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 46. Observed number of vaginal 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 3 1.82 1 0.48 [0.03] 0.00 1 1.72 7 1.36 12 1.26 0.65*2.21 2 Laboratory assistants 1 0.87 2 1.73 [0.04] 0.00 1 1.34 [1.27] 0.00 4 0.92 0.25*2.34 3 Physicians [0.55] 0.00 [0.50] 0.00 [0.01] 0.00 [0.31] 0.00 [1.14] 0.00 [2.51] 0.00 0.00*1.47 4 Dentists [0.49] 0.00 [0.57] 0.00 [0.00] 0.00 [0.27] 0.00 [0.94] 0.00 [2.28] 0.00 0.00*1.62 5 Nurses 14 1.45 10 1.69 [0.19] 0.00 1 0.17 5 0.32 30 0.80 0.54*1.15 6 Assistant nurses 6 0.87 7 1.13 [0.25] 0.00 3 0.52 37 1.39 53 1.16 0.87*1.52 7 ‘‘Other health workers’’ 2 0.36 8 1.65 [0.05] 0.00 7 1.18 13 1.45 30 1.18 0.80*1.69 8 Teachers 10 0.83 9 0.81 [0.35] 0.00 8 0.72 25 0.71 52 0.74 0.56*0.98 9 Religious workers etc 1 0.61 6 1.15 [0.05] 0.00 2 0.72 3 0.27 12 0.57 0.30*1.00 10 Artistic workers 1 1.16 [0.89] 0.00 [0.04] 0.00 [0.86] 0.00 [2.23] 0.00 1 0.20 0.01*1.14 11 Journalists [0.18] 0.00 [0.58] 0.00 [0.01] 0.00 [0.22] 0.00 1 0.98 1 0.50 0.01*2.77 12 Administrators 13 2.52 2 1.02 [0.03] 0.00 2 0.71 4 0.78 21 1.39 0.86*2.12 13 Clerical workers 42 0.85 34 0.95 3 3.19 31 0.86 109 1.26 219 1.05 0.92*1.20 14 Sales agents [0.46] 0.00 8 1.45 [0.10] 0.00 8 1.51 19 1.44 35 1.42 0.99*1.98 15 Shop workers 34 1.00 29 1.48 [0.58] 0.00 22 0.72 61 1.07 146 1.03 0.88*1.21 16 Farmers 12 0.50 15 1.10 1 2.21 20 0.95 6 1.12 54 0.84 0.63*1.09 17 Gardeners 4 1.29 26 0.69 [0.02] 0.00 12 0.95 8 0.54 50 0.73 0.54*0.97 18 Fishermen [0.12] 0.00 [0.08] 0.00 [0.02] 0.00 2 12.99 1 20.68 3 7.09 1.46*20.73 19 Forestry workers [0.03] 0.00 [0.15] 0.00 [0.00] 0.00 1 4.37 [0.31] 0.00 1 1.38 0.03*7.67 20 Miners and quarry workers [0.00] 0.00 [0.07] 0.00 [0.00] 0.00 [0.01] 0.00 [0.07] 0.00 [0.15] 0.00 0.00*24.66 21 Seamen [0.02] 0.00 [0.04] 0.00 [0.01] 0.00 [0.06] 0.00 0.00*61.87 22 Transport workers [0.03] 0.00 1 0.98 [0.02] 0.00 [0.16] 0.00 1 1.13 2 0.94 0.11*3.41 23 Drivers 1 1.18 1 2.26 [0.01] 0.00 1 1.69 3 1.50 6 1.54 0.56*3.35 24 Postal workers 1 0.55 6 1.00 [0.19] 0.00 8 1.12 17 1.07 32 1.03 0.70*1.45 25 Textile workers 7 0.62 12 0.87 [0.41] 0.00 11 0.93 47 1.35 77 1.07 0.84*1.34 26 Shoe and leather workers [0.84] 0.00 [1.68] 0.00 [0.02] 0.00 [0.85] 0.00 6 2.27 6 1.00 0.37*2.17 27 Smelting workers [0.20] 0.00 [0.40] 0.00 [0.00] 0.00 [0.09] 0.00 3 4.75 3 2.28 0.47*6.65 28 Mechanics 3 1.51 2 1.15 [0.00] 0.00 3 3.00 7 1.07 15 1.33 0.74*2.19 29 Plumbers [0.02] 0.00 [0.00] 0.00 [0.01] 0.00 [0.01] 0.00 [0.04] 0.00 0.00*94.10 30 Welders 1 7.59 [0.00] 0.00 [0.07] 0.00 1 4.38 2 4.68 0.57*16.92 31 Electrical workers 2 0.72 1 0.93 [0.00] 0.00 3 2.80 5 1.37 11 1.28 0.64*2.30 32 Wood workers [0.93] 0.00 2 0.57 [0.01] 0.00 [0.34] 0.00 3 2.81 5 0.86 0.28*2.00 33 Painters [0.04] 0.00 1 2.48 [0.00] 0.00 [0.08] 0.00 1 3.36 2 2.45 