Occupation and Breast Cancer: A Canadian Case-Control Study

Risk of breast cancer in daughters of agricultural workers in Denmark

OBJECTIVES

Agricultural workers face unique occupational hazards such as pesticide exposure, which has been associated with breast cancer. However, research considering the association between parental agricultural work and breast cancer in female offspring is lacking. Therefore, the aim of the present nested case-control study was to explore this association.

METHODS

The Danish Cancer Registry was utilized to identify women diagnosed with primary breast cancer. A total of 5587 cases were included in the study, and for each case, 20 cancer-free female controls were selected, matched on year of birth. It was a requisition that both cases and controls were born in Denmark and that either maternal or paternal employment history was available.

RESULTS

Adverse associations were consistently noted for different time windows of maternal employment in "Horticulture" and breast cancer. Inverse associations were observed for paternal employment in most of the examined agricultural industries, although a small increased risk was indicated for perinatal employment in "Horticulture". Furthermore, maternal preconceptional employment in "Horticulture" was observed to increase the risk of ER positive tumors (odds ratio [OR] = 1.79, 95% confidence interval [CI]: 1.13-2.85, whereas parental perinatal employment was linked to an elevated risk of ER negative tumors (maternal employment: OR = 2.48, 95% CI: 1.18-5.21; paternal employment: OR = 1.62, 95% CI: 0.70-3.77).

CONCLUSIONS

The present study indicates that maternal horticultural employment in different potential susceptible time windows may elevate the risk of breast cancer subtypes in daughters. These findings need to be reproduced in future prospective cohort studies, including information on e.g., pesticide exposure withing agricultural job categories and lifestyle factors.

Employment and risk of female breast cancer in Denmark

BACKGROUND

Occupational exposures may play a role in breast cancer etiology, and research focusing on identifying high-risk workplaces is important to advance the understanding and prevention of breast cancer.

METHODS

We undertook a population-based nested case-control study among women who were less than 70 years of age and born in Denmark, based on registry data including 38,375 breast cancer cases and 191,875 controls matched on year of birth, with information on lifetime work history. Odds ratios for women ever employed in a job branch were adjusted for socioeconomic status and reproductive variables.

RESULTS

Adjusted odds ratios of less than 0.75 were observed for several occupations in agriculture, hunting, forestry, and fishing, while increased risk patterns (odds ratios greater than 1.50) were noted for a number of production occupations, including employment in graphics and printing, and metal and machinery production. In services, several military professions were also associated with a high increased breast cancer risk.

CONCLUSIONS

The study shows a variation in the risk of female breast cancer by employment in different industrial and occupational sectors, and suggests that certain occupational exposures, for example, outdoor work, organic solvents, polycyclic aromatic hydrocarbons (PAHs), and night-shift work may play a role in the risk of breast cancer. Further hypothesis-testing studies focusing on these employments with a detailed assessment of specific occupational exposures are warranted.

Occupational exposure to organic solvents and breast cancer risk: a systematic review and meta-analysis

Breast cancer is the most common cancer worldwide. Recent studies suggest that organic solvent exposure could be closely related to breast cancer, although the evidence remains controversial. Thus, we evaluated existing epidemiological evidence for the association between occupational solvent exposure and breast cancer. PubMed, Embase, and Cochrane Library were searched to identify published case-control and cohort studies that addressed occupational exposure to organic solvents and breast cancer, up to April, 2021. Meta-analyses using random-effects models were conducted to obtain the pooled odds ratios (OR) and 95% confidence intervals (CI) on the incidence of breast cancer in relation to occupational exposure. The pooled OR of breast cancer among workers exposed to organic solvents overall was 1.18 (95%CI, 1.11 ~ 1.25; I² = 76.3%; 24 studies), compared to those with no exposure. After stratification by menopause and study location, it was revealed that the association between occupational exposure to organic solvents and the risk of breast cancer in postmenopausal women (OR, 1.35; 95% CI, 1.09 ~ 1.67; I² = 73.4%; 7 studies) was significant, and there was also a clear association in workers in Europe (OR, 1.21; 95% CI, 1.12 ~ 1.32; I² = 82.9%; 13 studies). We observed a significant association between occupational exposure to organic solvents and breast cancer in both cohort and case-control studies.

