Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment

Nested case‐control studies of non‐Hodgkin's lymphoma (52 cases), multiple myeloma (20 cases), nonlymphocytic leukemia (39 cases), and lymphocytic leukemia (18 cases) were conducted within a cohort of employed men from two chemical manufacturing facilities and a research and development center....

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:American journal of industrial medicine 1989, Vol.16 (6), p.631-643
Hauptverfasser: Ott, M. Gerald, Teta, M. Jane, Greenberg, Howard L.
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 643
container_issue 6
container_start_page 631
container_title American journal of industrial medicine
container_volume 16
creator Ott, M. Gerald
Teta, M. Jane
Greenberg, Howard L.
description Nested case‐control studies of non‐Hodgkin's lymphoma (52 cases), multiple myeloma (20 cases), nonlymphocytic leukemia (39 cases), and lymphocytic leukemia (18 cases) were conducted within a cohort of employed men from two chemical manufacturing facilities and a research and development center. Exposure odds ratios were examined in relation to 111 work areas, 21 specific chemicals, and 52 chemical activity groups. Associations were observed for a maintenance and construction subgroup (non‐Hodgkin's lymphoma) and a chlorohydrin production unit (nonlymphocytic leukemia). The odds ratio for the association of “foremen and others” with non‐Hodgkin's lymphoma was 3.2 (CI95 = 1.47–7.2) based on 11 cases. A duration‐response trend was observed for the chlorohydrin unit with three of four cases assigned 5 + years to that unit. An association between non‐Hodgkin's lymphoma and assignment to strong acid alcohol production units (OR = 8.3; CI95 = 2.3–30.7) was not supported by a duration‐response trend. Two highly correlated chemical groups, antioxidants (five cases) and nitriles (four cases), were over‐represented among multiple myeloma cases. A duration effect was observed. However, examination of work histories did not reveal common jobs or departments among these cases.
doi_str_mv 10.1002/ajim.4700160603
format Article
fullrecord <record><control><sourceid>proquest_osti_</sourceid><recordid>TN_cdi_osti_scitechconnect_5043335</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1560137081</sourcerecordid><originalsourceid>FETCH-LOGICAL-c5333-9dc0b8350ae984dedd1d2b71d4d7c87ca9490adebf72ff20f07fb71b20b0a4fe3</originalsourceid><addsrcrecordid>eNqFkctrFEEYxBtR4iZ69iQMIsHLJF-_Z_AUgomR9Ynisenph9txp2ed7lH3v7eXWVa8mNMHXb-qaiiEnmA4wwDkXN-G_oxJACxAAL2HFhhaWQOR7D5alINryhvxEB2ndFsozAQ7QkeEc9FitkAfl9t-s9I5mEpHW61cr_OwGYLbveSQ0uQqo6NxYxVipStTiGD0uup1nLw2eRpD_Fa5-DOMQ-xdzI_QA6_XyT3e3xP05erV58vX9fL99c3lxbI2nFJat9ZA11AO2rUNs85abEknsWVWmkYa3bIWtHWdl8R7Ah6kL3JHoAPNvKMn6NmcO6QcVDIhO7MyQ4zOZMWBlRJeoNMZ2ozDj8mlrPqQjFuvdXTDlBRpKSOYNgV88V8QcwGYSmjwnZmYMyYbTAp4PoNmHFIanVebMfR63CoMaree2q2n_q5XHE_30VPXO3vg93MV_fle16mM4MeyTEgHTAi26y3Yyxn7FdZue1erunhz8_afT9SzO6Tsfh_cevyuhKSSq6_vrhV8okSwD1cK6B_8r8Kf</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>15447812</pqid></control><display><type>article</type><title>Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment</title><source>MEDLINE</source><source>Wiley Journals</source><creator>Ott, M. Gerald ; Teta, M. Jane ; Greenberg, Howard L.</creator><creatorcontrib>Ott, M. Gerald ; Teta, M. Jane ; Greenberg, Howard L.