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International Journal of Epidemiology
Journal Prestige (SJR): 3.969
Citation Impact (citeScore): 5
Number of Followers: 313  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0300-5771 - ISSN (Online) 1464-3685
Published by Oxford University Press Homepage  [415 journals]
  • The challenge of conducting epidemiological research in times of pandemic
           and denialism: 1-year anniversary of the EPICOVID-19 project in Brazil

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      Authors: Hallal P; Victora C, Silveira M, et al.
      Pages: 1049 - 1052
      Abstract: As of 20 May 2021, Brazil was the country with the second-highest number of COVID-19 deaths and the third-highest number of COVID-19 cases in absolute numbers in the world. In relative numbers, on 20 May 2021, the 7-day daily rolling average of deaths was 9.08 per million people in Brazil. From the beginning of the pandemic until 20 May 2021, the Brazilian cumulative mortality rate was 2078 per million inhabitants. In late 2020, Manaus, a state capital in the heart of the Amazon region, experienced chaos as oxygen supplies were depleted and intensive care unit (ICU) occupancy exceeded 100%, generating waiting lists. A couple of months later, all remaining 25 states in Brazil experienced the same problem, with waiting lists for ICU beds and shortages of medical supplies. The surge of a new variant (P.1.) in the country in late 2020 partially explains this chaotic situation, but the variant was actually both a cause and a consequence of Brazil’s monumental failure at responding to the pandemic, as variants are more likely to emerge in places where the virus is circulating widely. Fifteen months into the pandemic, and despite these frightening numbers, Brazil has adopted neither national- nor state-level lockdowns, and the president himself fails to wear a mask at public gatherings. As scientists, we attempt to counterattack by disseminating evidence-based policies implemented in other countries and by conducting much-needed research, as we describe below.
      PubDate: Sat, 03 Jul 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab129
      Issue No: Vol. 50, No. 4 (2021)
       
  • Rounding up the usual suspects: confirmation bias in epidemiological
           research

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      Authors: Braithwaite R; Ban K, Stevens E, et al.
      Pages: 1053 - 1057
      Abstract: Investigators performing epidemiological research frequently form hypotheses based on data availability. One might ask how it could be otherwise. After all, what is the point of forming hypotheses if they can’t be tested' But when questions are identified to suit available data rather than data being identified to suit important questions, commonalities in measured and unmeasured variables extend across multiple studies and lead to a confirmation bias. Expected relationships are confirmed, and unexpected relationships remain undiscovered, even when their unveiling would have important informational value. We argue that this confirmation bias results from a structural cause, in particular misalignment of epidemiological research priorities with the social utility of research.
      PubDate: Fri, 30 Apr 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab091
      Issue No: Vol. 50, No. 4 (2021)
       
  • Data Resource Profile: Surveillance System of Risk and Protective Factors
           for Chronic Diseases by Telephone Survey for adults in Brazil (Vigitel)

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      Authors: da Silva L; Gouvêa E, Stopa S, et al.
      Pages: 1058 - 1063
      Abstract: Brazilian Ministry of Health10.13039/501100006506Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)001Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)309293/2016–2407331/2016–6
      PubDate: Sat, 29 May 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab104
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cohort Profile: Early Pandemic Evaluation and Enhanced Surveillance of
           COVID-19 (EAVE II) Database

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      Authors: Mulholland R; Vasileiou E, Simpson C, et al.
      Pages: 1064 - 1074
      Abstract: National Institute for Health Research Health Technology Assessment Programme13/34/14Medical Research Council10.13039/501100000265MR/R008345/1Scottish Government10.13039/100012095BREATHE—The Health Data Research Hub for Respiratory HealthMC_PC_19004UK Research and Innovation Industrial Strategy Challenge Fund and delivered through Health Data Research UK
      PubDate: Sat, 05 Jun 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab028
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cohort Profile: The Care Trajectories—Enriched Data (TorSaDE) cohort

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      Authors: Vanasse A; Chiu Y, Courteau J, et al.
      Pages: 1066 - 1066h
      Abstract: Healthcare trajectoriesCanadian Community Health Survey (CCHS)longitudinal administrative datachronic diseases
      PubDate: Sat, 20 Nov 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa167
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cohort Profile: The TEMPO Cohort Study

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      Authors: Mary-Krause M; Herranz Bustamante J, Bolze C, et al.
      Pages: 1067 - 1068k
      Abstract: TEMPOAgence Nationale de la Recherche (ANR)Institut de Recherche En Santé Publique (IRESP)Mission Interministérielle de Lutte contre les Drogues Et les Conduites Addictives (MILDeCA)Institut National du CAncer (INCA) and Fondation Pfizer
      PubDate: Thu, 20 May 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab026
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cohort Profile: The Hong Kong Cardiovascular Risk Factor Prevalence Study
           (CRISPS) and the follow-up studies

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      Authors: Lui D; Lee C, Woo Y, et al.
      Pages: 1069 - 1069h
      Abstract: CRISPScardiovascular diseasesdiabetes mellitusmetabolic syndromecohort profileChinese
      PubDate: Mon, 04 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa240
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cohort Profile Update: The Yorkshire Health Study

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      Authors: Stephenson J; Smith C, Goyder E, et al.
      Pages: 1070 - 1070d
      Abstract: Research platformpublic healthlong-term conditionshealthlifestylehealthcare resource usage
      PubDate: Thu, 11 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa272
      Issue No: Vol. 50, No. 4 (2021)
       
  • bootComb—an R package to derive confidence intervals for combinations of
           independent parameter estimates

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      Authors: Henrion M.
      Pages: 1071 - 1076
      Abstract: AbstractMotivationTo address the limits of facility- or study-based estimates, multiple independent parameter estimates may need to be combined. Specific examples include (i) adjusting an incidence rate for healthcare utilisation, (ii) deriving a disease prevalence from a conditional prevalence and the prevalence of the underlying condition, (iii) adjusting a seroprevalence for test sensitivity and specificity. Calculating combined parameter estimates is generally straightforward, but deriving corresponding confidence intervals often is not. bootComb is an R package using parametric bootstrap sampling to derive such intervals.ImplementationbootComb is a package for the statistical computation environment R.General featuresApart from a function returning confidence intervals for parameters combined from several independent estimates, bootComb provides auxiliary functions for 6 common distributions (beta, normal, exponential, gamma, Poisson and negative binomial) to derive best-fit distributions for parameters given their reported confidence intervals.AvailabilitybootComb is available from the Comprehensive R Archive Network (https://CRAN.R-project.org/package=bootComb).
      PubDate: Wed, 19 May 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab049
      Issue No: Vol. 50, No. 4 (2021)
       
  • Seroprevalence of COVID-19 infection in the Emirate of Abu Dhabi, United
           Arab Emirates: a population-based cross-sectional study

