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Khalifeh M, Goldfarb DG, Zeig-Owens R, Todd AC, Shapiro MZ, Carwile M, Dasaro CR, Li J, Yung J, Farfel MR, Brackbill RM, Cone JE, Qiao B, Schymura MJ, Prezant DJ, Hall C, Boffetta P. Cancer incidence in World Trade Center rescue and recovery workers by race and ethnicity. Am J Ind Med 2023; 66:1048-1055. [PMID: 37746817 DOI: 10.1002/ajim.23539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023]
Abstract
INTRODUCTION It is unclear whether differences in health outcomes by racial and ethnic groups among World Trade Center (WTC) rescue and recovery workers reflect those of the population of New York State (NYS) or show distinct patterns. We assessed cancer incidence in WTC workers by self-reported race and ethnicity, and compared it to population figures for NYS. METHODS A total of 61,031 WTC workers enrolled between September 11, 2001 and January 10, 2012 were followed to December 31, 2015. To evaluate the association between race/ethnicity and cancer risk, Poisson regression analysis was used to estimate hazard ratios (HR) adjusted for WTC exposure, age, calendar year, sex and, for lung cancer, cigarette smoking. RESULTS In comparison to Whites, Black workers had a higher incidence of prostate cancer (HR = 1.99, 95% CI = 1.69-2.34) and multiple myeloma (HR = 3.57, 95% CI = 1.97-6.45), and a lower incidence of thyroid (HR = 0.41, 95% CI = 0.22-0.78) and colorectal cancer (HR = 0.57; 95% CI = 0.33-0.98). Hispanic workers had a higher incidence of liver cancer (HR = 4.03, 95% CI = 2.23-7.28). Compared with NYS population, White workers had significantly higher incidence of prostate cancer (HR = 1.26, 95% CI = 1.18-1.35) and thyroid cancer (HR = 1.80, 95% CI = 1.55-2.08), while Black workers had significantly higher incidence of prostate cancer (HR = 1.22, 95% CI = 1.05-1.40). CONCLUSION Cancer incidence in WTC workers generally reflects data from the NYS population, but some differences were identified that merit further investigation.
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Affiliation(s)
- Malak Khalifeh
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
| | - David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Moshe Z Shapiro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Madeline Carwile
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jiehui Li
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Janette Yung
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Robert M Brackbill
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - James E Cone
- New York City Department of Health and Mental Hygiene, Long Island City, New York, USA
| | - Baozhen Qiao
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - Maria J Schymura
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, New York, USA
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles Hall
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Lee DJ, Ahn S, McClure LA, Caban-Martinez AJ, Kobetz EN, Ukani H, Boga DJ, Hernandez D, Pinheiro PS. Cancer risk and mortality among firefighters: a meta-analytic review. Front Oncol 2023; 13:1130754. [PMID: 37251928 PMCID: PMC10213433 DOI: 10.3389/fonc.2023.1130754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/26/2023] [Indexed: 05/31/2023] Open
Abstract
Background Firefighting is a hazardous occupation that is associated with an increased risk of select cancers. The number of studies has grown in recent years allowing for a synthesis of findings. Methods Following PRISMA guidelines, multiple electronic databases were searched to identify studies on firefighter cancer risk and mortality. We computed pooled standardized incidence risk (SIRE) and standardized mortality estimates (SMRE), tested for publication bias, and conducted moderator analyses. Results Thirty-eight studies published between 1978 and March 2022 were included for final meta-analysis. Overall, cancer incidence and mortality were significantly lower for firefighters (SIRE = 0.93; 95% CI: 0.91-0.95; SMRE = 0.93; 95% CI: 0.92 - 0.95) compared to the general population. Incident cancer risks were significantly higher for skin melanoma (SIRE = 1.14; 95% CI:1.08 - 1.21), other skin cancers (SIRE = 1.24; 95% CI:1.16-1.32), and prostate cancer (SIRE = 1.09; 95% CI: 1.04-1.14). Firefighters showed higher mortality for rectum (SMRE = 1.18; 95% CI: 1.02-1.36), testis (SMRE = 1.64; 95% CI: 1.00-2.67), and non-Hodgkin lymphoma (SMRE = 1.20; 95% CI: 1.02-1.40). There was evidence of publication bias for SIRE and SMRE estimates. Some moderators explained variations in study effects, including study quality scores. Conclusion Firefighters are at higher risk for several cancers; to the extent that some (e.g., melanoma and prostate) are screening amenable, more study into firefighter-specific recommendations for cancer surveillance is needed. Moreover, longitudinal studies with more detailed data on the specific length and types of exposures are necessary, as well as on unstudied subtypes of cancers (e.g., subtypes of brain cancer and leukemias) are needed.
