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Del Monaco A, Dimitriadis C, Xie S, Benke G, Sim MR, Walker-Bone K. Workers in Australian prebake aluminium smelters: update on risk of mortality and cancer incidence in the Healthwise cohort. Occup Environ Med 2023; 80:160-169. [PMID: 36720634 DOI: 10.1136/oemed-2022-108605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 12/16/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To investigate mortality and the rates of incident cancer among a cohort of aluminium industry workers. METHODS Among 4507 male employees who worked in either of two Australian prebake smelters for at least 3 months, data linkage was undertaken with the Australian National Death Index and Australian Cancer Database. Standardised Mortality Ratios (SMRs) and Standardised Incidence Rates (SIRs) were estimated for the whole cohort and for: production; maintenance and office workers. SMRs and SIRs were calculated by time since first employment. RESULTS Among production workers, there was an excess risk of mortality from mesothelioma (SMR 2.8, 95% CI 1.3 to 5.2), lung (SMR 1.4, 95% CI 1.0 to 1.8), prostate (SMR 1.9, 95% CI 1.3 to 2.7) and liver cancer (SMR 2.0, 95% CI 1.1 to 3.4) and the SIR was also increased for overall respiratory cancers, specifically lung cancers. An excess risk of death from stomach cancer (SMR 2.9, 95% CI 1.2 to 6.1) and Alzheimer's disease (SMR 3.4, 95% CI 1.1 to 7.9) was seen among maintenance workers. The overall risk of death was similar to that of the Australian general population, as was mortality from cancers overall and non-malignant respiratory disease. CONCLUSIONS No excess risk of death from bladder cancer or non-malignant respiratory disease was found. Excess lung cancer mortality and incidence may be explained by smoking and excess mortality from mesothelioma may be explained by asbestos exposure. An excess risk of mortality from liver and prostate cancer has been shown in production workers and requires further investigation.
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Affiliation(s)
- Anthony Del Monaco
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Christina Dimitriadis
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Sophia Xie
- Peter Maccullum Cancer Centre, Peter Maccullum Cancer Institute, Melbourne, Victoria, Australia.,Chronic Disease and Ageing, Monash University, Melbourne, Victoria, Australia
| | - Geza Benke
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Malcolm Ross Sim
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen Walker-Bone
- Monash Centre for Occupational and Environmental Health, Monash University, Melbourne, Victoria, Australia .,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
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Incidental Diagnosis of Urothelial Bladder Cancer: Associations with Overall Survival. Cancers (Basel) 2023; 15:cancers15030668. [PMID: 36765629 PMCID: PMC9913049 DOI: 10.3390/cancers15030668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/07/2023] [Accepted: 01/18/2023] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND We investigated whether an incidental diagnosis (ID) of bladder cancer (BC) was associated with improved survival. METHODS We retrospectively reviewed data of consecutive patients with no prior diagnosis of urothelial cancer who underwent a primary transurethral resection of bladder tumor (pTURBT) between January 2013 and February 2021 and were subsequently diagnosed with urothelial BC. The type of diagnosis (incidental or non-incidental) was identified. Overall, relative, recurrence-free, and progression-free survival rates (OS, RS, RFS, and PFS) after pTURBT were evaluated using the Kaplan-Meier curves and long-rank tests. A multivariable Cox regression model for the overall mortality was developed. RESULTS A total of 435 patients were enrolled. The median follow-up was 2.7 years. ID cases were more likely to be low-grade (LG) and non-muscle-invasive. ID vs. non-ID was associated with a trend toward an improved 7-year OS (66% vs. 49%, p = 0.092) and a significantly improved 7-year OS, if incidental cases were limited to ultrasound-detected tumors (75% vs. 49%, p = 0.013). ID was associated with improved survival among muscle-invasive BC (MIBC) patients (3-year RS: 97% vs. 23%, p < 0.001), but not among other subgroups stratified according to disease stage or grade. In multivariable analysis, only age, MIBC, and high-grade (HG) cancer demonstrated an association with mortality. PFS and RFS among non-MIBC patients did not differ in regard to the type of diagnosis. CONCLUSIONS Incidental diagnosis may contribute to an improved survival in BC patients, most probably in the mechanism of the relative downgrading of the disease, including the possible overdiagnosis of LG tumors. Nevertheless, in the subgroup analyses, we noted marked survival benefits in MIBC cases. Further prospective studies are warranted to gain a deeper understanding of the observed associations.
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Barbosa F, Rocha BA, Souza MCO, Bocato MZ, Azevedo LF, Adeyemi JA, Santana A, Campiglia AD. Polycyclic aromatic hydrocarbons (PAHs): Updated aspects of their determination, kinetics in the human body, and toxicity. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2023; 26:28-65. [PMID: 36617662 DOI: 10.1080/10937404.2022.2164390] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Polycyclic aromatic hydrocarbons (PAHs) are legacy pollutants of considerable public health concern. Polycyclic aromatic hydrocarbons arise from natural and anthropogenic sources and are ubiquitously present in the environment. Several PAHs are highly toxic to humans with associated carcinogenic and mutagenic properties. Further, more severe harmful effects on human- and environmental health have been attributed to the presence of high molecular weight (HMW) PAHs, that is PAHs with molecular mass greater than 300 Da. However, more research has been conducted using low molecular weight (LMW) PAHs). In addition, no HMW PAHs are on the priority pollutants list of the United States Environmental Protection Agency (US EPA), which is limited to only 16 PAHs. However, limited analytical methodologies for separating and determining HMW PAHs and their potential isomers and lack of readily available commercial standards make research with these compounds challenging. Since most of the PAH kinetic data originate from animal studies, our understanding of the effects of PAHs on humans is still minimal. In addition, current knowledge of toxic effects after exposure to PAHs may be underrepresented since most investigations focused on exposure to a single PAH. Currently, information on PAH mixtures is limited. Thus, this review aims to critically assess the current knowledge of PAH chemical properties, their kinetic disposition, and toxicity to humans. Further, future research needs to improve and provide the missing information and minimize PAH exposure to humans.
