1
|
Elser H, Falconi AM, Bass M, Cullen MR. Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015. SSM Popul Health 2018; 6:195-244. [PMID: 30417066 PMCID: PMC6215057 DOI: 10.1016/j.ssmph.2018.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 08/06/2018] [Accepted: 08/13/2018] [Indexed: 01/09/2023] Open
Abstract
Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.
Collapse
Affiliation(s)
- Holly Elser
- School of Public Health, Division of Epidemiology, University of California, Berkeley, 50 University Hall, Berkeley, CA 94720, United States
| | - April M. Falconi
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| | - Michelle Bass
- Population Research Librarian, Lane Medical Library & Knowledge Management Center, Stanford University School of Medicine, 300 Pasteur Dr L109, Stanford, CA 94305, United States
| | - Mark R. Cullen
- Stanford Center for Population Health Sciences, Stanford University, 1070 Arastradero Road, Palo Alto, CA 94304, United States
| |
Collapse
|
2
|
Turner MC, Benke G, Bowman JD, Figuerola J, Fleming S, Hours M, Kincl L, Krewski D, McLean D, Parent ME, Richardson L, Sadetzki S, Schlaefer K, Schlehofer B, Schüz J, Siemiatycki J, van Tongeren M, Cardis E. Interactions between occupational exposure to extremely low frequency magnetic fields and chemicals for brain tumour risk in the INTEROCC study. Occup Environ Med 2017; 74:802-809. [PMID: 28600451 PMCID: PMC8640944 DOI: 10.1136/oemed-2016-104080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 05/02/2017] [Accepted: 05/10/2017] [Indexed: 11/03/2022]
Abstract
OBJECTIVES In absence of clear evidence regarding possible effects of occupational chemical exposures on brain tumour aetiology, it is worthwhile to explore the hypothesis that such exposures might act on brain tumour risk in interaction with occupational exposure to extremely low frequency magnetic fields (ELF). METHODS INTEROCC is a seven-country (Australia, Canada, France, Germany, Israel, New Zealand and UK), population-based, case-control study, based on the larger INTERPHONE study. Incident cases of primary glioma and meningioma were ascertained from 2000 to 2004. Job titles were coded into standard international occupational classifications and estimates of ELF and chemical exposures were assigned based on job-exposure matrices. Dichotomous indicators of cumulative ELF (≥50th vs <50th percentile, 1-4 year exposure time window) and chemical exposures (ever vs never, 5-year lag) were created. Interaction was assessed on both the additive and multiplicative scales. RESULTS A total of 1939 glioma cases, 1822 meningioma cases and 5404 controls were included in the analysis, using conditional logistic regression. There was no clear evidence for interactions between ELF and any of the chemical exposures assessed for either glioma or meningioma risk. For glioma, subjects in the low ELF/metal exposed group had a lower risk than would be predicted from marginal effects. Results were similar according to different exposure time windows, to cut-points of exposure or in exposed-only analyses. CONCLUSIONS There was no clear evidence for interactions between occupational ELF and chemical exposures in relation to glioma or meningioma risk observed. Further research with more refined estimates of occupational exposures is recommended.
