Exposure to particulate air pollutants associated with numerous cancers

Researchers have found that long-term exposure to environmental pollutants was associated with increased risk of mortality for many types of cancer in an elderly Hong Kong population.

The study between the University of Birmingham and University of Hong Kong, published in Cancer Epidemiology, Biomarkers & Prevention, a journal of the American Association for Cancer Research, adds to growing concern around the health risks of prolonged exposure to ambient fine particulate matter.

Particulate matter is the term for particles found in the air, including hydrocarbons and heavy metals produced by transportation and power generation, among other sources. This study focused on ambient fine particulate matter, or matter with an aerodynamic diameter of less than 2.5 micrometers (PM2.5).

For every 10 microgram per cubic meter (µg/m³) of increased exposure to PM2.5, the risk of dying from any cancer rose by 22 percent.

Dr Neil Thomas, from the Institute of Applied Health at The University of Birmingham, said, “The implications for other similar cities around the world are that PM2.5 must be reduced to reduce the health burden. Air pollution remains a clear, modifiable public health concern.”

Dr Thuan Quoc Thach, from the University of Hong Kong, said, “Long-term exposure to particulate matter has been associated with mortality mainly from cardiopulmonary causes and lung cancer, but there have been few studies showing an association with mortality from other cancers. We suspected that these particulates could have an equivalent effect on cancers elsewhere in the body.”

The researchers recruited 66,280 people aged 65 or older between 1998 and 2001, and followed the subjects until 2011, ascertaining causes of death from Hong Kong registrations. Annual concentrations of PM2.5 at their homes were estimated using data from satellite data and fixed-site monitors.

After adjusting for smoking status, and excluding deaths that had occurred within three years of the baseline to control for competing diseases, the study showed that for every 10 µg/m³ of increased exposure to PM2.5, the risk of dying from any cancer rose by 22 percent. Increases of 10 µg/m³ of PM2.5 were associated with a 42 percent increased risk of mortality from cancer in the upper digestive tract and a 35 percent increased risk of mortality from accessory digestive organs, which include the liver, bile ducts, gall bladder, and pancreas.

For women, every 10 µg/m³ increase in exposure to PM2.5 was associated with an 80 percent increased risk of mortality from breast cancer, and men experienced a 36 percent increased risk of dying of lung cancer for every 10 µg/m³ increased exposure to PM2.5.

The team believe that possible explanations for the association between PM2.5 and cancer could include defects in DNA repair function, alterations in the body’s immune response, or inflammation that triggers angiogenesis, the growth of new blood vessels that allows tumours to spread. In the case of the digestive organs, heavy metal pollution could affect gut microbiota and influence the development of cancer.

The large scale of the study, as well as its documentation of cancer-specific mortality, enables a detailed investigation of the contribution of particulate matter to these cancers and counters the common problems associated with research into mortality via specific types of cancer in a population.

Dr Thomas added, “The next step is to determine whether other countries experience similar associations between PM2.5 and cancer deaths. This study, combined with existing research, suggests that other urban populations may carry the same risks but we'd be keen to look into this further.”

Dr Thach concluded, “The limitation to this study is the sole focus on PM2.5. Emerging research is beginning to study the effects of exposure to multiple pollutants on human health. We must be cautious though, as pollution is just one risk factor for cancer, and others, such as diet and exercise, may be more significant and more modifiable risk factors.”

Notes to editors

This study was funded by the Wellcome Trust.

For more information, a copy of the full paper, or interviews with Dr Thomas, please contact Luke Harrison, Media Relations Manager, University of Birmingham on +44 (0)121 414 5134.

To interview Dr Thuan Quoc Thach, please contact Julia Gunther at [email protected] or 215-446-6896.

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Exposure to particulate air pollutants associated with numerous cancers

Using oxygen to sterilise medical implants could save time and money

International researchers led by the University of Bath have demonstrated a cheap, effective and environmentally-friendly way to sterilise medical implants without changing their properties, in contrast to some techniques.

