Sinonasal cancer and occupation. Results from the reanalysis of twelve case-control studies

A pooled reanalysis of twelve case-control studies on sinonasal cancer and occupation from seven countries was conducted in order to study associations with occupations other than wood- and leather-related occupations. The pooled data set included a total of 930 cases (680 men and 250 women) and 3,136 controls (2,349 men and 787 women). All the studies included a detailed occupational history for cases and controls. Each job was coded using the same classifications for occupation and industry. Two approaches were used in the analysis: systematic analysis of occupations; a priori analysis using a preestablished list of occupations and industries. The results confirmed associations observed in several studies not included in this analysis. For agricultural workers, significant excesses were observed for squamous cell carcinoma among women (OR = 1.69) and men (OR = 3.72 for ten years or more of employment as an orchard worker), and adenocarcinomas among men (OR = 2.98 for ten years or more of employment). Associations with textile occupations were observed for adenocarcinoma among women (OR = 2.60) and squamous cell carcinoma among men (OR = 5.09 for fiber preparers, 3.01 for bleachers). Elevated risks for both histologic types were observed among men employed in food manufacturing (OR = 3.25, adenocarcinoma), or as food preservers (OR = 13.9, squamous cell carcinoma), and among men employed as cooks (OR = 1.99, squamous cell carcinoma). A positive association with squamous cell carcinoma was observed for male transport equipment operators (OR = 1.21), and also with adenocarcinoma for male motor-vehicle drivers (OR = 2.50). A number of other associations were observed in the systematic analysis. Am. J. Ind. Med. 31:153–165, 1997. © 1997, Wiley-Liss Inc.     

Occupation and risk of pancreatic cancer: a population-based case-control study in iowa

OBJECTIVE: Previous epidemiological studies have inconsistently linked various occupations and industries to pancreatic cancer risk. METHODS: We analyzed data from a population-based case-control study conducted in Iowa involving 376 histologically confirmed incident pancreatic cancer cases and 2434 control subjects. RESULTS: A significantly increased risk was observed among men who worked in the following industries: chemical and allied products, transportation, and elementary and secondary schools. Increased risks also were observed in men who were employed as truck drivers; railroad brake, signal, and switch operators; purchasing agents and buyers; teachers; insurance agents; and retail supervisors. Among women, a significantly increased risk of pancreatic cancer was found for employment in furniture and home furnishing stores, and a borderline significantly increased risk among textile sewing machine operators and tenders. CONCLUSIONS: Working in several occupations and industries was associated with an increased risk of pancreatic cancer in this study, and these associations warrant further investigation.     

Occupation and adult gliomas in the San Francisco Bay Area

The etiology of gliomas is not well understood. Some jobs might involve sustained and elevated exposures to carcinogens. This study compares lifetime job histories of 879 glioma cases diagnosed between August 1991 to April 1994 and May 1997 to August 1999 in the San Francisco Bay Area and 864 controls. Logistic analyses compared longest and ever held occupations of 1 year or more for all astrocytic and nonastrocytic cases and controls overall with adjustment for age, gender, and ethnicity and separately for men and women. Two-fold or higher or statistically significant elevated odds ratios were found overall and in men among those with longest held occupations, as firefighters, physicians, material moving equipment operators, and janitors; such elevated odds ratios were also observed for longest-held occupations among male motor vehicle operators and personal service workers and female messengers, legal/social service workers, electronic equipment operators, painters, and food processors. Odds ratios of 0.50 or less, but not statistically significant, were found for those with longest held jobs as writers/journalists, biological scientists, paper workers, mechanics, chemists, and photographers/photoprocessors. This study supports previously observed occupational associations and is one of the few studies with sufficient numbers to separately analyze occupations by gender.     

