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Ahn S, McClure LA, Pinheiro PS, Hernandez D, Boga DJ, Ukani H, Chavez JV, Quintela Fernandez JA, Caban-Martinez AJ, Kobetz E, Lee DJ. Methodological and Practical Challenges in Synthesizing Occupational Cancer Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:742. [PMID: 38928988 PMCID: PMC11203818 DOI: 10.3390/ijerph21060742] [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: 03/31/2024] [Revised: 05/11/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
Studies examining occupational exposures and cancer risk frequently report mixed findings; it is thus imperative for researchers to synthesize study results and identify any potential sources that explain such variabilities in study findings. However, when synthesizing study results using meta-analytic techniques, researchers often encounter a number of practical and methodological challenges. These challenges include (1) an incomparability of effect size measures due to large variations in research methodology; (2) a violation of the independence assumption for meta-analysis; (3) a violation of the normality assumption of effect size measures; and (4) a variation in cancer definitions across studies and changes in coding standards over time. In this paper, we first demonstrate these challenges by providing examples from a real dataset collected for a large meta-analysis project that synthesizes cancer mortality and incidence rates among firefighters. We summarize how each of these challenges has been handled in our meta-analysis. We conclude this paper by providing practical guidelines for handling challenges when synthesizing study findings from occupational cancer literature.
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Affiliation(s)
- Soyeon Ahn
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Coral Gables, FL 33146, USA
| | - Laura A. McClure
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Diana Hernandez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Devina J. Boga
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Henna Ukani
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Jennifer V. Chavez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | | | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Erin Kobetz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
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Laroche E, L’Espérance S. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2519. [PMID: 33802629 PMCID: PMC7967542 DOI: 10.3390/ijerph18052519] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
Firefighters are exposed to carcinogens that may increase their risk of developing many types of occupational cancer. Many systematic reviews (SRs) have been produced with sometimes conflicting conclusions. In this overview of reviews, we aim to assess the conclusion consistency across the available systematic reviews on the cancer risk in firefighters. Literature searches were conducted in several indexed databases and grey literature to retrieve systematic reviews aiming to evaluate cancer incidence or cancer mortality in firefighters. Results from included SRs were analyzed according to the tumour site. Out of 1054 records identified by the search in the databases, a total of 11 SRs were ultimately included. The original studies (n = 104) analyzed in the SRs were published between 1959 and 2018. The results consistently reported a significant increase in the incidence of rectal, prostate, bladder and testicular cancers as well as mesothelioma and malignant melanoma in firefighters compared to the general population. The SRs also indicate that death rates from rectal cancer and non-Hodgkin's lymphoma are higher among firefighters. Consistent SR results suggest that several types of cancer may be more frequent in firefighters than in the general population.
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Affiliation(s)
- Elena Laroche
- School of Administration Sciences, Université TELUQ, Quebec, QC G1K 9H6, Canada;
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Kaneko R, Sato Y, Kobayashi Y. Manufacturing Industry Cancer Risk in Japan: A Multicenter Hospital-Based Case Control Study. Asian Pac J Cancer Prev 2020; 21:2697-2707. [PMID: 32986371 PMCID: PMC7779432 DOI: 10.31557/apjcp.2020.21.9.2697] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Indexed: 11/25/2022] Open
Abstract
Background: It is well known that specific occupations can cause harm in developing malignant neoplasms. Chemical exposure is particularly high in the manufacturing industry and workers in this sector may face a higher occupational risk for cancer. We aimed to estimate inequalities in the risk of cancers related to occupational chemical exposure in various manufacturing categories. Methods: Using nationwide clinical inpatient data (1984−2017) in Japan, we undertook a multicenter, case-control study with regard to risks of developing cancers among various manufacturing industry categories. Using the food manufacturing industry as the reference group, odds ratios and 95% confidence intervals for each industry were estimated by conditional logistic regression, adjusted for sex, age, admission period, and the admitting hospital. Medical record summaries accounting for 89% of industrial categories with high odds ratios were collected to confirm diagnoses made on the basis of histology. We estimated industrial hazards based on the Pollutant Release and Transfer Register. Results: A reduced risk for some of common cancers was observed among lumber and wood products industries. Leather tanning, leather products and fur tended to show a higher risk: 2.36 (95% CI 1.15−4.83) for pancreatic cancer, 2.85 (95% CI 1.26−6.47) for liver cancer and 2.00 (95% CI 1.01–3.99) for lung cancer. For the electronics category, observations of high risk ranged from 2.09 (95%CI 1.18–3.70) for ureter cancer, to 2.49 (95% CI 1.79–3.55) for kidney cancer. Conclusions: This study revealed industry risk inequalities in manufacturing categories were present with regard to the risk of common cancers in Japan.
