Pub Date : 2026-02-21DOI: 10.1007/s10654-026-01374-6
Sarah E. Williford, K. Arnold Chan, Jeffrey S. Brown
{"title":"Re: Liu et al., “On the reported methodology in published TriNetX-based studies: an analysis of impossible index event designs”","authors":"Sarah E. Williford, K. Arnold Chan, Jeffrey S. Brown","doi":"10.1007/s10654-026-01374-6","DOIUrl":"https://doi.org/10.1007/s10654-026-01374-6","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"332 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-026-01363-9
Céline Bolliger, Eleftheria Michalopoulou, Christian Kreis, Matthias Lorez, Christina Schindera, Benjamin Kasenda, Claudia E. Kuehni, Daniela Dyntar, Katharina Roser, Ben D. Spycher
Cancers in adolescents and young adults (AYAs, aged 15–39 years) have distinct features and distribution of cancer types. This study investigated incidence, mortality, and cumulative risk of AYA cancers in Switzerland. Data on adolescent cancers (15–19 years; Swiss Childhood Cancer Registry) and young adult cancers (20–39 years; National Agency for Cancer Registration) were combined. We calculated age-standardized incidence and mortality rates, and accounted for incomplete regional coverage of cancer registration. We used joinpoint regression to investigate cancer incidence and mortality trends and estimate average annual percent changes. We included 44,048 cancers recorded between 1980 and 2019 and, after adjusting for incomplete coverage, we estimated a total of 69,901 cancers. Cancer incidence increased from 56.6 [95% confidence interval: 55.3, 58.0] per 100,000 person-years in 1980–1989 to 72.2 [71.1, 73.3] in 2010–2019, with a steeper increase for females. The most common cancers were carcinomas, mainly of the breast (9,629 cancers estimated), gastrointestinal tract (5,033) and thyroid (4,785), gonadal and related tumors (11,303), melanomas (9,695), and lymphomas (8,208). There were 9,865 AYA cancer deaths recorded over the study period. The age-standardized mortality rate declined from 13.3 [12.8, 13.7] per 100,000 person-years in 1980–1989 to 6.2 [5.9, 6.5] in 2010–2019, showing similar decreases in both sexes. This first comprehensive, nationwide study of AYA cancers in Switzerland showed increasing incidence and declining mortality, potentially due to changes in lifestyle or improved cancer registration and screening practices. Our results emphasize the need for ongoing surveillance and preventive strategies with a focus on AYAs.
{"title":"Incidence, mortality, and cumulative risk of cancer in adolescents and young adults in Switzerland","authors":"Céline Bolliger, Eleftheria Michalopoulou, Christian Kreis, Matthias Lorez, Christina Schindera, Benjamin Kasenda, Claudia E. Kuehni, Daniela Dyntar, Katharina Roser, Ben D. Spycher","doi":"10.1007/s10654-026-01363-9","DOIUrl":"https://doi.org/10.1007/s10654-026-01363-9","url":null,"abstract":"Cancers in adolescents and young adults (AYAs, aged 15–39 years) have distinct features and distribution of cancer types. This study investigated incidence, mortality, and cumulative risk of AYA cancers in Switzerland. Data on adolescent cancers (15–19 years; Swiss Childhood Cancer Registry) and young adult cancers (20–39 years; National Agency for Cancer Registration) were combined. We calculated age-standardized incidence and mortality rates, and accounted for incomplete regional coverage of cancer registration. We used joinpoint regression to investigate cancer incidence and mortality trends and estimate average annual percent changes. We included 44,048 cancers recorded between 1980 and 2019 and, after adjusting for incomplete coverage, we estimated a total of 69,901 cancers. Cancer incidence increased from 56.6 [95% confidence interval: 55.3, 58.0] per 100,000 person-years in 1980–1989 to 72.2 [71.1, 73.3] in 2010–2019, with a steeper increase for females. The most common cancers were carcinomas, mainly of the breast (9,629 cancers estimated), gastrointestinal tract (5,033) and thyroid (4,785), gonadal and related tumors (11,303), melanomas (9,695), and lymphomas (8,208). There were 9,865 AYA cancer deaths recorded over the study period. The age-standardized mortality rate declined from 13.3 [12.8, 13.7] per 100,000 person-years in 1980–1989 to 6.2 [5.9, 6.5] in 2010–2019, showing similar decreases in both sexes. This first comprehensive, nationwide study of AYA cancers in Switzerland showed increasing incidence and declining mortality, potentially due to changes in lifestyle or improved cancer registration and screening practices. Our results emphasize the need for ongoing surveillance and preventive strategies with a focus on AYAs.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"547 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-025-01342-6
