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Jiménez T, García-Pérez J, van der Haar R, Alba MÁ, Lucas P, Sierra MÁ, de Larrea-Baz NF, Salas-Trejo D, Llobet R, Martínez I, Pino MN, Alguacil J, González-Galarzo MC, Martínez-Cortés M, Pérez-Gómez B, Pollán M, Lope V. Occupation, occupational exposures and mammographic density in Spanish women. ENVIRONMENTAL RESEARCH 2021; 195:110816. [PMID: 33524328 DOI: 10.1016/j.envres.2021.110816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/25/2021] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Mammographic density (MD), the proportion of radiologically dense breast tissue, is a strong risk factor for breast cancer. Our objective is to investigate the influence of occupations and occupational exposure to physical, chemical, and microbiological agents on MD in Spanish premenopausal women. METHODS This is a cross-sectional study based on 1362 premenopausal workers, aged 39-50, who attended a gynecological screening in a breast radiodiagnosis unit of Madrid City Council. The work history was compiled through a personal interview. Exposure to occupational agents was evaluated using the Spanish job-exposure matrix MatEmESp. MD percentage was assessed using the validated semi-automated computer tool DM-Scan. The association between occupation, occupational exposures, and MD was quantified using multiple linear regression models, adjusted for age, educational level, body mass index, parity, previous breast biopsies, family history of breast cancer, energy intake, use of oral contraceptives, smoking, and alcohol consumption. RESULTS Although no occupation was statistically significantly associated with MD, a borderline significant inverse association was mainly observed in orchard, greenhouse, nursery, and garden workers (β = -6.60; 95% confidence interval (95%CI) = -14.27; 1.07) and information and communication technology technicians (β = -7.27; 95%CI = -15.37; 0.84). On the contrary, a positive association was found among technicians in art galleries, museums, and libraries (β = 8.47; 95%CI = -0.65; 17.60). Women occupationally exposed to fungicides, herbicides, and insecticides tended to have lower MD. The percentage of density decreased by almost 2% for every 5 years spent in occupations exposed to the mentioned agents. CONCLUSIONS Although our findings point to a lack of association with the occupations and exposures analyzed, this study supports a deeper exploration of the role of certain occupational agents in MD, such as pesticides.
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Affiliation(s)
- Tamara Jiménez
- Department of Preventive Medicine, Public Health and Microbiology, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | | | - Miguel Ángel Alba
- Área de Higiene Industrial, Quirón Prevención, S.L.U., Barcelona, Spain
| | - Pilar Lucas
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - María Ángeles Sierra
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Nerea Fernández de Larrea-Baz
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Dolores Salas-Trejo
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, València, Spain
| | - Inmaculada Martínez
- Valencian Breast Cancer Screening Program, General Directorate of Public Health, València, Spain; Centro Superior de Investigación en Salud Pública CSISP, FISABIO, València, Spain
| | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Centro de Investigación en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, Huelva, Spain
| | - Mª Carmen González-Galarzo
- Department of Developmental and Educational Psychology, University of Valencia, Valencia, Spain; Center for Research in Occupational Disease, Universitat Pompeu Fabra, Barcelona, Spain
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, Department of Epidemiology of Chronic Diseases, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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2
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El-Zaemey S, Fritschi L, Heyworth J, Boyle T, Saunders C, Wylie E, Stone J. No association between night shiftwork and mammographic density. Occup Environ Med 2020; 77:564-567. [PMID: 32467312 DOI: 10.1136/oemed-2019-106315] [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: 11/11/2019] [Revised: 05/07/2020] [Accepted: 05/09/2020] [Indexed: 11/04/2022]
Abstract
BACKGROUND Increased mammographic density is one of the strongest risk factors for breast cancer. Night shiftwork and its related factors, which include light at night, phase shift and sleep disruption, are believed to increase breast cancer risk however, their effects on mammographic density have barely been studied. METHODS This study included 1821 women enrolled in the Breast Cancer Environment and Employment Study between 2009 and 2011. Mammographic density was measured using the Cumulus software program. The association of night shiftwork factors with square root transformed absolute dense area (DA) and percentage dense area (PDA) were modelled using linear regression adjusted for confounders. RESULTS Ever doing graveyard shiftwork (between 24:00 and 05:00 hours) was not associated with PDA (β=-0.10; 95% CI -0.27 to 0.08)) and DA (β=-0.12; 95% CI -0.33 to 0.09)). No association was found between night shiftwork related factors (light at night, phase shift and sleep disturbance) with PDA or DA. CONCLUSIONS Shiftwork and its related factors are not associated with mammographic density. Using high-quality, comprehensive shiftwork data from a large population-based breast cancer case-control study, this study suggests that mammographic density does not play a role in the relationship between shiftwork and breast cancer risk.