Occupation and risk of female breast cancer: A case-control study in Morocco

BACKGROUND

Breast cancer is the most frequent cancer among Moroccan women. Environmental and occupational factors may play a role in breast cancer etiology. This study aimed to investigate the association between occupation, industry, and breast cancer risk among Moroccan women.

METHODS

A total of 300 breast cancer cases and 300 controls (matched by age and area of residence) were included in this study. Full occupational history was collected, with a detailed description of each job held for at least 6 months. Occupations were coded according to the International Standard Classification of Occupations (ISCO 08) and the Moroccan Analytical Classification of Professions (2001). Industries were coded according to the Statistical Classification of Economic Activities in the European Community (2008). Odds ratios (ORs) and 95% confidence intervals (CIs), adjusted for potential confounders were estimated by using conditional logistic regression.

RESULTS

An overall decreased risk of breast cancer was observed among women doing only household work (OR = 0.32; 95% CI = 0.18-0.55). An increased risk of breast cancer was observed among women in agricultural occupations, particularly those employed as agricultural laborers (ISCO 08 code: 921; OR = 2.91; 95% CI = 1.51-5.60) and the risk increased with duration of employment (P trend = .01). Analyses by industry corroborated these findings.

CONCLUSIONS

Our findings suggest that occupational exposures may be associated with increased risk of breast cancer among female agricultural workers in this population. Further investigations, with advanced methods of occupational exposure assessment, are warranted to clarify the role of chemicals involved in this high-risk occupation and to suggest preventive actions and screening.

Work and Breast Cancer: Recommendations to Address Research Needs

A review of case-control, cohort, and meta-analytic studies on breast cancer, occupation, and work-related exposures from 2002 to 2017 revealed significant methodological limitations in the current literature. As part of our review, we tabulated the demographic and life history data, breast cancer risk factors, occupational history, and exposure estimates collected and analyzed in each study. Opportunities exist for future research to explore occupation and breast cancer more rigorously and with greater nuance by gathering specific data on age at diagnosis, menopausal status, tumor characteristics, demographics, breast cancer risk factors, and occupational histories, work roles and settings, and exposures. Inclusion of workers in the planning and implementation of research on their occupational risks and exposures is one effective way to refine research questions and ensure research is relevant to workers' needs and concerns.

Breast Cancer Incidence and Exposure to Metalworking Fluid in a Cohort of Female Autoworkers

Breast cancer is the leading cancer diagnosed among women, and environmental studies have produced few leads on modifiable risk factors for breast cancer. Following an Institute of Medicine recommendation for occupational studies of women highly exposed to potential breast cancer risk factors, we took advantage of an existing cohort of 4,503 female autoworkers in Michigan exposed to metalworking fluid (MWF), complex mixtures of oils and chemicals widely used in metal manufacturing worldwide. Cox proportional hazards models were fit to estimate hazard ratios for incident breast cancer (follow-up, 1985-2013) and cumulative exposure (20-year lag) to straight mineral oils (a known human carcinogen) and water-based soluble and synthetic MWF. Because the state cancer registry began decades after the cohort was defined, we restricted our analyses to subcohorts of women hired closer to the start of follow-up. Among those hired after 1969, the hazard ratio associated with a 1 interquartile-range increase in straight MWF exposure was 1.13 (95% confidence interval: 1.03, 1.23). In separate analyses of premenopausal breast cancer, defined by age at diagnosis, the hazard ratio was elevated for exposure to synthetic MWF (chemical lubricants with no oil content), possibly suggesting a different mechanism in the younger women with breast cancer. This study adds to the limited literature regarding quantitative chemical exposures and breast cancer risk.

