1 00:00:05,400 --> 00:00:06,680 >>WELCOME. 2 00:00:06,680 --> 00:00:09,200 THANK YOU FOR JOINING US TODAY 3 00:00:09,200 --> 00:00:11,920 AT THE NIH RESEARCH FESTIVAL. 4 00:00:11,920 --> 00:00:13,920 MY NAME IS DARYL ZELDON. 5 00:00:13,920 --> 00:00:18,360 THE NIEHS SCIENTIFIC DIRECTOR. 6 00:00:18,360 --> 00:00:21,600 ON BEHALF OF THE WOMEN SCIENTIST 7 00:00:21,600 --> 00:00:25,720 ASSEMBLY REPRESENTATIVES, 8 00:00:25,720 --> 00:00:27,160 DR. FENTON AND WILLIAMS I'M 9 00:00:27,160 --> 00:00:30,840 PLEASED TO INTRODUCE THE NIH 10 00:00:30,840 --> 00:00:32,840 DIRECTOR'S WEDNESDAY AFTERNOON 11 00:00:32,840 --> 00:00:37,680 LECTURE HONORING J BURROWS. 12 00:00:37,680 --> 00:00:40,120 THIS LECTURE WAS ESTABLISHED IN 13 00:00:40,120 --> 00:00:43,040 1968 IN HONOR OF THE FIRST NIH 14 00:00:43,040 --> 00:00:45,320 DIRECTOR OF LABORATORIES AND 15 00:00:45,320 --> 00:00:45,760 CLINICS. 16 00:00:45,760 --> 00:00:49,320 AND PRESENTED BY AN NIH 17 00:00:49,320 --> 00:00:52,760 INTRAMURAL SCIENTIST IN 18 00:00:52,760 --> 00:00:57,160 RECOGNITION AND OF OUTSTANDING 19 00:00:57,160 --> 00:00:58,200 CONTRIBUTION TO BIOMEDICAL 20 00:00:58,200 --> 00:00:58,800 RESEARCH. 21 00:00:58,800 --> 00:01:03,640 DR. SANDLER HEADS THE CHRONIC 22 00:01:03,640 --> 00:01:06,640 DISEASE EPIDEMIOLOGY GROUP AND 23 00:01:06,640 --> 00:01:07,680 CHIEF OF OUR EPIDEMIOLOGY BRANCH 24 00:01:07,680 --> 00:01:08,040 SINCE 2003. 25 00:01:08,040 --> 00:01:11,680 THAT THE TIME SHE WAS ONLY THE 26 00:01:11,680 --> 00:01:13,080 SECOND WOMAN TO LEAD A 27 00:01:13,080 --> 00:01:18,600 LABORATORY OR BRANCH AT NIEHS. 28 00:01:18,600 --> 00:01:20,840 SHE'S AN ALSO ADJUNCT PROFESSOR 29 00:01:20,840 --> 00:01:23,120 AT THE UNIVERSITY OF NORTH 30 00:01:23,120 --> 00:01:25,960 CAROLINA, CHAPEL HILL AND HELD 31 00:01:25,960 --> 00:01:26,960 POSITIONS AT THE TWO 32 00:01:26,960 --> 00:01:31,600 EPIDEMIOLOGY JOURNALS. 33 00:01:31,600 --> 00:01:33,640 SHE'S PAST PRESIDENT OF THE 34 00:01:33,640 --> 00:01:35,480 AMERICAN COLLEGE OF 35 00:01:35,480 --> 00:01:35,800 EPIDEMIOLOGY. 36 00:01:35,800 --> 00:01:39,480 DR. SANDLER JOINED NIEHS AFTER 37 00:01:39,480 --> 00:01:44,520 RECEIVING HER MASTER'S IN PUBLIC 38 00:01:44,520 --> 00:01:47,600 HEALTH FROM YALE. 39 00:01:47,600 --> 00:01:49,400 DR. SANDLER LEADS THREE 40 00:01:49,400 --> 00:01:53,040 IMPACTFUL PROSPECTIVE COHORT 41 00:01:53,040 --> 00:01:55,520 STUDIES DESIGN TO EXAMINE THE 42 00:01:55,520 --> 00:01:56,840 IMPACT OF ENVIRONMENTAL 43 00:01:56,840 --> 00:01:59,200 EXPOSURES ON HUMAN HEALTH. 44 00:01:59,200 --> 00:02:01,560 ONE STUDY IS THE AGRICULTURAL 45 00:02:01,560 --> 00:02:05,120 HEALTH STUDY DEVELOPED IN 1993 46 00:02:05,120 --> 00:02:06,640 IN COLLABORATION WITH THE 47 00:02:06,640 --> 00:02:10,200 INVESTIGATORS AT NCI EVALUATED 48 00:02:10,200 --> 00:02:12,520 HOW AGRICULTURAL CHEMICALS AND 49 00:02:12,520 --> 00:02:14,640 LIFESTYLE AND GENETIC FACTORS 50 00:02:14,640 --> 00:02:18,160 AFFECT THE LIFE OF FARMING 51 00:02:18,160 --> 00:02:19,280 POPULATION AND LEADS THE EFFORT 52 00:02:19,280 --> 00:02:21,480 TO STUDY NON-CANCER END POINTS 53 00:02:21,480 --> 00:02:23,560 IN THE STUDY. 54 00:02:23,560 --> 00:02:25,840 HER WORK IS DEMONSTRATED 55 00:02:25,840 --> 00:02:26,680 ASSOCIATIONS BETWEEN PESTICIDE 56 00:02:26,680 --> 00:02:29,600 USE AND A RANGE OF CONDITIONS 57 00:02:29,600 --> 00:02:32,480 INCLUDING THINGS LIKE DIABETES, 58 00:02:32,480 --> 00:02:33,440 PARKINSON'S DISEASE, AUTOIMMUNE 59 00:02:33,440 --> 00:02:34,960 DISEASE AND SHINGLES. 60 00:02:34,960 --> 00:02:37,120 THE SISTER STUDY, ANOTHER LARGE 61 00:02:37,120 --> 00:02:39,240 STUDY SHE'LL BE SPEAKING ABOUT 62 00:02:39,240 --> 00:02:44,880 TODAY, HAS RECRUITED OVER 50,000 63 00:02:44,880 --> 00:02:50,600 WOMEN WITH SISTERS WITH BREAST 64 00:02:50,600 --> 00:03:00,920 CANCER BETWEEN 2003 AND 2008 AND 65 00:03:00,920 --> 00:03:03,680 FINDING WAYS TO PREVENT BREAST 66 00:03:03,680 --> 00:03:03,920 CANCER. 67 00:03:03,920 --> 00:03:04,800 NUMEROUS ENVIRONMENTAL 68 00:03:04,800 --> 00:03:06,160 INFLUENCES HAVE BEEN ASSOCIATED 69 00:03:06,160 --> 00:03:09,120 WITH BREAST CANCER RISK IN THE 70 00:03:09,120 --> 00:03:10,040 ONGOING STUDY AND SHE'LL TELL 71 00:03:10,040 --> 00:03:20,480 YOU MORE ABOUT THAT TODAY. 72 00:03:21,040 --> 00:03:24,320 AND FOLLOWING THE DEEP WATER 73 00:03:24,320 --> 00:03:25,600 HORIZON ACCIDENT IN MEXICO HELPS 74 00:03:25,600 --> 00:03:27,520 UNDERSTAND THE IMPACT OF OIL 75 00:03:27,520 --> 00:03:28,400 SPILL CLEAN UP WORKERS AND 76 00:03:28,400 --> 00:03:33,600 RESPONSE WORKERS. 77 00:03:33,600 --> 00:03:35,920 DR. SANDLER REACHED MULTIPLE AND 78 00:03:35,920 --> 00:03:38,520 INDIVIDUAL GROUP NIEHS AND 79 00:03:38,520 --> 00:03:40,000 DIRECTOR'S AWARDS FOR THE WORK 80 00:03:40,000 --> 00:03:40,760 SHE'S DONE. 81 00:03:40,760 --> 00:03:43,520 SHE'S CO-AUTHORED OVER 650 82 00:03:43,520 --> 00:03:46,440 PEER-REVIEWED MANUSCRIPTS AND 83 00:03:46,440 --> 00:03:49,640 RECRUITED AND MENTORED DOZENS 84 00:03:49,640 --> 00:03:53,520 POST GRADUATE FELLOWS AND JUNIOR 85 00:03:53,520 --> 00:03:54,600 INVESTIGATORS MANY OF WHOM ARE 86 00:03:54,600 --> 00:03:57,040 NOW INDEPENDENT INVESTIGATORS. 87 00:03:57,040 --> 00:03:59,360 SHE SPENT MOST OF THE LAST 88 00:03:59,360 --> 00:04:02,320 COUPLE DAYS MENTORING TRAINEES 89 00:04:02,320 --> 00:04:04,720 AND JUNIOR INVESTIGATORS ON THE 90 00:04:04,720 --> 00:04:06,320 MAIN CAMPUS AS PART OF THE 91 00:04:06,320 --> 00:04:07,800 SCIENTIST ASSEMBLY HOSTING HER 92 00:04:07,800 --> 00:04:08,440 VISIT. 93 00:04:08,440 --> 00:04:10,560 SHE WAS SELECTED AS OUR 94 00:04:10,560 --> 00:04:13,200 SCIENTIST OF THE YEAR SEVERAL 95 00:04:13,200 --> 00:04:15,080 YEARS AGO AND RECEIVED A 96 00:04:15,080 --> 00:04:19,120 MENTORING AWARD AND NAMED MENTOR 97 00:04:19,120 --> 00:04:24,320 OF THE YEAR AT NIEHS. 98 00:04:24,320 --> 00:04:26,520 SHE RECEIVED THE AWARD FOR 99 00:04:26,520 --> 00:04:28,840 OUTSTANDING MEDICAL SERVICE FROM 100 00:04:28,840 --> 00:04:30,680 THE MEDICAL ASSOCIATION AND ONE 101 00:04:30,680 --> 00:04:35,360 OF THE FEW LABORATORY BRANCH 102 00:04:35,360 --> 00:04:38,040 CHIEFS AND A SUPPORTER AND ROLE 103 00:04:38,040 --> 00:04:39,440 MODEL FOR JUNIOR FEMALE 104 00:04:39,440 --> 00:04:41,720 INVESTIGATORS WHO WANT TO REACH 105 00:04:41,720 --> 00:04:48,360 LEADERSHIP CAPACITY. 106 00:04:48,360 --> 00:04:50,800 THE TITLE OF HER TALK IS 107 00:04:50,800 --> 00:04:53,600 PROSPECTIVE COHORT STUDIES FOR 108 00:04:53,600 --> 00:04:57,440 ENVIRONMENTAL HEALTH RESEARCH. 109 00:04:57,440 --> 00:05:01,120 I WOULD LIKE TO THANK THE 110 00:05:01,120 --> 00:05:02,520 WOMEN'S SCIENCE ADVISERS. 111 00:05:02,520 --> 00:05:03,080 >> THANK YOU FOR NOMINATING ME 112 00:05:03,080 --> 00:05:08,480 AND SUPPORTING THE NOMINATION. 113 00:05:08,480 --> 00:05:09,880 I WANT TO GET OUT OF THE WAY I 114 00:05:09,880 --> 00:05:15,360 HAVE NO DISCLOSURES FINANCIAL OR 115 00:05:15,360 --> 00:05:22,480 OTHERWISE TO DECLARE I 116 00:05:22,480 --> 00:05:23,320 MYSTERIOUS LARYNGITIS SO IF 117 00:05:23,320 --> 00:05:24,440 START TO LOSE MY VOICE IT'S ALL 118 00:05:24,440 --> 00:05:24,640 GOOD. 119 00:05:24,640 --> 00:05:32,760 DON'T WORRY. 120 00:05:32,760 --> 00:05:35,320 IT'S AN HONOR TO RECOGNIZE 121 00:05:35,320 --> 00:05:37,120 DR. MIDER. 122 00:05:37,120 --> 00:05:41,320 HE WAS THE FIRST DIRECTOR OF NIH 123 00:05:41,320 --> 00:05:43,480 LABORATORIES IN CLINICS FROM 124 00:05:43,480 --> 00:05:46,000 1960 TO 1968 AND HELD OTHER 125 00:05:46,000 --> 00:05:47,320 IMPORTANT NIH POSITIONS. 126 00:05:47,320 --> 00:05:49,200 STARTING OUT AS A RESEARCH 127 00:05:49,200 --> 00:05:51,600 FELLOW BACK IN 1939. 128 00:05:51,600 --> 00:05:56,840 THIS NAMED LECTURE IS A REMINDER 129 00:05:56,840 --> 00:05:58,320 OF THE IS IMPORTANCE OF CLINICAL 130 00:05:58,320 --> 00:06:00,240 RESEARCH AT THE NIH AND 131 00:06:00,240 --> 00:06:01,080 OPPORTUNITIES FOR COLLABORATION 132 00:06:01,080 --> 00:06:07,520 BETWEEN CLINICAL AND BASIC 133 00:06:07,520 --> 00:06:08,560 SCIENTISTS. 134 00:06:08,560 --> 00:06:11,560 I ALSO WANT TO PUT IN A PLUG FOR 135 00:06:11,560 --> 00:06:13,760 THE STRONG EPIDEMIOLOGY AND 136 00:06:13,760 --> 00:06:14,600 STRONG SCIENCE RESEARCH PROGRAMS 137 00:06:14,600 --> 00:06:17,960 IN SOME OF THE INSTITUTES WHERE 138 00:06:17,960 --> 00:06:19,920 SUPPORT FOR LONG-TERM STUDIES 139 00:06:19,920 --> 00:06:22,800 FOSTERS INNOVATIVE, PRODUCTIVE 140 00:06:22,800 --> 00:06:23,560 AND TRANS DISCIPLINARY 141 00:06:23,560 --> 00:06:31,520 POPULATION HEALTH RESEARCH. 142 00:06:31,520 --> 00:06:34,120 AS DR. ZELDIN NOTED MY RESEARCH 143 00:06:34,120 --> 00:06:36,120 HAS TAKEN ADVANTAGE OF THREE 144 00:06:36,120 --> 00:06:38,680 LARGE COHORTS I'VE DEVELOPED 145 00:06:38,680 --> 00:06:40,440 WITHIN THE INTRAMURAL RESEARCH 146 00:06:40,440 --> 00:06:40,680 PROGRAM. 147 00:06:40,680 --> 00:06:41,840 IT WAS MADE POSSIBLE BECAUSE OF 148 00:06:41,840 --> 00:06:43,880 THE WILLINGNESS ON THE PART OF 149 00:06:43,880 --> 00:06:46,080 LEADERSHIP TO THINK BIG, TAKE 150 00:06:46,080 --> 00:06:48,360 RISKS AND PROVIDE SUSTAINED 151 00:06:48,360 --> 00:06:50,840 SUPPORT FOR LONG-TERM RESEARCH. 152 00:06:50,840 --> 00:06:53,440 THE COHORTS ARE LARGE 153 00:06:53,440 --> 00:06:55,960 PROSPECTIVE STUDIES THAT ADDRESS 154 00:06:55,960 --> 00:06:59,760 THE NIEHS MISSION FOCUSSING ON 155 00:06:59,760 --> 00:07:00,920 ENVIRONMENTAL OR SPECIFIC 156 00:07:00,920 --> 00:07:07,520 EXPOSURES OR BROADLY DEFINED 157 00:07:07,520 --> 00:07:11,920 EXPOSURE TO PESTICIDES. 158 00:07:11,920 --> 00:07:15,560 THE GULF DESIGN WAS LOOKING AT 159 00:07:15,560 --> 00:07:19,520 OIL-SPILL RELATED CHEMICALS. 160 00:07:19,520 --> 00:07:22,360 THE STUDIES ALL HAVE IN COMMON 161 00:07:22,360 --> 00:07:23,800 THEY'RE ADDRESSING QUESTIONS OF 162 00:07:23,800 --> 00:07:25,440 PUBLIC HEALTH CONCERN AND THEY 163 00:07:25,440 --> 00:07:27,560 FACILITATE MULTI-DISCIPLINARY 164 00:07:27,560 --> 00:07:28,520 AND COLLABORATIVE RESEARCH WHICH 165 00:07:28,520 --> 00:07:29,400 IS THE MOST EXCITING PART OF MY 166 00:07:29,400 --> 00:07:31,000 JOB. 167 00:07:31,000 --> 00:07:34,880 SO TODAY I PLAN TO FOCUS MOSTLY 168 00:07:34,880 --> 00:07:37,400 ON THE SISTER STUDY. 169 00:07:37,400 --> 00:07:41,640 A COHORT DESIGN TO STUDY 170 00:07:41,640 --> 00:07:42,440 ENVIRONMENTAL EXPOSURES MORE 171 00:07:42,440 --> 00:07:45,000 BROADLY THAT IS CELEBRATING THE 172 00:07:45,000 --> 00:07:46,480 20th ANNIVERSARY THIS YEAR. 173 00:07:46,480 --> 00:07:49,480 IN ADDITION TO ADDRESSING A 174 00:07:49,480 --> 00:07:50,560 SPECIFIC PUBLIC HEALTH CONCERN, 175 00:07:50,560 --> 00:07:52,760 NAMELY THE IMPACT OF 176 00:07:52,760 --> 00:07:54,200 ENVIRONMENTAL EXPOSURES ON HIGH 177 00:07:54,200 --> 00:07:56,640 RATES OF BREAST CANCER IN THE 178 00:07:56,640 --> 00:07:59,360 UNITED STATES, THE STUDY 179 00:07:59,360 --> 00:08:00,280 ILLUSTRATES THE VARIETY OF 180 00:08:00,280 --> 00:08:01,920 RESEARCH THAT ONE CAN DO ONCE 181 00:08:01,920 --> 00:08:03,560 YOU HAVE A RESOURCE SUCH AS ONE 182 00:08:03,560 --> 00:08:04,160 OF THESE LARGE PROSPECTIVE 183 00:08:04,160 --> 00:08:10,520 STUDIES. 