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Nikkilä R, Mäkitie A, Carpén T, Hansen J, Heikkinen S, Lynge E, Selander J, Mehlum IS, Torfadottir JE, Salo T, Pukkala E. Occupational variation in incidence of oropharyngeal cancer in the Nordic countries. Eur Arch Otorhinolaryngol 2024; 281:343-350. [PMID: 37563484 PMCID: PMC10764423 DOI: 10.1007/s00405-023-08168-6] [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: 04/06/2023] [Accepted: 07/31/2023] [Indexed: 08/12/2023]
Abstract
PURPOSE Evaluate the occupational variation in incidence of oropharyngeal cancer (OPC). METHODS We calculated standardized incidence ratios (SIRs) of OPC in occupational categories in the Nordic countries relative to the entire national populations. The data covered 6155 OPC cases. RESULTS Among men high risk of OPC was observed, among else, in waiters (SIR 6.28, 95% CI 4.68-8.26), beverage workers (SIR 3.00, 95% CI 1.72-4.88), and artistic workers (SIR 2.97, 95% CI 2.31-3.76). Among women high risk of OPC was observed in waiters (SIR 2.02, 95% CI 1.41-2.81) and packers (SIR 1.73, 95% CI 1.07-2.64). The lowest SIRs were observed in female gardeners (SIR 0.27, 95% CI 0.12-0.51) and male farmers (SIR 0.30, 95% CI 0.25-0.35). CONCLUSION The 20-fold variation in incidence of OPC between occupations needs further investigation in studies with detailed information on occupational and non-occupational risk factors.
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Affiliation(s)
- Rayan Nikkilä
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland
- Finnish Cancer Registry,, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland
| | - Antti Mäkitie
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland.
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
| | - Timo Carpén
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki, HUS Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland
- Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Department of Pathology, University of Helsinki, HUS Helsinki University Hospital, Helsinki, Finland
| | - Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Sanna Heikkinen
- Finnish Cancer Registry,, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland
| | - Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Nykøbing Falster, Denmark
| | - Jenny Selander
- Institute of Environmental Medicine, IMM Karolinska Institutet, Stockholm, Sweden
| | - Ingrid Sivesind Mehlum
- National Institute of Occupational Health (STAMI), Oslo, Norway
- Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Jóhanna Eyrún Torfadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Tuula Salo
- Cancer and Translational Medicine Unit, Medical Research Unit, University of Oulu, Oulu University Hospital, Oulu, Finland
- Oral and Maxillofacial Diseases, University of Helsinki, and Haartman Institute, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry,, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland
- Health Sciences Unit, Faculty of Social Sciences, Tampere University, Tampere, Finland
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Strand LA, Rudvin I, Martinsen JI, Fadum EA, Grimsrud TK. Lifelong differences in cancer incidence and mortality between subgroups of similar socioeconomic status in the Royal Norwegian Navy. Occup Environ Med 2023; 80:514-521. [PMID: 37474304 DOI: 10.1136/oemed-2023-108877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 07/05/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVES In a previous cohort study of 28 300 Navy servicemen, vessel crews showed higher cancer incidence and mortality than did land-based personnel. We have extended the follow-up to look for changes in cancer risk, and to explore temporal trends in cancer incidence and cancer mortality during more than six decades of follow-up. METHODS Cancer incidence and total cancer mortality were compared with the general population by calculating standardised ratios (standardised incidence ratios (SIRs), standardised mortality ratios) for the entire follow-up, with temporal trends through seven consecutive 10-year time spans from individual entry to follow-up. Rates were compared between the subgroups using Poisson regression, expressed as rate ratios (RRs). RESULTS Cancer incidence in Navy servicemen suggested a healthy soldier effect limited to the first three decades of follow-up and confined to land-based personnel. Overall, vessel crews showed 13% higher cancer incidence and 36% higher cancer mortality than other Navy servicemen. Some of the differences may be explained by a higher risk in vessel crews of cancers known to have less than 25% 5-year relative survival (RR=1.71), such as cancers of the lung, liver, pancreas and mesothelioma. CONCLUSION Through most of the observation time, vessel crews had an overall cancer SIR that was higher than that of land-based personnel. Much of this excess involved cancers with a generally poor prognosis, linked to lifestyle and work environment. The contrasts in cancer incidence and mortality between the two subgroups of Navy servicemen persisted through more than six decades.