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Affiliation(s)
- David J. Lee
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Soyeon Ahn
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Miami, FL, United States
| | - Laura A. McClure
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
| | - Alberto J. Caban-Martinez
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
- Department of Physical Medicine and Rehabilitation, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Erin N. Kobetz
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
- Department of Medicine, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Henna Ukani
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Devina J. Boga
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Diana Hernandez
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Paulo S. Pinheiro
- Department Public Health Sciences, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, United States
- Sylvester Comprehensive Cancer Center, University of Miami Health Systems, Miami, FL, United States
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Heikkinen S, Demers PA, Hansen J, Jakobsen J, Kjaerheim K, Lynge E, Martinsen JI, Mehlum IS, Pitkäniemi J, Selander J, Torfadóttir J, Weiderpass E, Pukkala E. Incidence of cancer among Nordic police officers. Int J Cancer 2023; 152:1124-1136. [PMID: 36196485 DOI: 10.1002/ijc.34311] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/25/2022] [Accepted: 09/02/2022] [Indexed: 01/21/2023]
Abstract
Police work may expose officers to various circumstances that have potential for increasing their risk of cancer, including traffic-related air pollution, night shift work and radiation from radars. In this study, we examined the incidence of cancer among Nordic male and female police officers. We utilize data from the Nordic Occupational Cancer (NOCCA) project, which linked census data on occupations from Finland, Iceland, Norway and Sweden to national cancer registries for the period 1961 to 2005. We report standardized incidence ratios (SIR) and 95% confidence intervals (CI) of selected cancers for each country by sex, age and calendar period. The cohort included 38 523 male and 1998 female police officers. As compared with the general population, male police officers had a 7% (95% CI: 4-9%) excess cancer risk, with elevated SIRs for various cancer sites, including prostate (SIR 1.19, 1.14-1.25), breast (SIR 1.77, 1.05-2.80), colon (SIR 1.22, 1.12-1.32) and skin melanoma (SIR 1.44, 1.28-1.60). Conversely, male police officers had a lower risk of lung cancer than the general population (SIR 0.72, 0.66-0.77). In female police officers, the SIR for cancer overall was 1.15 (0.98-1.34), and there was a slight excess of cancers of the breast (SIR 1.25, 0.97-1.59) and colon (SIR 1.21, 0.55-2.30). In conclusion, cancer incidence among the police officers was slightly higher than in the general population. Notably, SIRs were elevated for cancer sites potentially related to night shift work, namely colon, breast and prostate cancer.
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Affiliation(s)
- Sanna Heikkinen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Paul A Demers
- Occupational Cancer Research Center, Ontario Health, Ontario, Canada
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Jarle Jakobsen
- Department of Research, Cancer Registry of Norway, Oslo, Norway
| | | | | | | | | | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Tampere University, Tampere, Finland
| | | | - Jóhanna Torfadóttir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
- Tampere University, Tampere, Finland
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Lin S, Li J, Wu J, Yang F, Pei L, Shang X. Interactive effects of maternal exposure to chemical fertilizer and socio-economic status on the risk of low birth weight. BMC Public Health 2022; 22:1206. [PMID: 35710359 PMCID: PMC9204990 DOI: 10.1186/s12889-022-13604-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 06/06/2022] [Indexed: 11/17/2022] Open
Abstract
Background Maternal exposure to chemical fertilizer and disadvantaged maternal socio-economic status (SES) have been found to associate with increased risk of low birth weight (LBW). However, whether the two factors would interact to elevate the risk of LBW remains unknown. The present study aimed to explore the interactive effects of maternal exposure to chemical fertilizer during pregnancy and low SES on the risk of term LBW (tLBW). Methods In this population-based case–control study, 179 tLBW cases (birthweight < 2500 g and gestational age ≥ 37 weeks) and 204 controls (birthweight ≥ 2500 g and gestational age ≥ 37 weeks) were chosen from the Perinatal Health Care Surveillance System of Pingding County, Shanxi Province, China between 2007 and 2012. Data on basic socio-demographic, dietary and lifestyle characteristics and environmental exposure were directly extracted from the system. Maternal exposure to chemical fertilizer was measured at both household level and village level. Household-level exposure was indicated by household chemical fertilizer use in farming during pregnancy and the data was collected by trained healthcare workers after the selection of cases and controls in 2013. Village-level exposure was indicated by annual amount of village chemical fertilizer consumption per acre and the data came from the Annals of National Economics Statistics of Pingding County in 2010. Interactions between maternal exposure to chemical fertilizer and SES were assessed in logistic regressions using relative excess risk due to interaction (RERI), which indicates an additive interaction if larger than 0. Results The combination of low maternal SES and high exposure to village-level chemical fertilizer consumption was associated with increased risk of tLBW (aOR = 2.62, 95%CI: 1.44 ~ 4.77); The combination of low maternal SES and exposure to household chemical fertilizer use was associated with elevated risk of tLBW (aOR = 2.18, 95%CI: 1.24 ~ 3.83). Additive interactions were detected between high exposure to village-level chemical fertilizer consumption and low maternal SES (RERI:1.79, P < 0.001) and between exposure to household chemical fertilizer use and low maternal SES (RERI:0.77, P < 0.05). Conclusions Our study suggested negative impacts of potential agricultural pollutants on adverse pregnancy outcomes, especially in disadvantaged socio-economic populations. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13604-z.
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Affiliation(s)
- Shiqi Lin
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, 100871, China
| | - Jiajia Li
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, 100871, China
| | - Jilei Wu
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, 100871, China
| | - Fan Yang
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, 100871, China
| | - Lijun Pei
- Institute of Population Research/China Center on Population Health and Development, Peking University, Beijing, 100871, China.
| | - Xuejun Shang
- Department of Andrology, School of Medicine, Jinling Hospital, Nanjing University, No.305, East Zhongshan Road, Nanjing, 210002, Jiangsu, China.
