Professional Cleaning Activities and Lung Cancer Risk Among Women: Results From the ICARE Study

Cancer-Specific Mortality Odds Ratios in the Food, Accommodation, and Beverage Activities in Italy

OBJECTIVES

This study investigated cancer-specific mortality risks of workers employed in food, accommodation and beverage (FAB) activities. Methods: We performed a case-control study based on countrywide mortality and National Social Insurance data. Adjusted cancer-specific mortality odds ratios (MOR) were calculated. We modeled occupational exposure as "ever/never been employed" in FAB activities, using other sectors as reference. Analysis was performed by gender, length of employment and year of smoke banning. Results: About 20,000 cancer deaths in FAB were analyzed. Working in restaurants was positively associated with cancer of lung (MOR = 1.24), bladder (MOR = 1.24), pharynx, and larynx. Accommodation was associated with cancer of pharynx (MOR = 1.46), while beverage with cancer of liver (MOR = 1.22). Gender, length of employment and smoke banning were found effective in modifying some risks. Conclusions: Workers in FAB sectors were at risk for several cancers.

Volatile organic compounds emitted by conventional and "green" cleaning products in the U.S. market

Exposure to cleaning products has been associated with harm to the respiratory system, neurotoxicity, harm to the reproductive system, and elevated risk of cancer, with greatest adverse impacts for workers exposed in an occupational setting. Social and consumer interest in cleaning products that are safer for health created a market category of "green" products defined here as products advertised as healthier, non-toxic, or free from harmful chemicals as well as products with a third-party certification for safety or environmental features. In the present study we examined the air quality impacts of cleaning products and air fresheners, measuring the number, concentrations, and emission factors of volatile organic compounds (VOCs) in an air chamber following product application. Across seven common product categories, 30 products were tested overall including 14 conventional, 9 identified as "green" with fragrance, and 7 identified as "green" and fragrance-free. A total of 530 unique VOCs were quantified with 205 additional VOCs detected below the limits of quantification. Of the quantifiable VOCs, 193 were considered hazardous according to either the California's Department of Toxic Substances Control Candidate Chemicals List or the European Chemical Agency's Classification and Labeling Inventory. The total concentration of VOCs and total emission factors across all products with detections ranged from below limits of detection to 18,708 μg/m3, 38,035 μg/g product and 3803 μg/application. Greater total concentration, total emission factors, and numbers of VOCs were generally observed in conventional cleaning products compared to products identified as "green", particularly compared to fragrance-free products. A hazard index approach was utilized to assess relative risk from measured VOC emissions. The five products with the highest hazard indices were conventional products with emissions of 2-butoxyethanol, isopropanol, toluene and chloroform. Overall, this analysis suggests that the use of "green" cleaning products, especially fragrance-free products, may reduce exposure to VOC emissions.

Exposomics as a tool to investigate differences in health and disease by sex and gender

The health and disease of an individual is mediated by their genetics, a lifetime of environmental exposures, and interactions between the two. Genetic or biological sex, including chromosome composition and hormone expression, may influence both the types and frequency of environmental exposures an individual experiences, as well as the biological responses an individual has to those exposures. Gender identity, which can be associated with social behaviors such as expressions of self, may also mediate the types and frequency of exposures an individual experiences. Recent advances in exposome-level analysis have progressed our understanding of how environmental factors affect health outcomes; however, the relationship between environmental exposures and sex- and gender-specific health remains underexplored. The comprehensive, non-targeted, and unbiased nature of exposomic research provides a unique opportunity to systematically evaluate how environmental exposures interact with biological sex and gender identity to influence health. In this forward-looking narrative review, we provide examples of how biological sex and gender identity influence environmental exposures, discuss how environmental factors may interact with biological processes, and highlight how an intersectional approach to exposomics can provide critical insights for sex- and gender-specific health sciences.

Respiratory Tract Cancer Incidences across Industry Groups: A Nationwide Cohort Study with More Than 70 Million Person-Years of Follow-Up

The number of cases and incidence rates of laryngeal and lung cancers have been increasing globally. Therefore, identifying the occupational causes of such cancers is an important concern for policymakers to prevent cancers and deaths. We used national health insurance service claims data in Korea. We included 10,786,000 workers aged between 25 and 64 years. In total, 74,366,928 total person-years of follow-up were included in this study with a mean follow-up of 6.89 years for each person. The standardized incidence ratio (SIR) and 95% confidence intervals (CIs) referenced with the total workers were estimated. For laryngeal cancer, increased SIRs were observed in the land transportation industry among male workers (SIR [95% CI]: 1.65 [1.02–2.53]). For lung cancer, elevated SIRs were observed in the industries including animal production (1.72 [1.03–2.68]), fishing (1.70 [1.05–2.60]), mining (1.69 [1.22–2.27]), travel (1.41 [1.00–1.93]), and transportation (1.22 [1.15–1.30]) among male workers. For female works, healthcare (2.08 [1.04–3.72]) and wholesale (1.88 [1.18–2.85]) industries were associated with a high risk of lung cancer. As an increased risk of respiratory tract cancers has been identified in employees associated with certain industries, appropriate policy intervention is needed to prevent occupational cancers.

