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Everest L, Tan S, Navaneelan T, Demers PA, DeBono N, Berriault C, Sritharan J. Comparison of internal and external reference populations for occupational cancer surveillance in a cohort drawn from a diverse workforce. Am J Ind Med 2024; 67:865-873. [PMID: 38980251 DOI: 10.1002/ajim.23637] [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: 05/03/2024] [Revised: 06/21/2024] [Accepted: 06/26/2024] [Indexed: 07/10/2024]
Abstract
OBJECTIVES Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program. METHODS A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario. RESULTS SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal. CONCLUSIONS Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.
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Affiliation(s)
- Louis Everest
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Shirui Tan
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Tanya Navaneelan
- Occupational Cancer Research Centre, Ontario Health, 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
| | - Nathan DeBono
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Jeavana Sritharan
- 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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Arif AA, Adeyemi O. Mortality among workers employed in the mining industry in the United States: A 29-year analysis of the National Health Interview Survey-Linked Mortality File, 1986-2014. Am J Ind Med 2020; 63:851-858. [PMID: 32687235 DOI: 10.1002/ajim.23160] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/09/2020] [Accepted: 07/10/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Working in the mining industry increases the risk of chronic diseases and mortality. We investigated overall and cause-specific mortality rates among workers employed in the mining sector in the United States. METHODS We pooled 29 years of National Health Interview Survey (NHIS) public-use data from 1986 to 2014, with mortality follow-up until 31 December 2015. We grouped respondents into the mining and nonmining sectors based on the responses given at the time of the NHIS interview. We compared the overall and cause-specific mortality rates using standardized mortality ratios (SMR) and 95% confidence interval (CI) adjusted for the competing cause of death. RESULTS From 1986 to 2014, an estimated 14 million deaths were recorded among subjects eligible for mortality follow-up. Of these, an estimated 50,000 deaths occurred among those working in the mining sector. A significantly higher overall mortality (SMR = 1.26, 95% CI: 1.17-1.36), and mortality from heart diseases (adjusted SMR = 1.56, 95% CI: 1.31-1.83), cancer (adjusted SMR = 1.30, 95% CI: 1.14-1.48) and unintentional injuries (adjusted SMR = 1.41, 95%CI: 1.03-1.85) were observed among those employed in the mining sector. When the analyses were restricted to men, only the SMRs for heart disease and cancer remained statistically significant. No elevated SMR for deaths from chronic lower respiratory disease was observed in the study. CONCLUSION Workers employed in the mining sector have a significantly increased total death rate and death rates from heart disease, cancer, and unintentional injuries.
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Affiliation(s)
- Ahmed A. Arif
- Department of Public Health Sciences University of North Carolina at Charlotte Charlotte North Carolina
| | - Oluwaseun Adeyemi
- Department of Public Health Sciences University of North Carolina at Charlotte Charlotte North Carolina
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Xian W, Han B, Xia L, Ma Y, Xu H, Zhang L, Li L, Liu H. Focusing on the premature death of redeployed miners in China: an analysis of cause-of-death information from non-communicable diseases. Global Health 2019; 15:7. [PMID: 30670067 PMCID: PMC6341550 DOI: 10.1186/s12992-019-0450-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 01/09/2019] [Indexed: 11/10/2022] Open
Abstract
Background Reducing premature deaths is an important step towards achieving the World Health Organization’s sustainable development goal. Redeployed miners are more prone to disease or premature death due to the special occupational characteristics. Our aims were to describe the deaths of redeployed miners, assess the losses due to premature death and identify their main health problems. All the records of individuals were obtained from Fuxin Mining Area Social Security Administration Center. Year of life lost (YLL) and average year of life lost were used to assess the loss due to premature death. YLL rates per 1000 individuals were considered to compare deaths from different populations. Results Circulatory system diseases contributed the most years of life lost in the causes of death, followed by neoplasms. But average year of life lost in neoplasms was 6.85, higher than circulatory system diseases, 5.63. Cerebrovascular disease and ischemic heart disease were the main causes of death in circulatory system diseases. And average years of life lost in cerebrovascular disease and ischemic heart disease were 5.85 and 5.62, higher than those in other circulatory system diseases. Lung cancer was the principal cause of death in neoplasms. Average year of life lost in liver cancer was 7.92, the highest in neoplasms. Conclusions For redeployed miners, YLL rates per 1000 individuals in cerebrovascular disease, ischemic heart disease and lung cancer were higher than those in other populations, especially in men. It is important to attach importance to the health of redeployed miners, take appropriate measures to reduce premature death and achieve the sustainable development goal. Our findings also contribute to a certain theoretical reference for other countries that face or will face the same problem. Electronic supplementary material The online version of this article (10.1186/s12992-019-0450-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Wei Xian
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Bing Han
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Leizhen Xia
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Yining Ma
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Haodi Xu
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Lu Zhang
- School of Public Health, China Medical University, Shenyang, People's Republic of China
| | - Li Li
- Division of Environmental and Occupational Health Sciences, National Jewish Health, Denver, CO, USA
| | - Hongbo Liu
- School of Public Health, China Medical University, Shenyang, People's Republic of China.
