Abstract
PurposeLung cancer, mesothelioma and several lifestyle-associated cancer forms have been reported more common in merchant seafarers. However, few studies reflect recent occupational settings and women seafarers are usually too scarce for meaningful analyses. We conducted a study on cancer incidence between 1985 and 2011 in a Swedish cohort consisting of male and female seafarers.MethodsAll seafarers in the Swedish Seafarers’ Register with at least one sea service between 1985 and 2011 and a cumulated sea service time of ≥ 30 days (N = 75,745; 64% men, 36% women; 1,245,691 person-years) were linked to the Swedish Cancer Register and followed-up until 31 December 2011. Standardized incidence ratios (SIR) were calculated with the general population as reference.ResultsThere were 4159 cancer cases in total, with 3221 among men and 938 among women. Male seafarers had an increased risk of total cancer (SIR 1.05; 95% CI 1.01–1.09), lung cancer (SIR 1.51; 95% CI 1.35–1.67) and urinary bladder cancer (SIR 1.17; 95% CI 1.02–1.33). Several lifestyle-associated cancer forms were more common in men. Previous work on tankers was associated with leukaemia (SIR 1.41; 95% CI 1.00–1.86). The risk of cancer decreased with a start as a male seafarer after 1985, with a significant trend for total cancer (P < 0.001), lung cancer (P = 0.001) and, for tanker seafarers, leukaemia (P = 0.045). Women seafarers had an increased risk of lung cancer (SIR 1.54; 95% CI 1.23–1.87) but the risk of total cancer was not increased (SIR 0.83; 95% CI 0.78–0.89).ConclusionsIn this cohort of merchant Swedish seafarers 1985–2011, the risk of total cancer was increased in men but not in women compared to the general population. Lung cancer was increased in both genders. The risk of cancer seems to decrease over the last decades, but better exposure assessments to occupational carcinogens and longer observation times are needed.
Highlights
In 1998, a Swedish epidemiological cancer study on Swedish male merchant seafarers from national census, found an increased risk of total cancer by 29% (Standardized Incidence Ratio, Standardized incidence ratios (SIR), 1.29; 95% confidence interval, CI 1.22–1.39)(Nilsson 1998)
Fifty-one percent of male seafarers had ever worked in the deck department, 24% in the engine department and 37% in the catering/service department (Table 1)
Comparing incidence of cancer in seafarers with a first sea service before 1985 with seafarers with a later first employment, we found a significant trend of a decreased risk of cancer
Summary
In 1998, a Swedish epidemiological cancer study on Swedish male merchant seafarers from national census, found an increased risk of total cancer by 29% (Standardized Incidence Ratio, SIR, 1.29; 95% confidence interval, CI 1.22–1.39)(Nilsson 1998). In 1998, a Swedish epidemiological cancer study on Swedish male merchant seafarers from national census, found an increased risk of total cancer by 29% (Standardized Incidence Ratio, SIR, 1.29; 95% confidence interval, CI 1.22–1.39). Most performed on Nordic seafarers, have shown similar results together with increased risks of cancer of the urinary bladder, stomach, lip, skin, pancreas and the prostate (Greenberg 1991; Pukkala and Saarni 1996; Saarni et al 2002; Rafnsson and Sulem 2003; Pukkala et al 2009). There are several occupational factors present in seafaring that may explain an increased risk of cancer. From the ships interior or cargo, may cause pleural mesothelioma and lung cancer in seafarers (IARC 1987, 2012; Saarni et al 2002; Forsell et al 2007, 2017; Ugelvig Petersen et al 2018). Exposures to polyaromatic hydrocarbons (PAHs) present in soot, exhausts and in contaminated oils may
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