{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T04:34:27Z","timestamp":1774413267214,"version":"3.50.1"},"reference-count":71,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2010,2,3]],"date-time":"2010-02-03T00:00:00Z","timestamp":1265155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Recently, a population-based case-control study observed a 60% increased odds ratio (OR) for cutaneous squamous cell carcinoma (SCC) among women who had ever used oral contraceptives (OCs) compared with non users (95% confidence interval (CI) = 1.0\u20132.5). To further characterize the putative association between OC use and SCC risk, we conducted a nested case-control study using a large retrospective cohort of 111,521 Kaiser Permanente Northern California members. Multivariable conditional logistic regression was used to estimate ORs and CIs adjusting for known and hypothesized SCC risk factors. Pre-diagnostic OC use was associated with a statistically significant increased OR for SCC in univariate analysis (OR = 2.4, CI = 1.2\u20134.8), with borderline statistical significance in multivariable analysis (CI = 2.0, CI = 0.91\u20134.5). Given the high incidence of SCC in the general population and the prevalent use of OCs among women in the United States, there is a need for more large, carefully designed epidemiologic studies to determine whether the observed association between OC use and SCC can be replicated and to better understand the etiologic basis of an association if one exists.<\/jats:p>","DOI":"10.3390\/ijerph7020427","type":"journal-article","created":{"date-parts":[[2010,2,3]],"date-time":"2010-02-03T11:15:54Z","timestamp":1265195754000},"page":"427-442","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Potential Risk Factors for Cutaneous Squamous Cell Carcinoma include Oral Contraceptives: Results of a Nested Case-Control Study"],"prefix":"10.3390","volume":"7","author":[{"given":"Maryam M.","family":"Asgari","sequence":"first","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA"},{"name":"Department of Dermatology, University of California San Francisco, San Francisco, CA 94115, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4890-5111","authenticated-orcid":false,"given":"Jimmy T.","family":"Efird","sequence":"additional","affiliation":[{"name":"Center for Health of Vulnerable Populations, Office of the Dean, School of Nursing, University of North Carolina, Greensboro, NC 27402, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. Margaret","family":"Warton","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary D.","family":"Friedman","sequence":"additional","affiliation":[{"name":"Division of Research, Kaiser Permanente Northern California, Oakland, CA 94612, USA"},{"name":"Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA 94305, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2010,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1016\/0190-9622(92)70074-P","article-title":"Squamous cell carcinoma of the skin (excluding lip and oral mucosa)","volume":"26","author":"Johnson","year":"1992","journal-title":"J. Am. Acad. Dermatol"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1001\/archderm.1997.03890420073008","article-title":"Trends in the population-based incidence of squamous cell carcinoma of the skin first diagnosed between 1984 and 1992","volume":"133","author":"Gray","year":"1997","journal-title":"Arch. Dermatol"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1001\/jama.294.6.681","article-title":"Incidence of basal cell and squamous cell carcinomas in a population younger than 40 years","volume":"294","author":"Christenson","year":"2005","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2323","DOI":"10.1038\/sj.jid.5700897","article-title":"Trends in nonmelanoma skin cancer mortality rates in the United States, 1969 through 2000","volume":"127","author":"Lewis","year":"2007","journal-title":"J. Invest. Dermatol"},{"key":"ref_5","first-page":"885","article-title":"Metastatic cutaneous squamous cell carcinoma: an update","volume":"33","author":"Weinberg","year":"2007","journal-title":"Dermatol. Surg"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1067\/mjd.2003.186","article-title":"Skin cancer is among the most costly of all cancers to treat for the Medicare population","volume":"48","author":"Housman","year":"2003","journal-title":"J. Am. Acad. Dermatol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1002\/(SICI)1097-0215(19980729)77:3<347::AID-IJC7>3.0.CO;2-O","article-title":"Case-control study of sun exposure and squamous cell carcinoma of the skin","volume":"77","author":"English","year":"1998","journal-title":"Int. J. Cancer"},{"key":"ref_8","first-page":"419","article-title":"Chemical exposures, medical history, and risk of squamous and basal cell carcinoma of the skin","volume":"5","author":"Gallagher","year":"1996","journal-title":"Cancer Epidemiol. Biomarkers Prev"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1046\/j.1523-1747.2003.12246.x","article-title":"The influence of painful sunburns and lifetime sun exposure on the risk of actinic keratoses, seborrheic warts, melanocytic nevi, atypical nevi, and skin cancer","volume":"120","author":"Kennedy","year":"2003","journal-title":"J. Invest. Dermatol"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/S0190-9622(97)70137-3","article-title":"High rate of malignant