Identification of occupational cancer risks in British Columbia. A population-based case-control study of 995 incident breast cancer cases by menopausal status, controlling for confounding factors

Lifetime occupational histories as well as information on known and suspected breast cancer risk factors were collected by means of a self-administered questionnaire from 1018 women with incident breast cancer ascertained from the British Columbia Cancer Registry, and from 1020 population controls. A matched case-control study design was used. Conditional logistic regression for matched sets data and the likelihood ratio were used in a two-step procedure and were performed separately for pre-menopausal women, post-menopausal women, and for all cases combined. Excess risk was noted for several white-collar occupations. Significantly increased risk was observed: (1) among pre-menopausal women: in electronic data-processing operators; barbers and hairdressers; in sales and material processing occupations; and in the food, clothing, chemical and transportation industries; (2) among post-menopausal women: in schoolteaching; in medicine, health, and nursing occupations; in laundry and dry-cleaning occupations; and in the aircraft and automotive, including gasoline service station, industries. Several significant associations were also seen in the combined group of pre- and post-menopausal women, particularly in crop farmers and in the fruit and vegetable, publishing and printing, and motor vehicle repair industries. The results of this study suggest excess breast cancer risk in a number of occupations and industries, notably those that entail exposure to solvents and pesticides.     

Occupations,cigarette smoking,and lung cancer in the epidemiological follow-up to the NHANES I and the California Occupational Mortality Study.

What jobs are associated with the highest and lowest levels of cigarette use and of lung cancer? Are there gender differences in these jobs? Two data sets-the Epidemiological Follow-up to the National Health and Nutrition Examination Survey (NHEFS) and the California Occupational Mortality Study (COMS) were analyzed to answer these questions. For females, the broad occupations ranking from highest to lowest cigarette use in the NHEFS was: transportation operators, managers, craft workers, service workers, operatives, laborers, technicians, administrative workers, farm owners and workers, sales workers, no occupation, and professionals. The corresponding ranking for males was: transportation operators, no occupation, laborers, craft workers, service workers, technicians, and professionals. The highest-ranking jobs in the COMS were waitresses, telephone operators, and cosmetologists for women, and water-transportation workers, roofers, foresters and loggers for men. Teachers were especially low on all four lists. This study could not determine whether employment within any occupation encouraged smoking or if smokers selected certain occupations.     

Risk for prostate cancer by occupation and industry: A 24-state death certificate study

Current knowledge of the etiology of prostate cancer is limited. Numerous studies have suggested that certain occupations and industries may be associated with the occurrence of prostate cancer. Information on occupation and industry on death certificates from 24 states gathered from 1984 to 1993 was used in case control study on prostate cancer. A total of 60,878 men with prostate cancer as underlying cause of death was selected and matched with controls who died of all other causes except cancer. Similar to the findings of our parallel large case control study of prostate cancer, we observed excess risks in some white-collar occupations, such as administrators, managers, teachers, engineers, and sales occupations. However, some blue-collar occupations, such as power plant operators and stationary engineers, brickmasons, machinery maintenance workers, airplane pilots, longshoreman, railroad industry workers, and other occupations with potential exposure to PAH also showed risk of excess prostate cancer. Risk was significantly decreased for blue-collar occupations, including farm workers, commercial fishermen, mechanics and repairers, structural metal workers, mining, printing, winding, dry cleaning, textile machine operators, cooks, bakers, and bartenders. Although we observed excess risks of prostate cancer among some low socioeconomic status (SES) occupations, the overall results suggest that the effects of higher SES cannot be ruled out in associations between occupational factors and the risk of prostate cancer. Am. J. Ind. Med. 34:413–420, 1998. © 1998 Wiley-Liss, Inc.     

Disability in occupations in a national sample.

OBJECTIVES. We sought to develop lists of jobs whose members reported high and low levels of functional disability. METHODS. Samples of women (n = 6096) and men (n = 3653) were drawn from the National Health and Nutrition Examination Survey I Epidemiological Follow-up. Disability was measured with a modified Stanford Health Assessment Questionnaire. We analyzed women and men separately, and we calculated average disability indices within longest-held occupations while adjusting for age, age-squared, married spouse present, and education. We minimized attrition bias with an econometric technique. RESULTS. From highest to lowest association with disability, the female broad occupations ranking was as follows: farming, no occupation, laborers, service, technicians, operatives, crafts workers, transportation operators, professionals, sales workers, administrative support, and managers. The male broad occupations ranking was as follows: no occupation, farming, operatives, crafts workers, service, technicians, manager, administrative support, sales, and professionals. The highest levels of disability for women and men occurred among nonconstruction laborers, farm workers, twisting machine operators, servants, machinery maintenance workers, mining machine operators, and bus drivers. CONCLUSIONS. Our results suggest that, in understanding levels of functional disability, occupational safety and health play a larger role than is generally assumed.     

