1
|
Szkiela M, Kusideł E, Makowiec-Dąbrowska T, Kaleta D. How the Intensity of Night Shift Work Affects Breast Cancer Risk. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4570. [PMID: 33925799 PMCID: PMC8123502 DOI: 10.3390/ijerph18094570] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/09/2022]
Abstract
Background-In 2019, the IARC concluded that "night shift work is probably carcinogenic to humans (Group 2A), based on limited evidence from human epidemiological studies and sufficient evidence of cancer and strong mechanistic evidence in experimental Animals." The negative health consequences of night shift work may depend on how the night shifts are scheduled. The aim of this study was to investigate how the characteristics of night work affect the risk of developing breast cancer. Methods-A case-control study was conducted in 2015-2019 in the Lodz region. The case group included 494 women with breast cancer, while the control group included 515 healthy women. Results-Night work was found to be the third most important factor regarding breast cancer after a high BMI and a short or no breastfeeding period and before factors such as early menstruation, late menopause, no pregnancy, and smoking. The harmful effects of night work were influenced by its intensity, frequency, rotation, and the number of night shift years worked. Night work increases the breast cancer risk by 2.34 times, and high-intensity night work increases the breast cancer risk by 2.66 times. Conclusions-Appropriate ergonomic recommendations for night shift work for employers should be considered.
Collapse
Affiliation(s)
- Marta Szkiela
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Medical University of Lodz, 90-752 Lodz, Poland;
- Department of Hygiene and Health Promotion, Faculty of Health Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| | - Ewa Kusideł
- Department of Spatial Econometrics, Faculty of Economics and Sociology, University of Lodz, 90-255 Lodz, Poland;
| | - Teresa Makowiec-Dąbrowska
- Nofer Institute of Occupational Medicine in Łódź, Department of Environmental and Occupational Health Hazards, 91-348 Lodz, Poland;
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Faculty of Health Sciences, Medical University of Lodz, 90-752 Lodz, Poland;
- Department of Hygiene and Health Promotion, Faculty of Health Sciences, Medical University of Lodz, 90-752 Lodz, Poland
| |
Collapse
|
2
|
Brito-Marcelino A, Duarte-Tavares RJ, Marcelino KB, Silva-Neto JA. Cervical cancer related to occupational risk factors: review. Rev Bras Med Trab 2020; 18:103-108. [PMID: 32783011 DOI: 10.5327/z1679443520200419] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 12/18/2019] [Indexed: 11/05/2022] Open
Abstract
Background Occupational risk factors are associated with many types of neoplasms including cervical cancer. Objective To review the specialized literature for evidence on the relationship between cervical cancer and exposure to occupational hazards. Methods Literature search in electronic databases using keywords cervical cancer and occupational risk. Results Workers occupationally exposed to tobacco, fungi or bacteria, metalworking fluids and tetrachloroethylene used in dry cleaning and for metal degreasing exhibited higher susceptibility to cervical cancer. Conclusion Few studies sought to investigate relationships between cervical cancer and occupational hazards, which hinders the attempts at establishing a causal link.