184 00:08:10,520 --> 00:08:12,720 SOME BACKGROUND ON BREAST 185 00:08:12,720 --> 00:08:12,960 CANCER. 186 00:08:12,960 --> 00:08:14,120 IT'S THE MOST FREQUENT CANCER IN 187 00:08:14,120 --> 00:08:14,680 WOMEN. 188 00:08:14,680 --> 00:08:17,040 ABOUT 30% OF CANCER CASES ARE 189 00:08:17,040 --> 00:08:21,680 BREAST CANCER CASES OTHER THAN 190 00:08:21,680 --> 00:08:23,440 NON-MELANOMA SKIN CANCER. 191 00:08:23,440 --> 00:08:25,280 IN 2023 THEY EXPECT NEARLY 192 00:08:25,280 --> 00:08:27,560 300,000 CASES OF INVASIVE BREAST 193 00:08:27,560 --> 00:08:35,200 CANCER WILL BE DIAGNOSED AND 194 00:08:35,200 --> 00:08:39,160 ANOTHER 55,000 IN SITU CASES AND 195 00:08:39,160 --> 00:08:41,360 WE OFTEN HEARD ONE IN EIGHT 196 00:08:41,360 --> 00:08:42,080 WOMEN WILL DEVELOP BREAST CANCER 197 00:08:42,080 --> 00:08:44,440 IN THEIR LIFE TIME. 198 00:08:44,440 --> 00:08:53,080 THE INCIDENCE OF BREAST CANCER 199 00:08:53,080 --> 00:08:55,520 HAD LEVELLED OFF. 200 00:08:55,520 --> 00:09:00,200 THE INCIDENTS IN BLACK WOMEN IS 201 00:09:00,200 --> 00:09:02,640 APPROACHING THAT OF WHITE WOMEN. 202 00:09:02,640 --> 00:09:04,080 BREAST CANCER IS ALSO THE SECOND 203 00:09:04,080 --> 00:09:06,680 MOST FREQUENT CANCER DEATH IN 204 00:09:06,680 --> 00:09:12,440 THE UNITED STATES WITH NEARLY 205 00:09:12,440 --> 00:09:14,600 44,000 DEATHS THIS RATE. 206 00:09:14,600 --> 00:09:16,240 MORTALITY IS INCREASING DUE TO 207 00:09:16,240 --> 00:09:17,320 THE TREATMENTS AVAILABLE FOR 208 00:09:17,320 --> 00:09:22,720 WOMEN BUT THE MORTALITY STILL 209 00:09:22,720 --> 00:09:24,080 REMAINS DISTURBINGLY HIGHER IN 210 00:09:24,080 --> 00:09:25,320 BLACK WOMEN THAN OTHERS. 211 00:09:25,320 --> 00:09:35,080 AT THE TIME WE DESIGN OUR STUDY 212 00:09:35,080 --> 00:09:37,320 AND THERE'S RELATIVELY LOW RISKS 213 00:09:37,320 --> 00:09:40,040 AND AS YOU ALL NOTICE ON THIS 214 00:09:40,040 --> 00:09:41,160 LIST THERE'S NO WIDESPREAD 215 00:09:41,160 --> 00:09:41,800 ENVIRONMENTAL EXPOSURES ON THE 216 00:09:41,800 --> 00:09:48,120 LIST. 217 00:09:48,120 --> 00:09:53,680 WHY THE SISTER STUDY THEN? 218 00:09:53,680 --> 00:10:01,080 AT THE TIME IN THE EARLY 2000s 219 00:10:01,080 --> 00:10:03,560 THERE WAS CONCERN INCREASE IN 220 00:10:03,560 --> 00:10:06,160 BREAST CANCER AND THE LARGEST 221 00:10:06,160 --> 00:10:08,280 CHANGE WAS DUE TO CHANGES IN 222 00:10:08,280 --> 00:10:09,000 SCREENING PRACTICES. 223 00:10:09,000 --> 00:10:14,480 NOT ALL CAN BE EXPLAINED BY 224 00:10:14,480 --> 00:10:16,160 THAT. 225 00:10:16,160 --> 00:10:17,680 WOMEN WERE NOT ONLY CONCERNED 226 00:10:17,680 --> 00:10:22,160 ABOUT THE STEEP RISE IN CANCER 227 00:10:22,160 --> 00:10:28,520 INCIDENTS BUT IN ENDOCRINE 228 00:10:28,520 --> 00:10:30,080 DISRUPTING CHEMICALS IN PERSONAL 229 00:10:30,080 --> 00:10:31,520 PRODUCTS AND COMMON HOUSEHOLD 230 00:10:31,520 --> 00:10:32,680 PRODUCT. 231 00:10:32,680 --> 00:10:34,480 THERE WAS PRESSURE ON CONGRESS 232 00:10:34,480 --> 00:10:42,360 AND DHHS AND NIH FROM FROM 233 00:10:42,360 --> 00:10:44,400 BREAST CANCER GROUPS AND WOMEN'S 234 00:10:44,400 --> 00:10:45,720 CANCER GROUPS TO INCREASE 235 00:10:45,720 --> 00:10:46,920 SUPPORT FOR RESEARCH IN 236 00:10:46,920 --> 00:10:47,480 ENVIRONMENTAL EXPOSURES. 237 00:10:47,480 --> 00:10:50,440 THE EXISTING STUDIES AT THE TIME 238 00:10:50,440 --> 00:10:52,880 FOCUSSED ON LIFESTYLE, HORMONES 239 00:10:52,880 --> 00:10:56,000 AND REPRODUCTION IN GENES WHICH 240 00:10:56,000 --> 00:10:57,520 PARALLELS WITH THE LIST OF KNOWN 241 00:10:57,520 --> 00:10:58,880 BREAST CANCER RISK FACTOR. 242 00:10:58,880 --> 00:11:03,200 THE KNOWN RISK FACTORS DEPENDING 243 00:11:03,200 --> 00:11:05,840 ON WHO YOU ASK ACCOUNT FORD 30% 244 00:11:05,840 --> 00:11:09,800 AND 70% OF CASES BUT LIKELY LESS 245 00:11:09,800 --> 00:11:11,120 THAN 50%. 246 00:11:11,120 --> 00:11:14,200 OUR INSTITUTE LEADERSHIP AND KEN 247 00:11:14,200 --> 00:11:19,560 OLDEN WHO SPENT TIME TALKING TO 248 00:11:19,560 --> 00:11:25,280 ADVOCA 249 00:11:25,280 --> 00:11:25,560 ADVOCATES. 250 00:11:25,560 --> 00:11:27,080 WE WERE CHALLENGED TO DO 251 00:11:27,080 --> 00:11:30,240 SOMETHING NEW AND THEY GAVE US 252 00:11:30,240 --> 00:11:31,520 THE OPPORTUNITY TO THINK BIG. 253 00:11:31,520 --> 00:11:35,360 THE BASIC IDEA REPROPOSED WAS A 254 00:11:35,360 --> 00:11:36,080 PROSPECTIVE STUDY OF BREAST 255 00:11:36,080 --> 00:11:37,920 CANCER IN A SUSCEPTIBLE 256 00:11:37,920 --> 00:11:38,360 POPULATION. 257 00:11:38,360 --> 00:11:41,120 AT THE TIME MOST OF THE STUDIES 258 00:11:41,120 --> 00:11:43,520 FOCUSSED SPECIFICALLY ON 259 00:11:43,520 --> 00:11:44,520 ENVIRONMENT IN BREAST CANCER 260 00:11:44,520 --> 00:11:46,560 WERE RETROSPECTIVE CASE CONTROL 261 00:11:46,560 --> 00:11:48,440 STUDIES AND THESE KINDS OF 262 00:11:48,440 --> 00:11:50,320 STUDIES ARE PRONE TO CERTAIN 263 00:11:50,320 --> 00:11:51,960 BIASES BECAUSE THE EXPOSURES ARE 264 00:11:51,960 --> 00:11:55,760 ASSESSED AFTER THE DISEASE IS 265 00:11:55,760 --> 00:12:00,800 DIAGNOSED. 266 00:12:00,800 --> 00:12:05,800 THOUGH PEOPLE WERE ALL RILED UP 267 00:12:05,800 --> 00:12:07,480 IT'S BREAST CANCER IS STILL A 268 00:12:07,480 --> 00:12:09,680 RARE DISEASE AND WITH 120,000 269 00:12:09,680 --> 00:12:14,840 CASES EXPECTED TO BE DIAGNOSED A 270 00:12:14,840 --> 00:12:16,600 YEAR I WOULD NEED A LARGE COHORT 271 00:12:16,600 --> 00:12:19,520 TO STUDY BREAST CANCER IN OUR 272 00:12:19,520 --> 00:12:29,720 LIFE TIME. 273 00:12:38,040 --> 00:12:41,840 AND THERE'S FEWER PARTICIPANTS. 274 00:12:41,840 --> 00:12:43,240 MY COLLEAGUE CLAIR WINEBERG WHO 275 00:12:43,240 --> 00:12:44,800 HELPED DESIGN THE STUDY 276 00:12:44,800 --> 00:12:45,720 DEMONSTRATED AS WELL THAT WOMEN 277 00:12:45,720 --> 00:12:47,680 WHO HAVE A SISTER WITH BREAST 278 00:12:47,680 --> 00:12:51,240 CANCER THEMSELVES HAVE LIKELY TO 279 00:12:51,240 --> 00:12:54,760 HAVE A HIGHER PREVALENCE OF 280 00:12:54,760 --> 00:12:56,040 RELEVANT GENE VARIANCE AND 281 00:12:56,040 --> 00:12:57,560 EXPOSURES TO THINGS THEY HAVE IN 282 00:12:57,560 --> 00:12:59,240 COMMON WITH THEIR SISTER EARLY 283 00:12:59,240 --> 00:12:59,760 IN LIFE. 284 00:12:59,760 --> 00:13:01,560 IT GIVES GREATER POWER TO STUDY 285 00:13:01,560 --> 00:13:05,440 GENE ENVIRONMENT INTERACTIONS. 286 00:13:05,440 --> 00:13:07,280 AND ALSO TO IDENTIFY PREVIOUSLY 287 00:13:07,280 --> 00:13:14,200 UNKNOWN ENVIRONMENTAL RISKS. 288 00:13:14,200 --> 00:13:19,160 AND THEY'RE MORE MOTIVATED TO 289 00:13:19,160 --> 00:13:20,840 PARTICIPATE IN THE STUDY AND WE 290 00:13:20,840 --> 00:13:22,560 WANTED TO HAVE A COHORT OF 291 00:13:22,560 --> 00:13:26,080 50,000 WOMEN WITH A SISTER WHO 292 00:13:26,080 --> 00:13:28,480 HAD BREAST CANCER TO STUDY 293 00:13:28,480 --> 00:13:32,240 MEDICAL AND LIFESTYLE FACTORS 294 00:13:32,240 --> 00:13:32,600 WITH CANCER. 295 00:13:32,600 --> 00:13:36,880 WE WANTED TO HAVE A FRAMEWORK TO 296 00:13:36,880 --> 00:13:37,800 ADDRESS QUESTIONS OF PUBLIC 297 00:13:37,800 --> 00:13:41,760 CONCERN AND WANTED THE STUDY TO 298 00:13:41,760 --> 00:13:44,280 LOOK AT PROGNOSIS FOLLOWING A 299 00:13:44,280 --> 00:13:47,960 BREAST CANCER PROGNOSIS AND 300 00:13:47,960 --> 00:13:49,520 OTHER HEALTH OUTCOMES. 301 00:13:49,520 --> 00:13:51,080 WE WERE SUCCESSFUL IN OUR GOAL 302 00:13:51,080 --> 00:13:54,880 THOUGH IT TOOK US LONGER THAN WE 303 00:13:54,880 --> 00:13:56,080 HAD EXPECTED. 304 00:13:56,080 --> 00:14:01,720 BETWEEN 2003 AND 2009 WE 305 00:14:01,720 --> 00:14:05,560 ENROLLED 254 WOMEN WHO HAD 306 00:14:05,560 --> 00:14:07,560 SISTERS WITH BREAST CANCER 307 00:14:07,560 --> 00:14:09,160 BETWEEN 35 AND 74 AND 308 00:14:09,160 --> 00:14:12,080 IMPORTANTLY HAD NO BREAST CANCER 309 00:14:12,080 --> 00:14:13,240 AT ENROLLMENT. 310 00:14:13,240 --> 00:14:17,520 THEY COME FROM ALL 50 STATES AND 311 00:14:17,520 --> 00:14:18,600 PUERTO RICO. 312 00:14:18,600 --> 00:14:20,120 WE HAD HOPED TO HAVE A LOT OF 313 00:14:20,120 --> 00:14:20,480 DIVERSITY. 314 00:14:20,480 --> 00:14:24,560 IT'S VERY HARD TO DO THAT. 315 00:14:24,560 --> 00:14:27,560 AND WE WORKED HARD AND 16% OF 316 00:14:27,560 --> 00:14:30,920 OUR COHORT ARE WOMEN FROM OTHER 317 00:14:30,920 --> 00:14:33,520 RACES AND ETHNICITIES OTHER THAN 318 00:14:33,520 --> 00:14:34,080 NON-HISPANIC WHITE WOMEN. 319 00:14:34,080 --> 00:14:36,800 WE WISHED TO HAVE DONE BETTER 320 00:14:36,800 --> 00:14:39,160 BUT WE'RE BETTER THAN SOME OTHER 321 00:14:39,160 --> 00:14:40,560 COHORTS EXIST FROM THAT TIME 322 00:14:40,560 --> 00:14:40,800 PERIOD. 323 00:14:40,800 --> 00:14:43,560 AS WITH VOLUNTEER COHORTS 324 00:14:43,560 --> 00:14:47,160 EVERYWHERE OUR SISTERS HAVE A 325 00:14:47,160 --> 00:14:48,720 HIGHER LEVEL OF EDUCATION AND 326 00:14:48,720 --> 00:14:52,040 HIGHER SOCIO ECONOMIC STATUS. 327 00:14:52,040 --> 00:14:54,480 HALF HAD A COLLEGE DEGREE. 328 00:14:54,480 --> 00:14:58,080 WE HAVE TO CONSIDER HOW THAT 329 00:14:58,080 --> 00:15:02,920 IMPACTS OUR GENERALIZABILITY AND 330 00:15:02,920 --> 00:15:04,920 THE IMPORTANT THING THIS GAVE US 331 00:15:04,920 --> 00:15:05,720 WOMEN CAPABLE OF DOING THE 332 00:15:05,720 --> 00:15:08,720 THINGS WE ASKED THEM TO DO AND 333 00:15:08,720 --> 00:15:10,280 MORE INTERESTED IN BEING PART OF 334 00:15:10,280 --> 00:15:11,560 THE STUDY. 335 00:15:11,560 --> 00:15:12,200 THE FOLLOW-UP RESPONSE RATES 336 00:15:12,200 --> 00:15:15,000 HAVE PROVED TO BE VERY GOOD. 337 00:15:15,000 --> 00:15:16,480 85% TO 95% RESPONSE RATES FOR 338 00:15:16,480 --> 00:15:17,160 THE VARIOUS ACTIVITIES OVER THE 339 00:15:17,160 --> 00:15:19,000 YEARS. 340 00:15:19,000 --> 00:15:21,440 AND SINCE WE STARTED ENROLLING 341 00:15:21,440 --> 00:15:24,840 WE'VE ACCUMULATED MORE THAN 342 00:15:24,840 --> 00:15:26,680 4,000 WOMEN DIAGNOSED WITH 343 00:15:26,680 --> 00:15:29,120 BREAST CANCER SINCE THEY 344 00:15:29,120 --> 00:15:29,400 ENROLLED. 345 00:15:29,400 --> 00:15:35,360 IMPORTANTLY FOR FUNDING 346 00:15:35,360 --> 00:15:40,000 PERSPECTIVE, AT LEAST 300 PAPERS 347 00:15:40,000 --> 00:15:41,920 HAVE BEEN WRITTEN FROM THE 348 00:15:41,920 --> 00:15:42,120 STUDY. 349 00:15:42,120 --> 00:15:44,200 I DIDN'T WRITE THEM ALL MYSELF 350 00:15:44,200 --> 00:15:47,680 AND WE'RE AT THE BASIS FOR AT 351 00:15:47,680 --> 00:15:49,160 LEAST 17 FUNDED EXTRAMURAL 352 00:15:49,160 --> 00:15:50,920 GRANTS ON DIVERSE OUTCOMES. 353 00:15:50,920 --> 00:15:51,760 THEY'RE GRANTS WHERE THE WHOLE 354 00:15:51,760 --> 00:15:54,040 FOCUS IS WITHIN THE SISTER STUDY 355 00:15:54,040 --> 00:15:55,560 AND OTHERS WHERE WE JUST 356 00:15:55,560 --> 00:15:57,520 CONTRIBUTE DATA ALONG WITH OTHER 357 00:15:57,520 --> 00:16:02,240 STUDIES TO LARGER STUDIES. 358 00:16:02,240 --> 00:16:04,520 AND WE'VE ALSO BEEN USED FOR 359 00:16:04,520 --> 00:16:10,800 MULTIPLE DOCTORAL DISSERTATIONS. 360 00:16:10,800 --> 00:16:13,520 OUR STUDY WAS SOMETHING WHERE WE 361 00:16:13,520 --> 00:16:17,640 DEFINED EXPOSURES BROADLY. 