Introdução: O câncer de mama é o segundo câncer mais incidente no mundo e o mais freqüente entre as mulheres, entretanto, sua etiologia continua desconhecida. O câncer de mama está associado a múltiplos fatores de risco, dentre eles, os fatores ocupacionais e ambientais. Objetivo: Fazer revisão bibliográfica sobre câncer de mama e exposição ocupacional e ambiental a solventes. Método: Artigos em inglês, português e espanhol foram selecionados no Pubmed e no Latin American and Caribbean Center on Health Sciences Information LILACS entre dezembro de 1981 a março de 2011. Os termos utilizados foram: breast cancer, breast neoplasm, solvent, occupational exposure and environment exposure. Foram excluídos os artigos sobre fatores genéticos, marcadores biológicos, polimorfismos, campos eletromagnéticos e nutrição. Baseado na revisão bibliográfica foi construído questionário sobre o tema e realizado teste com 29 casos e 29 controles, em um hospital da cidade de Santo André SP. Resultados: Não foram identificados artigos no Lilacs. No Pubmed foram encontrados 39 artigos. Após as exclusões 33 estudos foram selecionados: 11 casos-controle, 12 revisões, 09 coorte e 01 transversal. Em 21 artigos os autores identificaram alguma evidência de associação para os compostos alquilfenólicos, solventes orgânicos, PAHs, benzeno, estireno e percloretileno, possivelmente explicado por uma ação genotóxica direta ou através de seus metabólitos, especialmente quando as exposições ocorrem nos períodos proliferativos das células mamárias, nos carcinomas com receptores de estrógeno e progesterona negativos. Quanto ao questionário, 74 por cento dos casos e 80 por cento dos controles relataram uso de produtos químicos no trabalho sendo que 45 por cento dos casos e 55 por cento dos controles se expuseram a solventes. 62,1 por cento das participantes colaboram muito bem com a pesquisa, apesar de que, quanto ao detalhamento das respostas, 17,2 por cento das entrevistas apresentaram algumas partes duvidosas. A história ocupacional obtida através do questionário foi classificada como confiável em 67,2 por cento das entrevistas. Conclusão: Há limitadas evidências de associação entre os solventes e o câncer de mama. São necessárias mais pesquisas, com atenção para as diferenças histopatológicas, imuno-histoquímicas e genéticas das neoplasias de mama. O questionário desenvolvido precisa ser aprimorado para melhorar a confiabilidade das respostas / Introduction: Breast cancer is the most incident cancer among women in the world. However its etiology is still unknown. Multiple risk factors have been described. Occupational and environmental factors may play a role in the carcinogenesis. Objective: To make a literature review of the occupational and environmental risk factors for breast cancer. Methods: Breast cancer studies written in English, Portuguese and Spanish were identified through Pubmed and Latin American and Caribbean Center on Health Sciences Information LILACS from December 1981 to March 2011. The keywords used for the search in titles were: breast cancer, breast neoplasm, solvent, occupational exposure and environment exposure. Articles about genetic factors, biological markers, polymorphisms, electromagnetic fields and nutrition were excluded. Results: No articles were identified in Lilacs and 39 in Pubmed. After exclusions 33 studies were selected: 11 case-controls, 12 reviews, 09 cohorts and 01 cross-sectional. In 21 articles the authors identified some evidence of association for alkylphenolic compounds, organic solvents, PAH, benzene, styrene and perchloroethylene, possibly explained by a direct genotoxic action of the solvents or indirectly through their metabolites, especially when expositions happen during the proliferative period of the mammary cells, with estrogen and progesterone negative breast cancer receptors. 74 per cent cases and 80 per cent controls were exposed to chemicals in the workplace. 45 per cent cases and 55 per cent controls were exposed to solvents. 62 per cent participants collaborated very well with the research, although details regarding the responses of 17 per cent were uncertain. Occupational history obtained from the questionnaire was rated as trustworthy in 67 per cent of interviews. Conclusions: There is limited evidence of an association between solvents and breast cancer. More studies must be conducted to better understand the association between breast cancer and solvents, paying attention to hormone receptors, histopathological characteristics and BRCA1/ BRCA2 genes. The questionnaire needs to be enhanced to improve the reliability or responses

