Occupational Cancer Research Articles

Trends and Projections of Mortality Attributed to Occupational Neoplasms and Occupational Tracheal, Bronchus, and Lung Cancer in the World, G7 Countries and Turkey

Background: The most important and remarkable aspect of occupational neoplasms is that they are preventable. We aimed to examine the trends and projections of mortality rates attributed to occupational neoplasms (MAON) and occupational tracheal, bronchus, and lung cancer (MAOLCa) in the world, G7 countries, and Turkey from 1990 to 2040. Methods: The study was ecological one. Data for the study were obtained from the Global Burden of Disease (GBD) Foresight Visualization. For the study, time points were set every five years. For each time point, the age-standardized MAON, MAOLCa, and their 95% confidence intervals (CIs) were recorded. Rates were analyzed by joinpoint regression analysis. Results: Globally, MAON was projected to decrease from 3.81% in 1990 to 2.83% in 2040. According to the joinpoint regression analysis, the joint year for the world was 2020. In Germany, the US, the UK, Italy, Canada and Turkey, the trend for MAON showed a decrease, similar to the global trend. However, MAON was stable in France and increased in Japan. Globally, MAOLCa was expected to decline gradually from 19.44% to 16.82% from 1990 to 2040. In the US, France and Turkey, the trend for MAOLca decreased, similar to the global trend. However, it was stable in the UK, Italy, and Canada and increased in Germany and Japan. Conclusion: MAON tended to decrease worldwide and in the six countries, except France and Japan. MAOLCa tends to decrease worldwide, in the US, France, and Turkey, increase in Germany and Japan, and remain stable in the UK, Italy, and Canada.

Occupational exposure to nickel or hexavalent chromium and the risk of lung cancer (SYNERGY)

Abstract Background Hexavalent chromium (Cr(VI)) and nickel (Ni) are known occupational carcinogens, with frequent exposures, for example, in welding-related activities. However, limited evidence exists on the exposure-response relationship of Cr(VI) or Ni with lung-cancer risk. We estimated lung-cancer risks based on quantitative indices of occupational exposure to each metal, and their interaction with smoking habits. Methods Fourteen case-control studies from Europe and Canada (16,901 cases, 20,965 control subjects) were pooled. A measurement-based job-exposure matrix was used to estimate year- and region-specific exposure levels for Cr(VI) and Ni, which were linked to the study subjects’ occupational histories. Odds ratios (OR) and 95% confidence intervals (CI) were calculated, adjusting for study, age group, smoking, and exposure to other occupational lung carcinogens. Results The OR for the highest quartile (>99.5 μg/m3-years) of cumulative exposure to Cr(VI) in men was 1.32 (95% CI 1.19-1.47) and for nickel (highest quartile >78.1 μg/m3-years) OR = 1.29 (95% CI 1.15-1.45). Corresponding effect estimates in women were slightly lower. The joint effects of Cr(VI) and nickel with smoking were generally greater than additive. Conclusions We observed positive exposure-response relationships in the low-dose range of Cr(VI) and Ni exposures, based on a large study population including detailed information on smoking habits and a measurement-based job-exposure matrix. Although, we cannot rule out a combined classical measurement and Berkson error structure that may have caused bias in our risk estimates, our results provide empirical evidence to further specify preventive measures at the workplace in order to protect workers from hazardous substances. Key messages • Relatively low cumulative levels of occupational exposure to Cr(VI) and Ni were associated with increased ORs for lung cancer, particularly in men. • Important empirical insights for the prevention of cancer at the workplace can be drawn from the results.

Seventy-five years of impactful environmental and occupational health research at the Nelson Institute of Environmental Medicine at New York University.

Founded in 1947 as the Institute of Industrial Medicine, the Nelson Institute and Department of Environmental Medicine at New York University (NYU) Grossman School of Medicine (NYUGSOM) was supported by a National Institute of Environmental Health Science (NIEHS) Center Grant for over 56 years. Nelson Institute researchers generated 75 years of impactful research in environmental and occupational health, radiation effects, toxicology, and cancer. Environmental health research is continuing at NYUGSOM in its departments of medicine and population health. The objective of this historical commentary is to highlight the major achievements of the Nelson Institute and the department in the context of its history at facilities in Sterling Forest, Tuxedo, NY and Manhattan, NY. Aspects of our discussion include leadership, physical facilities, and research in many areas, including air pollution, health effects of environmental radiation exposures, inhalation toxicology methodology, carcinogenesis by chemicals, metals, and hormones, cancer chemoprevention, human microbiome, ecotoxicology, epidemiology, biostatistics, and community health concerns. The research of the institute and department benefited from unique facilities, strong leadership focused on team-based science, and outstanding investigators, students, and staff. A major lasting contribution has been the training of hundreds of graduate students and postdoctoral fellows, many of whom have been and are training the next generation of environmental and occupational health researchers at various institutions.