Occupational Exposures and Lung Cancer Risk-An Analysis of the CARTaGENE Study

OBJECTIVE

To determine the associations between prevalent occupational agents and lung cancer risk.

METHODS

A case-cohort design (ncases= 147; nsub-cohort= 1,032) was nested within the CARTaGENE prospective cohort study. The Canadian Job Exposure Matrix was used to determine the probability of exposure to 27 agents in participants' longest-held jobs. Multivariable logistic regression with robust variance estimators was used to determine the associations between each agent and lung cancer risk while adjusting for established lung cancer risk factors.

RESULTS

Increased lung cancer risk was observed among those exposed to ashes, calcium sulfate, formaldehyde, cooking fumes, alkanes, aliphatic aldehydes, and cleaning agents. Lower lung cancer risk was found among participants exposed to carbon monoxide and polycyclic aromatic hydrocarbons from petroleum.

CONCLUSION

Our findings support the role of several occupational agents, for which we have limited knowledge, in contributing to lung cancer risk.

Lung Cancer Mortality in the Swiss Working Population: The Effect of Occupational and Non-Occupational Factors

OBJECTIVE

To assess the effect of occupational exposures on lung cancer mortality in Switzerland after adjustment for non-occupational lung carcinogens.

METHODS

Using data on 4,351,383 Swiss residents, we used negative binomial regression to assess the effect occupation on lung cancer mortality between 1990 and 2014, accounting for socio-demographic factors, predicted probabilities of smoking and measured environmental radon exposure.

RESULTS

After adjustment, male machine operators and workers in mining, stone working and building materials manufacturing showed the highest risk. Women working in electrical engineering, electronics, watchmaking, vehicle construction and toolmaking, and transport occupations also remained at high risk. Radon exposure had no effect on lung cancer mortality, while smoking demonstrated a significant effect in both sexes.

CONCLUSIONS

The results suggest the presence of occupational exposures to lung carcinogens in addition to non-occupational factors.

Influence of single nucleotide polymorphisms among cigarette smoking and non-smoking patients with coronary artery disease, urinary bladder cancer and lung cancer

Introduction

Cigarette smoke is suggested to be a risk factor for coronary artery disease (CAD), urinary bladder cancer (UBCa) or lung cancer (LCa). However, not all heavy smokers develop these diseases and elevated cancer risk among first-degree relatives suggests an important role of genetic factor.

Methods

Three hundred and ten healthy blood donors (controls), 98 CAD, 74 UBCa and 38 LCa patients were included in this pilot study. The influence of 92 single nucleotide polymorphisms (SNPs) and impact of cigarette smoking were analysed.

Results

Out of 92 SNPs tested, differences in distribution of 14 SNPs were detected between controls and patient groups. Only CTLA4 rs3087243 showed difference in both CAD and UBCa patient group compared to control group. Stratified by smoking status, the impact of smoking was associated to frequencies of 8, 3 and 4 SNPs in CAD, UBCa, LCa patients, respectively. None of these 92 SNPs showed a statistically significant difference to more than one type of disease among smoking patients. In non-smoking patients, 7, 3 and 6 SNPs were associated to CAD, UBCa, LCa, respectively. Out of these 92 SNPs, CTLA4 rs3087243 was associated to both non-smoking CAD and UBCa. The XRCC1 rs25487 was associated to both non-smoking UBCa and LCa.

Conclusion

SNPs might be important risk factors for CAD, UBCa and LCa. Distribution of the SNPs was specific for each patient group, not a random event. Impact of cigarette smoking on the disease was associated to the specific SNP sequences. Thus, smoking individuals with SNPs associated to risk of these serious diseases is an important target group for smoking cessation programs.

PERCEPTIONS OF DOMESTIC WORKERS ON LABOR RIGHTS AND IMPACTS ON THEIR WORKING AND HEALTH CONDITIONS

ABSTRACT Objective: to understand the perceptions of domestic workers on the legislative changes and impacts on their working and health conditions. Method: a qualitative study, conducted in a city in the inland of São Paulo, between December 2016 and March 2017, conducted through individual interviews with 15 domestic workers, using the snowball strategy and theoretical saturation sampling. For data analysis, Hermeneutics-Dialectics was adopted. Results: domestic workers face precarious working and health conditions, permeated by a lack of information about their rights at work, as well as discrimination, devaluation, musculoskeletal problems, mental suffering and presenteeism. Improvements in recent years have been reported, but the workers claim greater reach for formal registration and valuation for domestic work. Conclusion: constant evaluation and dissemination of the legislative changes with the domestic workers is essential, so that chronic situations of devaluation and precariousness of domestic work are replaced by the empowerment and transformation capacity of these women.