This inexpensive technology could save time and money while effectively sterilising medical implants, does not require extensive training and produces no waste products

Scientists from the University of Bath’s Department of Pharmacy & Pharmacology and Centre for Regenerative Medicine and from the Faculty of Pharmaceutical Sciences, University of São Paulo, Brazil, showed that ozone gas, obtained by passing electricity through oxygen, effectively sterilises one of the most common types of polymer used in medical implants.

Polymer implants, such as screws, pins and stents, are commonly used in surgical treatments, and there is an increasing use of implantable polymers in fields such as drug delivery, regenerative medicine and tissue engineering.

These materials must be sterile before use, but some methods of sterilisation alter their physical or chemical properties, potentially reducing performance.

The researchers showed that exposing the implants to as few as two controlled ‘pulses’ of ozone gas could sterilise the polymer, called poly(lactic-co-glycolic acid) (PLGA), killing spores of the Geobacillus stearothermophilus bacteria, the most common biological indicator used for validation of sterilisation processes.

Ozone treatment caused no changes in the PLGA and no loss of function, with cells still able to grow on the polymer scaffold, as they would in treatments.

This contrasts to methods such as gamma or electron beam radiation which are expensive and can damage the polymer. Other techniques also include risks to the polymer due to the heat, pressure and toxicity involved.

Ozone is cheap, safe and environmentally friendly because its only by-product is atmospheric oxygen, and is able to kill viruses, bacteria and fungi.

Dr Paul De Bank, Lecturer in Pharmaceutics at the University of Bath, said: “A significant worldwide effort is being made to create implantable polymeric matrices for a number of medical and surgical applications.

“Maintaining sterile manufacturing facilities is extremely costly, so the ideal scenario is to sterilise the matrix post-manufacture. Unfortunately, many sterilisation techniques adversely affect the physical or chemical properties of the materials used in the scaffolds, and this can alter their overall performance.

“We decided to investigate pulsed ozone gas as an alternative sterilisation method and chose PLGA as it’s perhaps the most widely used implantable polymer.

“We decided to look at nanofibers specifically as they are extremely fine and allowed us to easily determine if the sterilisation treatment affected the scaffold’s structure. The fact that ozone performed so well suggests it could be routinely used to sterilise not only PLGA, but a wide range of materials used in clinical implants.”

Carolina Rediguieri, a PhD student from São Paulo who carried out the work during a six month visit to Dr De Bank’s laboratory in Bath, said: “Sterility is a critical attribute of implantable materials that needs to be met in order to be applied in vivo. Our findings suggest that sterilisation by ozone gas is very likely to work for other implantable polymers as well, especially other polyesters.”

The study Ozone Gas as a Benign Sterilization Treatment for PLGA Nanofiber Scaffolds is published in the journal Tissue Engineering Part C: Methods.

The research was funded by University of Bath Global Partner Research Scholarship Scheme, National Council of Technological and Scientific Development of Brazil and the University of São Paulo.

93 per cent of the University’s Pharmacy & Pharmacology research was rated as world leading or internationally excellent in the recent independently-assessed Research Excellence Framework 2014. Overall Bath ranked in the top 3 of universities with a School of Pharmacy.  

We are one of the UK's leading universities with an international reputation for quality research and teaching. Our Mission is to deliver world class research and teaching, educating our graduates to become future leaders and innovators, and benefiting the wider population through our research, enterprise and influence. Our courses are innovative and interdisciplinary and we have an outstanding record of graduate employment.

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VIB/UGent researchers use viral particles to trap intact mammalian protein complexes

With his feet in both a proteomics lab and an interactomics lab, VIB/UGent professor Sven Eyckerman is well aware of the shortcomings of conventional approaches to analyze protein complexes. The lysis conditions required in mass spectrometry–based strategies to break open cell membranes often affect protein-protein interactions. “The first step in a classical study on protein complexes essentially turns the highly organized cellular structure into a big messy soup”, Eyckerman explains.