Yu-Jung Lin, Kuo-Wang Tsai, Kuo-Cheng Lu, Joshua Wang
{"title":"On the reported methodology in published TriNetX-based studies: an analysis of impossible index event designs","authors":"Yu-Jung Lin, Kuo-Wang Tsai, Kuo-Cheng Lu, Joshua Wang","doi":"10.1007/s10654-025-01342-6","DOIUrl":"https://doi.org/10.1007/s10654-025-01342-6","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"52 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-026-01362-w
Diana A. Nôga, Elisa M. S. Meth, André P. Pacheco, Jonathan Cedernaes, Pei Xue, Christian Benedict
Shift workers exhibit a higher incidence of coronary heart disease (CHD) than daytime workers. We examined whether this difference in CHD incidence between shift workers and daytime workers is associated with two dietary factors linked to lower CHD risk—daily fiber intake and meat avoidance—using UK Biobank data. The study included 222,801 participants (53.8% women; mean age 52.6 years), categorized as daytime workers, shift workers with no or occasional night shifts, or regular night shift workers. Dietary habits were assessed via touchscreen dietary questionnaires. During a median follow-up of 12.6 years, 12,265 fatal and non-fatal CHD events occurred. Compared with daytime workers, regular night shift work—but not shift work with no or occasional night shifts—was associated with higher CHD incidence (hazard ratio [HR] 1.10, 95% CI 1.01–1.20). HRs for CHD were higher (vs. daytime work) in both shift work groups among participants with lower daily fiber intake, whereas they were attenuated among those with higher fiber intake (p < 0.05 for interaction). Meat avoidance was associated with a 10.4% lower CHD HR compared with meat consumption (p = 0.020), although no significant interaction with work schedule was observed. In summary, while our finding that meat avoidance is associated with modestly lower CHD HR across work schedules aligns with established cardiovascular recommendations, our observation that higher fiber intake may reduce CHD differences specifically linked to night shift work highlights an additional, shift-specific dietary consideration that could complement the American Heart Association’s Life’s Essential 8.
轮班工人冠心病(CHD)的发病率高于白班工人。我们利用英国生物银行的数据,研究了轮班工人和白班工人之间冠心病发病率的差异是否与两种与降低冠心病风险相关的饮食因素有关——每日纤维摄入量和不吃肉。该研究包括222,801名参与者(53.8%为女性,平均年龄52.6岁),分为白班工人、不上夜班或偶尔上夜班的轮班工人和常规夜班工人。通过触摸屏饮食问卷评估饮食习惯。在中位随访12.6年期间,发生了12,265例致死性和非致死性冠心病事件。与白班工人相比,经常上夜班的工人(不上夜班或偶尔上夜班的不上夜班的工人)冠心病发病率较高(危险比[HR] 1.10, 95% CI 1.01-1.20)。在两个轮班工作组中,每日纤维摄入量较低的参与者中,冠心病的hr较高(与白天工作相比),而在纤维摄入量较高的参与者中,hr较低(相互作用p <; 0.05)。与吃肉相比,不吃肉与冠心病HR降低10.4%相关(p = 0.020),尽管没有观察到与工作时间表的显著相互作用。综上所述,虽然我们的研究结果表明,在工作时间表中,不吃肉与冠心病HR的适度降低有关,这与已建立的心血管建议相一致,但我们的观察结果表明,高纤维摄入量可能会减少与夜班工作有关的冠心病差异,这突出了一个额外的、针对轮班的饮食考虑,可以补充美国心脏协会的生命基本8项。
{"title":"Night shift work, dietary patterns, and coronary heart disease","authors":"Diana A. Nôga, Elisa M. S. Meth, André P. Pacheco, Jonathan Cedernaes, Pei Xue, Christian Benedict","doi":"10.1007/s10654-026-01362-w","DOIUrl":"https://doi.org/10.1007/s10654-026-01362-w","url":null,"abstract":"Shift workers exhibit a higher incidence of coronary heart disease (CHD) than daytime workers. We examined whether this difference in CHD incidence between shift workers and daytime workers is associated with two dietary factors linked to lower CHD risk—daily fiber intake and meat avoidance—using UK Biobank data. The study included 222,801 participants (53.8% women; mean age 52.6 years), categorized as daytime workers, shift workers with no or occasional night shifts, or regular night shift workers. Dietary habits were assessed via touchscreen dietary questionnaires. During a median follow-up of 12.6 years, 12,265 fatal and non-fatal CHD events occurred. Compared with daytime workers, regular night shift work—but not shift work with no or occasional night shifts—was associated with higher CHD incidence (hazard ratio [HR] 1.10, 95% CI 1.01–1.20). HRs for CHD were higher (vs. daytime work) in both shift work groups among participants with lower daily fiber intake, whereas