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Affiliation(s)
- Rena Kaneko
- Department of Gastroenterology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510 Japan.,Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Yuzuru Sato
- Department of Gastroenterology, Kanto Rosai Hospital, 1-1 Kizukisumiyoshi-cho, Nakahara-ku, Kawasaki, Kanagawa, 211-8510 Japan
| | - Yasuki Kobayashi
- Department of Public Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
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Andreotti G, Beane Freeman LE, Shearer JJ, Lerro CC, Koutros S, Parks CG, Blair A, Lynch CF, Lubin JH, Sandler DP, Hofmann JN. Occupational Pesticide Use and Risk of Renal Cell Carcinoma in the Agricultural Health Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:67011. [PMID: 32692250 PMCID: PMC7292387 DOI: 10.1289/ehp6334] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 05/05/2020] [Accepted: 05/14/2020] [Indexed: 05/12/2023]
Abstract
BACKGROUND Agricultural work and occupational pesticide use have been associated with increased risk of renal cell carcinoma (RCC), the most common form of kidney cancer. However, few prospective studies have investigated links to specific pesticides. OBJECTIVE We evaluated the lifetime use of individual pesticides and the incidence of RCC. METHODS We evaluated the associations between intensity-weighted lifetime days (IWDs) of 38 pesticides and incident RCC in the Agricultural Health Study, a prospective cohort of licensed pesticide applicators in Iowa and North Carolina. Among 55,873 applicators, 308 cases were diagnosed between enrollment (1993-1997) and the end of follow-up (2014-2015). We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) using Poisson regression, controlling for potential confounding factors, with lagged and unlagged pesticide exposures. RESULTS There was a statistically significant increased risk of RCC among the highest users of 2,4,5-T compared with never users [unlagged RR IWD Tertile 3 = 2.92 (95% CI: 1.65, 5.17; p trend = 0.001 )], with similar risk estimates for lagged exposure [20-y lag RR IWD Tertile 3 = 3.37 (95% CI: 1.83, 6.22; p trend = 0.001 )]. In 20-y lagged analyses, we also found exposure-response associations with chlorpyrifos [RR IWD Quartile 4 = 1.68 (95% CI: 1.05, 2.70; p trend = 0.01 )], chlordane [RR IWD Tertile 3 = 2.06 (95% CI: 1.10, 3.87; p trend = 0.02 )], atrazine [RR IWD Quartile 4 = 1.43 (95% CI: 1.00, 2.03; p trend = 0.02 )], cyanazine [RR IWD Quartile 4 = 1.61 (95% CI: 1.03, 2.50; p trend = 0.02 )], and paraquat [RR IWD > Median = 1.95 (95% CI: 1.03, 3.70; p trend = 0.04 )]. CONCLUSIONS This is, to our knowledge, the first prospective study to evaluate RCC risk in relation to various pesticides. We found evidence of associations with RCC for four herbicides (2,4,5-T, atrazine, cyanazine, and paraquat) and two insecticides (chlorpyrifos and chlordane). Our findings provide insights into specific chemicals that may influence RCC risk among pesticide applicators. Confirmation of these findings and investigations of the biologic plausibility and potential mechanisms underlying the observed associations are warranted. https://doi.org/10.1289/EHP6334.