Inspired by virus biology, Eyckerman came up with a creative solution. “We used the natural process of HIV particle formation to our benefit by hacking a completely safe form of the virus to abduct intact protein machines from the cell.” It is well known that the HIV virus captures a number of host proteins during its particle formation. By fusing a bait protein to the HIV-1 GAG protein, interaction partners become trapped within virus-like particles that bud from mammalian cells. Standard proteomic approaches are used next to reveal the content of these particles. Fittingly, the team named the method ‘Virotrap’.

The Virotrap approach is exceptional as protein networks can be characterized under natural conditions. By trapping protein complexes in the protective environment of a virus-like shell, the intact complexes are preserved during the purification process. The researchers showed the method was suitable for detection of known binary interactions as well as mass spectrometry-based identification of novel protein partners.

Virotrap is a textbook example of bringing research teams with complementary expertise together. Cross-pollination with the labs of Jan Tavernier (VIB/UGent) and Kris Gevaert (VIB/UGent) enabled the development of this platform.

Jan Tavernier: “Virotrap represents a new concept in co-complex analysis wherein complex stability is physically guaranteed by a protective, physical structure. It is complementary to the arsenal of existing interactomics methods, but also holds potential for other fields, like drug target characterization. We also developed a small molecule-variant of Virotrap that could successfully trap protein partners for small molecule baits.”

Kris Gevaert: “Virotrap can also impact our understanding of disease pathways. We were actually surprised to see that this virus-based system could be used to study antiviral pathways, like Toll-like receptor signaling. Understanding these protein machines in their natural environment is essential if we want to modulate their activity in pathology.“

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Publication
Trapping Mammalian Protein Complexes in Viral Particles, Eyckerman et al., Nature Communications 2016

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VIB/UGent researchers use viral particles to trap intact mammalian protein complexes

Clinicians studying rare brain tumours around the world connect through new SickKids registry

By Emily de Medeiros - With the goal of accelerating and improving diagnosis and treatment strategies for children affected by these rare and often fatal tumours, a new online registry for rare paediatric brain tumours was launched. Led by The Hospital for Sick Children (SickKids), this global network known as the Rare Brain Tumor Consortium (RBTC) has collected medical and biological information from nearly 1,000 unique brain tumours to date.

These rare brain tumours in children are also collectively known as embryonal tumours that include primitive neuroectodermal tumours (PNETs) and atypical teratoid rhabdoid tumours (ATRTs). They are estimated to make up five to 10 per cent of malignant brain tumours in children.

“Finding effective treatment options for these rare brain tumours can be challenging because they can often be mistaken for other more common tumours such as medulloblastoma, but these tumours behave differently,” explains Dr. Annie Huang, lead of the RBTC, Staff Oncologist in the Paediatric Brain Tumour Program in the Division of Oncology/Haematology and Senior Scientist in Cell Biology at SickKids.

In 2006, three-year-old Tal (Tali) Doron was diagnosed with ATRT, a condition that makes up only three per cent of all rare brain tumours found in children. “When we found out Tali’s condition was so rare, we were frightened and felt very isolated by the lack of information available to us,” says Kim Doron, Tali’s mom and co-founder of Tali’s Fund.

“On average, SickKids sees about three to four cases of rare tumours a year, which isn’t enough to conduct a clinical trial to see significant results,” explains Huang who is also Associate Professor in the Department of Paediatrics at the University of Toronto. “By studying large numbers of patients with rare brain tumours through the RBTC, we hope to better understand the biology of rare childhood brain tumors in order to accelerate the development of new approaches to diagnosis, establish more effective therapies, and ultimately improve patient outcomes.”  

Unfortunately in 2007, Tal‘s cancer returned after just a few months of being home. There were no further treatment options available due to the severity of her condition and she passed away a few weeks later at the age of four. “Tali, as well as other patients and families truly inspired the creation of this registry,” says Huang.