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      Authors: Alsuwaidi A; Al Hosani F, Al Memari S, et al.
      Pages: 1077 - 1090
      Abstract: AbstractBackgroundThe United Arab Emirates (UAE) was the first country in the Middle East to report severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Serosurveys are essential to understanding the extent of virus transmission. This cross-sectional study aims to assess the seroprevalence of SARS-CoV-2 infection in the Emirate of Abu Dhabi.MethodsBetween 19 July and 14 August 2020, 4487 households were selected using a random sample stratified by region and citizenship of the head of household (UAE citizen or non-citizen). A cluster sample of 40 labour camps was selected. Data on socio-demographic characteristics, risk factors and symptoms compatible with coronavirus disease 2019 (COVID-19) were collected. Each participant was first tested by Roche Elecsys® Anti-SARS-CoV-2 assay, followed, when reactive, by the LIAISON® SARS-CoV-2 S1/S2 IgG assay.ResultsAmong 8831 individuals from households, seroprevalence was 10·4% [95% confidence intervals (CIs) 9·5–11·4], with higher seroprevalence in Abu Dhabi and Al Ain regions compared with those in Al Dhafra. In households, we found no sex difference and UAE citizens had lower seroprevalence compared with those of other nationalities. Among 4855 workers residing in labour camps, seroprevalence was 68·6% (95% CI 61·7–74·7), with higher seroprevalence among workers from Southeast Asia. In households, individuals with higher body mass indexes demonstrated higher seroprevalences than individuals with normal weight. Anosmia and ageusia were strongly associated with seropositivity.ConclusionsThe majority of household populations in the Emirate of Abu Dhabi remained unexposed to SARS-CoV-2. In labour camps, SARS-CoV-2 transmission was high. Effective public health measures should be maintained.
      PubDate: Sat, 24 Apr 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab077
      Issue No: Vol. 50, No. 4 (2021)
       
  • Syndromic surveillance using monthly aggregate health systems information
           data: methods with application to COVID-19 in Liberia

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      Authors: Fulcher I; Boley E, Gopaluni A, et al.
      Pages: 1091 - 1102
      Abstract: AbstractBackgroundEarly detection of SARS-CoV-2 circulation is imperative to inform local public health response. However, it has been hindered by limited access to SARS-CoV-2 diagnostic tests and testing infrastructure. In regions with limited testing capacity, routinely collected health data might be leveraged to identify geographical locales experiencing higher than expected rates of COVID-19-associated symptoms for more specific testing activities.MethodsWe developed syndromic surveillance tools to analyse aggregated health facility data on COVID-19-related indicators in seven low- and middle-income countries (LMICs), including Liberia. We used time series models to estimate the expected monthly counts and 95% prediction intervals based on 4 years of previous data. Here, we detail and provide resources for our data preparation procedures, modelling approach and data visualisation tools with application to Liberia.ResultsTo demonstrate the utility of these methods, we present syndromic surveillance results for acute respiratory infections (ARI) at health facilities in Liberia during the initial months of the COVID-19 pandemic (January through August 2020). For each month, we estimated the deviation between the expected and observed number of ARI cases for 325 health facilities and 15 counties to identify potential areas of SARS-CoV-2 circulation.ConclusionsSyndromic surveillance can be used to monitor health facility catchment areas for spikes in specific symptoms which may indicate SARS-CoV-2 circulation. The developed methods coupled with the existing infrastructure for routine health data systems can be leveraged to monitor a variety of indicators and other infectious diseases with epidemic potential.
      PubDate: Mon, 31 May 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab094
      Issue No: Vol. 50, No. 4 (2021)
       
  • Predicting and forecasting the impact of local outbreaks of COVID-19: use
           of SEIR-D quantitative epidemiological modelling for healthcare demand and
           capacity

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      Authors: Campillo-Funollet E; Van Yperen J, Allman P, et al.
      Pages: 1103 - 1113
      Abstract: AbstractBackgroundThe world is experiencing local/regional hotspots and spikes in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes COVID-19 disease. We aimed to formulate an applicable epidemiological model to accurately predict and forecast the impact of local outbreaks of COVID-19 to guide the local healthcare demand and capacity, policy-making and public health decisions.MethodsThe model utilized the aggregated daily COVID-19 situation reports (including counts of daily admissions, discharges and bed occupancy) from the local National Health Service (NHS) hospitals and COVID-19-related weekly deaths in hospitals and other settings in Sussex (population 1.7 million), Southeast England. These data sets corresponded to the first wave of COVID-19 infections from 24 March to 15 June 2020. A novel epidemiological predictive and forecasting model was then derived based on the local/regional surveillance data. Through a rigorous inverse parameter inference approach, the model parameters were estimated by fitting the model to the data in an optimal sense and then subsequent validation.ResultsThe inferred parameters were physically reasonable and matched up to the widely used parameter values derived from the national data sets by Biggerstaff M, Cowling BJ, Cucunubá ZM et al. (Early insights from statistical and mathematical modeling of key epidemiologic parameters of COVID-19, Emerging infectious diseases. 2020;26(11)). We validate the predictive power of our model by using a subset of the available data and comparing the model predictions for the next 10, 20 and 30 days. The model exhibits a high accuracy in the prediction, even when using only as few as 20 data points for the fitting.ConclusionsWe have demonstrated that by using local/regional data, our predictive and forecasting model can be utilized to guide the local healthcare demand and capacity, policy-making and public health decisions to mitigate the impact of COVID-19 on the local population. Understanding how future COVID-19 spikes/waves could possibly affect the regional populations empowers us to ensure the timely commissioning and organization of services. The flexibility of timings in the model, in combination with other early-warning systems, produces a time frame for these services to prepare and isolate capacity for likely and potential demand within regional hospitals. The model also allows local authorities to plan potential mortuary capacity and understand the burden on crematoria and burial services. The model algorithms have been integrated into a web-based multi-institutional toolkit, which can be used by NHS hospitals, local authorities and public health departments in other regions of the UK and elsewhere. The parameters, which are locally informed, form the basis of predicting and forecasting exercises accounting for different scenarios and impacts of COVID-19 transmission.
      PubDate: Fri, 09 Jul 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab106
      Issue No: Vol. 50, No. 4 (2021)
       
  • Impact of age-selective vs non-selective physical-distancing measures
           against coronavirus disease 2019: a mathematical modelling study

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      Authors: Ortega-Quijano D; Ortega-Quijano N.
      Pages: 1114 - 1123
      Abstract: AbstractBackgroundThere is a real possibility of successive COVID-19-epidemic waves with devastating consequences. In this context, it has become mandatory to design age-selective measures aimed at achieving an optimal balance between protecting public health and maintaining a viable economic activity.MethodsWe programmed a Susceptible, Exposed, Infected, Removed (SEIR) model in order to introduce epidemiologically relevant age classes into the outbreak-dynamics analysis. The model was fitted to the official death toll and calculated age distribution of deaths in Wuhan using a constrained linear least-squares algorithm. Subsequently, we used synthetic location-specific and age-structured contact matrices to quantify the effect of age-selective interventions both on mortality and on economic activity in Wuhan. For this purpose, we simulated four different scenarios ranging from an absence of measures to age-selective interventions with stronger physical-distancing measures for older individuals.ResultsAn age-selective strategy could reduce the death toll by >30% compared with the non-selective measures applied during Wuhan’s lockdown for the same workforce. Moreover, an alternative age-selective strategy could allow a 5-fold increase in the population working on site without a detrimental impact on the death toll compared with the Wuhan scenario.ConclusionOur results suggest that age-selective-distancing measures focused on the older population could have achieved a better balance between COVID-19 mortality and economic activity during the first COVID-19 outbreak in Wuhan. However, the implications of this need to be interpreted along with considerations of the practical feasibility and potential wider benefits and drawbacks of such a strategy.
      PubDate: Fri, 12 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab043
      Issue No: Vol. 50, No. 4 (2021)
       
