The International Agency for Research on Cancer (IARC) Monographs Programme identifies chemicals, drugs, mixtures, occupational exposures, lifestyles and personal habits, and physical and biological agents that cause cancer in humans and has evaluated about 1000 agents since 1971. Monographs are written by ad hoc Working Groups (WGs) of international scientific experts over a period of about 12 months ending in an eight-day meeting. The WG evaluates all of the publicly available scientific information on each substance and, through a transparent and rigorous process,1 decides on the degree to which the scientific evidence supports that substance's potential to cause or not cause cancer in humans. For Monograph 112,2 17 expert scientists evaluated the carcinogenic hazard for four insecticides and the herbicide glyphosate.3 The WG concluded that the data for glyphosate meet the criteria for classification as a probable human carcinogen . The European Food Safety Authority (EFSA) is the primary agency of the European Union for risk assessments regarding food safety. In October 2015, EFSA reported4 on their evaluation of the Renewal Assessment Report5 (RAR) for glyphosate that was prepared by the Rapporteur Member State, the German Federal Institute for Risk Assessment (BfR). EFSA concluded that ‘glyphosate is unlikely to pose a carcinogenic hazard to humans and the evidence does not support classification with regard to its carcinogenic potential’. Addendum 1 (the BfR Addendum) of the RAR5 discusses the scientific rationale for differing from the IARC WG conclusion. Serious flaws in the scientific evaluation in the RAR incorrectly characterise the potential for a carcinogenic hazard from exposure to glyphosate. Since the RAR is the basis for the European Food Safety Agency (EFSA) conclusion,4 it is critical that these shortcomings are corrected. EFSA concluded ‘that there is very limited evidence for an association between glyphosate-based formulations …

There are few studies of the effects of nasal snuff and environmental factors on the risk of nasal cancer. This study aimed to investigate the impact of using nasal snuff and of other risk factors on the risk of nasal cancer in German men.

Kramer and Arminger in a preceding article in this volume insinuated that in a meta-analysis on childhood leukaemia in the vicinity of nuclear power plants (NPP) in five countries gross methodological errors had led to falsified statistics. Major assumptions were a) arbitrary exclusion of publications with nil results, and b) publication bias in conduct of the meta-analysis. It is demonstrated that all appropriate publications providing data on incident cases of leukaemia and on the underlying population or rates of incidence with confidence intervals had been included. In addition it is demonstrated that all publications excluded from the meta-analysis either did not provide sufficient data on NPPs or cases of these publications had been already included into the meta-analysis from other publications.

Summary Krämer and Arminger in a preceding article in this volume insinuated that in a meta-analysis on childhood leukaemia in the vicinity of nuclear power plants (NPP) in five countries gross methodological errors had led to falsified statistics. Major assumptions were a) arbitrary exclusion of publications with nil results, and b) publication bias in conduct of the meta-analysis. It is demonstrated that all appropriate publications providing data on incident cases of leukaemia and on the underlying population or rates of incidence with confidence intervals had been included. In addition it is demonstrated that all publications excluded from the meta-analysis either did not provide sufficient data on NPPs or cases of these publications had been already included into the meta-analysis from other publications.

Knowledge about the impact of menopausal hormone therapy (MHT) on the risk of ovarian cancer (OvC) is insufficient, and studies are inconsistent. Mortality from OvC ranks highest among cancer sites in female reproductive organs. We performed meta-analyses to assess the impact of specified types of MHT on the risk of OvC in cohort studies (CS), case-control studies (CCS), randomized controlled trials (RCT) and cancer registry studies (CRS). We used data published 1966-2006 on estrogen therapy (ET), estrogen/progestin therapy (EPT) or MHT (unspecified regimen) identified by a structured, computerized and manual literature search. We identified 42 studies (30CCS, 7CS, 1 RCT and 4 CRS) with 12 238 cases. The risk of OvC (ever-use, annual risk) is increased 1.28-fold by ET [confidence interval (CI) 1.18-1.40] and 1.11-fold by EPT (CI 1.02-1.21) with a suggestion of greater risks with ET. There appears to be no differential impact of any therapy on histological subtypes. Risks were greater in European than North American studies for both ET and EPT. In conclusion, ET as well as EPT, are risk factors for OvC. Given the widespread use of MHT, known benefits should be weighed against the increased risk of OvC, and more studies are warranted, particularly on factors with the greatest apparent risks.

