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Samsel K, Navaneelan T, DeBono N, Everest L, Demers PA, Sritharan J. Leukemia Incidence by Occupation and Industry: A Cohort Study of 2.3 Million Workers from Ontario, Canada. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:981. [PMID: 39200592 PMCID: PMC11353350 DOI: 10.3390/ijerph21080981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2024] [Revised: 07/23/2024] [Accepted: 07/24/2024] [Indexed: 09/02/2024]
Abstract
Although a significant body of evidence has attributed certain occupational exposures with leukemia, such as benzene, formaldehyde, 1,3-butadiene and ionizing radiation, more research is needed to identify work environments at increased risk for this disease. Our study aimed to identify occupational and industry groups associated with an elevated incidence of leukemia using a diverse cohort of workers' compensation claimants from Ontario, Canada. A total of 2,363,818 workers in the Occupational Disease Surveillance System (ODSS) cohort, with claims between 1983-2019, were followed for malignant leukemia diagnoses up to 31 December 2019. We used a Cox proportional-hazards model to estimate the relative incidence of leukemia in specific occupation and industry groups. After adjusting for age and birth year, males in protective services (HR = 1.17, 95% CI = 1.02-1.35), metal machining (HR = 1.23, 95% CI = 1.07-1.41), transport (HR = 1.15, 95% CI = 1.06-1.25), and mining occupations (HR = 1.28, 95% CI = 1.02-1.60) had elevated risks of leukemia compared to other workers in the ODSS, with comparable findings by industry. Among female workers, slight risk elevations were observed among product fabricating, assembling, and repairing occupations, with other increased risks seen in furniture and fixture manufacturing, storage, and retail industries. These findings underscore the need for exposure-based studies to better understand occupational hazards in these settings.
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Affiliation(s)
- Konrad Samsel
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Tanya Navaneelan
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
| | - Nathan DeBono
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Louis Everest
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
| | - Paul A. Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
| | - Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, Toronto, ON M5G 2L3, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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Dunnion C, Giltenane M, Dowling M. The 'inbetweeners': living on a watch and wait approach for chronic lymphocytic leukaemia - a qualitative study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2023; 32:794-800. [PMID: 37682762 DOI: 10.12968/bjon.2023.32.16.794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
BACKGROUND Chronic lymphocytic leukaemia (CLL) is an incurable disease; many people with the condition do not require active treatment and are monitored using a watch and wait approach. AIM The aim of this study was to explore the experiences of people living with a diagnosis of CLL and on watch and wait. METHODS Using a descriptive qualitative approach, seven participants on the watch and wait approach were interviewed. Data analysis was guided by systematic text condensation. FINDINGS Participants reported anxiety, referring to 'wait and worry'. Their information needs were not met, and they resorted to seeking information on possible future treatments themselves. They also experienced feeling like an imposter because they were not receiving active treatment like other patients with cancer. CONCLUSIONS A greater understanding of how information provision affects levels of anxiety and worry among people living with CLL on watch and wait is needed. In addition, clinical nurse specialists could deliver education on the watch and wait approach, supplemented by video-based educational materials developed by the haematology team.
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Affiliation(s)
- Claire Dunnion
- Haematology Clinical Nurse Specialist, Haematology department, Letterkenny University Hospital, Ireland
| | - Martina Giltenane
- Lecturer in Nursing. Department of Nursing Studies and Midwifery, University of Limerick, Ireland
| | - Maura Dowling
- Associate Professor, School of Nursing and Midwifery, University of Galway, Ireland
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Kenzik KM, Rocque G, Williams GR, Cherrington A, Bhatia S. Primary care and preventable hospitalizations among Medicare beneficiaries with non-metastatic breast cancer. J Cancer Surviv 2022; 16:853-864. [DOI: 10.1007/s11764-021-01079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/23/2021] [Indexed: 11/28/2022]
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Vos JAM, Wieldraaijer T, van Weert HCPM, van Asselt KM. Survivorship care for cancer patients in primary versus secondary care: a systematic review. J Cancer Surviv 2020; 15:66-76. [PMID: 32815087 PMCID: PMC7822798 DOI: 10.1007/s11764-020-00911-w] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/22/2020] [Indexed: 12/22/2022]
Abstract
Background Cancer survivorship care is traditionally performed in secondary care. Primary care is often involved in cancer management and could therefore play a more prominent role. Purpose To assess outcomes of cancer survivorship care in primary versus secondary care. Methods A systematic search of MEDLINE and EMBASE was performed. All original studies on cancer survivorship care in primary versus secondary care were included. A narrative synthesis was used for three distinctive outcomes: (1) clinical, (2) patient-reported, and (3) costs. Results Sixteen studies were included: 7 randomized trials and 9 observational studies. Meta-analyses were not feasible due to heterogeneity. Most studies reported on solid tumors, like breast (N = 7) and colorectal cancers (N = 3). Clinical outcomes were reported by 10 studies, patient-reported by 11, and costs by 4. No important differences were found on clinical and patient-reported outcomes when comparing primary- with secondary-based care. Some differences were seen relating to the content and quality of survivorship care, such as guideline adherence and follow-up tests, but there was no favorite strategy. Survivorship care in primary care was associated with lower societal costs. Conclusions Overall, cancer survivorship care in primary care had similar effects on clinical and patient-reported outcomes compared with secondary care, while resulting in lower costs. Implications for cancer survivors Survivorship care in primary care seems feasible. However, since the design and outcomes of studies differed, conclusive evidence for the equivalence of survivorship care in primary care is still lacking. Ongoing studies will help provide better insights.