Five decades of occupational cancer epidemiology.

In this discussion paper, we provide a narrative review of past and present occupational cancer studies in the journal with a viewpoint towards future occupational cancer research. We reviewed all references in the journal that mentioned cancer according to relevance to etiology, cancer type, agent type, study design, and study population. The Scandinavian Journal of Work, Environment & Health has published over 300 manuscripts on occupational cancer over the 50 past years. Although studies of cancer represent the primary health outcome in the journal overall, the relative ranking of cancer manuscripts has declined somewhat over time. A large body of evidence from studies of occupation and industry was apparent both in early research and continuing in recent years. There are several examples of the utility of pooled multi-country collaborative studies. Studies also took advantage of available high-quality national population and cancer registers in Nordic countries. There have been notable shifts in focus with regard to the cancer types examined, with increases in publications examining female breast cancer over the decades. The interplay of studies of occupational and environmental cancer has also been apparent. The journal offers a unique viewpoint to consider the evolution of occupational cancer evidence over time. Studies of occupational cancer have played a central role in global cancer hazard identification efforts. Although much has been gained, there remains a need for renewed global support for occupational cancer research. Concerted efforts will be needed to ensure a future robust evidence-base for occupational and environmental cancer worldwide.

The American Cancer Society National Lung Cancer Roundtable strategic plan: Lung cancer in women.

Lung cancer in women is a modern epidemic and represents a global health crisis. Cigarette smoking remains the most important risk factor for lung cancer in all patients and, among women globally, rates of smoking continue to increase. Although some data exist supporting sex-based differences across the continuum of lung cancer, there is currently a dearth of research exploring the differences in risk, biology, and treatment outcomes in women. Consequently, the American Cancer Society National Lung Cancer Roundtable recognizes the urgent need to promote awareness and future research that will close the knowledge gaps regarding lung cancer in women. To this end, the American Cancer Society National Lung Cancer Roundtable Task Group on Lung Cancer in Women convened a summit undertaking the following to: (1) summarize existing evidence and identify knowledge gaps surrounding the epidemiology, risk factors, biologic differences, and outcomes of lung cancer in women; (2) develop and prioritize research topics and questions that address research gaps and advance knowledge to improve quality of care of lung cancer in women; and (3) propose strategies for future research. PLAIN LANGUAGE SUMMARY: Lung cancer is the leading cause of cancer mortality in women, and, despite comparatively lower exposures to occupational and environmental carcinogens compared with men, disproportionately higher lung cancer rates in women who ever smoked and women who never smoked call for increased awareness and research that will close the knowledge gaps regarding lung cancer in women.

Sinonasal intestinal-type adenocarcinoma in northern Portugal: a woodworker’s occupational hazard

Abstract Background Sinonasal carcinomas (SNC) constitute about 3% of all head and neck carcinomas, squamous cell carcinoma being the most common histologic subtype. Some geographical patterns in incidence are observed, as occupational exposure to wood dust is associated with intestinal-type adenocarcinoma (ITAC). Aims This study aims to describe the prevalence and characteristics of sinonasal ITAC cases in a region of northern Portugal with a robust wood industry. Methods A retrospective study of all sinonasal malignancies diagnosed over 5 years, in a tertiary hospital, primarily focused on ITAC subtypes. Data on sociodemographic and clinical variables were collected through electronic medical records and telephonic assessments. Results Of all 33 cases, 85% were ITAC. ITAC predominantly affected males (96%) with a mean age of 66.2 years. Most patients diagnosed with sinonasal ITAC had occupational wood dust exposure (96%), particularly to hardwoods. Initial symptoms included unilateral nasal obstruction (75%) and epistaxis (71%). Despite a median time of 3 months from symptoms to consultation, 50% presented at an advanced stage, with a 29% mortality rate. Conclusions Sinonasal ITAC is an occupational hazard of woodworkers and represents the vast majority of SNC in the region. This study advocates for targeted community interventions, emphasizing occupational safety measures and healthcare awareness to reduce morbimortality associated with this occupational cancer.

Medico-legal evaluation of occupational skin diseases and occupational skin cancer.

The medico-legal evaluation of occupational skin diseases is one of the core competencies of dermatology. As a neutral medical expert, the dermatologist has a different role to that of a treating physician. In Germany, the so-called Bamberg Recommendation (Bamberger Empfehlung) provides a scientifically based assessment basis to ensure equal treatment of all persons undergoing medico-legal evaluation. In addition to dermatological expertise, knowledge of insurance law and legal terminology is essential for the medical expert. Dermatologists provide legal and administrative decisions of social courts and social insurance institutions with their qualified expert opinions. In this way, dermatology makes an important contribution to social security.

Assessing lifetime occupational chrysotile inhalation exposure, respiratory symptoms, and lung cancer risk among brake maintenance workers in Malaysia.

