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. Changes in diagnostic activity may at least partly explain the observed changes in the incidence of thyroid cancer in Iceland. Cancers of other endocrine glands Cancers of endocrine glands other than the thyroid gland are so rare that they have hardly ever been included in epidemiological studies or even routine tabulations as separate entities. Therefore, there is no published information about the time trends of these cancers in the Nordic countries. We do not publish tables on SIRs for each combination of gender, country and occupation as we do for more common cancers, because the majority of the strata would show zero number of cases. Those who want to check the exact numbers of cancer related to a given occupational category are advised to have a look at the appendix tables on the internet (http://astra.cancer.fi/NOCCA/Incidence/endo crine-glands) Glandula suprarenalis. There were 1 764 incident cases of cancer of the suprarenal gland included in the study. Among men, the incidence was significantly elevated among smelting workers (SIR 1.85, 95% CI 1.18 2.75), packers (1.72, 1.20 2.39), engine operators (1.55, 1.05 2.19) and woodworkers (1.33, 1.03 1.69). Male farmers had a deficit risk (0.77, 0.61 0.95). Shoe and leather workers had an excess risk among women (3.38, 1.36 6.96) based on seven cases, and building caretakers had an SIR of 1.42 (1.07 1.83), based on 58 cases. Female sales agents had a low risk (0.23, 0.03 0.84). Glandula parathyrioeda. Only 159 incident cases of parathyroid cancer were included in the study, 41 in men and 118 in women. There were no statistically significant excess or deficit risks. Thymus. In total, 680 incident cases of thymus cancer were included in the study. Men in the occupational category including glass makers and several other similar occupations, had an excess risk (SIR 2.23, 95% CI 1.07 4.10), and mechanics had a deficit risk, SIR 0.60 (95%CI 0.34 0.99). No significant variation in risk was found across the occupational categories of women. Hypophysis. There were 216 cases of cancer of the hypophysis. Beverage workers had an SIR of 16.60 (95% CI 2.01 59.95), however based on only two cases, and sales agents an SIR of 2.31 (1.11 4.25), Occupation and cancer in Nordic countries 743 based on ten cases. There were no significant SIRs among women. Corpus pineale. Only a total of 48 incident cases of corpus pineale were included in the present study. Swedish and Danish observations were missing, and there were no cases diagnosed in Finland. The only significant excess risk, SIR of 5.48 (1.13-16-01) among ‘‘other construction workers’’ is based on three cases and must be interpreted as a chance find. Comment. We could not identify studies indicating environmental or occupational causes of any of these rare tumours in the literature. Hence, all observations made in our data set should be interpreted as suggestive or chance findings to be confirmed or rejected on the basis of cumulative information from other parts of the world. Bone cancer Bone cancer is rare, and the disease has been on the decrease for both men and women in the Nordic countries (Figure 43), possibly due to improving means of separating bone metastases from primary bone cancers. It is now between about 1 per 100 000 in men and one-third less in women. ‘‘Other health workers’’ had an excess risk of bone cancer in men (SIR 2.25, 95%CI 1.29 3.66). Seamen, military personnel and public safety workers were also at excess risk (Table 64). The only category with a significantly decreased SIR was ‘‘other workers’’ (SIR 0.75, 0.56 0.99). There were no significant SIRs in women, except the one based on zero observed cases among woodworkers (95% CI 0.00 0.90; Table 65). About every second one of the bone cancers in the present study series was of chondrosarcoma type (http://astra.cancer.fi/NOCCA/Incidence/bonechondrosarcoma). Men in ‘‘other health work’’ had an an excess SIR of chondrosarcoma (2.97, 1.28 5.85), and the SIR was also elevated among military workers (2.88, 1.68 4.61), seamen (1.92, 1.05 3.22) and drivers (1.45, 1.09 1.88). In women, the only significant finding was among technical etc. workers (2.60, 1.12 5.12); this finding was dominated by the high SIR in Sweden. Comment. Previous studies have indicated that the main environmental factors for bone cancer are ionising radiation and chemotherapy. Radium dial painters exposed to radium 226, 228, and occupational and environmental exposure to plutonium in and around nuclear weapons factories had an
Acta Oncol Downloaded from informahealthcare.com by 212.35.100.66 on 04/06/11 For personal use only. 744 E. Pukkala et al. / 100 000 3 2 1 0 Men Denmark Finland Iceland Norway Sweden 1945 1960 1975 1990 2005 increased risk [133]. Exposure to ionising radiation and other physical agents such as gamma rays, neutrons and radon gas can be observed in radiologists, technologists, nuclear workers, underground miners, plutonium workers, clean-up workers following nuclear accidents and aircraft crew. In the present study we found an excess risk of osteosarcoma among health care workers, military workers and seamen. It would deserve further investigation to establish if these are associated with radiation exposure. Soft tissue cancer There has been a slight increase in the incidence of cancer of the soft tissue during the latest decades, but rates are still very low and similar (incidence around 2 per 100 000) in both genders and all Nordic countries (Figure 44). Among men, the only occupational categories with significantly elevated SIRs in the combined / 100 000 3 2 1 0 Women Denmark Finland Iceland Norway Sweden 1945 1960 1975 1990 2005 Figure 43. Age standardised (World) incidence rates for bone cancer 1943 2005, by country and gender. Modified from NORDCAN [49]. / 100 000 3 2 1 0 Denmark Finland Iceland Norway Sweden Men 1945 1960 1975 1990 2005 / 100 000 Nordic data were building caretakers (SIR 1.30, 95% CI 1.08 1.56) and military personnel (1.27, 1,01 1.59), but there were significant single-country excesses among Norwegian welders, Danish men in the category of ‘‘religious workers etc.’’, Finnish gardeners and Swedish public safety workers (Table 66). Fishermen and packers had SIRs significantly below 1.0. No occupational category was either at an excess risk or a deficit risk among women (Table 67). The data set included 1328 cases in the subgroup of fibrosarcoma (http://astra.cancer.fi/NOCCA/Inci dence/soft-tissue-fibrosarcoma) in men and 1 174 in women from Finland, Iceland, Norway and Sweden. The only significant excess in men was among building caretakers (1.71, 1.12 2.50) and in women among sales agents (1.62, 1.01 2.45). The only significant four-country SIR based on the 1 326 cases of liposarcoma (http://astra.cancer.fi/ NOCCA/Incidence/soft-tissue-liposarcoma) in men 3 2 1 0 Denmark Finland Iceland Norway Sweden Women 1945 1960 1975 1990 2005 Figure 44. Age standardised (World) incidence rates for soft tissue cancer 1943 2005, by country and gender. Modified from NORDCAN [49].
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Occupation and cancer - European Trade Union Institute (ETUI)

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