title: Epidemiology and Environmental Risk Factors Associated with Vestibular Schwannoma.
abstract: OBJECTIVE
  Vestibular schwannomas (VS) are tumors originating from the eighth cranial nerve. The etiology and environmental risk factors for VS remain unclear. The goal of this study was to explore some potential environmental risk factors associated with vestibular schwannoma (VS).
  
  
  METHODS
  A hospital-based case-control study with 1:1 matching based on age and sex was designed. A written questionnaire was administered. Multiple conditional logistic regression models were created to determine odds ratio (OR).
  
  
  RESULTS
  There were 353 matched pairs with an average age at diagnosis of 53 years (SD ± 12), 50% of participants were female, and >90% were white. Multivariate models revealed significantly increased OR with a history of hay fever (OR = 3.91, 95% confidence interval [CI] = 1.35-11.30) and managerial/professional occupations (OR = 4.41, 95% CI = 2.07-9.40). Tobacco use had a decreased association with VS (<20 pack-years OR = 0.10, 95% CI = 0.04-0.28; ≥ 20 pack-years OR = 0.03, 95% CI = 0.01-0.12).
  
  
  CONCLUSIONS
  The profile of patients with VS includes white race, age 50-60 years, either sex, and working in a professional occupation. Better access to health care and diagnostic imaging likely plays a role in the diagnosis of this tumor. Hay fever is strongly associated with VS. Tobacco use demonstrates an inverse relationship with VS, but the possible biologic mechanism for this is poorly understood, and tobacco remains a significant public health problem.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA. Electronic address: orenberk@bu.edu.
authors.forename: Oren
authors.initials: O
authors.lastname: Berkowitz
authors.affiliation: Department of Neurosurgery, Stanford School of Medicine, Stanford, California, USA.
authors.forename: Aditya K
authors.initials: AK
authors.lastname: Iyer
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kano
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Evelyn O
authors.initials: EO
authors.lastname: Talbott
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: L Dade
authors.initials: LD
authors.lastname: Lunsford
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000453:epidemiology* / Q000209:etiology* / Q000517:prevention & control; D019635:Neurosurgical Procedures / Q000379:methods*; D016017:Odds Ratio; D010414:Pennsylvania / Q000453:epidemiology; D016634:Radiosurgery; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Acoustic neuroma; Cranial nerve neoplasm; Epidemiology; Neurosurgery; Radiosurgery