At the time, Huang and her colleagues didn’t think a resource like the RBTC would be possible, but after more than a decade of collaborative research, the online registry was launched. “Not only will this registry benefit the research of rare brain tumours, but it will also offer a worldwide network for parents to connect with one another for moral support,” says Doron. “This resource would have helped us make more informed decisions about treatment options and given us comfort knowing we were not alone.”

To date, there are over 70 centres around the world that participate or contribute data to the registry. The RBTC facilitates dialogue between physicians around the world so they may offer support to one another and contribute data and information for research on diagnosis and treatment options. In addition, patients have easy access to reliable information and sources regarding these rare brain tumours.

“The more we know about these tumours, the better chance we have at making rare brain tumours a curable disease,” says Huang.

This online registry was funded and supported in part by SickKids Foundation, Tali’s Fund, Meagan’s Walk, Genome Canada, The Arthur and Sonia Labatt Brain Tumour Research Centre, Grace, b.r.a.i.n. Child, Canadian Institutes of Health Research, the Garron Family Cancer Centre, Martel Foundation, and the Mitchell Benjamin Duckman Fund.

Please visit the Rare Brain Tumor Consortium for more information.

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Heart Patient Plus One Finds Second Home at UC Health

Lesly Maytee Samayoa Solares was visiting a community clinic for severe vomiting, a symptom she thought was related to her pregnancy, when she learned something else was creating her discomfort.

An echocardiogram suggested the 28-year-old Florence, KY, resident was suffering from dilated cardiomyopathy, a disease of the heart muscle that weakens the heart’s ability to pump blood adequately throughout the body. Samayoa Solares was referred to UC Health’s Advanced Heart Failure Treatment Center in April 2015.

"They told me that my heart was sick,” says Samayoa Solares, a native of Guatemala, who spoke through an interpreter. "They said that it was too big and that it was not possible for me to have a baby with the heart like I had it at the moment.”

But a team of medical staff—physicians, cardiologists, high-risk obstetrics, anesthesiologists, nursing managers, and members of the cardiovascular intensive care unit—met to make the seemingly impossible a reality. They developed a plan of care to deliver Samayoa Solares’ baby. A few days prior to her planned admission, she came to the UC Medical Center Emergency Department with chest pain.

"She was admitted to the cardiovascular intensive care unit and four attending physicians met at her bedside,” says Stephanie Dunlap, DO, associate professor in UC’s College of Medicine and medical director of the UC Health Advanced Heart Failure Treatment Center. "The plan for care changed from normal vaginal delivery to cesarean section and was performed in UC Medical Center’s hybrid operating room.”

Samayoa Solares gave birth to a healthy baby boy, Julian, the weekend after Thanksgiving.

"She is remarkably asymptomatic,” says Dunlap, who with David Feldman, MD, are now Samayoa Solares’ primary physicians. "We have her on quite a bit of medical therapy and after the baby was delivered, she also had a defibrillator placed internally. This scenario is fairly unusual and that’s why she was transferred here because we have the advanced heart failure treatment program.”

Samayoa Solares’ pregnancy exacerbated her underlying heart condition.

"I had the symptoms a few years ago, but they were not as severe as this time last year,” says Samayoa Solares. "I had been seen by doctors in my country Guatemala, and they did not mention that my heart was sick. I was just told it was some tachycardia, and it was controlled with medications.

"Now, I feel like somebody who is normal, who can take care of herself and take care of her family,” says Samayoa Solares. "I do feel tired sometimes, but I work together with my husband, Jonathan, so we both take care of the family and he can go to work as well.”

Dunlap says physicians continue to monitor Samayoa Solares because she has an abnormal genetic type in her family that leads to premature deaths from heart disease.  Samayoa Solares says her mother and sister have suffered from heart failure and both are now deceased as a result.

