Breast Cancer Risk in Relation to Occupations with Exposure to Carcinogens and Endocrine Disruptors:a Canadian Case-Control Study

Background

Endocrine disrupting chemicals and carcinogens, some of which may not yet have been classified as such, are present in many occupational environments and could increase breast cancer risk. Prior research has identified associations with breast cancer and work in agricultural and industrial settings. The purpose of this study was to further characterize possible links between breast cancer risk and occupation, particularly in farming and manufacturing, as well as to examine the impacts of early agricultural exposures, and exposure effects that are specific to the endocrine receptor status of tumours.

Methods

1005 breast cancer cases referred by a regional cancer center and 1147 randomly-selected community controls provided detailed data including occupational and reproductive histories. All reported jobs were industry- and occupation-coded for the construction of cumulative exposure metrics representing likely exposure to carcinogens and endocrine disruptors. In a frequency-matched case?control design, exposure effects were estimated using conditional logistic regression.

Results

Across all sectors, women in jobs with potentially high exposures to carcinogens and endocrine disruptors had elevated breast cancer risk (OR = 1.42; 95% CI, 1.18-1.73, for 10 years exposure duration). Specific sectors with elevated risk included: agriculture (OR = 1.36; 95% CI, 1.01-1.82); bars-gambling (OR = 2.28; 95% CI, 0.94-5.53); automotive plastics manufacturing (OR = 2.68; 95% CI, 1.47-4.88), food canning (OR = 2.35; 95% CI, 1.00-5.53), and metalworking (OR = 1.73; 95% CI, 1.02-2.92). Estrogen receptor status of tumors with elevated risk differed by occupational grouping. Premenopausal breast cancer risk was highest for automotive plastics (OR = 4.76; 95% CI, 1.58-14.4) and food canning (OR = 5.70; 95% CI, 1.03-31.5).

Conclusions

These observations support hypotheses linking breast cancer risk and exposures likely to include carcinogens and endocrine disruptors, and demonstrate the value of detailed work histories in environmental and occupational epidemiology.

Children's Views on Children's Right to Work:Reflections from Belfast

The purpose of this article is to examine children’s attitudes regarding the right to work. The article is based on comments made by 245 15-year-old children on child employment and is supported by focus group interviews with 56 boys and 38 girls and tape-recorded interviews with 15 working pupils. One of most dominant themes to emerge from the data is children’s perception that they have a right to work. The article examines the legislation regarding child employment in Northern Ireland and the role of the state in determining the legislation. The author suggests that within this legislation, children are seen as vulnerable and in need of protection. Traditionally the protection of children in the workforce has been achieved by limiting the hours they can work and the occupations they can enter. Yet when children’s own views are taken into account, they move beyond the limits of protecting them through exclusion to suggesting frameworks whereby their protection may be achieved by empowering them within the labour market.

The census and women's work in Rangoon, 1872–1931

The colonial census was a bureaucratic device which provided an essential abstraction from social reality, a ‘statistical fix’ designed to map individual social groups in space. This paper considers the contradictions associated with colonial knowledge systems as reflected in the census grafted onto Burmese society in the nineteenth and early twentieth centuries. It attempts to chart the general adoption and adaptation, in the Burmese context, of a classificatory scheme which categorised labour as either productive or unproductive. Colonialism introduced new attitudes towards work and labour which reinforced patriarchal values which contrasted with more egalitarian Burmese socio-economic systems. The paper suggests that a simple classification of women workers as either productive or unproductive in the Burmese census between 1872 and 1931 resulted in the devaluation of their status as workers. This devaluation was a function of both real economic transformation taking place in the empire and changes in census classification, reflecting a gendering of occupations that undermined the cultural norms of Burmese society. The material result was that women became statistically less visible as economically productive workers. Such ascriptions of value to women workers were largely informed by moral considerations originating in England.

Prevalence of childhood abuse in mothers taking part in a study of parenting their own children.