they were attenuated among those with higher fiber intake (p < 0.05 for interaction). Meat avoidance was associated with a 10.4% lower CHD HR compared with meat consumption (p = 0.020), although no significant interaction with work schedule was observed. In summary, while our finding that meat avoidance is associated with modestly lower CHD HR across work schedules aligns with established cardiovascular recommendations, our observation that higher fiber intake may reduce CHD differences specifically linked to night shift work highlights an additional, shift-specific dietary consideration that could complement the American Heart Association’s Life’s Essential 8.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"8 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-026-01373-7
Jing Zhang, Dat Thien Tran, Tala El Ghoul, Susanne Strohmaier, Magdalena Żebrowska, Susan Redline, Richa Saxena, Martin K. Rutter, Eva S. Schernhammer
{"title":"A newly developed circadian imbalance index (CII) and risk of cardiovascular-kidney-metabolic disease in the UK biobank","authors":"Jing Zhang, Dat Thien Tran, Tala El Ghoul, Susanne Strohmaier, Magdalena Żebrowska, Susan Redline, Richa Saxena, Martin K. Rutter, Eva S. Schernhammer","doi":"10.1007/s10654-026-01373-7","DOIUrl":"https://doi.org/10.1007/s10654-026-01373-7","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"402 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-025-01354-2
Ann Taber, Ricco N. H. Flyckt, Margrethe H. B. Henriksen, Kaire Innos, Wenche Nystad, Lars J. Kjerpeseth, Brit L. Sandgren, Claus Varnum, Malene R. V. Pedersen, Christopher Johansen, Torben F. Hansen, Claus L. Brasen
{"title":"The Danish Chronic Disease Cohort: using digital footprints to identify chronic disease patterns","authors":"Ann Taber, Ricco N. H. Flyckt, Margrethe H. B. Henriksen, Kaire Innos, Wenche Nystad, Lars J. Kjerpeseth, Brit L. Sandgren, Claus Varnum, Malene R. V. Pedersen, Christopher Johansen, Torben F. Hansen, Claus L. Brasen","doi":"10.1007/s10654-025-01354-2","DOIUrl":"https://doi.org/10.1007/s10654-025-01354-2","url":null,"abstract":"","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"1 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146230943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-21DOI: 10.1007/s10654-026-01372-8
Aiste Steponenaite, Jonas P. Wallraff, Ursula Wild, Lorna Brown, Ben Bullock, Gurprit S. Lall, Sally Ferguson, Russell G. Foster, Jennifer Walsh, Greg Murray, Thomas C. Erren, Philip Lewis
Our objective was to systematically review the epidemiological evidence regarding health effects of daylight-saving time (DST) practices – the abolition of which have been called for without the epidemiology having been comprehensively reviewed. We searched PubMed, Web of Science, Scopus, PsychINFO, and EconLit up to June 2025. The primary inclusion criterion was human studies that consider either acute effects of transitions or DST vs standard time at a given time of year. Included studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. We narratively synthesize by broader outcome categories in Supplementary Material and provide a synthesis of syntheses in the main text. From 157 studies of varying designs and quality from 36 countries, we find that the messaging of transitions and DST during summer months being uniformly detrimental is not supported. DST-Onset transitions appear associated with increased acute myocardial infarction and fatal traffic accidents, but also with decreased crimes involving physical harm. DST-Offset transitions appear associated with decreased all-cause mortality and workplace accidents, but also with increased crimes involving physical harm. Living with DST (compared to Standard Time) appears associated with decreased all-cause mortality and traffic accidents in summer. Standard Time appears is potentially associated with decreased sleep duration during winter. No clear and consistent effects on psychiatric outcomes are identified. Limited studies prevent clear conclusions being drawn regarding other sleep parameters or circadian rhythms. This review indicates that transitions and living with DST (as opposed to Standard Time) during summer months are not uniformly detrimental; however, the evidence base remains limited and heterogeneous. Rather than advocating for maintaining or removing transitions, our synthesis supports a balanced approach. We recommend recognising both adverse and beneficial patterns and prioritising strategies to mitigate risks while awaiting more robust evidence. Registrationhttps://doi.org/10.17605/OSF.IO/R4W6M