362 00:16:17,640 --> 00:16:19,040 I OFTEN GUEST ASKED AT THE 363 00:16:19,040 --> 00:16:19,880 NATIONAL INSTITUTE OF 364 00:16:19,880 --> 00:16:21,760 ENVIRONMENTAL HEALTH AND ARE YOU 365 00:16:21,760 --> 00:16:25,040 STUDYING WATER OR AIR POLLUTION? 366 00:16:25,040 --> 00:16:27,560 WELL, WE'RE STUDYING ALCOHOL AND 367 00:16:27,560 --> 00:16:31,520 SMOKING AND IT'S ALL PART OF THE 368 00:16:31,520 --> 00:16:33,680 ENVIRONMENT AND IN THE SOCIAL 369 00:16:33,680 --> 00:16:33,920 VARIETY. 370 00:16:33,920 --> 00:16:35,880 SO WE COLLECT A LOT OF DATA TO 371 00:16:35,880 --> 00:16:37,480 DO THAT AND THIS PUT US IN A 372 00:16:37,480 --> 00:16:39,320 POSITION TO BE VERY RESPONSIVE 373 00:16:39,320 --> 00:16:42,840 TO SOME SUBSEQUENT CALLS FOR 374 00:16:42,840 --> 00:16:44,200 ENVIRONMENTAL BREAST CANCER 375 00:16:44,200 --> 00:16:46,640 RESEARCH THAT WAS MULT 376 00:16:46,640 --> 00:16:47,760 DISCIPLINARY THAT CONSIDERS 377 00:16:47,760 --> 00:16:49,720 GENETIC AND EPIGENETIC FACTORS 378 00:16:49,720 --> 00:16:51,560 AND TAKES A LIFE COURSE 379 00:16:51,560 --> 00:16:53,760 APPROACH. 380 00:16:53,760 --> 00:16:57,520 FOR DATA COLLECTION AT 381 00:16:57,520 --> 00:16:59,360 ENROLLMENT WE COMPLETED 382 00:16:59,360 --> 00:17:01,280 TELEPHONE INTERVIEWS AND WOMEN 383 00:17:01,280 --> 00:17:06,360 COMPLETED SELF-COMPLETED 384 00:17:06,360 --> 00:17:09,040 QUESTIONNAIRES AND WE TOOK 385 00:17:09,040 --> 00:17:09,680 CLINICAL MEASUREMENTS AND DREW 386 00:17:09,680 --> 00:17:11,680 BLOOD SAMPLES AND COLLECTED 387 00:17:11,680 --> 00:17:14,680 URINE SAMPLES AND OTHER SAMPLES 388 00:17:14,680 --> 00:17:15,880 FOR FOLLOW-UP WE HAVE ANNUAL 389 00:17:15,880 --> 00:17:17,240 HEALTH UPDATES. 390 00:17:17,240 --> 00:17:19,360 WE HAVE A MORE COMPREHENSIVE 391 00:17:19,360 --> 00:17:21,320 HEALTH AND EXPOSURE 392 00:17:21,320 --> 00:17:22,400 QUESTIONNAIRE EVERY TWO TO THREE 393 00:17:22,400 --> 00:17:24,160 YEARS AND FOR A SMALL SAMPLE WE 394 00:17:24,160 --> 00:17:27,280 WERE ABLE TO COMPLETE A SECOND 395 00:17:27,280 --> 00:17:27,880 SAMPLE COLLECTION WHICH I'LL 396 00:17:27,880 --> 00:17:30,840 TALK ABOUT LATER. 397 00:17:30,840 --> 00:17:32,320 WE COLLECT MEDICAL RECORDS FOR 398 00:17:32,320 --> 00:17:34,600 WOMEN WHO ARE DIAGNOSED WITH 399 00:17:34,600 --> 00:17:36,640 BREAST CANCER ALONG WITH TUMOR 400 00:17:36,640 --> 00:17:38,240 TISSUE FOR OTHER CANCERS WE 401 00:17:38,240 --> 00:17:41,720 COLLECT PATH REPORTS AND STARTED 402 00:17:41,720 --> 00:17:42,360 COLLECTING OVARIAN CANCER TUMOR 403 00:17:42,360 --> 00:17:47,680 TISSUE. 404 00:17:47,680 --> 00:17:49,560 WE COLLECT EXTENSIVE AMOUNTS OF 405 00:17:49,560 --> 00:17:51,440 DATA ACROSS THE LIFE SPAN. 406 00:17:51,440 --> 00:17:53,400 THIS FIGURE SHOWS THE STAGES OF 407 00:17:53,400 --> 00:17:54,200 BREAST CANCER DIFFERENTIATION 408 00:17:54,200 --> 00:17:57,200 THAT MAY BE ASSOCIATED WITH 409 00:17:57,200 --> 00:17:57,960 DIFFERENT LEVELS OF BREAST 410 00:17:57,960 --> 00:17:59,920 CANCER SUSCEPTIBILITY. 411 00:17:59,920 --> 00:18:01,720 OUR DATA COLLECTION STRATEGY AND 412 00:18:01,720 --> 00:18:04,240 ENROLLMENT WAS TO OBTAIN 413 00:18:04,240 --> 00:18:05,400 INFORMATION ON EXPOSURES DURING 414 00:18:05,400 --> 00:18:08,120 PERIODS OF ENHANCED 415 00:18:08,120 --> 00:18:10,640 SUSCEPTIBILITY RELATED TO THESE 416 00:18:10,640 --> 00:18:10,920 CHANGES. 417 00:18:10,920 --> 00:18:15,360 FOR EXAMPLE, PUBERTY IS A PERIOD 418 00:18:15,360 --> 00:18:17,200 OF RAPID BREAST CHANGE AN GROWTH 419 00:18:17,200 --> 00:18:19,480 AND DURING THIS TIME MAY BE 420 00:18:19,480 --> 00:18:20,480 RELEVANT TO BREAST CANCER RISK 421 00:18:20,480 --> 00:18:21,440 LATER IN LIFE. 422 00:18:21,440 --> 00:18:23,560 THOUGH WE TARGETED FACTORS KNOWN 423 00:18:23,560 --> 00:18:25,040 OR POTENTIALLY RELATED TO BREAST 424 00:18:25,040 --> 00:18:26,320 CANCER THE INFORMATION WE 425 00:18:26,320 --> 00:18:30,760 COLLECTED WAS RELEVANT TO MANY 426 00:18:30,760 --> 00:18:31,240 OTHER HEALTH OUTCOMES. 427 00:18:31,240 --> 00:18:33,040 SO WHAT ARE OUR SOURCES OF 428 00:18:33,040 --> 00:18:33,920 ENVIRONMENTAL DATA? 429 00:18:33,920 --> 00:18:35,560 THERE'S THE QUESTIONNAIRE DATA. 430 00:18:35,560 --> 00:18:39,280 WE ACTUALLY DEVOTE A LOT OF OUR 431 00:18:39,280 --> 00:18:40,000 QUESTIONNAIRE TO THE POTENTIAL 432 00:18:40,000 --> 00:18:42,000 FOR ENVIRONMENTAL EXPOSURES. 433 00:18:42,000 --> 00:18:46,400 ALSO BIOLOGIC SAMPLES AT 434 00:18:46,400 --> 00:18:48,560 ENROLLMENT AND TAKEN AT THE SUB 435 00:18:48,560 --> 00:18:49,520 SAMPLE. 436 00:18:49,520 --> 00:18:54,760 WE HAVE BROOD, URINE AND TOENAIL 437 00:18:54,760 --> 00:18:58,000 CLIPPINGS AND ASKED WOMEN TO 438 00:18:58,000 --> 00:18:59,440 COLLECT DUST FROM HIDDEN 439 00:18:59,440 --> 00:19:01,920 LOCATIONS IN THEIR HOUSE USING 440 00:19:01,920 --> 00:19:03,560 ALCOHOL WIPES. 441 00:19:03,560 --> 00:19:05,880 RECENTLY WE'VE TAKEN ADVANTAGE 442 00:19:05,880 --> 00:19:07,560 OF GEOSPATIAL DATA AND LINK 443 00:19:07,560 --> 00:19:09,240 RESIDENTIAL HISTORIES COLLECTED 444 00:19:09,240 --> 00:19:11,520 TO GEOSPATIAL DATA AND 445 00:19:11,520 --> 00:19:12,160 ENVIRONMENTAL SOCIO ECONOMIC AND 446 00:19:12,160 --> 00:19:15,240 SOCIAL FACTORS. 447 00:19:15,240 --> 00:19:21,160 I WANT TO TAKE A MINUTE TO 448 00:19:21,160 --> 00:19:26,680 EXPLAIN HOW WE DO OUR CASE 449 00:19:26,680 --> 00:19:27,560 CONTROL STUDIES. 450 00:19:27,560 --> 00:19:33,000 I'M DEPICTING IN THE TOP LEFT AT 451 00:19:33,000 --> 00:19:34,600 ENROLLMENT THE WOMEN WHO 452 00:19:34,600 --> 00:19:36,240 ENROLLED IN 2003 AND FOLLOWED 453 00:19:36,240 --> 00:19:37,600 THEM UP OVER TIME AND DURING 454 00:19:37,600 --> 00:19:39,960 THAT TIME SOME OF THEM WILL HAVE 455 00:19:39,960 --> 00:19:41,120 DEVELOPED BREAST CANCER. 456 00:19:41,120 --> 00:19:44,560 SO THEN WE DRAW A RANDOM SAMPLE 457 00:19:44,560 --> 00:19:46,560 OF THE COHORT AND WE THEN TAKE 458 00:19:46,560 --> 00:19:48,400 ALL THE REST OF THE CASES WHO 459 00:19:48,400 --> 00:19:50,520 HAVE BEEN DIAGNOSED AT THAT TIME 460 00:19:50,520 --> 00:19:53,520 FOR OUR CASE COHORT STUDY. 461 00:19:53,520 --> 00:19:57,680 THIS IS FAR MORE EFFICIENT AND 462 00:19:57,680 --> 00:19:58,880 GENERALIZABLE TO THE REST OF THE 463 00:19:58,880 --> 00:19:59,840 COHORT BECAUSE OF THE COST. 464 00:19:59,840 --> 00:20:04,600 THE HIGH COST OF MANY OF THE 465 00:20:04,600 --> 00:20:07,160 ASSAYS OF INTEREST. 466 00:20:07,160 --> 00:20:09,600 WE DREW A CASE COHORT SAMPLE 467 00:20:09,600 --> 00:20:12,600 WITH FOLLOW UP THROUGH 2014 AND 468 00:20:12,600 --> 00:20:15,120 DID THIS AGAIN RECENTLY WITH 469 00:20:15,120 --> 00:20:16,440 FOLLOW THROUGH 2019. 470 00:20:16,440 --> 00:20:19,080 FOR THE 2019 SAMPLE WE HAD THE 471 00:20:19,080 --> 00:20:21,120 ABILITY TO MAXIMIZE THE 472 00:20:21,120 --> 00:20:23,240 INCLUSION OF BLACK WOMEN AND 473 00:20:23,240 --> 00:20:25,560 THOSE WITH ESTROGEN NEGATIVE 474 00:20:25,560 --> 00:20:26,520 BREAST CANCER UNDER REPRESENTED 475 00:20:26,520 --> 00:20:28,880 IN OUR FIRST SAMPLE. 476 00:20:28,880 --> 00:20:31,560 WE'VE USED THESE CASE COHORT 477 00:20:31,560 --> 00:20:34,680 SAMPLES FOR MULTIPLE ANALYSES. 478 00:20:34,680 --> 00:20:36,920 WE END UP WITH SUBSETS OF WOMEN 479 00:20:36,920 --> 00:20:39,520 WHO HAVE LOTS OF BIOMARKER DATA. 480 00:20:39,520 --> 00:20:43,080 IMPORTANTLY, THESE RANDOM 481 00:20:43,080 --> 00:20:45,760 SAMPLES ARE USEFUL TO BE USED AS 482 00:20:45,760 --> 00:20:47,680 COMPARISON GROUP FOR OTHER TYPES 483 00:20:47,680 --> 00:20:48,440 OF HEALTH OUTCOMES. 484 00:20:48,440 --> 00:20:50,800 FOR EXAMPLE, WE HAVE A CASE 485 00:20:50,800 --> 00:20:55,200 COHORT STUDY OF TYPE 2 DIABETES. 486 00:20:55,200 --> 00:20:56,480 WE'VE USED THE CASE COHORT 487 00:20:56,480 --> 00:20:59,120 APPROACH FOR GENOMIC STUDIES, 488 00:20:59,120 --> 00:21:02,480 EPIGENOMIC STUDIES, STUDY DNA 489 00:21:02,480 --> 00:21:04,720 METHYLATION, AGING, VITAMIN D 490 00:21:04,720 --> 00:21:07,120 AND DIABETES METABOLOMICS AND 491 00:21:07,120 --> 00:21:11,200 METALS, FOR EXAMPLE. 492 00:21:11,200 --> 00:21:12,600 AND SO I ALSO SHOULD MENTION 493 00:21:12,600 --> 00:21:14,280 THAT THE RESEARCH THAT WE'VE 494 00:21:14,280 --> 00:21:17,120 DONE IN THE SISTER STUDY IS 495 00:21:17,120 --> 00:21:18,160 INCREDIBLY BROAD. 496 00:21:18,160 --> 00:21:19,480 COVERS A WIDE RANGE OF TOPICS 497 00:21:19,480 --> 00:21:21,160 AND APPROACHES AND WE DON'T DO 498 00:21:21,160 --> 00:21:22,280 IT ALL OURSELVES. 499 00:21:22,280 --> 00:21:25,360 WE HAVE THINGS THAT WE DO 500 00:21:25,360 --> 00:21:30,400 INTRAMURALLY AT NIEHS AND WE 501 00:21:30,400 --> 00:21:34,240 WORK WITH MANY CONSORTIA AND 502 00:21:34,240 --> 00:21:36,040 HAVE PARTNERSHIPS ACROSS NIEHS 503 00:21:36,040 --> 00:21:42,600 FOR FOCUSSED STUDIES. 504 00:21:42,600 --> 00:21:43,560 I'LL TRY TO TALK ABOUT THE 505 00:21:43,560 --> 00:21:53,240 RESEARCH. 506 00:21:53,240 --> 00:21:54,920 THERE'S DIFFERENT WORK WE'VE 507 00:21:54,920 --> 00:21:56,280 DONE AND EMPHASIZING THINGS MY 508 00:21:56,280 --> 00:21:57,720 GROUP HAS DONE AND THINGS I'M 509 00:21:57,720 --> 00:21:59,000 MORE COMFORTABLE WITH. 510 00:21:59,000 --> 00:22:01,080 TO ILLUSTRATE THE OPPORTUNITIES 511 00:22:01,080 --> 00:22:04,200 THAT CAN BE CREATED USING COHORT 512 00:22:04,200 --> 00:22:04,800 DATA. 513 00:22:04,800 --> 00:22:08,560 SO MANY OF OUR EARLIER ANALYSES 514 00:22:08,560 --> 00:22:10,560 FOCUSSED ON THE ROLE OF EARLY 515 00:22:10,560 --> 00:22:12,360 LIFE EXPOSURES IN BREAST CANCER 516 00:22:12,360 --> 00:22:12,560 RISK. 517 00:22:12,560 --> 00:22:15,040 WHEN WE FIRST GOT STARTED WE 518 00:22:15,040 --> 00:22:16,480 DIDN'T HAVE CASES. 519 00:22:16,480 --> 00:22:18,600 WE FOCUSSED AND ENDED UP 520 00:22:18,600 --> 00:22:21,240 FOCUSSING ON BREAST CANCER RISK 521 00:22:21,240 --> 00:22:24,600 FACTORS THINGS LIKE HOW 522 00:22:24,600 --> 00:22:25,560 ENVIRONMENTAL EXPOSURES 523 00:22:25,560 --> 00:22:26,640 CONTRIBUTE TO THINGS. 524 00:22:26,640 --> 00:22:31,280 WITH HAVE MANAGED TO SHOW THAT 525 00:22:31,280 --> 00:22:34,720 FOR EXAMPLE GETTING THE 526 00:22:34,720 --> 00:22:35,640 RECOMMENDED LEVELS OF EXERCISE 527 00:22:35,640 --> 00:22:38,640 FOR CHILDREN AND ADOLESCENCE 528 00:22:38,640 --> 00:22:42,120 FROM 5 TO 19 IS ACTUALLY AN 529 00:22:42,120 --> 00:22:43,000 OPPORTUNITY FOR BREAST CANCER 530 00:22:43,000 --> 00:22:45,880 RISK REDUCTION OR PREVENTION. 531 00:22:45,880 --> 00:22:51,440 WE'VE SHOWN THAT EVEN THOUGH WE 532 00:22:51,440 --> 00:22:57,960 COULD NOT SEE AN ASSOCIATION 533 00:22:57,960 --> 00:23:00,960 FROM EXPOSURE OF SMOKE IN EARLY 534 00:23:00,960 --> 00:23:05,240 LIFE WAS LED TO AN INCREASED 535 00:23:05,240 --> 00:23:06,800 BREAST CANCER RISK AS WELL AS IN 536 00:23:06,800 --> 00:23:11,240 UTERO EXPOSURE BEING RELEVANT. 537 00:23:11,240 --> 00:23:12,040 WE WERE INTERESTED AND HAVE BEEN 538 00:23:12,040 --> 00:23:14,840 INTERESTED ALL ALONG IN STUDYING 539 00:23:14,840 --> 00:23:16,800 ENVIRONMENTAL EXPOSURES. 