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Shen CT, Hsieh HM, Chuang YS, Pan CH, Wu MT. Breast Cancer Incidence among Female Workers by Different Occupations and Industries: A Longitudinal Population-Based Matched Case-Control Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10352. [PMID: 36011986 PMCID: PMC9408650 DOI: 10.3390/ijerph191610352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Breast cancer is the leading cause of cancer incidence worldwide and in Taiwan. The relationship between breast cancer and occupational types remains unclear. This study aimed to investigate lifetime breast cancer incidence by different occupational industries among female workers in Taiwan. METHODS A population-based retrospective case-control study was conducted using three nationwide population-based databases. Matched case and control groups were identified with 1-to-4 exact matching among 103,047 female workers with breast cancer diagnosed in 2008-2017 and those without breast cancer. Their lifetime labor enrollment records were tracked using the National Labor Insurance Database, 1950-2017. Conditional logistic regression was used to analyze the association between types of occupational industries and risk of incident breast cancer. RESULTS Our study found slightly significant breast cancer risk among the following major occupational classifications: manufacturing (OR: 1.027, 95% CI: 1.011-1.043); wholesale and retail trade (OR: 1.068, 95% CI: 1.052-1.084); information and communication (OR: 1.074, 95% CI: 1.043-1.105); financial and insurance activities (OR: 1.109, 95% CI: 1.086-1.133); real estate activities (OR: 1.050, 95% CI: 1.016-1.085); professional, scientific, and technical activities (OR: 1.118, 95% CI: 1.091-1.145); public administration, defense, and social security (OR: 1.054, 95% CI: 1.023-1.087), education (OR: 1.199, 95% CI: 1.168-1.230); and human health and social work activities (OR: 1.125, 95% CI: 1.096-1.156). CONCLUSIONS Greater percentages of industrial occupations (i.e., manufacturing, wholesale and retail, or health professionals) were associated with slightly increased breast cancer risk. Further studies should investigate the possible risk factors among female workers in those industries with slightly higher incidence of breast cancer.
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Affiliation(s)
- Cheng-Ting Shen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
| | - Yun-Shiuan Chuang
- Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taipei 40767, Taiwan
| | - Ming-Tsang Wu
- Research Center for Precision Environmental Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
- Department of Family Medicine, Kaohsiung Medical University Hospital, Kaohsiung City 807, Taiwan
- Department of Public Health and PhD Program in Environmental and Occupational Medicine, Kaohsiung Medical University, Kaohsiung City 807, Taiwan
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Pedersen JE, Hansen J. Employment and risk of female breast cancer in Denmark. Am J Ind Med 2022; 65:343-356. [PMID: 35267219 DOI: 10.1002/ajim.23342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/13/2022] [Accepted: 02/14/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Occupational exposures may play a role in breast cancer etiology, and research focusing on identifying high-risk workplaces is important to advance the understanding and prevention of breast cancer. METHODS We undertook a population-based nested case-control study among women who were less than 70 years of age and born in Denmark, based on registry data including 38,375 breast cancer cases and 191,875 controls matched on year of birth, with information on lifetime work history. Odds ratios for women ever employed in a job branch were adjusted for socioeconomic status and reproductive variables. RESULTS Adjusted odds ratios of less than 0.75 were observed for several occupations in agriculture, hunting, forestry, and fishing, while increased risk patterns (odds ratios greater than 1.50) were noted for a number of production occupations, including employment in graphics and printing, and metal and machinery production. In services, several military professions were also associated with a high increased breast cancer risk. CONCLUSIONS The study shows a variation in the risk of female breast cancer by employment in different industrial and occupational sectors, and suggests that certain occupational exposures, for example, outdoor work, organic solvents, polycyclic aromatic hydrocarbons (PAHs), and night-shift work may play a role in the risk of breast cancer. Further hypothesis-testing studies focusing on these employments with a detailed assessment of specific occupational exposures are warranted.
