BackgroundThe risk of mesothelioma has been shown to be associated with exposure to asbestos fibers. Most of the existing literature focuses on occupational exposure; however, non-occupational asbestos exposure has also been identified as an important risk factor.ObjectiveTo estimate the association between mesothelioma and non-occupational asbestos exposure, and evaluate control recruitment and exposure measurement methods.MethodsA systematic literature review was conducted to identify case-control (CC) and cohort studies that examined the association between mesothelioma and non-occupational exposure to asbestos, including neighborhood, domestic, and household exposure. Meta-analysis was performed to estimate a summary relative risk estimate (SRRE) and 95% confidence interval using random-effects models. Subgroup analyses were also conducted by exposure type, gender, region, and fiber type.ResultsTwenty CC and 7 cohort studies were selected. Controls in CC studies were selected from the general population (55%), hospital records (18%), cancer registry (23%) and a combination of population and hospital records (5%). Multiple methods were used to measure neighborhood exposure (e.g., linear distance and direction of residence from an asbestos factory), domestic (e.g., whether living with an asbestos worker) and household exposure (e.g., whether involved in asbestos-containing home improvement projects). Primary meta-analyses suggested a SRRE of mesothelioma of 5.33 (95%CI: 2.53, 11.23) from neighborhood exposure, 4.31 (95%CI, 2.58, 7.20) from domestic exposure, and 2.41 (95%CI, 1.30, 4.48) from household exposure with large I2 statistics ranging from 83–99%.ConclusionsNon-occupational asbestos exposure is significantly associated with an elevated risk of mesothelioma. Funnel plots indicated a potential of publication bias. Some SRREs should be interpreted with cautions because of high between-studies heterogeneity.
Aims Disability, an individual’s reduced capacity to perform physical tasks encountered in daily routine, is associated with urinary incontinence in the elderly. Our objective was to determine if urinary incontinence is associated with disability in community-dwelling women 40 years and older. Methods Cross-sectional study among US women ≥ 40 years (n=4,458) from National Health and Nutrition Examination Surveys 2005–2010. We estimated the age-stratified weighted prevalence and factors independently associated with disability (Activities of Daily Living (ADLs), Instrumental Activities of Daily Living (IADLs), mobility, and functional limitations) in women with and without urinary incontinence while controlling for confounders of the association between disability and urinary incontinence. Results The weighted prevalence of all disabilities was higher in women with urinary incontinence than women without urinary incontinence across most decades of life with the greatest difference in the prevalence of mobility disabilities: 40–49 years (12.1% versus 7.0%), 50–59 years (17.0% versus 9.2%), 60–69 years (28.3% versus 19.8%), and 70+ years (43.8% versus 33.0%, all P < .05). On multivariable analysis, after controlling for the confounding effect of age, co-morbidities, and income-poverty ratio, urinary incontinence was weakly associated with disabilities. The adjusted odds ratio (95% confidence interval) of disabilities for urinary incontinence was ADL 1.96 (1.07, 3.58), IADL 1.18 (0.78, 1.78), mobility 1.26 (1.01, 1.56) and functional limitations 1.36 (1.07, 1.73). Conclusions Urinary incontinence is weakly associated with disabilities and cannot be implicated as a cause of disability in community dwelling women.
We examine the feasibility of phytoremediation as an alternative strategy to limit the exposure of asbestos in site with asbestos-containing materials. We collected soils from four locations from two sites—one with naturally occurring asbestos, and another, a superfund site, where asbestos containing materials were disposed over decades—and performed ecotoxicology tests. We also performed two experiments with crop cultivar and two grasses from serpentine ecotype and cultivar to determined best choice for phytoremediation. Asbestos concentrations in different size fractions of soils varied by orders of magnitude. However, different asbestos concentrations had little effect on germination and root growth. Presence of co-contaminants such as heavy metals and lack of nutrients affected plant growth to different extents, indicating several of these limiting factors should be considered instead of the primary contaminant of concern. Crop cultivar survived on asbestos contaminated soil. Grasses from serpentine ecotype did not show higher biomass than the cultivar. Overall, these results showed that soil conditions play a critical role in screening different crop species for phytoremediation, and that asbestos concentration has limited to no effect on plant growth. Our study provided a framework for phytoremediation of asbestos-contaminated sites to limit long-term asbestos exposure.
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