Occupation and cancer - European Trade Union Institute (ETUI)

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Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. was among the public safety workers (1.64, 1.10 2.34), but Swedish artistic workers and building caretakers also had a significant, about twofold, excess of liposarcoma. In women (1 076 cases) there were no significant SIRs for liposarcoma in any occupational category in any country. Comment. Soft tissue sarcoma is a rare disease of the mesenchymal tissue other than bone and cartilage [134]. Epidemiological studies have suffered from problems of misclassification of histology, since the histopathological classification of this cancer in cancer registries is often inconsistent and pathologists frequently disagree on histologic subtypes. Previous studies have indicated that exposure to phenoxy herbicides, dioxins, and pesticides may be associated with an increased risk, but these studies are rather inconsistent [134]. Exposure to vinyl chloride has been suggested as being associated with the development of soft tissue sarcoma. Exposure to radiation as therapy is a well-established cause of secondary soft tissue sarcoma, while tobacco use, exogenous hormonal factors and diet have only been inconsistently associated with risk. Non-Hodgkin lymphoma Up to the 1990s, the incidence of non-Hodgkin lymphoma increased in all Nordic countries more rapidly than that of any other form of cancer (Figure 45). After that the increase has stopped [135]. Incidence in men is higher than in women in all countries, and Finland has the highest level. Variation in the incidence of non-Hodgkin lymphoma over occupational categories was small / 100 000 15 10 5 0 Denmark Finland Iceland Norway Sweden Men 1945 1960 1975 1990 2005 / 100 000 (Tables 68, 69). Male physicians had the highest significant SIR (1.22, 95% CI 1.08 1.39) and forestry workers the lowest one (0.86, 0.80 0.93). Among women, plumbers had the highest risk of Non-Hodgkin lymphoma (5.39, 1.11 15.76), however based on three cases only. Postal workers had the lowest significant SIR (0.89, 0.81 0.98). Comment. Known risk factors for non-Hodgkin lymphoma include immunosuppression, autoimmunity, HIV infection, and some specific viruses, but they explain only a small fraction of the cases [136]. Other possible risk associations with food products, medications, pesticides and hair dyes have been investigated, but the results are inconsistent [137]. Some carcinogenic substances found in working places may be associated with the development of non-Hodgkin lymphoma. These include 2,3, 7,8-Tetrachlorodibenzopara-dioxin (TCDD), nonarsenical insecticides, Tetrachloroethylene, and Trichloroethylene. These exposures are not easily identified in the occupational categories used here. Occupations such as hairdressers or barbers have also been associated with the development on non- Hodgkin lymphoma in some studies [87,103]. In the present study, the SIR among female hairdressers was 1.00, and among male hair dressers 0.99. An about 20% excess among both male and female physicians might indicate that accurate diagnostics of non-Hodgkin lymphoma is sometimes challenging. The rapidly changing classifications also made it difficult to find subcategories of non-Hodgkin lymphoma that would have been comparable over decades and countries, although there may well be work-related factors that are only relevant in some of the numerous sub-types of non-Hodgkin lymphoma. 15 10 5 0 Occupation and cancer in Nordic countries 749 Denmark Finland Iceland Norway Sweden Women 1945 1960 1975 1990 2005 Figure 45. Age standardised (World) incidence rates for non-Hodgkin lymphoma 1943 2005, by country and gender. Modified from NORDCAN [49].