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Affiliation(s)
- Julie E. Pedersen
- Danish Cancer Society Research Center Danish Cancer Society Copenhagen Denmark
| | - Johnni Hansen
- Danish Cancer Society Research Center Danish Cancer Society Copenhagen Denmark
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Shen CT, Hsieh HM, Pan CH, Wu MT, Chuang YS. Breast Cancer Risk Among Female Health Professionals: A 35-Year Population-Based Longitudinal Cohort Study in Taiwan. Am J Prev Med 2021; 61:831-840. [PMID: 34384653 DOI: 10.1016/j.amepre.2021.05.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/29/2021] [Accepted: 05/12/2021] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Breast cancer is the most frequently diagnosed cancer among women worldwide. Previous studies have found a higher risk in nurses but no clear relationship among other health professionals. This study aims to investigate the risks of incident breast cancer among female health professionals compared with that among nonhealth professionals in Taiwan. METHODS This longitudinal observational cohort study included >35 years (1979-2016) of data from 4 nationwide population-based databases in Taiwan and identified matched cohorts with 1-to-2 propensity score matching between 277,543 health professionals and 555,086 nonhealth professionals. This study calculated total person-years for study subjects and compared breast cancer incidence between matched health and nonhealth professionals. Multivariable Cox proportional hazards and competing risk analyses were used, stratified by birth age, job tenure categories, and types of health professional license. Statistical analyses were conducted in 2019-2020. RESULTS Health professionals had a significantly higher risk of breast cancer (hazard ratio=1.34, 95% CI=1.28-1.41; subdistribution hazard ratio=1.36, 95% CI=1.30, 1.42). Elevated risk of breast cancer incidence was associated with birth age, job tenure, and several health professional license types, including physician, pharmacist, registered nurse, midwife, medical technologist, and psychologist. CONCLUSIONS Elevated breast cancer risk was found overall in female health professionals. Regular ultrasonography for younger women and mammography for those aged >45 years may be necessary in the annual labor physical examination for female health professionals.
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Affiliation(s)
- Cheng-Ting Shen
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan
| | - Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Medical Research, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Community Medicine, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Chih-Hong Pan
- Institute of Labor, Occupational Safety and Health, Ministry of Labor, Taipei, Taiwan
| | - Ming-Tsang Wu
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Public Health, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yun-Shiuan Chuang
- Department of Family Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Andreu-Reinón ME, Huerta JM, Gavrila D, Amiano P, Mar J, Tainta M, Ardanaz E, Larumbe R, Navarro C, Colorado-Yohar SM, Navarro-Mateu F, Chirlaque MD. Incidence of Dementia and Associated Factors in the EPIC-Spain Dementia Cohort. J Alzheimers Dis 2021; 78:543-555. [PMID: 33016917 DOI: 10.3233/jad-200774] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Dementia has become a public health priority as the number of cases continues to grow worldwide. OBJECTIVE To assess dementia incidence and determinants in the EPIC-Spain Dementia Cohort. METHODS 25,015 participants (57% women) were recruited from three Spanish regions between 1992-1996 and followed-up for over 20 years. Incident cases were ascertained through individual revision of medical records of potential cases. Crude and age-adjusted incidence rates (IR) of dementia and sub-types (Alzheimer's disease (AD), and non-AD) were calculated by sex. Neelson-Aalen cumulative incidence estimates at 10, 15, and 20 years were obtained for each sex and age group. Multivariate Royston-Parmar models were used to assess independent determinants. RESULTS Global IR were higher in women for dementia and AD, and similar by sex for non-AD. IR ranged from 0.09 cases of dementia (95% confidence interval: 0.06-0.13) and 0.05 (0.03-0.09) of AD per 1000 person-years (py) in participants below 60 years, to 23.2 (15.9-33.8) cases of dementia and 14.6 (9.1-33.5) of AD (per 1000 py) in those ≥85 years. Adjusted IR were consistently higher in women than men for overall dementia and AD. Up to 12.5% of women and 9.1% of men 60-65 years-old developed dementia within 20 years. Low education, diabetes, and hyperlipidemia were the main independent predictors of dementia risk, whereas alcohol showed an inverse association. CONCLUSION Dementia incidence increased with age and was higher among women, but showed no geographical pattern. Dementia risk was higher among subjects with lower education, not drinking alcohol, and presenting cardiovascular risk factors.