Occupational class and exposure to job stressors among employed men and women in Japan

BACKGROUND: The relationship between occupational class and exposure to job stressors among employed men and women in Japan remains unclear. METHODS: Data of 16,444 men and 3,078 women were analyzed. The information was obtained from answers to a questionnaire distributed among employees of nine companies in Japan between 1996 and 1998 (average response rate, 85%). The International Standardized Classification of Occupations was used to classify respondents into eight occupational categories. The Job Content Questionnaire was used to measure job demands, job control, worksite support, and job insecurity. The associations between occupational class and job stressors, as well as job strain, were examined controlling for age, education, marital status, chronic medical condition, and personality traits, such as neuroticism and extraversion. RESULTS: Men and women in high-class occupations (e.g., managers and professionals) had significantly greater job control, while job demands and worksite social support were not greatly different among occupations. A clear occupational class gradient in job insecurity was observed in women. A greater prevalence of high job strain was observed in low-class occupations compared to high-class occupations in both men and women. The occupational class gradient in job strain was greater for women. These patterns did not change after controlling for other covariates. CONCLUSION: The present study suggests an occupational class gradient in job strain for employed men and women in Japan. Japanese women workers may have a greater occupational class gradient in job strain and job insecurity than men.     

Re: Occupational exposure to pesticides and pancreatic cancer. 2001. Ji B.‐T., Silverman D.T., Stewart P.A., Blair A., Swanson G.M., Baris D., Greenberg R.D., Hayes R., Brown L.M., Lillemoe K.D., Schoenberg J.B., Pottern L.M., Schwartz A.G., Hoover R. Am. J. Ind. Med. 39:92–99

To the Editor: In our recent paper describing associations of pancreatic cancer to pesticides, Table I presented JEM scores for selected occupations. We omitted several scores from the table, which indicated less variability across the study than was assessed. We have added all possible scores in Table I to reflect this variability. Also, several scores in the table may need further explanation. The supervisors, food and beverage preparation and food counter, fountain and related occupations had possible exposure to nonagricultural fungicides (i.e. disinfectants). Water and sewage treatment plant operators may handle herbicides to kill algae. Historically, textile mills and some dry cleaning operations applied insecticides to fabric. The subjects with jobs of mixing/blending machine operator/tender, or welder and cutter who were assigned pesticide exposures had worked in the chemical industry where pesticides may have been manufactured. The omissions were only in the reported data and not in the original data, and thus did not affect the epidemiologic results or conclusions.     

Maternal occupational exposure during pregnancy and the risk of spina bifida.

OBJECTIVES: A case-control study was carried out to explore associations between spina bifida and occupational exposure of the mother. METHODS: The cases were children with spina bifida aperta born between 1980 and 1992 from nine hospitals in the Netherlands. The controls were children born healthy in the same period as the cases, from hospitals and from the general population. Data collection was carried out in two steps. Firstly, postal questionnaires were sent to all the parents of cases and controls to gather information on occupations and potential confounders. In the second phase of the study, information on specific exposures was collected by means of job and task specific personal interviews. Interviews were performed with 55 case mothers and 66 control mothers who had occupations with a potential for chemical or physical exposure. Those exposures were assumed to be negligible for--for example, teachers and secretaries, so personal interviews were not indicated for these women. Information was collected on specific tasks in the period just after conception, and on the associated use of chemical or physical agents, frequency of exposure, and use of protective equipment. RESULTS: The analyses of occupation showed an increased risk for women working in agricultural occupations (OR = 3.4, CI:1.3-9.0), and, although less distinct, for cleaning women (OR = 1.7, CI:0.9-3.4). Only a few women seemed to be occupationally exposed to chemical or physical agents. No differences in occurrence of specific exposures could be detected between cases and controls. Besides, no differences were seen in pesticide or disinfectant exposure among case and control mothers in agricultural occupations. CONCLUSIONS: Occupational exposures of the mother during pregnancy were infrequent and did not seem to play an important part in the aetiology of spina bifida in this study. The association found between spina bifida and maternal agricultural occupations could not be explained by the use of pesticides by the mother or by any other occupational exposure.     