  • Interactions between SARS-CoV-2 and influenza, and the impact of
           coinfection on disease severity: a test-negative design

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      Authors: Stowe J; Tessier E, Zhao H, et al.
      Pages: 1124 - 1133
      Abstract: AbstractBackgroundThe impact of SARS-CoV-2 alongside influenza is a major concern in the northern hemisphere as winter approaches.MethodsTest data for influenza and SARS-CoV-2 from national surveillance systems between 20 January 2020 and 25 April 2020 were used to estimate influenza infection on the risk of SARS-CoV-2 infection. A test-negative design was used to assess the odds of SARS-CoV-2 in those who tested positive for influenza compared with those who tested negative. The severity of SARS-CoV-2 was also assessed using univariable and multivariable analyses.ResultsThe risk of testing positive for SARS-CoV-2 was 58% lower among influenza-positive cases and patients with a coinfection had a risk of death of 5.92 (95% confidence interval: 3.21–10.91) times greater than among those with neither influenza nor SARS-CoV-2. The odds of ventilator use or death and intensive care unit admission or death were greatest among coinfected patients.ConclusionsCoinfection of these viruses could have a significant impact on morbidity, mortality and health-service demand.
      PubDate: Mon, 03 May 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab081
      Issue No: Vol. 50, No. 4 (2021)
       
  • Maternal seafood intake during pregnancy, prenatal mercury exposure and
           child body mass index trajectories up to 8 years

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      Authors: Papadopoulou E; Botton J, Caspersen I, et al.
      Pages: 1134 - 1146
      Abstract: AbstractBackgroundMaternal seafood intake during pregnancy and prenatal mercury exposure may influence children’s growth trajectories.MethodsThis study, based on the Norwegian Mother, Father and Child Cohort Study (MoBa), includes 51 952 mother-child pairs recruited in pregnancy during 2002–08 and a subsample (n = 2277) with maternal mercury concentrations in whole blood. Individual growth trajectories were computed by modelling based on child’s reported weight and length/height from 1 month to 8 years. We used linear mixed-effects regression analysis and also conducted discordant-sibling analysis.ResultsMaternal lean fish was the main contributor to total seafood intake in pregnancy and was positively but weakly associated with child body mass index (BMI) growth trajectory. Higher prenatal mercury exposure (top decile) was associated with a reduction in child’s weight growth trajectory, with the estimates ranging from -130 g [95% Confidence Intervals (CI) = -247, -12 g] at 18 months to -608 g (95% CI = -1.102, -113 g) at 8 years. Maternal fatty fish consumption was positively associated with child weight and BMI growth trajectory, but only in the higher mercury-exposed children (P-interaction = 0.045). Other seafood consumption during pregnancy was negatively associated with child weight growth compared with no intake, and this association was stronger for higher mercury-exposed children (P-interaction = 0.004). No association was observed between discordant maternal seafood intake and child growth in the sibling analysis.ConclusionsWithin a population with moderate seafood consumption and low mercury exposure, we found that maternal seafood consumption in pregnancy was associated with child growth trajectories, and the direction of the association varied by seafood type and level of prenatal mercury exposure. Prenatal mercury exposure was negatively associated with child growth. Our findings on maternal seafood intake are likely non-causal.
      PubDate: Sat, 13 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab035
      Issue No: Vol. 50, No. 4 (2021)
       
  • Commentary: Post- COVID-19 mobility and traffic noise-induced health
           effects

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      Authors: Seidler A; Weihofen V.
      Pages: 1147 - 1150
      PubDate: Thu, 05 Aug 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab146
      Issue No: Vol. 50, No. 4 (2021)
       
  • Transportation noise and risk of stroke: a nationwide prospective cohort
           study covering Denmark

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      Authors: Sørensen M; Poulsen A, Hvidtfeldt U, et al.
      Pages: 1147 - 1156
      Abstract: AbstractBackgroundStudies on transportation noise and incident stroke are few and inconclusive. We aimed to investigate associations between road-traffic and railway noise and the risk of incident stroke in the entire Danish population.MethodsWe estimated road-traffic and railway noise (Lden) at the most and least exposed façades for all residential addresses across Denmark (2.8 million) for the period 1990–2017. Based on this, we estimated the 10-year time-weighted mean noise exposure for 3.6 million Danes aged >35 years, of whom 184 523 developed incident stroke during follow-up from 2000 to 2017. Analyses were conducted using Cox proportional-hazards models, with adjustment for various individual- and area-level demographic and socio-economic covariates collected from registries and air pollution [fine particulate matter with particles with a diameter of ≤2.5 µm (PM2.5) and nitrogen dioxide (NO2)].ResultsA 10-dB increase in the 10-year mean road-traffic noise at the most exposed façade was associated with an incidence rate ratio (IRR) of 1.04 [95% confidence interval (CI): 1.03–1.05] for all strokes. For road-traffic noise at the least exposed façade, the IRR per 10 dB was 1.03 (95% CI: 1.02–1.04) for all strokes. Railway noise was not associated with a higher risk of stroke.ConclusionRoad-traffic noise increased the risk of stroke. These findings add to the evidence of road-traffic noise as a cardiovascular risk factor.
      PubDate: Tue, 23 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab024
      Issue No: Vol. 50, No. 4 (2021)
       
  • Residential exposure to traffic-borne pollution as a risk factor for acute
           cardiocerebrovascular events: a population-based retrospective cohort
           study in a highly urbanized area

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      Authors: Magnoni P; Murtas R, Russo A.
      Pages: 1160 - 1171
      Abstract: AbstractBackgroundLong-term exposure to traffic-borne noise and air pollution has been variably associated with incidence of acute vascular events, namely acute myocardial infarction, ischaemic stroke and haemorrhagic stroke. This study aims at exploring this association within a highly urbanized city.MethodsThis is a population-based retrospective dynamic cohort study including all residents aged ≥ 35 years in the municipality of Milan over the years 2011–18 (1 087 110 inhabitants). Residential exposure to road traffic noise (day-evening-night levels) and nitrogen dioxide was estimated using a noise predictive model and a land use regression model, respectively. Cox proportional hazards regression analyses were performed to assess the incidence of acute vascular events and specific outcomes in single-exposure and two-exposure models including adjustment for sociodemographic confounders, fine particulate matter and surrounding greenness.ResultsA total of 27 282 subjects (2.5%) had an acute vascular event. Models using nitrogen dioxide produced inconsistent results. The strongest effect was observed for noise, with an optimal cut-off for dichotomization set at 70 dBA (hazard ratio 1.025, 95% confidence interval 1.000–1.050). This association was observed specifically for ischaemic and haemorrhagic stroke. When stratifying by age group and sex, a remarkable effect was found for haemorrhagic stroke in men aged <60 years (hazard ratio 1.439, 95% confidence interval 1.156–1.792).ConclusionsLiving by roads with a day-evening-night noise level above 70 dBA exerts a small but tangible independent effect on the risks of both ischaemic and haemorrhagic stroke. It is urgent to propose mitigation measures against pollution and noise originating from vehicular traffic in order to reduce their impact, especially in the population younger than 60 years.
      PubDate: Mon, 19 Jul 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab068
      Issue No: Vol. 50, No. 4 (2021)
       