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Affiliation(s)
- Gabriella Andreotti
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Laura E Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Joseph J Shearer
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Catherine C Lerro
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Stella Koutros
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Christine G Parks
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
- State Health Registry of Iowa, Iowa City, Iowa, USA
| | - Jay H Lubin
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Rockville, Maryland, USA
| | - Dale P Sandler
- Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina, USA
| | - Jonathan N Hofmann
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Rockville, Maryland, USA
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Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Cancer incidence and mortality among firefighters. Int J Cancer 2019; 145:2639-2646. [PMID: 30737784 DOI: 10.1002/ijc.32199] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/07/2022]
Abstract
Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle-Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta-analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non-Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in-depth exposure assessments are indicated.
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Affiliation(s)
- Hamed Jalilian
- Department of Occupational Health and Safety, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mansour Ziaei
- School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Yahya Khosravi
- Department of Occupational Health and Safety, Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway
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Abstract
BACKGROUND Dry cleaning workers are commonly exposed to tetrachloroethylene, a suspected bladder carcinogen, and other organic solvents. The health risks associated with solvent exposures in this industry are unclear. METHODS We extended mortality follow-up of 5,369 dry cleaning union members in St. Louis to further investigate solvent-related risks. We added 22 years of follow-up, from 1993 through 2014, via linkage to the National Death Index. Using Cox proportional hazards modeling, we computed hazard ratios (HRs) and 95% confidence intervals (CIs) relating cause-specific mortality with levels of a solvent exposure index previously developed by an industrial hygienist based on workers' job titles from union records. The models were fit adjusting for age, sex, and decade of union enrollment, and assuming different exposure lags. RESULTS In internal analyses of estimated solvent exposure with a 20-year lag, we observed exposure-response relationships for bladder cancer (HR medium exposure = 4.2; 95% CI = 0.7, 24.5 and HR high exposure = 9.2; 95% CI = 1.1, 76.7 vs. no exposure; Ptrend = 0.08) and kidney cancer (HR = 4.1; 95% CI = 0.7, 22.5 and 24.4; 2.9, 201.6; Ptrend = 0.004). High exposure was also associated with heart disease (HR = 1.6; 95% CI = 1.1, 2.2) and lymphatic/hematopoietic malignancies (HR = 4.3; 95% CI = 1.4, 13.6). CONCLUSIONS These findings are, to the best of our knowledge, the first cohort evidence relating solvent exposure levels among dry cleaners to elevated risks of selected cancers and heart disease. Additional studies employing solvent-specific exposure assessment are needed to clarify cancer risks associated with tetrachloroethylene.
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Marant Micallef C, Shield KD, Baldi I, Charbotel B, Fervers B, Gilg Soit Ilg A, Guénel P, Olsson A, Rushton L, Hutchings SJ, Straif K, Soerjomataram I. Occupational exposures and cancer: a review of agents and relative risk estimates. Occup Environ Med 2018; 75:604-614. [PMID: 29735747 DOI: 10.1136/oemed-2017-104858] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 03/26/2018] [Accepted: 04/04/2018] [Indexed: 01/05/2023]
Abstract
OBJECTIVES The contribution of occupational exposures to the cancer burden can be estimated using population-attributable fractions, which is of great importance for policy making. This paper reviews occupational carcinogens, and presents the most relevant risk relations to cancer in high-income countries using France as an example, to provide a framework for national estimation of cancer burden attributable to occupational exposure. METHODS Occupational exposures that should be included in cancer burden studies were evaluated using multiple criteria: classified as carcinogenic or probably carcinogenic by the International Agency for Research on Cancer (IARC) Monographs volumes 1-114, being a primary occupational exposure, historical and current presence of the exposure in France and the availability of exposure and risk relation data. Relative risk estimates were obtained from published systematic reviews and from the IARC Monographs. RESULTS Of the 118 group 1 and 75 group 2A carcinogens, 37 exposures and 73 exposure-cancer site pairs were relevant. Lung cancer was associated with the most occupational carcinogenic exposures (namely, 18), followed by bladder cancer and non-Hodgkin's lymphoma. Ionising radiation was associated with the highest number of cancer sites (namely, 20), followed by asbestos and working in the rubber manufacturing industry. Asbestos, bis(chloromethyl)ether, nickel and wood dust had the strongest effect on cancer, with relative risks above 5. CONCLUSIONS A large number of occupational exposures continues to impact the burden of cancer in high-income countries such as France. Information on types of exposures, affected jobs, industries and cancer sites affected is key for prioritising policy and prevention initiatives.
