P-538 Introduction: Several epidemiological studies have identified occupational exposure to low-frequency electromagnetic fields as a potential risk factor for neurodegenerative diseases. These studies are described in a review published by the International Commission on Non-Ionizing Radiation Protection (ICNIRP) in 2003. The purpose of our review was to evaluate the results of recent epidemiological studies not yet included in the ICNIRP report. Methods: A literature search was conducted in the databases of PubMed, ISI Web of Knowledge, DIMDI and Cochrane Library, as well as in specialised databases and journals. Epidemiological studies published between January 2000 and July 2005 were included in the review. Results: We identified eight new epidemiological studies concerning low-frequency electromagnetic field exposure and neurodegenerative diseases, which were not included in the ICNIRP report published in 2003. The findings of these studies contribute to the evidence of an association between occupational exposure to low-frequency electromagnetic field exposure and the risk of dementia. All eight studies investigated the association with the risk of dementia or Alzheimer's disease and reported relative risk estimates > 1 for the highest exposed workers ranging from 1.05 (95% CI: 0.71–1.56) to 4.04 (95% CI: 1.40–11.66). Regarding amyotrophic lateral sclerosis the recent results confirm earlier observations of an association with electric and electronic work and welding. Studies including other occupational groups estimated to have a high exposure to low-frequency electromagnetic fields did not observe this association. There are only few findings pointing towards an association between magnetic field exposure and Parkinson's disease. Discussion and Conclusions: We conclude that the epidemiological evidence of an association between occupational exposure to low-frequency electromagnetic fields and the risk of dementia has increased since the ICNIRP report was published in 2003. With respect to amyotrophic lateral sclerosis the recent results concerning estimated exposure to magnetic fields are inconsistent. Apparently, increased risks seem to be restricted to electric utility workers and welders and were generally not found in other occupations with high exposures to low-frequency electromagnetic fields. In order to investigate the relationship between occupational exposure to low-frequency electromagnetic fields and the risk of amyotrophic lateral sclerosis we should know more about the exposure characteristics and possibly relevant concomitants in occupational settings.
Background: Traumatic spinal cord injuries (TSCI) are a neurological condition associated with reduced well-being, increased morbidity and reductions in life expectancy. Estimates of all-cause and cause-specific mortality can aid in identifying targets for prevention and management of contributors for premature mortality. Objectives: To compare all-cause and cause-specific rates of mortality to that of the Swiss general population; to identify differentials in risk of cause-specific mortality according to lesion characteristics. Methods: All-cause and cause-specific standardized mortality ratios (SMRs) were calculated using data from the Swiss Spinal Cord Injury cohort study. Cause-specific subhazard ratios were estimated within a competing risk framework using flexible parametric survival models. Results: Between 1990 and 2011, 2,492 persons sustained a TSCI, of which 379 died. Persons with TSCI had a mortality rate more than 2 times higher than that of the Swiss general population (SMR 2.32; 95% CI 2.10–2.56). Tetraplegic lesions were associated with an increased risk of mortality due to respiratory and cardiovascular diseases, infections, and accidents. Cause-specific SMRs were notably elevated for SCI-related conditions such as urinary tract infections (UTIs) and septicemia. Conclusions: Elevated SMRs due to cardiovascular disease, UTIs and septicemia-related mortality suggest the need for innovation when managing associated secondary health conditions.
Choroid plexus papillomas (CPPs) are infrequently encountered brain tumors with the majority originating in the ventricular system. Rarely, CPP occurs outside of the ventricles.We report the case of a recurrent CPP that initially originated within the fourth ventricle, though years later it recurred in the left middle cerebellar peduncle.Patients with cerebellar plexus papilloma need long-term follow-up comprising regular magnetic resonance imagings since, in patients with a history of CPP, any new mild symptomatology, even years after the initial presentation, may be an early sign of tumor recurrence.
We conducted a systematic search of Medline, EMBASE, ISI Web of Knowledge and the Cochrane Library in March 2009 to identify all relevant peer-reviewed papers published before that date.Key and free-text words included "cellular phone, "Une traduction en français de ce résumé figure à la fin de l'article.Al final del artículo se facilita una traducción al español. املقالة. لهذه الكامل النص نهاية يف الخالصة لهذه العربية الرتجمةObjective To review and evaluate the recent literature on the health effects of exposure to mobile phone base station (MPBS) radiation.Methods We performed a systematic review of randomized human trials conducted in laboratory settings and of epidemiological studies that investigated the health effects of MPBS radiation in the everyday environment.Findings We included in the analysis 17 articles that met our basic quality criteria: 5 randomized human laboratory trials and 12 epidemiological studies.The majority of the papers ( 14) examined self-reported non-specific symptoms of ill-health.Most of the randomized trials did not detect any association between MPBS radiation and the development of acute symptoms during or shortly after exposure.The sporadically observed associations did not show a consistent pattern with regard to symptoms or types of exposure.We also found that the more sophisticated the exposure assessment, the less likely it was that an effect would be reported.Studies on health effects other than non-specific symptoms and studies on MPBS exposure in children were scarce. ConclusionThe evidence for a missing relationship between MPBS exposure up to 10 volts per metre and acute symptom development can be considered strong because it is based on randomized, blinded human laboratory trials.At present, there is insufficient data to draw firm conclusions about health effects from long-term low-level exposure typically occurring in the everyday environment.
