Documents Woodward, Alistair 2 results

"The aim of this historical (retrospective) cohort study was to investigate the relation between occupational exposure to radon daughters and subsequent mortality from lung cancer. Participants were former workers from the Radium Hill uranium mine, which operated in eastern South Australia from 1952 to 1961. A total of 2,574 workers were identified from mine records. Exposures to radon daughters were estimated from historical records of radon gas concentrations in the mine and from individual job histories. Exposures of underground workers were low by comparison with other mines of that period (mean 7.0 Working Level Months [WLM], median 3.0 WLM). Thirty-six percent of the cohort could not be traced beyond the end of employment at Radium Hill. Among those traced to the end of 1987, lung cancer mortality was increased relative to the Australian national population of the period( Standardized Mortality Ratio = 194,9 5 percent confidence interval [CI] = 142-245). Compared with surface workers, lung cancer mortality was markedly increased in the underground workers with radon daughter exposures > 40 WLM (relative risk = 5.2, CI = 1.8-15.1). From the available information, we conclude that this increase is unlikely to be due to differences in smoking habits or other confounders. Taken together with the findings from other occupational studies, these results support current moves towards more stringent radiation control in the workplace, and underline the importance of research into the possible effects of domestic radon exposures.3

"Multi-level research that attempts to describe ecological effects in themselves (for example, the effect on individual health from living in deprived communities), while also including individual level effects (for example, the effect of personal socioeconomic disadvantage), is now prominent in research on the socioeconomic determinants of health and disease. Such research often involves the application of advanced statistical multi-level methods. It is hypothesised that such research is at risk of reaching beyond an epidemiological understanding of what constitutes an ecological effect, and what sources of error may be influencing any observed ecological effect. This paper aims to present such an epidemiological understanding. Three basic types of ecological effect are described: a direct cross level effect (for example, living in a deprived community directly affects individual personal health), cross level effect modification (for example, living in a deprived community modifies the effect of individual socioeconomic status on individual health), and an indirect cross level effect (for example, living in a deprived community increases the risk of smoking, which in turn affects individual health). Sources of error and weaknesses in study design that may affect estimates of ecological effects include: a lack of variation in the ecological exposure (and health outcome) in the available data; not allowing for intraclass correlation; selection bias; confounding at both the ecological and individual level; misclassification of variables; misclassification of units of analysis and assignment of individuals to those units; model mis-specification; and multicollinearity. Identification of ecological effects requires the minimisation of these sources of error, and a study design that captures sufficient variation in the ecological exposure of interest."