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Our objective was to study the relations between the risk of lung cancer and dietary factors in New Caledonia, in the South Pacific. A population-based case-control study of respiratory cancers was conducted between 1993 and 1995 in New Caledonia; we analyzed data for 134 incident lung cancer cases (109 men and 25 women) and 295 controls (227 men and 68 women) who had completed a food frequency questionnaire. Odds ratios (ORs) associated with food and nutrient intakes were calculated with unconditional logistic regression, with adjustment for smoking, age, and ethnicity. Analyses were performed separately for men and women. Among men, no significant associations were observed with any foods, including vegetables and fruits. Nonetheless, high consumption of dark green leafy vegetables (highest vs. lowest tertile of intake) was associated with decreased risk (OR = 0.5, 95% confidence interval = 0.2-1.2, P for trend = 0.12), particularly among Melanesians (OR = 0.4, 95% confidence interval = 0.1-1.0, P for trend = 0.07). A similar protective effect was also suggested for high consumption of poultry (P for trend = 0.06) and fresh fish (P for trend = 0.08). No significant association was found with nutrients. Among women, the analyses concerned few subjects and were not informative. This study suggests that high consumption of dark green leafy vegetables may reduce the risk of lung cancer among men in this population. [ABSTRACT FROM AUTHOR]

Examines the diagnosis of respiratory cancer in New Caledonia. Effects of the nickel exposure on workers in a smelting plant; Comparison between the distribution of stays and distribution based on censuses; Time spent by people with primary lung cancer in a mining zone.

In this study, the authors characterized exposure to asbestos in the population of New Caledonia, an area where a high mesothelioma incidence was found to be associated with the use of a tremolite-containing whitewash on dwellings. The authors collected airborne samples from various sources. Lung tissue samples or bronchoalveolar lavage fluids were available for 80 subjects, who were interviewed regarding their residential and occupational histories. The authors analyzed all samples by analytical transmission electron microscopy. Results indicated that the use of the tremolite-based whitewash may generate high airborne fiber levels and result in asbestos lung contents comparable with those observed in occupational settings. The highest airborne tremolite concentrations were reached during sweeping in whitewashed houses. Lung concentrations of tremolite fibers were significantly higher in subjects exposed to the whitewash than in unexposed subjects, and the concentrations increased with the duration of exposure.

The paper examines HIV data in a Violence Against Women survey conducted in New Caledonia. A representative sample of 1012 women aged 18 to 54 were interviewed. It describes the effect on HIV prevention behavior of knowing someone who is HIV+ and examines condom use and other indicators of unprotected sexual behavior such as unwanted pregnancies and abortion. It also looks at HIV screening, both during antenatal care and at the woman's own initiative. Despite improved prevention behavior among young Islanders (18-24), the results indicate the persistence of strong inequalities among ethnic communities in HIV information and protection and in reproductive health. In New Caledonia to day, health inequity in these areas still clearly disadvantage the indigenous Melanesian and Polynesian women too, compared to European women.

Aims: To study the associations between occupational exposures and the risk of lung cancer in New Caledonia., Methods: All cases diagnosed between January 1993 and December 1995 (228 lung cancers) and 305 population controls were included. Detailed information on lifetime job history, smoking, and other potential risk factors was collected by interview. Occupational exposures were assessed from the questionnaires by an industrial hygienist, without knowledge of case-control status., Results: No significant association was found with exposures related to nickel mining and refining, the main industrial activity in the territory. Among men, an excess risk of lung cancer was found for bus and truck drivers. Increased risks were also observed in men with the highest level of cumulative exposure to cleaning products and inorganic fertilisers. Exposure to field dust was associated with lung cancer risk in both sexes, and risk increased with cumulative exposure level. In some areas tremolite asbestos derived from local outcroppings was used as a whitewash. The association between exposure to field dust and lung cancer was limited to men and women exposed to this whitewash-that is, living in areas where the soil may contain tremolite., Conclusion: This study shows several associations between occupational exposures and lung cancer. The findings suggest that exposure to tremolite fibres from cultivated fields may increase the risk of lung cancer in New Caledonia.

A previous study of respiratory cancers in New Caledonia (1978-1987) showed an excess risk of pleural cancer in this South Pacific French Territory, leading to the identification of an environmental pollution. In some villages, the residents use for their houses a whitewash made from a rock derived from local outcroppings. Analysis of samples of rock and whitewash showed that they consisted of tremolite asbestos. High levels of tremolite were detected in airborne samples collected in these villages and in biological specimens of patients with pulmonary cancer or mesothelioma; the concentrations of fibers are up to 78,000 fibers per litre of air and 44 millions of fibers per gramme of dry tissue. Besides the whitewash, the environmental exposure to tremolite fibers could also be associated with certain occupations. A case control study under process will allow the estimation of respiratory cancer risks associated with the exposure to tremolite.