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Affiliation(s)
- Leif Aage Strand
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Norway
| | - Inger Rudvin
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Norway
| | - Jan Ivar Martinsen
- Institute of Population based Cancer Research, Cancer Registry of Norway, Oslo, Norway
| | - Elin Anita Fadum
- Institute of Military Epidemiology, Norwegian Armed Forces Joint Medical Services, Ullensaker, Norway
- Institute for Studies of the Medical Profession, Oslo, Norway
| | - Tom K Grimsrud
- Institute of Population based Cancer Research, Cancer Registry of Norway, Oslo, Norway
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3
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Auguste A, Joachim C, Deloumeaux J, Gaete S, Michineau L, Herrmann-Storck C, Duflo S, Luce D. Head and neck cancer risk factors in the French West Indies. BMC Cancer 2021; 21:1071. [PMID: 34592954 PMCID: PMC8482677 DOI: 10.1186/s12885-021-08787-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 08/31/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVES The incidence of head and neck squamous cell carcinoma (HNSCC) in the French West Indies (FWI) is relatively high, despite a low prevalence of tobacco smoking and alcohol drinking. Little is known about other risk factors in the FWI. We assessed associations between several factors and HNSCC risk, their population attributable fractions (PAF) in the FWI, and compared these PAFs by subsite, sex and age. MATERIALS AND METHODS We conducted a population-based case-control study (145 cases and 405 controls). We used logistic regression models to estimate adjusted odds-ratios (OR), PAFs and their 95% confidence intervals (CI). RESULTS Tobacco smoking, alcohol drinking, high-risk HPV, family history of HNC, low BMI and several occupations and industries were significantly associated to the occurrence of HNSCC. The majority of HNSCC cases were attributable to tobacco smoking (65.7%) and alcohol (44.3%). The PAF for the combined consumption of tobacco and/or alcohol was 78.2% and was considerably larger in men (85%) than in women (33%). The PAFs for the remaining risk factors were 9% for family history of HNSCC, 9% for low BMI, 15% for high-risk HPV, and 25% for occupations. The overall PAF for all risk factors combined was 89.0% (95% CI = 82.0-93.2). The combined PAFs by sex were significantly greater in men (93.4%, 95% CI = 87.5-96.5) than in women (56.4%, 95% CI = 18.7-76.6). CONCLUSION Tobacco and alcohol appeared to have the greatest impact on HNSCC incidence among the studied risk factors, especially among men. Prevention programs for HNSCC in the FWI should target tobacco and alcohol cessation, particularly in men. Future research should emphasise on the role of occupational factors to better understand this disease.
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Affiliation(s)
- Aviane Auguste
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) -UMR_S 1085, F-97100, Pointe-à-Pitre, France
| | - Clarisse Joachim
- Martinique Cancer Registry, UF 1441 Registre des cancers, Pôle de Cancérologie Hématologie Urologie Pathologie, University Hospital of Martinique, Fort-de-France, Martinique, France
| | - Jacqueline Deloumeaux
- General Cancer Registry of Guadeloupe, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
- Biological Resource Center Karubiotec™, BRIF n° KARUBIOTEC-G, UA-00971, Pointe-à-Pitre, Guadeloupe, France
| | - Stanie Gaete
- Biological Resource Center Karubiotec™, BRIF n° KARUBIOTEC-G, UA-00971, Pointe-à-Pitre, Guadeloupe, France
| | - Léah Michineau
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) -UMR_S 1085, F-97100, Pointe-à-Pitre, France
| | - Cécile Herrmann-Storck
- Laboratory of Microbiology, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Suzy Duflo
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, University Hospital of Guadeloupe, Pointe-à-Pitre, Guadeloupe, France
| | - Danièle Luce
- Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) -UMR_S 1085, F-97100, Pointe-à-Pitre, France.
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Svedahl SR, Hilt B, Svendsen K. Work environment factors and respiratory complaints in Norwegian cooks. Int Arch Occup Environ Health 2019; 93:205-212. [PMID: 31531780 DOI: 10.1007/s00420-019-01473-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 09/05/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE Norwegian cooks exhibit relatively high mortality, particularly from respiratory diseases. Both occupational hazards and lifestyle factors have been suggested as possible explanations. Negative health effects from exposure to cooking fumes are well documented in non-Western populations, and it has been claimed that cooking fumes in Western style cooking might be substantially different. We hypothesise that exposure to cooking fumes contributes to respiratory diseases also in professional cooks in Western countries. The aim of this study was to elucidate if specific work environment factors related to cooking fume exposure are determinants for respiratory morbidity in Norwegian cooks. METHODS We surveyed specific work environment factors and respiratory complaints in 553 subjects that were currently working as skilled cooks. Inclusion was based on the register of people that had graduated as skilled cooks in central Norway between 1988 and 2008. Determinants for the occurrence of respiratory complaints were explored by logistic regression. RESULTS Overall, 17.2% of subjects reported respiratory complaints at work, while 8.1% had chronic bronchitis. Those who performed frying for over half of their workday exhibited an increased odds ratio for having chronic bronchitis of 2.5 (95% CI 1.2-5.3). Using gas for frying and using a fryer in the kitchen were also related to the occurrence of respiratory complaints. CONCLUSIONS This study in Norwegian cooks demonstrates a relationship between the extent of frying and the occurrence of work-related respiratory complaints. Therefore, reducing exposure to cooking fumes could reduce respiratory complaints in cooks, and potentially help alleviate excess morbidity and mortality in this occupation.