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Fidler MM, Reulen RC, Bright CJ, Henson KE, Kelly JS, Jenney M, Ng A, Whelan J, Winter DL, Frobisher C, Hawkins MM. Respiratory mortality of childhood, adolescent and young adult cancer survivors. Thorax 2018; 73:959-968. [PMID: 29748251 PMCID: PMC6166601 DOI: 10.1136/thoraxjnl-2017-210683] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Revised: 02/20/2018] [Accepted: 03/12/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Exposure to radiation and/or chemotherapy during cancer treatment can compromise respiratory function. We investigated the risk of long-term respiratory mortality among 5-year cancer survivors diagnosed before age 40 years using the British Childhood Cancer Survivor Study (BCCSS) and Teenage and Young Adult Cancer Survivor Study (TYACSS). METHODS The BCCSS comprises 34 489 cancer survivors diagnosed before 15 years from 1940 to 2006 in Great Britain. The TYACSS includes 200 945 cancer survivors diagnosed between 15 years and 39 years from 1971 to 2006 in England and Wales. Standardised mortality ratios and absolute excess risks were used. FINDINGS Overall, 164 and 1079 respiratory deaths were observed in the BCCSS and TYACSS cohorts respectively, which was 6.8 (95% CI 5.8 to 7.9) and 1.7 (95% CI 1.6 to 1.8) times that expected, but the risks varied substantially by type of respiratory death. Greatest excess numbers of deaths were experienced after central nervous system (CNS) tumours in the BCCSS and after lung cancer, leukaemia, head and neck cancer and CNS tumours in the TYACSS. The excess number of respiratory deaths increased with increasing attained age, with seven (95% CI 2.4 to 11.3) excess deaths observed among those aged 50+ years in the BCCSS and three (95% CI 1.4 to 4.2) excess deaths observed among those aged 60+ years in the TYACSS. It was reassuring to see a decline in the excess number of respiratory deaths among those diagnosed more recently in both cohorts. CONCLUSIONS Prior to this study, there was almost nothing known about the risks of respiratory death after cancer diagnosed in young adulthood, and this study addresses this gap. These new findings will be useful for both survivors and those involved in their clinical management and follow-up.
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Affiliation(s)
- Miranda M Fidler
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Raoul C Reulen
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chloe J Bright
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Katherine E Henson
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Clinical Trial Service Unite, University of Oxford, Oxford, UK
| | - Julie S Kelly
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Meriel Jenney
- Department of Paediatric Oncology, Children's Hospital for Wales, Cardiff, UK
| | - Antony Ng
- Department of Paediatric Oncology, Bristol Royal Hospital for Children, Bristol, UK
| | - Jeremy Whelan
- Department of Oncology, University College London Hospitals NHS Foundation Trust, London, UK
| | - David L Winter
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Clare Frobisher
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Michael M Hawkins
- Centre for Childhood Cancer Survivor Studies, Institute of Applied Health Research, University of Birmingham, Birmingham, UK
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Möhner M, Pohrt A, Gellissen J. Occupational exposure to respirable crystalline silica and chronic non-malignant renal disease: systematic review and meta-analysis. Int Arch Occup Environ Health 2017; 90:555-574. [PMID: 28409224 PMCID: PMC5583269 DOI: 10.1007/s00420-017-1219-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 04/05/2017] [Indexed: 12/12/2022]
Abstract
Background While occupational exposure to respirable silica is known to lead to lung disease, most notably silicosis, its association with chronic kidney disease is unclear. Objectives This review explores the association between occupational exposure to respirable silica and chronic non-malignant renal disease such as glomerulonephritis. The evidence has been collected and compiled. Possible sources of bias are thoroughly discussed. Methods Cohort studies with silica exposure and case–control studies of renal disease were searched in PubMed until January 2015. Two authors independently abstracted data; any disagreement was resolved by consulting a third reviewer. A meta-analysis was performed to evaluate the association to silica exposure. Results A total of 23 cohort and four case–control studies were included in the analysis. The meta-analysis of cohort studies yielded elevated overall SMRs for renal disease. Some studies, however, included dose–response analyses, most of which did not show a positive trend. The approaches and results of the case–control studies were very heterogeneous. Conclusions While the studies of cohorts exposed to silica found elevated SMRs for renal disease, no clear evidence of a dose–response relationship emerged. The elevated risk may be attributed to diagnostic and methodological issues. In order to permit a reliable estimation of a possible causal link, exposed cohorts should be monitored for renal disease, as the information from mortality studies is hardly reliable in this field. Electronic supplementary material The online version of this article (doi:10.1007/s00420-017-1219-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Matthias Möhner
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany.
| | - Anne Pohrt
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany
| | - Johannes Gellissen
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany
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Möhner M. Response to the letter to the editor from Morfeld. Int Arch Occup Environ Health 2016; 89:879-80. [PMID: 26898208 PMCID: PMC4871917 DOI: 10.1007/s00420-016-1121-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Accepted: 02/05/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Matthias Möhner
- Division of Work and Health, Federal Institute for Occupational Safety and Health, Nöldnerstr. 40/42, 10317, Berlin, Germany.
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Möhner 2015: the suggested approach does not correct for competing causes reliably and overstates SMRs. Int Arch Occup Environ Health 2016; 89:877-8. [PMID: 26898209 DOI: 10.1007/s00420-016-1120-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 02/05/2016] [Indexed: 10/22/2022]
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