Collapse
Affiliation(s)
- Arthur Brito-Marcelino
- Emergency Hospital of Sergipe - Aracaju (SE), Brazil. Emergency Hospital of Sergipe Brazil
| | | | - Katienne Brito Marcelino
- Department of Medicine, Universidade de Gurupi - Gurupi (TO), Brazil. Department of Medicine Universidade de Gurupi Brazil
| | - Julio Alves Silva-Neto
- Department of Pharmacology, Universidade de São Paulo - Ribeirão Preto (SP), Brazil. Universidade de São Paulo Department of Pharmacology Universidade de São Paulo Brazil
| |
Collapse
|
3
|
Murfin J, Irvine F, Meechan-Rogers R, Swift A. Education, income and occupation and their influence on the uptake of cervical cancer prevention strategies: A systematic review. J Clin Nurs 2019; 29:393-415. [PMID: 31713934 DOI: 10.1111/jocn.15094] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 09/11/2019] [Accepted: 10/20/2019] [Indexed: 02/06/2023]
Abstract
AIMS To report a systematic review of the literature exploring how education, income and occupation influence the uptake of cervical screening and HPV vaccination among eligible women in developed countries, including the United Kingdom, United States, Spain, Germany and Norway. BACKGROUND Cervical cancer remains a highly prevalent disease despite it being largely preventable through cervical screening and HPV vaccination. Incidence and mortality of cervical cancer are unequally distributed among socioeconomic groups, warranting research into how individual socioeconomic factors contribute to this unbalanced uptake of prevention strategies. DESIGN Systematic review and narrative synthesis. METHODS The PRISMA guidelines (PLoS Medicine, 6, 2009, e1000097) guided the selection of papers. MEDLINE, CINHAL, PsychINFO, Science Citation Index and HMIC were searched. Ten articles were suitable. Key findings were then extracted, and a narrative synthesis was completed, using suitable guidance and the AXIS tool. RESULTS Obtaining high school or college education is associated with uptake of both cervical screening and HPV vaccination. Total household income and income in respect of the countries' poverty line was measured less frequently than education, but associated with screening and vaccination in some studies. Occupation was infrequently measured in comparison to education and income, limiting conclusions of its association to uptake. CONCLUSION Education and income have an association with uptake of cervical screening and HPV vaccination among women. However, evidence is insufficient to affirm a relationship between occupation and uptake of screening and vaccination. Further research would be advised to strengthen these findings. RELEVANCE TO CLINICAL PRACTICE Interventions to promote cervical cancer prevention strategies should be targeted at women and girls with lower education levels and lower income. However, differences are displayed in the relationships between the individual socioeconomic factors and uptake of preventative strategies between countries and populations and so they should be considered separately. Nurses play a considerable role in people's perceptions and experiences of cervical screening and HPV vaccination. The review findings offer new insight that can inform future policy and nursing practice on targeting interventions to promote uptake among women who are underusing cervical cancer prevention programmes.
Collapse
Affiliation(s)
- Jessica Murfin
- School of Nursing, University of Birmingham, Birmingham, UK
| | - Fiona Irvine
- School of Nursing, University of Birmingham, Birmingham, UK
| | | | - Amelia Swift
- School of Nursing, University of Birmingham, Birmingham, UK
| |
Collapse
|
4
|
Pahwa M, Labrèche F, Kim J, Harris MA, Song C, Peters CE, Arrandale VH, Davies H, McLeod CB, Demers PA. The impact of night shift work on breast cancer: Results from the Burden of Occupational Cancer in Canada Study. Am J Ind Med 2019; 62:635-642. [PMID: 31172551 DOI: 10.1002/ajim.22999] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND We estimated the proportion and number of female breast cancer cases in Canada attributable to night shift work, a probable cause of breast cancer. METHODS Levin's equation was used to calculate population attributable fractions (PAFs) among Canadian women who ever worked night/rotating shifts from 1961 to 2000, accounting for labor turnover and survival to the year 2011. The calculated PAFs were applied to 2011 Canadian breast cancer incidence statistics to obtain the number of attributable cases. RESULTS Approximately 1.5 million women ever worked night/rotating shifts during 1961-2000 and survived to 2011. The PAFs ranged from 2.0% (95% confidence interval [CI]: 1.4-6.2) to 5.2% (95% CI: 3.7-13.6), and 470 to 1200 incident breast cancer cases in 2011 were likely due to shift work, of which 38% would have been diagnosed among women in health-related occupations. CONCLUSIONS More research is needed to increase the certainty of this association, but current evidence supports workplace-based prevention.