Occupational exposure to solvents and risk of breast cancer

BACKGROUND

Occupational exposure to some organic solvents may increase risk of breast cancer.

METHODS

In a population-based case-control study, 1,205 women diagnosed with primary breast cancer between 2009 and 2011 were drawn from the Western Australian Cancer Registry and matched to 1,789 controls from the electoral roll. Exposure to solvents was determined through telephone interviews using OccIDEAS.

RESULTS

About a third of women were occupationally exposed to solvents. Age adjusted breast cancer risks were elevated for women who had been exposed to aliphatic solvents odds ratio (OR) 1.21 (95%CI 0.99-1.48) and aromatic solvents OR 1.21 (95%CI 0.97-1.52). For most solvents the ORs were higher for those diagnosed before menopause.

CONCLUSIONS

This study suggests that there may be an association between occupational exposure to aliphatic and aromatic solvents and the risk of breast cancer at the low levels of exposure experienced by women in this study.

Breast cancer risk in relation to occupations with exposure to carcinogens and endocrine disruptors: a Canadian case-control study

BACKGROUND

Endocrine disrupting chemicals and carcinogens, some of which may not yet have been classified as such, are present in many occupational environments and could increase breast cancer risk. Prior research has identified associations with breast cancer and work in agricultural and industrial settings. The purpose of this study was to further characterize possible links between breast cancer risk and occupation, particularly in farming and manufacturing, as well as to examine the impacts of early agricultural exposures, and exposure effects that are specific to the endocrine receptor status of tumours.

METHODS

1005 breast cancer cases referred by a regional cancer center and 1146 randomly-selected community controls provided detailed data including occupational and reproductive histories. All reported jobs were industry- and occupation-coded for the construction of cumulative exposure metrics representing likely exposure to carcinogens and endocrine disruptors. In a frequency-matched case-control design, exposure effects were estimated using conditional logistic regression.

RESULTS

Across all sectors, women in jobs with potentially high exposures to carcinogens and endocrine disruptors had elevated breast cancer risk (OR = 1.42; 95% CI, 1.18-1.73, for 10 years exposure duration). Specific sectors with elevated risk included: agriculture (OR = 1.36; 95% CI, 1.01-1.82); bars-gambling (OR = 2.28; 95% CI, 0.94-5.53); automotive plastics manufacturing (OR = 2.68; 95% CI, 1.47-4.88), food canning (OR = 2.35; 95% CI, 1.00-5.53), and metalworking (OR = 1.73; 95% CI, 1.02-2.92). Estrogen receptor status of tumors with elevated risk differed by occupational grouping. Premenopausal breast cancer risk was highest for automotive plastics (OR = 4.76; 95% CI, 1.58-14.4) and food canning (OR = 5.70; 95% CI, 1.03-31.5).

CONCLUSIONS

These observations support hypotheses linking breast cancer risk and exposures likely to include carcinogens and endocrine disruptors, and demonstrate the value of detailed work histories in environmental and occupational epidemiology.

A geographical analysis of breast cancer clustering in southern Ontario: generating hypotheses on environmental influences

This article presents the results of spatial analysis of breast cancer clustering in southern Ontario. Data from the Cancer Care Ontario were analyzed using the Scan Statistic at the level of county, with further analysis conducted within counties that were identified as primary clusters at the dissemination area level. The results identified five counties as primary clusters of women diagnosed with breast cancer between 1986 and 2002: Essex (relative risk [RR] =1.096-1.061; p<0.001), Lambton (RR=1.05-1.167), Chatham-Kent (RR=1.133-1.191), Niagara (RR=1.228-1.290) and Toronto (RR=1.152-1.146). The within county analysis revealed several DAs with significantly higher (RR>3, p<0.05) rates of breast cancer, and supports our hypothesis that breast cancer risk in southern Ontario may be associated with industrial and environmental (such as pesticides) pollutants. Further research is needed to verify the environmental links within the identified clusters.