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1. Molnupiravir plus usual care versus usual care alone as early treatment for adults with COVID-19 at increased risk of adverse outcomes (PANORAMIC) : an open-label, platform-adaptive randomised controlled trial

Author

Christopher C Butler, F D Richard Hobbs, Oghenekome A Gbinigie, Najib M Rahman, Gail Hayward, Duncan B Richards, Jienchi Dorward, David M Lowe, Joseph F Standing, Judith Breuer, Saye Khoo, Stavros Petrou, Kerenza Hood, Jonathan S Nguyen-Van-Tam, Mahendra G Patel, Benjamin R Saville, Joe Marion, Emma Ogburn, Julie Allen, Heather Rutter, Nick Francis, Nicholas P B Thomas, Philip Evans, Melissa Dobson, Tracie-Ann Madden, Jane Holmes, Victoria Harris, May Ee Png, Mark Lown, Oliver van Hecke, Michelle A Detry, Christina T Saunders, Mark Fitzgerald, Nicholas S Berry, Lazaro Mwandigha, Ushma Galal, Sam Mort, Bhautesh D Jani, Nigel D Hart, Haroon Ahmed, Daniel Butler, Micheal McKenna, Jem Chalk, Layla Lavallee, Elizabeth Hadley, Lucy Cureton, Magdalena Benysek, Monique Andersson, Maria Coates, Sarah Barrett, Clare Bateman, Jennifer C Davies, Ivy Raymundo-Wood, Andrew Ustianowski, Andrew Carson-Stevens, Ly-Mee Yu, Paul Little, Akosua A Agyeman, Tanveer Ahmed, Damien Allcock, Adrian Beltran-Martinez, Oluseye E Benedict, Nigel Bird, Laura Brennan, Julianne Brown, Gerard Burns, Mike Butler, Zelda Cheng, Ruth Danson, Nigel de Kare-Silver, Devesh Dhasmana, Jon Dickson, Serge Engamba, Stacey Fisher, Robin Fox, Eve Frost, Richard Gaunt, Sarit Ghosh, Ishtiaq Gilkar, Anna Goodman, Steve Granier, Aleksandra Howell, Iqbal Hussain, Simon Hutchinson, Marie Imlach, Greg Irving, Nicholas Jacobsen, James Kennard, Umar Khan, Kyle Knox, Christopher Krasucki, Tom Law, Rem Lee, Nicola Lester, David Lewis, James Lunn, Claire I. Mackintosh, Mehul Mathukia, Patrick Moore, Seb Morton, Daniel Murphy, Rhiannon Nally, Chinonso Ndukauba, Olufunto Ogundapo, Henry Okeke, Amit Patel, Kavil Patel, Ruth Penfold, Satveer Poonian, Olajide Popoola, Alexander Pora, Vibhore Prasad, Rishabh Prasad, Omair Razzaq, Scot Richardson, Simon Royal, Afsana Safa, Satash Sehdev, Tamsin Sevenoaks, Divya Shah, Aadil Sheikh, Vanessa Short, Baljinder S Sidhu, Ivor Singh, Yusuf Soni, Chris Thalasselis, Pete Wilson, David Wingfield, Michael Wong, Maximillian N J Woodall, Nick Wooding, Sharon Woods, Joanna Yong, Francis Yongblah, Azhar Zafar, University of St Andrews. School of Medicine, and Group, PANORAMIC Trial Collaborative

Subjects
anti-viral, Medicine(all), Adult, MCC, COVID-19 Vaccines, SARS-CoV-2, COVID-19, Bayes Theorem, General Medicine, 3rd-DAS, Middle Aged, Treatment Outcome, SDG 3 - Good Health and Well-being, RA0421, Virology, RA0421 Public health. Hygiene. Preventive Medicine, Humans, Pharmacology (medical), Prospective Studies, Family Practice
Abstract

Background The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. Methods PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031. Findings Between Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir. Interpretation Molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community. Funding UK National Institute for Health and Care Research

Published
2023
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2. Genomic Investigations of Acute Hepatitis of Unknown Aetiology in Children

Author

Judith Breuer, Sofia Morfopoulou, Sarah Buddle, Oscar Torres Montaguth, Laura Atkinson, José Afonso Guerra-Assunção, Nathaniel Storey, Sunando Roy, Alexander Lennon, Jack Lee, Rachel Williams, Charlotte Williams, Helena Tutill, Nadua Bayzid, Luz Marina Martin Bernal, Catherine Moore, Kate Templeton, Matthew Holden, Priyen Shah, Samantha Cooray, Marie Voice, Michael Steele, Colin Fink, Thomas Whittaker, Giorgia Santilli, Paul Gissen, Rachel Brown, Benedikt Kaufer, Jana Reich, Julien Andreani, Peter Simmonds, Dimah Alrabiah, Sergi Castellano Hereza, Catarina Andrade, Glenn Anderson, Chayarani Kelgeri, Simon Waddington, Juan Antinao Diaz, James Hatcher, Surjo De, Riccardo Chiozzi, Konstantinos Thalassinos, Thomas Jacques, Katja Hoschler, Tiina Talts, Cristina Celma, Suam Gonzalez, Eileen Gallagher, Ruth Simmons, Conall Watson, Sema Mandal, Maria Zambon, Meera Chand, Luis Campos, Joanne Martin, Emma Thomson, Ines Ushiro-Lumb, Michael Levin, and Julianne Brown