This paper describes the incidence of maltreatment histories in a community sample of mothers of one-year old infants in Northern Ireland. The occurrence of five subsets of childhood maltreatment is examined: emotional abuse, emotional neglect, physical abuse, physical neglect and sexual abuse. Of the 201 women who completed the Childhood Trauma Questionnaire (CTQ), 70 mothers (35%) reported experiencing one or more types of maltreatment during childhood. Forty-eight mothers (24%) gave a history of being emotionally abused, 43 (21%) of emotional neglect, 27 (13%) of physical abuse, 20 (10%) of sexual abuse, and 19 (10%) of physical neglect. Physical abuse was the only type of maltreatment which showed an association with maternal socio-economic status, with higher incidence reported amongst Occupational Classes 4 and 5 (lower supervisory and technical occupations and semi-routine and routine groups). More than half of those with a history of abuse experienced more than one type of maltreatment (42 mothers or 60% of those reporting maltreatment). Differences in rates of incidence to more recent studies on younger adults are discussed, as well as implications for prevention and intervention.

Site formation processes in caves: the Holocene sediments of the Haua Fteah, Cyrenaica, Libya.

Caves have yielded some of the most globally important archaeological sequences, but often their interpretation has suffered from assumptions about cave sedimentary processes. Caves contain distinctive sedimentary environments: this has major implications for the understanding of contained archaeological materials. This paper describes and analyses the Holocene sediments in the Haua Fteah, a sequence regarded as essentially continuous by the original excavator. 50 years after it was first excavated, the Haua’s Epipalaeolithic to post-Classical chronological range and rich finds make it still the key Holocene archaeological site in North Africa. The reassessment shows, however, that the sequence is strongly discontinuous and this has major implications for the reinterpretation of the site, as the highlyresolved archaeological record is thus likely to reflect a series of brief occupations, rather than continuous human activity. As with many caves, the sedimentary record in the Haua Fteah is an extremely sensitive indicator of environments and processes in the wider landscape. Secure understanding of sedimentary process, from analysis of the highly individual records found in caves, is essential for full understanding of their contained archaeology.

Distance between home and work: A multilevel analysis of individual workers, neighbourhoods, and employment sites in Northern Ireland

Abstract. We explore the distances between home and work for employees at twenty-eight different employment sites across Northern Ireland. Substantively, this is important for better understanding the geography of labour catchments. Methodologically, with data on the distances between place of residence (566 wards) and place of work for some 15 000 workers, and the use of multilevel modelling (MLM), the analysis adds to the evidence derived from other census-based and survey-based studies. Descriptive analysis is supplemented with MLM that simultaneously explores individual, neighbourhood, and site variations in travel-to-work patterns using hierarchical and cross-classified model specifications, including individual and ecological predictor variables (and their cross-level interactions). In doing so we apportion variability to different levels and spatial contexts, and also outline the factors that shape spatial mobility. We find, as expected, that factors such as gender and occupation influence the distance between home and work, and also confirm the importance of neighbourhood characteristics (such as population density observed in ecological analyses at ward level) in shaping individual outcomes, with major differences found between urban and rural locations. Beyond this, the analysis of variability also points to the relative significance of residential location, with less individual variability in travel-to-work distance between workers within wards than within employment sites. We conclude by suggesting that, whilst some general ‘rules’ about the factors that shape labour catchments are possible (eg workers in rural areas and in higher occupations travel further than others), the complex variability between places highlighted by the MLM analysis illustrates the salience of place-specific uniqueness.

Redundancy and Workplace Occupation: The Case of the Republic of Ireland

Purpose – This paper aims to examine the antecedent influences and merits of workplace occupations as a tactical response to employer redundancy initiatives.

Design/methodology/approach – The data are based on analysis of secondary documentary material reporting on three workplace occupations in the Republic of Ireland during 2009.

Findings – Perceptions of both procedural (e.g. employer unilateral action) and substantive (e.g. pay and entitlements) justice appear pivotal influences. Spillover effects from other known occupations may also be influential. Workplace occupations were found to produce some modest substantive gains, such as enhancing redundancy payments. The tactic of workplace occupation was also found to transform unilateral employer action into scenarios based upon negotiated settlement supported by third-party mediation. However the tactic of workplace occupation in response to redundancy runs the risks of potential judicial injunction and sanction.

Research limitations/implications – Although operationally difficult, future studies should strive to collect primary data workplace occupations as they occur.

Originality/value – The paper identifies conditions conducive to the genesis of workplace occupations and the extent to which the tactic may be of benefit in particular circumstances to workers facing redundancy. It also contextualises the tactic in relation to both collective mobilisation and bargaining theories in employment relations.