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Affiliation(s)
- Claire Marant Micallef
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Kevin David Shield
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Isabelle Baldi
- Equipe Santé Environnement, Centre de recherche INSERM U 897, Bordeaux, France
| | - Barbara Charbotel
- Univ Lyon, Univ Lyon 1, IFSTTAR, Service des maladies professionnelles, Hospices Civils de Lyon, UMRESTTE, UMR_T9405, Lyon, France
| | - Béatrice Fervers
- Département Cancer Environnement, Centre Léon Bérard, Université de Lyon, Lyon, France
| | | | - Pascal Guénel
- Centre de recherche en Epidémiologie et Santé des Populations (CESP), Cancer and Environment team, Université Paris-Sud, Université Paris-Saclay, Villejuif, France
| | - Ann Olsson
- Section of Environment and Radiation, International Agency for Research on Cancer, Lyon, France
- The Institute of Environmental Medicine, Karolinksa Institutet, Stockholm, Sweden
| | - Lesley Rushton
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Sally J Hutchings
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Kurt Straif
- Section of Evidence Synthesis and Classification, International Agency for Research on Cancer IARC, Lyon, France
| | - Isabelle Soerjomataram
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
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Maxim LD, Utell MJ. Review of refractory ceramic fiber (RCF) toxicity, epidemiology and occupational exposure. Inhal Toxicol 2018; 30:49-71. [PMID: 29564943 DOI: 10.1080/08958378.2018.1448019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
This literature review on refractory ceramic fibers (RCF) summarizes relevant information on manufacturing, processing, applications, occupational exposure, toxicology and epidemiology studies. Rodent toxicology studies conducted in the 1980s showed that RCF caused fibrosis, lung cancer and mesothelioma. Interpretation of these studies was difficult for various reasons (e.g. overload in chronic inhalation bioassays), but spurred the development of a comprehensive product stewardship program under EPA and later OSHA oversight. Epidemiology studies (both morbidity and mortality) were undertaken to learn more about possible health effects resulting from occupational exposure. No chronic animal bioassay studies on RCF have been conducted since the 1980s. The results of the ongoing epidemiology studies confirm that occupational exposure to RCF is associated with the development of pleural plaques and minor decrements in lung function, but no interstitial fibrosis or incremental lung cancer. Evidence supporting a finding that urinary tumors are associated with RCF exposure remains, but is weaker. One reported, but unconfirmed, mesothelioma was found in an individual with prior occupational asbestos exposure. An elevated SMR for leukemia was found, but was absent in the highly exposed group and has not been observed in studies of other mineral fibers. The industry will continue the product stewardship program including the mortality study.
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Affiliation(s)
- L Daniel Maxim
- a Everest Consulting Associates , West Windsor , NJ , USA
| | - Mark J Utell
- b University of Rochester School of Medicine and Dentistry , Rochester , NY , USA
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Mariusdottir E, Ingimarsson JP, Jonsson E, Einarsson GV, Aspelund T, Gudnason V, Gudbjartsson T. Occupation as a risk factor for renal cell cancer: a nationwide, prospective epidemiological study. Scand J Urol 2016; 50:181-5. [DOI: 10.3109/21681805.2016.1151460] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Haygood TM, Sayyouh M, Wong J, Lin JC, Matamoros A, Sandler C, Madewell JE. Skeletal Muscle Metastasis from Renal Cell Carcinoma: 21 cases and review of the literature. Sultan Qaboos Univ Med J 2015; 15:e327-37. [PMID: 26357552 DOI: 10.18295/squmj.2015.15.03.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 03/10/2015] [Accepted: 03/30/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES This study aimed to raise radiologists' awareness of skeletal muscle metastases (SMM) in renal cell carcinoma (RCC) cases and to clarify their imaging appearance. METHODS A retrospective analysis was undertaken of 21 patients between 44-75 years old with 72 SMM treated from January 1990 to May 2009 at the MD Anderson Cancer Center in Houston, Texas, USA. Additionally, 37 patients with 44 SMM from a literature review were analysed. RESULTS Among the 21 patients, the majority of SMM were asymptomatic and detected via computed tomography (CT). Mean metastasis size was 18.3 mm and the most common site was the trunk muscles (83.3%). The interval between discovery of the primary tumour and metastasis detection ranged up to 234 months. Peripheral enhancement (47.1%) was the most common post-contrast CT pattern and non-contrasted CT lesions were often isodense. Magnetic resonance imaging (MRI) characteristics were varied. Five lesions with available T1-weighted pre-contrast images were hyperintense to the surrounding muscle. Other organ metastases were present in 20 patients. Of the 44 SMM reported in the literature, the majority were symptomatic. Average metastasis size was 53.4 mm and only 20.5% of SMM were in trunk muscles. The average interval between tumour discovery and metastasis detection was 101 months. Other organ metastases were recorded in 17 out of 29 patients. CONCLUSION SMM should always be considered in patients with RCC, even well after primary treatment. SMM from RCC may be invisible on CT without intravenous contrast; contrast-enhanced studies are therefore recommended. SMM are often hyperintense to the surrounding muscle on T1-weighted MRI scans.