Abstract

Since the first reports of hepatitis of unknown aetiology occurring in UK children, over 1000 cases have been reported worldwide, including 268 cases in the UK, with the majority younger than 6 years old. Using genomic, proteomic and immunohistochemical methods, we undertook extensive investigation of 28 cases and 136 control subjects. In five cases who underwent liver transplantation, we detected high levels of adeno-associated virus 2 (AAV2) in the explanted livers. AAV2 was also detected at high levels in blood from 10/11 non-transplanted cases. Low levels of Adenovirus (HAdV) and Human Herpesvirus 6B (HHV-6B), both of which enable AAV2 lytic replication, were also found in the five explanted livers and blood from 15/17 and 6/9 respectively, of the 23 non-transplant cases tested. In contrast, AAV2 was detected at low titre in 6/100 whole bloods from child controls from cohorts with presence or absence of hepatitis and/or adenovirus infection. Our data show an association of AAV2 at high titre in blood or liver tissue, with unexplained hepatitis in children infected in the recent HAdV-F41 outbreak. We were unable to find evidence by electron microscopy, immunohistochemistry or proteomics of HAdV or AAV2 viral particles or proteins in explanted livers, suggesting that hepatic pathology is not due to direct lytic infection by either virus. The potential that AAV2, although not previously associated with disease, may, together with HAdV-F41 and/or HHV-6, be causally implicated in the outbreak of unexplained hepatitis, requires further investigation.

Published
2022
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3. Viral Genome Sequencing Proves Nosocomial Transmission of Fatal Varicella

Author

Daniel P, Depledge, Julianne, Brown, Jasna, Macanovic, Gill, Underhill, and Judith, Breuer

Subjects
Male, Cross Infection, Herpesvirus 3, Human, whole genome sequencing, viruses, nosocomial transmission, virus diseases, fatal varicella, Genome, Viral, Middle Aged, Herpes Zoster, Kidney Transplantation, Intensive Care Units, Major Articles and Brief Reports, Chickenpox, Viruses, Humans, Female, Aged
Abstract

We report the first use of whole viral genome sequencing to identify nosocomial transmission of varicella-zoster virus with fatal outcome. The index case patient, nursed in source isolation, developed disseminated zoster with rash present for 1 day before being transferred to the intensive care unit (ICU). Two patients who had received renal transplants while inpatients in an adjacent ward developed chickenpox and 1 died; neither patient had direct contact with the index patient.

Published
2016

4. Determinants of mobile phone output power in a multinational study: implications for exposure assessment

Author

Susanna Lagorio, Anssi Auvinen, Ivano Iavarone, Daniel Bedard, Alistair Woodward, Simon Mann, Joachim Schüz, L. Montestrucq, Bruce K. Armstrong, Roger C Parslow, S. J. Hepworth, Martine Hours, Masao Taki, Angela Chetrit, L. Ardoino, Joe Wiart, Elisabeth Cardis, H. Collatz-Christensen, Graham G. Giles, Päivi Kurttio, Gabriele Berg-Beckhoff, Daniel Krewski, Sigrid Lönn, Julianne Brown, Siegal Sadetzki, Martine Vrijheid, Maria Feychting, Christoffer Johansen, Angus Cook, Isabelle Deltour, Tore Tynes, Mary L. McBride, E. Combalot, and Paolo Vecchia

Subjects
Adult, Male, Time Factors, Maximum power principle, Radio Waves, Computer science, Urban Health, Public Health, Environmental and Occupational Health, Environmental Exposure, Rural Health, Environmental exposure, Middle Aged, Radiation Dosage, Power (physics), Radiation Monitoring, GSM, Phone, Mobile phone, Case-Control Studies, Statistics, Humans, Female, Cell Phone, Call duration, Power control
Abstract

Objectives: The output power of a mobile phone is directly related to its radiofrequency (RF) electromagnetic field strength, and may theoretically vary substantially in different networks and phone use circumstances due to power control technologies. To improve indices of RF exposure for epidemiological studies, we assessed determinants of mobile phone output power in a multinational study. Methods: More than 500 volunteers in 12 countries used Global System for Mobile communications software-modified phones (GSM SMPs) for approximately 1 month each. The SMPs recorded date, time, and duration of each call, and the frequency band and output power at fixed sampling intervals throughout each call. Questionnaires provided information on the typical circumstances of an individual's phone use. Linear regression models were used to analyse the influence of possible explanatory variables on the average output power and the percentage call time at maximum power for each call. Results: Measurements of over 60 000 phone calls showed that the average output power was approximately 50% of the maximum, and that output power varied by a factor of up to 2 to 3 between study centres and network operators. Maximum power was used during a considerable proportion of call time (39% on average). Output power decreased with increasing call duration, but showed little variation in relation to reported frequency of use while in a moving vehicle or inside buildings. Higher output powers for rural compared with urban use of the SMP were observed principally in Sweden where the study covered very sparsely populated areas. Conclusions: Average power levels are substantially higher than the minimum levels theoretically achievable in GSM networks. Exposure indices could be improved by accounting for average power levels of different telecommunications systems. There appears to be little value in gathering information on circumstances of phone use other than use in very sparsely populated regions.