Cancer incidence and all-cause mortality among civilian men and women employed by the Royal Norwegian Navy between 1950 and 2005

OBJECTIVE

We aimed to investigate cancer incidence and all-cause mortality in a cohort of 8358 civilians (5134 men and 3224 women) employed by the Royal Norwegian Navy at any time between 1950 and 2005.

METHODS

The cohort was followed for cancer incidence and all-cause mortality from 1960 through 2015. Standardised incidence ratios (SIR) and mortality ratios (SMR) were calculated from national rates. Separate SIRs were calculated for a subgroup of male workshop workers and another of female cleaners.

RESULTS

Overall cancer incidence among men was similar to the reference rate; male breast cancer was more frequent (SIR = 3.23). Male workshop workers showed a SIR of 1.77 for stomach cancer, while their incidence of lympho-haematopoietic cancers was half that of the reference rates. Women had increased risks of overall cancer (SIR = 1.11), lung cancer (SIR = 1.35), and ovarian cancer (SIR = 1.39). Female cleaners showed a SIR of 2.33 for bladder cancer and a lowered incidence of brain cancer (SIR = 0.18). In the overall cohort, all-cause mortality was lower than expected for men (SMR = 0.92) and closer to the reference rate for women (SMR = 0.95).

CONCLUSION

In men, we observed a lowered all-cause mortality and an excess of stomach cancer in workshop workers. In women, increased risks of overall cancer, lung cancer and ovarian cancer was seen. An increased risk of bladder cancer and a lowered incidence of brain cancer was observed among female cleaners.

Development of a bar code-based exposure assessment method to evaluate occupational exposure to disinfectants and cleaning products: a pilot study

OBJECTIVE

Healthcare workers are highly exposed to various types of disinfectants and cleaning products. Assessment of exposure to these products remains a challenge. We aimed to investigate the feasibility of a method, based on a smartphone application and bar codes, to improve occupational exposure assessment among hospital/cleaning workers in epidemiological studies.

METHODS

A database of disinfectants and cleaning products used in French hospitals, including their names, bar codes and composition, was developed using several sources: ProdHyBase (a database of disinfectants managed by hospital hygiene experts), and specific regulatory agencies and industrial websites. A smartphone application has been created to scan bar codes of products and fill a short questionnaire. The application was tested in a French hospital. The ease of use and the ability to record information through this new approach were estimated.

RESULTS

The method was tested in a French hospital (7 units, 14 participants). Through the application, 126 records (one record referred to one product entered by one participant/unit) were registered, majority of which were liquids (55.5%) or sprays (23.8%); 20.6% were used to clean surfaces and 15.9% to clean toilets. Workers used mostly products with alcohol and quaternary ammonium compounds (>90% with weekly use), followed by hypochlorite bleach and hydrogen peroxide (28.6%). For most records, information was available on the name (93.7%) and bar code (77.0%). Information on product compounds was available for all products and recorded in the database.

CONCLUSION

This innovative and easy-to-use method could help to improve the assessment of occupational exposure to disinfectants/cleaning products in epidemiological studies.

Women Epidemiology Lung Cancer (WELCA) study: reproductive, hormonal, occupational risk factors and biobank

Background

Lung cancer aetiology and clinical aspects have been mainly studied in men, although specific risk factors probably exist in women. Here we present the rationale, design and organization of the WELCA study (Women Epidemiology Lung CAncer) that has been launched to investigate lung cancer in women, focusing particularly on hormonal and occupational factors.

Methods/Design

WELCA is a population based case-control study and planned to recruit 1000 cases and 1000 controls in three years, based on study power calculation. Eligible cases are female patients newly diagnosed with lung cancer, living in Paris and the Ile de France area and aged up to 75 years. Almost all Parisian pneumology and oncology clinical departments are involved. The control group is a random sample of the population living in the same area, frequency-matched on age and additionally stratified on the distribution of socio-professional categories of women residing there. After acquisition of written consent, research nurses administer standardized computer assisted questionnaires to all the subjects in face-to-face interviews and acquire anthropometric measures. Besides usual socio-demographic characteristics, information is gathered about menstrual and reproductive factors, hormonal treatments, lifestyle and leisure characteristics, occupational history, personal and familial medical history. Biological samples are also collected, in order to establish a biobank for molecular epidemiology studies. Molecular characteristics of the tumours will be obtained and patients will be followed up for five years.

Discussion

The WELCA study aims to answer key questions in lung cancer aetiology and clinical characteristics specifically in women. The role of hormonal impregnation is investigated, and the interactions with cigarette smoking or body mass index (BMI) will be analyzed in detail. The occupational history of the subjects is carefully reconstructed, focusing in particular on the service sector. The creation of a biobank for collection of serum, plasma, DNA and tumour tissue will allow the genetic and biochemical characterization of both the subjets and the tumours. The follow-up of the patients will help in disentangling the role of hormonal factors and tumour molecular characteristics in survival.