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Affiliation(s)
- Tamara Miner Haygood
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Mohamed Sayyouh
- Department of Diagnostic Radiology, University of Michigan Health System, University of Michigan, Ann Arbor, USA
| | - Jason Wong
- British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada; ; School of Population & Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Aurelio Matamoros
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Carl Sandler
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
| | - John E Madewell
- Department of Diagnostic Radiology, MD Anderson Cancer Center, Houston, Texas, USA
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Locke SJ, Colt JS, Stewart PA, Armenti KR, Baris D, Blair A, Cerhan JR, Chow WH, Cozen W, Davis F, De Roos AJ, Hartge P, Karagas MR, Johnson A, Purdue MP, Rothman N, Schwartz K, Schwenn M, Severson R, Silverman DT, Friesen MC. Identifying gender differences in reported occupational information from three US population-based case-control studies. Occup Environ Med 2014; 71:855-64. [PMID: 24683012 PMCID: PMC4177972 DOI: 10.1136/oemed-2013-101801] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Growing evidence suggests that gender-blind assessment of exposure may introduce exposure misclassification, but few studies have characterised gender differences across occupations and industries. We pooled control responses to job-specific, industry-specific and exposure-specific questionnaires (modules) that asked detailed questions about work activities from three US population-based case-control studies to examine gender differences in work tasks and their frequencies. METHODS We calculated the ratio of female-to-male controls that completed each module. For four job modules (assembly worker, machinist, health professional, janitor/cleaner) and for subgroups of jobs that completed those modules, we evaluated gender differences in task prevalence and frequency using χ(2) and Mann-Whitney U tests, respectively. RESULTS The 1360 female and 2245 male controls reported 6033 and 12 083 jobs, respectively. Gender differences in female:male module completion ratios were observed for 39 of 45 modules completed by ≥20 controls. Gender differences in task prevalence varied in direction and magnitude. For example, female janitors were significantly more likely to polish furniture (79% vs 44%), while male janitors were more likely to strip floors (73% vs 50%). Women usually reported more time spent on tasks than men. For example, the median hours per week spent degreasing for production workers in product manufacturing industries was 6.3 for women and 3.0 for men. CONCLUSIONS Observed gender differences may reflect actual differences in tasks performed or differences in recall, reporting or perception, all of which contribute to exposure misclassification and impact relative risk estimates. Our findings reinforce the need to capture subject-specific information on work tasks.
