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. suggest that fallopian tube cancer may have a similar aetiology as epithelial ovarian cancer. High parity may decrease risk of fallopian tube cancer [104]. Women of high socioeconomic class seem also to be at increased risk in comparison to women of low social class. We found no previous studies suggesting occupational or environmental causes of fallopian tube cancer, except for a Finnish study reporting an increased risk among academic, clerical and administrative workers, as well as private secretaries, nurses, hairdressers, barbers, and book-keepers and accountants [105]. The subjects included in the Finnish study overlap with the subjects included in the present study. Our study did not identify clear patterns of occupations associated with this malignancy, and the occupations associated with ovarian cancer were not the same as the occupations associated with fallopian tube cancers. Cancer of the vulva The incidence of cancer of the vulva has been around 1.5 per 100 000 in the Nordic countries, and it has been relatively stable over decades. High SIRs were found in domestic assistants (SIR 1.16, 95% CI 1.04 1.30) and building caretakers. Low SIRs were seen in nurses (0.72, 0.58 0.88), ‘‘other health workers’’ and teachers (Table 45). Comment. Cancer of the vulva is most probably related to HPV infection [106]. Nothing is known about possible occupational risk factors, and no pattern related to occupational category could be seen in the present study. / 100 000 100 75 50 25 Denmark Finland Iceland Norway Sweden Vaginal cancer Cancer of the vagina is rare. In our study we have only 2 725 cases, not many more than male breast cancer cases. High SIRs were found in chemical process workers (SIR 2.61, 95% CI 1.46 4.30) and building caretakers. The lowest SIRs were found in gardeners (0.73, 0.54 0.97) and teachers (Table 46). Comment. Cancer of the vagina is most probably related to HPV infection [106]. No occupational risk factors have been identified. Prostate cancer Prostate cancer was the most common cancer in the present study (340 000 cases) and accounts for nearly one third of all incident cancer among men in the Nordic countries. The incidence has increased by three to fourfold since 1960 in all countries except Denmark, where it has remained considerably lower than in the other countries (Figure 33). For Finland, Norway and Sweden the steepest rise was seen after 1990, around the time when testing for prostate specific antigen (PSA) became widely used. In the present study the highest SIRs were observed among dentists (SIR 1.22, 95% CI 1.13 1.31), administrators and religious workers (Table 47). The SIR was lowest (0.80, 0.79 0.82) among the economically inactive, followed by forestry workers and fishermen. 0 1945 1960 1975 1990 2005 Comment. Autopsies have revealed that the prevalence of latent prostate cancer is very high. More Figure 33. Age standardised (World) incidence rates for prostate cancer 1943 2005, by country. Modified from NORDCAN [49]. Men Occupation and cancer in Nordic countries 715
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 716 E. Pukkala et al. Table 45. Observed number of cancer of the vulva 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 5 1.31 4 0.54 [0.10] 0.00 3 1.12 9 0.54 21 0.68 0.42*1.05 2 Laboratory assistants 3 1.18 5 1.21 [0.14] 0.00 2 0.56 2 0.50 12 0.83 0.43*1.45 3 Physicians 2 1.53 [1.77] 0.00 [0.02] 0.00 [1.51] 0.00 4 1.11 6 0.73 0.27*1.59 4 Dentists 1 0.86 2 0.90 [0.01] 0.00 [1.32] 0.00 2 0.65 5 0.64 0.21*1.50 5 Nurses 20 0.86 7 0.34 [0.62] 0.00 25 0.92 37 0.71 89 0.72 0.58*0.88 6 Assistant nurses 16 1.01 13 0.58 1 1.04 24 0.89 81 0.93 135 0.88 0.75*1.05 7 ‘‘Other health workers’’ 9 0.67 12 0.69 1 5.12 20 0.71 26 0.89 68 0.77 0.60*0.97 8 Teachers 21 0.75 31 0.77 1 0.87 53 0.99 88 0.76 194 0.81 0.71*0.93 9 Religious workers etc 3 0.77 17 0.93 1 5.72 13 