540 00:23:16,800 --> 00:23:18,120 TRICKY TO DO FOR EXPOSURES THAT 541 00:23:18,120 --> 00:23:19,720 OCCURRED A LONG TIME AGO IN THE 542 00:23:19,720 --> 00:23:22,280 AIR POLLUTION DATA ARE LIMITED 543 00:23:22,280 --> 00:23:24,760 BEFORE 1990 AND OUR ENROLLMENT 544 00:23:24,760 --> 00:23:27,320 COVERS A LARGE RANGE OF BIRTH 545 00:23:27,320 --> 00:23:27,520 YEARS. 546 00:23:27,520 --> 00:23:30,120 PEOPLE ON AVERAGE 55 WHEN THEY 547 00:23:30,120 --> 00:23:31,560 JOINED AND STARTED AS OLD AS 74 548 00:23:31,560 --> 00:23:33,280 WHEN THEY JOINED. 549 00:23:33,280 --> 00:23:36,160 SO WE RELIED ON OURSELF REPORTED 550 00:23:36,160 --> 00:23:36,400 DATA. 551 00:23:36,400 --> 00:23:38,800 WE ASKED A LOT OF QUESTIONS 552 00:23:38,800 --> 00:23:41,400 ABOUT CHARACTERISTICS OF THE 553 00:23:41,400 --> 00:23:42,640 LONGEST LIVED CHILDHOOD HOME AND 554 00:23:42,640 --> 00:23:43,680 ONE OF THE THINGS WE ADDRESSED 555 00:23:43,680 --> 00:23:46,760 WAS THE TRAFFIC AT THE HOME. 556 00:23:46,760 --> 00:23:48,720 WE'VE SHOWN THAT BREAST CANCER 557 00:23:48,720 --> 00:23:50,280 RISK WAS ASSOCIATED WITH LIVING 558 00:23:50,280 --> 00:23:53,000 ON OR NEAR A ROAD WITH A MEDIAN 559 00:23:53,000 --> 00:23:55,560 BARRIER AND AS SHOWN IN THE 560 00:23:55,560 --> 00:23:57,120 GRAPH, LIVING NEAR A ROADWAY 561 00:23:57,120 --> 00:24:06,440 HEAVILY TRAFFICKED. 562 00:24:06,440 --> 00:24:07,720 WE WERE INTERESTED IN EARLY 563 00:24:07,720 --> 00:24:12,280 SOCIO ECONOMIC ADVERSITY. 564 00:24:12,280 --> 00:24:14,320 HERE I'M SHOWING RESULTS FROM 565 00:24:14,320 --> 00:24:16,400 SOCIO ECONOMIC ADVERSITY AND 566 00:24:16,400 --> 00:24:18,440 OBESITY IN ADULTHOOD AND KNOW 567 00:24:18,440 --> 00:24:19,680 THE ECONOMIC POSITION 568 00:24:19,680 --> 00:24:24,680 CONCURRENTLY IS ASSOCIATED WITH 569 00:24:24,680 --> 00:24:27,080 OBESITY THE RELATIONSHIP BETWEEN 570 00:24:27,080 --> 00:24:27,960 CHILDHOOD POSITION AND OBESITY 571 00:24:27,960 --> 00:24:31,560 IS LESS WELL STUDIED. 572 00:24:31,560 --> 00:24:42,680 OUR QUESTIONNAIRE WE COLLEC COL 573 00:25:00,080 --> 00:25:01,520 AND WE SHOWED LOWER SOCIO 574 00:25:01,520 --> 00:25:03,480 ECONOMIC POSITION WAS ASSOCIATED 575 00:25:03,480 --> 00:25:06,560 WITH ADULT OBESITY WITH ABOUT A 576 00:25:06,560 --> 00:25:08,320 RELATIVE RISK FOR EVERY INCREASE 577 00:25:08,320 --> 00:25:12,280 IN THE SCORE OF ABOUT 1.16. 578 00:25:12,280 --> 00:25:16,720 WE ALSO LOOKED TO SEE WHETHER 579 00:25:16,720 --> 00:25:18,360 ADULT OBESITY WHICH TRACKS WITH 580 00:25:18,360 --> 00:25:19,840 CHILDHOOD OBESITY EXPLAINED AND 581 00:25:19,840 --> 00:25:21,160 ONLY 40% WAS EXPLAINED. 582 00:25:21,160 --> 00:25:23,800 THERE WAS STILL A SIGNIFICANT 583 00:25:23,800 --> 00:25:25,560 COMPONENT OF CHILDHOOD IN THE 584 00:25:25,560 --> 00:25:28,680 RELATIONSHIP. 585 00:25:28,680 --> 00:25:30,800 WE ALSO CREATED LATENT VARIABLES 586 00:25:30,800 --> 00:25:32,560 FOR SOCIO ECONOMIC POSITION IN 587 00:25:32,560 --> 00:25:35,400 ADULTHOOD AND LOOKED AT 588 00:25:35,400 --> 00:25:35,720 TRAJECTORIES. 589 00:25:35,720 --> 00:25:41,280 AND THE GRAPH IS PROBABLY HARD 590 00:25:41,280 --> 00:25:48,040 TO SEE. 591 00:25:48,040 --> 00:25:49,480 WE COMPARED TRAJECTORIES AND 592 00:25:49,480 --> 00:25:51,160 SHOWED EVERYTHING OTHER THAN 593 00:25:51,160 --> 00:25:52,480 BEING WELL OFF FOR YOUR WHOLE 594 00:25:52,480 --> 00:25:54,600 LIFE WAS ASSOCIATED WITH AN 595 00:25:54,600 --> 00:25:56,760 INCREASED RISK ADULT OBESITY. 596 00:25:56,760 --> 00:26:01,080 SO THIS SUGGESTS THAT THE 597 00:26:01,080 --> 00:26:04,360 ECONOMIC ADVANTAGE IN ADULTHOOD 598 00:26:04,360 --> 00:26:07,440 CAN'T OVERCOME THE INFLUENCE OF 599 00:26:07,440 --> 00:26:09,080 ADVERSE SOCIO ECONOMIC PRESSURES 600 00:26:09,080 --> 00:26:09,880 IN CHILDHOOD. 601 00:26:09,880 --> 00:26:13,320 I'M GOING TO COME BACK TO SES 602 00:26:13,320 --> 00:26:14,160 AND BREAST CANCER IN A LITTLE 603 00:26:14,160 --> 00:26:16,080 BIT LATER BUT KEEP IN MIND THAT 604 00:26:16,080 --> 00:26:19,560 BREAST CANCER IS ACTUALLY A 605 00:26:19,560 --> 00:26:23,560 DISEASE MORE COMMON IN PEOPLE 606 00:26:23,560 --> 00:26:29,200 WHO ARE WELL OFF. 607 00:26:29,200 --> 00:26:33,840 IN EXPOSURE WE'RE CONSIDERING IS 608 00:26:33,840 --> 00:26:35,120 THE FISCAL OR PSYCHOLOGICAL 609 00:26:35,120 --> 00:26:37,440 TRAUMA IN EARLY LIFE FOR WHICH 610 00:26:37,440 --> 00:26:37,960 WE'VE USED LATENT CLASS 611 00:26:37,960 --> 00:26:41,080 APPROACH. 612 00:26:41,080 --> 00:26:43,120 I'M NOT GOING TO WALK YOU 613 00:26:43,120 --> 00:26:45,680 THROUGH THE FIGURE IT'S VERY 614 00:26:45,680 --> 00:26:47,600 COMPLICATED TO TELL YOU WE 615 00:26:47,600 --> 00:26:48,320 COLLECTED A LOT OF INFORMATION 616 00:26:48,320 --> 00:26:53,000 ON ABOUT 20 TRAUMAS THAT PEOPLE 617 00:26:53,000 --> 00:26:54,160 EXPERIENCED AT DIFFERENT TIME 618 00:26:54,160 --> 00:26:58,280 POINTS BUT HERE IN CHILDHOOD AND 619 00:26:58,280 --> 00:27:00,600 LOOKED THE PATTERNS WHICH 620 00:27:00,600 --> 00:27:03,560 CO-OCCURRED AND CAME UP WITH 621 00:27:03,560 --> 00:27:07,440 CONCLUSIVE OF CLUSTERS. 622 00:27:07,440 --> 00:27:09,640 YOU HAD SUFFICIENT OVERLAP IN 623 00:27:09,640 --> 00:27:12,160 THE EXPERIENCES. 624 00:27:12,160 --> 00:27:17,480 AND WE SHOWED THAT SEXUAL TRAUMA 625 00:27:17,480 --> 00:27:19,320 OR HOUSEHOLD DYSFUNCTION AND 626 00:27:19,320 --> 00:27:20,680 ANOTHER ONE CALLED MODERATE 627 00:27:20,680 --> 00:27:22,280 TRAUMA WERE ASSOCIATED WITH 628 00:27:22,280 --> 00:27:25,080 ELEVATED RISK FOR BREAST CANCER 629 00:27:25,080 --> 00:27:27,120 AND THE ASSOCIATION MORE 630 00:27:27,120 --> 00:27:28,840 APPARENT AMONG WOMEN WHO 631 00:27:28,840 --> 00:27:30,240 REPORTED HAVING NO SOCIAL 632 00:27:30,240 --> 00:27:30,960 SUPPORT DURING CHILDHOOD. 633 00:27:30,960 --> 00:27:33,640 I ALSO WANT TO POINT OUT THAT 634 00:27:33,640 --> 00:27:35,200 PART OF THE IMPETUS FOR DOING 635 00:27:35,200 --> 00:27:37,560 THIS WAS WHEN WE MET WITH 636 00:27:37,560 --> 00:27:40,440 INTEREST GROUPS IN DESIGNING THE 637 00:27:40,440 --> 00:27:42,560 STUDY, EVERYBODY WANTED TO KNOW 638 00:27:42,560 --> 00:27:44,600 IF STRESS CAUSED THEIR BREAST 639 00:27:44,600 --> 00:27:44,840 CANCER. 640 00:27:44,840 --> 00:27:46,280 SO IT WASN'T SOMETHING THAT CAME 641 00:27:46,280 --> 00:27:50,440 OUT OF OUR EARLIER RESEARCH. 642 00:27:50,440 --> 00:27:53,760 HIGH EARLY LIFE TRAUMAS WERE 643 00:27:53,760 --> 00:27:55,920 ALSO ASSOCIATED WITH SHORTER 644 00:27:55,920 --> 00:27:57,760 TELOMERES AND SOME CONSIDERED A 645 00:27:57,760 --> 00:28:00,400 MEASURE OF BIOLOGIC AGING. 646 00:28:00,400 --> 00:28:01,680 THIS ASSOCIATION WAS NOT 647 00:28:01,680 --> 00:28:04,920 MEDIATED THROUGH ADULT TRAUMA. 648 00:28:04,920 --> 00:28:07,560 SOCIO ECONOMIC POSITION OR 649 00:28:07,560 --> 00:28:08,680 HEALTH STATUS. 650 00:28:08,680 --> 00:28:13,520 IN WORK BEING LED BY CHANDRA 651 00:28:13,520 --> 00:28:17,800 JACKSON A COLLABORATOR AT NIEHS 652 00:28:17,800 --> 00:28:23,120 MULTIPLE EARLY LIFE TRAUMA WAS 653 00:28:23,120 --> 00:28:24,960 ASSOCIATED WITH POOR SLEEP AND 654 00:28:24,960 --> 00:28:27,520 DIABETES AND GOING BACK TO WHAT 655 00:28:27,520 --> 00:28:31,960 WE KNEW ABOUT GREAT CANCER AND 656 00:28:31,960 --> 00:28:37,560 EARLY MENARCHE IS ESTABLISHED AS 657 00:28:37,560 --> 00:28:40,160 RISK FOR BREAST CANCER IT CAN'T 658 00:28:40,160 --> 00:28:41,600 ACCOUNT FOR TRENDS IN BREAST 659 00:28:41,600 --> 00:28:46,640 CANCER INCIDENTS. 660 00:28:46,640 --> 00:28:56,600 BREAST DEVELOPMENT THELARCHE MAY 661 00:28:56,600 --> 00:28:58,000 BE A VULNERABLE EXPOSURE WINDOW 662 00:28:58,000 --> 00:29:01,640 AND IT'S DECLINED RAPIDLY OVER 663 00:29:01,640 --> 00:29:03,440 TIME. 664 00:29:03,440 --> 00:29:09,200 WE SHOWED IN FACT EARLY 665 00:29:09,200 --> 00:29:12,520 TELEARCHE HAS A HAZARD OF HAVING 666 00:29:12,520 --> 00:29:13,520 BREAST DEVELOPMENT BEFORE THE 667 00:29:13,520 --> 00:29:15,200 AGE OF 10. 668 00:29:15,200 --> 00:29:18,280 THE STRONGEST ASSOCIATION WITH 669 00:29:18,280 --> 00:29:21,360 BREAST CANCER WAS FOR WOMEN WHO 670 00:29:21,360 --> 00:29:25,440 HAD EARLY TELEARCHE AND EARLY 671 00:29:25,440 --> 00:29:26,280 MENARCHE WITH A 30% INCREASE IN 672 00:29:26,280 --> 00:29:34,400 THE HAZARD. 673 00:29:34,400 --> 00:29:37,280 AND I FORGOT THIS SLIDE. 674 00:29:37,280 --> 00:29:40,400 GIVEN THE TRENDS IN AGE OF 675 00:29:40,400 --> 00:29:42,680 TELEARCHE AND THE ASSOCIATION 676 00:29:42,680 --> 00:29:45,760 WITH BREAST CANCER WE SOUGHT TO 677 00:29:45,760 --> 00:29:50,520 IDENTIFY RISK FACTORS FOR EARLY 678 00:29:50,520 --> 00:29:52,080 THELARCHE WITH EARLY 679 00:29:52,080 --> 00:29:57,280 ENVIRONMENTAL EXPOSURES WOULD 680 00:29:57,280 --> 00:30:01,640 LEAD TOW EXPOSURES WOULD 681 00:30:01,640 --> 00:30:03,560 LEAD TO EXPOSURES WOULD 682 00:30:03,560 --> 00:30:14,120 LEAD TO THIS AND HAVING AN EARLY 683 00:30:15,640 --> 00:30:25,040 YOUNG MATERNAL AGE BE AN EFFECT 684 00:30:25,040 --> 00:30:27,160 AND THE OTHER WINDOW OF 685 00:30:27,160 --> 00:30:29,480 SUSCEPTIBILITY WERE THINGS THAT 686 00:30:29,480 --> 00:30:32,960 HAPPEN BEFORE THE FIRST FULL 687 00:30:32,960 --> 00:30:34,080 TERM PREGNANCY WHEN BREAST 688 00:30:34,080 --> 00:30:37,800 TISSUE IS FULLY DIFFERENT SH 689 00:30:37,800 --> 00:30:40,160 DIFFERENTIATED AND WE LOOKED AT 690 00:30:40,160 --> 00:30:42,280 EXPOSURE AND WE ONLY SAW AN 691 00:30:42,280 --> 00:30:45,200 EFFECT IN WOMEN WHO WERE EXPOSED 692 00:30:45,200 --> 00:30:46,160 TO OCCUPATIONALLY SOLVENTS 693 00:30:46,160 --> 00:30:47,360 BEFORE THE FIRST FULL-TERM 694 00:30:47,360 --> 00:30:57,520 PREGNANCY. 695 00:30:59,400 --> 00:31:01,320 ANOTHER EXPOSURE IS THE 696 00:31:01,320 --> 00:31:02,320 RELATIONSHIP BETWEEN SHIFT WORK, 697 00:31:02,320 --> 00:31:02,840 LIGHT AT NIGHT AND BREAST 698 00:31:02,840 --> 00:31:05,880 CANCER. 699 00:31:05,880 --> 00:31:08,760 IN 2016 THE NTP CONVENED A 700 00:31:08,760 --> 00:31:12,200 WORKSHOP AND PUBLISHED A FINAL 701 00:31:12,200 --> 00:31:13,520 HAZARD ASSESSMENT REPORT IN 2021 702 00:31:13,520 --> 00:31:16,400 THAT CONCLUDED PERSISTENT NIGHT 703 00:31:16,400 --> 00:31:18,920 SHIFT WORK CAN CAUSE BREAST 704 00:31:18,920 --> 00:31:21,320 CANCER IN WOMEN AND THAT CERTAIN 705 00:31:21,320 --> 00:31:23,200 LIGHTING CONDITIONS SUCH AS 706 00:31:23,200 --> 00:31:32,320 OUTDOOR LIGHTING, SELF-LUMINOUS 707 00:31:32,320 --> 00:31:34,000 THE LIGHT ON YOUR TABLE CAN 708 00:31:34,000 --> 00:31:34,320 CAUSE CANCER. 709 00:31:34,320 --> 00:31:35,960 SO WE ADDRESSED THIS IN SOME 710 00:31:35,960 --> 00:31:38,520 STUDIES THAT WE CARRIED OUT. 711 00:31:38,520 --> 00:31:39,400 FIRST, WE FOUND THAT SLEEPING 712 00:31:39,400 --> 00:31:43,560 WITH A LIGHT OR TV ON WAS 713 00:31:43,560 --> 00:31:45,760 ASSOCIATED WITH A SMALLER BUT 714 00:31:45,760 --> 00:31:47,640 NOT QUITE STATISTICALLY 715 00:31:47,640 --> 00:31:51,560 SIGNIFICANT INCREASE IN ESTROGEN 716 00:31:51,560 --> 00:31:52,960 RECEPTOR POSITIVE BREAST CANCER 717 00:31:52,960 --> 00:31:53,800 BUT NOT OTHER FORM OF BREAST 718 00:31:53,800 --> 00:31:56,040 CANCER AND WOMEN WHO REPORTED 719 00:31:56,040 --> 00:31:58,200 HAVING DIFFICULTY SLEEPING AT 720 00:31:58,200 --> 00:31:59,760 LEAST FOUR NIGHTS A WEEK ALSO 721 00:31:59,760 --> 00:32:03,600 HAD AN INCREASED CHANCE OF 722 00:32:03,600 --> 00:32:04,880 DEVELOPING POST-MENOPAUSAL 723 00:32:04,880 --> 00:32:05,880 BREAST CANCER. 