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Affiliation(s)
- Sarah J. Locke
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Joanne S. Colt
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | | | - Karla R. Armenti
- New Hampshire Department of Health and Human Services, Division of Public Health Services, Bureau of Public Health Statistics and Informatics, Concord, New Hampshire, USA
| | - Dalsu Baris
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Aaron Blair
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | | | - Wong-Ho Chow
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Wendy Cozen
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, USA
| | - Faith Davis
- Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Anneclaire J. De Roos
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Patricia Hartge
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Margaret R. Karagas
- Department of Community and Family Medicine, Dartmouth Medical School, Lebanon, New Hampshire, USA
| | | | - Mark P. Purdue
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
| | | | - Richard Severson
- Department of Family Medicine and Public Health Sciences, Wayne State University, Detroit, Michigan, USA
| | - Debra T. Silverman
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - Melissa C. Friesen
- Occupational and Environmental Epidemiology, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
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Alanee S, Dynda D, LeVault K, Mueller G, Sadowski D, Wilber A, Jenkins WD, Dynda M. Delivering kidney cancer care in rural Central and Southern Illinois: a telemedicine approach. Eur J Cancer Care (Engl) 2014; 23:739-44. [PMID: 25286964 DOI: 10.1111/ecc.12248] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2014] [Indexed: 11/29/2022]
Abstract
There is a growing body of experience and research suggesting that telemedicine (video conferencing, smart phones and online patient portals) could be the solution to addressing gaps in the provision of specialised healthcare in rural areas. The proposed role of telemedicine in providing needed services in hard to reach areas is not new. The United States Telecommunication Act of 1996 provided the initial traction for telemedicine by removing important economic and legal obstacles regarding the use of technology in healthcare delivery. This initial ruling has been supplemented by the availability of federal funding to support efforts aimed at developing telemedicine in underserved areas. In this paper, we explore one aspect of disease disparity pertinent to rural Illinois (kidney cancer incidence and mortality) and describe how we are planning to use an existing telemedicine program at Southern Illinois University School of Medicine (SIUSOM) to improve kidney cancer (Kca) care in rural Illinois. This represents an example of the possible role of telemedicine in addressing healthcare disparities in rural areas/communities and provides a description of general challenges and barriers to the implementation and maintenance of such systems.
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Affiliation(s)
- S Alanee
- Department of Surgery, Division of Urology, Southern Illinois University School of Medicine, Springfield, IL, USA; Simmons Cancer Institute, Southern Illinois University School of Medicine, Springfield, IL, USA
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13
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De P, Otterstatter MC, Semenciw R, Ellison LF, Marrett LD, Dryer D. Trends in incidence, mortality, and survival for kidney cancer in Canada, 1986-2007. Cancer Causes Control 2014; 25:1271-81. [PMID: 25034462 PMCID: PMC4194017 DOI: 10.1007/s10552-014-0427-x] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 07/01/2014] [Indexed: 01/19/2023]
Abstract
Purpose
Kidney cancer is one of the fastest rising cancers worldwide. We aimed to examine the trends in incidence, mortality, and survival for this cancer in Canada. Methods Incidence data for kidney cancer for 1986–2010 were from the Canadian Cancer Registry and the National Cancer Incidence Reporting System. These data were only available up to 2007 for the province of Quebec and consequently for the same year nationally, for Canada. Mortality data for 1986–2009 were from the Canadian Vital Statistics Death Database. Changes in age-standardized rates were analyzed by Joinpoint regression. Incidence rates were projected to 2025 using a Nordpred age-period-cohort model. Five-year relative survival ratios (RSR) were analyzed for 2004–2008 and earlier periods. Results Between 1986 and 2007, the age-standardized incidence rate (ASIR) per 100,000 rose from 13.4 to 17.9 in males and 7.7 to 10.3 in females. Annual increases in ASIR were greatest for age groups <65 years (males) and ≥65 years (females). The ASIRs increased significantly over time in both sexes for renal cell carcinoma (RCC) but not for other kidney cancer types. RCC rates are projected to increase until at least 2025. Mortality rates decreased only slightly in each sex since 1986 (0.4 %/year in males; 0.8 %/year in females). The 5-year RSR for kidney cancer was 68 % but differed largely by morphology and age, and has increased slightly over time. Conclusions The incidence rate of kidney cancer in Canada has risen since at least 1986, led largely by RCC. Increasing detection of incidental tumors, and growing obesity and hypertension rates are possible factors associated with this increase. Greater prevention of modifiable risk factors for kidney cancer is needed.
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Affiliation(s)
- Prithwish De
- Cancer Control Policy, Canadian Cancer Society, 55 St Clair Ave West, Suite 300, Toronto, Ontario, Canada,
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