Background : Atrazine is an agricultural herbicide used extensively in corn production worldwide. Atrazine is an endocrine disruptor and has been linked to many other deleterious health outcomes. Exposure assessment studies have been carried out in Iowa among farm and non-farm populations. However, commercial pesticide applicators have been left out of those studies. Atrazine is also used in developing countries in grain production. In developing countries there is great concern about acute pesticide poisonings, but chronic exposure to less acutely toxic pesticides has not been studied extensively. This study assessed the in-home contamination of atrazine among commercial pesticide applicators in Iowa and then quantitatively analyzed these results with results from similar studies. Occupational inhalation exposure to atrazine was also assessed in Honduras. Methods : Dust samples were taken from 29 commercial pesticide applicator households in four different locations. This sampling was done once during the atrazine application season and again six months later during winter months to assess atrazine persistence. Occupational and household characteristics were analyzed for associations with atrazine dust levels. Data from two previous studies that analyzed farm and non-farm household dust samples for atrazine were combined with data from the commercial applicator's homes. This new and larger dataset was analyzed to identify which population has the greatest risk for take-home atrazine exposure and what determinants were associated with in-home atrazine dust levels. Lastly, corn production practices in Honduras were evaluated and personal air samples were taken from pesticide applicators during atrazine application to assess inhalation exposure. Results : The first study found that atrazine levels persist into the winter months in the homes of commercial applicators. Atrazine handling (days, pounds, and acres sprayed) were all positively associated with in-home atrazine levels. Commercial applicators that change their shoes inside had higher atrazine levels. More frequent floor cleaning was associated with lower atrazine levels. The second study identified commercial applicators' homes as the most contaminated compared with farmers who apply atrazine to their own land, farmers who hire out atrazine application, and non-farm homes. Farmers that apply their own atrazine also had significantly higher atrazine levels in their homes. The association between atrazine handling and household atrazine levels was highly significant in this study (p < 0.001). In Honduras, atrazine is applied to corn fields with tractor/boom equipment and manual backpack sprayers. Despite applying about one-fifteenth the amount of atrazine, backpack sprayers are exposed to nearly equal amounts of atrazine via inhalation exposure and likely have greater exposure via the dermal route. Among backpack sprayers, which type of spray nozzle used is associated with inhalation exposure. Among tractor/boom applicators, tractor drivers have much lower inhalation exposure than workers who operate and observe the boom. Conclusions : The amount of atrazine handled is the most important determinant for predicting in-home atrazine levels in Iowa. Ubiquitous atrazine contamination and its distribution within homes and among household type provide strong evidence for the take-home pathway. While some improvements have been made in Honduras regarding pesticide application, poor farm workers and small farmers still use antiquated pesticide application techniques which leads to a higher risk of inhalation and dermal exposure.

Polychlorinated biphenyls (PCBs) are a group of 209 persistent organic pollutants, whose documented carcinogenic, neurological and respiratory toxicities are expansive and growing. Existing inhalation estimates demonstrate ubiquitous exposure to World Health Organization (WHO) indicator PCBs and limited other PCB congeners in North America and Europe. However, inhalation exposure estimates of most lower-chlorinated congeners are lacking, and continuing release of PCBs from urban areas demands location-specific assessments of PCB exposure in ambient air and contaminated environments. Using paired indoor and outdoor airborne PCB measurements and activity questionnaires from the AESOP Study, we assess congener-specific exposure rates for adolescent children and their mothers in East Chicago, Indiana and Columbus Junction, Iowa. Our cohorts of 129 (EC) and 135 (CJ) and our detection of 202 individual congeners and coelutions allows unprecedented quantification of congener-specific inhalation exposure, which we compare to dietary exposure using Total Diet Survey PCB concentrations. ∑PCB inhalation is greater for children than for their mothers in both locations, and is greater for East Chicago mothers and children than for Columbus Junction mothers and children, respectively. Schools attended by AESOP Study children have higher indoor PCB concentrations than do homes, and contribute to more than half of children's inhalation PCB exposure. Inhalation of the potentially neurotoxic congeners PCB 11, 40/41/71, and 51 was apparent among individuals at each location. Additional, congener-specific and biological inferences are possible via comparison with sera-based PCB concentrations for these cohorts.

