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. Table 5. Observed number of lip cancer among women 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 [1.17] 0.00 4 1.33 [0.02] 0.00 1 1.63 6 1.08 11 1.06 0.53*1.90 2 Laboratory assistants [0.82] 0.00 1 0.54 [0.03] 0.00 [0.77] 0.00 1 0.64 2 0.40 0.05*1.44 3 Physicians [0.41] 0.00 1 1.49 [0.00] 0.00 [0.31] 0.00 1 0.79 2 0.75 0.09*2.72 4 Dentists [0.35] 0.00 [1.17] 0.00 [0.00] 0.00 [0.26] 0.00 1 1.00 1 0.36 0.01*2.00 5 Nurses 6 0.83 12 1.28 [0.13] 0.00 5 0.83 21 1.24 44 1.11 0.81*1.49 6 Assistant nurses 12 2.44 11 0.96 [0.18] 0.00 7 1.17 34 1.17 64 1.24 0.95*1.58 7 ‘‘Other health workers’’ 2 0.48 7 0.82 [0.04] 0.00 8 1.35 18 1.82 35 1.23 0.86*1.71 8 Teachers 15 1.68 14 0.70 [0.22] 0.00 7 0.62 36 0.95 72 0.92 0.72*1.16 9 Religious workers etc 1 0.83 5 0.77 [0.03] 0.00 3 1.05 8 0.64 17 0.74 0.43*1.18 10 Artistic workers 1 1.53 [1.41] 0.00 [0.03] 0.00 [0.86] 0.00 2 0.83 3 0.56 0.12*1.64 11 Journalists [0.13] 0.00 1 1.01 [0.01] 0.00 [0.23] 0.00 2 1.79 3 1.22 0.25*3.55 12 Administrators 2 0.53 5 1.58 1 38.52 1 0.35 6 1.08 15 0.97 0.54*1.60 13 Clerical workers 34 0.97 46 0.76 [0.68] 0.00 24 0.68 108 1.17 212 0.94 0.83*1.08 14 Sales agents 2 5.96 9 0.81 [0.08] 0.00 6 1.14 12 0.89 29 0.96 0.64*1.38 15 Shop workers 20 0.81 31 0.80 [0.48] 0.00 36 1.19 59 1.02 146 0.96 0.81*1.13 16 Farmers 7 0.39 40 1.25 [0.40] 0.00 21 0.96 [5.37] 0.00 68 0.88 0.68*1.12 17 Gardeners 2 0.88 102 1.18 [0.01] 0.00 16 1.24 16 1.07 136 1.17 0.99*1.38 18 Fishermen [0.09] 0.00 [0.17] 0.00 [0.01] 0.00 1 6.40 [0.05] 0.00 1 2.09 0.05*11.65 19 Forestry workers [0.02] 0.00 [0.31] 0.00 [0.00] 0.00 [0.23] 0.00 [0.33] 0.00 [0.90] 0.00 0.00*4.12 20 Miners and quarry workers [0.00] 0.00 [0.15] 0.00 [0.00] 0.00 [0.01] 0.00 [0.08] 0.00 [0.24] 0.00 0.00*15.42 21 Seamen [0.02] 0.00 [0.04] 0.00 [0.01] 0.00 [0.07] 0.00 0.00*55.30 22 Transport workers [0.02] 0.00 1 0.45 [0.02] 0.00 [0.16] 0.00 3 3.33 4 1.20 0.33*3.06 23 Drivers 1 1.67 [0.77] 0.00 [0.01] 0.00 [0.61] 0.00 3 1.36 4 0.95 0.26*2.44 24 Postal workers 2 1.55 6 0.49 [0.16] 0.00 12 1.74 16 0.99 36 0.98 0.68*1.35 25 Textile workers 5 0.62 29 1.00 [0.34] 0.00 7 0.61 38 1.11 79 0.95 0.76*1.19 26 Shoe and leather workers [0.58] 0.00 3 0.85 [0.02] 0.00 [0.80] 0.00 [2.58] 0.00 3 0.40 0.08*1.17 27 Smelting workers [0.14] 0.00 [0.85] 0.00 [0.00] 0.00 [0.09] 0.00 [0.68] 0.00 [1.75] 0.00 0.00*2.10 28 Mechanics 1 0.74 3 0.90 [0.00] 0.00 [0.96] 0.00 4 0.58 8 0.64 0.28*1.26 29 Plumbers [0.02] 0.00 [0.01] 0.00 [0.01] 0.00 [0.01] 0.00 [0.04] 0.00 0.00*93.16 30 Welders [0.21] 0.00 [0.00] 0.00 [0.07] 0.00 [0.26] 0.00 [0.54] 0.00 0.00*6.86 31 Electrical workers 1 0.53 2 1.20 [0.00] 0.00 2 1.96 2 0.52 7 0.83 0.34*1.72 32 Wood workers [0.64] 0.00 8 1.05 [0.00] 0.00 [0.35] 0.00 2 1.75 10 1.03 0.49*1.89 33 Painters [0.02] 0.00 2 2.41 [0.00] 0.00 [0.08] 0.00 [0.31] 0.00 2 1.61 0.20*5.82 34 ‘‘Other construction workers’’ [0.02] 0.00 6 1.79 [0.00] 0.00 [0.03] 0.00 [0.04] 0.00 6 1.74 0.64*3.79 35 Bricklayers [0.00] 0.00 [0.10] 0.00 [0.00] 0.00 [0.00] 0.00 [0.11] 0.00 0.00*34.41 36 Printers 1 1.38 3 0.88 [0.03] 0.00 2 2.12 4 1.39 10 1.25 0.60*2.31 37 Chemical process workers [1.16] 0.00 4 2.15 [0.01] 0.00 2 2.38 1 0.43 7 1.13 0.45*2.33 38 Food workers 4 0.70 9 0.89 1 1.58 10 1.80 8 1.14 32 1.10 0.75*1.56 39 Beverage workers [0.51] 0.00 [0.59] 0.00 [0.00] 0.00 [0.05] 0.00 1 2.27 1 0.63 0.02*3.49 40 Tobacco workers 2 2.81 [0.34] 0.00 [0.19] 0.00 [0.27] 0.00 2 1.33 0.16*4.80 41 Glass makers etc [1.35] 0.00 8 1.20 [0.02] 0.00 3 1.67 10 1.63 21 1.31 0.81*2.01 42 Packers 1 2.52 16 1.34 [0.07] 0.00 5 1.15 6 0.65 28 1.07 0.71*1.55 43 Engine operators [0.01] 0.00 5 2.76 [0.00] 0.00 [0.06] 0.00 1 1.76 6 2.45 0.90*5.33 44 Public safety workers [0.04] 0.00 1 2.45 [0.01] 0.00 [0.58] 0.00 1 1.33 2 1.11 0.13*4.02 45 Cooks and stewards [0.02] 0.00 13 0.96 [0.26] 0.00 7 1.09 8 0.58 28 0.82 0.55*1.19 46 Domestic assistants 18 1.96 16 1.24 [0.08] 0.00 20 1.22 37 1.04 91 1.23 0.99*1.51 47 Waiters 2 1.37 2 0.19 [0.02] 0.00 7 1.05 15 1.05 26 0.79 0.52*1.16 48 Building caretakers 30 1.14 59 1.22 [0.51] 0.00 21 0.73 45 1.23 155 1.10 0.94*1.29 49 Chimney sweeps [0.00] 0.00 [0.02] 0.00 [0.00] 0.00 [0.00] 0.00 [0.03] 0.00 0.00*125.55 50 Hairdressers 1 0.62 2 0.52 [0.02] 0.00 [1.70] 0.00 6 1.01 9 0.69 0.31*1.30 51 Launderers 2 0.67 3 0.72 [0.08] 0.00 3 1.20 5 0.67 13 0.75 0.40*1.29 52 Military personnel [0.01] 0.00 [0.02] 0.00 [0.01] 0.00 [0.02] 0.00 [0.06] 0.00 0.00*59.73 53 ‘‘Other workers’’ 11 1.48 13 0.93 [0.47] 0.00 13 0.88 20 1.23 57 1.08 0.81*1.39 54 Economically inactive 208 1.01 365 1.01 5 2.71 204 1.04 718 0.96 1 500 0.99 0.94*1.04 1 54 All categories 394 1.00 868 1.00 7 1.00 454 1.00 1 285 1.00 3 008 1.00 Ref. Obs observed number of cases; SIR standardised incidence ratio; 95% CI 95% confidence interval. Occupation and cancer in Nordic countries 661
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 662 E. Pukkala et al. men. A small increase has been seen during the period. Consistently high SIRs for men were observed among waiters (SIR 4.43, 3.18 6.01), beverage manufacturing workers, cooks and stewards, hairdressers, and artistic workers (Table 6). The Nordic combined SIR was elevated for journalists, based on elevations in Finland, Norway and Sweden. Seamen had elevated risks in Denmark and Norway. Low SIRs were observed among male farmers (0.51, 0.45 0.57), gardeners, forestry workers, teachers and fishermen. High SIRs among women were seen in artistic workers (driven by 4 cases in Denmark) and waiters (Table 7). Clerical workers also had a significant excess, driven by Sweden and