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Affiliation(s)
- Sonia El-Zaemey
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Jane Heyworth
- School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Terry Boyle
- School of Public Health, Curtin University, Perth, Western Australia, Australia.,Australian Centre for Precision Health, School of Health Sciences, University of South Australia Cancer Research Institute, Adelaide, South Australia, Australia
| | - Christobel Saunders
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth Wylie
- Medical School, University of Western Australia, Perth, Western Australia, Australia.,BreastScreen Western Australia, Women and Newborn Health Service, Perth, Western Australia, Australia
| | - Jennifer Stone
- Centre for Genetic Origins of Health and Disease, University of Western Australia, Perth, Western Australia, Australia .,The RPH Research Foundation, Royal Perth Hospital, Perth, Western Australia, Australia
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3
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Lope V, Toribio MJ, Pérez-Gómez B, Castelló A, Mena-Bravo A, Sierra MÁ, Lucas P, Herrán-Vidaurrázaga MDC, González-Vizcayno C, Pino MN, Cruz-Campos I, Roca-Navarro MJ, Aragonés N, Romieu I, Martínez-Cortés M, Luque de Castro MD, Pollán M. Serum 25-hydroxyvitamin D and mammographic density in premenopausal Spanish women. J Steroid Biochem Mol Biol 2019; 189:101-107. [PMID: 30836177 DOI: 10.1016/j.jsbmb.2019.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 01/29/2019] [Accepted: 03/01/2019] [Indexed: 10/27/2022]
Abstract
The role of vitamin D in mammographic density is still unclear. This study examines the association between serum 25-hydroxyvitamin D (25(OH)D) and mammographic density, overall and by specific women characteristics. DDM-Madrid is a cross-sectional study that recruited 1403 premenopausal women in a breast radiodiagnosis unit of Madrid City Council. Information was collected with a questionnaire and plasma 25(OH)D was measured by solid-phase extraction on-line coupled to liquid chromatography-tandem mass spectrometry. Percent mammographic density was assessed using a semi-automated computer tool (DM-Scan). Multivariable linear regression models were used to quantify the associations, categorizing 25(OH)D levels (nmol/L) into 3 groups according to the cut-offs established by the US Endocrine Society. Models were adjusted for age, education, body mass index, age at menarche, parity, previous breast biopsies, family history of breast cancer, physical activity, energy intake, use of corticoids, hypercholesterolemia and day of sample extraction. Mean serum 25(OH)D level was 49.4 + 18.9 nmol/L. Women with sufficient concentrations of 25(OH)D showed a slight decrease in mammographic density (β >75nmol/L=-3.40; p = 0.037). No differences were observed according to women characteristics except for parity, where the protective effect of 25(OH)D was only seen among nulliparous (β >75nmol/L=-13.00; p-heterogeneity = 0.006). In light of the protective effect of vitamin D on mammographic density and the high prevalence of vitamin D insufficiency in our population, improving these levels could be an effective measure for the prevention of health problems related to the lack of this essential vitamin.
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Affiliation(s)
- Virginia Lope
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain.