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Patil SP, Fattakhova E, Hofer J, Oravic M, Bender A, Brearey J, Parker D, Radnoff M, Smith Z. Machine-Learning Guided Discovery of Bioactive Inhibitors of PD1-PDL1 Interaction. Pharmaceuticals (Basel) 2022; 15:ph15050613. [PMID: 35631439 PMCID: PMC9145945 DOI: 10.3390/ph15050613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/06/2022] [Accepted: 05/13/2022] [Indexed: 02/06/2023] Open
Abstract
The selective activation of the innate immune system through blockade of immune checkpoint PD1-PDL1 interaction has proven effective against a variety of cancers. In contrast to six antibody therapies approved and several under clinical investigation, the development of small-molecule PD1-PDL1 inhibitors is still in its infancy with no such drugs approved yet. Nevertheless, a promising series of small molecules inducing PDL1 dimerization has revealed important spatio-chemical features required for effective PD1-PDL1 inhibition through PDL1 sequestration. In the present study, we utilized these features for developing machine-learning (ML) classifiers by fitting Random Forest models to six 2D fingerprint descriptors. A focused database of ~16 K bioactive molecules, including approved and experimental drugs, was screened using these ML models, leading to classification of 361 molecules as potentially active. These ML hits were subjected to molecular docking studies to further shortlist them based on their binding interactions within the PDL1 dimer pocket. The top 20 molecules with favorable interactions were experimentally tested using HTRF human PD1-PDL1 binding assays, leading to the identification of two active molecules, CRT5 and P053, with the IC50 values of 22.35 and 33.65 µM, respectively. Owing to their bioactive nature, our newly discovered molecules may prove suitable for further medicinal chemistry optimization, leading to more potent and selective PD1-PDL1 inhibitors. Finally, our ML models and the integrated screening protocol may prove useful for screening larger libraries for novel PD1-PDL1 inhibitors.
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Affiliation(s)
- Sachin P. Patil
- NanoBio Lab, School of Engineering, Widener University, Chester, PA 19013, USA
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
- Correspondence: ; Tel.: +1-610-499-4492
| | - Elena Fattakhova
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
| | - Jeremy Hofer
- Department of Computer Science, Widener University, Chester, PA 19013, USA;
| | - Michael Oravic
- Department of Biomedical Engineering, Widener University, Chester, PA 19013, USA;
| | - Autumn Bender
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
| | - Jason Brearey
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
| | - Daniel Parker
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
| | - Madison Radnoff
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
| | - Zackary Smith
- Department of Chemical Engineering, Widener University, Chester, PA 19013, USA; (E.F.); (A.B.); (J.B.); (D.P.); (M.R.); (Z.S.)
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6
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Sritharan J, Kirkham TL, MacLeod J, Marjerrison N, Lau A, Dakouo M, Logar-Henderson C, Norzin T, DeBono NL, Demers PA. Cancer risk among firefighters and police in the Ontario workforce. Occup Environ Med 2022; 79:533-539. [PMID: 35354650 PMCID: PMC9304109 DOI: 10.1136/oemed-2021-108146] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/05/2022] [Indexed: 11/23/2022]
Abstract
Objective Firefighters and police often work in high-stress, complex environments with known and suspected carcinogenic exposures. We aimed to characterise cancer incidence among firefighters and police. Methods The Occupational Disease Surveillance System (ODSS) was used to identify workers employed as firefighters or police in Ontario. A cohort of workers were identified using lost-time workers’ compensation claims data and followed for cancer in the Ontario Cancer Registry (1983–2020). Cox proportional hazard models were used to estimate HRs and 95% CIs for primary site-specific cancer diagnoses adjusted for age at start of follow-up, birth year and sex. Results A total of 13 642 firefighters and 22 595 police were identified in the cohort. Compared with all other workers in the ODSS, firefighters and police had increased risk of prostate cancer (firefighters: HR=1.43, 95% CI 1.31 to 1.57; police: HR=1.47, 95% CI 1.35 to 1.59), colon cancer (firefighters: HR=1.39, 95% CI 1.19 to 1.63; police: HR=1.39, 95% CI 1.21 to 1.60) and skin melanoma (firefighters: HR=2.38, 95% CI 1.99 to 2.84; police: HR=2.27, 95% CI 1.96 to 2.62). Firefighters also had increased risk of cancer of the pancreas, testis and kidney, as well as non-Hodgkin’s lymphoma and leukaemia. Police had increased risk of thyroid, bladder and female breast cancer. When compared directly with the police, firefighters had an elevated risk of mesothelioma and testicular cancer. Conclusions Firefighters and police demonstrated some similar as well as some unique cancer risks. Findings from this larger worker population may have important implications for workplace and policy-level changes to improve preventative measures and reduce potential exposures to known carcinogenic hazards.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jill MacLeod
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Niki Marjerrison
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Ashley Lau
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | | | - Tenzin Norzin
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Nathan L DeBono
