on Cancer as probably carcinogenic to humans. The epidemiologic evidence is evaluated as limited because most studies lack adequate control for potential confounders and only a few studies have reported on exposure-response relationships.Objectives: Investigate lung cancer risk associated with occupational exposure to diesel motor exhaust, while controlling for potential confounders.Methods: The SYNERGY project pooled information on lifetime work histories and tobacco smoking from 13,304 cases and 16,282 controls from 11 case-control studies conducted in Europe and Canada. A general population job exposure matrix based on ISCO-68 occupational codes, assigning no, low, or high exposure to diesel motor exhaust, was applied to determine level of exposure.Measurements and Main Results: Odds ratios of lung cancer and 95% confidence intervals were estimated by unconditional logistic regression, adjusted for age, sex, study, ever-employment in an occupation with established lung cancer risk, cigarette pack-years, and time-since-quitting smoking. Cumulative diesel exposure was associated with an increased lung cancer risk highest quartile versus unexposed (odds ratio 1.31; 95% confidence interval, 1.19-1.43), and a significant exposure-response relationship (P value < 0.01). Corresponding effect estimates were similar in workers never employed in occupations with established lung cancer risk, and in women and never-smokers, although not statistically significant.Conclusions: Our results show a consistent association between occupational exposure to diesel motor exhaust and increased risk of lung cancer. This association is unlikely explained by bias or confounding, which we addressed by adjusted models and subgroup analyses. [ABSTRACT FROM AUTHOR]

The relapse of the nasal deviations, in particular the cartilaginous portion, is determined by cartilage intrinsic stress. The authors use the disentail antero-posterior technique to remove an L shape cartilage portion. To avoid complications, we suggest a minor cartilage dissection. The intranasal examination is necessary looking for a cartilaginous deviation without external manifestation in the nasal pyramid. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the effects of exposure to occupational asbestos and man-made vitreous fibers (MMVF) across a wide range of occupations on risk of mesothelioma. METHODOLOGY: Two population-based case-control studies (1979-1986 and 1996-2001) provided 35 histologically confirmed mesothelioma cases and 1965 controls. A detailed job history was obtained to evaluate occupational exposure to many agents, including asbestos and MMVF. RESULTS: The mesothelioma odds ratio for exposure to any asbestos type was 3.7 (95% confidence interval = 1.7 to 7.8). The subset exposed to amphibole fibers experienced an odds ratio = 7.0 (95% confidence interval = 2.7 to 18.5). Effects of MMVF could not be disentangled from those of asbestos. DISCUSSION: In workers with exposure levels lower than in most historical cohort studies and across a wide range of industries, a strong association was found between asbestos, especially when it was amphibole, and mesothelioma. [ABSTRACT FROM AUTHOR]

The supratip prominence is one of the most common deformity that requires a revision rhinoplasty. Their etiology can result from a variety of causes, that including poor management of skeletal tissue in the supratip region. The authors add an unpublished cause: septal fistula (septal communication). The overstepped mucosal at the inferior edge and the anterior septal angle, with the exceeding mucosal from opposite side, producing a permanent septal communication. The diagnosis is based on the clinical exploration; we recommend an exhaustive inspection of the nasal fosses (septum). Surgical procedure consist on surgical resection of the communication using local septal flaps for plastic repair. Finally we describe the preventive management. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of occupational asbestos and man-made vitreous fibers (MMVF) on the risk of lung cancer in two population-based case-control studies entailing exposure at lower levels than in historic cohort studies.Methodology: Study I (1979 to 1986) comprised 857 cases and 1066 population and cancer controls. Study II (1996 to 2001) comprised 858 cases and 1295 population controls. A detailed job history was obtained to evaluate lifetime occupational exposure to 294 agents, including asbestos and MMVF.Results: We found increased risks for substantial exposure to asbestos (odds ratio = 1.78; 95% confidence interval: 0.94 to 3.36). The corresponding odds ratio for substantial exposure to MMVF was 1.10 (95% confidence interval: 0.37 to 3.22).Discussion: Low and moderate levels of exposure to asbestos, as encountered in this population, were associated with some excess risk of lung cancer. Results for MMVF were inconclusive. [ABSTRACT FROM AUTHOR]

Objectives: We investigated the effects of alcohol consumption on the risk of cancers of the upper aerodigestive tract (UADT) in a hospital-based case-control study in Brazil.Methods: A total of 784 cases of cancers of the mouth, pharynx, and larynx and 1578 non-cancer controls matched on age, gender, hospital area, and admission period provided information on alcohol drinking, smoking, and other characteristics via interview. Using logistic regression, we evaluated the relative risks (RR) of UADT cancer for different beverage types based on cumulative ethanol content exposure and frequency of consumption.Results: Relative to nondrinkers of any alcohol, risks of UADT cancers varied across sites both with increased exposure to ethanol and by alcohol type. RRs at equivalent levels of ethanol consumption were highest for cancers of the mouth for hard liquor (6.9 for > 100 kg lifetime consumption, 95% confidence interval (CI) = 2.8-17.1) and cachaça (4.5 for 101-500 kg, 95% CI = 2.2-9.0). Although RRs increased with frequency of drinks per week, when evaluated against higher proportional alcohol intake, reductions in risk were observed for beer and wine.Conclusion: Although methods of measurement can influence the interpretation of the carcinogenic nature of alcohols, increased RRs persisted with continued exposure for all types. [ABSTRACT FROM AUTHOR]