Published
2009
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5. Recall bias in the assessment of exposure to mobile phones

Author

Jack Siemiatycki, Bruce K. Armstrong, Marie-Élise Parent, Daniel Bedard, Julianne Brown, Mary L. McBride, Daniel Krewski, Susanna Lagorio, Ivano Iavarone, Stephen S. Moore, Lesley Richardson, Isabelle Deltour, Graham G. Giles, Martine Vrijheid, and Elisabeth Cardis

Subjects
medicine.medical_specialty, Recall, Epidemiology, business.industry, Public Health, Environmental and Occupational Health, Environmental Exposure, Environmental exposure, Audiology, Toxicology, Pollution, Mobile phone, Phone, Case-Control Studies, Recall bias, Mental Recall, medicine, Humans, Telecommunications, business, Risk assessment, Cell Phone, Call duration, Exposure assessment
Abstract

Most studies of mobile phone use are case-control studies that rely on participants' reports of past phone use for their exposure assessment. Differential errors in recalled phone use are a major concern in such studies. INTERPHONE, a multinational case-control study of brain tumour risk and mobile phone use, included validation studies to quantify such errors and evaluate the potential for recall bias. Mobile phone records of 212 cases and 296 controls were collected from network operators in three INTERPHONE countries over an average of 2 years, and compared with mobile phone use reported at interview. The ratio of reported to recorded phone use was analysed as measure of agreement. Mean ratios were virtually the same for cases and controls: both underestimated number of calls by a factor of 0.81 and overestimated call duration by a factor of 1.4. For cases, but not controls, ratios increased with increasing time before the interview; however, these trends were based on few subjects with long-term data. Ratios increased by level of use. Random recall errors were large. In conclusion, there was little evidence for differential recall errors overall or in recent time periods. However, apparent overestimation by cases in more distant time periods could cause positive bias in estimates of disease risk associated with mobile phone use.

Published
2008
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6. Validation of short term recall of mobile phone use for the Interphone study

Author

S. J. Hepworth, Tiina Salminen, Gabriele Berg, K. G. Blaasaas, Ivano Iavarone, Päivi Kurttio, Siegal Sadetzki, Martine Vrijheid, Angela Chetrit, Lucile Montestrucq, Alistair Woodward, Joachim Schüz, Bruce K. Armstrong, Lesley Richardson, Roger C Parslow, Graham G. Giles, Stefan Lönn, Isabelle Deltour, Julianne Brown, Tore Tynes, Elisabeth Cardis, Christoffer Johansen, Susanna Lagorio, Martine Hours, Anssi Auvinen, Matthew Carroll, Helle Collatz Christensen, Patricia A. McKinney, Maria Feychting, and Lars Klaeboe

Subjects
Observer Variation, medicine.medical_specialty, Recall, business.industry, Public Health, Environmental and Occupational Health, Reproducibility of Results, Audiology, Term (time), Surgery, Cohen's kappa, Phone, Mobile phone, Case-Control Studies, Mental Recall, Humans, Medicine, Original Article, Geometric mean, business, Categorical variable, Cell Phone, Kappa
Abstract

Aim: To validate short term recall of mobile phone use within Interphone, an international collaborative case control study of tumours of the brain, acoustic nerve, and salivary glands related to mobile telephone use. Methods: Mobile phone use of 672 volunteers in 11 countries was recorded by operators or through the use of software modified phones, and compared to use recalled six months later using the Interphone study questionnaire. Agreement between recalled and actual phone use was analysed using both categorical and continuous measures of number and duration of phone calls. Results: Correlations between recalled and actual phone use were moderate to high (ranging from 0.5 to 0.8 across countries) and of the same order for number and duration of calls. The kappa statistic demonstrated fair to moderate agreement for both number and duration of calls (weighted kappa ranging from 0.20 to 0.60 across countries). On average, subjects underestimated the number of calls per month (geometric mean ratio of recalled to actual = 0.92, 95% CI 0.85 to 0.99), whereas duration of calls was overestimated (geometric mean ratio = 1.42, 95% CI 1.29 to 1.56). The ratio of recalled to actual use increased with level of use, showing underestimation in light users and overestimation in heavy users. There was substantial heterogeneity in this ratio between countries. Inter-individual variation was also large, and increased with level of use. Conclusions: Volunteer subjects recalled their recent phone use with moderate systematic error and substantial random error. This large random error can be expected to reduce the power of the Interphone study to detect an increase in risk of brain, acoustic nerve, and parotid gland tumours with increasing mobile phone use, if one exists.