Between February 1990 to the end of 1995 six cases of childhood leukemia were diagnosed among residents of the small rural community Elbmarsch in Northern Germany. Five of these cases were diagnosed in only ]6 months between Feb. ]990 and May 1991. The cases all lived in close proximity (500-4500 m) to Germany's largest capacity nuclear boiling water reactor (KKK). Standardized incidence ratios (SIR) and exact 95% confidence intervals were calculated for a circular area with a 5 km radius around the plant. For the time period 1990 to 1995 the SIR was 464 (208-1034). If the analysis is restricted to the years ]990 and 199], the SIR increases to 1175 (4892827). This cluster of childhood leukemia cases cannot presently be explained in terms of established and putative risk factors for childhood leukemia, including radiation. from medical sources. After this unprecedented childhood leukemia cluster had been detected, it was hypothesized that leukemia incidence could also be increased in adults. To test this hypothesis, a retrospective incidence study was conducted which covered 10 years (1984-]993) and three adjacent counties with a total population of about 470,000. Case ascertainment was done perusing documents of multiple primary data sources including all hospitals, institutes of pathology, oncology centers, as well as practicing physicians and three Departments of Health within the study area and in adjacent counties, respectively. After linking of documents from all sources a total of ]985 verified cases of leukemias, malignant lymphomas and multiple myeloma remained. Incidence rates were standardized to the 1987 West Germany census population structure. Proximity to KKK was operationalized by constructing concentric circles with radii 5 km (10, 15, 20 km) around the site of the plant. When overall incidence was used as a reference, SIR for leukemia in the 5 km-region was elevated for both genders (observed 51, expected 40; SIR 128; p=0.046), whereas no such elevation was observed in any of the other circles. The increased incidence was attributable to males (SIR ]56; p=O.Ol) and was most pronounced, but not confined to, chronic myeloid leukemia.When the analysis was restricted to persons below age 65, SIR were significantly increased for both males and females. The excess risk observed over the 10 year study period was exclusively due to an increased incidence from 1989 through 1993. A subsequent case control study including all cases identified in the incidence study is indicated to identify possible causes for the excess leukemia risk for children and adults in the vicinity of KKK. Introduction The rural community Elbmarsch is situated on the southern bank of the river Elbe, some 30 km south-east of the City of Hamburg in Lower Saxony. In a population of less than 2000 children under 15 years 6 ca-

To investigate the impact of aircraft noise on prescription prevalences of cardiovascular drugs in the vicinity of a major German airport with respect to social gradients.

OBJECTIVE:A recent study suggested that risk of bladder cancer may be higher in women than in men who smoked comparable amounts of cigarettes. We pooled primary data from 14 case-control studies of bladder cancer from Europe and North America and evaluated differences in risk of smoking by gender.METHODS:The pooled analysis included 8316 cases (21% women) and 17,406 controls (28% women) aged 30-79 years. Odds ratios (ORs) and 95% confidence intervals (95% CI) for smoking were adjusted for age and study. Exposure-response was evaluated in a stratified analysis by gender and by generalized additive models.RESULTS:The odds ratios for current smokers compared to nonsmokers were 3.9 (95% CI 3.5-4.3) for males and 3.6 (3.1-4.1) for females. In 11 out of 14 studies, ORs were slightly higher in men. ORs for current smoking were similar for men (OR = 3.4) and women (OR = 3.7) in North America, while in Europe men (OR = 5.3) had higher ORs than women (OR = 3.9). ORs increased with duration and intensity in both genders and the exposure-response patterns were remarkably similar between genders.CONCLUSION:These results do not support the hypothesis that women have a higher relative risk of smoking-related bladder cancer than men.

We conducted meta-analyses to assess the impact of menopausal hormone therapy (MHT) on the risk of incident invasive breast cancer (BC) in cohort studies (CS), case-control studies (CCS) and randomized controlled trials (RCTs) published 1989-2004. We used published data providing information upon unopposed estrogen therapy (ET), estrogen-progestin therapy (EPT) or all MHT combined. Major outcomes were MHT-associated overall risk of BC and change of risk per year used. There is a linear increase of overall risk by midterm year of case ascertainment based upon data of all study types for MHT and to a larger extent for EPT, not for ET. Effects are larger in CS than in CCS. Meta-analyses stratified by <1992 versus > or =1992 as midterm year of case ascertainment indicate larger summary risks for the latter period for all MHT analysed, in particular for EPT. Annual increases in BC risk for EPT across study types are 0-9%, for ET 0-3%. In conclusion, there is evidence that relative risks for BC risks by MHT, in particular EPT, have been increasing in recent years. Given the widespread use of MHT, and often long duration, more detailed knowledge about differential BC risks of both estrogens and progestins are necessary to minimize BC risk in symptomatic women who consider MHT.