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Affiliation(s)
- María Encarnación Andreu-Reinón
- Section of Neurology, Department of Internal Medicine, Rafael Méndez Hospital, Murcia Health Service, Lorca, Murcia, Spain.,Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain
| | - José María Huerta
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Diana Gavrila
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Amiano
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, Basque Government, Donostia-San Sebastián, Spain.,Biodonostia Health Research Institute, San Sebastián, Spain
| | - Javier Mar
- Biodonostia Health Research Institute, San Sebastián, Spain.,Clinical Management Unit, OSI Alto Deba, Arrasate-Mondragón, Spain.,AP-OSIs Gipuzkoa Research Unit, OSI Alto Deba, Arrasate-Mondragón, Spain.,Health Services Research Network on Chronic Patients (REDISSEC), Bilbao, Spain
| | - Mikel Tainta
- CITA Alzheimer Foundation, Donostia-San Sebastián, Spain.,Neurology Service, OSI Goierri-Alto Urola, Zumárraga, Spain
| | - Eva Ardanaz
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Institute of Navarra, IdiSNA, Pamplona, Spain
| | - Rosa Larumbe
- Public Health Institute of Navarra, IdiSNA, Pamplona, Spain.,Neuroepigenetics Laboratory, Navarrabiomed, Public University of Navarre (UPNA), Pamplona, Spain.,Department of Neurology, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Carmen Navarro
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,Department of Health and Social Sciences, University of Murcia, Murcia, Spain
| | - Sandra M Colorado-Yohar
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Research Group on Demography and Health, National Faculty of Public Health, University of Antioquia, Medellín, Colombia
| | - Fernando Navarro-Mateu
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM). Servicio Murciano de Salud, Murcia, Spain
| | - María Dolores Chirlaque
- Murcia Biomedical Research Institute (IMIB-Arrixaca), Murcia, Spain.,Department of Epidemiology, Murcia Regional Health Council, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.,Department of Health and Social Sciences, University of Murcia, Murcia, Spain
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Sari GN, Eshak ES, Shirai K, Fujino Y, Tamakoshi A, Iso H. Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study. BMC Public Health 2020; 20:1106. [PMID: 32664915 PMCID: PMC7362447 DOI: 10.1186/s12889-020-09134-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Breast cancer represented the leading cause of cancer deaths among women in Japan. Although physical activity has been reported protective against breast cancer, scientific evidence is limited on the risk of breast cancer according to job category or occupational activity in Japanese. Our objective was to examine the association of job category and occupational activity with breast cancer incidence in Japanese female workers using the data from the Japan Collaborative Cohort (JACC) Study. METHODS A prospective cohort study involving 19,041 women aged 40-79 years who have reported their occupational data and followed-up from 1988 to 2009. All variables were assessed by a self-administered questionnaire. Cancer incidence data were obtained from 24 areas of the JACC study through cancer population data registration, or review of hospital records. The Cox proportional hazard models were operated to calculate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). RESULTS There were 138 incident cases of breast cancer during 13.3 years median follow-up period. Office workers compared with manual workers were at a higher risk of breast cancer after adjusting for reproductive health factors and physical activity indicators; the multivariable HR (95% CI) was 1.65 (1.07-2.55). Also, women who had mainly a sitting position during work compared with those moving during work had the higher risk: the multivariable HR (95%CI) of 1.45 (1.01-2.12). The excess risk of breast cancer was observed for office workers when time spent in walking was < 30 min/ day; HR (95% CI) was 1.11 (1.01-1.23), and for women mainly at a sitting position during work when time spent in walking was 30-59 min or < 30 min/day; HRs (95% CIs) were 1.87 (1.07-3.27) and 1.74 (1.07-2.83), respectively. CONCLUSION The job category and occupational activity were associated with risk of breast cancer incidence. A high risk was observed in office workers and in women with a sitting position during work. These observed increased risks were evident in women with less daily walking activity.
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Affiliation(s)
- Gita Nirmala Sari
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Health Polytechnic of Jakarta III, Ministry of Health, Jakarta, Indonesia
| | - Ehab Salah Eshak
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Department of Public Health, Faculty of Medicine, Minia University, El-Minia, Egypt
| | - Kokoro Shirai
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
| | - Yoshihisa Fujino
- University of Occupational and Environmental Health, Kitakyushu, Fukuoka, Japan
| | - Akiko Tamakoshi
- Department of Public Health, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita-shi, Osaka, 565-0871 Japan
- Department of Public Health Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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Khalis M, El Rhazi K, Fort E, Chajès V, Charaka H, Huybrechts I, Moskal A, Biessy C, Romieu I, Abbass F, El Marnissi B, Mellas N, Nejjari C, Soliman AS, Charbotel B. Occupation and risk of female breast cancer: A case-control study in Morocco. Am J Ind Med 2019; 62:838-846. [PMID: 31380573 DOI: 10.1002/ajim.23027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Breast cancer is the most frequent cancer among Moroccan women. Environmental and occupational factors may play a role in breast cancer etiology. This study aimed to investigate the association between occupation, industry, and breast cancer risk among Moroccan women. METHODS A total of 300 breast cancer cases and 300 controls (matched by age and area of residence) were included in this study. Full occupational history was collected, with a detailed description of each job held for at least 6 months. Occupations were coded according to the International Standard Classification of Occupations (ISCO 08) and the Moroccan Analytical Classification of Professions (2001). Industries were coded according to the Statistical Classification of Economic Activities in the European Community (2008). Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders were estimated by using conditional logistic regression. RESULTS An overall decreased risk of breast cancer was observed among women doing only household work (OR = 0.32; 95% CI = 0.18-0.55). An increased risk of breast cancer was observed among women in agricultural occupations, particularly those employed as agricultural laborers (ISCO 08 code: 921; OR = 2.91; 95% CI = 1.51-5.60) and the risk increased with duration of employment (P trend = .01). Analyses by industry corroborated these findings. CONCLUSIONS Our findings suggest that occupational exposures may be associated with increased risk of breast cancer among female agricultural workers in this population. Further investigations, with advanced methods of occupational exposure assessment, are warranted to clarify the role of chemicals involved in this high-risk occupation and to suggest preventive actions and screening.