  • Cardiovascular morbidity and mortality associations with biomass- and
           fossil-fuel-combustion fine-particulate-matter exposures in Dhaka,
           Bangladesh

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      Authors: Rahman M; Begum B, Hopke P, et al.
      Pages: 1172 - 1183
      Abstract: AbstractBackgroundFine-particulate-matter (i.e. with an aerodynamic diameter of ≤2.5 µm, PM2.5) air pollution is commonly treated as if it had ‘equivalent toxicity’, irrespective of the source and composition. We investigate the respective roles of fossil-fuel- and biomass-combustion particles in the PM2.5 relationship with cardiovascular morbidity and mortality using tracers of sources in Dhaka, Bangladesh. Results provide insight into the often observed levelling of the PM2.5 exposure–response curve at high-pollution levels.MethodsA time-series regression model, adjusted for potentially confounding influences, was applied to 340 758 cardiovascular disease (CVD) emergency-department visits (EDVs) during January 2014 to December 2017, 253 407 hospital admissions during September 2013 to December 2017 and 16 858 CVD deaths during January 2014 to October 2017.ResultsSignificant associations were confirmed between PM2.5-mass exposures and increased risk of cardiovascular EDV [0.27%, (0.07% to 0.47%)] at lag-0, hospitalizations [0.32% (0.08% to 0.55%)] at lag-0 and deaths [0.87%, (0.27% to 1.47%)] at lag-1 per 10-μg/m3 increase in PM2.5. However, the relationship of PM2.5 with morbidity and mortality effect slopes was less steep and non-significant at higher PM2.5 concentrations (during crop-burning-dominated exposures) and varied with PM2.5 source. Fossil-fuel-combustion PM2.5 had roughly a four times greater effect on CVD mortality and double the effect on CVD hospital admissions on a per-µg/m3 basis than did biomass-combustion PM2.5.ConclusionBiomass burning was responsible for most PM2.5 air pollution in Dhaka, but fossil-fuel-combustion PM2.5 dominated the CVD adverse health impacts. Such by-source variations in the health impacts of PM2.5 should be considered in conducting ambient particulate-matter risk assessments, as well as in prioritizing air-pollution-mitigation measures and clinical advice.
      PubDate: Tue, 06 Apr 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab037
      Issue No: Vol. 50, No. 4 (2021)
       
  • Prospective association between dietary pesticide exposure profiles and
           postmenopausal breast-cancer risk in the NutriNet-Santé cohort

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      Authors: Rebouillat P; Vidal R, Cravedi J, et al.
      Pages: 1184 - 1198
      Abstract: AbstractBackgroundSome pesticides, used in large quantities in current agricultural practices all over Europe, are suspected of adverse effects on human reproductive health (breast and prostate cancers), through mechanisms of endocrine disruption and possible carcinogenic properties, as observed in agricultural settings. However, evidence on dietary pesticide exposure and breast cancer (BC) is lacking for the general population. We aimed to assess the associations between dietary exposure to pesticides and BC risk among postmenopausal women of the NutriNet-Santé cohort.MethodsIn 2014, participants completed a self-administered semi-quantitative food-frequency questionnaire distinguishing conventional and organic foods. Exposures to 25 active substances used in EU plant-protection products were estimated using a pesticide-residue database accounting for farming practices, from Chemisches und Veterinäruntersuchungsamt Stuttgart, Germany. Non-negative matrix factorization (NMF), adapted for data with excess zeros, was used to establish exposure profiles. The four extracted NMF components’ quintiles were introduced into Cox models estimating hazard ratio (HR) and 95% confidence interval (95% CI), adjusted for known confounding factors.ResultsA total of 13 149 postmenopausal women were included in the analysis (169 BC cases, median follow-up = 4.83 years). Negative associations between Component 3, reflecting low exposure to synthetic pesticides, and postmenopausal BC risk were found [HRQ5 = 0.57; 95% CI (0.34; 0.93), p-trend = 0.006]. Positive association between Component 1 score (highly correlated to chlorpyrifos, imazalil, malathion, thiabendazole) and postmenopausal BC risk was found specifically among overweight and obese women [HRQ5 = 4.13; 95% CI (1.50; 11.44), p-trend = 0.006]. No associations were detected for the other components.ConclusionThese associations suggest a potential role of dietary pesticide exposure on BC risk. Further research is needed to investigate the mechanisms and confirm these results in other populations.
      PubDate: Mon, 15 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab015
      Issue No: Vol. 50, No. 4 (2021)
       
  • A systematic review on lagged associations in climate–health studies

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      Authors: Wang P; Zhang X, Hashizume M, et al.
      Pages: 1199 - 1212
      Abstract: AbstractBackgroundLagged associations in climate–health studies have already been ubiquitously acknowledged in recent years. Despite extensive time-series models having proposed accounting for lags, few studies have addressed the question of maximum-lag specification, which could induce considerable deviations of effect estimates.MethodsWe searched the PubMed and Scopus electronic databases for existing climate–health literature in the English language with a time-series or case-crossover study design published during 2000–2019 to summarize the statistical methodologies and reported lags of associations between climate variables and 14 common causes of morbidity and mortality. We also aggregated the results of the included studies by country and climate zone.ResultsThe associations between infectious-disease outcomes and temperatures were found to be lagged for ∼1–2 weeks for influenza, 3–6 weeks for diarrhoea, 7–12 weeks for malaria and 6–16 weeks for dengue fever. Meanwhile, the associations between both cardiovascular and respiratory diseases and hot temperatures lasted for <5 days, whereas the associations between cardiovascular diseases and cold temperatures were observed to be 10–20 days. In addition, rainfall showed a 4- to 10-week lagged association with infectious diarrheal diseases, whereas the association could be further delayed to 8–12 weeks for vector-borne diseases.ConclusionOur findings indicated some general patterns for possible lagged associations between some common health outcomes and climatic exposures, and suggested a necessity for a biologically plausible and reasonable definition of the effect lag in the modelling practices for future environmental epidemiological studies.
      PubDate: Fri, 15 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa286
      Issue No: Vol. 50, No. 4 (2021)
       
  • Occupational exposure to respirable crystalline silica and risk of
           autoimmune rheumatic diseases: a nationwide cohort study