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Affiliation(s)
- Sindre Rabben Svedahl
- Department of Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway. .,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Bjørn Hilt
- Department of Occupational Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristin Svendsen
- Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
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Haldorsen T, Martinsen JI, Kjærheim K, Grimsrud TK. Adjustment for tobacco smoking and alcohol consumption by simultaneous analysis of several types of cancer. Cancer Causes Control 2017; 28:155-165. [PMID: 28155007 PMCID: PMC5306353 DOI: 10.1007/s10552-016-0847-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 12/28/2016] [Indexed: 11/12/2022]
Abstract
PURPOSE Tobacco smoking and alcohol consumption are risk factors for several types of cancer and may act as confounders in aetiological studies. Large register-based cohorts often lack data on tobacco and alcohol. We present a method for computing estimates of cancer risk adjusted for tobacco and alcohol without exposure information. METHODS We propose the use of confirmatory factor analysis models for simultaneous analysis of several cancer sites related to tobacco and alcohol. In the analyses, the unobserved pattern of smoking habits and alcohol drinking is considered latent common factors. The models allow for different effects on each cancer site, and also for appropriate latent site-specific factors for subgroup variation. Results may be used to compute expected numbers of cancer from reference rates, adjusted for tobacco smoking and alcohol consumption. This method was applied to results from a large, published study of work-related cancer based on census data (1970) and 21 years of cancer incidence data from the national cancer registry. RESULTS The results from our analysis were in accordance with recognised risks in selected occupational groups. The estimated relative effects from tobacco and alcohol on cancer risk were largely in line with results from Nordic reports. For lung cancer, adjustment for tobacco implied relative changes in SIR between a decrease from 1.16 to 0.72 (Fishermen), and an increase from 0.47 to 0.95 (Forestry workers). CONCLUSIONS We consider the method useful for achieving less confounded estimates of cancer risk in large cohort studies with no available information on smoking and alcohol consumption.
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Affiliation(s)
- Tor Haldorsen
- Department of Research, Cancer Registry of Norway, Pb 5313, Majorstuen, 0304, Oslo, Norway
| | - Jan Ivar Martinsen
- Department of Research, Cancer Registry of Norway, Pb 5313, Majorstuen, 0304, Oslo, Norway
| | - Kristina Kjærheim
- Department of Research, Cancer Registry of Norway, Pb 5313, Majorstuen, 0304, Oslo, Norway
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Pb 5313, Majorstuen, 0304, Oslo, Norway.
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6
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Strand LA, Martinsen JI, Borud EK. Cancer incidence and all-cause mortality in a cohort of 21582 Norwegian military peacekeepers deployed to Lebanon during 1978–1998. Cancer Epidemiol 2015; 39:571-7. [DOI: 10.1016/j.canep.2015.04.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 04/17/2015] [Accepted: 04/18/2015] [Indexed: 10/23/2022]
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Bigert C, Gustavsson P, Straif K, Pesch B, Brüning T, Kendzia B, Schüz J, Stücker I, Guida F, Brüske I, Wichmann HE, Pesatori AC, Landi MT, Caporaso N, Tse LA, Yu ITS, Siemiatycki J, Pintos J, Merletti F, Mirabelli D, Simonato L, Jöckel KH, Ahrens W, Pohlabeln H, Tardón A, Zaridze D, Field J, 't Mannetje A, Pearce N, McLaughlin J, Demers P, Szeszenia-Dabrowska N, Lissowska J, Rudnai P, Fabianova E, Dumitru RS, Bencko V, Foretova L, Janout V, Boffetta P, Forastiere F, Bueno-de-Mesquita B, Peters S, Vermeulen R, Kromhout H, Olsson AC. Lung cancer risk among cooks when accounting for tobacco smoking: a pooled analysis of case-control studies from Europe, Canada, New Zealand, and China. J Occup Environ Med 2015; 57:202-9. [PMID: 25654522 PMCID: PMC7508228 DOI: 10.1097/jom.0000000000000337] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVES To investigate the risk of lung cancer among cooks, while controlling for smoking habits. METHODS We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits from 16 case-control studies conducted in Europe, Canada, New Zealand, and China. RESULTS Before adjustment for smoking, we observed an increased risk of lung cancer in male cooks, but not in female cooks. After adjusting, there was no increased risk and no significant exposure-response relationship. Nevertheless, subgroup analyses highlighted some possible excess risks of squamous cell carcinoma and small cell carcinoma in female cooks. CONCLUSIONS There is evidence that lung cancer risks among cooks may be confounded by smoking. After adjustment, cooks did not experience an increased risk of lung cancer overall. The subgroup analyses showing some excess risks among female cooks require cautious interpretation.