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Li J, Yung J, Qiao B, Takemoto E, Goldfarb DG, Zeig-Owens R, Cone JE, Brackbill RM, Farfel MR, Kahn AR, Schymura MJ, Shapiro MZ, Dasaro CR, Todd AC, Kristjansson D, Prezant DJ, Boffetta P, Hall CB. Cancer Incidence in World Trade Center Rescue and Recovery Workers: 14 Years of Follow-Up. J Natl Cancer Inst 2022; 114:210-219. [PMID: 34498043 PMCID: PMC8826586 DOI: 10.1093/jnci/djab165] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Statistically significantly increased cancer incidence has been reported from 3 cohorts of World Trade Center (WTC) disaster rescue and recovery workers. We pooled data across these cohorts to address ongoing public concerns regarding cancer risk 14 years after WTC exposure. METHODS From a combined deduplicated cohort of 69 102 WTC rescue and recovery workers, a sample of 57 402 workers enrolled before 2009 and followed through 2015 was studied. Invasive cancers diagnosed in 2002-2015 were identified from 13 state cancer registries. Standardized incidence ratios (SIRs) were used to assess cancer incidence. Adjusted hazard ratios (aHRs) were estimated from Cox regression to examine associations between WTC exposures and cancer risk. RESULTS Of the 3611 incident cancers identified, 3236 were reported as first-time primary (FP) cancers, with an accumulated 649 724 and 624 620 person-years of follow-up, respectively. Incidence for combined FP cancers was below expectation (SIR = 0.96, 95% confidence interval [CI] = 0.93 to 0.99). Statistically significantly elevated SIRs were observed for melanoma-skin (SIR = 1.43, 95% CI = 1.24 to 1.64), prostate (SIR = 1.19, 95% CI = 1.11 to 1.26), thyroid (SIR = 1.81, 95% CI = 1.57 to 2.09), and tonsil (SIR = 1.40, 95% CI = 1.00 to 1.91) cancer. Those arriving on September 11 had statistically significantly higher aHRs than those arriving after September 17, 2001, for prostate (aHR = 1.61, 95% CI = 1.33 to 1.95) and thyroid (aHR = 1.77, 95% CI = 1.11 to 2.81) cancers, with a statistically significant exposure-response trend for both. CONCLUSIONS In the largest cohort of 9/11 rescue and recovery workers ever studied, overall cancer incidence was lower than expected, and intensity of WTC exposure was associated with increased risk for specific cancer sites, demonstrating the value of long-term follow-up studies after environmental disasters.
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Affiliation(s)
- Jiehui Li
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - Janette Yung
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - Baozhen Qiao
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, NY, USA
| | - Erin Takemoto
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - David G Goldfarb
- Fire Department of the City of New York (FDNY), Brooklyn, NY, USA
- Department of Medicine, Montefiore Medical Center, New York, NY, USA
| | - Rachel Zeig-Owens
- Fire Department of the City of New York (FDNY), Brooklyn, NY, USA
- Department of Medicine, Montefiore Medical Center, New York, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - James E Cone
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - Robert M Brackbill
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - Mark R Farfel
- New York City Department of Health and Mental Hygiene, World Trade Center Health Registry, Long Island City, NY, USA
| | - Amy R Kahn
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, NY, USA
| | - Maria J Schymura
- New York State Department of Health, Bureau of Cancer Epidemiology, Albany, NY, USA
| | - Moshe Z Shapiro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Dana Kristjansson
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
| | - David J Prezant
- Fire Department of the City of New York (FDNY), Brooklyn, NY, USA
- Department of Medicine, Montefiore Medical Center, New York, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Paolo Boffetta
- Medicine Department of Family, Population and Preventive Medicine Health Sciences, Stony Brook University, Stony Brook Cancer Center, Stony Brook, NY, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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8
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Occupation and prostate Cancer risk: results from the epidemiological study of prostate cancer (EPICAP). J Occup Med Toxicol 2022; 17:5. [PMID: 35130905 PMCID: PMC8819870 DOI: 10.1186/s12995-022-00346-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Background Although prostate cancer (PCa) is the most frequent male cancer in industrialized countries, little is known about its aetiology. The literature has suggested an influence of the environment, including occupational exposures, but results are inconsistent. In this context, we investigated PCa risk associated to employment among several occupations using data from EPICAP study. Methods EPICAP is a French population-based case-control study including 819 PCa incident cases and 879 controls frequency-matched on age. In-person interviews gathered data on potential risk factors and lifetime occupational histories for each job held at least 6 months. Then, occupations were coded using ISCO 68. Unconditional logistic regressions were performed to assess the association between occupations (ever occupied and by duration) and PCa risk, whether all and aggressive, after adjusting for potential confounders. Results For ≥10 years of employment, we found positive associations with PCa, whether overall and aggressive, among Medical, Dental and Veterinary workers (OR (odds ratios) =5.01 [95% confidence interval] [1.27; 19.77]), Members of the armed forces (OR = 5.14 [0.99; 26.71]) and Fishermen, hunters and related workers (OR = 4.58 [1.33; 15.78]); whether overall and non-aggressive PCa, among Legislative officials and Government administrators (OR = 3.30 [1.10; 9.84]) or Managers (OR = 1.68 [1.18; 2.41]); however a negative association, whether overall and non-aggressive PCa, among Material-Handling and Related Equipment Operators, Dockers and Freight Handlers (OR = 0.40 [0.17; 0.97]). Conclusion Excess PCa risks were observed in the EPICAP study mostly among white collar workers exposed to several factors in their work environment. These emerging associations can be used to lead future research investigating specific occupational exposures. Supplementary Information The online version contains supplementary material available at 10.1186/s12995-022-00346-2.