Dunlap urges pregnant mothers with underlying heart failure to come to UC Health early during their pregnancy for care.  Samayoa Solares seconds that thought. She says her journey to hospital was part of "God’s call.”

"The people and the team in this hospital gave us love and care,” says Samayoa Solares. "They treated us like we were their own family, like they were my family, like what my husband would have done and like what my parents would have done for me.

"I would describe the staff here as angels.  They really work out of love, more than just for a paycheck,” says Samayoa Solares, again speaking through an interpreter. "They are worried when I’m not doing well, and they are happy when I am. They do everything possible.”

She says UC Health’s rehabilitation and therapy providers also played an important role in helping her through the healing process.

"I was waiting for this pregnancy even before I knew I was pregnant and when I found out I was so happy and thankful to God that when they asked me if I wanted to stop the pregnancy and I chose not to I was thankful to the team because they supported me at every step of the journey,” says Samayoa Solares.

"I believe God puts you in the journey that he wants,” she says. "I don’t see the hospital as a medical center, but I see it as a second home. It’s not like I want to be here all the time, but I can come here when I need to.

"God works through the doctors and staff at the hospital to make miracles happen,” explains Samayoa Solares.

Media Contact:     Cedric Ricks, 513-558-4657

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Working longer may lead to a longer life, new OSU research shows

The researchers found that healthy adults who retired one year past age 65 had an 11 percent lower risk of death from all causes, even when taking into account demographic, lifestyle and health issues. Adults who described themselves as unhealthy were also likely to live longer if they kept working, the findings showed, which indicates that factors beyond health may affect post-retirement mortality.

“It may not apply to everybody, but we think work brings people a lot of economic and social benefits that could impact the length of their lives,” said Chenkai Wu, the lead author of the study. He conducted the research as part of his master’s thesis at OSU, where he is now a doctoral student in the College of Public Health and Human Sciences.

The findings were published recently in the Journal of Epidemiology and Community Health. Co-authors include Associate Professor Robert Stawski and Assistant Professor Michelle Odden of OSU and Gwenith Fisher of Colorado State University. The research was supported by a grant from the National Institute on Aging.

The research was the basis for Wu’s master’s thesis in human development and family science; he’s now pursuing a doctorate in epidemiology.

Wu took an interest in the effects of retirement on health in part because of China’s mandatory laws, which are often debated. Retirement age is also an issue for debate elsewhere around the world, including the United States, he said.

“Most research in this area has focused on the economic impacts of delaying retirement. I thought it might be good to look at the health impacts,” Wu said. “People in the U.S. have more flexibility about when they retire compared to other countries, so it made sense to look at data from the U.S.”

Wu examined data collected from 1992 through 2010 through the Healthy Retirement Study, a long-term study of U.S. adults led by the University of Michigan and funded by the National Institute on Aging. Of the more than 12,000 initial participants in the study, Wu narrowed his focus to 2,956 people who began the study in 1992 and had retired by the end of the study period in 2010. 

Poor health is one reason people retire early and also can lead to earlier death, so researchers wanted to find a way to mitigate a potential bias in that regard.

To do so, they divided the group into unhealthy retirees, or those who indicated that health was a factor in their decision to retire – and healthy retirees, who indicated health was not a factor. About two-thirds of the group fell into the healthy category, while a third were in the unhealthy category.

During the study period, about 12 percent of the healthy and 25.6 percent of the unhealthy retirees died. Healthy retirees who worked a year longer had an 11 percent lower risk of mortality, while unhealthy retirees who worked a year longer had a 9 percent lower mortality risk. Working a year longer had a positive impact on the study participants’ mortality rate regardless of their health status.

“The healthy group is generally more advantaged in terms of education, wealth, health behaviors and lifestyle, but taking all of those issues into account, the pattern still remained,” said Stawski, senior author of the paper. “The findings seem to indicate that people who remain active and engaged gain a benefit from that.”

Additional research is needed to better understand the links between work and health, the researchers said. As people get older their physical health and cognitive function are likely to decline, which could affect both their ability to work and their longevity.