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Affiliation(s)
- Fernando Barbosa
- Analytical and System Toxicology Laboratory, Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Bruno A Rocha
- Analytical and System Toxicology Laboratory, Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Marília C O Souza
- Analytical and System Toxicology Laboratory, Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Mariana Z Bocato
- Analytical and System Toxicology Laboratory, Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Lara F Azevedo
- Analytical and System Toxicology Laboratory, Department of Clinical Analyses, Toxicology and Food Sciences, School of Pharmaceutical Sciences of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Sao Paulo, Brazil
| | - Joseph A Adeyemi
- Department of Biology, School of Sciences, Federal University of Technology, Akure, Nigeria
| | - Anthony Santana
- Department of Chemistry, University of Central Florida, Orlando, FL, USA
| | - Andres D Campiglia
- Department of Chemistry, University of Central Florida, Orlando, FL, USA
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LeHuray A. A Review of Hazard Classifications of PAH-Containing Substances Illustrates the Need for Quantitative Assessment Methods. Polycycl Aromat Compd 2022. [DOI: 10.1080/10406638.2020.1830812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Anne LeHuray
- Chemical Management Associates, LLC, Alexandria, Virginia, USA
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McClure ES, Vasudevan P, DeBono N, Robinson WR, Marshall SW, Richardson D. Cancer and noncancer mortality among aluminum smelting workers in Badin, North Carolina. Am J Ind Med 2020; 63:755-765. [PMID: 32649003 PMCID: PMC7890681 DOI: 10.1002/ajim.23150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Badin, North Carolina, hosted an aluminum smelting plant from 1917 to 2007. The Concerned Citizens of West Badin reported suspected excess cancer mortality among former employees. This study aimed to investigate these concerns. METHODS The study cohort was enumerated from United Steel Workers' records of workers employed from 1980 to 2007. Cause-specific mortality rates in the cohort were compared with North Carolina population mortality rates using standardized mortality ratios (SMRs), standardized by age, sex, race, and calendar period. We estimated cause-specific adjusted standardized mortality ratios (aSMRs) using negative controls to mitigate healthy worker survivor bias (HWSB). Standardized rate ratios (SRRs) were calculated to compare mortality rates between workers ever employed vs never employed in the pot room. RESULTS All-cause mortality among Badin workers was lower than in the general population (SMR: 0.81, 95% confidence interval [CI]: 0.71-0.92). After adjusting for HWSB, excesses for all cancers (aSMR: 1.55, 95% CI: 1.10-2.21), bladder cancer (3.47, 95% CI: 1.25-9.62), mesothelioma (17.33, 95% CI: 5.40-55.59), and respiratory cancer (1.24, 95% CI: 0.77-1.99) were observed. Black males worked the highest proportion of their employed years in the pot room. Potroom workers experienced higher respiratory cancer (SRR: 2.99, 95% CI: 1.23-7.26), bladder cancer (SRR: 1.58, 95% CI: 0.15-15.28), and mesothelioma (SRR: 3.36, 95% CI: 0.21-53.78) mortality rates than never workers in the pot room. CONCLUSIONS This study responds to concerns of a group of former aluminum workers. The results, while imprecise, suggest excess respiratory and bladder cancers among pot room workers in a contemporary cohort of union employees at a US smelter.
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Affiliation(s)
- Elizabeth S McClure
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Pavithra Vasudevan
- Department of African and African Diaspora Studies/Center for Women’s and Gender Studies, University of Texas, Austin, TX
| | - Nathan DeBono
- Occupational Cancer Research Centre, Toronto, Ontario
| | - Whitney R Robinson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Stephen W. Marshall
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - David Richardson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Elser H, Neophytou AM, Tribett E, Galusha D, Modrek S, Noth EM, Meausoone V, Eisen EA, Cantley LF, Cullen MR. Cohort Profile: The American Manufacturing Cohort (AMC) study. Int J Epidemiol 2020; 48:1412-1422j. [PMID: 31220278 DOI: 10.1093/ije/dyz059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Holly Elser
- Division of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.,Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Erika Tribett
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Deron Galusha
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, College of Business, San Francisco, CA, USA
| | - Elizabeth M Noth
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Valerie Meausoone
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Linda F Cantley
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark R Cullen
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
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The global burden of urinary bladder cancer: an update. World J Urol 2019; 38:1895-1904. [PMID: 31676912 PMCID: PMC7363726 DOI: 10.1007/s00345-019-02984-4] [Citation(s) in RCA: 473] [Impact Index Per Article: 94.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/17/2019] [Indexed: 12/24/2022] Open
Abstract
Bladder cancer is among the top ten most common cancer types in the world, with approximately 550,000 new cases annually. The highest burden of bladder cancer is currently falling on most developed communities across the globe. But with an anticipated shift in world demographics with growing and aging populations mainly on the African continent, and important shifts in exposure to different risk factors across the world, this is likely to change over the next decades. In this review, we provide an overview of the current incidence, mortality, prevalence, survival, risk factors and costs of bladder cancer worldwide.
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