我们的目标是系统地审查有关夏令时做法对健康影响的流行病学证据——在没有全面审查流行病学的情况下就呼吁废除夏令时。我们检索了PubMed、Web of Science、Scopus、PsychINFO和EconLit,检索时间截止到2025年6月。主要纳入标准是考虑过渡或夏时制与一年中给定时间标准时间的急性效应的人类研究。使用准实验研究乔安娜布里格斯研究所批判性评估清单对纳入的研究进行批判性评估。我们在补充材料中叙述地综合了更广泛的结果类别,并在正文中提供了综合的综合。从来自36个国家的157项不同设计和质量的研究中,我们发现夏季过渡和夏令时的信息不一致是有害的。dst发作转换似乎与急性心肌梗死和致命交通事故的增加有关,但也与涉及人身伤害的犯罪减少有关。dst偏移转换似乎与全因死亡率和工作场所事故的降低有关,但也与涉及人身伤害的犯罪增加有关。使用夏令时(与标准时间相比)似乎与夏季全因死亡率和交通事故的降低有关。标准时间的出现可能与冬季睡眠时间的减少有关。没有明确和一致的影响精神病学结果确定。有限的研究阻止了对其他睡眠参数或昼夜节律得出明确的结论。这篇综述表明,在夏季的几个月里,过渡和使用夏令时(与标准时间相反)并不总是有害的;然而,证据基础仍然有限且不一致。我们的综合并不提倡维护或删除转换,而是支持一种平衡的方法。我们建议认识到不利和有益的模式,并在等待更有力的证据的同时,优先考虑减轻风险的战略。注册https://doi.org/10.17605/OSF.IO/R4W6M
{"title":"A systematic review of epidemiological studies into daylight-saving time & health identifying beneficial & adverse effects","authors":"Aiste Steponenaite, Jonas P. Wallraff, Ursula Wild, Lorna Brown, Ben Bullock, Gurprit S. Lall, Sally Ferguson, Russell G. Foster, Jennifer Walsh, Greg Murray, Thomas C. Erren, Philip Lewis","doi":"10.1007/s10654-026-01372-8","DOIUrl":"https://doi.org/10.1007/s10654-026-01372-8","url":null,"abstract":"Our objective was to systematically review the epidemiological evidence regarding health effects of daylight-saving time (DST) practices – the abolition of which have been called for without the epidemiology having been comprehensively reviewed. We searched PubMed, Web of Science, Scopus, PsychINFO, and EconLit up to June 2025. The primary inclusion criterion was human studies that consider either acute effects of transitions or DST vs standard time at a given time of year. Included studies were critically appraised using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. We narratively synthesize by broader outcome categories in Supplementary Material and provide a synthesis of syntheses in the main text. From 157 studies of varying designs and quality from 36 countries, we find that the messaging of transitions and DST during summer months being uniformly detrimental is not supported. DST-Onset transitions appear associated with increased acute myocardial infarction and fatal traffic accidents, but also with decreased crimes involving physical harm. DST-Offset transitions appear associated with decreased all-cause mortality and workplace accidents, but also with increased crimes involving physical harm. Living with DST (compared to Standard Time) appears associated with decreased all-cause mortality and traffic accidents in summer. Standard Time appears is potentially associated with decreased sleep duration during winter. No clear and consistent effects on psychiatric outcomes are identified. Limited studies prevent clear conclusions being drawn regarding other sleep parameters or circadian rhythms. This review indicates that transitions and living with DST (as opposed to Standard Time) during summer months are not uniformly detrimental; however, the evidence base remains limited and heterogeneous. Rather than advocating for maintaining or removing transitions, our synthesis supports a balanced approach. We recommend recognising both adverse and beneficial patterns and prioritising strategies to mitigate risks while awaiting more robust evidence. <jats:italic>Registration</jats:italic> <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.17605/OSF.IO/R4W6M\" ext-link-type=\"uri\">https://doi.org/10.17605/OSF.IO/R4W6M</jats:ext-link>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"59 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146231107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-02-01Epub Date: 2026-01-24DOI: 10.1007/s10654-025-01334-6
Isabel A L Slurink, Annemarijn R de Boer, Marc J M Bonten, Miriam C J M Sturkenboom, Patricia C J L Bruijning-Verhagen