Published
2006
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7. Risk of brain tumours in relation to estimated RF dose from mobile phones: results from five Interphone countries

Author

Lynne D. Richardson, Elisabeth Cardis, Martine Vrijheid, Alistair Woodward, Graham G. Giles, Rodrigo Villegas, Jordi Figuerola, Marie-Élise Parent, Daniel Krewski, Bruce K. Armstrong, Martine Hours, Julianne Brown, Avital Jarus-Hakak, L. Montestruq, Louise Nadon, Angela Chetrit, Chen Hoffmann, Siegal Sadetzki, Mary L. McBride, Joseph D. Bowman, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, Sydney School of Public Health, The University of Sydney, Engineering and Physical Hazards Branch, National Institute for Occupational Safety and Health, Cancer Epidemiology Centre, Cancer Council Victoria, Centre for MEGA Epidemiology, University of Melbourne-School of Population Health, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR T9405), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR), McLaughlin Centre for Population Health Risk Assessment, University of Ottawa [Ottawa], BC Cancer Research Centre, BC Cancer Agency (BCCRC), Institut Armand Frappier (INRS-IAF), Réseau International des Instituts Pasteur (RIIP)-Institut National de la Recherche Scientifique [Québec] (INRS), Cancer and Radiation Epidemiology Unit, Chaim Sheba Medical Center-Gertner Institute, Sackler Faculty of Medicine, Tel Aviv University [Tel Aviv], School of Population Health, University of Auckland [Auckland], Department of Diagnostic Imaging, Chaim Sheba Medical Center, Department of Population health, Hospital Research Centre-University of Montreal, Funding for the Interphone Study was provided by the European Fifth Framework Program, 'Quality of Life and Management of Living Resources' (contract QLK4-CT-1999901563), the International Union against Cancer (UICC). The UICC received funds for this purpose from the Mobile Manufacturers' Forum and GSM Association. Provision of funds to the Interphone Study investigators via the UICC was governed by agreements that guaranteed Interphone's complete scientific independence. The terms of these agreements are publicly available at http://www.iarc.fr/en/research-groups/RAD/RCAd.html Specific additional funds were provided for the development and analysis of the radio frequency exposure gradient and by the Fondation Santé et Radiofréquences, France and the Bundesamt fuer Strahlenschutz, Germany. The Australian centre was supported by the National Health and Medical Research Council (EME grant 219129), and BKA was supported by the University of Sydney Medical Foundation Program Grant and Julianne Brown by an Australian Postgraduate Award. The Cancer Council NSW and the Cancer Council Victoria provided most of the infrastructure for the project in Australia. The Canada-Montréal data collection was funded by a grant from the Canadian Institutes of Health Research (project MOP-42525). Additionally, Dr Siemiatycki's research team was partly funded by the Canada Research Chair programme and by the Guzzo-CRS Chair in Environment and Cancer. Dr. Parent had salary support from the Fonds de recherche en santé du Québec. The other Canadian centres were supported by a universityeindustry partnership grant from the Canadian Institutes of Health Research (CIHR), the latter including partial support from the Canadian Wireless Telecommunications Association. The CIHR universityeindustry partnerships program also includes provisions that ensure complete scientific independence of the investigators. DK is the NSERC/SSHRC/McLaughlin Chair in Population Health Risk Assessment at the University of Ottawa. Additional funding for the study in France was provided by l'Association pour la Recherche sur le Cancer (ARC) (contract 5142) and three network operators (Orange, SFR, Bouygues Télécom). The funds provided by the operators represented 5% of the total cost of the French study and were governed by contracts guaranteeing the complete scientific independence of the investigators. In New Zealand, funding was provided by the Health Research Council, Hawkes Bay Medical Research Foundation and the Cancer Society of New Zealand. The findings and conclusions in this paper have not been formally disseminated by the National Institute for Occupational Safety and Health and should not be construed to represent any agency determination or policy.

Subjects
Oncology, Male, epidemiological study, MESH: Neoplasms, Radiation-Induced, Neoplasms, Radiation-Induced, Radio Waves, non-ionising radiation, MESH: Logistic Models, MESH: Meningioma, MESH: Radio Waves, MESH: Electromagnetic Fields, MESH: Glioma, 0302 clinical medicine, MESH: New Zealand, MESH: Risk Factors, Mobile phones, 030212 general & internal medicine, MESH: Middle Aged, ionising radiation, Brain Neoplasms, MESH: Israel, risk assessment, Brain, MESH: Case-Control Studies, RF exposure assessment, 030220 oncology & carcinogenesis, MESH: Brain Neoplasms, Original Article, epidemiology, Female, physics, Algorithms, electromagnetic fields, medicine.medical_specialty, MESH: Radiation Dosage, Rf exposure, MESH: Australia, MESH: Algorithms, [SDV.CAN]Life Sciences [q-bio]/Cancer, Radiation Dosage, Meningioma, 03 medical and health sciences, MESH: Canada, Glioma, Internal medicine, medicine, cancer, Humans, MESH: Humans, business.industry, MESH: Time Factors, Public Health, Environmental and Occupational Health, Case-control study, MESH: Adult, Odds ratio, medicine.disease, MESH: Meningeal Neoplasms, hygiene/occupational hygiene, MESH: Male, MESH: Odds Ratio, Surgery, nervous system diseases, MESH: France, Increased risk, Multicenter study, MESH: Cellular Phone, business, MESH: Female, Cell Phone
Abstract