Congenital malformations by the parental occupation in finland

Summary The Finnish Register of Congenital Malformations, a case-referent register, was used to analyze the associations between the parental occupation and the children born with malformations. The women working in industrial and construction occupations had more children with central nervous system (CNS) and musculoskeletal malformations than the referent mothers. The women employed in transport and communication occupations had more children with oral clefts as compared to the referent mothers. The specific occupations with an increased odds ratio included telephone operators and teachers (oral clefts), and gardeners and women in food industry and unspecific factory work (musculoskeletal malformations). No statistically significant odds ratios were found when the material was analysed according to the paternal occupation. Some associations were found with a low social class and malformations.     

Does occupation moderate the association between domain-based physical activity and depressive symptoms?

Our aim was to test the potential moderating role of occupation type in the association between the domains of physical activity and depressive symptoms. We used data of 51,895 adults (44.8% women, 40.7 ± 13.3 years), currently employed, from the 2019 Brazilian National Health Survey. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9). Self-reported physical activity (min/week) was assessed in four domains (i.e., leisure-time, transportation, occupational, and household). Type of occupation was characterized into five categories according to the International Standard Classification of Occupations: 1) Managers/qualified professionals, 2) Technicians/associate professionals, 3) Clerks/service workers, 4) Qualified manual workers, 5) Elementary manual workers. Age, ethnicity, educational level, income, and TV-viewing were used as covariates. Poisson regression was used for the analysis of association and moderation, through the inclusion of interaction terms. In the whole sample, leisure-time physical activity was associated with lower depressive symptoms, while transportation, occupational and household physical activity were associated with higher depressive symptoms. Type of occupation modified the association between leisure-time physical activity and depressive symptoms. That is, compared to managers/qualified professionals, leisure-time physical activity had larger associations with increased depressive symptoms in technicians/associate professionals (considering an increase of 100 min/wk of physical activity: unstandardized coefficient [B]:0.073, 95%CI:0.024; 0.121), qualified (B:0.067, 95%CI:0.025; 0.110) and elementary (B:0.065, 95%CI:0.016; 0.115) manual workers than among managers/qualified professionals. Stratified analyzes by occupation suggested that leisure-time physical activity was associated with lower depressive symptoms especially among managers/qualified professionals, while household physical activity and occupational physical activity were consistently associated with higher depressive symptoms across the different occupations. Transportation physical activity was associated with elevated depressive symptoms among clerks/service workers and qualified manual workers. The association between the domains of physical activity and depressive symptoms is dependent on the type of occupation. Future research exploring the association between domain-based physical activity and depression should account for the type of occupation.     

Socioeconomic differences in the progression of carotid atherosclerosis in middle-aged men and women with subclinical atherosclerosis in Sweden

While the persistence of socioeconomic differences in cardiovascular disease (CVD) has been recognized for many years, less is known about whether socioeconomic factors are of importance to CVD before symptoms of the disease appear. In this study the associations among educational level, occupational status and progression of atherosclerosis were investigated in 1016 Swedish middle-aged men and women with signs of subclinical atherosclerosis, i.e., carotid plaque (defined as focal intima-media thickness (IMT) > 1.2 mm). IMT in the common carotid artery (CCA) and in the carotid bifurcation area, as well as carotid plaque score, was determined by B-mode ultrasound. Results showed only weak associations between educational level, occupational status and age-, sex- and baseline IMT-adjusted progression of IMT in the CCA. However, in the age, sex- and baseline IMT-adjusted analyses, those in unskilled manual occupations showed a significantly higher yearly progression of carotid IMT in the bifurcation area compared to those in high- or medium-level non-manual occupations. Those with primary education tended to show a higher yearly progression of carotid IMT in the bifurcation area compared to those with completed secondary education. After adjustment for risk factors, the magnitude of these associations were somewhat attenuated. Similar patterns of associations were seen for the change of carotid plaque score. We conclude that low socioeconomic status (SES) is associated with progression of atherosclerosis in a middle-aged population with signs of subclinical atherosclerosis. Even though socioeconomic differences in cardiovascular risk factor levels could explain part of the found differences in progression rate in women, the mechanisms involved remain to be further established.     

Cancer mortality among women employed in fast-growing U.S. occupations.