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      Authors: Boudigaard S; Schlünssen V, Vestergaard J, et al.
      Pages: 1213 - 1226
      Abstract: AbstractBackgroundExposure to respirable crystalline silica is suggested to increase the risk of autoimmune rheumatic diseases. We examined the association between respirable crystalline silica exposure and systemic sclerosis, rheumatoid arthritis, systemic lupus erythematosus and small vessel vasculitis.MethodsIn a cohort study of the total Danish working population, we included 1 541 505 male and 1 470 769 female workers followed since entering the labour market 1979–2015. Each worker was annually assigned a level of respirable crystalline silica exposure estimated with a quantitative job exposure matrix. We identified cases of autoimmune rheumatic diseases in a national patient register and examined sex-specific exposure-response relations by cumulative exposure and other exposure metrics.ResultsWe identified 4673 male and 12 268 female cases. Adjusted for age and calendar year, men exposed to high levels of respirable crystalline silica compared with non-exposed showed increased incidence rate ratio (IRR) for the four diseases combined of 1.53 [95% confidence interval (CI): 1.39–1.69], for systemic sclerosis of 1.62 (1.08–2.44) and rheumatoid arthritis of 1.57 (1.41–1.75). The overall risk increased with increasing cumulative exposure attained since entering the workforce [IRR: 1.07 (1.05–1.09) per 50 µg/m3-years]. Female workers were less exposed to respirable crystalline silica, but showed comparable risk patterns with overall increased risk with increasing cumulative exposure [IRR: 1.04 (0.99–1.10) per 50 µg/m3-years].ConclusionsThis study shows an exposure-dependent association between occupational exposure to respirable crystalline silica and autoimmune rheumatic diseases and thus suggests causal effects, most evident for systemic sclerosis and rheumatoid arthritis.
      PubDate: Mon, 18 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa287
      Issue No: Vol. 50, No. 4 (2021)
       
  • Commentary: Silica—A Multisystem Hazard

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      Authors: Ehrlich R.
      Pages: 1226 - 1228
      Abstract: Silica has a long history. Inhalation of silica, a ubiquitous constituent of the Earth’s crust in the form of quartz, produces the singular inflammatory and fibrotic lung disease we know as silicosis. The close association of pulmonary tuberculosis and silicosis as separate diseases was identified during the early years of the 20th century.1 The nature of silica’s association with lung cancer, an association accepted by the International Agency for Research on Cancer (IARC) in 2007, continues to be refined.2 However, despite all our knowledge, epidemics of silica-related disease persist in both traditional and new industries, including in high-income countries.3,4
      PubDate: Thu, 11 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab020
      Issue No: Vol. 50, No. 4 (2021)
       
  • Selection into shift work is influenced by educational attainment and body
           mass index: a Mendelian randomization study in the UK Biobank

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      Authors: Daghlas I; Richmond R, Lane J, et al.
      Pages: 1229 - 1240
      Abstract: AbstractBackgroundShift work is associated with increased cardiometabolic disease risk. This observation may be partly explained by cardiometabolic risk factors having a role in the selection of individuals into or out of shift work. We performed Mendelian randomization (MR) analyses in the UK Biobank (UKB) to test this hypothesis.MethodsWe used genetic risk scores (GRS) to proxy nine cardiometabolic risk factors and diseases (including educational attainment, body mass index (BMI), smoking, and alcohol consumption), and tested associations of each GRS with self-reported frequency of current shift work among employed UKB participants of European ancestry (n = 190 573). We used summary-level MR sensitivity analyses to assess robustness of the identified effects, and we tested whether effects were mediated through sleep timing preference.ResultsGenetically instrumented liability to lower educational attainment (odds ratio (OR) per 3.6 fewer years in educational attainment = 2.40, 95% confidence interval (CI) = 2.22–2.59, P = 4.84 × 10–20) and higher body mass index (OR per 4.7 kg/m2 higher BMI = 1.30, 95% CI = 1.14–1.47, P = 5.85 × 10–5) increased odds of reporting participation in frequent shift work. Results were unchanged in sensitivity analyses allowing for different assumptions regarding horizontal pleiotropy. No selection effects were evident for the remaining exposures, nor for any exposures on selection out of shift work. Sleep timing preference did not mediate the effects of BMI and educational attainment on selection into shift work.ConclusionsLiability to lower educational attainment and higher BMI may influence selection into shift work. This phenomenon may bias epidemiological studies of shift work that are performed in the UKB.
      PubDate: Sat, 13 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab031
      Issue No: Vol. 50, No. 4 (2021)
       
  • Oestradiol and the risk of myocardial infarction in women: a cohort study
           of UK Biobank participants

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      Authors: Peters S; Woodward M.
      Pages: 1241 - 1249
      Abstract: AbstractBackgroundIt is commonly assumed that high oestradiol levels in women are cardioprotective. We assessed the association between oestradiol and the risk of incident myocardial infarction (MI) in women.MethodsWe used data from 263 295 female UK Biobank participants [mean age 56.2; standard deviation (SD) 8.0 years] without previous cardiovascular disease (CVD). Associations of oestradiol with age and other cardiovascular risk factors were assessed. Cox proportional hazards models estimated crude, ag- and multiple-adjusted hazard ratios (HR) for MI associated with oestradiol levels.ResultsAfter a mean follow-up of 9 years, 2206 incident cases of MI had been recorded, including 230 events among the 57 204 women (mean age 48) with detectable oestradiol levels. In the unadjusted analyses, a unit higher in log-transformed oestradiol was associated with an HR [95% confidence interval (CI) for MI of 0.73 (0.58; 0.92)]. After adjusting for age, this HR became 0.94 (0.75; 1.17), and after further adjusting for classical CVD risk factors, it was 1.05 (0.83; 1.31. Results were similar in subgroup analyses defined by age, menopausal status, socioeconomic status, contraceptive pill use and the use of hormone replacement therapy. The multivariable-adjusted HR for the 171 431 women (mean age 59) with undetectable levels of oestradiol, compared with those with detectable levels, was 0.97 (0.92; 1.02).ConclusionsHigher levels of oestradiol were not associated with a decreased risk of MI. The presumed cardioprotective effects of oestradiol seem to be largely confounded by age and further confounded by other cardiovascular risk factors.
      PubDate: Sun, 17 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa284
      Issue No: Vol. 50, No. 4 (2021)
       
  • Duration of diabetes-related complications and mortality in type 1
           diabetes: a national cohort study

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      Authors: Bjerg L; Gudbjörnsdottir S, Franzén S, et al.
      Pages: 1250 - 1259
      Abstract: AbstractBackgroundPeople with type 1 diabetes often live for many years with different combinations of diabetes-related complications. We aimed to quantify how complication duration and total complication burden affect mortality, using data from national registers.MethodsThis study included 33 396 individuals with type 1 diabetes, registered in the Swedish National Diabetes Register at any time between 2001 and 2012. Each individual was followed and classified according to their time-updated diabetes-related complication status. The main outcomes were all-cause mortality, cardiovascular (CV) mortality and non-CV mortality. Poisson models were used to estimate the rate of these outcomes as a function of the time-updated complication duration.ResultsOverall, 1748 of the 33 396 individuals died during 198 872 person-years of follow-up. Overall, the time-updated all-cause mortality rate ratio (MRR) was 2.25 [95% confidence interval (CI): 1.99–2.54] for patients with diabetic kidney disease, 0.98 (0.82–1.18) for patients with retinopathy and 4.00 (3.56–4.50) for patients with cardiovascular disease relative to individuals without complications. The excess rate was highest in the first period after a diagnosis of CVD, with an 8-fold higher mortality rate, and stabilized after some 5 years. After diagnosis of diabetic kidney disease, we observed an increase in all-cause mortality with an MRR of around 2 compared with individuals without diabetic kidney disease, which stabilized after few years.ConclusionsIn this cohort we show that duration of diabetes-related complications is an important determinant of mortality in type 1 diabetes, for example the MRR associated with CVD is highest in the first period after diagnosis of CVD. A stronger focus on time-updated information and thorough consideration of complication duration may improve risk stratification in routine clinical practice.
      PubDate: Sat, 16 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa290
      Issue No: Vol. 50, No. 4 (2021)
       
