Objectives-To investigate the relation with a case-control study between symptomatic osteochondrosis or spondylosis of the lumbar spine and cumulative occupational exposure to lifting or carrying and to working postures with extreme forward bending. Methods-From two practices and four clinics were recruited 229 male patients with radiographically confirmed osteochondrosis or spondylosis of the lumbar spine associated with chronic complaints. Of these 135 had additionally had acute lumbar disc herniation. A total of 197 control subjects was recruited: 107 subjects with anamnestic exclusion of lumbar spine disease were drawn as a random population control group and 90 patients admitted to hospital for urolithiasis who had no osteochondrosis or spondylosis of the lumbar spine radiographically were recruited as a hospital based control group. Data were gathered in a structured personal interview and analysed using logistic regression to control for age, region, nationality, and other diseases aVecting the lumbar spine. To calculate cumulative forces to the lumbar spine over the entire working life, the MainzDortmund dose model (MDD), which is based on an overproportional weighting of the lumbar disc compression force relative to the respective duration of the lifting process was applied with modifications: any objects weighing >5 kg were included in the calculation and no minimum daily exposure limits were established. Calculation of forces to the lumbar spine was based on self reported estimates of occupational lifting, trunk flexion, and duration. Results-For a lumbar spine dose >9×10 6 Nh (Newton×hours), the risk of having radiographically confirmed osteochondrosis or spondylosis of the lumbar spine as measured by the odds ratio (OR) was 8.5 (95% confidence interval (95% CI) 4.1 to 17.5) compared with subjects with a load of 0 Nh. To avoid diVerential bias, forces to the lumbar spine were also calculated on the basis of an internal job exposure matrix based on the control subjects' exposure assessments for their respective job groups. Although ORs were lower with this approach, they remained significant. Conclusions-The calculation of the sum of forces to the lumbar spine is a useful tool for risk assessment for symptomatic osteochondrosis or spondylosis of the lumbar spine. The results suggest that cumulative occupational exposure to lifting or carrying and extreme forward bending increases the risk for developing symptomatic osteochondrosis or spondylosis of the lumbar spine. (Occup Environ Med 2001;58:735-746)

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Seidler A, Heiskel H, Bickeboller R, Elsner G. Association between diesel exposure at work and prostate cancer.Scand J Work Environ Health 1 998;24(6):486-494. ObjectivesThe possible etiologic relevance of occupational factors such as cadmium, cutting oils, diesel fuel and fumes, herbicides, polycyclic aromatic hydrocarbons (PAH), polychlorinated biphenyls, soot, tar, mineral oil, and solvents to prostate cancer was studied. Methods A case-referent study design was used to recruit 192 subjects with histologically confirmed prostate cancer and 210 referents who had prostate cancer histologically excluded either in orie of two urologic practices (Hamburg and Frankfurt) or in the urological policliilic of the Frankfurt University. Data were gathered with a self-administered questionnaire and analyzed using logistic regression to control for age, region, and cigarette smoking. A job-exposure matrix was used for assigning exposure. For the calculation of dose-years, the duration of contact with specific substa~lces was weighted by the intensity and probability of exposure according to a jobexposure matrix. Results The analysis of dose-years yielded a statistically significant association between occupational exposure to diesel fuel or fumes and prostate cancer (odds ratio 3.7,95% confidence interval 1.4-9.8, for subjects exposed to more than 25 dose-years in a co~npa~ison with subjects never exposed). For the other substances, no statistically significant differences in exposure were found between the cases and referents. When only jobs with a high exposurc probability were used to classify the participants as exposed, only exposure to PAH was significantly associated with prostate cancer. Conclusions In keeping with results from other studies, this study provides further evidence that exposure to diesel fuel or furnes -possibly mediated through PAH -may be associated with the developmeat of prostate cancer.

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In a case-control study 192 patients with histologically confirmed prostate cancer were compared with 210 men in whom carcinoma of the prostate had been histologically excluded. Cases and controls were recruited from two urological practices in Hamburg and Frankfurt/M. and from the urologic policlinic at the University of Frankfurt/M. The probands were questioned about smoking habits and alcohol consumption, about all occupational activities of least one years' duration, and about exposure to specific substances. Odds ratios (OR) were calculated using logistic regression analysis, adjusting for age, region and smoking. There were no differences between patients and controls in self-reported occupational exposures or the consumption of alcohol or smoking. There was a positive association between having worked in transportation/communication and having prostate cancer (p for trend = 0.006): ORs varied according to the number of years worked as follows: 1-10 years versus never, OR = 0.6 (95% Cl: 0.3-1.2), 11-30 years, OR = 2.0 (95% Cl: 0.8-4.8), > 30 years OR = 3.2 (95% Cl: 1.3-7.5). Work in other occupational groups was not associated with an increased risk for prostate cancer. These results suggest that transport work may be associated with the development of prostate cancer.