Environmental, lifestyle, and familial/ethnic factors associated with myeloproliferative neoplasms

Myeloproliferative neoplasms (MPNs) are characterized by overproduction of mature functional blood cells and are often associated with an acquired genetic mutation of Janus Kinase 2V617F. The etiology of MPNs remains unknown. The aim of this article was to review and collate all known published data investigating environmental and lifestyle factors associated with MPNs. Medline, Embase, PubMed, Cochrane, and Web of Science were systematically searched using terms for MPNs and observational study designs to identify studies investigating the risk factors for MPNs published before March 2010. Of 9,156 articles identified, 19 met the selection criteria. Although the studies exhibited heterogeneity, in case definitions, study design, and risk factors investigated, several themes emerged. A strong association was found with Jewish descent, and with a family history of MPNs. Autoimmune conditions, specifically Crohn's disease, were more common in patients with MPNs. Certain occupational groups were significantly associated with MPNs including occupations with potential exposure to benzene and/or petroleum. Blood donation was associated with an increased risk of polycythemia vera specifically. The vast heterogeneity in studies identified as part of this review suggests that large scale systematic assessment of etiological factors associated with MPNs is warranted. (C) 2011 Wiley-Liss, Inc.

Moral distress experienced by health care professionals who provide home-based palliative care

Health care providers regularly encounter situations of moral conflict and distress in their practice. Moral distress may result in unfavorable outcomes for both health care providers and those in their care. The purpose of this study was to examine the experience of moral distress from a broad range of health care occupations that provide home-based palliative care as the initial step of addressing the issue. A critical incident approach was used in qualitative interviews to elicit the experiences on moral distress from 18 health care providers drawn from five home visiting organizations in south central Ontario, Canada. Most participants described at least two critical incidents in their interview generating a total of 47 critical incidents. Analyses of the critical incidents revealed 11 issues that triggered moral distress which clustered into three themes, (a) the role of informal caregivers, b) challenging clinical situations and (c) service delivery issues. The findings suggest that the training and practice environments for health care providers need to be designed to recognize the moral challenges related to day-to-day practice.

Worked to Death? A census-based longitudinal study of the relationship between the numbers of hours spent working and mortality risk

Background There has been an increasing interest in the health effects of long
working hours, but little empirical evidence to substantiate early
10 case series suggesting an increased mortality risk. The aim of the
current study is to quantify the mortality risk associated with long
working hours and to see if this varies by employment relations and
conditions of occupation.
Methods A census-based longitudinal study of 414 949 people aged 20-59/64
15 years, working at least 35 h/week, subdivided into four occupational
classes (managerial/professional, intermediate, own account workers,
workers in routine occupations) with linkage to deaths records
over the following 8.7 years. Cox proportional hazards models were
used to examine all-cause and cause-specific mortality risk.
20 Results Overall 9.4% of the cohort worked 55 or more h/week, but this
proportion was greater in the senior management and professional
occupations and in those who were self-employed. Analysis of 4447
male and 1143 female deaths showed that hours worked were
associated with an increased risk of all-cause mortality only for
25 men working for more than 55 or more h/week in routine/semiroutine
occupations [adjusted hazard ratios (adjHR) 1.31: 95%
confidence intervals (CIs) 1.11, 1.55)] compared with their peers
working 35–40 h/week. Their equivalent risk of death from cardiovascular
disease was (adjHR 1.49: 95% CIs 1.10, 2.00).
30 Conclusions These findings substantiate and add to the earlier studies indicating
the deleterious impact of long working hours but also suggest that
the effects are moderated by employment relations or conditions of
occupation. The policy implications of these findings are discussed.

Identification of 100 fundamental ecological questions

Fundamental ecological research is both intrinsically interesting and provides the basic knowledge required to answer applied questions of importance to the management of the natural world. The 100th anniversary of the British Ecological Society in 2013 is an opportune moment to reflect on the current status of ecology as a science and look forward to high-light priorities for future work. To do this, we identified 100 important questions of fundamental importance in pure ecology. We elicited questions from ecologists working across a wide range of systems and disciplines. The 754 questions submitted (listed in the online appendix) from 388 participants were narrowed down to the final 100 through a process of discussion, rewording and repeated rounds of voting. This was done during a two-day workshop and thereafter. The questions reflect many of the important current conceptual and technical pre-occupations of ecology. For example, many questions concerned the dynamics of environmental change and complex ecosystem interactions, as well as the interaction between ecology and evolution. The questions reveal a dynamic science with novel subfields emerging. For example, a group of questions was dedicated to disease and micro-organisms and another on human impacts and global change reflecting the emergence of new subdisciplines that would not have been foreseen a few decades ago. The list also contained a number of questions that have perplexed ecologists for decades and are still seen as crucial to answer, such as the link between population dynamics and life-history evolution. Synthesis. These 100 questions identified reflect the state of ecology today. Using them as an agenda for further research would lead to a substantial enhancement in understanding of the discipline, with practical relevance for the conservation of biodiversity and ecosystem function. © 2013 The Authors. Journal of Ecology © 2013 British Ecological Society.