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Affiliation(s)
- Mohamed Khalis
- Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco
- IFSTTAR, UMRESTTE, UCBL, University of Lyon, Lyon, France
| | - Karima El Rhazi
- Department of Epidemiology, Faculty of Medicine and Pharmacy, Fez, Morocco
| | - Emmanuel Fort
- IFSTTAR, UMRESTTE, UCBL, University of Lyon, Lyon, France
| | - Véronique Chajès
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Hafida Charaka
- Department of Research and Development, Hassan II University Hospital of Fez, Fez, Morocco
| | - Inge Huybrechts
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Aurélie Moskal
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Carine Biessy
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Romieu
- Nutrition and Metabolism Section, International Agency for Research on Cancer, Lyon, France
| | - Fouad Abbass
- Department of Research and Development, Hassan II University Hospital of Fez, Fez, Morocco
| | - Boujemaa El Marnissi
- Department of Research and Development, Hassan II University Hospital of Fez, Fez, Morocco
| | - Nawfel Mellas
- Department of Oncology, Hassan II University Hospital of Fez, Fez, Morocco
| | - Chakib Nejjari
- Department of Public Health, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Amr S Soliman
- Department of Community Health and Social Medicine, City University of New York, New York, New York
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Engel CL, Sharima Rasanayagam M, Gray JM, Rizzo J. Work and Female Breast Cancer: The State of the Evidence, 2002-2017. New Solut 2019; 28:55-78. [PMID: 29658425 DOI: 10.1177/1048291118758460] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The authors undertook a scoping review to assess the literature from 2002 to 2017 on the relationship between occupation and female breast cancer. Case-control, cohort, and meta-analytic studies suggest that women working as flight attendants, in medical professions, some production positions, sales and retail, and scientific technical staff are likely to have elevated risk of breast cancer. In addition, occupational exposures to night-shift work, ionizing radiation, some chemicals, job stress, and sedentary work may increase risk of breast cancer. Occupational physical activity appears to decrease risk. Workplace exposures to passive smoke and occupational exposure to nonionizing radiation do not appear to affect breast cancer risk. Some studies of occupational categories and workplace exposures indicate that risk may be modified by duration of exposure, timing of exposure, dose, hormone-receptor subtypes, and menopausal status at diagnosis. The compelling data from this review reveal a substantial need for further research on occupation and breast cancer.