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Affiliation(s)
- Carolina Bigert
- From the Institute of Environmental Medicine (Drs Bigert and Gustavsson), Karolinska Institutet, Stockholm, Sweden; International Agency for Research on Cancer (Drs Straif, Schüz, and Olsson), Lyon, France; Institute for Prevention and Occupational Medicine of the German Social Accident Insurance-Institute of the Ruhr-Universität Bochum (IPA) (Drs Pesch and Brüning, Mr Kendzia), Germany; Inserm, Centre for Research in Epidemiology and Population Health (CESP) (Drs Stücker and Guida), U1018, Environmental Epidemiology of Cancer Team, F-94807, Villejuif, France; Université Paris-Sud (Drs Stücker and Guida), UMRS 1018, F-94807, Villejuif, France; Institut für Epidemiologie I (Drs Brüske and Wichmann), Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg, Germany; Department of Clinical Sciences and Community Health (Dr Pesatori), Università degli Studi di Milano, Milan, Italy; National Cancer Institute (Drs Landi and Caporaso), Bethesda, MD; Division of Occupational and Environmental Health (Drs Tse and Yu), School of Public Health and Primary Care, The Chinese University of Hong Kong, China; Research Centre of University of Montréal Hospital Centre (Drs Siemiatycki and Pintos), University of Montréal, Canada; Cancer Epidemiology Unit (Drs Merletti and Mirabelli), Department of Medical Sciences, University of Turin, Italy; Department of Environmental Medicine and Public Health (Dr Simonato), University of Padua, Italy; Institute for Medical Informatics (Dr Jöckel), Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany; Bremen Institute for Prevention Research and Social Medicine (Drs Ahrens and Pohlabeln), Bremen, Germany; CIBERESP (Dr Tardón), University of Oviedo, Spain; Russian Cancer Research Centre (Dr Zaridze), Moscow, Russia; Roy Castle Lung Cancer Research Programme, Cancer Research Centre (Dr Field), University of Liverpool, UK; Centre for Public Health Research (Drs Mannetje and Pearce), Massey University, Wellingt
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Jansson C, Oh JK, Martinsen JI, Lagergren J, Plato N, Kjaerheim K, Pukkala E, Sparén P, Tryggvadottir L, Weiderpass E. Occupation and risk of oesophageal adenocarcinoma and squamous-cell carcinoma: The Nordic Occupational Cancer Study. Int J Cancer 2015; 137:590-7. [DOI: 10.1002/ijc.29409] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 11/10/2014] [Accepted: 11/19/2014] [Indexed: 01/25/2023]
Affiliation(s)
- Catarina Jansson
- Upper Gastrointestinal Surgery; Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
| | - Jin-Kyoung Oh
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
- Risk Appraisal and Prevention Branch, National Cancer Control Institute, National Cancer Center; Goyang Republic of Korea
| | | | - Jesper Lagergren
- Upper Gastrointestinal Surgery; Department of Molecular Medicine and Surgery; Karolinska Institutet; Stockholm Sweden
- Division of Cancer Studies; King's College London; London United Kingdom
| | - Nils Plato
- The Institute of Environmental Medicine, Karolinska Institutet; Stockholm Sweden
| | | | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research; Helsinki Finland
- School of Health Sciences, University of Tampere; Tampere Finland
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry; Reykjavik Iceland
- Faculty of Medicine, University of Iceland; Reykjavik Iceland
| | - Elisabete Weiderpass
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
- Cancer Registry of Norway; Oslo Norway
- Department of Genetic Epidemiology; Folkhälsan Research Center; Helsinki Finland
- Department of Community Medicine; Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway; Tromsø Norway