The incidence of lung, pleural, nasal, larynx, and pharynx cancer in relation to work in the nickel mining and refining industry was studied from 1978 to 1987 in the male population of the French territory of New Caledonia in the South Pacific. The results showed no greater risk in the population of nickel workers than in the general male population. The incidence of respiratory cancer in New Caledonia was found to be comparable to that of industrialized countries, except for pleural cancer for which there was an excess risk in New Caledonia. A case-control study within the cohort of nickel industry workers comprised 80 lung cancer, 12 larynx cancer, 20 pharynx cancer cases, and 298 controls, and took account of 18 substances to which workers were exposed, five of them nickel compounds. None of the substances, or any other occupational variable, was shown to increase the risk of respiratory cancer, except for cancer of the larynx in relation to level and duration of exposure to dust and engine exhaust fumes on mining sites (odds ratios ranged from five to 5.4 and were significant). These results provide no evidence that exposures specific to the nickel industry in New Caledonia increase the risk of respiratory cancer. This might be due to the involvement of less airborne nickel than the amount observed in positive studies elsewhere. The high incidence of respiratory cancer in New Caledonia, compared with other South Pacific islands, might be attributable to an environmental risk connected with the presence of mineral fibers in the geologic strata, as well as to tobacco and alcohol consumption levels similar to those prevailing in France.

All cases of primary pleural cancers that were reported during a 10-y period (i.e., 1978-1987) in New Caledonia were recorded and compared with five cancer registers. There was an excess of primary pleural cancers in the area of New Caledonia, and it was particularly evident among the Melanesian ethnic group. Neither geographical nor occupational factors accounted for these results, but an environmental factor could not be excluded.

The high blood pressure is one of the main cardiovascular risk factors in New Caledonia as it is every where. A study carried out in THIO from August 1985 to August 1988 displayed a frequency and a seriousness not frequent (17.8 p.c. of hypertensives in the population over 30 years of age by applying strict criteria), noticeably in the Melanesian ethnic group and mainly in the women. Such a result ought to instigate complementary epidemiological surveys, but also to urge on an active policy of screening, prevention and treatment.

In Epidemiology, no simple test is available for comparing an observed number of exposed person-years with an expected number. The number of person-years is a sum of lengths of stays which is not normally distributed under the null hypothesis. A method is proposed and an example is given. The objective was to study in the French territory of New-Caledonia the relationship between past places of living and occurrence of respiratory cancers. The total observed number of person-years in a zone, among cases, was compared to an expected distribution, based on censuses and controlling for two confounding factors, period of stay and ethnic group. Different methods are compared: a test based on a simulated distribution, and parametric approaches with normality assumption. If the number of cases is small, the simulation test seems to be the best approach.

A method, based on the Delphi technique, for evaluating occupational risks in a quantifiable manner was devised in the course of a case-control study on respiratory cancers in the nickel mining and refining industry in New Caledonia. There were four stages in the evaluation process: identification of eleven potential carcinogenic factors in the company during the 1930-1977 period; grouping of a limited number of work-stations; evaluation of exposure levels for the different factors for each workstation; computation of the cumulative value of exposure for each subject under study. A partial validation study shows that this kind of approach may prove useful for future occupational epidemiological studies.

The incidence rate of respiratory (lung and upper respiratory tract) cancer related to the nickel industry was studied in the male population of New Caledonia over a 7-year period (1978-1984). The findings show no excess incidence of lung or upper respiratory tract (larynx, pharynx, nasal cavities) cancer cases in the population of nickel workers compared with the rest of the male population in New Caledonia. This result was corroborated by a case-control study which does not indicate any particular role of hazards specific to the nickel mining and refining industry. Our findings, which may be specific for the type of ore processed in New Caledonia, must nevertheless be confirmed by extending the study to a total of 10 years (1978-1987). The incidence rate of male respiratory cancer in New Caledonia was also compared to that of cancers of this type reported in certain regions of industrialized countries (Australia, France, U.K., USA). Such findings are very similar to those observed in New Caledonia, thereby confirming a predominant role of tobacco and alcohol consumption in a territory which, despite certain characteristics of a developing country, has life-style habits similar to those of industrialized countries.