  • Adiposity rebound and cardiometabolic health in childhood: results from
           the Generation XXI birth cohort

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      Authors: Fonseca M; Moreira C, Santos A.
      Pages: 1260 - 1271
      Abstract: AbstractBackgroundWe aimed to evaluate the association of adiposity rebound (AR) timing on cardiometabolic health in childhood.MethodsParticipants were part of the Generation XXI birth cohort, enrolled in 2005/2006 in Porto. All measurements of the child’s weight and height performed by health professionals as part of routine healthcare were collected. Individual body mass index (BMI) curves were fitted for 3372 children, using mixed-effects models with smooth spline functions for age and random effects. The AR was categorized into very early (<42 months), early (42–59 months), normal (60–83 months) and late (≥84 months). At age 10 years, cardiometabolic traits were assessed and age- and sex-specific z-scores were generated. Adjusted regression coefficients and 95% confidence intervals [β (95% CI)] were computed.ResultsThe mean age at AR was 61.9 months (standard deviations 15.7). Compared with children with normal AR, children with very early or early AR had higher z-scores for BMI [β = 0.40 (95% CI: 0.28; 0.53); β = 0.21 (95% CI: 0.12; 0.30)], waist circumference [β = 0.33 (95% CI: 0.23; 0.43); β = 0.18 (95% CI: 0.10; 0.25)], waist–height ratio [β = 0.34 (95% CI: 0.24; 0.44); β = 0.14 (95% CI: 0.07; 0.22)], fat mass index [β = 0.24 (95% CI: 0.15; 0.33); β = 0.14 (95% CI: 0.08; 0.21)], fat-free mass index [β = 0.25 (95% CI: 0.14; 0.35); β = 0.11 (95% CI: 0.03; 0.19)], systolic blood pressure [β = 0.10 (95% CI: 0.01; 0.20); β = 0.08 (95% CI: 0.01; 0.15)], insulin [β = 0.16 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.01; 0.19)], HOMA-IR [β = 0.17 (95% CI: 0.04; 0.29); β = 0.10 (95% CI: 0.03; 0.19)] and C-reactive protein [β = 0.14 (95% CI: 0.02; 0.26); β = 0.10 (95% CI: 0.01; 0.19)]. Children with very early AR also had worse levels of diastolic blood pressure [β = 0.09 (95% CI: 0.02; 0.16)], triglycerides [β = 0.21 (95% CI: 0.08; 0.34)] and high-density lipoprotein cholesterol [β=−0.18 (95% CI: −0.31; −0.04)]. When analysed continuously, each additional month of age at the AR was associated with healthier cardiometabolic traits.ConclusionThe earlier the AR, the worse the cardiometabolic health in late childhood, which was consistently shown across a wide range of outcomes and in the categorical and continuous approach.
      PubDate: Mon, 01 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab002
      Issue No: Vol. 50, No. 4 (2021)
       
  • Meta Salud Diabetes for cardiovascular disease prevention in Mexico: a
           cluster-randomized behavioural clinical trial

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      Authors: Rosales C; Denman C, Bell M, et al.
      Pages: 1272 - 1282
      Abstract: AbstractBackgroundHealthy lifestyle interventions offered at points of care, including support groups, may improve chronic disease management, especially in low-resource populations. We assessed the effectiveness of an educational intervention in type 2 diabetes (T2D) support groups to reduce cardiovascular disease (CVD) risk.MethodsWe recruited 518 participants to a parallel, two-arm, cluster-randomized, behavioural clinical trial across 22 clinics in Sonora, Mexico, between August 2016 and October 2018. We delivered a 13-week secondary prevention intervention, Meta Salud Diabetes (MSD), within the structure of a support group (GAM: Grupo de Ayuda Mutua) in government-run (community) Health Centres (Centros de Salud). The primary study outcomes were difference in Framingham CVD risk scores and hypertension between intervention (GAM+MSD) and control (GAM usual care) arms at 3 and 12 months.ResultsCVD risk was 3.17% age-points lower in the MSD arm versus control at 3 months [95% confidence interval (CI): −5.60, −0.75, P = 0.013); at 12 months the difference was 2.13% age-points (95% CI: −4.60, 0.34, P = 0.088). There was no evidence of a difference in hypertension rates between arms. Diabetes distress was also lower at 3 and 12 months in the MSD arm. Post-hoc analyses showed greater CVD risk reduction among men than women and among participants with HbA1c < 8.ConclusionsMSD contributed to a positive trend in reducing CVD risk in a low-resource setting. This study introduced an evidence-based curriculum that provides T2D self-management strategies for those with controlled T2D (i.e. HbA1c < 8.0) and may improve quality of life.
      PubDate: Sun, 11 Apr 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab072
      Issue No: Vol. 50, No. 4 (2021)
       
  • Genetic risk scores for cardiometabolic traits in sub-Saharan African
           populations

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      Authors: Ekoru K; Adeyemo A, Chen G, et al.
      Pages: 1283 - 1296
      Abstract: AbstractBackgroundThere is growing support for the use of genetic risk scores (GRS) in routine clinical settings. Due to the limited diversity of current genomic discovery samples, there are concerns that the predictive power of GRS will be limited in non-European ancestry populations. GRS for cardiometabolic traits were evaluated in sub-Saharan Africans in comparison with African Americans and European Americans.MethodsWe evaluated the predictive utility of GRS for 12 cardiometabolic traits in sub-Saharan Africans (AF; n = 5200), African Americans (AA; n = 9139) and European Americans (EUR; n = 9594). GRS were constructed as weighted sums of the number of risk alleles. Predictive utility was assessed using the additional phenotypic variance explained and the increase in discriminatory ability over traditional risk factors [age, sex and body mass index (BMI)], with adjustment for ancestry-derived principal components.ResultsAcross all traits, GRS showed up to a 5-fold and 20-fold greater predictive utility in EUR relative to AA and AF, respectively. Predictive utility was most consistent for lipid traits, with percentage increase in explained variation attributable to GRS ranging from 10.6% to 127.1% among EUR, 26.6% to 65.8% among AA and 2.4% to 37.5% among AF. These differences were recapitulated in the discriminatory power, whereby the predictive utility of GRS was 4-fold greater in EUR relative to AA and up to 44-fold greater in EUR relative to AF. Obesity and blood pressure traits showed a similar pattern of greater predictive utility among EUR.ConclusionsThis work demonstrates the poorer performance of GRS in AF and highlights the need to improve representation of multiple ethnic populations in genomic studies to ensure equitable clinical translation of GRS.
      PubDate: Wed, 17 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab046
      Issue No: Vol. 50, No. 4 (2021)
       
