An Evaluation of Different Methods in Epidemiologic Studies of Radiation Risks

The probability of detecting possible late effects of ionizing radiation in human populations depends on the size of exposure in the study population and on the epidemiologic evaluation method used. This is not only due to the mathematical or statistical properties of the method, but also to the choice of the control population, which may be either external (usually large) or internal (usually not so large). Moreover, the use of a large external control population often results in an increasing influence of selection factors expressing themselves e.g. through the ‘healthy worker’ effect. In this paper three different methods usually employed in follow-up studies are reviewed: the calculation of Standardized Mortality Ratios (SMR), a contingency table analysis based on Person-Years (PY) and the comparison of Cumulative Mean Doses (CMD) within different subcohorts. The methods are illustrated with a simple radiation risk model; nevertheless, most of the conclusions apply to non-radiation risk studies as well. The CMD-method is shown to be heavily selection sensitive.     

Epidemiologic interference of virus populations

Summary There are a few simulation studies for interference models in the literature but the present paper discusses an analytical model for the competition of two interfering virus populations in a community. The mathematical model consist of eight coupled differential equations which have up to four equilibrium points. Criteria for local stability are given.This paper has been read at the workshop on Nonlinear Models in Biology and Medicine, 23rd Biometric Colloquium, German Region of the Biometric Society, Nuremberg, March 1977     

Epidemiologic problems of pneumococcal infection

During the microbiological examination of 314 tentatively healthy donors, residents of Leningrad, Streptococcus pneumoniae was detected in the rhinopharynx of 94 donors (29.9%) in amounts ranging from a few individual microbial cells to 10(6) microbial cells with the mean geometric concentration equal to 3.58 lg. Antipneumococcal antibodies were detected in the blood of 147 donors (46.8%). The occurrence of antipneumococcal antibodies was approximately 2.5 times higher than the average level of carriership, but in most cases the dynamics of immunological reactions changed in the same direction. Considerable monthly and annual fluctuations in the occurrence of pneumococcal carriership and antipneumococcal antibodies, as well as their correlation with the epidemic rises of acute respiratory diseases, influenza and other acute respiratory viral diseases, were established. These data indicate that pneumococcal infection plays a definite role in the epidemic rises of acute respiratory diseases.     

Epidemiologic aspects of Taylorella equigenitalis

Contagious equine metritis (CEM) is a sexually transmissible disease in mares. Although the disease is commonly diagnosed by culturing the causative bacterium Taylorella equigenitalis (T. equigenitalis) . false negative results do occur. A recently developed Polymerase Chain Reaction (PCR) assay, however, appeared to be much more sensitive, with initial results indicating an unexpected high incidence of the agent in selected horses. In this study, samples from 107 randomly selected mares with no clinical signs of CEM submitted for conventional culture were all negative for T. equigenitalis . but in the PCR-assay 54 (49%) were positive for Taylorella -DNA. Positives in the PCR-assay were found in all breeds tested, even in horses imported from the isolated population in Iceland. These findings suggest that T. equigenitalis was present long before it was first isolated in 1977, The high incidence of Taylorella in horse populations without apparent clinical signs of CEM, the occurrence of incidental clinical case and the known variability between strains, all indicate that Taylorella is endemic in the horse population. In order to explore whether the organism is present in species other than the horse, we also used the PCR-assay on clinically health donkeys (n = 14), zebras (n = 15), Przewalski horses (n = 2) and cows (n = 21). All the animals showed negative results except one of the Przewalski horses, and one cow that was repeatedly found to give positive reaction. We also found that the fertility of 7 stallions with cultures positive for Taylorella (6 used in an AI-program and 1 by natural breeding) was not affected, as shown by the normal range of foaling rates in mares inseminated or bred by these stallions. The overall results may be interpreted to mean that Taylorella is of limited significance in horse breeding.     

Epidemiologic surveillance of mesothelioma in Canada

The number of fatal malignant mesotheliomas was ascertained for the period 1960-70 by contacting all pathologists in Canada. The annual incidence was steady between 1966 and 1970 at 1.4 per million population. Of 71 cases registered in 1968-70 and not previously reported, 66% were pleural, 24% peritoneal and the remainder in both sites; 45% of tumours were in women. The diagnosis of mesothelioma was approved by the Canadian Mesothelioma Panel in 59%. Sixty-nine cases were successfully investigated epidemiologically. A history of definite or probable occupational asbestos exposure was found in 30% of male cases compared with 11% of controls, but in none of the female cases or controls. However, among cases, four women and one man had had domestic exposure to dusty clothing of an asbestos worker. Most of the excess occupational exposure was in the manufacture of asbestos products or insulation and little in mining or milling. No case other than those occupationally or domestically exposed had lived within 20 miles of asbestos mines or mills.     

Molecular Biomarkers and Epidemiologic Risk Assessment

The use of molecular biomarkers in epidemiologic studies has been advancedas a way to improve risk assessments for occupational and environmental exposuresto toxic agents. We have used the detection of two cancer-related, molecular biomarkers of vinyl chloride exposure (mutant ras-p21 and mutant p53) to examine workers with equivalent cumulative exposures that would be above or below the current permissible workplace exposure limit for vinyl chloride for differences in the presence of these biomarkers. Workers with cumulative exposures above the current permissible exposure limit (equivalent of > 40 ppm-years) have a statistically significantly increased occurrence of both biomarkers in comparison to unexposed controls (p < 10^?3). Although workers with cumulative exposures of < 10 ppm-years, i.e., well below the current limit, do not have a statistically significantly increased occurrence of these biomarkers (p > 0.05), workers with cumulative exposures of 10 to 40 ppm-years, i.e., still below the current limit, are found to have a statistically significant increase (p < 0.05). This suggests that the current exposure limit may not be adequately protective and illustrates the potential utility of molecular biomarkers in the refinement of risk assessments for toxic exposures.