Our study examined cancer mortality before the age of 65 for women employed in the fastest growing and/or traditionally female occupations. Analysis of mortality data from 28 U.S. states for 1984-1995 revealed elevated proportionate cancer mortality ratios (PCMRs). The highest PCMRs observed were thyroid cancer among health aides, lymphatic and multiple myeloma among computer programmers, and brain cancer among actresses and directresses. Some of the excess mortality occurred for occupations that have been previously cited. These included elevated breast and ovarian cancer among teachers, Hodgkin's disease among hairdressers and cosmetologists, and thyroid cancer among health aides and therapists. A few of the associations were new, i.e., had not been previously observed. These included cancer of the connective tissue and lymphatic system among computer programmers, ovarian cancer and leukemia among secretaries, and lymphatic cancer and multiple myeloma among child care workers. These findings should be further investigated with epidemiologic and environmental studies.     

Case-control study of disturbed eating behaviors and related psychographic characteristics in young adults with and without diet-related chronic health conditions

Young adults with diet-related chronic health conditions (DRCHCs; i.e., type 1 diabetes, celiac disease, cystic fibrosis, inflammatory bowel diseases, irritable bowel syndrome) face challenges complying with dietary restrictions required to effectively manage their health condition. These restrictions could put them at risk for disturbed eating. The purpose of this study was to determine if young adults with and without DRCHCs differed with regard to disturbed eating behaviors and related psychographics characteristics (i.e., body image attributes, mental disorders, intrapersonal characteristics and sociocultural environment [i.e., media and family]). Each DRCHC participant (cases=166) was matched to 4 healthy participants (controls=664) based on gender and BMI (±0.50 BMI units). Conditional logistic regression analyses indicate cases were twice as likely to have been diagnosed by a healthcare provider with an eating disorder (p=0.08, OR=1.99, CI(90) [1.03-3.83]). Cases were significantly more likely to use Inappropriate Compensatory Behaviors to manage their weight, i.e., excessive exercise (p=0.04, OR=1.41, CI(95) [1.02-1.94]) and misuse medication (p=0.04, OR=1.14, CI(95) [1.00-1.29]) than controls. Depression and anxiety were significantly higher, and health status was significantly poorer in cases compared with controls. DRCHC participants were less likely to report feeling body image pressures from the media, placed a greater value on their health, used social diversion, and recalled a greater emphasis being placed on their mothers' weights and mealtimes being less structured than control participants. Findings indicate that nutrition and other healthcare professionals should incorporate screening DRCHC patients for disturbed eating behaviors and eating disorders in their standards of care.     

Occupational exposures associated with work-related asthma and work-related wheezing among U.S. workers

BACKGROUND: National estimates of occupational asthma (OA) in the United States are sparse. METHODS: Using data from the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, we analyzed associations between occupation and work-related asthma and work-related wheezing among U.S. workers. RESULTS: This study identified several occupations that were at risk of developing work-related asthma and/or wheezing, with cleaners and equipment cleaners showing the highest risks. Other major occupations identified were farm and agriculture; entertainment; protective services; construction; mechanics and repairers; textile; fabricators and assemblers; other transportation and material moving occupations; freight, stock, and material movers; and motor vehicle operators. The population attributable risks for work-related asthma and work-related wheezing were 26% and 27%, respectively. CONCLUSIONS: This study adds evidence to the literature that identifies work-related asthma as an important public health problem. Several occupations are targeted for additional evaluation and study. Of particular interest are cleaners, which are being increasingly reported as a risk group for asthma. Future intervention strategies need to be developed for effective control and prevention of asthma in the workplace.     