Approximately 92% of the land in Iowa, 64% in Indiana, and 27% in Michigan is agricultural farmland. Nearly 77% of farmland in Iowa and Indiana, and 58% of farmland in Michigan, were treated with herbicides in 2012 (USDA). Pesticide drift, or “overspray”, is defined as any off-site movement of pesticide during its application. Exposure to this drift has the potential to damage crops and landscaping, kill aquatic animals, and cause DNA damage, cancer, and allergic wheeze in applicators. The Pesticide Bureau of the Iowa Department of Agricultural and Land Stewardship (IDALS), the Indiana State Chemist (ISC), and the Michigan Department of Agriculture and Rural Development (MDARD) investigate complaints of pesticide misuse, including reports of pesticide drift. Individual narrative reports and case summaries are available, but have not been analyzed to identify contributing factors to prevent field, worker, and community exposures; nor has the community at large been surveyed about reporting practices. The aim of this research was to (1) identify determinants of pesticide drift events in the Midwest, comparing between states; (2) whether differing state policies were associated with drift characteristics and/or reporting of incidents; and (3) determine the proportion of events that occurred due to applicators ignoring pesticide label guidance. This examination will provide guidance when developing policies and prevention efforts used to minimize the hazards associated with pesticide drift. Narrative case reports from IDALS and MDARD, and case summaries from ISC spanning 2010-2016 were analyzed. Narratives and case summaries were converted to trackable data for ease of analysis using Excel. Data analysis includes descriptive statistics on continuous variables (e.g., distance, wind speed), chi-square tests, and t-tests. Analysis includes: crop damage associations with wind speed by chemical; ratio of human exposures across aerial applications, and associations of distance to target crop and reported plant damage. Key state policies were compared and the responses from a survey concerning the reporting of drift incidents was analyzed. The proportion of cases that violated weather and distance recommendations/label directions for the five most common pesticides in each were analyzed. Between 2010 and 2015, Iowa received 471 reported drift cases; between 2011 and 2016 Indiana received 391, and between 2014 and 2016 Michigan received 91 reports. The five most common pesticides analyzed for during drift investigations varied between states, but 2,4-D, glyphosate, and atrazine were common to all states. The method of application, (i.e., aerial or ground), wind speed, and the intended target crop were significantly associated with drift events across all three states. While Iowa was the only state to contain regulatory language concerning drift to bees or livestock, all states still reported 4 to 5% of cases in which pesticides drifted onto animals. Michigan was the only state to suggest the creation and use of a drift management plan and was the only state requiring applicators to inform neighbors of drift. About 30% of confirmed drift cases involved applications within 7.62 meters of desirable vegetation, and about 40% of applications occurred in wind greater than 4.5 m/s. More education, training, and community involvement are suggested interventions to reduce drift cases.