724 00:32:05,880 --> 00:32:08,040 WE FOUND A LITTLE SUPPORT FOR AN 725 00:32:08,040 --> 00:32:09,000 OVER ALL ASSOCIATION OF SHIFT 726 00:32:09,000 --> 00:32:10,440 WORK OR NIGHT WORK IN BREAST 727 00:32:10,440 --> 00:32:15,640 CANCER AND THIS COULD 728 00:32:15,640 --> 00:32:17,480 POTENTIALLY IN HIGHER SES COHORT 729 00:32:17,480 --> 00:32:19,440 OF WOMEN BUT WE FOUND SUGGESTIVE 730 00:32:19,440 --> 00:32:22,320 ASSOCIATIONS FOR WOMEN WHO HAD 731 00:32:22,320 --> 00:32:23,280 SHORT-TERM EXPERIENCES WORKING 732 00:32:23,280 --> 00:32:25,600 AT NIGHT OR DOING ROTATING SHIFT 733 00:32:25,600 --> 00:32:27,560 WORK. 734 00:32:27,560 --> 00:32:30,400 IMPORTANTLY WE ALSO FOUND NO 735 00:32:30,400 --> 00:32:31,600 ASSOCIATION WITHOUT NIGHTTIME 736 00:32:31,600 --> 00:32:31,840 LIGHT. 737 00:32:31,840 --> 00:32:34,760 WE INITIALLY SAW THIS BUT ONCE 738 00:32:34,760 --> 00:32:35,560 WE TOOK INTO ACCOUNT OTHER 739 00:32:35,560 --> 00:32:39,600 THINGS ASSOCIATED WITH URBAN 740 00:32:39,600 --> 00:32:41,960 LIVING AND HAVING A LOT OF LIGHT 741 00:32:41,960 --> 00:32:43,720 AT NIGHT LIKE AIR POLLUTION THAT 742 00:32:43,720 --> 00:32:50,840 THERE WAS NO LONGER ANY 743 00:32:50,840 --> 00:32:51,200 RELATIONSHIP. 744 00:32:51,200 --> 00:32:52,280 RESEARCH THAT RECEIVED A LOT OF 745 00:32:52,280 --> 00:32:54,520 ATTENTION WHEN WE PUBLISHED IT 746 00:32:54,520 --> 00:32:56,520 WAS LOOKING AT SELF-REPORTED 747 00:32:56,520 --> 00:33:00,760 EXPOSURE TO LIGHT AT NIGHT AND 748 00:33:00,760 --> 00:33:02,840 BREAST CANCER WHERE WE FOUND 749 00:33:02,840 --> 00:33:05,400 SLEEPING WITH A LIGHT AT NIGHT 750 00:33:05,400 --> 00:33:08,360 WAS ASSOCIATED WITH INCREASED 751 00:33:08,360 --> 00:33:11,040 CHANCE OF BEING OBESE AND 752 00:33:11,040 --> 00:33:12,240 BECOMING OBESE. 753 00:33:12,240 --> 00:33:18,600 LIGHT AT NIGHT CAN AFFECT 754 00:33:18,600 --> 00:33:21,920 MELATONIN AND CIRCADIAN RIDGE 755 00:33:21,920 --> 00:33:23,480 AND INCREASE OBESITY. 756 00:33:23,480 --> 00:33:27,320 ANY LIGHT AT NIGHT REGARDLESS OF 757 00:33:27,320 --> 00:33:29,320 THE SOURCE WAS ASSOCIATED WITH A 758 00:33:29,320 --> 00:33:30,480 SMALL CHANCE OF BEING OBESE WHEN 759 00:33:30,480 --> 00:33:35,560 YOU ENROLLED WITH THE STUDY WITH 760 00:33:35,560 --> 00:33:37,800 THE BIGGEST HAZARD FOR LIGHT AT 761 00:33:37,800 --> 00:33:40,320 NIGHT OR TV OR LIGHT ON IN THE 762 00:33:40,320 --> 00:33:41,280 ROOM. 763 00:33:41,280 --> 00:33:43,400 WHEN WE STARTED WITH WOMEN NOT 764 00:33:43,400 --> 00:33:45,160 OBESE AT ENROLLMENT AND FOLLOWED 765 00:33:45,160 --> 00:33:49,560 THEM OVER TIME, SLEEPING WITH A 766 00:33:49,560 --> 00:33:51,920 TV AND LIGHT ON WAS ASSOCIATED 767 00:33:51,920 --> 00:33:53,320 WITH MULTIPLE MEASURES OF WEIGHT 768 00:33:53,320 --> 00:33:54,760 GAIN. 769 00:33:54,760 --> 00:33:57,680 OUR STUDY WE HAD DECIDEDLY NOT 770 00:33:57,680 --> 00:33:59,480 PLANNED TO BE A DIET STUDY. 771 00:33:59,480 --> 00:34:01,880 THERE WERE COHORTS ESTABLISHED 772 00:34:01,880 --> 00:34:03,920 SPECIFICALLY TO LOOK AT DIET AND 773 00:34:03,920 --> 00:34:09,200 BREAST CANCER BUT SOME HOW WE 774 00:34:09,200 --> 00:34:11,200 FELT WE COULDN'T AVOID LOOKING 775 00:34:11,200 --> 00:34:13,280 AT IT AND THERE'S SPECIFIC 776 00:34:13,280 --> 00:34:15,080 COMPONENTS AND NUTRIENT AND THE 777 00:34:15,080 --> 00:34:18,320 RESULTS ARE SORT OF 778 00:34:18,320 --> 00:34:18,640 CONTRADICTORY. 779 00:34:18,640 --> 00:34:20,440 LESS IS KNOWN ABOUT DIETARY 780 00:34:20,440 --> 00:34:21,880 PATTERNS WHICH IS A MORE 781 00:34:21,880 --> 00:34:23,560 REALISTIC PICTURE OF WHAT PEOPLE 782 00:34:23,560 --> 00:34:27,080 ARE EATING. 783 00:34:27,080 --> 00:34:28,480 WE DID COLLECT A FOOD 784 00:34:28,480 --> 00:34:30,320 QUESTIONNAIRE AT ENROLLMENT TO 785 00:34:30,320 --> 00:34:31,720 STUDY DIET PATTERNS NOT 786 00:34:31,720 --> 00:34:32,720 INDIVIDUAL FOODS. 787 00:34:32,720 --> 00:34:34,840 WE HAD TWO CLASSES OF DIETS WE 788 00:34:34,840 --> 00:34:37,120 LOOKED AT AND 789 00:34:37,120 --> 00:34:39,360 RECOMMENDATION-BASED DIETS A 790 00:34:39,360 --> 00:34:40,720 HEALTHY EATING INDEX OR 791 00:34:40,720 --> 00:34:43,560 MEDITERRANEAN DIET AND LOOKED AT 792 00:34:43,560 --> 00:34:47,240 MORE MECHANISTICALLY BASED DIETS 793 00:34:47,240 --> 00:34:48,640 SUCH AS AN ANTI-INFLAMMATORY 794 00:34:48,640 --> 00:34:49,200 DIET. 795 00:34:49,200 --> 00:34:51,480 SO WHEN WE LOOKED AT THE 796 00:34:51,480 --> 00:34:56,080 RECOMMENDATION-BASED DIETS WHAT 797 00:34:56,080 --> 00:34:59,280 I'M SHOWING HERE IS THAT WOMEN 798 00:34:59,280 --> 00:35:04,840 MOST ADHERENT TO A MEDITERRANEAN 799 00:35:04,840 --> 00:35:10,680 DIET COMPARED TO THOSE LEAST 800 00:35:10,680 --> 00:35:11,160 ADH 801 00:35:11,160 --> 00:35:14,960 ADHERENT HAD A SMALL DECREASE IN 802 00:35:14,960 --> 00:35:17,720 THE RISK OF THE ESTROGEN 803 00:35:17,720 --> 00:35:20,880 RECEPTOR NEGATIVE OR TRIPLE 804 00:35:20,880 --> 00:35:22,360 NEGATIVE BREAST CANCER. 805 00:35:22,360 --> 00:35:24,400 ASSOCIATIONS WERE STILL SEEN FOR 806 00:35:24,400 --> 00:35:27,440 OTHER RECOMMENDATION-BASED DIETS 807 00:35:27,440 --> 00:35:28,040 THAT MIGHT BE CONSIDERED LESS 808 00:35:28,040 --> 00:35:37,120 RIGOROUS THAN THE DASH DIET 809 00:35:37,120 --> 00:35:38,520 WHICH IS A HYPERTENSION DIET. 810 00:35:38,520 --> 00:35:43,560 I'M BLANKING ON WHAT THE ACRONYM 811 00:35:43,560 --> 00:35:46,360 IS. 812 00:35:46,360 --> 00:35:47,720 WE SAW LESS. 813 00:35:47,720 --> 00:35:50,840 SO YOU WILL THE DIETS HAVE IN 814 00:35:50,840 --> 00:35:54,000 COMMON EATING LOTS OF FRUITS AND 815 00:35:54,000 --> 00:35:55,520 VEGETABLES AND WHOLE GRAIN NUTS 816 00:35:55,520 --> 00:36:00,240 AND LEGUME AND TRYING TO EAT 817 00:36:00,240 --> 00:36:01,120 LESS MEAT. 818 00:36:01,120 --> 00:36:05,960 WE CONSIDERED DIET PATTERNS 819 00:36:05,960 --> 00:36:09,800 ASSOCIATED WITH INFLAMMATION OR 820 00:36:09,800 --> 00:36:14,080 OXIDATIVE STRESS AND DIET IS 821 00:36:14,080 --> 00:36:19,560 IMPORTANT IN REGULATING CHRONIC 822 00:36:19,560 --> 00:36:22,360 INFLAMMATION AND WE HAVE AN 823 00:36:22,360 --> 00:36:27,120 DIETARY INDEX WE CALCULATED FOR 824 00:36:27,120 --> 00:36:30,160 OUR STUDY AND OXIDATIVE BALANCE 825 00:36:30,160 --> 00:36:30,920 SCORE. 826 00:36:30,920 --> 00:36:31,440 FOR BOTH THEY WERE SCORED 827 00:36:31,440 --> 00:36:37,600 OPPOSITE. 828 00:36:37,600 --> 00:36:39,080 FOLLOWING THE POOR DIET FOR 829 00:36:39,080 --> 00:36:40,800 INFLAMMATORY INDEX INCREASES THE 830 00:36:40,800 --> 00:36:43,120 RISK OF ESPECIALLY ESTROGEN 831 00:36:43,120 --> 00:36:44,120 RECEPTOR AND TRIPLE NEGATIVE 832 00:36:44,120 --> 00:36:50,560 BREAST CANCER. 833 00:36:50,560 --> 00:36:52,960 FOLLOWING A GOOD DIET FOR 834 00:36:52,960 --> 00:36:54,560 OXIDATIVE BALANCE IS ASSOCIATED 835 00:36:54,560 --> 00:36:56,160 WITH A DECREASE SLIGHTLY OF 836 00:36:56,160 --> 00:36:57,240 TRIPLE NEGATIVE BREAST CANCER. 837 00:36:57,240 --> 00:36:59,200 WHEN YOU PUT THEM TOGETHER WE 838 00:36:59,200 --> 00:37:01,840 SEE THEY'RE BOTH PRETTY 839 00:37:01,840 --> 00:37:02,160 BENEFICIAL. 840 00:37:02,160 --> 00:37:04,800 SO IF YOU HAVE THE WORSE OF 841 00:37:04,800 --> 00:37:06,320 BOTH, YOU HAVE A SUBSTANTIALLY 842 00:37:06,320 --> 00:37:09,240 INCREASED RISK OF DEVELOPING 843 00:37:09,240 --> 00:37:10,640 ESTROGEN RECEPTOR OR TRIPLE 844 00:37:10,640 --> 00:37:11,560 NEGATIVE BREAST CANCER. 845 00:37:11,560 --> 00:37:12,720 IT'S IMPORTANT THESE TWO 846 00:37:12,720 --> 00:37:16,080 CONDITIONS ARE RARER. 847 00:37:16,080 --> 00:37:19,560 THEY HAVE HIGHER MORTALITY AND 848 00:37:19,560 --> 00:37:20,200 MORE OFTEN FOUND IN BLAM BLACK 849 00:37:20,200 --> 00:37:24,000 WOMEN. 850 00:37:24,000 --> 00:37:25,600 I THINK OUR SPLASHIEST WORK TO 851 00:37:25,600 --> 00:37:26,880 DATE IS OUR WORK ON HAIR 852 00:37:26,880 --> 00:37:31,000 PRODUCTS AND CANCER INSTITUTE.I 853 00:37:31,000 --> 00:37:31,560 DATE IS OUR WORK ON HAIR 854 00:37:31,560 --> 00:37:34,240 PRODUCTS AND CANCER INSTITUTE. 855 00:37:34,240 --> 00:37:35,320 IT TURNED OUT TO BE A GREAT 856 00:37:35,320 --> 00:37:37,000 INTEREST TO THE PUBLIC AND THE 857 00:37:37,000 --> 00:37:38,200 INTEREST GOES ON. 858 00:37:38,200 --> 00:37:41,080 WE STARTED THE STUDY BECAUSE OF 859 00:37:41,080 --> 00:37:43,160 PRIOR WORK LINKING THE EFFORT 860 00:37:43,160 --> 00:37:46,880 LINKING HAIR DYES TO CANCER. 861 00:37:46,880 --> 00:37:47,880 PERMANENT DYES AND OTHER HAIR 862 00:37:47,880 --> 00:37:53,280 PRODUCTS ARE KNOWN SOURCES OF 863 00:37:53,280 --> 00:38:01,360 EXPOSURE TO MUTE I GENS AND 864 00:38:01,360 --> 00:38:01,840 ENDOCRINE DISRUPTORS. 865 00:38:01,840 --> 00:38:04,000 MOST OFTEN BLADDER CANCER BUT 866 00:38:04,000 --> 00:38:07,600 ALSO LEUKEMIA, LYMPHOMA AND 867 00:38:07,600 --> 00:38:16,280 BREAST CANCER. 868 00:38:16,280 --> 00:38:18,120 IT LOOKED AT HAIR DRESSES AND 869 00:38:18,120 --> 00:38:21,360 THE RESULT OF PERSON USE FOR 870 00:38:21,360 --> 00:38:25,640 HAIR DYES WERE LESS CONSISTENT. 871 00:38:25,640 --> 00:38:36,160 IN 2010 WORKPLACE HAIR DRESSER 872 00:38:43,440 --> 00:38:46,240 CANCER WERE A FACTOR AND HAIR 873 00:38:46,240 --> 00:38:55,080 CHEMICALS ARE CAPABLE OF 874 00:38:55,080 --> 00:38:57,240 REACHING THE BREAST TISSUE AND 875 00:38:57,240 --> 00:39:00,800 WEAR WAVING PRODUCTS KNOWN AS 876 00:39:00,800 --> 00:39:05,520 PERM CONTAIN A CARCINOGEN AND 877 00:39:05,520 --> 00:39:09,760 OTHER THINGS THAT ARE NOT 878 00:39:09,760 --> 00:39:10,520 ESPECIALLY HEALTHFUL AND 879 00:39:10,520 --> 00:39:11,600 CHEMICAL STRAIGHTERS IN AND 880 00:39:11,600 --> 00:39:12,120 RELAXERS CONTAIN A LOT OF 881 00:39:12,120 --> 00:39:19,480 THINGS. 882 00:39:19,480 --> 00:39:27,560 SOME RELEASE FORMALDEHYDE WHEN 883 00:39:27,560 --> 00:39:28,360 HEATED. 884 00:39:28,360 --> 00:39:30,480 WE ADDED A PERSONAL PRODUCTS 885 00:39:30,480 --> 00:39:33,840 QUESTIONNAIRE AT ENROLLMENT TO 886 00:39:33,840 --> 00:39:34,800 OUR STUDY BASICALLY BECAUSE OF 887 00:39:34,800 --> 00:39:36,120 THE INFLUENCE OF THE WOMEN WE 888 00:39:36,120 --> 00:39:36,720 TALKED TO ABOUT DESIGNING THE 889 00:39:36,720 --> 00:39:38,360 STUDY. 890 00:39:38,360 --> 00:39:42,160 AND IN THE QUESTIONNAIRE WE 891 00:39:42,160 --> 00:39:44,680 ASKED ABOUT FREQUENCY OF USE OF 892 00:39:44,680 --> 00:39:48,200 HAIR PRODUCTS 10 TO 13 AND IN 893 00:39:48,200 --> 00:39:49,560 THE 12 MONTHS BEFORE ENROLLMENT. 894 00:39:49,560 --> 00:39:54,960 WE INCLUDED HAIR DYES AND WE 895 00:39:54,960 --> 00:39:58,040 INCLUDED HAIR STRAIGHT NERS AND 896 00:39:58,040 --> 00:40:01,000 RELAXERS AND OTHER PRODUCTS. 897 00:40:01,000 --> 00:40:02,080 I WANT TO MENTION THAT MORE THAN 898 00:40:02,080 --> 00:40:05,080 HALF THE WOMEN IN THE UNITED 899 00:40:05,080 --> 00:40:06,280 STATES, AGE 40 AND OLDER USED 900 00:40:06,280 --> 00:40:11,560 HAIR DYES, MYSELF INCLUDED. 