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

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A.2 A.2. Scientific background and rationale for study elements other diseases. There is also robust evidence that psychosocial stress at work is a strong predictor of mental disorders, including depression 276, 413 (see also Sect. A.2.4.4). Exposure to an adverse psychosocial work environment (e.g., high demand, low control, low support, low reward, injustice, and job insecurity) increases the risk of CVD, depression, cognitive decline, and dementia. Status passages during working life and changes in social prestige have been reported to exert an influence on all-cause mortality and CVD, independently of the family biography and other lifestyle factors 414 . Night work can desynchronize biological clocks 415 and disrupt circadian processes, such as tissue regeneration and DNA repair, and thereby may increase the risk of cancer 373 . Moreover, shift work increases the incidence of CVD and diabetes mellitus 416 . Assessment of occupational exposures: Examinations and questionnaires (at baseline and during reassessment) Level 1: Questionnaire (filter questions for later administration of specific questionnaires, e.g., on shift work) Level 2: Specific questionnaires (psychosocial factors at work) Level 3: Specific questionnaires (following filter questions, e.g., on shift work, stress at work, hazardous exposures) Secondary data: Occupational history Environmental exposures Air pollution and noise: Air pollution has been consistently associated with all-cause mortality and with CVD mortality417 . Studies assessing traffic-related pollution have highlighted that other components of fine particulate matter – ultrafine particles, organic carbohydrates, or other oxidative stressinducing components such as transition metals – are associated with severe health effects. In addition to traffic-related air pollutants, environmental noise is increasingly becoming a problem as well. A multicenter European study on aircraft noise showed an excess risk of hypertension related to long-term noise exposure418 . The overall evidence on the association between noise and ischemic heart disease is still mixed419, 420 and relatively scarce. However, there is still strong suspicion that traffic-related exposures to air pollutants, noise, and stress increase the risk of CVD and other diseases. Furthermore, comprehensive assessments of these kinds of exposures are sparse and other chronic diseases related to oxidative stress, such as diabetes421 or neurodegenerative diseases422 , are just emerging as being potentially affected by traffic exposures. In the National Cohort, geocoding data can be connected with study participants’ addresses of residence (small-area neighborhood) and with habitual workplaces to determine average local levels of outdoor air pollution and noise. In addition, several questions relating to indoor exposure will be addressed. Assessment of exposure to air pollution and noise: Examinations and questionnaires (at baseline and during reassessment) Level 1: Questionnaire (incl. home and work addresses) Secondary data: Geocoding data on air pollution, noise, and microclimate Ionizing radiation is known to increase the risk for cancer and potentially for certain noncancer endpoints. Medical exposure is the major source of exposure to ionizing radiation in the 52
A.2 Scientific background and rationale for study elements population and represents an important confounder or effect modifier for other risk factors (genetic, environmental, etc.). Cumulative medical exposure to radiation will be estimated from individuals' health insurance data on the use of diagnostic and therapeutic devices that employ ionizing radiation. The effective dose from external environmental radiation exposure is estimated to lie in the range of 0.5 to 1.2 mSv per year in Germany (German Radiation Protection Commission 2008). No data exist for individual external environmental radiation exposure; however, representative data on the individual distribution of radon concentrations in homes have been collected recently 423 . Assessment of exposure to ionizing radiation: Examinations and questionnaires (at baseline and during reassessment) Level 3: Questionnaire for medical exposure Bracelet dosimeter for assessing background exposure Secondary data: Health insurance data (estimation of medical exposure to ionizing radiation) Geocoding data on background radiation 53 A.2
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The National Cohort A prospective e
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Applicants Applicants Applicants Cl
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Applicants IV
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Executive Summary 2. The National C
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Executive Summary 3. Scientific aim
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Executive Summary essary to address
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Executive Summary 7. Examples for s
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Contents A.2.4 major areas of expos
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Contents A.3.8.2 Social security da
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Contents A.6.4.2 Minimally detectab
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Abbreviations C.2 mEThOdS fOr STATI
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Abbreviations DXA Dual-energy x-ray
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Abbreviations CHS Cardiovascular He
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A.3 A.3 Study design Project title
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A.3 A.3 Study design diseases in va
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A.3 A.3 Study design associations,
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A.3 A.3 Study design Informed Conse
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A.3 A.3 Study design 6. Since being
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A.3 A.3 Study design the possible d
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A.3 A.3 Study design A.3.5 Collecti
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A.3 A.3 Study design Blood In addit
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A.3 A.3 Study design the anterior n
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A.3 A.3 Study design study. For exa
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A.3 A.3 Study design large-size sto
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A.3 A.3 Study design routinely prep
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A.3 A.3 Study design Subjects who m
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A.3 A.3 Study design A.3.6.3 reliab
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A.3 A.3 Study design In addition, a
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A.3 A.3 Study design Disease Questi
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A.3 A.3 Study design Data routinely
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A.3 A.3 Study design tial misclassi
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A.3 A.3 Study design � The KORA c
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A.3 A.3 Study design Table 3.16: Co
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A.4 A.4 Integrated Data Management
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A.5 A.5 Methods for quality assuran
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A.6 A.6 Planned statistical analyse
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A.6 A.6 Table Planned 6.4: Expected
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A.6 Planned statistical analyses an
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A.7 A.7 Ethical aspects logical/gen
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A.7 A.7 Ethical aspects The more ex
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A.7 A.7 Ethical aspects pants, trav
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A.7 A.7 Ethical aspects Data handli
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A.7 Table 7.2 Availability of ident
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A.7 A.7 Ethical aspects Should bios
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A.7 A.7 Ethical aspects ing finding
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C.2 Table S6.5: Sample size needed
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C.3 References 17. Keil, U., et al.
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C.3 References 50. Benjamin, E.J.,
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C.3 References 225. Schmidt, C.O.,
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C.3 References 294. McCrae, R.R. an
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C.3 References 327. Lynch, J.W., G.
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C.3 References 360. Mair, C., A.V.
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C.3 References 395. Lesourd, B., Nu
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C.3 References 431. Statistisches B
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C.3 References 462. Bundeszentrale
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C.3 References 494. Rammstedt, B. a
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C.3 References 526. Mack, F., et al
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C.3 References 560. Palatini, P., A
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C.3 References 590. Greenland, P.,
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C.3 References 623. Olin, A.C., et
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C.3 References 658. Pate, R.R., J.R
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C.3 References 691. Zenge, M.O., et
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C.3 References 727. Ryu, O.H., et a
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C.3 References 757. BSI-Standard 10
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C.3 References 790. Davis, C.E., et
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