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Affiliation(s)
- Connie L Engel
- 1 Breast Cancer Prevention Partners, San Francisco, CA, USA
| | | | - Janet M Gray
- 1 Breast Cancer Prevention Partners, San Francisco, CA, USA
| | - Jeanne Rizzo
- 1 Breast Cancer Prevention Partners, San Francisco, CA, USA
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Katuwal S, Martinsen JI, Kjaerheim K, Sparen P, Tryggvadottir L, Lynge E, Weiderpass E, Pukkala E. Occupational variation in the risk of female breast cancer in the Nordic countries. Cancer Causes Control 2018; 29:1027-1038. [DOI: 10.1007/s10552-018-1076-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/23/2018] [Indexed: 12/31/2022]
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Rodgers KM, Udesky JO, Rudel RA, Brody JG. Environmental chemicals and breast cancer: An updated review of epidemiological literature informed by biological mechanisms. ENVIRONMENTAL RESEARCH 2018; 160:152-182. [PMID: 28987728 DOI: 10.1016/j.envres.2017.08.045] [Citation(s) in RCA: 234] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 08/28/2017] [Accepted: 08/29/2017] [Indexed: 05/20/2023]
Abstract
BACKGROUND Many common environmental chemicals are mammary gland carcinogens in animal studies, activate relevant hormonal pathways, or enhance mammary gland susceptibility to carcinogenesis. Breast cancer's long latency and multifactorial etiology make evaluation of these chemicals in humans challenging. OBJECTIVE For chemicals previously identified as mammary gland toxicants, we evaluated epidemiologic studies published since our 2007 review. We assessed whether study designs captured relevant exposures and disease features suggested by toxicological and biological evidence of genotoxicity, endocrine disruption, tumor promotion, or disruption of mammary gland development. METHODS We systematically searched the PubMed database for articles with breast cancer outcomes published in 2006-2016 using terms for 134 environmental chemicals, sources, or biomarkers of exposure. We critically reviewed the articles. RESULTS We identified 158 articles. Consistent with experimental evidence, a few key studies suggested higher risk for exposures during breast development to dichlorodiphenyltrichloroethane (DDT), dioxins, perfluorooctane-sulfonamide (PFOSA), and air pollution (risk estimates ranged from 2.14 to 5.0), and for occupational exposure to solvents and other mammary carcinogens, such as gasoline components (risk estimates ranged from 1.42 to 3.31). Notably, one 50-year cohort study captured exposure to DDT during several critical windows for breast development (in utero, adolescence, pregnancy) and when this chemical was still in use. Most other studies did not assess exposure during a biologically relevant window or specify the timing of exposure. Few studies considered genetic variation, but the Long Island Breast Cancer Study Project reported higher breast cancer risk for polycyclic aromatic hydrocarbons (PAHs) in women with certain genetic variations, especially in DNA repair genes. CONCLUSIONS New studies that targeted toxicologically relevant chemicals and captured biological hypotheses about genetic variants or windows of breast susceptibility added to evidence of links between environmental chemicals and breast cancer. However, many biologically relevant chemicals, including current-use consumer product chemicals, have not been adequately studied in humans. Studies are challenged to reconstruct exposures that occurred decades before diagnosis or access biological samples stored that long. Other problems include measuring rapidly metabolized chemicals and evaluating exposure to mixtures.
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Affiliation(s)
- Kathryn M Rodgers
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Julia O Udesky
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Ruthann A Rudel
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
| | - Julia Green Brody
- Silent Spring Institute, 320 Nevada Street, Newton, MA 02460, United States.
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Kullberg C, Selander J, Albin M, Borgquist S, Manjer J, Gustavsson P. Female white-collar workers remain at higher risk of breast cancer after adjustments for individual risk factors related to reproduction and lifestyle. Occup Environ Med 2017; 74:652-658. [PMID: 28456763 PMCID: PMC5574386 DOI: 10.1136/oemed-2016-104043] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 02/14/2017] [Accepted: 03/19/2017] [Indexed: 01/27/2023]
Abstract
Objectives The aim was to investigate the variation in risk of breast cancer between occupational groups with a focus on white-collar and blue-collar workers and to investigate to what extent the differences were explained by risk factors related to reproduction and lifestyle. Methods Between 1991 and 1996, 14 119 women born between 1923 and 1950 and residents of Malmö, Sweden, were included in this cohort study. Individual data on risk factors (eg, age, parity, age at first child, months of breast feeding per child, hormonal replacement therapy, physical activity, alcohol consumption, smoking, height and body mass index) and occupational history were assessed using a questionnaire. First-time diagnoses of invasive breast cancer were identified through the Swedish Cancer Registry up until 31 December 2013. Results A total of 897 women were diagnosed with breast cancer. Analyses adjusted for age showed an increased risk for white-collar workers compared with blue-collar workers and indicated higher risks in the occupational categories: professionals, administrative and bookkeeping than among women in sales, transportation, production and service work. This difference was only marginally attenuated after adjustment for an extensive set of risk factors related to reproduction and lifestyle. Conclusion Reproductive and lifestyle factors explain only a minor part of the increased risk of breast cancer in white-collar workers. Further studies are needed to investigate the remaining factors for the difference in risk between occupational groups.