Collapse
Affiliation(s)
- Manisha Pahwa
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
| | - France Labrèche
- Institut de recherche Robert‐Sauvé en santé et en sécurité du travailMontréal Quebec Canada
- Department of Environmental and Occupational Health, School of Public HealthUniversité de MontréalMontréal Quebec Canada
| | - Joanne Kim
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- Department of Epidemiology, Biostatistics and Occupational HealthMcGill UniversityMontréal Quebec Canada
| | - M. Anne Harris
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- School of Occupational and Public Health, Faculty of Community ServicesRyerson UniversityToronto Ontario Canada
- Dalla Lana School of Public Health, Division of Occupational and Environmental HealthUniversity of TorontoToronto Ontario Canada
| | - Chaojie Song
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
| | - Cheryl E. Peters
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- CAREX CanadaSimon Fraser UniversityBurnaby British Columbia Canada
- Cancer Epidemiology and Prevention Research, Alberta Health ServicesCancerControl AlbertaCalgary Alberta Canada
- Department of Oncology, Cumming School of MedicineUniversity of CalgaryCalgary Alberta Canada
| | - Victoria H. Arrandale
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- Dalla Lana School of Public Health, Division of Occupational and Environmental HealthUniversity of TorontoToronto Ontario Canada
| | - Hugh Davies
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- CAREX CanadaSimon Fraser UniversityBurnaby British Columbia Canada
- School of Population and Public Health, Division of Occupational and Environmental HealthUniversity of British ColumbiaVancouver British Columbia Canada
| | - Christopher B. McLeod
- School of Population and Public Health, Division of Occupational and Environmental HealthUniversity of British ColumbiaVancouver British Columbia Canada
- Institute for Work & HealthToronto Ontario Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Prevention and Cancer ControlCancer Care OntarioToronto Ontario Canada
- Dalla Lana School of Public Health, Division of Occupational and Environmental HealthUniversity of TorontoToronto Ontario Canada
- CAREX CanadaSimon Fraser UniversityBurnaby British Columbia Canada
- School of Population and Public Health, Division of Occupational and Environmental HealthUniversity of British ColumbiaVancouver British Columbia Canada
| |
Collapse
|
5
|
Night shift work and risk of breast cancer in women: the Generations Study cohort. Br J Cancer 2019; 121:172-179. [PMID: 31138896 PMCID: PMC6738051 DOI: 10.1038/s41416-019-0485-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 05/02/2019] [Indexed: 12/11/2022] Open
Abstract
Background It is plausible that night shift work could affect breast cancer risk, possibly by melatonin suppression or circadian clock disruption, but epidemiological evidence is inconclusive. Methods Using serial questionnaires from the Generations Study cohort, we estimated hazard ratios (HR) and 95% confidence intervals (95%CI) for breast cancer in relation to being a night shift worker within the last 10 years, adjusted for potential confounders. Results Among 102,869 women recruited in 2003–2014, median follow-up 9.5 years, 2059 developed invasive breast cancer. The HR in relation to night shift work was 1.00 (95%CI: 0.86–1.15). There was a significant trend with average hours of night work per week (P = 0.035), but no significantly raised risks for hours worked per night, nights worked per week, average hours worked per week, cumulative years of employment, cumulative hours, time since cessation, type of occupation, age starting night shift work, or age starting in relation to first pregnancy. Conclusions The lack of overall association, and no association with all but one measure of dose, duration, and intensity in our data, does not support an increased risk of breast cancer from night shift work in women.
Collapse
|
6
|
Katuwal S, Martinsen JI, Kjaerheim K, Sparen P, Tryggvadottir L, Lynge E, Weiderpass E, Pukkala E. Occupational variation in the risk of female breast cancer in the Nordic countries. Cancer Causes Control 2018; 29:1027-1038. [DOI: 10.1007/s10552-018-1076-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 08/23/2018] [Indexed: 12/31/2022]
|
7
|
Acheampong T, Yuan JM, Koh WP, Jin A, Odegaard A. Occupational exposure to endocrine disrupting substances and the risk of breast Cancer: the Singapore Chinese health study. BMC Public Health 2018; 18:929. [PMID: 30055614 PMCID: PMC6064056 DOI: 10.1186/s12889-018-5862-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 07/18/2018] [Indexed: 11/28/2022] Open
Abstract
Background Evidence from basic research links exposure to endocrine disrupting chemicals (EDCs) with a higher risk for breast cancer. However, there is less evidence from observational epidemiological research and the results are equivocal. Therefore, we examined the association between occupational exposure to substances where exposure to EDCs is likely and the risk of breast cancer. Methods A prospective study consisting of a population-based cohort of 33,458 Singaporean Chinese women aged 45–74 years enrolled in the Singapore Chinese Health Study (SCHS) from 1993 to 98 and followed through 2014. Subjects’ self-reported occupational exposure and duration to industries, job titles, and substance types were garnered at baseline, and cases of incident breast cancer (N = 988) were determined by linkage with the Singapore Cancer Registry. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated for exposure to substances, job titles, and industries. Results There was no association between cumulative exposure to substances via occupation where EDC exposure is likely and risk of breast cancer. These results were consistent for hypothesized high (HR 0.94, 95% CI: 0.66–1.35), medium (HR 1.03 95% CI: 0.77–1.38) and low (HR 0.74, 95% CI 0.48–1.13) combined substance exposure groups when compared with those who were not exposed via occupation. Similar null associations were observed when examining job titles and industry categories. Conclusions There was no association between EDC related occupational exposures and breast cancer risk in working women of the Singaporean Chinese Health Study. Future studies that employ rigorous methods with regard to exposure assessment of EDCs are needed. Electronic supplementary material The online version of this article (10.1186/s12889-018-5862-2) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Teofilia Acheampong
- Department of Epidemiology, University of California Irvine, School of Medicine, 224 Irvine Hall, Irvine, CA, 92697, United States.