Humans are continuously exposed to complex mixtures of anthropogenic chemicals. This thesis focus on human exposure to persistent organic pollutants (POPs). POPs ability to bioaccumulate and biomagnify together with the extensive historical use of POPs in e.g. agriculture and industry have resulted in detection of these compounds in humans and animals from all over the world. Adverse health effects caused by POPs are of particular concern for newborns and young individuals. The objective of this thesis is to assess human exposure to a selected set of POPs and their metabolites. More specifically, one aim of my thesis is to determine the exposure to polychlorinated biphenyls (PCBs) and in particular their methylsulfonyl and hydroxylated metabolites in humans from a “hot-spot” area of PCB contamination in eastern Slovakia. The maternal transfer of these chemicals is studied. Further, another specific aim is to determine occurrence, levels and, when possible, temporal trends of POPs in children and adults from three developing countries, Nicaragua, Guinea-Bissau and Bangladesh. High concentrations of PCBs and their metabolites are shown in men and women from Michalovce in eastern Slovakia. Placental transfer of methylsulfonyl-metabolites of PCBs and 4,4’-DDE was observed for the first time. Decreasing temporal trends of the majority of POPs are shown in serum from a cohort of policemen from Guinea-Bissau. In contrast, the levels of polybrominated diphenyl ethers (PBDEs) show an increasing time trend. Within five years, decreasing levels of POPs were also shown in children working and living at a waste disposal site in Nicaragua. Children working and living at waste disposal sites in Bangladesh have considerably lower levels of POPs compared to the children from Nicaragua except for 4,4’-DDT and 4,4’-DDE that are present at very high concentrations, indicating ongoing use of technical DDT. There are many studies on levels and trends of environmental pollutants from the developed industrial countries in the world, whereas data from developing countries is still scarce. This thesis contributes to partly fill this data gap since it includes assessments of POPs in children and adults from four countries on four continents. / At the time of doctoral defense, the following papers were unpublished and had a status as follows: Paper 5: Manuscript. Paper 6: Manuscript.

Aims: The aims of this thesis were to describe and gain an understanding of how people who live in the vicinity of wind turbines are affected by wind turbine noise, and how individual, situational and visual factors, as well as sound properties, moderate the response. Methods: A cross-sectional study was carried out in a flat, mainly rural area in Sweden, with the objective to estimate the prevalence of noise annoyance and to examine the dose-response relationship between A-weighted sound pressure levels (SPLs) and perception of and annoyance with wind turbine noise. Subjective responses were obtained through a questionnaire (n = 513; response rate: 68%) and outdoor, A-weighted SPLs were calculated for each respondent. To gain a deeper understanding of the observed noise annoyance, 15 people living in an area were interviewed using open-ended questions. The interviews were analysed using the comparative method of Grounded Theory (GT). An additional cross-sectional study, mainly exploring the influence of individual and situational factors, was carried out in seven areas in Sweden that differed with regard to terrain (flat or complex) and degree of urbanization (n = 765; response rate: 58%). To further explore the impact of visual factors, data from the two cross-sectional studies were tested with structural equation modelling. A proposed model of the influence of visual attitude on noise annoyance, also comprising the influence of noise level and general attitude, was tested among respondents who could see wind turbines versus respondents who could not see wind turbines from their dwelling, and respondents living in flat versus complex terrain. Results: Dose-response relationships were found both for perception of noise and for noise annoyance in relation to A-weighted SPLs. The risk of annoyance was enhanced among respondents who could see at least one turbine from their dwelling and among those living in a rural in comparison with a suburban area. Noise from wind turbines was appraised as an intrusion of privacy among people who expected quiet and peace in their living environment. Negative experiences that led to feelings of inferiority added to the distress. Sound characteristics describing the amplitude modulated aerodynamic sound were appraised as the most annoying (swishing, whistling and pulsating/throbbing). Wind turbines were judged as environmentally friendly, efficient and necessary, but also as ugly and unnatural. Being negative towards the visual impact of the wind turbines on the landscape scenery, rather than towards wind turbines as such, was strongly associated with annoyance. Self-reported health impairment was not correlated to SPL, while decreased well-being was associated with noise annoyance. Indications of possible hindrance to psycho-physiological restoration were observed. Conclusions: Wind turbine noise is easily perceived and is annoying even at low A-weighted SPLs. This could be due to perceived incongruence between the characteristics of wind turbine noise and the background sound. Wind turbines are furthermore prominent objects whose rotational movement attracts the eye. Multimodal sensory effects or negative aesthetic response could enhance the risk of noise annoyance. Adverse reactions could possibly lead to stress-related symptoms due to prolonged physiological arousal and hindrance to psychophysiological restoration. The observed differences in prevalence of noise annoyance between living environments make it necessary to assess separate dose-response relationships for different types of landscapes.