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Affiliation(s)
- Cecilia Kullberg
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Selander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Maria Albin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholms Lans Landsting, Stockholm, Sweden
| | - Signe Borgquist
- Department of Clinical Sciences, Lunds Universitet, Lund, Sweden
| | - Jonas Manjer
- Department of Clinical Sciences, Lunds Universitet, Lund, Sweden.,Department of Surgery, Skåne University Hospital, Malmö, Sweden
| | - Per Gustavsson
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholms Lans Landsting, Stockholm, Sweden
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Bell K. Bread and Roses: A Gender Perspective on Environmental Justice and Public Health. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13101005. [PMID: 27754351 PMCID: PMC5086744 DOI: 10.3390/ijerph13101005] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/20/2016] [Accepted: 09/26/2016] [Indexed: 12/19/2022]
Abstract
Gender continues to be a relatively marginal issue in environmental justice debates and yet it remains an important aspect of injustice. To help redress the balance, this article explores women’s experience of environmental justice through a review of the existing literature and the author’s prior qualitative research, as well as her experience of environmental activism. The analysis confirms that women tend to experience inequitable environmental burdens (distributional injustice); and are less likely than men to have control over environmental decisions (procedural injustice), both of which impact on their health (substantive injustice). It is argued that these injustices occur because women generally have lower incomes than men and are perceived as having less social status than their male counterparts as a result of entwined and entrenched capitalist and patriarchal processes. In the light of this analysis, it is proposed that environmental justice research, teaching, policy and practice should be made more gender aware and feminist orientated. This could support cross-cutting debates and activities in support of the radical social change necessary to bring about greater social and environmental justice more generally.
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Affiliation(s)
- Karen Bell
- School for Policy Studies, University of Bristol, Bristol BS8 1TZ, UK.
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12
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Breast Cancer and Occupation: The Need for Action: APHA Policy Statement Number 20146, Issued November 18, 2014. New Solut 2015; 25:242-252. [PMID: 26078289 DOI: 10.1177/1048291115589808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Breast cancer is the most prevalent cancer among women in the United States and other countries, making it a major public health concern. Despite significant scientific evidence about its known or suspected causes, research and prevention measures to identify and eliminate occupational and other environmental hazards and risk factors for breast cancer remain largely overlooked. As a result, hazards continue unabated for women generally, especially those who work outside the home. The science linking breast cancer and occupation in particular is growing. Researchers have identified commonly used chemicals that induce breast tumors in test animals. Animal studies link chemicals that mimic reproductive hormones to elevated breast cancer rates. Other animal and human studies link chemical exposures to increased breast cancer rates, including two recent investigations focused on occupational hazards. But the latter are the exception. Studies that attempt to identify and characterize workplace agents linked to breast cancer, as well as intervention studies focusing on the use of less toxic processes and substances, are limited. In what might be construed as a case of gender and social class bias, many research and funding agencies have ignored or downplayed the role of occupational studies despite their relevance to prevention efforts. Action required starts with making a national priority of promoting and supporting research on occupational and other environmental causes of breast cancer. Other public health actions include hazard surveillance and primary prevention activities such as reductions in the use of toxic materials, informed substitution, and green chemistry efforts. The original document is accessible at the APHA website, http://www.apha.org/policies-and-advocacy/public-health-policy-statements/policy-database/2015/01/07/14/55/breast-cancer-and-occupation.
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13
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Blair A, Hines C, Thomas K, Alavanja M, Beane Freeman L, Hoppin J, Kamel F, Lynch C, Lubin J, Silverman D, Whelan E, Zahm SH, Sandler DP. Investing in prospective cohorts for etiologic study of occupational exposures. Am J Ind Med 2015; 58:113-22. [PMID: 25603935 PMCID: PMC4516175 DOI: 10.1002/ajim.22403] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2014] [Indexed: 12/13/2022]
Abstract
Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to initiate prospective cohorts to investigate high priority, occupational exposures.
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Affiliation(s)
- A. Blair
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - C.J. Hines
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - K.W. Thomas
- National Exposure Research Laboratory, U.S. Environmental Protection Agency, North Carolina
| | - M.C.R. Alavanja
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - L.E. Beane Freeman
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - J.A. Hoppin
- Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina
| | - F. Kamel
- Epidemiology Branch, National Institute for Environmental Health Sciences, North Carolina
| | - C.F. Lynch
- College of Public Health, University of Iowa, Iowa City, Iowa
| | - J.H. Lubin
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - D.T. Silverman
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - E. Whelan
- National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - S. H. Zahm
- Division of Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - D. P. Sandler
- Epidemiology Branch, National Institute for Environmental Health Sciences, North Carolina
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El-Zaemey S, Heyworth J, Glass DC, Peters S, Fritschi L. Household and occupational exposure to pesticides and risk of breast cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2014; 24:91-102. [PMID: 23767826 DOI: 10.1080/09603123.2013.800958] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
The association between breast cancer in women and the use of household or occupational pesticides was examined in a population-based case-control study. This study was conducted in Western Australia in 2009-2011 and included 1,789 controls and 1,205 cases. Information on household pesticide exposure was collected from questionnaires. For occupational pesticide exposure, job-specific modules (JSMs) were used. To evaluate potential recall bias, we stratified the analysis by belief about whether pesticides contribute to breast cancer. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Women's exposures to pesticides in households and workplaces were not related to increased risk of breast cancer (OR = 1.10; CI: 0.86-1.37) and (OR = 0.77; CI: 0.45-1.32), respectively. The prevalence of occupational exposure to pesticides among women in our study was low. In the stratified analyses, the odd ratios associated with household pesticide use were similar among participants who believed pesticides increased breast cancer risk and those who did not. The results of our study did not show associations between breast cancer and household or occupational exposure to pesticides.
