No abstract

The cohort consisted of 10,173 men who had worked for at least one year in jobs involving exposure to vinyl chloride prior to 1 January 1973. These men were employed at 37 plants in the U.S., belonging to 17 companies. Observation of the mortality experience of the cohort was updated from 31 December 1972 to 31 December 1982 (the study now covering 1942-1982). A total of 1,536 cohort members were identified as having died. The observed mortality, by cause, was compared with the expected based on U.S. mortality rates, standardized for age, race, and calendar time. Analyses by length of exposure, latency, age at first exposure, calendar year of first exposure, and type of products were performed. The study confirmed that the vinyl chloride workers experience a significant mortality excesses in angiosarcoma (15 deaths), cancer of the liver and biliary tract (SMR = 641), and cancer of the brain and other central nervous system (SMR = 180). In addition, the study also found a significant mortality excess in emphysema/chronic obstructive pulmonary disease (COPD) (SMR = 179). On the other hand, the study did not find any excess in either respiratory cancer or lymphatic and hematopoietic cancer. This study also found an increase in biliary tract cancers, independent from liver cancer.

During 1999-2000, the California Hospice and Palliative Care Association (CHAPCA) surveyed its 160 member hospices regarding bereavement support services. Over 80% of hospices participated, providing information about program content, staff training, and costs incurred by participants. Results revealed that a greater percentage of larger hospices and non-profit hospices offer support groups and workshops than do smaller hospices and for-profit hospices. Volunteers account for almost one quarter of bereavement staff. The professional background of paid staff is varied, with social workers and clergy being most common overall but nurses more common in small hospices. Almost 90% of hospices provide all bereavement support at no charge to the bereaved. Services most likely to be associated with a fee include special support groups, children's programs, and professional counseling to individuals and families.

We examined the association between magnetic field (MF) exposure and survival among children with acute lymphoblastic leukaemia (ALL) treated at 51 Pediatric Oncology Group centres between 1996 and 2001. Of 1672 potentially eligible children under treatment, 482 (29%) participated and personal 24-h MF measurements were obtained from 412 participants. A total of 386 children with ALL and 361 with B-precursor ALL were included in the analysis of event-free survival (time from diagnosis to first treatment failure, relapse, secondary malignancy, or death) and overall survival. After adjustment for risk group and socioeconomic status, the event-free survival hazard ratio (HR) for children with measurements X0.3 mT was 1.9 (95% confidence interval (CI) 0.8, 4.9), compared to o0.1 mT. For survival, elevated HRs were found for children exposed to X0.3 mT (multivariate HR ¼ 4.5, 95% CI 1.5 -13.8) but based on only four deaths among 19 children. While risk was increased among children with exposures above 0.3 mT, the small numbers limited inferences for this finding.

The Childhood Leukemia Survival Study is examining the possible association between magnetic field exposure and survival of children with newly diagnosed acute lymphocytic leukemia ( ALL ). We report the results of serial 24 -h personal magnetic field monitoring for 412 US and Canadian children and present the correlations between annual values. The mean time -weighted average ( TWA ) and geometric mean ( GM ) were similar for first, second, and third year measurements [ TWA: 0.11 T (n = 412 ), 0.13 T (n = 304 ), and 0.12 T (n = 134 ), respectively ]. There were no consistent differences in mean TWA or GM based on age or gender. Significantly lower mean TWA and GM were found for children living in rural areas. Higher exposures were noted among children living in urban areas, among apartments dwellers, and those living in rental homes. Measurements taken during summer months and among children residing in the northeast and Canada also tended to be higher. Correlations for most metrics were increased among children who had annual measurements performed during the same season. The metric with the highest year -to -year correlation was the GM. The lowest correlations were found for metrics estimating field intermittency and temporal stability. First to second year GMs were well correlated when taken in the same home ( Spearman rank correlation = 0.70 ), but a lower correlation ( 0.44 ) was noted among residentially mobile children. Our findings suggest that summarizing exposure using a single measurement of GM can estimate exposures for residentially stable children, but is not a good predictor of personal exposures among children who change residence during the study interval.