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Quantitative estimates of exposure to 1,3-butadiene (BD), styrene (STY), and dimethyldithiocarbamate (DMDTC) were developed for a follow-up study of workers at six North American synthetic rubber plants. Procedures entailed identifying tasks and jobs involving exposure, identifying factors influencing historical changes in exposure potential, and using mathematical models to calculate job- and time-period-specific exposures. Exposure metrics included 8-hour time-weighted average (TWA) intensity, the annual number of peak exposures (BD: >100 ppm, STY: >50 ppm) and TWA intensity below and above the peak threshold. The 5th and 95th percentiles of the approximate probability distribution of each exposure estimate served as its 90% uncertainty interval. Job- and year-specific estimates were linked with subjects' work histories to obtain cumulative exposure indices. Exposure estimates varied among tasks, jobs, plants, and time periods. BD TWAs were approximately 10 ppm during the 1940s-1960s and declined during the 1970s and 1980s. STY TWAs were always <2 ppm. DMDTC exposure began in the 1950s, was high through the 1960s, and later declined. BD peak exposure accounted for a large proportion of cumulative BD exposure, whereas almost none of the STY exposure was experienced at levels >50 ppm. Exposure indices were correlated. Exposures were higher than previously estimated. Multiple correlations among DMDTC, BD, and STY exposure estimates make it difficult to estimate agent-specific effects. Limitations of the methodology include the potential inaccuracy of the estimates, the lack of adequate industrial hygiene data to validate the estimates, the additional inaccuracy of linkage with poorly specified job groups, and the potential for differential exposure misclassification because the jobs and work areas where excess leukemia mortality occurred were well-known at the time of this study. Nevertheless, the new exposure estimates were highly correlated with the old, yielding equivalent exposure ranking of workers and were comparable to limited industrial hygiene data published by NIOSH.
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http://dx.doi.org/10.1080/15459620490452004 | DOI Listing |
JAMA Dermatol
September 2025
Department of Population Health, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
Importance: Increasingly, strategies to systematically detect melanomas invoke targeted approaches, whereby those at highest risk are prioritized for skin screening. Many tools exist to predict future melanoma risk, but most have limited accuracy and are potentially biased.
Objectives: To develop an improved melanoma risk prediction tool for invasive melanoma.
JAMA Netw Open
September 2025
Oncostat U1018, Institut National de la Santé et de la Recherche Médicale (INSERM), Ligue Contre le Cancer, Paris-Saclay University, Villejuif, France.
Importance: Antibiotics, steroids, and proton pump inhibitors (PPIs) are suspected to decrease the efficacy of immunotherapy.
Objective: To explore the association of comedications with overall survival (OS) in patients with advanced non-small-cell lung cancer (NSCLC).
Design, Setting, And Participants: This nationwide retrospective cohort study used target trial emulations of patients newly diagnosed with NSCLC from January 2015 to December 2022, identified from the French national health care database.
JAMA Netw Open
September 2025
Division of Critical Care Medicine, Department of Anesthesiology and Critical Care, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Importance: Lower survival rates among Black adults relative to White adults after in-hospital cardiac arrest are well-described, but these findings have not been consistently replicated in pediatric studies.
Objective: To use a large, national, population-based inpatient database to evaluate the associations between in-hospital mortality in children receiving cardiopulmonary resuscitation (CPR) and patient race or ethnicity, patient insurance status, and the treating hospital's proportion of Black and publicly insured patients.
Design, Setting, And Participants: This retrospective population-based cohort study used the Healthcare Cost and Utilization Project Kids' Inpatient Database (1997-2019 triennial versions).
JAMA Netw Open
September 2025
Social and Behavioral Sciences Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland.
Importance: Higher intellectual abilities have been associated with lower mortality risk in several longitudinal cohort studies. However, these studies did not fully account for early life contextual factors or test whether the beneficial associations between higher neurocognitive functioning and mortality extend to children exposed to early adversity.
Objective: To explore how the associations of child neurocognition with mortality changed according to the patterns of adversity children experienced.