International audience; OBJECTIVES: The objective of this study was to examine the associations of brain tumours with radio frequency (RF) fields from mobile phones. METHODS: Patients with brain tumour from the Australian, Canadian, French, Israeli and New Zealand components of the Interphone Study, whose tumours were localised by neuroradiologists, were analysed. Controls were matched on age, sex and region and allocated the 'tumour location' of their matched case. Analyses included 553 glioma and 676 meningioma cases and 1762 and 1911 controls, respectively. RF dose was estimated as total cumulative specific energy (TCSE; J/kg) absorbed at the tumour's estimated centre taking into account multiple RF exposure determinants. RESULTS: ORs with ever having been a regular mobile phone user were 0.93 (95% CI 0.73 to 1.18) for glioma and 0.80 (95% CI 0.66 to 0.96) for meningioma. ORs for glioma were below 1 in the first four quintiles of TCSE but above 1 in the highest quintile, 1.35 (95% CI 0.96 to 1.90). The OR increased with increasing TCSE 7+ years before diagnosis (p-trend 0.01; OR 1.91, 95% CI 1.05 to 3.47 in the highest quintile). A complementary analysis in which 44 glioma and 135 meningioma cases in the most exposed area of the brain were compared with gliomas and meningiomas located elsewhere in the brain showed increased ORs for tumours in the most exposed part of the brain in those with 10+ years of mobile phone use (OR 2.80, 95% CI 1.13 to 6.94 for glioma). Patterns for meningioma were similar, but ORs were lower, many below 1.0. CONCLUSIONS: There were suggestions of an increased risk of glioma in long-term mobile phone users with high RF exposure and of similar, but apparently much smaller, increases in meningioma risk. The uncertainty of these results requires that they be replicated before a causal interpretation can be made.

Published
2011
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9. Infinitesimal risk as public health crisis: news media coverage of a doctor-patient HIV contact tracing investigation

Author

Deborah Lupton, Simon Chapman, and Julianne Brown

Subjects
Male, medicine.medical_specialty, Health (social science), media_common.quotation_subject, HIV Infections, Criminology, Infectious Disease Transmission, Professional-to-Patient, History and Philosophy of Science, Risk Factors, medicine, Humans, Homosexuality, Mass Media, Homosexuality, Male, Outrage, health care economics and organizations, News media, media_common, Mass media, business.industry, Public health, Obstetrics, Framing (social sciences), Pretext, Sociology, Medical, Female, Public Health, Contact Tracing, New South Wales, business, Attitude to Health, Prejudice, Health department
Abstract

Among the most prominent health or medical stories covered in 1994 by the Australian news media was that concerning an HIV positive hospital obstetrician and the attempt by the New South Wales Health Department to trace and test 149 women on whom he had operated. All press and television coverage of the issue was reviewed. The surface news narrative of the search for missing, "innocent" mothers potentially infected with a deadly and infectious illness is shown to serve as a "hard news" pretext enabling a wider major discourse to operate about a health system accused as being captive to gay and civil libertarian politics, allowing "guilty" doctors at high risk of HIV to endanger "innocent" patients. Expert consensus held that the women were at "infinitesimal risk" of acquiring HIV. However, media accounts of the investigation all but belied this, illustrating that the news media's framing of risk has more to do with its reproduction of moral outrage components than with "scientific" notions of calculable risk.

Published
1996

10. A framework for applying a health outcomes approach

Author

Dianne Kelleher, Elizabeth Terracini, Magnolia Cardona, Margaret Williamson, Ruth Colagiuri, Helen Moore, Kym Scanlon, Glen Close, Cait Lonie, Andrew Wilson, Hanna Noworytko, and Julianne Brown

Subjects
Government, medicine.medical_specialty, Health economics, business.industry, Public health, Applied psychology, Public Health, Environmental and Occupational Health, Population health, Disease, Health outcomes, Health services, Nursing, Health care, medicine, business
Abstract

Traditionally the performance of the health system has been assessed by measuring the number, type, length and cost of interactions with patients. With the focus on outcomes, attention is turning to measuring the impact of health services on the health of people.

Published
1995
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11. The INTERPHONE study: design, epidemiological methods, and description of the study population.