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Affiliation(s)
- Sonia El-Zaemey
- a School of Population Health , The University of Western , 35 Stirling Highway, Crawley , 6009 , Australia
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15
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Brophy JT, Keith MM, Watterson A, Park R, Gilbertson M, Maticka-Tyndale E, Beck M, Abu-Zahra H, Schneider K, Reinhartz A, DeMatteo R, Luginaah I. Breast cancer risk in relation to occupations with exposure to carcinogens and endocrine disruptors: a Canadian case-control study. Environ Health 2012; 11:87. [PMID: 23164221 PMCID: PMC3533941 DOI: 10.1186/1476-069x-11-87] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 11/06/2012] [Indexed: 05/20/2023]
Abstract
BACKGROUND Endocrine disrupting chemicals and carcinogens, some of which may not yet have been classified as such, are present in many occupational environments and could increase breast cancer risk. Prior research has identified associations with breast cancer and work in agricultural and industrial settings. The purpose of this study was to further characterize possible links between breast cancer risk and occupation, particularly in farming and manufacturing, as well as to examine the impacts of early agricultural exposures, and exposure effects that are specific to the endocrine receptor status of tumours. METHODS 1005 breast cancer cases referred by a regional cancer center and 1146 randomly-selected community controls provided detailed data including occupational and reproductive histories. All reported jobs were industry- and occupation-coded for the construction of cumulative exposure metrics representing likely exposure to carcinogens and endocrine disruptors. In a frequency-matched case-control design, exposure effects were estimated using conditional logistic regression. RESULTS Across all sectors, women in jobs with potentially high exposures to carcinogens and endocrine disruptors had elevated breast cancer risk (OR = 1.42; 95% CI, 1.18-1.73, for 10 years exposure duration). Specific sectors with elevated risk included: agriculture (OR = 1.36; 95% CI, 1.01-1.82); bars-gambling (OR = 2.28; 95% CI, 0.94-5.53); automotive plastics manufacturing (OR = 2.68; 95% CI, 1.47-4.88), food canning (OR = 2.35; 95% CI, 1.00-5.53), and metalworking (OR = 1.73; 95% CI, 1.02-2.92). Estrogen receptor status of tumors with elevated risk differed by occupational grouping. Premenopausal breast cancer risk was highest for automotive plastics (OR = 4.76; 95% CI, 1.58-14.4) and food canning (OR = 5.70; 95% CI, 1.03-31.5). CONCLUSIONS These observations support hypotheses linking breast cancer risk and exposures likely to include carcinogens and endocrine disruptors, and demonstrate the value of detailed work histories in environmental and occupational epidemiology.