</creatorcontrib><description>Nested case‐control studies of non‐Hodgkin's lymphoma (52 cases), multiple myeloma (20 cases), nonlymphocytic leukemia (39 cases), and lymphocytic leukemia (18 cases) were conducted within a cohort of employed men from two chemical manufacturing facilities and a research and development center. Exposure odds ratios were examined in relation to 111 work areas, 21 specific chemicals, and 52 chemical activity groups. Associations were observed for a maintenance and construction subgroup (non‐Hodgkin's lymphoma) and a chlorohydrin production unit (nonlymphocytic leukemia). The odds ratio for the association of “foremen and others” with non‐Hodgkin's lymphoma was 3.2 (CI95 = 1.47–7.2) based on 11 cases. A duration‐response trend was observed for the chlorohydrin unit with three of four cases assigned 5 + years to that unit. An association between non‐Hodgkin's lymphoma and assignment to strong acid alcohol production units (OR = 8.3; CI95 = 2.3–30.7) was not supported by a duration‐response trend. Two highly correlated chemical groups, antioxidants (five cases) and nitriles (four cases), were over‐represented among multiple myeloma cases. A duration effect was observed. However, examination of work histories did not reveal common jobs or departments among these cases.</description><identifier>ISSN: 0271-3586</identifier><identifier>EISSN: 1097-0274</identifier><identifier>DOI: 10.1002/ajim.4700160603</identifier><identifier>PMID: 2556914</identifier><identifier>CODEN: AJIMD8</identifier><language>eng</language><publisher>New York: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>560300 - Chemicals Metabolism &amp; Toxicology ; Aged ; Alkanesulfonates - adverse effects ; alkyl sulfates ; ANTIOXIDANTS ; Biological and medical sciences ; CARCINOGENESIS ; CHEMICAL INDUSTRY ; DISEASES ; EPIDEMIOLOGY ; ethylene chlorohydrin ; Ethylene Chlorohydrin - adverse effects ; FEDERAL REGION III ; Follow-Up Studies ; HAZARDS ; HEALTH HAZARDS ; Hematologic and hematopoietic diseases ; HEMIC DISEASES ; Humans ; IMMUNE SYSTEM DISEASES ; INDUSTRY ; LEUKEMIA ; Leukemia, Lymphoid - chemically induced ; Leukemia, Lymphoid - mortality ; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis ; lymphoma ; Lymphoma, Non-Hodgkin - chemically induced ; Lymphoma, Non-Hodgkin - mortality ; LYMPHOMAS ; Male ; Medical sciences ; Middle Aged ; multiple myeloma ; Multiple Myeloma - chemically induced ; Multiple Myeloma - mortality ; NEOPLASMS ; NITRILES ; NORTH AMERICA ; OCCUPATIONAL DISEASES ; Occupational Diseases - chemically induced ; Occupational Diseases - mortality ; occupational epidemiology ; ORGANIC COMPOUNDS ; ORGANIC NITROGEN COMPOUNDS ; PATHOGENESIS ; PERSONNEL ; RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT ; USA ; WEST VIRGINIA ; West Virginia - epidemiology</subject><ispartof>American journal of industrial medicine, 1989, Vol.16 (6), p.631-643</ispartof><rights>Copyright © 1989 Wiley Periodicals, Inc., A Wiley Company</rights><rights>1990 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5333-9dc0b8350ae984dedd1d2b71d4d7c87ca9490adebf72ff20f07fb71b20b0a4fe3</citedby><cites>FETCH-LOGICAL-c5333-9dc0b8350ae984dedd1d2b71d4d7c87ca9490adebf72ff20f07fb71b20b0a4fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fajim.4700160603$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fajim.4700160603$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,4010,27900,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=6648123$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/2556914$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://www.osti.gov/biblio/5043335$$D View this record in Osti.gov$$Hfree_for_read</backlink></links><search><creatorcontrib>Ott, M. Gerald</creatorcontrib><creatorcontrib>Teta, M. Jane</creatorcontrib><creatorcontrib>Greenberg, Howard L.