Author

Elisabeth Cardis, Lesley Richardson, Isabelle Deltour, Bruce Armstrong, Maria Feychting, Christoffer Johansen, Monique Kilkenny, Patricia McKinney, Baruch Modan, Joachim Schüz, Anthony Swerdlow, Martine Vrijheid, Gabriele Berg, Maria Blettner, Joseph Bowman, Julianne Brown, Angela Chetrit, Helle Christensen, Angus Cook, and Sarah Hepworth

Subjects
CELL phones, RADIO frequency, CANCER risk factors, WIRELESS communications
Abstract

Abstract  The very rapid worldwide increase in mobile phone use in the last decade has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. A multinational case–control study, INTERPHONE, was set-up to investigate whether mobile phone use increases the risk of cancer and, more specifically, whether the RF fields emitted by mobile phones are carcinogenic. The study focused on tumours arising in the tissues most exposed to RF fields from mobile phones: glioma, meningioma, acoustic neurinoma and parotid gland tumours. In addition to a detailed history of mobile phone use, information was collected on a number of known and potential risk factors for these tumours. The study was conducted in 13 countries. Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK using a common core protocol. This paper describes the study design and methods and the main characteristics of the study population. INTERPHONE is the largest case–control study to date investigating risks related to mobile phone use and to other potential risk factors for the tumours of interest and includes 2,765 glioma, 2,425 meningioma, 1,121 acoustic neurinoma, 109 malignant parotid gland tumour cases and 7,658 controls. Particular attention was paid to estimating the amount and direction of potential recall and participation biases and their impact on the study results. [ABSTRACT FROM AUTHOR]

Published
2007
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12. In-line skating injuries in children in Eastern Sydney

Author

Bernie Towler and Julianne Brown

Subjects
Gerontology, medicine.medical_specialty, Government, Health economics, business.industry, Public health, Public Health, Environmental and Occupational Health, Population health, Disease, Family medicine, Health care, medicine, Line (text file), business
Abstract

Injury is an important cause of deaths and hospitalisations of Eastern Sydney children. More than one-third of hospital admissions for injury in 1989-90 were due to falls.

Published
1994
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14. The INTERPHONE study: design, epidemiological methods, and description of the study population

Author

Anthony J. Swerdlow, Angus Cook, Simon Mann, Avital Jarus-Hakak, Patricia McKinney, S. J. Hepworth, Julianne Brown, Minouk J. Schoemaker, Joachim Schüz, Lesley Richardson, Maria Feychting, Masao Taki, Toru Takebayashi, Marie-Élise Parent, Maria Blettner, Brigitte Schlehofer, Neil Pearce, Tiina Salminen, Naohito Yamaguchi, Christoffer Johansen, Joe Wiart, Stefan Lönn, Kenneth Muir, Ivano Iavarone, Bruce K. Armstrong, Angela Chetrit, Jack Siemiatycki, Siegal Sadetzki, Lars Klaeboe, Alistair Woodward, Isabelle Deltour, Martie van Tongeren, Martine Vrijheid, Gabriele Berg, Monique F Kilkenny, Louise Nadon, Paolo Vecchia, Susanna Lagorio, Elisabeth Cardis, Anssi Auvinen, Helle Collatz Christensen, Mary L. McBride, Tore Tynes, Joseph D. Bowman, Martine Hours, Daniel Krewski, Graham G. Giles, and Baruch Modan

Subjects
Adult, Male, medicine.medical_specialty, Radio Waves, Epidemiology, Population, Epidemiological method, Risk Assessment, Interviews as Topic, 03 medical and health sciences, 0302 clinical medicine, Environmental health, Neoplasms, medicine, Humans, 030212 general & internal medicine, education, education.field_of_study, business.industry, Developed Countries, Parotid gland tumour, Middle Aged, Surgery, Acoustic neurinoma, Mobile phone, 030220 oncology & carcinogenesis, Epidemiologic Research Design, Cellular Phone, Population study, Female, Risk assessment, business, Epidemiologic Methods, Cell Phone
Abstract

The very rapid worldwide increase in mobile phone use in the last decade has generated considerable interest in the possible health effects of exposure to radio frequency (RF) fields. A multinational case-control study, INTERPHONE, was set-up to investigate whether mobile phone use increases the risk of cancer and, more specifically, whether the RF fields emitted by mobile phones are carcinogenic. The study focused on tumours arising in the tissues most exposed to RF fields from mobile phones: glioma, meningioma, acoustic neurinoma and parotid gland tumours. In addition to a detailed history of mobile phone use, information was collected on a number of known and potential risk factors for these tumours. The study was conducted in 13 countries. Australia, Canada, Denmark, Finland, France, Germany, Israel, Italy, Japan, New Zealand, Norway, Sweden, and the UK using a common core protocol. This paper describes the study design and methods and the main characteristics of the study population. INTERPHONE is the largest case-control study to date investigating risks related to mobile phone use and to other potential risk factors for the tumours of interest and includes 2,765 glioma, 2,425 meningioma, 1,121 acoustic neurinoma, 109 malignant parotid gland tumour cases and 7,658 controls. Particular attention was paid to estimating the amount and direction of potential recall and participation biases and their impact on the study results.