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Affiliation(s)
- J A M Vos
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands.
| | - T Wieldraaijer
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
| | - H C P M van Weert
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
| | - K M van Asselt
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Post-box 22660, 1100 DD, Amsterdam, the Netherlands
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Avelino KY, Frias IA, Lucena-Silva N, Gomes RG, de Melo CP, Oliveira MD, Andrade CA. Attomolar electrochemical detection of the BCR/ABL fusion gene based on an amplifying self-signal metal nanoparticle-conducting polymer hybrid composite. Colloids Surf B Biointerfaces 2016; 148:576-584. [DOI: 10.1016/j.colsurfb.2016.09.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Revised: 09/05/2016] [Accepted: 09/21/2016] [Indexed: 02/07/2023]
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Beiggi S, Banerji V, Deneka A, Griffith J, Gibson SB, Johnston JB. Comparison of outcome of patients with CLL who are referred or nonreferred to a specialized CLL clinic: a Canadian population-based study. Cancer Med 2016; 5:971-9. [PMID: 26889755 PMCID: PMC4924353 DOI: 10.1002/cam4.559] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 08/28/2015] [Accepted: 09/01/2015] [Indexed: 02/04/2023] Open
Abstract
Chronic lymphocytic leukemia and small lymphocytic lymphoma (CLL/SLL) patients in Manitoba are either referred to the CLL Clinic at CancerCare Manitoba (CCMB) or are followed by other hematologists and general practitioners. However, it has been unclear whether referral to the CLL clinic influences patient outcome. Overall survival (OS) was assessed for all CLL/SLL patients diagnosed in Manitoba between 2007 and 2011. Of 555 patients, 281 (51%) were referred to the CLL clinic. Patients seen in this clinic had a twofold increased OS compared to patients who were managed by other hematologists and general practitioners (HR 2.375, P 0.0002) when adjusted for age, gender, presence of pre‐ or post‐CLL cancer, treatment and urban/rural location. In the nonreferred population there was a striking correlation between advancing age and decreasing OS. However, this correlation was almost eliminated in the referred population who were more likely to receive chemotherapy. Patients referred and seen in the CLL clinic have an improved OS compared to nonreferred patients and this appears to be primarily related to improved OS in the elderly. Possible explanations for this finding are discussed.
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Affiliation(s)
- Sara Beiggi
- Department of Biochemistry and Medical Genetics, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0J9, Canada.,Manitoba Institute of Cell Biology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada
| | - Versha Banerji
- Department of Biochemistry and Medical Genetics, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0J9, Canada.,Manitoba Institute of Cell Biology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada.,Department of Internal Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba, R3E 2N2, Canada.,Department of Hematology and Medical Oncology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada
| | - Angela Deneka
- Department of Epidemiology and Cancer Registry, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada
| | - Jane Griffith
- Department of Epidemiology and Cancer Registry, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada.,Department of Community Health Sciences, University of Manitoba, 750 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0W3, Canada
| | - Spencer B Gibson
- Department of Biochemistry and Medical Genetics, University of Manitoba, 745 Bannatyne Avenue, Winnipeg, Manitoba, R3E 0J9, Canada.,Manitoba Institute of Cell Biology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada
| | - James B Johnston
- Manitoba Institute of Cell Biology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada.,Department of Internal Medicine, University of Manitoba, 820 Sherbrook Street, Winnipeg, Manitoba, R3E 2N2, Canada.,Department of Hematology and Medical Oncology, Cancer Care Manitoba, 675 McDermot Ave, Winnipeg, Manitoba, R3E 0V9, Canada
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