Collapse
Affiliation(s)
- Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
| | | | - Joseph D Bowman
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Jordi Figuerola
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | | | - Martine Hours
- Université de Lyon, Université Lyon 1/IFSTTAR, Unité Mixte de Recherche Epidémiologique Transport Travail Environnement, Lyon, France
| | | | - Daniel Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of Ottawa, Ottawa, Canada
- School of Epidemiology, Public Health and Disease Prevention, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | | | | | - Siegal Sadetzki
- The Cancer & Radiation Epidemiology Unit, The Gertner Institute, Chaim Sheba Medical Center, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Klaus Schlaefer
- Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Brigitte Schlehofer
- Unit of Environmental Epidemiology, German Cancer Research Center, Heidelberg, Germany
| | - Joachim Schüz
- International Agency for Research on Cancer (IARC), Section of Environment and Radiation, Lyon, France
| | - Jack Siemiatycki
- University of Montreal Hospital Research Centre, Montreal, Canada
| | | | - Elisabeth Cardis
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| |
Collapse
|
3
|
Chen L, Zou X, Wang Y, Mao Y, Zhou L. Central nervous system tumors: a single center pathology review of 34,140 cases over 60 years. BMC Clin Pathol 2013; 13:14. [PMID: 23639346 PMCID: PMC3655926 DOI: 10.1186/1472-6890-13-14] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Accepted: 04/26/2013] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Tumor epidemiology is a significant part of CNS (central nervous system) tumor studies. Reassessment of original sections can update our knowledge of tumor spectrum. Here, we discuss the features of CNS tumor pathology in a single center. METHODS A total of 34140 cases from 1950 to 2009 were collected; sections from 1990 to 2009 were reassessed according to WHO 2007 classification, and cases from 1950 to 1989 were classified according to the previous pathological diagnosis. RESULTS Seven CNS tumor categories during 1990 to 2009 were as follow: neuroepithelial tissue (38.0%), tumors of the meninges (36.5%), tumors of the sellar region (4.1%), germ cell tumors (1.3%), tumors of cranial and paraspinal nerves (13.3%), lymphomas and hematopoietic neoplasm (1.7%), metastatic tumors (5.1%), where histological types by age and sex were diverse. Overall, males exceeded females in distributions of most CNS tumor subtypes, while tumors of the meninges occurred more frequently in females. The case number of lymphomas and hematopoietic neoplasms grew the fastest during the past five years, and the distribution of neuroepithelial tumors remained stable over the past twenty years. CONCLUSIONS Despite the possibilities of cross sample biases, the data in this series could suggest a similar CNS tumor spectrum as might occur in other developing countries.
Collapse
Affiliation(s)
- Liang Chen
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai, Jing An District, 200040, China
| | - Xiang Zou
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai, Jing An District, 200040, China
| | - Yin Wang
- Department of Neuropathology, Huashan Hospital, Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai, Jing An District, 200040, China
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai, Jing An District, 200040, China
| | - Liangfu Zhou
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wu Lu Mu Qi Zhong Road, Shanghai, Jing An District, 200040, China
| |
Collapse
|
4
|
McElvenny DM, Hurley MA, Lenters V, Heederik D, Wilkinson S, Coggon D. Lung cancer mortality in a cohort of UK cotton workers: an extended follow-up. Br J Cancer 2011; 105:1054-60. [PMID: 21847124 PMCID: PMC3185933 DOI: 10.1038/bjc.2011.312] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background: A recent systematic review and meta-analysis suggested that occupational exposure to endotoxins protects against lung cancer. To explore this hypothesis further, the follow-up of mortality of a cohort of 3551 workers, who were employed in the British cotton industry during 1966–1971, was extended by 23 years. Methods: Subjects had originally been recruited to a survey of respiratory disease, which collected information about occupation and smoking habits. Cumulative exposures to endotoxins were estimated from data on endotoxin levels by work areas in cotton mills. Risks of lung cancer were estimated using survival modelling. Results: During follow-up, 2018 deaths were recorded before the age of 90 years, including 128 deaths from lung cancer. After adjustment for smoking, hazard ratios (95% confidence intervals) for cumulative endotoxin exposures of ⩽30 000, >30 000 and ⩽200 000, >200 000 and ⩽400 000, >400 000 and ⩽600 000 and >600 000 endotoxin units (EU) m−3 years were 1, 0.8 (0.5–1.6), 0.7 (0.4–1.3), 0.6 (0.3–1.0) and 0.5 (0.3–0.9), respectively (P for trend=0.005). Conclusion: Our findings strengthen the evidence that occupational exposure to endotoxins protects against lung cancer, and suggest that the effect depends on cumulative dose and persists after exposure ceases.