</creatorcontrib><title>Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment</title><title>American journal of industrial medicine</title><addtitle>Am. J. Ind. Med</addtitle><description>Nested case‐control studies of non‐Hodgkin's lymphoma (52 cases), multiple myeloma (20 cases), nonlymphocytic leukemia (39 cases), and lymphocytic leukemia (18 cases) were conducted within a cohort of employed men from two chemical manufacturing facilities and a research and development center. Exposure odds ratios were examined in relation to 111 work areas, 21 specific chemicals, and 52 chemical activity groups. Associations were observed for a maintenance and construction subgroup (non‐Hodgkin's lymphoma) and a chlorohydrin production unit (nonlymphocytic leukemia). The odds ratio for the association of “foremen and others” with non‐Hodgkin's lymphoma was 3.2 (CI95 = 1.47–7.2) based on 11 cases. A duration‐response trend was observed for the chlorohydrin unit with three of four cases assigned 5 + years to that unit. An association between non‐Hodgkin's lymphoma and assignment to strong acid alcohol production units (OR = 8.3; CI95 = 2.3–30.7) was not supported by a duration‐response trend. Two highly correlated chemical groups, antioxidants (five cases) and nitriles (four cases), were over‐represented among multiple myeloma cases. A duration effect was observed. However, examination of work histories did not reveal common jobs or departments among these cases.</description><subject>560300 - Chemicals Metabolism &amp; Toxicology</subject><subject>Aged</subject><subject>Alkanesulfonates - adverse effects</subject><subject>alkyl sulfates</subject><subject>ANTIOXIDANTS</subject><subject>Biological and medical sciences</subject><subject>CARCINOGENESIS</subject><subject>CHEMICAL INDUSTRY</subject><subject>DISEASES</subject><subject>EPIDEMIOLOGY</subject><subject>ethylene chlorohydrin</subject><subject>Ethylene Chlorohydrin - adverse effects</subject><subject>FEDERAL REGION III</subject><subject>Follow-Up Studies</subject><subject>HAZARDS</subject><subject>HEALTH HAZARDS</subject><subject>Hematologic and hematopoietic diseases</subject><subject>HEMIC DISEASES</subject><subject>Humans</subject><subject>IMMUNE SYSTEM DISEASES</subject><subject>INDUSTRY</subject><subject>LEUKEMIA</subject><subject>Leukemia, Lymphoid - chemically induced</subject><subject>Leukemia, Lymphoid - mortality</subject><subject>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</subject><subject>lymphoma</subject><subject>Lymphoma, Non-Hodgkin - chemically induced</subject><subject>Lymphoma, Non-Hodgkin - mortality</subject><subject>LYMPHOMAS</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>multiple myeloma</subject><subject>Multiple Myeloma - chemically induced</subject><subject>Multiple Myeloma - mortality</subject><subject>NEOPLASMS</subject><subject>NITRILES</subject><subject>NORTH AMERICA</subject><subject>OCCUPATIONAL DISEASES</subject><subject>Occupational Diseases - chemically induced</subject><subject>Occupational Diseases - mortality</subject><subject>occupational epidemiology</subject><subject>ORGANIC COMPOUNDS</subject><subject>ORGANIC NITROGEN COMPOUNDS</subject><subject>PATHOGENESIS</subject><subject>PERSONNEL</subject><subject>RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT</subject><subject>USA</subject><subject>WEST VIRGINIA</subject><subject>West Virginia - epidemiology</subject><issn>0271-3586</issn><issn>1097-0274</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkctrFEEYxBtR4iZ69iQMIsHLJF-_Z_AUgomR9Ynisenph9txp2ed7lH3v7eXWVa8mNMHXb-qaiiEnmA4wwDkXN-G_oxJACxAAL2HFhhaWQOR7D5alINryhvxEB2ndFsozAQ7QkeEc9FitkAfl9t-s9I5mEpHW61cr_OwGYLbveSQ0uQqo6NxYxVipStTiGD0uup1nLw2eRpD_Fa5-DOMQ-xdzI_QA6_XyT3e3xP05erV58vX9fL99c3lxbI2nFJat9ZA11AO2rUNs85abEknsWVWmkYa3bIWtHWdl8R7Ah6kL3JHoAPNvKMn6NmcO6QcVDIhO7MyQ4zOZMWBlRJeoNMZ2ozDj8mlrPqQjFuvdXTDlBRpKSOYNgV88V8QcwGYSmjwnZmYMyYbTAp4PoNmHFIanVebMfR63CoMaree2q2n_q5XHE_30VPXO3vg93MV_fle16mM4MeyTEgHTAi26y3Yyxn7FdZue1erunhz8_afT9SzO6Tsfh_cevyuhKSSq6_vrhV8okSwD1cK6B_8r8Kf</recordid><startdate>1989</startdate><enddate>1989</enddate><creator>Ott, M. Gerald</creator><creator>Teta, M. Jane</creator><creator>Greenberg, Howard L.