| | - María José Toribio
- Servicio de Medicina Preventiva y Gestión de Calidad, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Beatriz Pérez-Gómez
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Adela Castelló
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Faculty of Medicine, University of Alcalá, Alcalá de Henares, Madrid, Spain
| | - Antonio Mena-Bravo
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - María Ángeles Sierra
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | - Pilar Lucas
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
| | | | | | - Marina Nieves Pino
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | | | | | - Nuria Aragonés
- Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain; Epidemiology Section, Public Health Division, Department of Health of Madrid, Spain
| | - Isabelle Romieu
- Center for Research on Population Health, National Institute of Public Health, Cuernavaca, Mexico; Hubert Department of Global Health, Emory University, Atlanta, GA, USA
| | - Mercedes Martínez-Cortés
- Servicio de Prevención y Promoción de la Salud, Madrid Salud, Ayuntamiento de Madrid, Madrid, Spain
| | - María D Luque de Castro
- Department of Analytical Chemistry, University of Córdoba, Córdoba, Spain; Maimónides Institute of Biomedical Research (IMIBIC), Reina Sofia University Hospital, University of Córdoba, Córdoba, Spain
| | - Marina Pollán
- National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health, CIBERESP, Madrid, Spain
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Gynaecological cancer and night shift work: A systematic review. Maturitas 2018; 110:21-28. [PMID: 29563031 DOI: 10.1016/j.maturitas.2018.01.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 01/08/2018] [Accepted: 01/12/2018] [Indexed: 12/19/2022]
Abstract
Night shift work can affect hormonal balance, and so might be a risk factor for gynaecological malignancies. This report presents a systematic review on the association between this occupational exposure and the incidence of gynaecological cancers other than breast cancer. We searched for original articles addressing this issue in PubMed/MEDLINE, EMBASE and Web of Science, and used the Newcastle-Ottawa Quality Index to evaluate the methodological quality of those reports selected for review. Globally, we found only six articles, which provided the results of just six research studies: four examined ovarian cancer, two endometrial tumours and two cervical cancer. Our results show that this matter has received scant attention from the research community, and that the little evidence available does not show any clear relationship between night shift work and ovarian, endometrial or cervical cancer. More prospective rigorous studies are needed to evaluate these associations.
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García-Pérez J, Pollán M, Pérez-Gómez B, González-Sánchez M, Cortés Barragán RA, Maqueda Blasco J, González-Galarzo MC, Alba MÁ, van der Haar R, Casas S, Vicente C, Medina P, Ederra M, Santamariña C, Moreno MP, Casanova F, Pedraz-Pingarrón C, Moreo P, Ascunce N, García M, Salas-Trejo D, Sánchez-Contador C, Llobet R, Lope V. Occupation and mammographic density: A population-based study (DDM-Occup). ENVIRONMENTAL RESEARCH 2017; 159:355-361. [PMID: 28843166 DOI: 10.1016/j.envres.2017.08.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/21/2017] [Accepted: 08/14/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers. METHODS We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms. RESULTS Mammographic density was higher, although non-statistically significant, among secondary school teachers (eβ = 1.41; 95%CI = 0.98-2.03) and nurses (eβ = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (eβ = 0.81; 95%CI = 0.66-1.00) and housewives (eβ = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035). CONCLUSIONS Nurses and secondary school teachers were the occupations with the highest mammographic density in our study, showing the latter a positive trend with duration of employment. Future studies are necessary to confirm if these results are due to chance or are the result of a true association whose causal hypothesis is, for the moment, unknown.
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Affiliation(s)
- Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | - Mario González-Sánchez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
| | | | - Jerónimo Maqueda Blasco
- Instituto Nacional de Seguridad e Higiene en el Trabajo, Ministerio de Empleo y Seguridad Social, Madrid, Spain.
| | | | - Miguel Ángel Alba
- Área de Higiene Industrial, PREMAP Seguridad y Salud S.L.U., Barcelona, Spain.
| | | | - Silvia Casas
- Programa de Detección Precoz de Cáncer de Mama, Dirección General de Salud Pública y Participación, Palma, Spain.
| | - Cándida Vicente
- Programa de Prevención de Cáncer de Mama, Dirección General de Salud Pública, Valencia, Spain.
| | - Pilar Medina
- Programa de Prevención y Control del Cáncer, Unidad de Biomarcadores y Susceptibilidad, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; Navarra Breast Cancer Screening Program, Public Health Institute, Pamplona, Spain.
| | - Carmen Santamariña
- Galicia Breast Cancer Screening Program, Regional Authority of Health, Galicia Regional Government, Corunna, Spain.
| | - María Pilar Moreno
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain.
| | - Francisco Casanova
- Sección de Promoción de la Salud del Servicio Territorial de Sanidad de Burgos, Dirección General de Salud Pública de la Consejería de Sanidad de Castilla y León, Burgos, Spain.
| | - Carmen Pedraz-Pingarrón
- Sección de Promoción de la Salud del Servicio Territorial de Sanidad de Burgos, Dirección General de Salud Pública de la Consejería de Sanidad de Castilla y León, Burgos, Spain.
| | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain.