Arsenic is a well-known lung carcinogen in humans. In 2006, IARC upgraded inorganic lead as a possible human carcinogen (2A). The aim of this thesis has been to evaluate the lung cancer mortality and incidence in long-term exposed primary lead smelter workers and also to estimate present exposures to arsenic and lead in relation to those occurring in the past. The basic cohort (N=3832 workers; hired before 1967 and followed up from 1950-1981; SMR comparisons with general and local reference populations) showed an excess of deaths for total mortality, malignant neoplasms (e.g. lung and stomach cancer), ischaemic heart diseases, and cerebrovascular diseases compared to the general population. In a subcohort of lead workers (N=437; regular blood lead sampling since 1950) only the raised SMR for lung cancer (162) was sustained. In a follow-up study of the basic cohort (N=3979), a subcohort of lead exposed workers (N=1992) was formed. The expected mortality in 1955-1987 and cancer incidence in 1958-1987 were calculated relative to county rates. A cumulative blood lead index (CBLI) was used for dose-response analyses. The lung cancer incidence was raised in the total cohort (SIR 2.8; 95 % CI 2.1 3.8). A higher lung cancer risk was observed in workers hired before 1950 (SIR 3.6; 95 % CI 2.6-5.0). The increased lung cancer risks were further elevated in the subcohort of lead exposed workers, especially in the highest exposed subgroup (SIR 5.1; 95 % 2.0-10.5; latency period of 15 y). No excesses of other malignancies were observed. The increased relative risks for lung cancer may have been caused by interactions between inorganic lead and other substances at the smelter, e.g. arsenic. To further analyze the effects from inorganic lead, two subcohorts of workers at the lead departments were formed from the original cohort (N=3979), one of 710 workers and the other of 383 workers. The lung cancer incidence was raised in both subcohorts (Lead subcohort 1; SIR 2.4; 95 % CI 1.2-4.5; Lead subcohort 2; SIR 3.6; 95 % CI 1.2-8.3). Among the 10 workers that had developed lung cancer in lead subcohort 1 all but one had a considerable exposure also to arsenic. Thus, a possible interaction effect between lead and arsenic may explain the increased lung cancer risks. To further elucidate the impact from lead and arsenic a case control study was undertaken. In the basic cohort (N=3979), 46 male workers had contracted respiratory malignancies. They were compared with 141 agematched male referents from the primary smelter by conditional logistic regression analysis using smoking habits, cumulative blood lead and air arsenic exposure as predictor variables. The lung cancer cases showed a significantly higher smoking rate than referents (Odds ratio, OR = 4.0; 95 % CI 1.6-10.1; p=0.003). When restricted to smokers, the cumulative arsenic air exposure index, but not the lead exposure indices, were significantly higher among the cases (OR=1.07; 95 % CI 1.02-1.11; p = 0.005). Accordingly, cumulative arsenic exposure and smoking were identified as significant risk factors for the development of lung cancer in the final analyses, while lead exposure was not a significant risk factor. However, inorganic lead still may play a minor role in the multifactorial genesis of lung cancer. These studies describe risks from exposures occurring from time periods before 1950 up to 1981. Because of the long latency period for lung cancer, exposures after 1970 probably have had limited impact on the reported results. Compared to the levels in the early 1970´s present exposures to arsenic are lower by a factor of ten or more and risks probably correspondingly lower.