‘“Indelible characters”:Tattoos, Power and the Late Nineteenth-Century Irish Convict Body

Since the late nineteenth-century works of criminologists Lombroso and Lacassagne, tattoos in Europe have been commonly associated with deviant bodies. Like many other studies of tattoos of non-indigenous origin, the locus of our research is the convict body. Given the corporeal emphasis of prison records, we argue that tattoos form a crucial part of the power dynamic. Tattoos in the carceral context embody an inherent paradox of their being a component in the reidentification of 'habitual criminals'. We argue that their presence can be regarded as an expression of convict agency: by the act of imprinting unique identifiers on their bodies, convicts boldly defied the official gaze, while equally their description in official records exacted power over the deviant body. Cursory findings show an alignment with other national studies; corporeal inscriptions in Ireland were more prevalent in men's prisons than women's and associated, however loosely, with certain occupations. For instance, maritime and military motifs find representation. Recidivists were more likely to have tattoos than first-time offenders; inscriptions were described as monotone, rudimentary in design and incorporated a limited range of impressions. Further to our argument that tattoos form an expression of convict defiance of prison authority, we have found an unusual idiosyncrasy in the convict record, that is, that the agency of photography, while undermined in general terms, was manipulated by prison officers.

Prehistoric foragers and farmers in south-east Asia:Renewed investigations at Niah Cave, Sarawak

The paper describes the initial results from renewed investigations at Niah Cave in Sarawak on the island of Borneo, famous for the discovery in 1958 of the c. 40,000-year old 'Deep Skull'. The archaeological sequences from the West Mouth and the other entrances of the cave complex investigated by Tom and Barbara Harrisson and other researchers have potential implications for three major debates regarding the prehistory of south-east Asia: the timing of initial settlement by anatomically modern humans; the means by which they subsisted in the late Pleistocene and early Holocene; and the timing, nature, and causation of the transition from foraging to farming. The new project is informing on all three debates. The critical importance of the Niah stratigraphies was commonly identified - including by Tom Harrisson himself - as because the site provided a continuous sequence of occupation over the past 40,000 years. The present project indicates that Niah was first used at least 45,000 years ago, and probably earlier; that the subsequent Pleistocene and Holocene occupations were highly variable in intensity and character; and that in some periods, perhaps of significant duration, the caves may have been more or less abandoned. The cultural sequence that is emerging from the new investigations may be more typical of cave use in tropical rainforests in south-east Asia than the Harrisson model.

These Fine Lines: Locating Noncitizenship in Political Protest in Europe

Since 2012, refugee protest camps and occupations have been established throughout Europe that contest the exclusion of refugees and asylum seekers, but that also make concrete demands for better living conditions and basic rights. It is a movement that is led by migrants as noncitizens, and so reveals new ways of thinking of the political agency and status of noncitizenship not as simply reactive to an absence of citizenship, but as a powerful and transgressive subjectivity in its own right. This paper argues that we should resist collapsing analysis back into the frameworks of citizenship, and instead be attentive to the politics of presence and solidarity manifest in these protest camps as a way of understanding, and engaging, noncitizen activism.

Technological aids for the rehabilitation of memory and executive functioning in children and adolescents with acquired brain injury (Review).