Excess mortality during the COVID-19 pandemic partly exceeded COVID-19-related deaths, indicating that other causes may have contributed. We conducted a retrospective data-linkage study including all Dutch inhabitants to investigate the impact of COVID-19 vaccination on excess mortality using a modified self-controlled case series method. We found a 44% lower relative incidence of all-cause deaths in the first three weeks after the primary vaccination compared to more than three weeks after vaccination (IRR 0.56, 95%CI 0.54-0.57). This lower incidence was consistent across vaccine types, doses, genders, age groups, and individuals with or without prior SARS-CoV-2 infection or comorbidities, and for non-COVID-19 related deaths. For booster vaccinations, the relative incidence was similar (IRR 0.49, 95%CI 0.49-0.50). In comparison, we observed a 16-fold higher incidence of all-cause deaths in the three weeks following a registered positive SARS-CoV-2 infection compared to more than three weeks after infection (IRR 16.19, 95%CI 15.78-16.60). A lower relative incidence of short-term deaths following COVID-19 vaccination support that COVID-19 vaccination is not associated with the observed excess mortality.
{"title":"COVID-19 vaccination and short-term mortality risk: a nationwide self-controlled case series study in The Netherlands.","authors":"Isabel A L Slurink, Annemarijn R de Boer, Marc J M Bonten, Miriam C J M Sturkenboom, Patricia C J L Bruijning-Verhagen","doi":"10.1007/s10654-025-01334-6","DOIUrl":"10.1007/s10654-025-01334-6","url":null,"abstract":"<p><p>Excess mortality during the COVID-19 pandemic partly exceeded COVID-19-related deaths, indicating that other causes may have contributed. We conducted a retrospective data-linkage study including all Dutch inhabitants to investigate the impact of COVID-19 vaccination on excess mortality using a modified self-controlled case series method. We found a 44% lower relative incidence of all-cause deaths in the first three weeks after the primary vaccination compared to more than three weeks after vaccination (IRR 0.56, 95%CI 0.54-0.57). This lower incidence was consistent across vaccine types, doses, genders, age groups, and individuals with or without prior SARS-CoV-2 infection or comorbidities, and for non-COVID-19 related deaths. For booster vaccinations, the relative incidence was similar (IRR 0.49, 95%CI 0.49-0.50). In comparison, we observed a 16-fold higher incidence of all-cause deaths in the three weeks following a registered positive SARS-CoV-2 infection compared to more than three weeks after infection (IRR 16.19, 95%CI 15.78-16.60). A lower relative incidence of short-term deaths following COVID-19 vaccination support that COVID-19 vaccination is not associated with the observed excess mortality.</p>","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":" ","pages":"173-184"},"PeriodicalIF":5.9,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12975842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-28DOI: 10.1007/s10654-026-01365-7
Paolo Boffetta,Giulia Collatuzzo,K M Venkat Narayan
The association between diabetes and low-level arsenic exposure in drinking water has not been adequately investigated. We conducted a two-stage meta-analysis of dose-response relationships from studies reporting incidence or prevalence of diabetes with average exposure up to 150 µg/L arsenic in drinking water. We conducted a literature search and included cross-sectional, case control and cohort studies and we extracted results for exposure to arsenic up to average concentration of 150 µg/L water. Prevalence and incidence were generically referred to as risk. We conducted study-specific linear regression to estimate the relative risk (RR) of diabetes for a 10 µg/L increase of arsenic, and combined the study-specific results in a random-effect meta-analysis. We addressed publication bias by excluding studies with the largest standard error; and identified a subset of high-quality studies. We also performed a one-stage meta-regression. We selected 11 studies including 12 populations from seven countries. The meta-analysis of their results yielded a relative risk (RR) of type 2 diabetes for a 10 µg/L arsenic increase within the range 0-150 µg/L equal to 1.07 (95% confidence interval [CI] 1.02-1.21, p heterogeneity = 0.006). There was evidence of publication bias (p = 0.004); after accounting for publication bias, the summary RR was 1.02 (95% CI 0.99-1.06, eight studies). The RR based on the high-quality studies was 1.03 (95% CI 0.97-1.09, five studies). The corresponding RR of the meta-regression was 1.007 (95% CI 0.998-1.017, 32 risk estimates). Accounting for publication bias and study quality, and considering heterogeneity of risk estimates, our two-stage meta-analysis supports a null association between low levels of arsenic in drinking water and type 2 diabetes.