Suicide mortality and pesticide use among Canadian farmers

Background An exploratory, case-control study was used to investigate a new hypothesis about suicide among farm operators. This hypothesis suggested a biologically plausible link between exposures to certain pesticides and the occurrence of suicide among farm operators. These analyses were based on data from the Canadian Farm Operator Cohort. Methods Canadian male farm operators who committed suicide between 1971–1987 (n = 1,457) were compared with a frequency matched (by age and province) sample of control farm operators (n = 11,656) who were alive at the time of death of individual cases. Comparisons focused on past exposures to pesticides reported to the 1971 Canada Census of Agriculture. Results Multivariate logistic regression analyses indicated no associations between suicide and (1) acres sprayed with herbicides, (2) acres sprayed with insecticides, and (3) the costs of agricultural chemicals purchased; after controlling for important covariates. There was, however, a suggestive increase in risk for suicide associated with herbicide and insecticide spraying among a subgroup of farm operators who were most likely to be directly exposed to pesticides: OR = 1.71 (95% CI = 1.08–2.71) for 1–48 vs. 0 acres sprayed. Additional risk factors that were identified included seasonal vs. year-round farm work (OR = 1.68; 95% CI = 1.15–2.46); and high levels of paid labor on the farm (e.g., OR = 1.61; 95% CI = 1.24–2.10, for >13 vs. 0 weeks per year). Factors that were protective included marriage (odds ratio (OR) = 0.69; 95% confidence interval (CI) = 0.58–0.81), having more than one person resident in the farm house (e.g., two vs. one person; OR = 0.62; 95% CI = 0.42–0.92); and higher levels of education (e.g., postsecondary vs. primary; OR = 0.40; 95% CI = 0.17–0.96). Conclusions This study does not provide strong support for the main hypothesis under study, that exposure to pesticides is an important risk factor for suicide among farmers. Although secondary to the main hypothesis, a number of other risk factors for suicide were suggested. These have implications for the future study and targeting of suicide prevention programs in rural Canada. Am. J. Ind. Med. 34:364–372, 1998. © 1998 Wiley-Liss, Inc.     

Using a representative sample of workers for constructing the SUMEX French general population based job-exposure matrix

Background: Job-exposure matrices (JEMs) applicable to the general population are usually constructed by using only the expertise of specialists. Aims: To construct a population based JEM for chemical agents from data based on a sample of French workers for surveillance purposes. Methods: The SUMEX job-exposure matrix was constructed from data collected via a cross-sectional survey of a sample of French workers representative of the main economic sectors through the SUMER-94 survey: 1205 occupational physicians questioned 48 156 workers, and inventoried exposure to 102 chemicals. The companies'' economic activities and the workers'' occupations were coded according to the official French nomenclatures. A segmentation method was used to construct job groups that were homogeneous for exposure prevalence to chemical agents. The matrix was constructed in two stages: consolidation of occupations according to exposure prevalence; and establishment of exposure indices based on individual data from all the subjects in the sample. Results: An agent specific matrix could be constructed for 80 of the chemicals. The quality of the classification obtained for each was variable: globally, the performance of the method was better for less specific and therefore more easy to assess agents, and for exposures specific to certain occupations. Conclusions: Software has been developed to enable the SUMEX matrix to be used by occupational physicians and other prevention professionals responsible for surveillance of the health of the workforce in France.     

Smoking as a confounder in case-control studies of occupational bladder cancer in women.

BACKGROUND: In studies in men, risk estimates on occupation and bladder cancer are distorted by about 10% when not adjusting for smoking. We examined the degree to which occupational risk estimates for bladder cancer in women are confounded by smoking, and the degree of residual confounding by inadequate control of this effect. METHODS: Primary data of 11 case-control studies on occupation and bladder cancer from Denmark, France, Germany, Greece, Italy, and Spain were pooled. Information for smoking and lifetime occupational history for 700 female cases and 2,425 female controls ages 30-79 was abstracted and recoded. Logistic regression was used to calculate odds ratios (OR) by occupation, applying five models which differed in their degree of adjustment for smoking. RESULTS: In major occupational groups, risk estimates were distorted by less than 10% when not adjusting for smoking. A statistically significant excess risk for bladder cancer was found in 13 specific occupations and industries. In most occupations, adjustment for smoking led the ORs towards the null value, but all statistically significant associations were maintained after adjustment. In three occupations (lathe operators, field crop workers, and wood manufacturers), a statistically significant excess risk was masked when not adjusting for smoking. In six occupations, estimates were distorted by more than 10% (-22% up to +40%). In occupations where smoking acted as a positive confounder, the proportion of confounding removed using a dichotomous smoking variable (ever/never) was around 60%. In one occupation (buyers), controlling for smoking status (ever, never) led to over-adjustment, because the percentage of smokers was high but the quantity smoked was low.