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Reijula J, Kjaerheim K, Lynge E, Martinsen JI, Reijula K, Sparén P, Tryggvadottir L, Weiderpass E, Pukkala E. Cancer incidence among waiters: 45 years of follow-up in five Nordic countries. Scand J Public Health 2015; 43:204-11. [PMID: 25564114 DOI: 10.1177/1403494814565130] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS To study cancer risk patterns among waiters in the Nordic countries. METHODS We identified a cohort of 16,134 male and 81,838 female waiters from Denmark, Finland, Iceland, Norway and Sweden. During the follow-up period from 1961 to 2005, we found that 19,388 incident cancer cases were diagnosed. Standardised incidence ratio (SIR) was defined as the observed number of cancer cases divided by the expected number, based on national age, time period and gender-specific cancer incidence rates in the general population. RESULTS The SIR of all cancers in waiters, in the five countries combined, was 1.46 (95% CI 1.41-1.51) in men and 1.09 (1.07-1.11) in women. In male waiters, the SIR decreased from 1.79 (1.63-1.96) in 1961-1975, to 1.33 (1.26-1.40) in 1991-2005, but remained stable among women. The SIR among male waiters was highest for cancers in the pharynx (6.11; 95% CI 5.02-7.37), oral cavity (4.91; 95% CI 3.81-6.24) and tongue (4.36; 95% CI 3.13-5.92); and in female waiters, in the larynx (2.17; 95% CI 1.63-2.82), oral cavity (1.96; 95% CI 1.60-2.34) and lung (1.89; 95% CI 1.80-1.99). CONCLUSIONS The risk of cancer among waiters was higher than in the general population. The elevated incidence in some cancer sites can likely be explained by higher alcohol consumption, the prevalence of smoking and occupational exposure to tobacco smoke. Hopefully, the incidence of cancer among waiters will decrease in the future, due to the banning of tobacco smoking in restaurants and bars in the Nordic countries.
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Affiliation(s)
- Jere Reijula
- Finnish Institute of Occupational Health, Helsinki, Finland University of Helsinki, Hjelt Institute, Helsinki, Finland
| | | | | | | | - Kari Reijula
- Finnish Institute of Occupational Health, Helsinki, Finland University of Helsinki, Hjelt Institute, Helsinki, Finland
| | - Pär Sparén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | | | - Elisabete Weiderpass
- Cancer Registry of Norway, Oslo, Norway Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden Department of Community Medicine, UiT the Arctic University of Norway, Tromsø, Norway Samfundet Folkhalsan, Helsinki, Finland
| | - Eero Pukkala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland School of Health Sciences, University of Tampere, Tampere, Finland
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Kjaerheim K, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Effects of occupation on risks of avoidable cancers in the Nordic countries. Eur J Cancer 2011; 46:2545-54. [PMID: 20843484 DOI: 10.1016/j.ejca.2010.07.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2010] [Accepted: 07/22/2010] [Indexed: 01/13/2023]
Abstract
Knowledge of cancer risk according to occupational affiliation is an essential part of formatting preventive actions aimed at the adult population. Herein, data on 10 major cancer sites amenable by life style exposures from the Nordic Occupational Cancer Study (NOCCA) are presented. All subjects aged 30-64 years participating in one or more national censuses in Denmark, Finland, Iceland, Norway, or Sweden between 1960 and 1990 were included in the cohort and followed up for cancer from inclusion until 2003/2005 via a linkage with the national cancer registries, and standardised incidence ratios (SIRs) were computed. Variation in risk across occupations was generally larger in men than in women. In men, the most consistent cluster with high risk of numerous cancer types included waiters, cooks and stewards, beverage workers, seamen, and chimney sweeps. Two clusters of occupations with generally low cancer risks were seen in both men and women. The first one comprised farmers, gardeners, and forestry workers, the second one included groups with high education, specifically those in health and pedagogical work. Although cancer risk varies by occupation, only a smaller part of the variation can be attributed to occupational exposures in the strict sense. Preventive measures at the work place are important to avoid established and new occupational health hazards. This study also indicates that the work place in addition should be seen as a useful arena for reaching groups of adults with more or less similar habits and attitudes for general health promotion.