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Affiliation(s)
- James T Brophy
- Occupational and Environmental Health Research Group, Centre for Public Health and Population Health Research, University of Stirling, Stirling, Scotland, FK9 4LA, UK
- Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada
| | - Margaret M Keith
- Occupational and Environmental Health Research Group, Centre for Public Health and Population Health Research, University of Stirling, Stirling, Scotland, FK9 4LA, UK
- Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada
| | - Andrew Watterson
- Occupational and Environmental Health Research Group, Centre for Public Health and Population Health Research, University of Stirling, Stirling, Scotland, FK9 4LA, UK
| | - Robert Park
- Education and Information Division, National Institute for Occupational Safety and Health (NIOSH), 4676 Columbia Parkway, Cincinnati, Ohio, 45226, USA
| | - Michael Gilbertson
- Occupational and Environmental Health Research Group, Centre for Public Health and Population Health Research, University of Stirling, Stirling, Scotland, FK9 4LA, UK
| | - Eleanor Maticka-Tyndale
- Department of Sociology, Anthropology, and Criminology, University of Windsor, 401 Sunset Avenue, Windsor, ON, N9B 3P4, Canada
| | - Matthias Beck
- Queen’s University Belfast, University Road, Belfast, Northern Ireland, BT7 1NN, UK
| | - Hakam Abu-Zahra
- Windsor Regional Cancer Centre, 2220 Kildare Road, Windsor, ON, N8W 2X3, Canada
| | - Kenneth Schneider
- Windsor Regional Cancer Centre, 2220 Kildare Road, Windsor, ON, N8W 2X3, Canada
| | - Abraham Reinhartz
- Occupational Health Clinics for Ontario Workers, 15 Gervais Drive, Suite 601, Don Mills, ON, M3C1Y8, Canada
| | - Robert DeMatteo
- Occupational Health Clinics for Ontario Workers, 15 Gervais Drive, Suite 601, Don Mills, ON, M3C1Y8, Canada
| | - Isaac Luginaah
- Department of Geography, Social Science Centre, University of Western Ontario, London, ON, N6A 5C2, Canada
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Villeneuve S, Févotte J, Anger A, Truong T, Lamkarkach F, Gaye O, Kerbrat P, Arveux P, Miglianico L, Imbernon E, Guénel P. Breast cancer risk by occupation and industry: analysis of the CECILE study, a population-based case-control study in France. Am J Ind Med 2011; 54:499-509. [PMID: 21472744 DOI: 10.1002/ajim.20952] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2011] [Indexed: 11/10/2022]
Abstract
BACKGROUND It has been suggested that certain occupational exposures may play a role in breast cancer etiology. The recognition of high-risk occupations may give clues about potential mammary carcinogens in the work place. METHODS We conducted a population-based case-control study in France including 1,230 breast cancer cases and 1,315 population controls with detailed information on lifetime work history. Odds ratios for women ever employed in an occupation or industry were adjusted for well-established risk factors for breast cancer. RESULTS Adjusted odds ratios were marginally increased in some white-collar occupations, as well as in textile workers (2.4; 95% CI [0.9-6.0]), rubber and plastics product makers (1.8; 95% CI [0.9-3.5]), and in women employed for more than 10 years as nurses (1.4; 95% CI [0.9-2.1]) and as tailors/dressmakers (1.5; 95% CI [0.9-2.6]). The incidence of breast cancer was increased among women employed in the manufacture of chemicals, of non-metallic mineral products, and decreased among women in agriculture. CONCLUSIONS These findings suggest a possible role of occupational exposures in breast cancer, including night-shift work, solvents and endocrine disrupting chemicals and require further studies with detailed assessment of occupational exposures.
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Affiliation(s)
- Sara Villeneuve
- National Institute of Health and Medical Research, Center for Research in Epidemiology and Population Health, Environmental Epidemiology of Cancer, Villejuif, France
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Lee KH, Shu XO, Gao YT, Ji BT, Yang G, Blair A, Rothman N, Zheng W, Chow WH, Kang D. Breast cancer and urinary biomarkers of polycyclic aromatic hydrocarbon and oxidative stress in the Shanghai Women's Health Study. Cancer Epidemiol Biomarkers Prev 2010; 19:877-83. [PMID: 20160264 DOI: 10.1158/1055-9965.epi-09-1098] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Polycyclic aromatic hydrocarbon (PAH) exposure and oxidative stress from such and other exposures have been associated with breast cancer in some studies. To further evaluate the role of PAH metabolites and oxidative stress on the development of breast cancer, we conducted a nested case-control study in the Shanghai Women's Health Study. We measured urinary 1-hydroxypyrene and 2-naphthol as PAH metabolites and urinary levels of 8-hydroxy-2'-deoxyguanosine and malondialdehyde as oxidative stress biomarkers in 327 breast cancer cases and 654 controls in the Shanghai Women's Health Study. Information on demographic characteristics, past medical history, lifestyles, history of menstruation, pregnancy history, eating and drinking habit, history of residence, employment history, family history, husband's information, and physical activity were collected by a self-administered questionnaire. The mean age was 52.3 in breast cancer cases (n = 354) and 52.5 in controls (n = 708). Age at menarche (P = 0.04), months of breast-feeding the first baby (P = 0.05), and grade of education (P(trend) < 0.01) were significantly different between cases and controls. No association was observed for PAH metabolites and the oxidative stress biomarkers of urinary malondialdehyde and 8-hydroxy-2'-deoxyguanosine and risk of breast cancer. This nested case-control study provides no evidence of association between PAH exposure and oxidative stress and risk of breast cancer in Shanghai women.
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Affiliation(s)
- Kyoung-Ho Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Institute of Environmental Medicine, SNUMRC, Seoul, Korea
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