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 750 E. Pukkala et al. Table 68. Observed number of non-Hodgkin lymphoma among men in the Nordic countries and standardised incidence ratios 1961 2005, by country and occupational category. Denmark Finland Iceland Norway Sweden Total No Occupational category Obs SIR Obs SIR Obs SIR Obs SIR Obs SIR Obs SIR 95% CI 1 Technical workers, etc 422 1.04 598 1.08 10 1.61 332 1.11 1 958 1.04 3 320 1.05 1.02*1.09 2 Laboratory assistants 5 0.63 12 0.86 1 0.84 12 0.92 6 0.54 36 0.76 0.53*1.05 3 Physicians 40 1.21 36 1.12 4 1.78 47 1.32 107 1.21 234 1.22 1.08*1.39 4 Dentists 11 1.12 7 1.07 1 1.67 15 0.99 36 0.86 70 0.94 0.74*1.19 5 Nurses [0.47] 0.00 3 1.35 [0.03] 0.00 4 1.61 9 1.38 16 1.36 0.78*2.21 6 Assistant nurses 5 0.51 4 1.87 [0.37] 0.00 4 0.72 29 0.92 42 0.85 0.61*1.15 7 ‘‘Other health workers’’ 31 1.09 32 1.07 [0.64] 0.00 13 0.97 62 0.86 138 0.95 0.81*1.13 8 Teachers 187 1.05 248 1.11 17 1.98 207 0.99 518 1.03 1 177 1.05 0.99*1.11 9 Religious workers etc 75 1.03 108 0.84 7 1.24 106 1.05 398 1.02 694 0.99 0.92*1.07 10 Artistic workers 19 0.84 46 1.06 2 1.32 23 0.81 125 1.09 215 1.02 0.89*1.16 11 Journalists 10 0.93 19 0.91 1 1.11 22 1.69 45 0.84 97 0.98 0.79*1.19 12 Administrators 451 1.01 370 1.12 17 1.30 367 1.09 704 1.02 1 909 1.05 1.01*1.10 13 Clerical workers 189 0.96 223 1.06 13 0.85 252 1.01 755 1.00 1 432 1.00 0.95*1.06 14 Sales agents 93 0.89 318 1.03 10 1.31 296 1.07 1 118 1.02 1 835 1.02 0.98*1.07 15 Shop workers 448 1.01 135 0.98 5 0.88 129 1.08 368 1.03 1 085 1.02 0.96*1.08 16 Farmers 770 0.91 1 298 0.98 24 1.11 689 1.06 1 712 1.01 4 493 0.99 0.96*1.02 17 Gardeners 113 0.94 200 0.98 [0.72] 0.00 142 0.83 595 0.92 1 050 0.92 0.86*0.97 18 Fishermen 45 1.09 18 1.02 14 0.89 206 0.95 65 0.95 348 0.97 0.87*1.07 19 Forestry workers 19 1.09 179 0.75 [0.14] 0.00 110 0.92 422 0.90 730 0.86 0.80*0.93 20 Miners and quarry workers 4 0.75 52 1.34 [0.25] 0.00 34 0.89 133 1.12 223 1.11 0.97*1.26 21 Seamen 38 0.84 46 0.87 8 2.06 170 0.82 105 0.98 367 0.88 0.80*0.98 22 Transport workers 85 0.88 169 1.11 4 0.58 99 0.97 354 0.95 711 0.98 0.91*1.05 23 Drivers 323 1.02 507 0.99 10 0.91 317 1.05 993 1.08 2 150 1.04 1.00*1.09 24 Postal workers 62 0.99 92 1.20 1 0.77 66 1.22 229 1.15 450 1.14 1.04*1.25 25 Textile workers 45 0.82 48 1.00 2 0.89 60 1.09 212 1.02 367 1.00 0.90*1.11 26 Shoe and leather workers 9 0.67 21 1.02 [0.47] 0.00 17 0.80 74 0.94 121 0.90 0.75*1.08 27 Smelting workers 123 0.98 79 1.06 3 0.90 68 0.87 300 0.89 573 0.93 0.86*1.01 28 Mechanics 349 1.04 498 0.98 12 1.06 398 0.94 1 628 0.97 2 885 0.98 0.94*1.01 29 Plumbers 37 1.21 88 1.03 [1.76] 0.00 41 0.81 193 1.01 359 1.00 0.90*1.11 30 Welders 74 0.85 [0.72] 0.00 45 0.74 222 0.98 341 0.91 0.82*1.01 31 Electrical workers 79 0.97 217 0.97 6 0.85 180 0.95 599 1.02 1 081 0.99 0.93*1.05 32 Wood workers 235 1.02 450 0.90 3 0.50 425 0.96 1 057 1.01 2 170 0.97 0.93*1.02 33 Painters 77 1.01 85 0.78 4 1.63 77 1.06 318 1.03 561 0.99 0.91*1.07 34 ‘‘Other construction workers’’ 272 0.96 295 0.91 11 0.85 84 0.91 527 0.94 1 189 0.93 0.88*0.99 35 Bricklayers 84 1.00 51 0.97 33 0.77 143 1.05 311 0.99 0.88*1.10 36 Printers 55 1.02 50 0.93 3 1.44 46 0.94 172 0.98 326 0.98 0.88*1.09 37 Chemical process workers 45 0.93 90 1.06 [1.07] 0.00 101 1.09 239 0.96 475 0.99 0.91*1.09 38 Food workers 163 1.03 50 0.82 12 1.30 99 0.90 268 1.03 592 0.99 0.91*1.07 39 Beverage workers 20 1.05 4 1.03 [0.15] 0.00 4 2.00 11 0.79 39 1.00 0.71*1.36 40 Tobacco workers 4 1.31 1 1.39 [0.01] 0.00 3 2.01 2 1.65 10 1.54 0.74*2.83 41 Glass makers etc 74 0.80 90 1.01 2 1.20 56 0.96 243 0.85 465 0.88 0.81*0.97 42 Packers 79 0.97 187 1.05 8 1.50 183 1.13 502 1.01 959 1.04 0.98*1.11 43 Engine operators 84 0.99 275 1.08 4 0.52 124 1.11 435 0.98 922 1.02 0.96*1.09 44 Public safety workers 86 1.09 154 1.08 5 1.00 84 1.13 268 1.01 597 1.05 0.97*1.14 45 Cooks and stewards 4 0.64 7 0.69 1 0.38 30 0.81 46 0.92 88 0.83 0.67*1.03 46 Domestic assistants [0.07] 0.00 [0.55] 0.00 [0.01] 0.00 1 2.45 3 0.58 4 0.65 0.18*1.65 47 Waiters 14 1.09 13 1.31 [0.31] 0.00 17 1.15 25 0.98 69 1.09 0.84*1.37 48 Building caretakers 101 1.23 112 0.96 4 2.02 53 1.37 198 1.00 468 1.07 0.98*1.17 49 Chimney sweeps 2 0.91 7 0.83 2 0.52 11 0.73 22 0.75 0.47*1.13 50 Hairdressers 28 1.19 4 1.64 [0.37] 0.00 14 1.33 49 0.98 95 1.09 0.88*1.33 51 Launderers 15 1.30 [2.52] 0.00 [0.19] 0.00 5 0.81 34 0.94 54 0.96 0.72*1.25 52 Military personnel 46 1.09 55 1.08 78 1.12 164 1.03 343 1.06 0.96*1.18 53 ‘‘Other workers’’ 269 1.06 112 0.82 15 0.74 290 0.99 606 1.01 1 292 0.99 0.94*1.04 54 Economically inactive 285 1.22 721 1.08 9 0.60 111 0.73 935 1.00 2 061 1.03 0.99*1.08 1 54 All categories 6 129 1.00 8 558 1.00 253 1.00 6 391 1.00 20 330 1.00 41 661 1.00 Ref. Obs observed number of cases; SIR standardised incidence ratio; 95% CI 95% confidence interval.
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