This study investigated factors which influence work after a spinal cord lesion using routinely collected outpatient data including an ICF-based questionnaire.The retrospective analysis was based on a sample of 290 outpatients with chronic spinal cord lesions of whom 43% reported to work. 15 factors possibly affecting occupational activity were evaluated by bivariate analyses and multivariable regression modelling.Negative associations were identified between working activities and the factors "age at time of spinal cord injury" (OR: 0.96, 95%-KI: 0.93-0.99, p<0.002) and "problems with covering distances" (OR: 0.44, 95%-KI: 0.25-0.79, p<0.006). A similar tendency was observed for "problems with shopping".These findings indicate that age and aspects of mobility are important influencing factors for resumption of work after a spinal cord lesion. Therefore, mobility should be considered as an important target for interventions in long-term rehabilitation.ZIEL: Anhand von ambulanten Routinedaten und eines ICF-basierten Fragebogens wurden Einflussfaktoren auf die Arbeitstätigkeit nach einer Rückenmarksläsion überprüft.Die retrospektive Auswertung basierte auf einer Stichprobe von 290 Patienten mit Querschnittlähmung, davon 43% arbeitstätig. In bivariaten Analysen und multiplen Regressionsmodellen wurden 15 mögliche Einflussfaktoren evaluiert.Negative Zusammenhänge mit der Arbeitstätigkeit zeigten sich für die Faktoren „Alter bei Rückenmarksläsion“ (OR: 0,96, 95%-KI: 0,93–0,99, p<0,002) und „Probleme beim Zurücklegen von Entfernungen“ (OR: 0,44, 95%-KI: 0,25–0,79, p<0,006). Ein ähnlicher Trend bestand für „Schwierigkeiten beim Einkaufen“.Die Resultate weisen darauf hin, dass neben dem Alter bei Rückenmarksläsion auch Aspekte der Mobilität für die Arbeitstätigkeit von Personen mit Querschnittlähmungen entscheidend sind. Interventionen zur Verbesserung der Mobilität sollten daher in der Langzeitrehabilitation einen hohen Stellenwert einnehmen.
The medical record held in primary care provides the most comprehensive summary of all medical events.Diagnostic, laboratory, and prescribing data are all linked in individual patient records.Networks of GPs in some European countries are routinely recording data electronically in a way which allows extraction of epidemiological information from routine operational data at low cost.This workshop is based on a current EU funded project on the use of electronic medical records for epidemiological purposes in practice networks.We will explore the potential of these information systems to inform public health policy and consider their wider application.
P-540 Introduction: There is concern regarding the possible health effects of cellular phone use. Many studies of this issue have been funded by the telecommunications industry, which might have resulted in conflicts of interest and influenced results. We examined whether the source of funding of studies of the effects of low-level radiofrequency radiation is associated with the results of studies. Methods: We searched Embase, Medline and a specialist database in February 2005 and scrutinised references lists from relevant publications. We included all studies of controlled exposure to radiofrequency radiation with health related outcomes (electroencephalogram, cognitive or cardiovascular function, hormone levels, symptoms and subjective wellbeing). Data on the source of funding, study design, methodological quality and other study characteristics were extracted in duplicate. The primary outcome was the reporting of at least one statistically significant association between the exposure and a health related outcome. Data were analysed using logistic regression models. Results: Of 59 studies, 12 (20%) were exclusively funded by the telecommunications industry, 11 (19%) were funded by public agencies or charities, 14 (24%) had mixed funding (including industry) and in 22 (37%) the source of funding was not reported. Studies exclusively funded by industry were least likely to report a statistically significant result: the odds ratio was 0.11 (95% confidence interval 0.02–0.78), compared to studies funded by public agencies or charities. This finding was not materially altered in analyses adjusted for the number of outcomes reported, study quality and other factors. Studies with mixed funding had an OR for reporting a statistically significant effect of 0.56 (95% C.I. 0.08 – 3.8), studies with no reported source of funding 0.76 (95% C.I. 0.12 – 4.7), respectively. Study quality varied by source of funding: studies with mixed funding (including public agencies or charities and industry) had the highest quality regarding adequate randomisation, blinding, exposure set-up and statistics, whereas studies with no reported source of funding did worst. Conclusions: We found that the studies exclusively funded by industry were substantially less likely to report statistically significant effects of low-level radiofrequency radiation from mobile phones on a range of endpoints that may be relevant to health.