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11
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Lee CH, Yang SF, Peng CY, Li RN, Chen YC, Chan TF, Tsai EM, Kuo FC, Huang JJ, Tsai HT, Hung YH, Huang HL, Tsai S, Wu MT. The precancerous effect of emitted cooking oil fumes on precursor lesions of cervical cancer. Int J Cancer 2010; 127:932-41. [PMID: 20013811 DOI: 10.1002/ijc.25108] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although cooking emission from high-temperature frying has been deemed a Group 2A carcinogen by the International Agency for Research on Cancer, little is known about its impact on cervical tumorigenesis. To investigate the precancerous consequence of cooking oil fumes on cervical intraepithelial neoplasm (CIN), a community-based case-control study, which takes all known risk factors into consideration, was conducted in Taiwan. From 2003 to 2008, in a Pap smear screening and biopsy examination network, 206 pathology-verified women with inflammations/atypical squamous cells of undetermined significance or CIN grade-1 (CIN1) and 73 with CIN2-3 (defined as low-grade squamous intraepithelial lesions (LGSIL) and high-grade squamous intraepithelial lesions (HGSIL), respectively); and 1,200 area-and-age-matched controls with negative cytology were recruited. Multinomial logistic regression was applied in the multivariate analysis to determine the likelihood of contracting LGSIL or HGSIL. The risks of the two lesions increased with the increase of carcinogenic high-risk human papillomavirus DNA load, with a clear dose-response relationship. Chefs were observed to experience a 7.9-fold elevated HGSIL risk. Kitchens with poor fume ventilation during the main cooking life-stage correlated to a 3.7-fold risk of HGSIL, but not for LGSIL. More than 1 hr of daily cooking in kitchens with poor fume conditions appeared to confer an 8.4-fold HGSIL risk, with an 8.3-fold heterogeneously higher odds ratio than that (aOR = 1.0) for LGSIL. Similar risk pattern has been reproduced among never-smoking women. Our findings demonstrate the association between indoor exposure to cooking fumes from heated oil and the late development of cervical precancerous lesions. This final conclusion needs to be verified by future research.
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Affiliation(s)
- Chien-Hung Lee
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan
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Reulen RC, Kellen E, Buntinx F, Brinkman M, Zeegers MP. A meta-analysis on the association between bladder cancer and occupation. ACTA ACUST UNITED AC 2010:64-78. [PMID: 18815919 DOI: 10.1080/03008880802325192] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Raoul C. Reulen
- Centre for Childhood Cancer Survivor Studies, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
| | - Eliane Kellen
- Department of General Practice, Catholic University of Leuven, Leuven, Belgium
| | - Frank Buntinx
- Department of General Practice, Catholic University of Leuven, Leuven, Belgium
- Department of General Practice, Maastricht University, Maastricht, The Netherlands
| | - Maree Brinkman
- Department of General Practice, Catholic University of Leuven, Leuven, Belgium
- Cancer Epidemiology Centre, The Cancer Council, Victoria, Australia
| | - Maurice P. Zeegers
- Unit of Genetic Epidemiology, Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
- Department of Complex Genetics, Nutrition and Toxicology Research Institute, University of Maastricht, The Netherlands
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Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparén P, Tryggvadottir L, Weiderpass E, Kjaerheim K. Occupation and cancer – follow-up of 15 million people in five Nordic countries. Acta Oncol 2009; 48:646-790. [DOI: 10.1080/02841860902913546] [Citation(s) in RCA: 372] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Weichenthal S, Dufresne A, Infante-Rivard C. Indoor ultrafine particles and childhood asthma: exploring a potential public health concern. INDOOR AIR 2007; 17:81-91. [PMID: 17391231 DOI: 10.1111/j.1600-0668.2006.00446.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
UNLABELLED Exposure to airborne particulate matter has a negative effect on respiratory health in both children and adults. The ultrafine fraction of particulate air pollution is of particular interest because of its increased ability to cause oxidative stress and inflammation in the lungs. We reviewed the literature, and to date findings suggest that ultrafine particles (UFPs) may play an important role in triggering asthma symptoms. Furthermore, we believe that indoor UFP exposures may be particularly important because people spend the majority of their time indoors where sources of these contaminants are often present. While several epidemiological studies have examined the respiratory effects of ambient UFP exposures, the relationship between indoor UFP exposures and childhood asthma has yet to be examined in clinical or epidemiological studies. However, the portable instrumentation necessary to conduct such investigations is increasingly available, and we expect that this issue will be addressed in the near future. Therefore, the aim of this article is to provide a general review of UFP toxicity as related to childhood asthma in order to draw attention to a potentially important public health concern. PRACTICAL IMPLICATIONS A number of indoor sources of ultrafine particles (UFPs) have been identified, but the health effects of indoor UFP exposures remain largely unexplored. The potential respiratory effects of such exposures seem most concerning because these particles are known to cause oxidative stress and inflammation in the lungs. Subsequently, indoor UFP exposures may contribute to the exacerbation of asthma symptoms in susceptible individuals. This paper provides a review of UFP toxicity as related to childhood asthma, and to date evidence suggests that further investigation into the respiratory effects of indoor UFP exposures is warranted.
