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 42. Observed number of cancer of the corpus uteri 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 54 1.10 100 1.11 [1.12] 0.00 29 1.23 188 1.04 371 1.07 0.97*1.19 2 Laboratory assistants 31 0.88 57 1.04 1 0.57 35 1.24 44 0.89 168 0.99 0.85*1.15 3 Physicians 24 1.44 25 1.13 [0.29] 0.00 17 1.50 44 1.06 110 1.19 0.99*1.44 4 Dentists 15 1.02 44 1.85 [0.13] 0.00 9 0.97 30 0.95 98 1.24 1.00*1.51 5 Nurses 326 1.14 315 1.14 7 0.84 210 0.94 587 1.09 1 445 1.08 1.03*1.14 6 Assistant nurses 178 0.85 258 0.89 8 0.74 229 1.03 915 0.95 1 588 0.93 0.89*0.98 7 ‘‘Other health workers’’ 215 1.29 263 1.18 2 0.86 219 1.01 288 0.90 987 1.06 1.00*1.13 8 Teachers 414 1.14 607 1.21 15 1.03 457 1.10 1 295 1.06 2 788 1.11 1.07*1.15 9 Religious workers etc 61 1.23 278 1.22 5 2.29 132 1.29 433 1.12 909 1.18 1.10*1.26 10 Artistic workers 30 1.21 50 1.29 5 2.74 31 1.03 96 1.23 212 1.22 1.07*1.40 11 Journalists 8 1.48 36 1.40 [0.49] 0.00 9 1.06 41 1.13 94 1.23 0.99*1.51 12 Administrators 179 1.18 105 1.29 4 2.69 116 1.20 181 1.06 585 1.17 1.08*1.27 13 Clerical workers 1 762 1.18 1 824 1.13 36 0.82 1 429 1.09 3 353 1.08 8 404 1.11 1.09*1.13 14 Sales agents 19 1.39 244 1.07 3 0.62 183 1.13 406 1.02 855 1.06 0.99*1.13 15 Shop workers 1 041 1.03 846 0.94 34 1.20 1 039 0.99 1 895 1.02 4 855 1.00 0.97*1.03 16 Farmers 614 0.85 425 0.91 19 0.91 645 1.01 157 1.03 1 860 0.93 0.89*0.98 17 Gardeners 81 0.86 1 427 0.94 2 2.90 349 0.90 506 1.04 2 365 0.95 0.91*0.99 18 Fishermen 2 0.55 5 1.56 1 1.35 3 0.56 [1.50] 0.00 11 0.76 0.38*1.36 19 Forestry workers 2 2.09 1 0.15 [0.10] 0.00 11 1.41 11 1.04 25 0.96 0.62*1.42 20 Miners and quarry workers [0.04] 0.00 1 0.36 [0.02] 0.00 [0.44] 0.00 1 0.38 2 0.34 0.04*1.22 21 Seamen [0.84] 0.00 [0.00] 0.00 [1.29] 0.00 [0.28] 0.00 [2.42] 0.00 0.00*1.53 22 Transport workers 1 1.00 52 1.23 1 1.33 10 1.63 33 1.14 97 1.22 0.99*1.49 23 Drivers 17 0.68 15 0.75 2 5.47 13 0.60 52 0.68 99 0.69 0.56*0.84 24 Postal workers 61 1.15 265 1.01 5 0.51 247 1.00 614 1.13 1 192 1.07 1.01*1.13 25 Textile workers 314 0.93 585 1.01 16 0.94 339 0.94 1 025 1.00 2 279 0.98 0.94*1.02 26 Shoe and leather workers 28 1.12 80 1.09 [0.89] 0.00 25 0.94 91 1.13 224 1.09 0.95*1.24 27 Smelting workers 9 1.51 19 1.10 [0.05] 0.00 1 0.29 21 0.88 50 0.99 0.73*1.30 28 Mechanics 58 0.97 63 0.82 [0.17] 0.00 24 0.69 220 0.94 365 0.90 0.81*1.00 29 Plumbers [0.56] 0.00 [0.17] 0.00 1 3.61 [0.32] 0.00 1 0.76 0.02*4.21 30 Welders 5 0.83 [0.01] 0.00 1 0.35 10 1.12 16 0.90 0.51*1.45 31 Electrical workers 87 1.04 37 0.74 [0.14] 0.00 35 0.91 115 0.89 274 0.91 0.81*1.02 32 Wood workers 32 1.13 140 0.93 [0.29] 0.00 16 1.25 36 0.93 224 0.97 0.85*1.11 33 Painters [1.00] 0.00 17 0.93 [0.07] 0.00 6 2.09 8 0.78 31 0.96 0.65*1.36 34 ‘‘Other construction workers’’ [0.78] 0.00 53 0.91 [0.04] 0.00 3 2.79 [1.22] 0.00 56 0.91 0.69*1.18 35 Bricklayers [0.17] 0.00 1 0.48 [0.07] 0.00 [0.04] 0.00 1 0.43 0.01*2.38 36 Printers 27 0.87 63 0.85 1 0.71 33 1.01 99 1.04 223 0.95 0.83*1.08 37 Chemical process workers 38 0.77 25 0.65 1 1.54 24 0.82 82 1.09 170 0.88 0.76*1.03 38 Food workers 211 0.86 206 1.04 20 0.57 152 0.85 206 0.96 795 0.91 0.85*0.97 39 Beverage workers 14 0.63 8 0.72 [0.09] 0.00 3 1.76 8 0.60 33 0.68 0.47*0.96 40 Tobacco workers 26 0.85 5 0.80 6 0.95 12 1.28 49 0.93 0.69*1.23 41 Glass makers etc 67 1.14 130 0.93 1 1.09 63 0.98 168 0.82 429 0.92 0.83*1.01 42 Packers 11 0.64 219 0.87 2 0.59 156 1.04 310 1.05 698 0.97 0.90*1.05 43 Engine operators 1 2.22 44 1.08 [0.04] 0.00 2 0.84 12 0.58 59 0.92 0.70*1.18 44 Public safety workers 3 1.69 7 0.82 [0.65] 0.00 15 0.90 19 0.82 44 0.87 0.63*1.16 45 Cooks and stewards 2 3.18 262 0.98 13 1.01 202 1.06 413 1.04 892 1.03 0.96*1.10 46 Domestic assistants 363 0.95 286 1.06 4 1.07 529 1.03 1 150 1.06 2 332 1.03 0.99*1.08 47 Waiters 47 0.74 203 0.86 [1.45] 0.00 194 0.86 361 0.82 805 0.83 0.78*0.89 48 Building caretakers 985 0.91 812 0.89 35 1.31 899 0.93 1 046 0.92 3 777 0.92 0.89*0.95 49 Chimney sweeps [0.11] 0.00 1 1.88 [0.13] 0.00 [0.02] 0.00 1 1.26 0.03*7.03 50 Hairdressers 80 1.26 93 1.07 1 0.71 57 0.96 192 0.98 423 1.04 0.95*1.14 51 Launderers 110 0.89 65 0.88 5 1.20 57 0.72 200 0.91 437 0.87 0.80*0.96 52 Military personnel 1 1.49 [0.91] 0.00 [0.32] 0.00 [0.72] 0.00 1 0.38 0.01*2.13 53 ‘‘Other workers’’ 298 0.97 262 0.92 27 1.01 447 0.90 512 1.00 1 546 0.95 0.90*1.00 54 Economically inactive 7 676 0.98 5 807 0.99 111 1.19 5 821 1.00 22 847 0.99 42 262 0.99 0.98*1.00 1 54 All categories 15 623 1.00 16 741 1.00 387 1.00 14 533 1.00 40 333 1.00 87 617 1.00 Ref. Obs observed number of cases; SIR standardised incidence ratio; 95% CI 95% confidence interval. Occupation and cancer in Nordic countries 711