糖尿病与饮用水中低水平砷暴露之间的关系尚未得到充分调查。我们进行了一项两阶段的荟萃分析,分析了饮用水中砷平均暴露量高达150微克/升时糖尿病发病率或患病率的剂量-反应关系。我们进行了文献检索,包括横断面研究、病例对照研究和队列研究,并提取了砷暴露于平均浓度为150 μ g/L水的结果。患病率和发病率通常被称为风险。我们进行了特定研究的线性回归,以估计砷含量每增加10微克/升,糖尿病的相对风险(RR),并将特定研究的结果结合在随机效应荟萃分析中。我们通过排除标准误差最大的研究来解决发表偏倚问题;并确定了一些高质量的研究。我们还进行了单阶段元回归。我们选择了11项研究,包括来自7个国家的12个人群。荟萃分析结果显示,在0 ~ 150µg/L范围内,砷浓度每增加10µg/L, 2型糖尿病的相对危险度(RR)为1.07(95%置信区间[CI] 1.02 ~ 1.21, p异质性= 0.006)。有证据表明存在发表偏倚(p = 0.004);考虑发表偏倚后,总RR为1.02 (95% CI 0.99-1.06, 8项研究)。基于高质量研究的RR为1.03 (95% CI 0.97-1.09, 5项研究)。meta回归的相应RR为1.007 (95% CI 0.998-1.017, 32个风险估计)。考虑到发表偏倚和研究质量,并考虑到风险估计的异质性,我们的两阶段荟萃分析支持饮用水中低水平砷与2型糖尿病之间的零关联。
{"title":"Low-level exposure to arsenic in drinking water and risk of type 2 diabetes: a systematic review and meta-analysis.","authors":"Paolo Boffetta,Giulia Collatuzzo,K M Venkat Narayan","doi":"10.1007/s10654-026-01365-7","DOIUrl":"https://doi.org/10.1007/s10654-026-01365-7","url":null,"abstract":"The association between diabetes and low-level arsenic exposure in drinking water has not been adequately investigated. We conducted a two-stage meta-analysis of dose-response relationships from studies reporting incidence or prevalence of diabetes with average exposure up to 150 µg/L arsenic in drinking water. We conducted a literature search and included cross-sectional, case control and cohort studies and we extracted results for exposure to arsenic up to average concentration of 150 µg/L water. Prevalence and incidence were generically referred to as risk. We conducted study-specific linear regression to estimate the relative risk (RR) of diabetes for a 10 µg/L increase of arsenic, and combined the study-specific results in a random-effect meta-analysis. We addressed publication bias by excluding studies with the largest standard error; and identified a subset of high-quality studies. We also performed a one-stage meta-regression. We selected 11 studies including 12 populations from seven countries. The meta-analysis of their results yielded a relative risk (RR) of type 2 diabetes for a 10 µg/L arsenic increase within the range 0-150 µg/L equal to 1.07 (95% confidence interval [CI] 1.02-1.21, p heterogeneity = 0.006). There was evidence of publication bias (p = 0.004); after accounting for publication bias, the summary RR was 1.02 (95% CI 0.99-1.06, eight studies). The RR based on the high-quality studies was 1.03 (95% CI 0.97-1.09, five studies). The corresponding RR of the meta-regression was 1.007 (95% CI 0.998-1.017, 32 risk estimates). Accounting for publication bias and study quality, and considering heterogeneity of risk estimates, our two-stage meta-analysis supports a null association between low levels of arsenic in drinking water and type 2 diabetes.","PeriodicalId":11907,"journal":{"name":"European Journal of Epidemiology","volume":"78 1","pages":""},"PeriodicalIF":13.6,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146056881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}