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Affiliation(s)
- S Weichenthal
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
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Yu ITS, Chiu YL, Wong TW, Tang JL. Deaths from nasopharyngeal cancer among waiters and waitresses in Chinese restaurants. Int Arch Occup Environ Health 2004; 77:499-504. [PMID: 15558301 DOI: 10.1007/s00420-004-0543-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2003] [Accepted: 05/19/2004] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Previous studies have shown that waiters have a high risk of developing cancers of the buccal cavity and pharynx, but nasopharyngeal cancer (NPC) has not been specifically studied. This study was carried out to investigate whether waiters/waitresses in Chinese restaurants have an increased risk of dying from NPC. METHODS A mortality odds ratio study was used to estimate the relative risk of dying from NPC for waiters/waitresses working in Chinese restaurants in Hong Kong during the period 1986-1995, using the general population as the external comparison group and deceased kitchen workers as an internal comparison group. Cases were deaths from NPC and the controls were deaths from the selected sets of reference causes. RESULTS Seventeen deaths from NPC were identified among 415 deceased waiters and four NPC deaths occurred among 140 deceased waitresses. The adjusted mortality odds ratio (aMOR) for NPC was increased among waiters, being 3.02 (95% CI 1.82-5.00) and 2.61 (95% CI 1.02-6.69) in the external and internal comparisons, respectively. For waitresses, the aMOR was 4.58 (95% CI 1.63-12.86) in the external comparison. Analysis by duration of union membership suggested a dose-response relationship. CONCLUSIONS An increased risk of dying from NPC was observed among waiters/waitresses and could not be fully explained by bias or confounding factors. Possible risk factors related to poor indoor air quality in the service areas of Chinese restaurants in Hong Kong should be further investigated.
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Affiliation(s)
- Ignatius T S Yu
- Department of Community and Family Medicine, The Chinese University of Hong Kong, 4/F., School of Public Health, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, China.
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Larsen S, Jorgensen H. Better than their reputation? - Do hotel and restaurant students drink more? ACTA ACUST UNITED AC 2003. [DOI: 10.1111/j.1471-5740.2003.00074.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Tobacco smoke is a major component of indoor air pollution. Exposure to environmental tobacco smoke (ETS) is prevalent worldwide despite growing awareness of its adverse health effects on non-smokers. ETS contains the same toxic substances as identified in mainstream tobacco smoke. Cotinine (a metabolite of nicotine) can be measured in urine and serum of non-smokers exposed to ETS and reflects the degree of exposure. In children, exposure to ETS leads to reduced lung function, increased risk of lower respiratory tract illnesses, acute exacerbation of asthma resulting in hospitalization, increased prevalence of non-allergic bronchial hyperresponsiveness, increased risk for sudden infant death syndrome (SIDS) and possibly increased risk for asthma. Exposure to ETS is responsible for excess cost to the family's financial resources and demands on health services. In adults, exposure to ETS is associated with increased risk of lung cancer, particularly in those with high exposure and acute and chronic respiratory symptoms that improve after the cessation of exposure. Healthcare providers should advocate for non-smokers' rights in the community and support legislation to limit tobacco exposure.
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Affiliation(s)
- Moira Chan-Yeung
- Division of Respiratory and Critical Care Medicine, Department of Medicine, The University of Hong Kong, Hong Kong, SAR, China.
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Harvei S, Kravdal O. The importance of marital and socioeconomic status in incidence and survival of prostate cancer. An analysis of complete Norwegian birth cohorts. Prev Med 1997; 26:623-32. [PMID: 9327469 DOI: 10.1006/pmed.1997.0153] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Previous studies of the association between social and family status and prostate cancer (PCa) have given somewhat divergent results. Little attention has been paid to the possible importance of these factors for survival. METHODS In this study, hazard regression models for PCa incidence and mortality were estimated on the basis of register- and census-based histories for complete Norwegian birth cohorts, giving a follow-up time of 16 million person years and 30,000 cases of PCa. RESULTS A significant excess incidence of about 20% was found for ever-married men and for those with higher education. Marriage and socioeconomic resources appeared, however, to have a favorable effect on survival. Five-year relative survival from metastasized cancer among men with a high educational level was found to be 15 percentage points higher than among men with lower education. CONCLUSIONS The observed differences in incidence are not easily explained. They apparently run counter to the hypothesis that multiple partners give a higher PCa risk, but may be consistent with the view that fat and meat consumption is risky. Better survival from PCa in higher socioeconomic groups and among married men may reflect differences in the search for, access to, or quality of treatment or a better constitution to fight the disease.