  • Paternal body mass index and offspring DNA methylation: findings from the
           PACE consortium

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      Authors: Sharp G; Alfano R, Ghantous A, et al.
      Pages: 1297 - 1315
      Abstract: AbstractBackgroundAccumulating evidence links paternal adiposity in the periconceptional period to offspring health outcomes. DNA methylation has been proposed as a mediating mechanism, but very few studies have explored this possibility in humans.MethodsIn the Pregnancy And Childhood Epigenetics (PACE) consortium, we conducted a meta-analysis of coordinated epigenome-wide association studies (EWAS) of paternal prenatal body mass index (BMI) (with and without adjustment for maternal BMI) in relation to DNA methylation in offspring blood at birth (13 data sets; total n = 4894) and in childhood (6 data sets; total n = 1982).ResultsWe found little evidence of an association at either time point: at all CpGs, the false-discovery-rate-adjusted P-values were >0.05. In secondary sex-stratified analyses, we found just four CpGs for which there was robust evidence of an association in female offspring. To compare our findings to those of other studies, we conducted a systematic review, which identified seven studies, including five candidate gene studies showing associations between paternal BMI/obesity and offspring or sperm DNA methylation at imprinted regions. However, in our own study, we found very little evidence of enrichment for imprinted genes.ConclusionOur findings do not support the hypothesis that paternal BMI around the time of pregnancy is associated with offspring-blood DNA methylation, even at imprinted regions.
      PubDate: Fri, 29 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa267
      Issue No: Vol. 50, No. 4 (2021)
       
  • Common genetic polymorphisms contribute to the association between chronic
           lymphocytic leukaemia and non-melanoma skin cancer

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      Authors: Besson C; Moore A, Wu W, et al.
      Pages: 1325 - 1334
      Abstract: AbstractBackgroundEpidemiological studies have demonstrated a positive association between chronic lymphocytic leukaemia (CLL) and non-melanoma skin cancer (NMSC). We hypothesized that shared genetic risk factors between CLL and NMSC could contribute to the association observed between these diseases.MethodsWe examined the association between (i) established NMSC susceptibility loci and CLL risk in a meta-analysis including 3100 CLL cases and 7667 controls and (ii) established CLL loci and NMSC risk in a study of 4242 basal cell carcinoma (BCC) cases, 825 squamous cell carcinoma (SCC) cases and 12802 controls. Polygenic risk scores (PRS) for CLL, BCC and SCC were constructed using established loci. Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).ResultsHigher CLL-PRS was associated with increased BCC risk (OR4th-quartile-vs-1st-quartile = 1.13, 95% CI: 1.02–1.24, Ptrend = 0.009), even after removing the shared 6p25.3 locus. No association was observed with BCC-PRS and CLL risk (Ptrend = 0.68). These findings support a contributory role for CLL in BCC risk, but not for BCC in CLL risk. Increased CLL risk was observed with higher SCC-PRS (OR4th-quartile-vs-1st-quartile = 1.22, 95% CI: 1.08–1.38, Ptrend = 1.36 × 10–5), which was driven by shared genetic susceptibility at the 6p25.3 locus.ConclusionThese findings highlight the role of pleiotropy regarding the pathogenesis of CLL and NMSC and shows that a single pleiotropic locus, 6p25.3, drives the observed association between genetic susceptibility to SCC and increased CLL risk. The study also provides evidence that genetic susceptibility for CLL increases BCC risk.
      PubDate: Mon, 22 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab042
      Issue No: Vol. 50, No. 4 (2021)
       
  • A comprehensive evaluation of methods for Mendelian randomization using
           realistic simulations and an analysis of 38 biomarkers for risk of type 2
           diabetes

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      Authors: Qi G; Chatterjee N.
      Pages: 1335 - 1349
      Abstract: AbstractBackgroundPrevious studies have often evaluated methods for Mendelian randomization (MR) analysis based on simulations that do not adequately reflect the data-generating mechanisms in genome-wide association studies (GWAS) and there are often discrepancies in the performance of MR methods in simulations and real data sets.MethodsWe use a simulation framework that generates data on full GWAS for two traits under a realistic model for effect-size distribution coherent with the heritability, co-heritability and polygenicity typically observed for complex traits. We further use recent data generated from GWAS of 38 biomarkers in the UK Biobank and performed down sampling to investigate trends in estimates of causal effects of these biomarkers on the risk of type 2 diabetes (T2D).ResultsSimulation studies show that weighted mode and MRMix are the only two methods that maintain the correct type I error rate in a diverse set of scenarios. Between the two methods, MRMix tends to be more powerful for larger GWAS whereas the opposite is true for smaller sample sizes. Among the other methods, random-effect IVW (inverse-variance weighted method), MR-Robust and MR-RAPS (robust adjust profile score) tend to perform best in maintaining a low mean-squared error when the InSIDE assumption is satisfied, but can produce large bias when InSIDE is violated. In real-data analysis, some biomarkers showed major heterogeneity in estimates of their causal effects on the risk of T2D across the different methods and estimates from many methods trended in one direction with increasing sample size with patterns similar to those observed in simulation studies.ConclusionThe relative performance of different MR methods depends heavily on the sample sizes of the underlying GWAS, the proportion of valid instruments and the validity of the InSIDE assumption. Down-sampling analysis can be used in large GWAS for the possible detection of bias in the MR methods.
      PubDate: Mon, 04 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa262
      Issue No: Vol. 50, No. 4 (2021)
       
  • The use of negative control outcomes in Mendelian randomization to detect
           potential population stratification

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      Authors: Sanderson E; Richardson T, Hemani G, et al.
      Pages: 1350 - 1361
      Abstract: AbstractA key assumption of Mendelian randomization (MR) analysis is that there is no association between the genetic variants used as instruments and the outcome other than through the exposure of interest. One way in which this assumption can be violated is through population stratification, which can introduce confounding of the relationship between the genetic variants and the outcome and so induce an association between them. Negative control outcomes are increasingly used to detect unobserved confounding in observational epidemiological studies. Here we consider the use of negative control outcomes in MR studies to detect confounding of the genetic variants and the exposure or outcome. As a negative control outcome in an MR study, we propose the use of phenotypes which are determined before the exposure and outcome but which are likely to be subject to the same confounding as the exposure or outcome of interest. We illustrate our method with a two-sample MR analysis of a preselected set of exposures on self-reported tanning ability and hair colour. Our results show that, of the 33 exposures considered, genome-wide association studies (GWAS) of adiposity and education-related traits are likely to be subject to population stratification that is not controlled for through adjustment, and so any MR study including these traits may be subject to bias that cannot be identified through standard pleiotropy robust methods. Negative control outcomes should therefore be used regularly in MR studies to detect potential population stratification in the data used.
      PubDate: Thu, 11 Feb 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa288
      Issue No: Vol. 50, No. 4 (2021)
       