transformation in hyperkeratotic actinic keratoses","volume":"37","author":"Suchniak","year":"1997","journal-title":"J. Am. Acad. Dermatol"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1056\/NEJM200103293441306","article-title":"Cutaneous squamous-cell carcinoma","volume":"344","author":"Alam","year":"2001","journal-title":"N. Engl. J. Med"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1111\/j.1540-9740.2007.06174.x","article-title":"Immunosuppression and squamous cell carcinoma: a focus on solid organ transplant recipients","volume":"6","author":"Herman","year":"2007","journal-title":"Skinmed"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s004280050327","article-title":"Sun-exposure- and aging-dependent p53 protein accumulation results in growth advantage for tumour cells in carcinogenesis of nonmelanocytic skin cancer","volume":"434","author":"Liang","year":"1999","journal-title":"Virchows. Arch"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1111\/j.1751-1097.1983.tb03385.x","article-title":"Promotional effects of ultraviolet radiation on human basal and squamous cell carcinoma","volume":"38","author":"Rundel","year":"1983","journal-title":"Photochem. Photobiol"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1158\/1055-9965.2006.13.12","article-title":"UV dose determines key characteristics of nonmelanoma skin cancer","volume":"13","author":"Ramos","year":"2004","journal-title":"Cancer Epidemiol. Biomarkers Prev"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1159\/000064535","article-title":"Photocarcinogenesis: UVA vs. UVB radiation","volume":"15","year":"2002","journal-title":"Skin Pharmacol. Appl. Skin Physiol"},{"key":"ref_17","first-page":"143","article-title":"The immune system in ultraviolet carcinogenesis","volume":"1","author":"Nishigori","year":"1996","journal-title":"J. Investig. Dermatol. Symp. Proc"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/S1011-1344(01)00198-1","article-title":"The epidemiology of UV induced skin cancer","volume":"63","author":"Armstrong","year":"2001","journal-title":"J. Photochem. Photobiol"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1097\/EDE.0b013e3181567ebe","article-title":"Squamous cell and basal cell carcinoma of the skin in relation to radiation therapy and potential modification of risk by sun exposure","volume":"18","author":"Karagas","year":"2007","journal-title":"Epidemiology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"876","DOI":"10.1086\/521031","article-title":"Cutaneous human papillomaviruses found in sun-exposed skin: Beta-papillomavirus species 2 predominates in squamous cell carcinoma","volume":"196","author":"Forslund","year":"2007","journal-title":"J. Infect. Dis"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1038\/sj.jid.5701227","article-title":"Detection of human papillomavirus DNA in cutaneous squamous cell carcinoma among immunocompetent individuals","volume":"128","author":"Asgari","year":"2007","journal-title":"J. Invest. Dermatol"},{"key":"ref_22","first-page":"157","article-title":"Occurrence of other cancers among patients with prior basal cell and squamous cell skin cancer","volume":"7","author":"Karagas","year":"1998","journal-title":"Cancer Epidemiol. Biomarkers Prev"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1093\/oxfordjournals.aje.a117358","article-title":"New primary cancers after squamous cell skin cancer","volume":"141","author":"Frisch","year":"1995","journal-title":"Am. J. Epidemiol"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/S1047-2797(01)00276-9","article-title":"Risk of subsequent cancer following invasive or in situ squamous cell skin cancer","volume":"12","author":"Efird","year":"2002","journal-title":"Ann. Epidemiol"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1001\/jama.280.10.910","article-title":"Increased cancer mortality following a history of nonmelanoma skin cancer","volume":"280","author":"Kahn","year":"1998","journal-title":"JAMA"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2760","DOI":"10.1038\/jid.2009.168","article-title":"Oral contraceptives: a risk factor for squamous cell carcinoma","volume":"129","author":"Applebaum","year":"2009","journal-title":"J. Invest. Dermatol"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1016\/0091-7435(73)90064-9","article-title":"Multiphasic checkup evaluation study. 1. Methods and population","volume":"2","author":"Cutler","year":"1973","journal-title":"Prev. Med"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/0895-4356(88)90043-1","article-title":"Sigmoidoscopy and mortality from colorectal cancer: the Kaiser Permanente Multiphasic Evaluation Study","volume":"41","author":"Selby","year":"1988","journal-title":"J. Clin. Epidemiol"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/0091-7435(73)90065-0","article-title":"Sieyears of multiphasic health checkups","volume":"2","author":"Ramcharan","year":"1973","journal-title":"Prev. Med"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/ki.1982.133","article-title":"The frequency of kidney and urinary tract diseases in a defined population","volume":"22","author":"Hiatt","year":"1982","journal-title":"Kidney Int"},{"key":"ref_31","first-page":"355","article-title":"The multitest laboratory in health care","volume":"11","author":"Collen","year":"1969","journal-title":"J. Occup. Med"},{"key":"ref_32","unstructured":"Cote, R (1993). College of American Pathologists. SNOMED International: The Systematized Nomenclature of Human and Veterinary Medicine. v.1, College of American Pathologist."