Background The use of technology in healthcare settings is on the increase and may represent a cost-effective means of delivering rehabilitation. Reductions in treatment time, and delivery in the home, are also thought to be benefits of this approach. Children and adolescents with brain injury often experience deficits in memory and executive functioning that can negatively affect their school work, social lives, and future occupations. Effective interventions that can be delivered at home, without the need for high-cost clinical involvement, could provide a means to address a current lack of provision. We have systematically reviewed studies examining the effects of technology-based interventions for the rehabilitation of deficits in memory and executive functioning in children and adolescents with acquired brain injury. Objectives To assess the effects of technology-based interventions compared to placebo intervention, no treatment, or other types of intervention, on the executive functioning and memory of children and adolescents with acquired brain injury. Search methods We ran the search on the 30 September 2015. We searched the Cochrane Injuries Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic + EMBASE (OvidSP), ISI Web of Science (SCI-EXPANDED, SSCI, CPCI-S, and CPSI-SSH), CINAHL Plus (EBSCO), two other databases, and clinical trials registers. We also searched the internet, screened reference lists, and contacted authors of included studies. Selection criteria Randomised controlled trials comparing the use of a technological aid for the rehabilitation of children and adolescents with memory or executive-functioning deficits with placebo, no treatment, or another intervention. Data collection and analysis Two review authors independently reviewed titles and abstracts identified by the search strategy. Following retrieval of full-text manuscripts, two review authors independently performed data extraction and assessed the risk of bias. Main results Four studies (involving 206 participants) met the inclusion criteria for this review. Three studies, involving 194 participants, assessed the effects of online interventions to target executive functioning (that is monitoring and changing behaviour, problem solving, planning, etc.). These studies, which were all conducted by the same research team, compared online interventions against a 'placebo' (participants were given internet resources on brain injury). The interventions were delivered in the family home with additional support or training, or both, from a psychologist or doctoral student. The fourth study investigated the use of a computer program to target memory in addition to components of executive functioning (that is attention, organisation, and problem solving). No information on the study setting was provided, however a speech-language pathologist, teacher, or occupational therapist accompanied participants. Two studies assessed adolescents and young adults with mild to severe traumatic brain injury (TBI), while the remaining two studies assessed children and adolescents with moderate to severe TBI. Risk of bias We assessed the risk of selection bias as low for three studies and unclear for one study. Allocation bias was high in two studies, unclear in one study, and low in one study. Only one study (n = 120) was able to conceal allocation from participants, therefore overall selection bias was assessed as high. One study took steps to conceal assessors from allocation (low risk of detection bias), while the other three did not do so (high risk of detection bias). Primary outcome 1: Executive functioning: Technology-based intervention versus placebo Results from meta-analysis of three studies (n = 194) comparing online interventions with a placebo for children and adolescents with TBI, favoured the intervention immediately post-treatment (standardised mean difference (SMD) -0.37, 95% confidence interval (CI) -0.66 to -0.09; P = 0.62; I2 = 0%). (As there is no 'gold standard' measure in the field, we have not translated the SMD back to any particular scale.) This result is thought to represent only a small to medium effect size (using Cohen’s rule of thumb, where 0.2 is a small effect, 0.5 a medium one, and 0.8 or above is a large effect); this is unlikely to have a clinically important effect on the participant. The fourth study (n = 12) reported differences between the intervention and control groups on problem solving (an important component of executive functioning). No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. The quality of evidence for this outcome according to GRADE was very low. This means future research is highly likely to change the estimate of effect. Primary outcome 2: Memory One small study (n = 12) reported a statistically significant difference in improvement in sentence recall between the intervention and control group following an eight-week remediation programme. No means or standard deviations were presented for this outcome, therefore an effect size could not be calculated. Secondary outcomes Two studies (n = 158) reported on anxiety/depression as measured by the Child Behavior Checklist (CBCL) and were included in a meta-analysis. We found no evidence of an effect with the intervention (mean difference -5.59, 95% CI -11.46 to 0.28; I2 = 53%). The GRADE quality of evidence for this outcome was very low, meaning future research is likely to change the estimate of effect. A single study sought to record adverse events and reported none. Two studies reported on use of the intervention (range 0 to 13 and 1 to 24 sessions). One study reported on social functioning/social competence and found no effect. The included studies reported no data for other secondary outcomes (that is quality of life and academic achievement). Authors' conclusions This review provides low-quality evidence for the use of technology-based interventions in the rehabilitation of executive functions and memory for children and adolescents with TBI. As all of the included studies contained relatively small numbers of participants (12 to 120), our findings should be interpreted with caution. The involvement of a clinician or therapist, rather than use of the technology, may have led to the success of these interventions. Future research should seek to replicate these findings with larger samples, in other regions, using ecologically valid outcome measures, and reduced clinician involvement.