OBJECTIVE:The purpose of this representative, nationwide telephone survey was to collect information about postmenopausal hormone therapy (HT) use in relation to women's knowledge about the Women's Health Initiative Randomized Controlled Trial 2002 (WHI-RCT) in Germany. DESIGN:During July 2003, telephone interviews were conducted with randomly selected women aged 45 to 60 years (N = 10,030; response 59.9%; completed interviews n = 6,007). They were asked about information sources regarding the WHI-RCT, and use of HT in conjunction with it. RESULTS:Most women stated that they knew about the WHI-RCT (88.6%), and those with high educational status appeared to have more information than those with middle or low educational status. Among informed women (uninformed excluded), 46.6% continued, 25.7% stopped, and 14.2% ceased use of HT before the WHI-RCT. The prevalence of lifetime use of HT was higher in West Germany (37.4%) than in East Germany (29.2%), the highest prevalence of use was in the group aged 55 to 59 years. The most common reason to continue HT was the benefit risk assessment by physicians (58%); the most common reason to stop HT were women's perceptions that the risks of HT exceeded the benefits (56%). If information was solely given by physicians, women were more likely to continue HT (60.4%), compared with mass media (46.1%), as a source of information. CONCLUSIONS:The survey demonstrates the impact of the WHI-RCT in Germany, and shows that both the media and advice given by physicians were important. Women who continued to use HT did so largely because of their physician's advice. Women who discontinued were mainly those who had a negative subjective perception about risk of HT.

Biometrical JournalVolume 46, Issue S1 p. 64-64 Oral Sessions Abstracts S30.1: Northern Germany Leukaemia and Lymphoma Study – results of a population-based case-control study on radiation as a risk factor Wolfgang Hoffmann, Wolfgang Hoffmann [email protected] Institut für Community Medicine, Abt. Versorgungsepidemiologie und Community HealthSearch for more papers by this authorClaudia Terschüren, Claudia TerschürenSearch for more papers by this authorWalter Schill, Walter SchillSearch for more papers by this authorHermann Pohlabeln, Hermann PohlabelnSearch for more papers by this authorEberhard Greiser, Eberhard GreiserSearch for more papers by this author Wolfgang Hoffmann, Wolfgang Hoffmann [email protected] Institut für Community Medicine, Abt. Versorgungsepidemiologie und Community HealthSearch for more papers by this authorClaudia Terschüren, Claudia TerschürenSearch for more papers by this authorWalter Schill, Walter SchillSearch for more papers by this authorHermann Pohlabeln, Hermann PohlabelnSearch for more papers by this authorEberhard Greiser, Eberhard GreiserSearch for more papers by this author First published: 17 March 2004 https://doi.org/10.1002/bimj.200490269AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume46, IssueS1Supplement: Abstracts of the Joint Meeting of the IBS‐DR and the DAEMarch 2004Pages 64-64 RelatedInformation

Objectives: We examined which occupations and industries are currently at high risk for bladder cancer in men. Methods: We combined data from 11 case–control studies conducted between 1976–1996 in six European countries. The study comprised 3346 incident cases and 6840 controls, aged 30–79 years. Lifetime occupational and smoking histories were examined using common coding. Results: Odds ratios for eight a priori defined high-risk occupations were low, and with the exception of metal workers and machinists (OR = 1.16, 95% CI = 1.02–1.32), were not statistically significant. Higher risks were observed for specific categories of painters, metal, textile and electrical workers, for miners, transport operators, excavating-machine operators, and also for non-industrial workers such as concierges and janitors. Industries entailing a high risk included salt mining, manufacture of carpets, paints, plastics and industrial chemicals. An increased risk was found for exposure to PAHs (OR for highest exposure tertile = 1.23, 95% CI = 1.07–1.4). The risk attributable to occupation ranged from 4.2 to 7.4%, with an estimated 4.3% for exposure to PAHs. Conclusions: Metal workers, machinists, transport equipment operators and miners are among the major occupations contributing to occupational bladder cancer in men in Western Europe. In this population one in 10 to one in 20 cancers of the bladder can be attributed to occupation.

OBJECTIVES:The reason for the Study of Health in Pomerania (SHIP) is the lack of epidemiological studies with a broad range of health indicators. Furthermore, in Germany there is a need for studies that take into account the particular situation of life after the reunification. One objective of SHIP is to provide prevalence estimates on a broad range of diseases, risk and health factors for a defined region in the former GDR.METHODS:A sample of 7008 women and men aged 20 to 79 years in a north-east region of Germany, 4900 expected participants. The sample was drawn in two steps: First, 32 communities in the region were selected. Second, within the communities a simple random sample was drawn from residence registries, stratified by gender and age. The data collection and instruments include four parts: oral health examination, medical examination, health-related interview, and a health- and risk-factor-related questionnaire. The oral health examination includes the teeth, periodontium, oral mucosa, craniomandibular system, and prosthodontics. The medical examination includes blood pressure measurements, electrocardiography, echocardiography, carotid, thyroid and liver ultrasounds, neurological screening, blood and urine sampling. The computer-aided health-related interview includes cardiovascular symptoms, utilisation of medical services, health-related behaviours, and socioeconomic variables. The self-administered questionnaire comprises housing conditions, social network, work conditions, subjective well-being and individual consequences from the German reunification.

Objective: Estimating the risk of bladder cancer from cigar and pipe smoking is complicated by a small number of non-cigarette smokers included in most relevant studies.

Background: Using a combined analysis of 11 case–control studies from Europe, we have investigated the relationship between cigarette smoking and bladder cancer in women.