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15. Acoustic neuroma risk in relation to mobile telephone use: results of the INTERPHONE international case-control study

Author

L. Montestruq, Gabriele Berg-Beckhoff, Anthony J. Swerdlow, N Yamaguchi, Maria Blettner, Joachim Schüz, Neil Pearce, Louise Nadon, Anna Lahkola, C. Johansen, Daniel Krewski, Bruce K. Armstrong, Anne-Sophie Evrard, Tore Tynes, Monika Moissonnier, J Siemiatycki, Ivano Iavarone, Anders Ahlbom, Avital Jarus-Hakak, Martine Vrijheid, M. Bernard, K. G. Blaasaas, Alistair Woodward, S. J. Hepworth, Salminen T, Isabelle Deltour, J Brown, Elisabeth Cardis, Martine Hours, Angela Chetrit, Päivi Kurttio, Patricia A. McKinney, Sigrid Lönn, Maria Feychting, Lars Klaeboe, Siegal Sadetzki, Brigitte Schlehofer, Helle Collatz Christensen, Toru Takebayashi, Interphone Study Grp, Susanna Lagorio, Anssi Auvinen, G.G. Giles, Angus Cook, M. M McBride, Minouk J. Schoemaker, Marie-Élise Parent, Kenneth Muir, Institut Armand Frappier (INRS-IAF), Institut National de la Recherche Scientifique [Québec] (INRS)-Réseau International des Instituts Pasteur (RIIP), International Agency for Cancer Research (IACR), IMIM-Hospital del Mar, Generalitat de Catalunya, Center for Genomic Regulation (CRG-UPF), CIBER de Epidemiología y Salud Pública (CIBERESP), Sydney Cancer Centre and School of Public Health, The University of Sydney, Cancer Epidemiology Centre, The Cancer Council Victoria, School of Public Health and Hospital Research Center, Centre for Population Health Risk Assessment, University of Ottawa [Ottawa], Cancer Research Centre, BC Cancer Agency (BCCRC), Danish Cancer Society, Institute of Cancer Epidemiology, Radiation and Nuclear Safety Authority [Helsinki] (STUK), Département Transport, Santé, Sécurité (IFSTTAR/TS2), Institut Français des Sciences et Technologies des Transports, de l'Aménagement et des Réseaux (IFSTTAR)-Université de Lyon, Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes Gutenberg - Universität Mainz (JGU), Department of Epidemiology and International Public Health, Universität Bielefeld = Bielefeld University-Faculty of Public Health, Unit of Environmental Epidemiology, German Cancer Research Center - Deutsches Krebsforschungszentrum [Heidelberg] (DKFZ), Cancer & Radiation Epidemiology Unit, Gertner Institute, Chaim Sheba Medical Center, National Centre for Epidemiology Surveillance and Health Promotion, National Institute of Health, Department of Preventive Medicine and Public Health, University School of Medicine, Department of Public Health, University of Otago [Dunedin, Nouvelle-Zélande], Norwegian Radiation Protection Authority, The Cancer Registry of Norway, Norwegian Armed Forces Medical Services, The Institute of Environmental Medicine [Stockholm] (IMM), Karolinska Institutet [Stockholm], University of Leeds, The Health Science Research Institute, University of Warwick [Coventry], Institute of Cancer Research, Institute of cancer research, Center for Research in Environmental Epidemiology (CREAL), Universitat Pompeu Fabra [Barcelona] (UPF)-Catalunya ministerio de salud, This work was supported by funding from the European Fifth Framework Program, ‘Quality of Life and Management of Living Resources’ (contract QLK4-CT-1999901563) and the International Union against Cancer (UICC). The UICC received funds for this purpose from the Mobile Manufacturers’ Forum and GSM Association. Provision of funds to the INTERPHONE study investigators via the UICC was governed by agreements that guaranteed INTERPHONE's complete scientific independence. The terms of these agreements are publicly available at http://www.iarc.fr/en/research-groups/RAD/RCAd.html.The Australian centre was supported by the Australian National Health and Medical Research Council (EME Grant 219129) with funds originally derived from mobile phone service licence fees, Julianne Brown was partly supported by an Australian Postgraduate Award. Cancer Council NSW and Cancer Council Victoria provided most of the infrastructure for the project in Australia.The Canadian centres in Ottawa/Vancouver were supported by a university–industry partnership grant from the Canadian Institutes of Health Research (CIHR), the latter including partial support from the Canadian Wireless Telecommunications Association. The CIHR university–industry partnerships program also includes provisions that ensure complete scientific independence of the investigators. D. Krewski is the Natural Sciences and Engineering Research Council of Canada Chair in Risk Science at the University of Ottawa.The Canada – Montreal study was primarily funded by a grant from the Canadian Institutes of Health Research (project 15 MOP-42525). Additionally, Dr Siemiatycki's research team was partly funded by the Canada Research Chair programme and by the Guzzo-CRS Chair in Environment and Cancer. Dr Parent had a salary award from the Fonds de la recherche en santé du Québec.Additional funding for the study in France was provided by l’Association pour la Recherche sur le Cancer (ARC) [Contrat No. 5142] and three network operators (Orange, SFR, Bouygues Télécom). The funds provided by the operators represented 5% of the total cost of the French study and were governed by contracts guaranteeing the complete scientific independence of the investigators.The Finnish Interphone study received additional national funding from Emil Aaltonen Foundation and Academy of Finland (Grant No. 80921).The German Interphone study received additional national funding from the 'Deutsches Mobilfunkforschungsprogramm [German Mobile Phone Research Program]' of the German Federal Ministry of Environment, Nuclear Safety, and Nature Protection, the Ministry of Environment and Traffic of the state of Baden-Württemberg, the Ministry of Environment of the state of North Rhine-Westphalia, and the MAIFOR Programme of the University of Mainz.The Japanese Interphone study was fully funded by the Ministry of Internal Affairs and Communications of Japan.Funding in New Zealand for this project was provided by the Health Research Council of New Zealand, the Cancer Society of New Zealand, the Wellington Medical Research Foundation, the Hawke's Bay Medical Research Foundation and the Waikato Medical Research Foundation.The Swedish centre was additionally supported by the Swedish Research Council and the Swedish Cancer Society.The UK North study received additional funding from the Health and Safety Executive, the Department of Health, the Mobile Telecommunications, Health and Research (MTHR) program, and the Scottish Executive. The University of Leeds received some financial support on behalf of the 4 centres of the ‘UK North Study’ from the UK Network Operators (O2, Orange, T-Mobile, Vodafone, ‘3’) under legal signed contractual agreements which guaranteed complete independence for the scientific investigators.The Southeast England Centre wishes to acknowledge additional funding from the Mobile Telecommunications, Health and Research (MTHR) programme. The views expressed in this publication are those of the authors and not necessarily of the funders., and The INTERPHONE Study Group