901 00:40:11,560 --> 00:40:22,000 AND HAIR STRAIGHTENER IS 902 00:40:22,720 --> 00:40:25,600 PREDOMINANT AMONG BLACK AND 903 00:40:25,600 --> 00:40:26,160 AFRICAN AMERICAN WOMEN AND 904 00:40:26,160 --> 00:40:27,480 CONTINUES LIFE LONG. 905 00:40:27,480 --> 00:40:29,360 IT'S A GRAPH SHOWING DATA FROM 906 00:40:29,360 --> 00:40:31,560 ANOTHER NIH STUDY THE STUDY OF 907 00:40:31,560 --> 00:40:32,560 ENVIRONMENT, LIFESTYLE AND 908 00:40:32,560 --> 00:40:35,240 FIBROIDS AND SHOWING THAT BY AGE 909 00:40:35,240 --> 00:40:37,040 10 A THIRD OF THE WOMEN ALL 910 00:40:37,040 --> 00:40:39,800 BLACK WOMEN IN THIS STUDY USED 911 00:40:39,800 --> 00:40:43,560 STRAIGHTENERS AT LEAST TWICE A 912 00:40:43,560 --> 00:40:45,600 YEAR. 913 00:40:45,600 --> 00:40:47,560 IN TERMS OF BREAST CANCER AND 914 00:40:47,560 --> 00:40:51,600 HAIR PRODUCTS, WE DID SEE A 915 00:40:51,600 --> 00:40:52,760 SMALL OVER ALL ASSOCIATION 916 00:40:52,760 --> 00:40:55,600 BETWEEN PERMANENT HAIR DYES AND 917 00:40:55,600 --> 00:41:00,120 BREAST CANCER RISK. 918 00:41:00,120 --> 00:41:04,080 BY FAR THOUGH IT WASN'T QUITE 919 00:41:04,080 --> 00:41:07,480 STATISTICALLY SIGNIFICANT BY FAR 920 00:41:07,480 --> 00:41:08,360 OUR GREATEST ASSOCIATION WAS FOR 921 00:41:08,360 --> 00:41:11,040 HAIR STRAIGHTENERS. 922 00:41:11,040 --> 00:41:14,720 WHEN WE LOOKED AT FREQUENCY 923 00:41:14,720 --> 00:41:20,800 USING HAIR STRAIGHT NER -- 924 00:41:20,800 --> 00:41:22,960 STRAIGHTENERS WAS ASSOCIATED 925 00:41:22,960 --> 00:41:25,440 WITH A 35% INCREASE WITH BREAST 926 00:41:25,440 --> 00:41:26,480 CANCER RISK. 927 00:41:26,480 --> 00:41:28,000 FOR THE PERMANENT HAIR DYES 928 00:41:28,000 --> 00:41:32,000 THERE WAS A 7% INCREASE FOR 929 00:41:32,000 --> 00:41:34,040 WHITE WOMEN AND POTENTIALLY IT 930 00:41:34,040 --> 00:41:35,040 REFLECTED THE DIFFERENT PRODUCTS 931 00:41:35,040 --> 00:41:37,400 THAT ARE MARKETED TO BLACK WOMEN 932 00:41:37,400 --> 00:41:39,360 AS WELL AS DIFFERENCES IN HAIR 933 00:41:39,360 --> 00:41:40,640 TEXTURE AND ABSORPTION. 934 00:41:40,640 --> 00:41:42,680 FOR STRAIGHTENERS THE 935 00:41:42,680 --> 00:41:45,200 ASSOCIATIONS DIDN'T VARY BY 936 00:41:45,200 --> 00:41:45,400 RACE. 937 00:41:45,400 --> 00:41:47,320 BUT BECAUSE SO MANY MORE BLACK 938 00:41:47,320 --> 00:41:49,600 WOMEN THAN WHITE WOMEN IN OUR 939 00:41:49,600 --> 00:41:52,320 STUDY USE THESE PRODUCTS IT'S 940 00:41:52,320 --> 00:41:55,560 POTENTIALLY A MUCH MORE 941 00:41:55,560 --> 00:41:57,360 MEANINGFUL RISK. 942 00:41:57,360 --> 00:41:59,440 WE ALSO LOOKED AT HAIR PRODUCT 943 00:41:59,440 --> 00:42:01,600 USE AT AGE 10 TO 13 IN RELATION 944 00:42:01,600 --> 00:42:07,240 TO BREAST CANCER AND DID SEE 945 00:42:07,240 --> 00:42:12,280 THAT PREMENOPAUSAL BUT NOT POST 946 00:42:12,280 --> 00:42:13,600 MENOPAUSAL CANCER WAS ASSOCIATED 947 00:42:13,600 --> 00:42:18,200 WITH THE USE OF THE HAIR 948 00:42:18,200 --> 00:42:19,080 STRAIGHTENERS AND PERMS AND IT 949 00:42:19,080 --> 00:42:23,080 WAS SAME BY RACE BUT IN OUR 950 00:42:23,080 --> 00:42:25,920 STUDY, 75% OF WOMEN REPORTED 951 00:42:25,920 --> 00:42:28,560 CHILDHOOD USE OF HAIR 952 00:42:28,560 --> 00:42:31,600 STRAIGHTENERS VERSUS 3% IN WHITE 953 00:42:31,600 --> 00:42:35,560 WOMEN. 954 00:42:35,560 --> 00:42:37,600 ADOLESCENT HAIR DIE USE WAS UB 955 00:42:37,600 --> 00:42:39,480 COMMON IN NOT-ASSOCIATED BREAST 956 00:42:39,480 --> 00:42:47,680 CANCER BUT SAW A HAZARD RATIO OF 957 00:42:47,680 --> 00:42:53,520 1. 77 AND THIS RAISED A LOT OF 958 00:42:53,520 --> 00:42:55,200 CONCERN AND GOT PRESS AND 959 00:42:55,200 --> 00:42:57,120 ANOTHER NIEHS EPIDEMIOLOGIST AND 960 00:42:57,120 --> 00:43:05,640 HER TEAM STUDIED THE USE OF HAIR 961 00:43:05,640 --> 00:43:08,320 PRODUCTS ON OUTERIN CANCER AND 962 00:43:08,320 --> 00:43:10,680 NO ASSOCIATION ON OVARIAN CANCER 963 00:43:10,680 --> 00:43:15,080 BUT THE MOST RECENT RESULTS WERE 964 00:43:15,080 --> 00:43:17,680 ESPECIALLY CONCERNING GIVEN THE 965 00:43:17,680 --> 00:43:21,080 RISING RATES OF UTERINE CANCER 966 00:43:21,080 --> 00:43:22,000 IN THE U.S. 967 00:43:22,000 --> 00:43:24,640 I WANT TO WORK ON AMBIENT 968 00:43:24,640 --> 00:43:25,320 ENVIRONMENTAL EXPOSURES BECAUSE 969 00:43:25,320 --> 00:43:28,720 I'M RUNNING OUT OF TIME. 970 00:43:28,720 --> 00:43:30,440 WE COLLECTED SELF-REPORTED 971 00:43:30,440 --> 00:43:31,760 INFORMATION ON EXPOSURES AT 972 00:43:31,760 --> 00:43:35,040 RESIDENCE LEVEL AND THEN WE HAVE 973 00:43:35,040 --> 00:43:35,640 GEOSPATIAL INFORMATION WE'RE 974 00:43:35,640 --> 00:43:40,160 TAKING ADVANTAGE OF. 975 00:43:40,160 --> 00:43:41,920 VARIOUS LEVELS OF SPATIAL 976 00:43:41,920 --> 00:43:42,600 RESOLUTION FOR THIS. 977 00:43:42,600 --> 00:43:44,200 ONE OF EARLIER PAPERS WE LOOKED 978 00:43:44,200 --> 00:43:46,320 AT INDOOR AIR POLLUTION AND 979 00:43:46,320 --> 00:43:49,000 FOUND THAT HAVING A FIRE PLACE 980 00:43:49,000 --> 00:43:50,600 IN THE HOME OR USING A FIRE 981 00:43:50,600 --> 00:43:54,760 PLACE OR STOVE IN THE HOME WAS 982 00:43:54,760 --> 00:43:55,440 ASSOCIATED WITH BREAST CANCER 983 00:43:55,440 --> 00:43:58,000 RISK AND THAT THE TYPE OF 984 00:43:58,000 --> 00:44:02,120 MATERIAL THAT WAS ASSOCIATED 985 00:44:02,120 --> 00:44:07,040 WITH RISK WAS WOOD AND GAS. 986 00:44:07,040 --> 00:44:09,320 DR. WHITE'S GROUP IS FOCUSSED ON 987 00:44:09,320 --> 00:44:13,360 AIR POLLUTION IN RELATION TO 988 00:44:13,360 --> 00:44:15,200 BREAST CANCER. 989 00:44:15,200 --> 00:44:17,080 IT'S CLASSIFIED AS AN CARCINOGEN 990 00:44:17,080 --> 00:44:21,520 TO HUMANS AND IN THE INHALED 991 00:44:21,520 --> 00:44:23,880 POLLUTANTS FOUND IN BREAST FLUID 992 00:44:23,880 --> 00:44:27,040 BUT IT'S A COMPLEX HETEROGENEOUS 993 00:44:27,040 --> 00:44:32,000 MIXTURE OF CARCINOGENIC AND 994 00:44:32,000 --> 00:44:33,240 ENDOCRINE DISRUPTING COMPOUNDS. 995 00:44:33,240 --> 00:44:43,560 IT'S NOT ONE SINGLE THING. 996 00:44:43,560 --> 00:44:46,000 ECO LOGIC EVIDENCE SHOW IT'S 997 00:44:46,000 --> 00:44:48,280 HIGHER IN URBAN AREAS AND THE 998 00:44:48,280 --> 00:44:51,560 INCREASE HAS BEEN SHOWN TO 999 00:44:51,560 --> 00:44:53,280 INCREASE WITH TRAFFIC RELATED 1000 00:44:53,280 --> 00:44:53,560 EMISSIONS. 1001 00:44:53,560 --> 00:44:57,320 YOU CAN SEE IN THE GRAPH THE 1002 00:44:57,320 --> 00:45:05,040 PARALLEL RISES IN BREAST CANCER 1003 00:45:05,040 --> 00:45:08,280 INCIDENTS. 1004 00:45:08,280 --> 00:45:10,200 EPIDEMIOLOGIC STUDIES SHOW OTHER 1005 00:45:10,200 --> 00:45:11,000 MEASURES OF TRAFFIC POLLUTION 1006 00:45:11,000 --> 00:45:14,960 BUT PARTICULATE MATTER AND PM2.5 1007 00:45:14,960 --> 00:45:17,360 ARE INCONSISTENT AND RECENT 1008 00:45:17,360 --> 00:45:18,000 META-ANALYSIS FOUND NO EVIDENCE 1009 00:45:18,000 --> 00:45:23,560 OF AN EFFECT. 1010 00:45:23,560 --> 00:45:24,160 PARTICULATE MATTER IS AN 1011 00:45:24,160 --> 00:45:25,960 AGGREGATE OF DIFFERENT THINGS 1012 00:45:25,960 --> 00:45:28,160 THAT ARE MEASURED OR REPORTED 1013 00:45:28,160 --> 00:45:31,160 BASED ONLY ON PARTICLE SIZE. 1014 00:45:31,160 --> 00:45:33,120 THIS GEOGRAPHIC VARIABILITY IN 1015 00:45:33,120 --> 00:45:35,560 THE COMPOSITION AND VARYING 1016 00:45:35,560 --> 00:45:39,440 EXPOSURE SOURCES. 1017 00:45:39,440 --> 00:45:44,160 IN OUR EARLY REPORTS WE ALSO 1018 00:45:44,160 --> 00:45:45,160 CONFIRMED AN ASSOCIATION JUST 1019 00:45:45,160 --> 00:45:55,680 WITH ESTROGEN RECEPTOR AND P 1020 00:46:09,800 --> 00:46:10,320 PROGES 1021 00:46:10,320 --> 00:46:12,160 PROGESTERONE ASSOCIATION IN THE 1022 00:46:12,160 --> 00:46:21,360 CHEMICAL COMPOSITION. 1023 00:46:21,360 --> 00:46:23,160 I WANT TO TALK ABOUT HEALTH 1024 00:46:23,160 --> 00:46:23,400 DISPARITY. 1025 00:46:23,400 --> 00:46:24,960 WHERE YOU LIVE MATTERS. 1026 00:46:24,960 --> 00:46:27,240 IT'S A SOURCE OF EXPOSURE TO 1027 00:46:27,240 --> 00:46:28,440 MULTIPLE STRESSORS AND 1028 00:46:28,440 --> 00:46:29,600 DETERMINES YOUR ACCESS TO HEALTH 1029 00:46:29,600 --> 00:46:31,560 CARE, OTHER RESOURCES AND 1030 00:46:31,560 --> 00:46:38,400 SERVICES. 1031 00:46:38,400 --> 00:46:40,880 ONE OF THE MEASURES A GEOGRAPHIC 1032 00:46:40,880 --> 00:46:42,680 MEASURE OF SOCIO ECONOMIC 1033 00:46:42,680 --> 00:46:44,480 DISPARITIES WE'VE USED IS 1034 00:46:44,480 --> 00:46:49,600 SOMETHING CALLED THE AREA 1035 00:46:49,600 --> 00:46:58,280 DEPRIVATION INDEX IT COMBINES 17 1036 00:46:58,280 --> 00:47:01,200 CENSUS AND AMERICAN COMMUNITY 1037 00:47:01,200 --> 00:47:11,760 SURVEY VARIABLES AND YOU CAN SEE 1038 00:47:12,080 --> 00:47:13,240 HIGH DISADVANTAGE AND SCORED IN 1039 00:47:13,240 --> 00:47:15,760 THE OPPOSITE AND THE BLUE IS LOW 1040 00:47:15,760 --> 00:47:21,360 DISADVANTAGE. 1041 00:47:21,360 --> 00:47:22,600 IN THE SISTER STUDY PARTICIPANTS 1042 00:47:22,600 --> 00:47:25,600 ARE PRETTY WELL OFF AND HALF THE 1043 00:47:25,600 --> 00:47:27,440 SISTER PARTICIPANTS HAVE AN AREA 1044 00:47:27,440 --> 00:47:29,520 DEPRIVATION INDEX LESS THAN THE 1045 00:47:29,520 --> 00:47:31,560 U.S. 30th PERCENTILE. 1046 00:47:31,560 --> 00:47:34,280 HARD TO COMPUTE BUT SUFFICE TO 1047 00:47:34,280 --> 00:47:36,280 SAY WHEN WE'RE LOOKING AT THIS 1048 00:47:36,280 --> 00:47:38,000 WE'RE COMPARING PEOPLE WITH 1049 00:47:38,000 --> 00:47:41,960 SCORES IN THE TOP 50% AND 1050 00:47:41,960 --> 00:47:45,240 DISADVANTAGED BROADLY TO OTHER 1051 00:47:45,240 --> 00:47:48,240 GROUPS MORE POPULATED AND THE 1052 00:47:48,240 --> 00:47:50,640 AREA OF DEPRIVATION INDEX WAS 1053 00:47:50,640 --> 00:47:51,320 ASSOCIATED WITH HYPERTENSION IN 1054 00:47:51,320 --> 00:48:00,080 OUR STUDY. 1055 00:48:00,080 --> 00:48:02,520 HARDER TO GET A HANDLE ON BREAST 1056 00:48:02,520 --> 00:48:06,200 CANCER AND IT'S THE HIGH SES 1057 00:48:06,200 --> 00:48:06,440 DISEASE. 1058 00:48:06,440 --> 00:48:10,800 IT'S HY IN HIGH-INCOME -- 1059 00:48:10,800 --> 00:48:12,480 ASSOCIATED WITH HIGH-INCOME 1060 00:48:12,480 --> 00:48:13,920 COUNTRIES AND WE SAW AN INVERSE 1061 00:48:13,920 --> 00:48:16,040 ASSOCIATION AS WE EXPECTED 1062 00:48:16,040 --> 00:48:18,200 BETWEEN THE AREA DEPRIVATION 1063 00:48:18,200 --> 00:48:19,760 INDEX AND OVER ALL BREAST CANCER 1064 00:48:19,760 --> 00:48:21,720 INCIDENTS BUT WHEN WE TRY TO 1065 00:48:21,720 --> 00:48:24,320 TEASE IT A PART FOR ESTROGEN 1066 00:48:24,320 --> 00:48:26,720 RECEPTOR POSITIVE BREAST CANCER, 1067 00:48:26,720 --> 00:48:28,840 THAT'S THE CASE, BUT FOR ER 1068 00:48:28,840 --> 00:48:31,000 NEGATIVE BREAST CANCER WE START 1069 00:48:31,000 --> 00:48:35,480 TO SEE EVIDENCE OF A POSITIVE 1070 00:48:35,480 --> 00:48:36,680 TREND WITH WORSE DISADVANTAGE 1071 00:48:36,680 --> 00:48:39,600 AND NOTABLY THOUGH WE'RE WAY 1072 00:48:39,600 --> 00:48:42,760 UNDERPOWERED TO DO THIS THE 1073 00:48:42,760 --> 00:48:43,920 GREATEST HAZARD RATIO WAS AMONG 1074 00:48:43,920 --> 00:48:45,880 BLACK WOMEN WITH ESTROGEN 1075 00:48:45,880 --> 00:48:47,640 NEGATIVE RECEPTOR BREAST CANCER 1076 00:48:47,640 --> 00:48:49,720 WHICH IS CONSISTENT WITH RESULTS 1077 00:48:49,720 --> 00:48:51,400 FROM ANOTHER STUDY COMPRISED 1078 00:48:51,400 --> 00:48:57,280 SOLELY OF BLACK WOMEN. 