Collapse
Affiliation(s)
- D M McElvenny
- School of Health, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK.
| | | | | | | | | | | |
Collapse
|
5
|
Lundin JI, Checkoway H. Endotoxin and cancer. CIENCIA & SAUDE COLETIVA 2010; 15:2787-98. [PMID: 20922287 DOI: 10.1590/s1413-81232010000600016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/07/2009] [Indexed: 11/22/2022] Open
Abstract
Exposure to endotoxin, a component of gram-negative bacterial cell walls, is widespread in many industrial settings and in the ambient environment. Heavy-exposure environments include livestock farms, cotton textile facilities, and saw mills. In this article, we review epidemiologic, clinical trial, and experimental studies pertinent to the hypothesis that endotoxin prevents cancer. Since the 1970s, epidemiologic studies of cotton textile and other endotoxin-exposed occupational groups have consistently demonstrated reduced lung cancer risks. Experimental animal toxicology research and some limited therapeutic trials in cancer patients offer additional support for an anticarcinogenic potential. The underlying biological mechanisms of anticarcinogenesis are not entirely understood but are thought to involve the recruitment and activation of immune cells and proinflammatory mediators (e.g., tumor necrosis factor α and interleukin-1 and -6). In view of the current state of knowledge, it would be premature to recommend endotoxin as a cancer-chemopreventive agent. However, further epidemiologic and experimental investigations that can clarify further dose-effect and exposure-timing relations could have substantial public health and basic biomedical benefits.
Collapse
Affiliation(s)
- Jessica I Lundin
- Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Office E-179E, Box 357234, 1959 NE Pacific St., Seattle, WA 98195, USA. jlundin2@.u.washington.edu
| | | |
Collapse
|
6
|
Lundin JI, Checkoway H. Endotoxin and cancer. ENVIRONMENTAL HEALTH PERSPECTIVES 2009; 117:1344-50. [PMID: 19750096 PMCID: PMC2737008 DOI: 10.1289/ehp.0800439] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2008] [Accepted: 05/07/2009] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Exposure to endotoxin, a component of gram-negative bacterial cell walls, is widespread in many industrial settings and in the ambient environment. Heavy-exposure environments include livestock farms, cotton textile facilities, and saw mills. Concentrations are highly variable in non-occupational indoor and outdoor environments. Endotoxin is a potent inflammagen with recognized health effects, including fever, shaking chills, septic shock, toxic pneumonitis, and respiratory symptoms. Somewhat paradoxically, given the putative role of inflammation in carcinogenesis, various lines of evidence suggest that endotoxin may prevent cancer initiation or limit tumor growth. The hypothesis that components of bacteria may retard cancer progression dates back to William B. Coley's therapeutic experiments ("bacterial vaccine") in the 1890s. DATA SOURCES In this article, we review epidemiologic, clinical trial, and experimental studies pertinent to the hypothesis that endotoxin prevents cancer. Since the 1970s, epidemiologic studies of cotton textile and other endotoxin-exposed occupational groups have consistently demonstrated reduced lung cancer risks. Experimental animal toxicology research and some limited therapeutic trials in cancer patients offer additional support for an anticarcinogenic potential. The underlying biological mechanisms of anticarcinogenesis are not entirely understood but are thought to involve the recruitment and activation of immune cells and proinflammatory mediators (e.g., tumor necrosis factor alpha and interleukin-1 and -6). CONCLUSIONS In view of the current state of knowledge, it would be premature to recommend endotoxin as a cancer-chemopreventive agent. Nonetheless, further epidemiologic and experimental investigations that can clarify further dose-effect and exposure-timing relations could have substantial public health and basic biomedical benefits.
Collapse
Affiliation(s)
- Jessica I. Lundin
- Address correspondence to J.I. Lundin, Department of Environmental and Occupational Health Sciences, University of Washington, School of Public Health, Office E-179E, Box 357234, 1959 NE Pacific St., Seattle, WA 98195 USA. Telephone: (206) 221-5619. Fax: (206) 685-3990. E-mail:
| | | |
Collapse
|