| | - Jian-Min Yuan
- University of Pittsburgh, University of Pittsburgh Medical Center (Shadyside) Cancer Pavilion, 5150 Centre Avenue, Pittsburgh, PA, 15232, United States
| | - Woon Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, Singapore, 117549, Singapore
| | - Aizhen Jin
- Health Services and Systems Research, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Andrew Odegaard
- Department of Epidemiology, University of California Irvine, School of Medicine, 224 Irvine Hall, Irvine, CA, 92697, United States
| |
Collapse
|
8
|
Gray JM, Rasanayagam S, Engel C, Rizzo J. State of the evidence 2017: an update on the connection between breast cancer and the environment. Environ Health 2017; 16:94. [PMID: 28865460 PMCID: PMC5581466 DOI: 10.1186/s12940-017-0287-4] [Citation(s) in RCA: 109] [Impact Index Per Article: 15.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 07/17/2017] [Indexed: 05/23/2023]
Abstract
BACKGROUND In this review, we examine the continually expanding and increasingly compelling data linking radiation and various chemicals in our environment to the current high incidence of breast cancer. Singly and in combination, these toxicants may have contributed significantly to the increasing rates of breast cancer observed over the past several decades. Exposures early in development from gestation through adolescence and early adulthood are particularly of concern as they re-shape the program of genetic, epigenetic and physiological processes in the developing mammary system, leading to an increased risk for developing breast cancer. In the 8 years since we last published a comprehensive review of the relevant literature, hundreds of new papers have appeared supporting this link, and in this update, the evidence on this topic is more extensive and of better quality than that previously available. CONCLUSION Increasing evidence from epidemiological studies, as well as a better understanding of mechanisms linking toxicants with development of breast cancer, all reinforce the conclusion that exposures to these substances - many of which are found in common, everyday products and byproducts - may lead to increased risk of developing breast cancer. Moving forward, attention to methodological limitations, especially in relevant epidemiological and animal models, will need to be addressed to allow clearer and more direct connections to be evaluated.
Collapse
Affiliation(s)
- Janet M. Gray
- Department of Psychology and Program in Science, Technology, and Society, Vassar College, 124 Raymond Avenue, Poughkeepsie, NY 12604-0246 USA
| | - Sharima Rasanayagam
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
| | - Connie Engel
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
| | - Jeanne Rizzo
- Breast Cancer Prevention Partners, 1388 Sutter St., Suite 400, San Francisco, CA 94109-5400 USA
| |
Collapse
|
9
|
Affiliation(s)
- Ian N Olver
- Sansom Institute for Health Research, University of South Australia, Adelaide, SA
| |
Collapse
|
10
|
Fenga C. Occupational exposure and risk of breast cancer. Biomed Rep 2016; 4:282-292. [PMID: 26998264 DOI: 10.3892/br.2016.575] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 12/24/2015] [Indexed: 11/05/2022] Open
Abstract
Breast cancer is a multifactorial disease and the most commonly diagnosed cancer in women. Traditional risk factors for breast cancer include reproductive status, genetic mutations, family history and lifestyle. However, increasing evidence has identified an association between breast cancer and occupational factors, including environmental stimuli. Epidemiological and experimental studies demonstrated that ionizing and non-ionizing radiation exposure, night-shift work, pesticides, polycyclic aromatic hydrocarbons and metals are defined environmental factors for breast cancer, particularly at young ages. However, the mechanisms by which occupational factors can promote breast cancer initiation and progression remains to be elucidated. Furthermore, the evaluation of occupational factors for breast cancer, particularly in the workplace, also remains to be explained. The present review summarizes the occupational risk factors and the associated mechanisms involved in breast cancer development, in order to highlight new environmental exposures that could be correlated to breast cancer and to provide new insights for breast cancer prevention in the occupational settings. Furthermore, this review suggests that there is a requirement to include, through multidisciplinary approaches, different occupational exposure risks among those associated with breast cancer development. Finally, the design of new epigenetic biomarkers may be useful to identify the workers that are more susceptible to develop breast cancer.