  • Declining mortality in older people with type 2 diabetes masks rising
           excess risks at younger ages: a population-based study of all-cause and
           cause-specific mortality over 13 years

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      Authors: Sacre J; Harding J, Shaw J, et al.
      Pages: 1362 - 1372
      Abstract: AbstractBackgroundExcess mortality in people with vs without type 2 diabetes (T2DM) has fallen, but it is unclear whether men/women at all ages have benefited and which causes of death have driven these trends.MethodsAll-cause and cause-specific mortality rates and excess mortality [by mortality rate ratios (MRRs) relative to the non-diabetic general population] were examined in 1 268 018 Australians with T2DM registered on the National Diabetes Services Scheme (2002–2014).ResultsAge-standardized mortality decreased in men (−2.2%/year; Ptrend < 0.001) and women with T2DM (−1.3%/year; Ptrend < 0.001) throughout 2002–14, which translated to declines in the MRRs (from 1.51 to 1.45 in men; 1.59 to 1.46 in women; Ptrend < 0.05 for both). Declining mortality rates in T2DM were observed in men aged 40+ years and women aged 60+ years (Ptrends <0.001), but not at younger ages. However, the only age group in which excess mortality declined relative to those without diabetes was 80+ years (Ptrends < 0.05); driven by reductions in excess cancer-related deaths in men and cardiovascular disease (CVD) in women. Among age groups <80 years, CVD and cancer MRRs remained similar or increased over time, despite falls in both CVD and cancer mortality rates. MRRs for non-CVD/non-cancer-related deaths increased in 60–79 year-olds, but were otherwise unchanged.ConclusionsDeclining excess mortality attributable to T2DM from 2002–14 was driven entirely by reductions in those aged 80+ years. Declines in total mortality among those with T2DM were apparent in more age groups, but often to a lesser extent than in the general population, thereby serving to increase the excess risk associated with T2DM.
      PubDate: Mon, 18 Jan 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyaa270
      Issue No: Vol. 50, No. 4 (2021)
       
  • Reflection on modern methods: shared-parameter models for longitudinal
           studies with missing data

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      Authors: Griswold M; Talluri R, Zhu X, et al.
      Pages: 1384 - 1393
      Abstract: AbstractA primary goal of longitudinal studies is to examine trends over time. Reported results from these studies often depend on strong, unverifiable assumptions about the missing data. Whereas the risk of substantial bias from missing data is widely known, analyses exploring missing-data influences are commonly done either ad hoc or not at all. This article outlines one of the three primary recognized approaches for examining missing-data effects that could be more widely used, i.e. the shared-parameter model (SPM), and explains its purpose, use, limitations and extensions. We additionally provide synthetic data and reproducible research code for running SPMs in SAS, Stata and R programming languages to facilitate their use in practice and for teaching purposes in epidemiology, biostatistics, data science and related fields. Our goals are to increase understanding and use of these methods by providing introductions to the concepts and access to helpful tools.
      PubDate: Fri, 11 Jun 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab086
      Issue No: Vol. 50, No. 4 (2021)
       
  • Correction of ‘Bias factor, maximum bias and the E-value’

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      Authors: Sjölander A; VanderWeele T.
      Pages: 1394 - 1395
      Abstract: We would like to correct an incorrect statement in the paper ‘Bias factor, maximum bias and the E-value: insight and extended applications’, recently published in the International Journal of Epidemiology by Cusson and Infante-Rivard.1 In the box of Key Messages, the authors state:
      PubDate: Mon, 29 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab055
      Issue No: Vol. 50, No. 4 (2021)
       
  • Reply to Sjölander and VanderWeele on ‘Bias factor, maximum
           bias and the E-value’

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      Authors: Cusson A; Infante-Rivard C.
      Pages: 1395 - 1396
      Abstract: Sjölander and VanderWeele do not report faults in our demonstration of additional formulas for the E-value given the stated assumptions and the conventional relative risk definitions adopted,1 and likewise, for our extension of the E-value interpretation on the odds ratio scale.
      PubDate: Wed, 24 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab056
      Issue No: Vol. 50, No. 4 (2021)
       
  • Occupational exposure to respirable crystalline silica and autoimmunity:
           sex differences in mouse models

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      Authors: Lescoat A; Ballerie A, Lecureur V.
      Pages: 1396 - 1397
      Abstract: We read with great interest the nationwide cohort study from Boudigaard and colleagues, recently published in the IJE and exploring the association of occupational exposure to crystalline silica with systemic autoimmune diseases.1 In this study, the authors show an exposure-dependent association between respirable silica and rheumatic diseases such as systemic sclerosis (SSc) and rheumatoid arthritis. This exposure-response relation was especially demonstrated in male workers, suggesting either a gender effect or the impact of higher/longer exposure in men as compared with women. These sex differences have also been highlighted in recent single-centre and nationwide studies in SSc.2,3
      PubDate: Thu, 15 Jul 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab125
      Issue No: Vol. 50, No. 4 (2021)
       
  • Authors’ response to: Occupational exposure to respirable crystalline
           silica and autoimmunity: sex-differences in mouse models

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      Authors: Boudigaard S; Schlünssen V, Vestergaard J, et al.
      Pages: 1397 - 1400
      Abstract: Danish Working Environment Research Fund34–2016-09Deutsche Gesetzliche Unfallversicherung to elaborate SYNJEM
      PubDate: Mon, 05 Jul 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab133
      Issue No: Vol. 50, No. 4 (2021)
       
  • Corrigendum to: Cohort profile: The Singapore Epidemiology of Eye Diseases
           Study (SEED)

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      Authors: Majithia S; Tham Y, Chee M, et al.
      Pages: 1401 - 1401
      Abstract: First published online: 4 January 2021, Int J Epidemiol 2020; doi: https://doi.org/10.1093/ije/dyaa238
      PubDate: Mon, 28 Jun 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab114
      Issue No: Vol. 50, No. 4 (2021)
       
  • Corrigendum to: Cohort Profile: The National Academy of Sciences-National
           Research Council Twin Registry (NAS-NRC Twin Registry)

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      Authors: Gatz M; Harris J, Kaprio J, et al.
      Pages: 1402 - 1402
      Abstract: First published online: 1 September 2014, Int J Epidemiol 2015;44:819–825. doi: https://doi.org/10.1093/ije/dyu181
      PubDate: Thu, 24 Jun 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab130
      Issue No: Vol. 50, No. 4 (2021)
       
  • Erratum to: An egalitarian society' Widening inequalities in premature
           mortality from non-communicable diseases in Australia, 2006-16

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      Authors: Adair T; Lopez A.
      Pages: 1403 - 1403
      Abstract: First published online: 8 December 2020, Int J Epidemiol 2020; doi: https://doi.org/10.1093/ije/dyaa226
      PubDate: Fri, 19 Mar 2021 00:00:00 GMT
      DOI: 10.1093/ije/dyab040
      Issue No: Vol. 50, No. 4 (2021)
       
 
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