Environmental Exposures And Risk For Cancer and Chronic Diseases In Adults

National Institute Of Environmental Health Sciences

Investigators

Linked publications & trials

Abstract

Using data from the North Carolina Kidney Disease Study we evaluated associations between self-reported job history and specific occupational exposures, including solvents, dusts, metals and silica with risk for kidney disease. Our study included 548 cases with renal dysfunction confirmed by hospital chart review and 514 matched population controls. Specifically, we evaluated chronic kidney disease in relation to work in agriculture and manufacturing jobs in the presence of dusty conditions. We previously reported that occupational silica exposure was associated with increased chronic kidney disease risk. In related work using the Agricultural Health Study Cohort we linked the cohort to the US Renal Data System to evaluate risk for incident End Stage Renal Disease (ESRD). In that study, we found a positive exposure-response trend for five herbicides and one insecticide in relation to risk for end stage renal disease. We also found that doctor visits and hospitalizations due to unusually high pesticide exposures were also related in increased risk for future renal failure. We are studying a range of autoimmune diseases and autoimmunity using data collected in the Sister and Agricultural Health Study Cohorts as well as using population data such as NHANES and data from other studies such as the NIEHS Myositis registry (in collaboration with Drs. Miller and Rider in the NIEHS Autoimmunity Research Group) and the Women's Health Initiative. We studied factors associated with antinuclear antibodies (ANA) using the National Health Examination and Nutrition Survey (NHANES), including vitamin D and medication use, as well as the relationship of ANA with mortality risk (all-cause, cardiovascular disease and cancer). Findings of an ANA association with vitamin D in middle age and older adults, conducted in the context of work with the NIA below were recently published, and manuscripts on other findings have been submitted and are in preparation. Related work using the Sister Study cohort evaluated associations between early life and childhood factors and systemic lupus erythematosus (SLE), and between childhood residential and agricultural pesticide exposures and rheumatoid arthritis (RA), as described in recently published papers. Findings include associations of both SLE and RA with reported childhood exposures to residential and agricultural pesticides. A newer project in collaboration with investigators from the National Institute on Aging (NIA) is evaluating changes in ANA over time, exploring associations between vitamin D and other factors with ANA levels and trajectories, and evaluating whether ANA levels are associated with telomere shortening over time. Manuscripts are in preparation describing associations of ANA with years of age and health status, as well as findings of no association between ANA and vitamin D levels. Other analyses are ongoing, including changes over time and association between ANA, telomere length and telomere length change (markers of immune aging). Work on ALS is described in greater detail in a report by Freya Kamel. Briefly, work was carried in two settings using linked registry data in Sweden and in a case-control study nested within a registry of ALS in U.S. Veterans. As part of an NIH, Karolinska Institute partnership, we worked with a doctoral student who studied risk factors for Amyotrophic lateral sclerosis. Using data from Swedish registries, she found both higher and lower risk of ALS associated with several industries and occupations, with findings largely consistent with earlier reports. She also found an association between fractures and ALS that we speculate is largely due to early effects of incipient ALS. We also reported associations between specific military-related exposures and experiences and risk for ALS in our study of US veterans included in a national registry of ALS patients. We also evaluated links between blood levels of metals and ALS risk and survival. We found that selenium and zinc levels were inversely associated with ALS risk whereas copper was positively associated with increased risk. We also reported that body mass index had an association with ALS prognosis that was not explained by reverse causality.