},{"key":"ref_33","first-page":"1335","article-title":"Nonsteroidal anti-inflammatory drug use in the prevention and treatment of squamous cell carcinoma","volume":"30","author":"Asgari","year":"2004","journal-title":"Dermatol. Surg"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1016\/j.jaad.2005.05.049","article-title":"Nonsteroidal anti-inflammatory drugs and the risk of actinic keratoses and squamous cell cancers of the skin","volume":"53","author":"Butler","year":"2005","journal-title":"J. Am. Acad. Dermatol"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1868","DOI":"10.1038\/sj.jid.5700798","article-title":"Gene-drug interaction at the glucocorticoid receptor increases risk of squamous cell skin cancer","volume":"127","author":"Patel","year":"2007","journal-title":"J. Invest. Dermatol"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1155\/2007\/914823","article-title":"The epidemiology of human papillomavirus infection and cervical cancer","volume":"23","author":"Bosch","year":"2007","journal-title":"Dis. Markers"},{"key":"ref_37","unstructured":"Kelsey, J, Whittemore, A, Thompson, W, and Evans, A (1996). Methods in Observational Epidemiology, Oxford University Press."},{"key":"ref_38","unstructured":"Allison, P (1999). Logistic Regression Using the SAS System: Theory and Application, SAS Institute."},{"key":"ref_39","first-page":"381","article-title":"Early detection and treatment of skin cancer","volume":"62","author":"Jerant","year":"2000","journal-title":"Am Fam Physician"},{"key":"ref_40","first-page":"611","article-title":"Correlation between serum estradiol\/progesterone ratio and survival length in invasive squamous cell cervical cancer","volume":"25","author":"Hellberg","year":"2005","journal-title":"Anticancer Res"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1093\/carcin\/bgn243","article-title":"Modulation of basal and squamous cell carcinoma by endogenous estrogen in mouse models of skin cancer","volume":"30","author":"Mancuso","year":"2009","journal-title":"Carcinogenesis"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1111\/j.1471-0528.1991.tb15402.x","article-title":"Presence of an oestradiol receptor-related protein in the skin: changes during the normal menstrual cycle","volume":"98","author":"Fraser","year":"1991","journal-title":"Br. J. Obstet. Gynaecol"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"349","DOI":"10.2165\/00128071-200506060-00002","article-title":"Oral contraceptives and skin cancer","volume":"6","author":"Leslie","year":"2005","journal-title":"Am. J. Clin. Dermatol"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"9837","DOI":"10.1074\/jbc.C600001200","article-title":"Estrogen receptor-\u03b1 binds p53 tumor suppressor protein directly and represses its function","volume":"281","author":"Liu","year":"2006","journal-title":"J. Biol. Chem"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1046\/j.1523-1747.1998.00090.x","article-title":"Induction of squamous cell carcinoma in p53-deficient mice after ultraviolet irradiation","volume":"110","author":"Li","year":"1998","journal-title":"J. Invest. Dermatol"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/1523-1747.ep12412256","article-title":"Genetic alternations in non-melanoma skin cancer","volume":"103","author":"Rees","year":"1994","journal-title":"J. Invest. Dermatol"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"4216","DOI":"10.1073\/pnas.90.9.4216","article-title":"Mutation hotspots due to sunlight in the p53 gene of nonmelanoma skin cnacers","volume":"90","author":"Ziegler","year":"1993","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.virol.2007.10.015","article-title":"Comparative transforming potential of different human papillomaviruses associated with non-melanoma skin cancer","volume":"371","author":"Massimi","year":"2008","journal-title":"Virology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1093\/jnci\/djj092","article-title":"Human papillomavirus infection and incidence of squamous cell and basas cell carcinomas of the skin","volume":"98","author":"Karagas","year":"2006","journal-title":"J. Natl. Cancer Inst"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"890","DOI":"10.1001\/archderm.139.7.890","article-title":"Evidence for the association of human papillomavirus infection and cutaneous squamous cell carcinoma in immunocompetent individuals","volume":"139","author":"Masini","year":"2003","journal-title":"Arch. Dermatol"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/0190-9622(90)70299-W","article-title":"Occurrence of human papillomavirus type 16 DNA in cutaneous squamous and basal cell neoplasms","volume":"23","author":"Eliezri","year":"1990","journal-title":"J. Am. Acad. Dermatol"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"802","DOI":"10.1093\/jnci\/88.12.802","article-title":"Human papillomavirus infections in nonmelanoma skin cancers from renal transplant recipients and nonimmunosuppressed patients","volume":"88","author":"Shamanin","year":"1996","journal-title":"J. Natl. Cancer Inst"},{"key":"ref_53","first-page":"3041","article-title":"The biological role of smoking, oral contraceptive use and endogenous sexual steroid hormones in invasive squamous epithelial cervical cancer","volume":"25","author":"Hellberg","year":"2005","journal-title":"Anticancer Res"},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"The International Collaboration of Epidemiological Studies of Cervical Cancer (2006). Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int. J. Cancer, 120, 885\u201391.","DOI":"10.1002\/ijc.22357"},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"The International Collaboration of Epidemiological Studies of Cervical Cancer, Appleby, P, Beral, V, Berrington de Gonz\u00e1lez, A, Colin, D, Franceschi, S, Goodhill, A, Green, J, Peto, J, Plummer, M, and Sweetland, S (2007). Cervical cancer and hormonal contraceptives: collaborative reanalysis of individual data for 16,573 women with cervical cancer and 35,509 women without cervical cancer from 24 epidemiological studies. Lancet, 370, 1609\u201321.","DOI":"10.1016\/S0140-6736(07)61684-5"},{"key":"ref_56","unstructured":"National Cancer Institute (NCI)."},{"key":"ref_57","unstructured":"Gordon, N (2006). How Does the Adult Kaiser Permanente Membership in Northern California Compare with the Larger Community?, Kaiser Permanente Division of Research."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"703","DOI":"10.2105\/AJPH.82.5.703","article-title":"Overcoming the absence of socioeconomic data in medical records","volume":"82","author":"Krieger","year":"1992","journal-title":"Am. J. Public Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"895","DOI":"10.1007\/s10552-007-9034-4","article-title":"Occupation and keratinocyte cancer risk: a population-based case-control study","volume":"18","author":"Marehbian","year":"2007","journal-title":"Cancer Causes Control"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1136\/oem.2005.025825","article-title":"Occupational exposure to eight organic dusts and respiratory cancer among Finns","volume":"63","author":"Laakkonen","year":"2006","journal-title":"Occup. Environ. Med"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1136\/oem.2006.028316","article-title":"Organic dusts and respiratory cancer: a complex issue","volume":"63","author":"Rushton","year":"2006","journal-title":"Occup. Environ. Med"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1524","DOI":"10.1001\/archderm.136.12.1524","article-title":"Risk of developing a subsequent nonmelanoma skin cancer in patients with a history of nonmelanoma skin cancer: a critical review of the literature and meta-analysis","volume":"136","author":"Marcil","year":"2000","journal-title":"Arch. Dermatol"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1002\/(SICI)1097-0215(19980529)76:5<628::AID-IJC3>3.0.CO;2-S","article-title":"Demographic characteristics, pigmentary and cutaneous risk factors for squamous cell carcinoma of the skin: a case-control study","volume":"76","author":"English","year":"1998","journal-title":"Int. J. Cancer"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"2097","DOI":"10.1001\/jama.1989.03430150065027","article-title":"The emerging epidemic of melanoma and squamous cell skin cancer","volume":"262","author":"Glass","year":"1989","journal-title":"JAMA"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1200\/JCO.2001.19.1.231","article-title":"Relation between smoking and skin cancer","volume":"19","author":"Wensveen","year":"2001","journal-title":"J. Clin. Oncol"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1007\/s10227-005-0020-8","article-title":"Cutaneous effects of smoking","volume":"8","author":"Freiman","year":"2004","journal-title":"J. Cutan. Med. Surg"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/j.1742-1241.1998.tb11592.x","article-title":"A comparison of risk factors for malignant melanoma, squamous cell carcinoma and basal cell carcinoma in the UK","volume":"52","author":"Lear","year":"1998","journal-title":"Int. J. Clin. Pract"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1093\/jnci\/87.14.1061","article-title":"A prospective study of incident squamous cell carcinoma of the skin in the nurses\u2019 health study","volume":"87","author":"Grodstein","year":"1995","journal-title":"J. Natl. Cancer Inst"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1326","DOI":"10.1038\/sj.bjc.6602475","article-title":"Tobacco smoking, snuff dipping and the risk of cutaneous squamous cell carcinoma: a nationwide cohort study in Sweden","volume":"92","author":"Odenbro","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_70","first-page":"796","article-title":"Level of education and the risk of cancer in Sweden","volume":"12","author":"Hemminki","year":"2003","journal-title":"Cancer Epidemiol. Biomarkers Prev"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"692","DOI":"10.1002\/ijc.11150","article-title":"Socioeconomic factors in cancer in Sweden","volume":"105","author":"Hemminki","year":"2003","journal-title":"Int. J. Cancer"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/7\/2\/427\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T22:01:24Z","timestamp":1760220084000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/7\/2\/427"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,2,3]]},"references-count":71,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,2]]}},"alternative-id":["ijerph7020427"],"URL":"https:\/\/doi.org\/10.3390\/ijerph7020427","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,2,3]]}}}