Journal Articles

Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915

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Author: search.filters.author.Pearce NSubject: search.filters.subject.320000 Medical and Health Sciences

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    Using directed acyclic graphs to consider adjustment for socioeconomic status in occupational cancer studies.
    (B M J PUBLISHING GROUP, 2008-07) Richiardi L; Barone-Adesi F; Merletti F; Pearce N
    There is an ongoing debate on whether analyses of occupational studies should be adjusted for socioeconomic status (SES). In this paper directed acyclic graphs (DAGs) were used to evaluate common scenarios in occupational cancer studies with the aim of clarifying this issue. It was assumed that the occupational exposure of interest is associated with SES and different scenarios were evaluated in which (a) SES is not a cause of the cancer under study, (b) SES is not a cause of the cancer under study, but is associated with other occupational factors that are causes of the cancer, (c) SES causes the cancer under study and is associated with other causal occupational factors. These examples illustrate that a unique answer to the issue of adjustment for SES in occupational cancer studies is not possible, as in some circumstances the adjustment introduces bias, in some it is appropriate and in others both the adjusted and the crude estimates are biased. These examples also illustrate the benefits of using DAGs in discussions of whether or not to adjust for SES and other potential confounders.
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    Ian Prior and epidemiology in New Zealand.
    (B M J PUBLISHING GROUP, 2009-09) Pearce N
    Ian Prior was born in Masterton, New Zealand, in 1923, and died in Wellington, New Zealand, in 2009. In 1959 Ian became the Director of the Medical Unit at Wellington Hospital, and in the early 1960s he established the Epidemiology Unit. Without doubt he is the founder of epidemiology in New Zealand, and has also had a major influence in Australia and further afield. I was delighted to be invited to write this piece about Ian for the Journal of Epidemiology and Community Health, not as an obituary but as an essay on an epidemiologist who inspired many of us in New Zealand, and whose example will continue to inspire many around the world. Ian Prior's work represents not only an important historical legacy but also an important guide to the future of epidemiology. This includes his work on the effects of social and environmental changes and the wider social context on individual "lifestyle", his willingness to work collaboratively with researchers from other disciplines including social scientists, his insistence on seeing quantitative biomedical phenomena (such as blood pressure) in the wider social context, and perhaps most of all his insistence that epidemiologists cannot hide from the wider realities of the world in which they live.
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    Epidemiology in Latin America: an opportunity for a global dialogue.
    (B M J PUBLISHING GROUP, 2008-09) Pearce N
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    Respiratory symptoms in children living near busy roads and their relationship to vehicular traffic: results of an Italian multicenter study (SIDRIA 2).
    (BIOMED CENTRAL LTD, 2009-06-18) Migliore E; Berti G; Galassi C; Pearce N; Forastiere F; Calabrese R; Armenio L; Biggeri A; Bisanti L; Bugiani M; Cadum E; Chellini E; Dell'orco V; Giannella G; Sestini P; Corbo G; Pistelli R; Viegi G; Ciccone G; SIDRIA-2 Collaborative Group
    BACKGROUND: Epidemiological studies have provided evidence that exposure to vehicular traffic increases the prevalence of respiratory symptoms and may exacerbate pre-existing asthma in children. Self-reported exposure to road traffic has been questioned as a reliable measurement of exposure to air pollutants. The aim of this study was to investigate whether there were specific effects of cars and trucks traffic on current asthma symptoms (i.e. wheezing) and cough or phlegm, and to examine the validity of self-reported traffic exposure. METHODS: The survey was conducted in 2002 in 12 centers in Northern, Center and Southern Italy, different in size, climate, latitude and level of urbanization. Standardized questionnaires filled in by parents were used to collect information on health outcomes and exposure to traffic among 33,632 6-7 and 13-14 years old children and adolescents. Three questions on traffic exposure were asked: the traffic in the zone of residence, the frequency of truck and of car traffic in the street of residence. The presence of a possible response bias for the self-reported traffic was evaluated using external validation (comparison with measurements of traffic flow in the city of Turin) and internal validations (matching by census block, in the cities of Turin, Milan and Rome). RESULTS: Overall traffic density was weakly associated with asthma symptoms but there was a stronger association with cough or phlegm (high traffic density OR = 1.24; 95% CI: 1.04, 1.49). Car and truck traffic were independently associated with cough or phlegm. The results of the external validation did not support the existence of a reporting bias for the observed associations, for all the self-reported traffic indicators examined. The internal validations showed that the observed association between traffic density in the zone of residence and respiratory symptoms did not appear to be explained by an over reporting of traffic by parents of symptomatic subjects. CONCLUSION: Children living in zones with intense traffic are at higher risk for respiratory effects. Since population characteristics are specific, the results of validation of studies on self-reported traffic exposure can not be generalized.