Collapse
Affiliation(s)
- Concettina Fenga
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, Occupational Medicine Section, 'Policlinico G. Martino' Hospital, University of Messina, Messina I-98125, Italy
| |
Collapse
|
11
|
Datta K, Roy A, Nanda D, Das I, Guha S, Ghosh D, Sikdar S, Biswas J. Association of breast cancer with sleep pattern--a pilot case control study in a regional cancer centre in South Asia. Asian Pac J Cancer Prev 2015; 15:8641-5. [PMID: 25374182 DOI: 10.7314/apjcp.2014.15.20.8641] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The rising trend of breast cancer both in developed and developing countries is a real threat challenging all efforts to screening, prevention and treatment aspects to reduce its impact. In spite of modern preventive strategies, the upward trend of breast cancer has become a matter of great concern in both developed and developing countries. Chittaranjan National Cancer Institute is a premier regional cancer institute in eastern region of India catering to a large number of cancer patients every year. A pilot case control study of fifty breast cancer patients and 100 matched controls was conducted during 2013 to evaluate the effects of habitual factors like working in night shift, not having adequate sleep, and not sleeping in total darkness on breast cancer of women. The study revealed that not sleeping in total darkness was associated with higher odds of outcome of breast cancer of women. This positive correlation can play a vital role in formulation of preventive strategies through life style modification.
Collapse
Affiliation(s)
- Karabi Datta
- Department of Epidemiology Biostatistics, Chittaranjan National Cancer Institute, Kolkata, India E-mail :
| | | | | | | | | | | | | | | |
Collapse
|
12
|
Ruder AM, Hein MJ, Hopf NB, Waters MA. Mortality among 24,865 workers exposed to polychlorinated biphenyls (PCBs) in three electrical capacitor manufacturing plants: a ten-year update. Int J Hyg Environ Health 2013; 217:176-87. [PMID: 23707056 DOI: 10.1016/j.ijheh.2013.04.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2012] [Revised: 03/21/2013] [Accepted: 04/16/2013] [Indexed: 11/16/2022]
Abstract
The objective of this analysis was to evaluate mortality among a cohort of 24,865 capacitor-manufacturing workers exposed to polychlorinated biphenyls (PCBs) at plants in Indiana, Massachusetts, and New York and followed for mortality through 2008. Cumulative PCB exposure was estimated using plant-specific job-exposure matrices. External comparisons to US and state-specific populations used standardized mortality ratios, adjusted for gender, race, age and calendar year. Among long-term workers employed 3 months or longer, within-cohort comparisons used standardized rate ratios and multivariable Poisson regression modeling. Through 2008, more than one million person-years at risk and 8749 deaths were accrued. Among long-term employees, all-cause and all-cancer mortality were not elevated; of the a priori outcomes assessed only melanoma mortality was elevated. Mortality was elevated for some outcomes of a priori interest among subgroups of long-term workers: all cancer, intestinal cancer and amyotrophic lateral sclerosis (women); melanoma (men); melanoma and brain and nervous system cancer (Indiana plant); and melanoma and multiple myeloma (New York plant). Standardized rates of stomach and uterine cancer and multiple myeloma mortality increased with estimated cumulative PCB exposure. Poisson regression modeling showed significant associations with estimated cumulative PCB exposure for prostate and stomach cancer mortality. For other outcomes of a priori interest--rectal, liver, ovarian, breast, and thyroid cancer, non-Hodgkin lymphoma, Alzheimer disease, and Parkinson disease--neither elevated mortality nor positive associations with PCB exposure were observed. Associations between estimated cumulative PCB exposure and stomach, uterine, and prostate cancer and myeloma mortality confirmed our previous positive findings.
Collapse
Affiliation(s)
- Avima M Ruder
- Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
| | - Misty J Hein
- Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Nancy B Hopf
- Institute for Work and Health (IST), Rue du Bugnon 21, CH-1011 Lausanne, Switzerland
| | - Martha A Waters
- Division of Applied Research Technology, National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| |
Collapse
|