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Goldfarb DG, Zeig-Owens R, Kristjansson D, Li J, Brackbill RM, Farfel MR, Cone JE, Yung J, Kahn AR, Qiao B, Schymura MJ, Webber MP, Dasaro CR, Shapiro M, Todd AC, Prezant DJ, Boffetta P, Hall CB. Temporal association of prostate cancer incidence with World Trade Center rescue/recovery work. Occup Environ Med 2021; 78:699-706. [PMID: 34507966 PMCID: PMC8458078 DOI: 10.1136/oemed-2021-107405] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/20/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The World Trade Center (WTC) attacks on 11 September 2001 created a hazardous environment with known and suspected carcinogens. Previous studies have identified an increased risk of prostate cancer in responder cohorts compared with the general male population. OBJECTIVES To estimate the length of time to prostate cancer among WTC rescue/recovery workers by determining specific time periods during which the risk was significantly elevated. METHODS Person-time accruals began 6 months after enrolment into a WTC cohort and ended at death or 12/31/2015. Cancer data were obtained through linkages with 13 state cancer registries. New York State was the comparison population. We used Poisson regression to estimate hazard ratios and 95% CIs; change points in rate ratios were estimated using profile likelihood. RESULTS The analytic cohort included 54 394 male rescue/recovery workers. We observed 1120 incident prostate cancer cases. During 2002-2006, no association with WTC exposure was detected. Beginning in 2007, a 24% increased risk (HR: 1.24, 95% CI 1.16 to 1.32) was observed among WTC rescue/recovery workers when compared with New York State. Comparing those who arrived earliest at the disaster site on the morning of 11 September 2001 or any time on 12 September 2001 to those who first arrived later, we observed a positive, monotonic, dose-response association in the early (2002-2006) and late (2007-2015) periods. CONCLUSIONS Risk of prostate cancer was significantly elevated beginning in 2007 in the WTC combined rescue/recovery cohort. While unique exposures at the disaster site might have contributed to the observed effect, screening practices including routine prostate specific antigen screening cannot be discounted.
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Affiliation(s)
- David G Goldfarb
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Division of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Dana Kristjansson
- Department of Genetics and Bioinformatics, Norwegian Institute of Public Health, Oslo, Norway
- Center of Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Jiehui Li
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Robert M Brackbill
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Mark R Farfel
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - James E Cone
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Janette Yung
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, New York, USA
| | - Amy R Kahn
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Baozhen Qiao
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Maria J Schymura
- Bureau of Cancer Epidemiology, New York State Department of Health, Albany, New York, USA
| | - Mayris P Webber
- Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Division of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Epidemiology and Population Health, Division of Epidemiology, Montefiore Medical Center, Bronx, New York, USA
| | - Christopher R Dasaro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Moshe Shapiro
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Andrew C Todd
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - David J Prezant
- Department of Medicine, Division of Pulmonary Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, World Trade Center Health Program, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Division of Epidemiology, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Paolo Boffetta
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Emilia-Romagna, Italy
| | - Charles B Hall
- Department of Epidemiology & Population Health, Division of Biostatistics, Albert Einstein College of Medicine, Bronx, New York, USA
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Laroche E, L’Espérance S. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2519. [PMID: 33802629 PMCID: PMC7967542 DOI: 10.3390/ijerph18052519] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
Firefighters are exposed to carcinogens that may increase their risk of developing many types of occupational cancer. Many systematic reviews (SRs) have been produced with sometimes conflicting conclusions. In this overview of reviews, we aim to assess the conclusion consistency across the available systematic reviews on the cancer risk in firefighters. Literature searches were conducted in several indexed databases and grey literature to retrieve systematic reviews aiming to evaluate cancer incidence or cancer mortality in firefighters. Results from included SRs were analyzed according to the tumour site. Out of 1054 records identified by the search in the databases, a total of 11 SRs were ultimately included. The original studies (n = 104) analyzed in the SRs were published between 1959 and 2018. The results consistently reported a significant increase in the incidence of rectal, prostate, bladder and testicular cancers as well as mesothelioma and malignant melanoma in firefighters compared to the general population. The SRs also indicate that death rates from rectal cancer and non-Hodgkin's lymphoma are higher among firefighters. Consistent SR results suggest that several types of cancer may be more frequent in firefighters than in the general population.
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Affiliation(s)
- Elena Laroche
- School of Administration Sciences, Université TELUQ, Quebec, QC G1K 9H6, Canada;
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11
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Sanaati F, Geranmayeh M, Behboodi Moghadam Z, Zareiyan A, Samadaee Gelehkolaee K, Mirghafourvand M. A population-based study of health-promoting behaviors and their predictors in Iranian males, 2019. Arch Public Health 2021; 79:23. [PMID: 33632343 PMCID: PMC7905917 DOI: 10.1186/s13690-021-00543-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 02/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Health-promoting lifestyle (HPL) is any measure taken to maintain a person's health. The most important and influential factor in maintaining and enhancing health are health-promoting behaviors (HPB). This study aimed to determine HPB and their predictors among Iranian men. METHODS In this cross-sectional study, 783 Iranian men, living in Tehran, were selected, using multistage cluster sampling. The employed questionnaires, namely the sociodemographic questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), and the second part of the Personal Resource Questionnaire (PRQ 85-Part 2), were completed through interviews. The relationship between the dependent variables (HPLP-II and its subdomains) and independent variables (sociodemographic characteristics and social support) was investigated using the adjusted General Linear Model (GLM). RESULTS The mean ± standard deviation of the total HPLP-II score was 2.72 ± 0.44 in the range of 1-4. Among the six dimensions of the HPB, the participants achieved the highest score (3.00 ± 0.52) and lowest score (1.96 ± 0.56) in spiritual growth and physical activity, respectively. The Pearson test showed that the perceived social support was significantly correlated with HPLP-II (r = 0.23; p < 0.001) and all of its subdomains (r = 0.09-0.24; p < 0.001). Based on the adjusted general linear model, social support, age, job, and income adequacy were the predictors of HPL in men and could explain 30.9% of the variance of the HPL score. CONCLUSIONS The research findings confirmed the importance of social support and modifying variables (social and personal) in the incidence of HPB in men.