0.97 23 0.62 57 0.78 0.59*1.01 10 Artistic workers 5 2.31 1 0.31 [0.15] 0.00 1 0.23 4 0.55 11 0.64 0.32*1.15 11 Journalists 1 2.40 2 0.97 [0.04] 0.00 1 0.95 4 1.20 8 1.16 0.50*2.28 12 Administrators 9 0.71 9 1.28 [0.11] 0.00 12 0.83 13 0.75 43 0.83 0.60*1.12 13 Clerical workers 120 1.06 111 0.86 4 1.09 159 0.92 260 0.93 654 0.94 0.87*1.01 14 Sales agents 1 0.91 24 1.15 [0.36] 0.00 31 1.08 42 0.92 98 1.01 0.82*1.23 15 Shop workers 73 0.89 69 0.96 3 1.33 157 1.03 195 1.03 497 1.00 0.91*1.09 16 Farmers 45 0.78 63 1.16 [1.55] 0.00 94 0.81 21 1.09 223 0.89 0.78*1.02 17 Gardeners 6 0.80 136 0.96 [0.06] 0.00 63 0.92 60 1.20 265 0.99 0.88*1.12 18 Fishermen [0.29] 0.00 [0.30] 0.00 [0.06] 0.00 1 1.34 [0.17] 0.00 1 0.64 0.02*3.56 19 Forestry workers [0.07] 0.00 [0.58] 0.00 [0.01] 0.00 3 2.60 [1.04] 0.00 3 1.05 0.22*3.07 20 Miners and quarry workers [0.00] 0.00 [0.26] 0.00 [0.00] 0.00 [0.05] 0.00 [0.23] 0.00 [0.55] 0.00 0.00*6.75 21 Seamen [0.06] 0.00 [0.00] 0.00 [0.17] 0.00 [0.03] 0.00 [0.26] 0.00 0.00*14.28 22 Transport workers [0.08] 0.00 5 1.37 [0.06] 0.00 [0.77] 0.00 3 1.02 8 1.07 0.46*2.10 23 Drivers 2 1.02 1 0.63 [0.03] 0.00 4 1.35 6 0.92 13 1.00 0.53*1.70 24 Postal workers 5 1.15 19 0.86 [0.72] 0.00 34 0.97 51 1.00 109 0.96 0.80*1.16 25 Textile workers 32 1.20 58 1.13 [1.32] 0.00 65 1.04 129 1.08 284 1.09 0.97*1.22 26 Shoe and leather workers 1 0.52 6 0.97 [0.08] 0.00 6 1.36 11 1.23 24 1.11 0.71*1.66 27 Smelting workers [0.46] 0.00 6 4.14 [0.00] 0.00 [0.38] 0.00 1 0.50 7 1.63 0.65*3.36 28 Mechanics 5 1.14 6 0.95 [0.01] 0.00 4 0.82 22 1.03 37 1.00 0.71*1.38 29 Plumbers [0.06] 0.00 [0.01] 0.00 [0.03] 0.00 [0.03] 0.00 [0.13] 0.00 0.00*29.02 30 Welders [0.46] 0.00 [0.00] 0.00 [0.29] 0.00 1 1.40 1 0.68 0.02*3.77 31 Electrical workers 8 1.30 5 1.31 [0.01] 0.00 5 0.99 12 1.02 30 1.12 0.75*1.60 32 Wood workers 2 0.95 20 1.55 [0.03] 0.00 [1.63] 0.00 1 0.29 23 1.14 0.72*1.71 33 Painters [0.08] 0.00 3 2.02 [0.01] 0.00 [0.38] 0.00 [0.98] 0.00 3 1.03 0.21*3.00 34 ‘‘Other construction workers’’ [0.07] 0.00 10 1.83 [0.00] 0.00 [0.15] 0.00 [0.11] 0.00 10 1.73 0.83*3.18 35 Bricklayers [0.01] 0.00 [0.18] 0.00 [0.01] 0.00 [0.00] 0.00 [0.20] 0.00 0.00*18.24 36 Printers [2.41] 0.00 4 0.63 [0.11] 0.00 9 1.82 9 0.95 22 0.95 0.59*1.44 37 Chemical process workers 5 1.29 2 0.61 [0.05] 0.00 7 1.58 12 1.56 26 1.34 0.88*1.97 38 Food workers 21 1.10 22 1.26 2 0.70 28 0.94 31 1.27 104 1.11 0.92*1.35 39 Beverage workers 3 1.69 1 1.00 [0.01] 0.00 [0.23] 0.00 1 0.63 5 1.08 0.35*2.53 40 Tobacco workers 2 0.82 2 3.53 2 1.86 2 2.33 8 1.63 0.70*3.20 41 Glass makers etc 7 1.58 9 0.75 [0.08] 0.00 15 1.62 26 1.30 57 1.25 0.94*1.62 42 Packers 1 0.76 22 1.04 [0.27] 0.00 20 0.88 35 1.13 78 1.02 0.81*1.28 43 Engine operators [0.03] 0.00 5 1.51 [0.01] 0.00 [0.25] 0.00 1 0.66 6 1.17 0.43*2.55 44 Public safety workers [0.16] 0.00 [0.81] 0.00 [0.05] 0.00 4 1.36 4 1.76 8 1.28 0.55*2.53 45 Cooks and stewards [0.05] 0.00 23 0.93 1 0.99 35 0.99 51 1.02 110 0.99 0.82*1.20 46 Domestic assistants 32 1.05 20 0.77 [0.29] 0.00 112 1.27 144 1.19 308 1.16 1.04*1.30 47 Waiters 6 1.22 31 1.60 1 8.36 38 1.10 47 0.97 123 1.14 0.96*1.36 48 Building caretakers 99 1.12 110 1.29 1 0.49 161 1.11 127 1.02 498 1.12 1.02*1.22 49 Chimney sweeps [0.01] 0.00 [0.04] 0.00 [0.02] 0.00 [0.00] 0.00 [0.07] 0.00 0.00*51.04 50 Hairdressers 3 0.59 7 0.93 [0.14] 0.00 10 1.14 13 0.70 33 0.82 0.57*1.16 51 Launderers 13 1.29 4 0.58 [0.32] 0.00 17 1.24 32 1.19 66 1.14 0.88*1.45 52 Military personnel [0.05] 0.00 1 16.96 [0.03] 0.00 1 16.55 2 9.81 1.19*35.43 53 ‘‘Other workers’’ 28 1.12 21 0.82 2 0.90 87 1.16 64 1.18 202 1.11 0.97*1.28 54 Economically inactive 709 1.01 641 1.02 13 1.73 1 128 0.99 2 667 1.01 5 158 1.01 0.98*1.04 1 54 All categories 1 324 1.00 1 570 1.00 31 1.00 2 453 1.00 4 375 1.00 9 753 1.00 Ref. Obs observed number of cases; SIR standardised incidence ratio; 95% CI 95% confidence interval.
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