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Liss</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T2</scope><scope>7TV</scope><scope>7U2</scope><scope>7U7</scope><scope>C1K</scope><scope>7TB</scope><scope>8FD</scope><scope>FR3</scope><scope>OTOTI</scope></search><sort><creationdate>1989</creationdate><title>Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment</title><author>Ott, M. Gerald ; Teta, M. Jane ; Greenberg, Howard L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5333-9dc0b8350ae984dedd1d2b71d4d7c87ca9490adebf72ff20f07fb71b20b0a4fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1989</creationdate><topic>560300 - Chemicals Metabolism &amp; Toxicology</topic><topic>Aged</topic><topic>Alkanesulfonates - adverse effects</topic><topic>alkyl sulfates</topic><topic>ANTIOXIDANTS</topic><topic>Biological and medical sciences</topic><topic>CARCINOGENESIS</topic><topic>CHEMICAL INDUSTRY</topic><topic>DISEASES</topic><topic>EPIDEMIOLOGY</topic><topic>ethylene chlorohydrin</topic><topic>Ethylene Chlorohydrin - adverse effects</topic><topic>FEDERAL REGION III</topic><topic>Follow-Up Studies</topic><topic>HAZARDS</topic><topic>HEALTH HAZARDS</topic><topic>Hematologic and hematopoietic diseases</topic><topic>HEMIC DISEASES</topic><topic>Humans</topic><topic>IMMUNE SYSTEM DISEASES</topic><topic>INDUSTRY</topic><topic>LEUKEMIA</topic><topic>Leukemia, Lymphoid - chemically induced</topic><topic>Leukemia, Lymphoid - mortality</topic><topic>Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis</topic><topic>lymphoma</topic><topic>Lymphoma, Non-Hodgkin - chemically induced</topic><topic>Lymphoma, Non-Hodgkin - mortality</topic><topic>LYMPHOMAS</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>multiple myeloma</topic><topic>Multiple Myeloma - chemically induced</topic><topic>Multiple Myeloma - mortality</topic><topic>NEOPLASMS</topic><topic>NITRILES</topic><topic>NORTH AMERICA</topic><topic>OCCUPATIONAL DISEASES</topic><topic>Occupational Diseases - chemically induced</topic><topic>Occupational Diseases - mortality</topic><topic>occupational epidemiology</topic><topic>ORGANIC COMPOUNDS</topic><topic>ORGANIC NITROGEN COMPOUNDS</topic><topic>PATHOGENESIS</topic><topic>PERSONNEL</topic><topic>RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT</topic><topic>USA</topic><topic>WEST VIRGINIA</topic><topic>West Virginia - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ott, M. Gerald</creatorcontrib><creatorcontrib>Teta, M. Jane</creatorcontrib><creatorcontrib>Greenberg, Howard L.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Pollution Abstracts</collection><collection>Safety Science and Risk</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Mechanical &amp; Transportation Engineering Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>OSTI.GOV</collection><jtitle>American journal of industrial medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ott, M. Gerald</au><au>Teta, M. Jane</au><au>Greenberg, Howard L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment</atitle><jtitle>American journal of industrial medicine</jtitle><addtitle>Am. J. Ind. Med</addtitle><date>1989</date><risdate>1989</risdate><volume>16</volume><issue>6</issue><spage>631</spage><epage>643</epage><pages>631-643</pages><issn>0271-3586</issn><eissn>1097-0274</eissn><coden>AJIMD8</coden><abstract>Nested