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Affiliation(s)
- Fovziye Sanaati
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnaz Geranmayeh
- Department of Midwifery, Faculty of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Armin Zareiyan
- Public Health Department, Nursing Faculty, AjA University of Medical Sciences, Tehran, Iran
| | | | - Mojgan Mirghafourvand
- Midwifery Department, Social determinants of Health Research Center, Tabriz University of Medical Sciences, P.O. Box: 51745-347, Shariati Street, Tabriz, 513897977, Iran.
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12
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Leiser CL, Taddie M, Hemmert R, Richards Steed R, VanDerslice JA, Henry K, Ambrose J, O'Neil B, Smith KR, Hanson HA. Spatial clusters of cancer incidence: analyzing 1940 census data linked to 1966-2017 cancer records. Cancer Causes Control 2020; 31:609-615. [PMID: 32323050 PMCID: PMC7574665 DOI: 10.1007/s10552-020-01302-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 04/15/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE A life course perspective to cancer incidence is important for understanding effects of the environment during early life on later cancer risk. We assessed spatial clusters of cancer incidence based on early life location defined as 1940 US Census Enumeration District (ED). METHODS A cohort of 260,585 individuals aged 0-40 years in 1940 was selected. Individuals were followed from 1940 to cancer diagnosis, death, or last residence in Utah. We geocoded ED centroids in Utah for the 1940 Census. Spatial scan statistics with purely spatial elliptic scanning window were used to identify spatial clusters of EDs with excess cancer rates across 26 cancer types, assuming a discrete Poisson model. RESULTS Cancer was diagnosed in 66,904 (25.67%) individuals during follow-up across 892 EDs. Average follow-up was 50.9 years. We detected 15 clusters of excess risk for bladder, breast, cervix, colon, lung, melanoma, oral, ovary, prostate, and soft tissue cancers. An urban area had dense overlap of multiple cancer types, including two EDs at increased risk for five cancer types each. CONCLUSIONS Early environments may contribute to cancer risk later in life. Life course perspectives applied to the study of cancer incidence can provide insights for increasing understanding of cancer etiology.
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Affiliation(s)
- Claire L Leiser
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
- Department of Epidemiology, University of Washington, Seattle, WA, USA.
| | - Marissa Taddie
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Rachael Hemmert
- Department of Obstetrics and Gynecology, University of Utah, Salt Lake City, UT, USA
| | - Rebecca Richards Steed
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Geography, University of Utah, Salt Lake City, UT, USA
| | - James A VanDerslice
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kevin Henry
- Department of Geography and Urban Studies, Temple University, Philadelphia, PA, USA
| | - Jacob Ambrose
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Brock O'Neil
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
| | - Ken R Smith
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Family and Consumer Studies, University of Utah, Salt Lake City, UT, USA
| | - Heidi A Hanson
- Population Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
- Department of Surgery, University of Utah, Salt Lake City, UT, USA
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13
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Singh S, McDonald JT, Ilie G, Adisesh A. An examination of the association between lifetime history of prostate and pancreatic cancer diagnosis and occupation in a population sample of Canadians. PLoS One 2020; 15:e0227622. [PMID: 32023280 PMCID: PMC7001921 DOI: 10.1371/journal.pone.0227622] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 12/24/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Occupation was assessed as possible risk factors for prostate (PCa) and pancreatic cancer in a large Canadian worker cohort. METHODS The Canadian Census Health and Environment Cohort (CanCHEC) was derived from linking the 1991 Canadian Census Cohort to the Canadian Cancer Database (1969-2010), Canadian Mortality Database (1991-2011), and Tax Summary Files (1981-2011). From the total sample of 1,931,110 persons, we identified and derived two samples of 28,610 men and 3,220 men and women with a past history of PCa and pancreatic cancer diagnoses, respectively. Cox proportional hazards models were used to estimate hazards ratios and 95% confidence intervals for occupation. RESULTS In Canadian men aged 24-64 years, the highest elevated risks of PCa were observed for library clerks (HR = 2.36, 95% CI:1.12-4.97), medical radiation technologists (HR = 1.66, 95% CI:1.04-2.65), telecommunications and line cable workers (HR = 1.62, 95% CI: 1.22-3.16) and commissioned police officers (HR = 1.54, 95% CI: 1.10-2.16. The highest elevated risk for pancreatic cancer were observed for commissioned police officers (HR = 4.34, 95% CI: 1.85-10.21), photographic and film processors (HR = 3.97, 95% CI:1.69-9.34), railway and motor transport labourers (HR = 3.94, 95% CI: 1.67-9.29), and computer engineers (HR = 3.82, 95%CI: 1.52-9.61). CONCLUSION These findings emphasize the need for further study of job-related exposures and the potential influence of non-occupational factors such as screening practices.