“This is just the tip of the iceberg,” Stawski said. “We see the relationship between work and longevity, but we don’t know everything about people’s lives, health and well-being after retirement that could be influencing their longevity.”

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Young gay and bisexual men six times more likely to attempt suicide than older counterparts

Rainbow flagYoung gay and bisexual men are at significantly greater risk of poor mental health than older men in that group, according to new research published in the Journal of Public Health.

Conducted by the London School of Hygiene & Tropical Medicine and funded by Stonewall, the study found gay and bisexual men under the age of 26 were six times more likely to attempt suicide or self-harm compared to men in that group aged over 45. They were also twice as likely to be depressed or anxious. The researchers say the results reinforce the importance of mental health interventions reaching those who need them most, as well as people who actively seek help.

The study is the first to examine the mental health differences within gay and bisexual men in the UK. Using data from the Stonewall Gay and Bisexual Men’s Health Survey, the researchers analysed responses of 5,799 gay and bisexual men aged 16 and over living in the UK. Depression, anxiety, attempted suicide and self-harm were examined against a range of life factors. Age, ethnicity, income and education were all found to have a large impact on mental health.

Black gay and bisexual men were twice as likely to be depressed and five times more likely to have attempted suicide than the white majority. Men in the lower wage bracket were more likely to be depressed, anxious, attempt suicide or self-harm. Those with lower levels of education were twice as likely to experience one of those issues compared to those with degree level education, only in part due to earning a lower wage.

Although more research is needed, the authors suggest older men are able to cope better with homophobia and that homophobia is more prevalent in the lives of younger men. The study also indicates that gay and bisexual men may experience discrimination or marginalisation unrelated to their sexuality.

Lead author Dr Ford Hickson from the London School of Hygiene & Tropical Medicine said: “Mental illness is one of the biggest health challenges facing the world today and can affect people from all walks of life. We know minority groups are at higher risk of poor mental health than the heterosexual majority, however the mental health differences within sexual minorities is unclear.

“Our study showed that among gay and bisexual men, age and ethnicity had a significant impact on mental health, as did income and education. This is possibly because men are better able to cope with homophobia the older they are, or if they are relatively privileged in other areas of their lives.”

The researchers also discovered cohabitation is key for positive mental health, with men who are living with a male partner 50% less likely to suffer from depression compared to gay and bisexual men living alone. Living in London was also shown to be advantageous, perhaps because London has the largest population of gay men in the world and isolation and discrimination are less common there.

Dr Hickson said: “Minority groups are usually thought to be more homogenous than they actually are, when in fact there is great variation in health and life situations among this group. What’s clear is that health inequalities among gay and bisexual men mirror those in the broader society.

“Poor mental health is not evenly distributed across race, income or education. We must ensure that access to life-changing support services are targeted to where they are needed most. Everyone has the right to good mental health.”

April Guasp, Head of Research at Stonewall, said: “We’re really pleased to see this further in-depth analysis of mental health issues faced by gay and bisexual men. It’s known that a range of factors can increase risk of poor mental health among the population in general and the same holds true for gay and bisexual men. This study contributes to better understanding of the specific risks within LGBT communities and will hopefully lead to more targeted health interventions.”

The authors note that their findings may be limited because survey participants were not a random sample of the population and were therefore unlikely to be representative of all UK gay and bisexual men.
Publication

    Ford Hickson, Calum Davey, David Reid, PeterWeatherburn, Adam Bourne. Mental health inequalities among gay and bisexual men in England, Scotland and Wales: a large community-based cross-sectional survey. Journal of Public Health. DOI:10.1093/pubmed/fdw021

Related links

    Sigma research group

    Feature - Sex in the UK: how culture and society can define your sexual health

Related course

    MSc Public Health

Image: Rainbow flag. Credit: Flickr/kevingoebel
 London School of Hygiene & Tropical Medicine

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