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Affiliation(s)
- S Harvei
- Institute for Epidemiological Cancer Research, Cancer Registry of Norway, Montebello, Oslo, Norway
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Kjeerheim K, Haldorsen T, Andersen A, Mykletun R, Aasland OG. Work-related stress, coping resources, and heavy drinking in the restaurant business. WORK AND STRESS 1997. [DOI: 10.1080/02678379708256818] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kjærheim K, Mykletun R, Haldorsen T. Selection into the restaurant business based on personality characteristics and the risk of heavy drinking. PERSONALITY AND INDIVIDUAL DIFFERENCES 1996. [DOI: 10.1016/0191-8869(96)00086-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kjaerheim K, Mykletun R, Aasland OG, Haldorsen T, Andersen A. Heavy drinking in the restaurant business: the role of social modelling and structural factors of the work-place. Addiction 1995; 90:1487-95. [PMID: 8528034 DOI: 10.1046/j.1360-0443.1995.901114877.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The role of social modelling and structural factors of the work-place in predicting the probability of heavy drinking was investigated in a sample of 3267 Norwegian male and female waiters and cooks. In the logistic regression analysis, the probability of heavy drinking was increased by two social modelling factors and one structural factor. Having co-workers who, at least weekly, took an end-of-work drink at the work-place gave an odds ratio for heavy drinking of 2.8 (95% CI 1.9-4.1), and having co-workers who went out after work at least every week gave an odds ratio of 1.8 (95% CI 1.2-2.8). Working at a place with a liberal alcohol policy gave an odds ratio 1.5 (95% CI 1.1-2.2). Among the background factors, only household type significantly predicted heavy drinking. As compared with living with children, the odds for heavy drinking when living alone was 4.3 (95% CI 2.9-6.4). The results indicate that preventive measures in the restaurant business should not only concentrate on the individual, but also deal with factors related to the occupational activity that promote and sustain heavy drinking.
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Affiliation(s)
- K Kjaerheim
- Institute for Epidemiological Cancer Research, Oslo, Norway
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Abstract
The extent to which major cohort studies now rely on centralized machine-readable files of personal records is taken largely for granted by investigators, but not by the public, privacy advocates, politicians, or the popular press. When widespread linkage into personal histories for statistical studies was first envisaged a few decades ago, it was regarded as impractical. But privacy advocates now fear the statistical uses even more than the administrative applications, perhaps because the latter are inevitable to prevent abuses, and often are associated with monetary benefits or personal convenience. Indeed a concept of 'privacy' has arisen that is deemed to be violated even in statistical studies where confidentiality is assured, unless the particular purpose is approved by all individuals. This concept motivates much of the political thinking. What could be lost to preventive medicine and clinical testing by this is illustrated with data from cohort studies reported in this journal (CCC) in 1993.
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Abstract
Previous studies have found high risk of cancers of the upper aerogastric tract, liver, and lung among waiters. Since approximately 75 percent of those working in the restaurant business in Norway are women, we have analyzed cancer incidence in a cohort of waitresses, to determine whether they have the same high cancer-risk as their male colleagues. The cohort consisted of 5,314 waitresses organized in the Restaurant Workers' Union between 1932 and 1978. The follow-up period was from 1959 to 1991. The standardized incidence ratio (SIR) for all causes of cancer was 1.0 (95 percent confidence interval [CI] = 0.9-1.1), based on 430 observed cases. Cancers of the tongue, mouth, pharynx, larynx, esophagus, and liver were grouped together as alcohol-associated cancers. SIR for these cancers combined was 1.1 (CI = 0.5-2.2). For lung cancer, SIR was 2.3 (CI = 1.6-3.1). Cervical cancer was also more frequent than expected, and breast cancer less frequent than expected. The larger excess of lung cancer and cervical cancer appeared in the sub-cohort working in restaurants with a license to serve alcohol. No excess risk of alcohol-associated cancers could be detected in this cohort of Norwegian waitresses. A longer follow-up period will be necessary to evaluate possible consequences of an increased alcohol consumption among younger waitresses. Waitresses in Norway are, like their male colleagues, at high risk for lung cancer.
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Affiliation(s)
- K Kjaerheim
- Cancer Registry of Norway, Institute for Epidemiological Cancer Research, Montebello, Oslo
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