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Affiliation(s)
- Smriti Singh
- Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Gabriela Ilie
- Department of Community Health and Epidemiology, Urology, and Radiation Oncology, Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Anil Adisesh
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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14
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Peters CE, Villeneuve PJ, Parent MÉ. Occupation as a predictor of prostate cancer screening behaviour in Canada. J Med Screen 2020; 27:215-222. [PMID: 32000565 DOI: 10.1177/0969141320902485] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVES If prostate cancer screening practices relate to occupation, this would have important implications when studying the aetiological role of workplace exposures on prostate cancer. We identified variations in screening by occupation among men in Montreal, Canada (2005-2012). METHODS Prostate specific antigen testing and digital rectal examination (ever-screened and frequency of screening, previous five years) were examined among population controls from the Prostate Cancer & Environment Study. Face-to-face interviews elicited lifestyle and occupational histories. Multivariable logistic regression was used to estimate the odds of ever-screening for the longest-held occupation, adjusting for potential confounders. Negative binomial models were used to examine relationships with screening frequency. RESULTS Among 1989 controls, 81% reported ever having had a prostate specific antigen test, and 77% a digital rectal examination. Approximately 40% of men reported having a prostate specific antigen test once a year, on average. Compared with those in management or administrative jobs, men in primary industry (odds ratio 0.26, 95% confidence interval 0.10-0.65), construction (0.44, 0.25-0.79), machining (0.45, 0.21-0.97), and teaching (0.37, 0.20-0.70) were less likely to have undergone prostate specific antigen screening. Results were similar when considering the most recent job. CONCLUSIONS Our findings highlight substantial variations in prostate cancer screening by occupation. Men in occupations where carcinogen exposures are more common are less likely to participate in prostate screening activities. This could be an important source of bias, and occupational studies of prostate cancer should account for screening practices.
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Affiliation(s)
- Cheryl E Peters
- Department of Health Sciences, Carleton University, Ottawa, Canada.,Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, Laval, Canada.,Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Canada
| | - Marie-Élise Parent
- Centre Armand-Frappier Santé Biotechnologie, Institut national de la recherche scientifique, Université du Québec, Laval, Canada
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Sritharan J, MacLeod JS, McLeod CB, Peter A, Demers PA. Prostate cancer risk by occupation in the Occupational Disease Surveillance System (ODSS) in Ontario, Canada. HEALTH PROMOTION AND CHRONIC DISEASE PREVENTION IN CANADA-RESEARCH POLICY AND PRACTICE 2019; 39:178-186. [PMID: 31091061 DOI: 10.24095/hpcdp.39.5.02] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Previous Canadian epidemiologic studies have identified associations between occupations and prostate cancer risk, though evidence is limited. However, there are no well-established preventable risk factors for prostate cancer, which warrants the need for further investigation into occupational factors to strengthen existing evidence. This study uses occupation and prostate cancer information from a large surveillance cohort in Ontario that linked workers' compensation claim data to administrative health databases. METHODS Occupations were examined using the Occupational Disease Surveillance System (ODSS). ODSS included 1 231 177 male workers for the 1983 to 2015 period, whose records were linked to the Ontario Cancer Registry (OCR) in order to identify and follow up on prostate cancer diagnoses. Cox proportional hazard models were used to calculate age-adjusted hazard ratios and 95% CI to estimate the risk of prostate cancer by occupation group. RESULTS A total of 34 997 prostate cancer cases were diagnosed among workers in ODSS. Overall, elevated prostate cancer risk was observed for men employed in management/ administration (HR 2.17, 95% CI = 1.98-2.38), teaching (HR 1.99, 95% CI = 1.79-2.21), transportation (HR 1.20, 95% CI = 1.16-1.24), construction (HR 1.09, 95% CI = 1.06-1.12), firefighting (HR 1.62, 95% CI = 1.47-1.78), and police work (HR 1.20, 95% CI = 1.10-1.32). Inconsistent findings were observed for clerical and farming occupations. CONCLUSION Associations observed in white collar, construction, transportation, and protective services occupations were consistent with previous Canadian studies. Findings emphasize the need to assess job-specific exposures, sedentary behaviour, psychological stress, and shift work. Understanding specific occupational risk factors can lead to better understanding of prostate cancer etiology and improve prevention strategies.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Jill S MacLeod
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Christopher B McLeod
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.,Institute for Work & Health, Toronto, Ontario, Canada
| | - Alice Peter
- Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Alicandro G, Bertuccio P, Sebastiani G, La Vecchia C, Frova L. Mortality among Italian male workers in the construction industry: a census-based cohort study. Eur J Public Health 2019; 30:247-252. [DOI: 10.1093/eurpub/ckz129] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Abstract
Background
Advances in technologies, occupational hygiene and increased surveillance have reduced the excess mortality previously found in the construction industry. This study is aimed to evaluate cause-specific mortality in a recent cohort of construction workers.
Methods
We carried out a record-linkage cohort study based on the 2011 Italian census and the mortality archives (2012–2015), including 1 068 653 construction workers. We estimated mortality rate ratios (MRR) using Poisson regression models including terms for age and geographic area.
Results
Compared with non-manual workers, construction workers showed an excess mortality from all causes (MRR: 1.34), all neoplasms (MRR: 1.30), head and neck (MRR: 2.05), stomach (MRR: 1.56), liver (MRR: 1.62), lung (MRR: 1.80), prostate (MRR: 1.24) and bladder (MRR: 1.60) cancers, respiratory (MRR: 1.41) and liver (MRR: 1.79) diseases, all external causes (MRR: 1.87), falls (MRR: 2.87) and suicide (MRR: 1.58). Compared with manual workers in other industries, construction workers showed excess mortality from prostate (MRR: 1.27) and non-melanoma skin cancers (MRR: 1.95), all external causes (MRR: 1.14), falls (MRR: 1.94) and suicide (MRR: 1.18). Most of this excess mortality disappeared after adjusting for education, with the exception of prostate and non-melanoma skin cancers, all external causes, falls and suicide.