1079 00:48:57,280 --> 00:48:58,400 I'D LIKE TO LEAVE TIME FOR 1080 00:48:58,400 --> 00:49:01,880 QUESTIONS BUT I WANT TO TALK 1081 00:49:01,880 --> 00:49:05,760 ABOUT OUR EPIGENETIC WORK AND 1082 00:49:05,760 --> 00:49:09,960 MECHANISMS ARE AFFECTED BY 1083 00:49:09,960 --> 00:49:11,200 ENVIRONMENTAL AND AGING AS WELL 1084 00:49:11,200 --> 00:49:13,040 AS LIFESTYLE EXPOSURES AND WE 1085 00:49:13,040 --> 00:49:16,760 CARRIED OUT A CASE COHORT STUDY 1086 00:49:16,760 --> 00:49:18,320 AND FIRST THING WE DID WITH THE 1087 00:49:18,320 --> 00:49:21,920 CASE COHORT WAS TO CARRY OUT 1088 00:49:21,920 --> 00:49:23,480 GENOME WIDE ASSOCIATION STUDY OF 1089 00:49:23,480 --> 00:49:25,280 BREAST CANCER. 1090 00:49:25,280 --> 00:49:26,840 WE IDENTIFIED MANY MARKERS THAT 1091 00:49:26,840 --> 00:49:29,880 WERE ASSOCIATED WITH INCIDENT 1092 00:49:29,880 --> 00:49:31,760 INVASIVE BREAST CANCER AND 1093 00:49:31,760 --> 00:49:38,080 REPLICATED THE RESULTS IN AN 1094 00:49:38,080 --> 00:49:39,440 INDEPENDENT STUDY AND LOWER 1095 00:49:39,440 --> 00:49:41,160 INVASIVE AND LOWER METHYLATION 1096 00:49:41,160 --> 00:49:46,680 AND INVASIVE CASES. 1097 00:49:46,680 --> 00:49:48,960 WE HAVE BEEN MORE FOCUSSED 1098 00:49:48,960 --> 00:49:50,520 RECENTLY ON USING THOSE 1099 00:49:50,520 --> 00:49:53,320 INDIVIDUAL CPGs IN COMBINATIONS 1100 00:49:53,320 --> 00:49:55,040 TO PREDICT BIOLOGIC PROCESSES 1101 00:49:55,040 --> 00:49:57,040 AND PHENOTYPES. 1102 00:49:57,040 --> 00:49:59,680 THESE CAN BE COMBINED UP TO 1103 00:49:59,680 --> 00:50:03,120 MEASURE PERIPHERAL IMMUNE CELL 1104 00:50:03,120 --> 00:50:04,040 COMPOSITION, CIRCULATING LEVELS 1105 00:50:04,040 --> 00:50:07,560 AND AGING PHENOTYPES AND 1106 00:50:07,560 --> 00:50:10,280 MORTALITY PREDICTORS. 1107 00:50:10,280 --> 00:50:12,720 I'M GOING TO FOCUS ON THE 1108 00:50:12,720 --> 00:50:14,600 SO-CALLED EPIGENETIC CLOCK 1109 00:50:14,600 --> 00:50:18,200 MEASURE BIOLOGIC AGE AND AGE 1110 00:50:18,200 --> 00:50:19,200 ACCELERATION IS CONSIDERED THE 1111 00:50:19,200 --> 00:50:21,040 DIFFERENCE BETWEEN BIOLOGICAL 1112 00:50:21,040 --> 00:50:24,680 AGE AND CHRONOLOGICAL AGE. 1113 00:50:24,680 --> 00:50:26,880 OUR GOAL IS WE'VE BEEN LOOKING 1114 00:50:26,880 --> 00:50:29,920 AT ENVIRONMENTAL AND LIFE STYLE 1115 00:50:29,920 --> 00:50:32,280 EXPOSURES TO AGE ACCELERATION 1116 00:50:32,280 --> 00:50:35,280 AND IN TERM LOOKING AT 1117 00:50:35,280 --> 00:50:36,840 DEMETHYLATION ACCELERATION IN 1118 00:50:36,840 --> 00:50:37,880 RELATION TO BREAST CANCER 1119 00:50:37,880 --> 00:50:39,560 INCIDENTS USING THE BLOCKS 1120 00:50:39,560 --> 00:50:41,240 LISTED HERE THAT DO SLIGHTLY 1121 00:50:41,240 --> 00:50:42,920 DIFFERENT THING, PREDICTING AGE 1122 00:50:42,920 --> 00:50:49,960 AND MORTALITY OR AGING RATES. 1123 00:50:49,960 --> 00:50:53,400 IN CONSIDERING ENVIRONMENTAL AND 1124 00:50:53,400 --> 00:50:55,400 LIFESTYLE EXPOSURES WE FOUND A 1125 00:50:55,400 --> 00:50:59,560 LOT OF ASSOCIATIONS WITH DNA 1126 00:50:59,560 --> 00:51:00,600 METHYLATION ACCELERATION AND 1127 00:51:00,600 --> 00:51:02,040 GOING BACK TO THE SOCIAL 1128 00:51:02,040 --> 00:51:04,040 VARIABLES WE USED THE AREA 1129 00:51:04,040 --> 00:51:06,680 DEPRIVATION INDEX AND SLOWED FOR 1130 00:51:06,680 --> 00:51:10,520 SEVERAL OF THESE CLOCKS THE 1131 00:51:10,520 --> 00:51:13,600 INCREASING LEVELS OF DNA 1132 00:51:13,600 --> 00:51:14,720 METHYLATION AGING WERE 1133 00:51:14,720 --> 00:51:17,080 ASSOCIATED ERROR INCREASING 1134 00:51:17,080 --> 00:51:22,800 LEVELS OF AREA DEPRIVATION WERE 1135 00:51:22,800 --> 00:51:27,680 ASSOCIATED WITH MORE -- I'M 1136 00:51:27,680 --> 00:51:27,880 TIRED. 1137 00:51:27,880 --> 00:51:32,880 WITH GREATER RATES OF AGING. 1138 00:51:32,880 --> 00:51:35,520 WE ALSO USED DNA METHYLATION AGE 1139 00:51:35,520 --> 00:51:37,640 IN RELATION TO BREAST CANCER 1140 00:51:37,640 --> 00:51:41,480 INCIDENTS IN WORK LED BY MY 1141 00:51:41,480 --> 00:51:42,520 COLLEAGUE JEFF TAYLOR AND OTHERS 1142 00:51:42,520 --> 00:51:44,480 WHO MOVED ON FROM BEING A 1143 00:51:44,480 --> 00:51:47,440 POSTDOC WITH US TO BEING A 1144 00:51:47,440 --> 00:51:50,880 RESEARCHER AT THE MOFFETT CANCER 1145 00:51:50,880 --> 00:51:51,120 INSTITUTE. 1146 00:51:51,120 --> 00:51:53,440 WE SHOWED DNA METHYLATION AGE 1147 00:51:53,440 --> 00:51:56,320 ACCELERATION WAS ASSOCIATED WITH 1148 00:51:56,320 --> 00:51:57,920 BREAST CANCER INCIDENTS USING 1149 00:51:57,920 --> 00:51:59,160 SEVERAL OF THESE CLOCKS. 1150 00:51:59,160 --> 00:52:00,800 THE MOST RECENT STUDY IS ONE 1151 00:52:00,800 --> 00:52:02,960 THAT'S EXCITING WHERE WE'VE BEEN 1152 00:52:02,960 --> 00:52:05,680 ABLE TO TAKE ADVANTAGE OF OUR 1153 00:52:05,680 --> 00:52:06,760 TWICE-MEASURED PARTICIPANTS THAT 1154 00:52:06,760 --> 00:52:08,840 GAVE US A SECOND BLOOD SAMPLE 1155 00:52:08,840 --> 00:52:09,960 ABOUT EIGHT YEARS LATER AFTER 1156 00:52:09,960 --> 00:52:10,680 THE FIRST. 1157 00:52:10,680 --> 00:52:13,400 WE'VE BEEN ABLE TO LOOK AT 1158 00:52:13,400 --> 00:52:21,800 CHANGES IN MYTHALATION -- 1159 00:52:21,800 --> 00:52:22,800 METHYLATION IN TIME ACCOUNTING 1160 00:52:22,800 --> 00:52:25,480 FOR DIFFERENCES AFROM THE START 1161 00:52:25,480 --> 00:52:28,360 AND SHOWING DIFFERENCES FROM AGE 1162 00:52:28,360 --> 00:52:29,360 AT THE SECOND BLOOD DRAW 1163 00:52:29,360 --> 00:52:31,600 COMPARING CASES TO NON-CASES. 1164 00:52:31,600 --> 00:52:35,800 THERE WAS DIFFERENTIAL AGING 1165 00:52:35,800 --> 00:52:37,680 AMONG THE CASES USING THE SECOND 1166 00:52:37,680 --> 00:52:39,480 TIME POINT USING SEVERAL OF 1167 00:52:39,480 --> 00:52:42,720 THESE CLOCKS. 1168 00:52:42,720 --> 00:52:44,560 AND IMPORTANTLY AND SOMETHING WE 1169 00:52:44,560 --> 00:52:45,880 NEED TO THINK ABOUT MORE IS WHEN 1170 00:52:45,880 --> 00:52:48,400 WE LOOK ONLY AT THE CASES THE 1171 00:52:48,400 --> 00:52:49,080 ASSOCIATIONS WERE STRONGER AMONG 1172 00:52:49,080 --> 00:52:52,480 WOMEN TREATED WITH RADIATION. 1173 00:52:52,480 --> 00:52:59,280 WE EXPECT THEM TO SEE IT FOR 1174 00:52:59,280 --> 00:53:01,360 CHEMOTHERAPY AND CONSISTENTLY 1175 00:53:01,360 --> 00:53:02,160 RADIATION POPPED UP. 1176 00:53:02,160 --> 00:53:06,080 EVEN IN LARGE COHORTS, WE'RE 1177 00:53:06,080 --> 00:53:06,920 UNDER POWERED TO STUDY RARE 1178 00:53:06,920 --> 00:53:08,240 EXPOSURES OR OUTCOMES. 1179 00:53:08,240 --> 00:53:10,920 OUR WORK IN THE SISTER STUDY LED 1180 00:53:10,920 --> 00:53:14,000 US TO DEVELOP A CONSORTIUM 1181 00:53:14,000 --> 00:53:15,640 FOCUSSED ON PREMENOPAUSAL BREAST 1182 00:53:15,640 --> 00:53:18,360 CANCER AND I WANT TO SHARE TWO 1183 00:53:18,360 --> 00:53:18,640 EXAMPLES. 1184 00:53:18,640 --> 00:53:23,120 THE FIRST IS THAT THERE'S BEEN A 1185 00:53:23,120 --> 00:53:26,920 CONUNDRUM THAT PARITY IS 1186 00:53:26,920 --> 00:53:29,520 PROTECTIVE FOR BREAST CANCER BUT 1187 00:53:29,520 --> 00:53:31,560 INCREASES SHORTLY AFTER THE 1188 00:53:31,560 --> 00:53:33,640 FIRST FULL-TERM BIRTH. 1189 00:53:33,640 --> 00:53:35,200 WE WANTED TO LOOK AT THIS IN THE 1190 00:53:35,200 --> 00:53:41,880 SISTER STUDY BUT WERE 1191 00:53:41,880 --> 00:53:45,320 UNDERPOWERED AND IT PROMPTED US 1192 00:53:45,320 --> 00:53:47,600 TO DO THIS AND THERE'S AN 1193 00:53:47,600 --> 00:53:50,640 INCREASED RISK FOR BREAST CANCER 1194 00:53:50,640 --> 00:53:53,760 AMONG WOMEN THAT PEAKED AT FIVE 1195 00:53:53,760 --> 00:53:58,920 YEARS AFTER THE MOST RECENT 1196 00:53:58,920 --> 00:54:04,600 BIRTH AND THIS PROTECTION -- 1197 00:54:04,600 --> 00:54:09,440 INCREASE LASTED A LONG TIME AND 1198 00:54:09,440 --> 00:54:10,920 LASTED 24 YEARS AND WE LOOKED AT 1199 00:54:10,920 --> 00:54:12,960 ANOTHER BIT OF CONFLICTING 1200 00:54:12,960 --> 00:54:14,000 EVIDENCE IN THE BREAST CANCER 1201 00:54:14,000 --> 00:54:19,560 LITERATURE WHERE INCREASING BODY 1202 00:54:19,560 --> 00:54:26,720 MASS INCREASE IS A RISK FACTOR 1203 00:54:26,720 --> 00:54:32,000 FOR BREAST CANCER POST 1204 00:54:32,000 --> 00:54:33,560 MENOPAUSAL AND THERE'S THERE'S 1205 00:54:33,560 --> 00:54:35,560 LINEAR ASSOCIATION BETWEEN 1206 00:54:35,560 --> 00:54:36,840 INCREASING BODY MASS INDEX 1207 00:54:36,840 --> 00:54:40,720 BEFORE MENOPAUSE AND IN 1208 00:54:40,720 --> 00:54:41,800 PREMENOPAUSAL WOMEN UNDER THE 1209 00:54:41,800 --> 00:54:43,560 AGE OF 55. 1210 00:54:43,560 --> 00:54:45,720 I'M COMING TO A CLOSE, 1211 00:54:45,720 --> 00:54:47,600 THANKFULLY. 1212 00:54:47,600 --> 00:54:54,680 WE'RE WORKING TOWARDS THE FUTURE 1213 00:54:54,680 --> 00:54:56,960 TO ENHANCE OUR EXPOSURE AND 1214 00:54:56,960 --> 00:54:58,040 WE'RE ADDING INFORMATION ON HAIR 1215 00:54:58,040 --> 00:55:00,880 TEXTURE WHICH WE THINK IS 1216 00:55:00,880 --> 00:55:03,200 IMPORTANT IN OUR HAIR PRODUCT 1217 00:55:03,200 --> 00:55:05,720 USE RESULTS WE'RE ADDING 1218 00:55:05,720 --> 00:55:07,600 INFORMATION ON SUNSCREEN USE AND 1219 00:55:07,600 --> 00:55:09,320 HOUSING CHARACTERISTICS AND 1220 00:55:09,320 --> 00:55:10,200 CLIMATE RESILIENCE. 1221 00:55:10,200 --> 00:55:12,360 WE WANT IT KNOW IF PEOPLE ARE 1222 00:55:12,360 --> 00:55:13,760 PROTECTED BY HEAT WAVES BY 1223 00:55:13,760 --> 00:55:15,160 HAVING FANS AND AIR CONDITIONS 1224 00:55:15,160 --> 00:55:16,240 AND HOW THAT'S GOING TO AFFECT 1225 00:55:16,240 --> 00:55:19,800 YOUR HEALTH IN THE FUTURE. 1226 00:55:19,800 --> 00:55:23,000 WE'RE ALSO PLANNING TO PILOT A 1227 00:55:23,000 --> 00:55:25,080 SECOND OR SOMETIMES THIRD 1228 00:55:25,080 --> 00:55:26,040 BIOLOGIC SAMPLE QUESTION 1229 00:55:26,040 --> 00:55:27,120 COLLECTION WHICH IS REALLY 1230 00:55:27,120 --> 00:55:30,360 IMPORTANT IN THESE TYPES OF 1231 00:55:30,360 --> 00:55:31,240 STUDIES BECAUSE THE SPOT SAMPLE 1232 00:55:31,240 --> 00:55:32,720 DOESN'T DO IT FOR YOU IN 1233 00:55:32,720 --> 00:55:33,440 UNDERSTANDING HEALTH. 1234 00:55:33,440 --> 00:55:35,560 THIS TIME WE'RE GOING TO FOCUS 1235 00:55:35,560 --> 00:55:39,040 ON MAKING SURE THAT WE INCLUDE A 1236 00:55:39,040 --> 00:55:41,240 LARGER SAMPLE OF OUR BLACK WOMEN 1237 00:55:41,240 --> 00:55:42,080 AND HISPANIC WOMEN INCLUDING 1238 00:55:42,080 --> 00:55:45,760 WOMEN WHO ALREADY GAVE A SECOND 1239 00:55:45,760 --> 00:55:47,120 SAMPLE AND FOCUS ON THE RARE 1240 00:55:47,120 --> 00:55:49,040 BREAST CANCER SUB TYPES. 1241 00:55:49,040 --> 00:55:51,840 THANKS TO A COLLABORATION WE'VE 1242 00:55:51,840 --> 00:55:53,200 LINED UP WITH COLLABORATORS AT 1243 00:55:53,200 --> 00:55:56,080 THE NCI WE'LL BE COLLECTING 1244 00:55:56,080 --> 00:55:56,880 FECAL SAMPLES FOR MICROBIOME 1245 00:55:56,880 --> 00:55:57,160 RESEARCH. 1246 00:55:57,160 --> 00:55:58,520 THAT'S IT. 1247 00:55:58,520 --> 00:56:01,640 I'M NOT GOING TO GO THROUGH ALL 1248 00:56:01,640 --> 00:56:04,400 THE THANK YOU BUT TO MENTION MY 1249 00:56:04,400 --> 00:56:09,840 SISTER STUDY CO-INVESTIGATORS 1250 00:56:09,840 --> 00:56:11,800 AND PICTURES I'M SHOWING ARE A 1251 00:56:11,800 --> 00:56:13,400 SNAPSHOT OF ONE POINT IN TIME OF 1252 00:56:13,400 --> 00:56:15,560 THE MANY STUDY INVESTIGATORS AND 1253 00:56:15,560 --> 00:56:17,000 FELLOWS AT NIEHS WHO USE THE 1254 00:56:17,000 --> 00:56:17,800 STUDY AS WELL AS THE ORIGINAL 1255 00:56:17,800 --> 00:56:19,720 STUDY DEVELOPMENT ATTEMPT. 