This research is trying to understand the relationship between spokesperson and athletic products. With the increasing competing markets, major athletic brands are focusing on marketing strategies in order to attract and obtain consumers. Among them, brand¡¦s marketing is extremely important to sports industry. This is because the enterprise can attract consumer¡¦s attention through its spokesperson and represent their unique characteristics to promote its products. Using spokesperson to endorse its brand is a bridge to communicate with the consumers. The successful career of a professional sports endorser will create an image for the brand, which will lead the consumers belief by wearing the products will have the similar and expected results. When a brand decides on its spokesperson, it is based on the spokesperson¡¦s public image and personal characteristics. First of all, the enterprise will consider if the spokesperson¡¦s image is positive, then they will review if his/her characteristics fit well with their athletic products. This research will related spokesman from western countries for examination on the relationship of the spokesperson with brands and regarding the buying effects on consumer. According to Ohanian¡¦s (1991) research paper, celebrity endorser¡¦s source credibility, contains three dimensions: attractiveness, trustworthiness, and expertise, has positive impact on consumers¡¦ purchase intent. This research proved that the source credibility theory applies to sports brands¡¦ marketing in Taiwan market as well. The research findings not only confirm with Ohanian¡¦s theory, but also discovered one additional factor, exposure, that affect consumers¡¦ perception on endorser¡¦s credibility, but also influence consumers¡¦ intention to purchase. Based on the initial findings, the study then designed questionnaire for survey for the consumers. The survey results proved that endorser¡¦s exposures have significant impact on the consumers. When the Exposure Effect enhances the endorser¡¦s attractiveness, the endorser¡¦s source of credibility affects consumer¡¦s buying perception. Thus, the study suggests the sports brand marketers, for better marketing values, to investigate the endorser¡¦s media exposures, in order to elevate consumers¡¦ buying intention.

Thesis (D.P.H.)--University of Alabama at Birmingham, 2007. / Title from PDF title page (viewed on Feb. 19, 2010). Includes bibliographical references.

Increasing vehicle dependence in the United States has resulted in substantial emissions of traffic-related air pollutants that contribute to the deterioration of urban air quality. Exposure to urban air pollutants trigger a number of public health concerns, including the potential of inequality of exposures and health effects among population subgroups. To better understand the impact of traffic-related pollutants on air quality, exposure, and exposure inequality, modeling methods that can appropriately characterize the spatiotemporally resolved concentration distributions of traffic-related pollutants need to be improved. These modeling methods can then be used to investigate the impacts of urban design and transportation management choices on air quality, pollution exposures, and related inequality. This work will address these needs with three objectives: 1) to improve modeling methods for investigating interactions between city and transportation design choices and air pollution exposures, 2) to characterize current exposures and the social distribution of exposures to traffic-related air pollutants for the case study area of Hillsborough County, Florida, and 3) to determine expected impacts of urban design and transportation management choices on air quality, air pollution exposures, and exposure inequality. To achieve these objectives, the impacts of a small-scale transportation management project, specifically the '95 Express' high occupancy toll lane project, on pollutant emissions and nearby air quality was investigated. Next, a modeling method capable of characterizing spatiotemporally resolved pollutant emissions, concentrations, and exposures was developed and applied to estimate the impact of traffic-related pollutants on exposure and exposure inequalities among several population subgroups in Hillsborough County, Florida. Finally, using these results as baseline, the impacts of sprawl and compact urban forms, as well as vehicle fleet electrification, on air quality, pollution exposure, and exposure inequality were explored. Major findings include slightly higher pollutant emissions, with the exception of hydrocarbons, due to the managed lane project. Results also show that ambient concentration contributions from on-road mobile sources are disproportionate to their emissions. Additionally, processes not captured by the CALPUFF model, such as atmospheric formation, contribute substantially to ambient concentration levels of the secondary pollutants such as acetaldehyde and formaldehyde. Exposure inequalities for NOx, 1,3-butadiene, and benzene air pollution were found for black, Hispanic, and low income (annual household income less than $20,000) subgroups at both short-term and long-term temporal scales, which is consistent with previous findings. Exposure disparities among the subgroups are complex, and sometimes reversed for acetaldehyde and formaldehyde, due primarily to their distinct concentration distributions. Compact urban form was found to result in lower average NOx and benzene concentrations, but higher exposure for all pollutants except for NOx when compared to sprawl urban form. Evidence suggests that exposure inequalities differ between sprawl and compact urban forms, and also differ by pollutants, but are generally consistent at both short and long-term temporal scales. In addition, vehicle fleet electrification was found to result in generally lower average pollutant concentrations and exposures, except for NOx. However, the elimination of on-road mobile source emissions does not substantially reduce exposure inequality. Results and findings from this work can be applied to assist transportation infrastructure and urban planning. In addition, method developed here can be applied elsewhere for better characterization of air pollution concentrations, exposure and related inequalities.