Conclusions
Construction workers are at high risk of dying from external causes, while the excess mortality found for several cancers, liver and respiratory diseases may be at least partially due to the high prevalence of low education and unfavorable lifestyle factors. The excess mortality from prostate cancer requires further evaluations.
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Affiliation(s)
- Gianfranco Alicandro
- Italian National Institute of Statistics (Istat), Rome, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Paola Bertuccio
- Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy
| | | | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Milan, Italy
| | - Luisa Frova
- Italian National Institute of Statistics (Istat), Rome, Italy
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Adler C, Friesen MC, Yeboah ED, Tettey Y, Biritwum RB, Adjei AA, Tay E, Okyne V, Mensah JE, Truelove A, Yang B, Kelly SP, Zhou CK, McCullough LE, Pardo L, Hoover RN, Hsing AW, Cook MB, Koutros S. Usual adult occupation and risk of prostate cancer in West African men: the Ghana Prostate Study. Occup Environ Med 2018; 76:71-77. [PMID: 30530485 DOI: 10.1136/oemed-2018-105391] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 10/30/2018] [Accepted: 11/06/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVES Established prostate cancer (PCa) risk factors include age, family history of PCa and African ancestry. Studies, mostly among highly screened, predominantly European ancestral populations, suggest that employment in certain occupations (eg, farming, military) may also have an increased risk for PCa. Here, we evaluated the association between usual adult occupation and PCa risk in Ghanaian men, a population with historically low rates of PCa screening. METHODS The Ghana Prostate Study is a case-control study of PCa that was conducted from 2004 to 2012 in 749 cases and 964 controls. In-person interviews were conducted to collect information from participants, including longest held job. Industrial hygienists classified job titles into occupational categories. Unconditional logistic regression was used to calculate ORs and 95% CIs for the association between longest held job and PCa risk (overall, aggressive (Gleason≥7)), controlling for potential confounders. RESULTS Risk was increased among men in management (overall PCa OR=2.2, 95% CI 1.4 to 3.2; aggressive PCa OR=2.2, 95% CI 1.3 to 3.5) and military occupations (overall PCa OR=3.4, 95% CI 1.7 to 7.0; aggressive PCa OR=3.5, 95% CI 1.5 to 8.3). Risks were also elevated for management and military-specific jobs based on 3-digit level Standard Occupational Classification definitions. Sensitivity analyses accounting for access to medical care did not show significant differences. CONCLUSIONS Our study provides some evidence for increased risk of PCa among men in management and military occupations, which is consistent with the published literature. Additional research is needed to clarify the drivers of the associations between these occupations and PCa.
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Affiliation(s)
- Colin Adler
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Melissa C Friesen
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Yao Tettey
- University of Ghana Medical School, Accra, Ghana
| | | | | | - Evelyn Tay
- University of Ghana Medical School, Accra, Ghana
| | | | | | | | - Baiyu Yang
- Stanford Cancer Institute, Stanford School of Medicine, Palo Alto, California, USA
| | - Scott P Kelly
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | | | - Larissa Pardo
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Robert N Hoover
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Ann W Hsing
- Stanford Cancer Institute, Stanford School of Medicine, Palo Alto, California, USA.,Stanford Prevention Research Center, Stanford School of Medicine, Palo Alto, California, USA
| | - Michael B Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
| | - Stella Koutros
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
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Harris MA, Kirkham TL, MacLeod JS, Tjepkema M, Peters PA, Demers PA. Surveillance of cancer risks for firefighters, police, and armed forces among men in a Canadian census cohort. Am J Ind Med 2018; 61:815-823. [PMID: 30073696 DOI: 10.1002/ajim.22891] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Firefighters, police, and armed services may be exposed to hazards such as combustion by-products and shift work. METHODS The CanCHEC cohort linked 1991 census data to the Canadian cancer registry for follow up. Cox proportional hazards modeling was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) to estimate risks for firefighter, police, or armed forces compared to workers in other occupations. RESULTS The cohort of 1 108 410 men included 4535 firefighters, 10 055 police, and 9165 armed forces. For firefighters, elevated risks were noted for Hodgkin's lymphoma (HR: 2.89, 95%CI: 1.29-6.46), melanoma (HR: 1.67, 95%CI: 1.17-2.37), and prostate cancer (HR: 1.18, 95%CI: 1.01-1.37). Police had elevated risks for melanoma (HR:1.69, 95%CI: 1.32-2.16) and prostate cancer (HR:1.28, 95%CI: 1.14-1.42). No significant associations were found for armed forces workers. CONCLUSIONS Canadian firefighters, police, and armed services, may be at an increased risk of developing certain cancers. Results suggested that a healthy worker effect may influence risk estimates.
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Affiliation(s)
- M. Anne Harris
- School of Occupational and Public Health; Ryerson University; Toronto Ontario Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto Ontario Canada
| | - Tracy L. Kirkham
- Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
| | - Jill S. MacLeod
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto Ontario Canada
| | - Michael Tjepkema
- Statistics Canada; Health Analysis Division; Toronto Ontario Canada
| | - Paul A. Peters
- Department of Health Sciences; Carleton University; Toronto Ontario Canada
| | - Paul A. Demers
- Dalla Lana School of Public Health; University of Toronto; Toronto Ontario Canada
- Occupational Cancer Research Centre; Cancer Care Ontario; Toronto Ontario Canada
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