Denmark. In Sweden there were seven cases of tongue cancer among chemical process workers (which was not observed among males). Consistently low SIRs were observed among nurses (0.69, 0.49 0.95) and launderers and dry cleaning workers (0.50, 0.24 0.93). Comment. Both tobacco and alcohol are established risk factors, while the consumption of fruit and/or vegetables has frequently been seen to reduce risk [50]. Infection with human papilloma virus entails an increased risk. There are no established occupational risk factors for cancer of the tongue, although it cannot be excluded that exposure to inhaled organic or inorganic dust may play a role. The high risk groups identified in the present study are mostly groups where smoking and drinking prevalence also has been shown to be high.. For male hairdressers and female chemical process workers, it is possible that occupational exposures contribute to risk. / 100 000 2 1.5 1 .5 Denmark Finland Iceland Norway Sweden Men 0 1945 1960 1975 1990 2005 / 100 000 Cancer of the salivary glands Cancer in the salivary glands, mainly seen in the parotid gland, is rare. The rates have been stable through the period both among men and women, with the exception of higher rates seen among Danish men and women during the 1960s (Figure 14). At the combined Nordic level no male occupation had a significantly elevated risk. At the national level, physicians in Norway (SIR 2.91, 95% CI 1.26 5.73) and dentists in Denmark (4.61, 1.26 11.81) had high SIRs. Forestry workers, wood workers, and smelter and metal foundry workers all had low risks (Table 8). Among women, clerical workers had a combined SIR of 1.14 (1.02 1.28), driven by the large number of cases in Sweden. Consistently low SIRs were seen in the group of other health and medical workers (Table 9). Comment. Therapeutic and diagnostic radiation and UV radiation to the head and neck are established risk factors for cancer of the salivary glands [50]. Alcohol, tobacco, and viral infections play a minor role, if any. The observed occupational variations in risk are most probably due to chance. Cancer of the oral cavity In both men and women, cancer of the mouth has increased by approximately 50% in Finland, Norway and Sweden, and with 200% in Denmark (Figure 15). Among men, elevated risks were seen for waiters (SIR 5.05, 95% CI 3.91 6.41), cooks and stewards, seamen, journalists and artistic workers. Low risks were observed for farmers (0.55, 0.50 0.60), gardeners, teachers and forestry workers (Table 10). 2 1.5 1 .5 Denmark Finland Iceland Norway Sweden Women 0 1945 1960 1975 1990 2005 Figure 14. Age standardised (World) incidence rates for cancer of the salivary glands 1943 2005, by country and gender. Modified from NORDCAN [49].
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