| | - Nieves Ascunce
- Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain; Navarra Breast Cancer Screening Program, Public Health Institute, Pamplona, Spain.
| | - Montse García
- Programa de Prevención y Control del Cáncer, Unidad de Biomarcadores y Susceptibilidad, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), Institut Català d'Oncologia, L'Hospitalet de Llobregat, Spain.
| | - Dolores Salas-Trejo
- Programa de Prevención de Cáncer de Mama, Dirección General de Salud Pública, Valencia, Spain.
| | - Carmen Sánchez-Contador
- Programa de Detección Precoz de Cáncer de Mama, Dirección General de Salud Pública y Participación, Palma, Spain.
| | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain.
| | - Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain; Consortium for Biomedical Research in Epidemiology & Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Spain.
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6
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Lope V, García-Pérez J, Pérez-Gómez B, Pedraza-Flechas AM, Alguacil J, González-Galarzo MC, Alba MA, van der Haar R, Cortés-Barragán RA, Pedraz-Pingarrón C, Moreo P, Santamariña C, Ederra M, Vidal C, Salas-Trejo D, Sánchez-Contador C, Llobet R, Pollán M. Occupational exposures and mammographic density in Spanish women. Occup Environ Med 2017; 75:124-131. [PMID: 29074552 DOI: 10.1136/oemed-2017-104580] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 09/20/2017] [Accepted: 09/28/2017] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The association between occupational exposures and mammographic density (MD), a marker of breast cancer risk, has not been previously explored. Our objective was to investigate the influence of occupational exposure to chemical, physical and microbiological agents on MD in adult women. METHODS This is a population-based cross-sectional study based on 1476 female workers aged 45-65 years from seven Spanish breast cancer screening programmes. Occupational history was surveyed by trained staff. Exposure to occupational agents was assessed using the Spanish job-exposure matrix MatEmESp. Percentage of MD was measured by two radiologists using a semiautomatic computer tool. The association was estimated using mixed log-linear regression models adjusting for age, education, body mass index, menopausal status, parity, smoking, alcohol intake, type of mammography, family history of breast cancer and hormonal therapy use, and including screening centre and professional reader as random effects terms. RESULTS Although no association was found with most of the agents, women occupationally exposed to perchloroethylene (eβ=1.51; 95% CI 1.04 to 2.19), ionising radiation (eβ=1.23; 95% CI 0.99 to 1.52) and mould spores (eβ=1.44; 95% CI 1.01 to 2.04) tended to have higher MD. The percentage of density increased 12% for every 5 years exposure to perchloroethylene or mould spores, 11% for every 5 years exposure to aliphatic/alicyclic hydrocarbon solvents and 3% for each 5 years exposure to ionising radiation. CONCLUSIONS Exposure to perchloroethylene, ionising radiation, mould spores or aliphatic/alicyclic hydrocarbon solvents in occupational settings could be associated with higher MD. Further studies are needed to clarify the accuracy and the reasons for these findings.
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Affiliation(s)
- Virginia Lope
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Javier García-Pérez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Beatriz Pérez-Gómez
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
| | - Ana María Pedraza-Flechas
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Juan Alguacil
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
| | | | - Miguel Angel Alba
- Área de Higiene Industrial, PREMAP Seguridad y Salud S.L.U, Barcelona, Spain
| | | | | | | | - Pilar Moreo
- Aragon Breast Cancer Screening Program, Aragon Health Service, Zaragoza, Spain
| | - Carmen Santamariña
- Servicio de Alertas Epidemiolóxicas, Programa Galego Diagnostico Precoz Cancro de Mama, Unidade Central A Coruña, Conselleria de Sanidade, A Coruña, Spain
| | - María Ederra
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain.,Public Health Institute, Navarra Breast Cancer Screening Programme, Pamplona, Spain
| | - Carmen Vidal
- Prevention and Control Program, Catalan Institute of Oncology, Barcelona, Spain
| | - Dolores Salas-Trejo
- Valencia Breast Cancer Screening Program, General Directorate Public Health, Valencia, Spain
| | | | - Rafael Llobet
- Institute of Computer Technology, Universitat Politècnica de València, Valencia, Spain
| | - Marina Pollán
- Cancer and Environmental Epidemiology Unit, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Epidemiology and Public Health (CIBER Epidemiología y Salud Pública - CIBERESP), Madrid, Spain
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