Scientific Concept of the National Cohort (status ... - Nationale Kohorte

A.2 Scientific background and rationale for study elements
Assessment of microbial colonization:
Collection of relevant biomaterials (at baseline and during reassessment):
Level 3 Analyses of saliva, nasal swabs, and stool samples
(on nested case-control basis)
Zoonoses and chronic disease risk
Approximately 20% of the National Cohort participants are expected to own one or more
household pet 401 . Pets may pose health risks, for instance, by (1) causing injuries 402 , (2)
inducing allergies 403 , and (3) being a source of infectious agents. In addition to parasitic,
fungal, and viral infections, pets transmit a number of bacterial pathogens 404 . Furthermore,
several studies have shown a national burden of zoonotic infections caused by nutritional
exposure and by direct or indirect contact to farm animals even in the general population 405 .
Our goal is to study the impact of pathogens that are shared by humans and animals on
human health. Two pathogens could act as proxies of special interest. Bartonella spp. are
highly prevalent in cats and dogs in Germany (seroprevalence ~15%) 406, 407 and can cause
severe infections in humans, especially in immunocompromised individuals 408, 409 . Pets and
farm animals may represent community reservoirs of antimicrobial-resistant bacteria 410, 411 .
The Level 1 questionnaire will contain screening questions regarding past and present exposure
to household pets and farm animals. Individuals reporting a significant exposure in
their history will then be selected for targeted substudies at Level 3. For instance, we will
study exposure to Bartonella spp. and Staphylococcus aureus in pets and their owners in
parallel. The ability of the owners to obtain nasal swabs and stool samples from their cats
or dogs and their willingness to have a veterinarian draw blood from their pets will be tested
in 2011 in a feasibility study headed by the University of Veterinary Medicine in Hannover.
Assessment of zoonotic infections:
Examinations and questionnaires (at baseline and during reassessment)
Level 1: Questionnaire (screening questions)
Level 3: Collection of biomaterials in participants and animals
for microbial analysis
A.2.4.8 Occupational and environmental exposures
Occupation
Most people spend a major part of their lifetime at work, often exposing them to hazardous
chemical and physical risks and to negative psychosocial stress. Exposures at the
workplace are generally higher than in the environmental setting; they have been measured,
regulated, and monitored for approximately 40 years now and have been addressed
in particular in specialized, occupational cohort studies. In the National Cohort, complete
occupational histories will be obtained for study participants by data retrieval from the National
Institute for Employment Research (Federal Employment Agency). These data will be
linked to job exposure matrices (JEM) to estimate possible past exposures to occupational
risk factors for cancer, cardiovascular, musculoskeletal, and neurodegenerative diseases.
Several kinds of exposures can be investigated this way, including physical and biomechanical
work factors, exposure to fine (PM4