Subjects
Male, Cancer Research, MESH: Neoplasms, Radiation-Induced, Neoplasms, Radiation-Induced, Epidemiology, MESH: Electromagnetic Fields, Decile, MESH: Glioma, 0302 clinical medicine, Risk Factors, Phone, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Meningeal Neoplasms, Odds Ratio, Medicine, Mobile phones, MESH: Middle Aged, Brain Neoplasms, Brain tumour, Glioma, Neuroma, Acoustic, MESH: Follow-Up Studies, Middle Aged, Prognosis, MESH: Case-Control Studies, 3. Good health, Survival Rate, Oncology, Reporting bias, 030220 oncology & carcinogenesis, Censoring (clinical trials), MESH: Brain Neoplasms, Female, Adult, MESH: Survival Rate, Acoustic neuroma, Radiofrequency electromagnetic fields, MESH: Prognosis, MESH: International Agencies, 03 medical and health sciences, Electromagnetic Fields, Vestibular schwannoma, Humans, MESH: Humans, business.industry, International Agencies, MESH: Adult, Odds ratio, medicine.disease, MESH: Meningeal Neoplasms, Confidence interval, MESH: Male, MESH: Odds Ratio, MESH: Cellular Phone, Mobile phone, Case-Control Studies, business, MESH: Female, Cell Phone, 030217 neurology & neurosurgery, Follow-Up Studies, Demography, MESH: Neuroma, Acoustic
Abstract

Background: The rapid increase in mobile telephone use has generated concern about possible health risks of radiofrequency electromagnetic fields from these devices. Methods: A case-control study of 1105 patients with newly diagnosed acoustic neuroma (vestibular schwannoma) and 2145 controls was conducted in 13 countries using a common protocol. Past mobile phone use was assessed by personal interview. In the primary analysis, exposure time was censored at one year before the reference date (date of diagnosis for cases and date of diagnosis of the matched case for controls); analyses censoring exposure at five years before the reference date were also done to allow for a possible longer latent period. Results: The odds ratio (OR) of acoustic neuroma with ever having been a regular mobile phone user was 0.85 (95% confidence interval 0.69-1.04). The OR for >= 10 years after first regular mobile phone use was 0.76 (0.52-1.11). There was no trend of increasing ORs with increasing cumulative call time or cumulative number of calls, with the lowest OR (0.48 (0.30-0.78)) observed in the 9th decile of cumulative call time. In the 10th decile (>= 1640 h) of cumulative call time, the OR was 1.32 (0.88-1.97); there were, however, implausible values of reported use in those with >= 1640 h of accumulated mobile phone use. With censoring at 5 years before the reference date the OR for >= 10 years after first regular mobile phone use was 0.83 (0.58-1.19) and for >= 1640 h of cumulative call time it was 2.79(1.51-5.16). but again with no trend in the lower nine deciles and with the lowest OR in the 9th decile. In general, ORs were not greater in subjects who reported usual phone use on the same side of the head as their tumour than in those who reported it on the opposite side, but it was greater in those in the 10th decile of cumulative hours of use. Conclusions: There was no increase in risk of acoustic neuroma with ever regular use of a mobile phone or for users who began regular use 10 years or more before the reference date. Elevated odds ratios observed at the highest level of cumulative call time could be due to chance, reporting bias or a causal effect. As acoustic neuroma is usually a slowly growing tumour, the interval between introduction of mobile phones and occurrence of the tumour might have been too short to observe an effect, if there is one. (C) 2011 Elsevier Ltd. All rights reserved.

Published
2011
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