0.30*8.87 34 ‘‘Other construction workers’’ [0.03] 0.00 2 1.39 [0.00] 0.00 [0.03] 0.00 [0.03] 0.00 2 1.30 0.16*4.70 35 Bricklayers [0.01] 0.00 [0.05] 0.00 [0.00] 0.00 [0.00] 0.00 [0.05] 0.00 0.00*68.05 36 Printers [1.05] 0.00 3 1.75 [0.03] 0.00 1 1.02 2 0.70 6 0.90 0.33*1.97 37 Chemical process workers 3 1.80 3 3.35 [0.01] 0.00 2 2.28 7 3.04 15 2.61 1.46*4.30 38 Food workers 6 0.73 2 0.43 1 1.25 7 1.24 10 1.41 26 0.99 0.64*1.44 39 Beverage workers 2 2.59 [0.26] 0.00 [0.00] 0.00 [0.05] 0.00 [0.46] 0.00 2 1.30 0.16*4.68 40 Tobacco workers 1 0.94 [0.15] 0.00 [0.21] 0.00 [0.27] 0.00 1 0.59 0.02*3.30 41 Glass makers etc [1.97] 0.00 3 0.93 [0.02] 0.00 3 1.60 9 1.49 15 1.14 0.64*1.88 42 Packers 2 3.50 9 1.58 [0.07] 0.00 6 1.34 9 0.98 26 1.30 0.85*1.90 43 Engine operators [0.02] 0.00 3 3.29 [0.00] 0.00 [0.06] 0.00 1 2.00 4 2.70 0.73*6.90 44 Public safety workers [0.07] 0.00 [0.22] 0.00 [0.02] 0.00 [0.55] 0.00 [0.68] 0.00 [1.53] 0.00 0.00*2.42 45 Cooks and stewards [0.02] 0.00 6 0.91 [0.32] 0.00 10 1.55 19 1.35 35 1.27 0.89*1.77 46 Domestic assistants 8 0.62 6 0.87 [0.10] 0.00 15 0.90 31 0.89 60 0.84 0.64*1.08 47 Waiters 3 1.39 8 1.50 [0.03] 0.00 11 1.62 18 1.27 40 1.40 1.00*1.91 48 Building caretakers 54 1.45 32 1.41 [0.64] 0.00 32 1.12 44 1.22 162 1.30 1.11*1.51 49 Chimney sweeps [0.00] 0.00 [0.01] 0.00 [0.00] 0.00 [0.00] 0.00 [0.02] 0.00 0.00*198.01 50 Hairdressers 2 0.92 3 1.46 [0.04] 0.00 1 0.57 2 0.35 8 0.68 0.30*1.35 51 Launderers 7 1.67 3 1.64 [0.11] 0.00 2 0.78 13 1.70 25 1.53 0.99*2.26 52 Military personnel [0.02] 0.00 [0.02] 0.00 [0.01] 0.00 [0.02] 0.00 [0.07] 0.00 0.00*56.25 53 ‘‘Other workers’’ 15 1.43 7 1.01 3 4.98 11 0.74 23 1.44 59 1.21 0.92*1.56 54 Economically inactive 287 1.01 137 0.88 1 0.42 215 1.05 714 0.92 1 354 0.95 0.90*1.00 1 54 All categories 547 1.00 411 1.00 9 1.00 463 1.00 1 295 1.00 2 725 1.00 Ref. Obs observed number of cases; SIR standardised incidence ratio; 95% CI 95% confidence interval. Occupation and cancer in Nordic countries 717
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 718 E. Pukkala et al. than 20% of men who have reached the age of 50 have prostatic carcinoma that meets the histopathologic criteria for malignancy, but most of those cancers seem to have a low potential for growth [107]. Therefore, the incidence must be interpreted in the context of prostate cancer-related diagnostic activity. This is exemplified by the Danish experience during the past three decades, where both the level of diagnostic activity and the prostate cancer incidence have been lower than in the other Nordic countries [108,109]. Before the introduction of PSA testing in the late 1980s, trans-urethral resections of the prostate (TURP), widely applied as a treatment for benign prostate hyperplasia, were responsible for a large number