1256 00:56:19,720 --> 00:56:25,400 SO YOU CAN FIND OUT MORE ON OUR 1257 00:56:25,400 --> 00:56:25,640 WEBSITE. 1258 00:56:25,640 --> 00:56:27,920 IT'S OUR 20th ANNIVERSARY AND 1259 00:56:27,920 --> 00:56:29,160 THE COMMUNICATION HAS RUN OF IT 1260 00:56:29,160 --> 00:56:32,240 AND THEY DEVELOPED A FABULOUS 1261 00:56:32,240 --> 00:56:32,440 VIDEO. 1262 00:56:32,440 --> 00:56:34,720 THERE IS A PREVIEW OF THE VIDEO 1263 00:56:34,720 --> 00:56:37,440 THAT CAN BE SEEN ON YOUTUBE. 1264 00:56:37,440 --> 00:56:38,720 I'VE WATCHED AND SHOWN THIS TO 1265 00:56:38,720 --> 00:56:43,880 EVERYBODY TODAY BUT YOU CAN'T 1266 00:56:43,880 --> 00:56:46,880 GET IT UNTIL SEPTEMBER 29th AND 1267 00:56:46,880 --> 00:56:51,560 CAN FIND THAT AND THE FULL VIDEO 1268 00:56:51,560 --> 00:56:52,760 AND THANK YOU AND HAPPY TO TAKE 1269 00:56:52,760 --> 00:56:54,720 QUESTIONS IF THERE'S TIME. 1270 00:56:54,720 --> 00:56:55,440 >> REBECCA HERE. 1271 00:56:55,440 --> 00:56:58,120 THANK YOU FOR THE WONDERFUL 1272 00:56:58,120 --> 00:57:03,320 PRESENTATION. 1273 00:57:03,320 --> 00:57:09,760 AND I'M AT THE INFECTIOUS 1274 00:57:09,760 --> 00:57:10,520 DISEASE INSTITUTE AND WANT TO 1275 00:57:10,520 --> 00:57:12,440 LINK WITH WHAT YOU'VE DONE. 1276 00:57:12,440 --> 00:57:15,240 WHAT DATA DO YOU COLLECT ON THE 1277 00:57:15,240 --> 00:57:16,200 INFECTIOUS DISEASE, DIAGNOSIS 1278 00:57:16,200 --> 00:57:19,240 AND ICT CODES OR ANYTHING ELSE. 1279 00:57:19,240 --> 00:57:22,720 >> WE HAVEN'T YET LINKED IN THIS 1280 00:57:22,720 --> 00:57:24,520 COHORT MEDICARE AND IN THE 1281 00:57:24,520 --> 00:57:28,680 AGRICULTURAL HEALTH STUDY WE CAN 1282 00:57:28,680 --> 00:57:30,920 DO SOME OF THAT IN RELATION TO 1283 00:57:30,920 --> 00:57:31,760 PESTICIDE USE. 1284 00:57:31,760 --> 00:57:34,160 WE HAVE SOME SELF-REPORTED DATA. 1285 00:57:34,160 --> 00:57:35,320 INTERESTED IN COLLABORATION 1286 00:57:35,320 --> 00:57:35,560 THOUGH. 1287 00:57:35,560 --> 00:57:37,520 WE ASK ABOUT VACCINES AND DURING 1288 00:57:37,520 --> 00:57:38,840 COVID WE ASKED A LOT OF 1289 00:57:38,840 --> 00:57:42,080 QUESTIONS ABOUT COVID INFECTION 1290 00:57:42,080 --> 00:57:46,520 AND STRESSORS RELATED TO 1291 00:57:46,520 --> 00:57:49,800 COVID-19 AND THE DATA IS UNDER 1292 00:57:49,800 --> 00:57:51,440 UTILIZED AND WE'LL WELCOME YOUR 1293 00:57:51,440 --> 00:57:51,800 COLLABORATION. 1294 00:57:51,800 --> 00:58:02,040 >> THANK YOU. 1295 00:58:09,880 --> 00:58:12,600 AND CAN YOU EXTEND IT TO THE 1296 00:58:12,600 --> 00:58:14,480 NEXT GENERATION FROM SISTERS TO 1297 00:58:14,480 --> 00:58:15,960 DAUGHTERS AND GRAND DAUGHTERS. 1298 00:58:15,960 --> 00:58:17,800 >> FROM YOUR MOUTH TO MY 1299 00:58:17,800 --> 00:58:22,880 SCIENTIFIC DIRECTOR'S EARS. 1300 00:58:22,880 --> 00:58:27,320 THE ADVANTAGE WOULD BE OF COURSE 1301 00:58:27,320 --> 00:58:30,240 WE COLLECTED ALL THESE 1302 00:58:30,240 --> 00:58:30,920 REPRODUCTIVE HISTORIES AND LINK 1303 00:58:30,920 --> 00:58:32,440 IT BACK TO WHAT'S IN THEIR 1304 00:58:32,440 --> 00:58:34,880 DAUGHTERS AND HAVE THE GENETIC 1305 00:58:34,880 --> 00:58:35,200 INFORMATION. 1306 00:58:35,200 --> 00:58:37,520 IT'S A FABULOUS THING WE TALK 1307 00:58:37,520 --> 00:58:37,720 ABOUT. 1308 00:58:37,720 --> 00:58:38,480 THERE'S A LOT OF ON OUR PLATE 1309 00:58:38,480 --> 00:58:40,480 RIGHT NOW AND IT'S NOT A GOOD 1310 00:58:40,480 --> 00:58:42,680 BUDGET YEAR COMING UP. 1311 00:58:42,680 --> 00:58:47,840 >> AT LEAST IN SOME AREA THERE'S 1312 00:58:47,840 --> 00:58:50,480 CONNECTION MAINLY IN TERMS OF 1313 00:58:50,480 --> 00:58:56,360 DIABETES RISK FACTORS IN THE 1314 00:58:56,360 --> 00:58:56,920 FRAMINGHAM HEART STUDY. 1315 00:58:56,920 --> 00:58:59,640 >> THE FRAMINGHAM IS A DIFFERENT 1316 00:58:59,640 --> 00:59:01,240 STUDY BECAUSE THE PARTICIPANTS 1317 00:59:01,240 --> 00:59:03,240 ARE INTENSIVELY STUDIED 1318 00:59:03,240 --> 00:59:04,840 CLINICALLY AND WE'RE GETTING 1319 00:59:04,840 --> 00:59:05,760 MORE OBSERVATIONAL WORK BUT 1320 00:59:05,760 --> 00:59:07,040 YEAH, THE OPPORTUNITIES ARE 1321 00:59:07,040 --> 00:59:11,880 THERE AND THIS IS A SOLELY 1322 00:59:11,880 --> 00:59:13,800 INTRAMURAL COHORT OPPOSED TO 1323 00:59:13,800 --> 00:59:15,440 OTHER COHORTS THE NIH SUPPORTS. 1324 00:59:15,440 --> 00:59:19,320 >> CONGRATULATIONS. 1325 00:59:19,320 --> 00:59:20,360 MORE POWER TO YOU. 1326 00:59:20,360 --> 00:59:22,720 >> CHARLES FROM NCI HERE. 1327 00:59:22,720 --> 00:59:25,800 YOU SHOWED ACCELERATED AGING FOR 1328 00:59:25,800 --> 00:59:28,840 CHEMOTHERAPY FOR RADIATION AND 1329 00:59:28,840 --> 00:59:31,720 NOT CHEMOTHERAPY -- 1330 00:59:31,720 --> 00:59:33,080 >> THE OTHER WAY. 1331 00:59:33,080 --> 00:59:35,960 LESS SO IN CHEMOTHERAPY. 1332 00:59:35,960 --> 00:59:39,840 >> RIGHT. 1333 00:59:39,840 --> 00:59:41,800 WE'RE DOING THE DNA METHYLATION 1334 00:59:41,800 --> 00:59:44,360 WORK AND INTERESTED IN RADIATION 1335 00:59:44,360 --> 00:59:45,920 AND THE EFFECT ON DNA 1336 00:59:45,920 --> 00:59:48,360 METHYLATION AND AGING. 1337 00:59:48,360 --> 00:59:50,160 WHY DO YOU THINK RADIATION HAS 1338 00:59:50,160 --> 00:59:52,600 SUCH AN EFFECT AND CHEMOTHERAPY 1339 00:59:52,600 --> 00:59:52,920 DOESN'T? 1340 00:59:52,920 --> 00:59:53,760 WHAT'S DRIVING THIS? 1341 00:59:53,760 --> 00:59:56,280 >> I'M NOT REALLY SURE BUT 1342 00:59:56,280 --> 00:59:58,280 THERE'S THE POSSIBILITY OF 1343 00:59:58,280 --> 01:00:00,840 WHAT'S GOING DIRECTLY AFFECTING 1344 01:00:00,840 --> 01:00:02,720 THE CARDIOVASCULAR SYSTEM. 1345 01:00:02,720 --> 01:00:03,360 THERE'S CARDIOVASCULAR AGING IN 1346 01:00:03,360 --> 01:00:13,800 WOMEN TREATED FOR CANCER. 1347 01:00:14,760 --> 01:00:17,000 AND WE HAD IMMUNE CELL 1348 01:00:17,000 --> 01:00:17,800 POPULATIONS. 1349 01:00:17,800 --> 01:00:20,440 >> WE SHOULD TALK MORE ABOUT 1350 01:00:20,440 --> 01:00:20,640 THAT. 1351 01:00:20,640 --> 01:00:22,200 >> I LOOK FORWARD TO IT AND WE 1352 01:00:22,200 --> 01:00:23,080 TALKED ABOUT OPPORTUNITIES AT 1353 01:00:23,080 --> 01:00:23,280 LUNCH. 1354 01:00:23,280 --> 01:00:23,880 I LOOK FORWARD TO THAT. 1355 01:00:23,880 --> 01:00:29,520 >> THANK YOU. 1356 01:00:29,520 --> 01:00:32,080 >> DALE, THANK YOU FOR SUCH A 1357 01:00:32,080 --> 01:00:34,320 BEAUTIFUL AND IMPORTANT STUDY. 1358 01:00:34,320 --> 01:00:37,640 HAVE MAYBE A NAIVE QUESTION. 1359 01:00:37,640 --> 01:00:40,880 YOU'VE DESCRIBED IN NICE DETAIL 1360 01:00:40,880 --> 01:00:45,640 A LOT OF FACTORS THAT INCREASE 1361 01:00:45,640 --> 01:00:47,880 THE CHANCE OF RISK FACTOR. 1362 01:00:47,880 --> 01:00:49,880 IF A WOMAN HAS MULTIPLE 1363 01:00:49,880 --> 01:00:52,040 INDEPENDENT RISK FACTORS AND 1364 01:00:52,040 --> 01:00:53,280 DOES EVERYTHING WRONG COMPARED 1365 01:00:53,280 --> 01:00:55,920 TO HER SISTER DO THE INCIDENTS 1366 01:00:55,920 --> 01:00:59,360 CONTINUE TO GO UP OR THERE A 1367 01:00:59,360 --> 01:00:59,840 MAXIMUM? 1368 01:00:59,840 --> 01:01:01,800 >> THAT'S THE FUNDAMENTAL 1369 01:01:01,800 --> 01:01:03,680 QUESTION, RIGHT. 1370 01:01:03,680 --> 01:01:05,800 HOW CAN WE COMBINE ALL THESE 1371 01:01:05,800 --> 01:01:08,000 EXPOSURES AND COME UP WITH AN 1372 01:01:08,000 --> 01:01:09,720 INDEX OF THINGS THAT WOULD 1373 01:01:09,720 --> 01:01:11,360 ENHANCE YOUR RISK. 1374 01:01:11,360 --> 01:01:13,680 PEOPLE HAVE LOOKED AT GENE 1375 01:01:13,680 --> 01:01:15,520 ENVIRONMENT INTERACTIONS OR 1376 01:01:15,520 --> 01:01:18,920 LOOKED AT THE LARGE GENOMIC 1377 01:01:18,920 --> 01:01:20,720 STUDIES WHERE THEY'VE LOOKED AT 1378 01:01:20,720 --> 01:01:25,680 THE POLY GENIC RISK SCORES PLUS 1379 01:01:25,680 --> 01:01:26,960 BEHAVIORAL RISK CANCER BREAST 1380 01:01:26,960 --> 01:01:29,320 CANCER AND DO SHOW INCREASED 1381 01:01:29,320 --> 01:01:29,520 RISK. 1382 01:01:29,520 --> 01:01:31,920 AS THE A LONG TERM GOAL WE NEED 1383 01:01:31,920 --> 01:01:35,760 TO PUT IT TOGETHER. 1384 01:01:35,760 --> 01:01:37,840 THE EPIDEMIOLOGISTS WORK ONE WAY 1385 01:01:37,840 --> 01:01:39,080 BECAUSE THE OTHER WAY IS HARDER 1386 01:01:39,080 --> 01:01:44,600 AND WORKING ONE AT A TIME GUIDES 1387 01:01:44,600 --> 01:01:48,240 US INSTEAD OF PUTTING INTO A BIG 1388 01:01:48,240 --> 01:01:48,880 ARTIFICIAL INTELLIGENCE MACHINE 1389 01:01:48,880 --> 01:01:49,560 LEARNING PROGRAM AND SEEING WHAT 1390 01:01:49,560 --> 01:01:50,840 COMES OUT WE'LL HAVE INFORMATION 1391 01:01:50,840 --> 01:01:53,040 TO GUIDE WHAT WE WANT TO PUT 1392 01:01:53,040 --> 01:01:54,240 TOGETHER BUT I THINK WE SHOULD 1393 01:01:54,240 --> 01:01:54,880 DO THAT. 1394 01:01:54,880 --> 01:01:57,040 THANK YOU. 1395 01:01:57,040 --> 01:02:00,520 >> MAYBE ONE QUESTION ONLINE. 1396 01:02:00,520 --> 01:02:03,080 THERE'S AN EXCITING EVENT AT 1397 01:02:03,080 --> 01:02:03,280 3:30. 1398 01:02:03,280 --> 01:02:05,360 NOT ALL BEAUTY PRODUCTS ARE 1399 01:02:05,360 --> 01:02:06,960 CREATED EQUALLY. 1400 01:02:06,960 --> 01:02:10,040 HAIR DYES, STRAIGHTENERS AND 1401 01:02:10,040 --> 01:02:10,960 SOME ARE MORE NATURAL AND SAFER 1402 01:02:10,960 --> 01:02:12,360 AND THE FORMULATIONS HAVE 1403 01:02:12,360 --> 01:02:15,360 CHANGED OVER THE YEARS. 1404 01:02:15,360 --> 01:02:17,200 HOW DO YOU DIFFERENTIATE AMONG 1405 01:02:17,200 --> 01:02:17,840 THEM? 1406 01:02:17,840 --> 01:02:20,840 DO YOU KNOW THE FORMULA NAME? 1407 01:02:20,840 --> 01:02:22,360 >> THAT WOULD BE NICE. 1408 01:02:22,360 --> 01:02:23,000 THAT'S AN IMPORTANT POINT. 1409 01:02:23,000 --> 01:02:24,960 WE'RE LOOKING ON AVERAGE. 1410 01:02:24,960 --> 01:02:27,880 IN ANOTHER CITY WHICH I DON'T 1411 01:02:27,880 --> 01:02:29,360 WANT TO GIVE AWAY BECAUSE IT 1412 01:02:29,360 --> 01:02:31,400 HASN'T BEEN PEER REVIEWED WE 1413 01:02:31,400 --> 01:02:32,960 TRIED TO LOOK AT BIRTH COHORTS 1414 01:02:32,960 --> 01:02:34,120 BECAUSE THE PRODUCTS CHANGED 1415 01:02:34,120 --> 01:02:37,520 OVER TIME SO IT'S A POOR 1416 01:02:37,520 --> 01:02:39,480 SUBSTITUTION FOR WHAT'S IN THE 1417 01:02:39,480 --> 01:02:39,920 PRODUCTS. 1418 01:02:39,920 --> 01:02:41,120 WE CAN READ WHAT'S ON THE BOX 1419 01:02:41,120 --> 01:02:43,760 BUT WE'D HAVE TO GO BACK IN TIME 1420 01:02:43,760 --> 01:02:48,280 AND GET HISTORICAL AIR -- HAIR 1421 01:02:48,280 --> 01:02:49,400 PRODUCTS IT'S TRICKIER TO DO. 1422 01:02:49,400 --> 01:02:50,440 I WISH WE COULD. 1423 01:02:50,440 --> 01:02:53,480 WE RECENTLY COMPLETED OUR FOURTH 1424 01:02:53,480 --> 01:02:54,960 FOLLOW-UP AND COLLECTED MORE 1425 01:02:54,960 --> 01:02:57,440 INFORMATION BUT WE STILL WERE 1426 01:02:57,440 --> 01:02:59,960 AFRAID PEOPLE CAN'T TELL IS THE 1427 01:02:59,960 --> 01:03:01,680 PRODUCTS USED BUT GOT MORE 1428 01:03:01,680 --> 01:03:03,400 INFORMATION ABOUT PRODUCTS USED. 1429 01:03:03,400 --> 01:03:06,480 >> LET'S THANK DALE AGAIN FOR A 1430 01:03:06,480 --> 00:00:00,000 WONDERFUL MIDER LECTURE.