case‐control studies of non‐Hodgkin's lymphoma (52 cases), multiple myeloma (20 cases), nonlymphocytic leukemia (39 cases), and lymphocytic leukemia (18 cases) were conducted within a cohort of employed men from two chemical manufacturing facilities and a research and development center. Exposure odds ratios were examined in relation to 111 work areas, 21 specific chemicals, and 52 chemical activity groups. Associations were observed for a maintenance and construction subgroup (non‐Hodgkin's lymphoma) and a chlorohydrin production unit (nonlymphocytic leukemia). The odds ratio for the association of “foremen and others” with non‐Hodgkin's lymphoma was 3.2 (CI95 = 1.47–7.2) based on 11 cases. A duration‐response trend was observed for the chlorohydrin unit with three of four cases assigned 5 + years to that unit. An association between non‐Hodgkin's lymphoma and assignment to strong acid alcohol production units (OR = 8.3; CI95 = 2.3–30.7) was not supported by a duration‐response trend. Two highly correlated chemical groups, antioxidants (five cases) and nitriles (four cases), were over‐represented among multiple myeloma cases. A duration effect was observed. However, examination of work histories did not reveal common jobs or departments among these cases.</abstract><cop>New York</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>2556914</pmid><doi>10.1002/ajim.4700160603</doi><tpages>13</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0271-3586
ispartof American journal of industrial medicine, 1989, Vol.16 (6), p.631-643
issn 0271-3586
1097-0274
language eng
recordid cdi_osti_scitechconnect_5043335
source MEDLINE; Wiley Journals
subjects 560300 - Chemicals Metabolism & Toxicology
Aged
Alkanesulfonates - adverse effects
alkyl sulfates
ANTIOXIDANTS
Biological and medical sciences
CARCINOGENESIS
CHEMICAL INDUSTRY
DISEASES
EPIDEMIOLOGY
ethylene chlorohydrin
Ethylene Chlorohydrin - adverse effects
FEDERAL REGION III
Follow-Up Studies
HAZARDS
HEALTH HAZARDS
Hematologic and hematopoietic diseases
HEMIC DISEASES
Humans
IMMUNE SYSTEM DISEASES
INDUSTRY
LEUKEMIA
Leukemia, Lymphoid - chemically induced
Leukemia, Lymphoid - mortality
Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis
lymphoma
Lymphoma, Non-Hodgkin - chemically induced
Lymphoma, Non-Hodgkin - mortality
LYMPHOMAS
Male
Medical sciences
Middle Aged
multiple myeloma
Multiple Myeloma - chemically induced
Multiple Myeloma - mortality
NEOPLASMS
NITRILES
NORTH AMERICA
OCCUPATIONAL DISEASES
Occupational Diseases - chemically induced
Occupational Diseases - mortality
occupational epidemiology
ORGANIC COMPOUNDS
ORGANIC NITROGEN COMPOUNDS
PATHOGENESIS
PERSONNEL
RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT
USA
WEST VIRGINIA
West Virginia - epidemiology
title Lymphatic and hematopoietic tissue cancer in a chemical manufacturing environment
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-11T16%3A33%3A03IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_osti_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Lymphatic%20and%20hematopoietic%20tissue%20cancer%20in%20a%20chemical%20manufacturing%20environment&rft.jtitle=American%20journal%20of%20industrial%20medicine&rft.au=Ott,%20M.%20Gerald&rft.date=1989&rft.volume=16&rft.issue=6&rft.spage=631&rft.epage=643&rft.pages=631-643&rft.issn=0271-3586&rft.eissn=1097-0274&rft.coden=AJIMD8&rft_id=info:doi/10.1002/ajim.4700160603&rft_dat=%3Cproquest_osti_%3E1560137081%3C/proquest_osti_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=15447812&rft_id=info:pmid/2556914&rfr_iscdi=true