of incidental findings of prostate cancer. The aetiology of prostate cancer is poorly understood. Consumption of red meat and dairy products is probably associated with an increased risk, whereas tomatoes and tomato products, especially those with high lycopene content, are associated with a reduced risk [110]. There are no established occupational risk factors, but cadmium, polychlorinated biphenyls and high electromagnetic fields have been suggested. The present results do not support an association with industrial occupations, as SIRs were not elevated among miners, chemical process workers, smelting workers, welders, painters or chimney sweeps. Furthermore, the contrasts between the highest and lowest SIRs were small. On the other hand, the present results support an association with diagnostic activity, as higher SIRs were observed for occupations that are related to higher social status and thus presumably better access to health care. / 100 000 15 10 5 0 Denmark Finland Iceland Norway Sweden Testicular cancer Incidence in the Nordic countries has been increasing over time and is nowadays about twofold in Denmark and Norway as compared with the other Nordic countries (Figure 34). The rates in Denmark and Norway are among the highest in the world. The highest significant excess risk of testicular cancer was found in physicians (SIR 1.48, 95% CI 1.15 1.88), followed by artistic workers, religious etc. workers, printers and administrators (Table 48). The lowest risk was observed in forestry workers (0.70, 0.54 0.88), engine operators and welders. Sixty percent of the testicular cancers in the present series are seminomas (http://astra.cancer. fi/NOCCA/Incidence/testis-seminoma). Physicians had the highest risk of seminoma with an SIR of 1.48 (95% CI 1.07 1.99), followed by artistic workers (1.47, 1.06 1.99) and religious etc. workers (1.33, 1.14 1.56). The lowest SIRs were observed among cooks and stewards (0.56, 0.29 0.98) and forestry workers (0.64, 0.47 0.86). The occupational category of administrators was the only one with a significantly elevated SIR of testicular non-seminoma cancer (1.21, 1.04 1.42; http://astra.cancer.fi/NOCCA/Incidence/ testis-non-seminoma). The only SIRs significantly below 1.0 were observed among engine operators (0.60, 0.41 0.84) and public safety workers (0.67, 0.43 0.99). Comment. The mean age at diagnosis of testicular cancer in the Nordic countries is only 30 years, i.e., relatively low as compared with other cancer sites. Many of the cancers were diagnosed before the starting age of follow-up in the present study Men 1945 1960 1975 1990 2005 Figure 34. Age standardised (World) incidence rates for testicular cancer 1943 2005, by country. Modified from NORDCAN [49].
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