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 712 E. Pukkala et al. non-significant elevated risk, and in clerical workers (11 cases) with a presentation of non-significant decreased risk. Comment. No previous study has identified occupational or environmental risk factors for choriocarcinoma. This is a rare type of malignancy, and epidemiological studies are scarce, but there are indications that increasing maternal age and family history increase risk. All other hypothesised risk factors (use of oral contraceptives, HPV infections, smoking and alcohol use, paternal age, parity, endogenous hormone factors, history of other cancers) are inconsistently related to risk [101]. We are not aware of studies on risk of choriocarcinoma according to occupational categories. Given the way our database was constructed we could only count incidence rates by women (and not by pregnancy which would be more appropriate). Ovarian cancer Incidence of ovarian cancer, excluding borderline tumours, in the Nordic countries in the 1960s and 1970s was between 10 and 15 per 100 000, but rates have decreased in the last decades (Figure 32). There was a somewhat increased risk of ovarian cancer, excluding borderline tumours, among printers SIR 1.25 (95% CI 1.11 1.41) and hairdressers (1.16, 1.05 1.27) in the study population. None of the occupational categories showed a markedly lowered risk of ovarian cancer (Table 43). For borderline ovarian tumours (http://astra. cancer.fi/NOCCA/Incidence/ovary-borderline), the highest SIRs were observed among women working as printers (1.50, 1.09 2.01), mechanics (1.40, / 100 000 15 10 5 Denmark Finland Iceland Norway 0 Sweden 1945 1960 1975 1990 2005 1.10 1.75), postal workers (1.24, 1.07 1.44), cooks and stewards (1.21, 1.01 1.44). The lowest SIRs were found among physicians (0.45, 0.19 0.89), laboratory assistants (0.59, 0.36 0.91) and gardeners (0.80, 0.70 0.92). Comment. Increased risk of ovarian cancer is associated with reproductive factors leading to incessant ovulation [102]. Previous studies have also found indications of elevated risks associated with aromatic hydrocarbon solvents, leather dust, man-made vitreous fibres, asbestos and diesel, gasoline and engine exhausts. Female hairdressers and printers have also been previously reported to be at increased risk of ovarian cancer [87,103]. In this study the occupational variation of ovarian cancer incidence was small. In most epidemiological studies borderline ovarian tumours have the same risk factors as invasive ovarian cancer. So far no occupational study has accessed the risk of borderline tumours. The findings in our study suggest that borderline ovarian tumours may share the same occupational risk factors that have been suggested for invasive ovarian cancer. Fallopian tube cancers Primary fallopian tube carcinoma is very rare. In Western countries, it accounts for about 1% of all female genital malignant tumours. Derived from six cases only, a significant fourfold risk of fallopian tube cancer was shown in smelting workers SIR 4.00 (95% CI 1.47 8.70). The other work groups with a high SIR were artistic workers, hairdressers, packers and nurses (Table 44). Farming was the occupation with the lowest risk (0.67, 0.47 0.94). Comment. The aetiology of fallopian tube cancer remains poorly known. The few existing studies Women Figure 32. Age standardised (World) incidence rates for ovarian cancer 1943 2005, by country. Modified from NORDCAN [49].
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