This study aimed to estimate workers' occupational lifetime exposure to chrysotile and examine the respiratory symptoms and lung cancer risk. A total of 112 workers were interviewed about their occupational histories. Exposure modeling using information on the determinants of exposure was used to estimate chrysotile emissions. The cumulative lifetime exposure was then assessed for each worker. Respiratory symptoms were obtained using a validated questionnaire. Lung cancer mortality rate was also predicted using a model. Almost all the workers were male and young (mean age = 30 years, SD = 7). The estimated lifetime occupational chrysotile inhalation exposure ranged from 0.0001 to 0.0486 f/mL.years (median = 0.0018 f/mL.years, IQR = 0.486). A high prevalence of cough symptom (11.7%), and low estimated cancer risk (<1%) were reported. In conclusion, the lung cancer risk among our cohort of workers was at a low level because of lower cumulative lifetime occupational chrysotile exposure.

Examining the Completeness of Industry and Occupation Data Among Patients Newly Diagnosed with Cancer in North Carolina

Background Occupational exposure to toxic substances has been associated with cancer. Including industry and occupation (I/O) in cancer surveillance can help identify potential links between occupational exposures and cancers using data already collected to monitor statewide cancer trends. I/O reporting is required in cancer registries and recently in death records. In this study, we examined the completeness of I/O information in North Carolina cancer and death certificate data. Methods The North Carolina Central Cancer Registry (NC CCR) is the sole repository of North Carolina cancer incidence data. NC CCR (2020–2021) and death certificate data (2020–2022) were analyzed for completeness of I/O. NC CCR incidence records for 1995–2021 diagnoses were linked to North Carolina death files (2020–2022). Results NC CCR data had I/O in 17% to 51% of the cases, depending on cancer type. I/O was included in 41% of 2020 death certificates and increased to a 99.9% inclusion in 2021 and 2022 death certificates. In 2020, 20,018 (18%) of 109,677 total deaths matched with a cancer record during NC CCR data linkage. In 2021, 20,225 (16%) of 119,237 total deaths matched with a cancer record, and in 2022, 20,367 (17%) of 116,406 total deaths matched to a cancer record. Limitations Data presented here only examine the completeness of 10 cancer types that the NC CCR regularly analyzes using the most recent data available (2021). Conclusion Health care providers should routinely record I/O using the standards explained in the training for providers on I/O data collection, provided by the North Carolina Department of Health and Human Services, and should increase their frequency of reporting I/O to NC CCR. Death certificate data may provide I/O data for individuals whose information is missing from cancer registry data.

Occupational Benzene Exposure and Cancer Risk among Chinese Men: A Report from the Shanghai Men's Health Study.

Benzene exposure has been associated with increased risk of leukemia and other cancers; however, epidemiologic evidence is inconsistent for the latter, and confounding from smoking and alcohol was rarely adjusted. We investigated associations between occupational benzene exposure and risk of leukemia, lymphoma, myeloma, and lung, stomach, liver, and kidney cancers in a population-based cohort of 61,377 men, ages 40 to 74 years. A job-exposure matrix, constructed by industrial hygienists specifically for the study population, was used to derive cumulative benzene exposure from all jobs held. Cox regressions were performed to estimate adjusted HRs (aHR) and 95% confidence intervals (CI) for benzene-cancer risk associations with adjustment for potential confounders. Over 15 years of follow-up, 1,145 lung cancer, 656 stomach cancer, 445 liver cancer, 243 kidney cancer, 100 leukemia, 124 lymphoma, and 46 myeloma cases were identified. Benzene exposure >550 mg/m3 was associated with an increased risk of leukemia (aHR = 2.3; 95% CI, 1.1-4.5), lung cancer (aHR = 1.2; 95% CI, 1.0-1.6), and stomach cancer (aHR = 1.4; 95% CI, 1.0-1.9); benzene exposure was associated with early cancer diagnosis age. The benzene-leukemia and benzene-stomach cancer associations followed a linear dose-response pattern (Plinear = 0.016 and 0.023), whereas the benzene-lung cancer association was evident at higher exposure levels (Pnonlinear = 0.027). Alcohol consumption modified the benzene-leukemia association (aHR = 3.0; 95% CI, 1.1-8.3 for drinkers and aHR = 0.9; 95% CI, 0.4-2.0 for nondrinkers, Pinteraction = 0.047). Benzene exposure was associated with an increased risk of leukemia, stomach cancer, and lung cancer. Alcohol consumption may modify the benzene-leukemia association, although estimates are imprecise. Our study provides additional evidence that benzene exposure increases cancer risk beyond leukemia, information important for policymakers to develop programs to mitigate cancer risk among benzene-exposed workers.

The Study of Exposure to Occupational Carcinogens in Iran: A Scoping Review

Background: Occupational exposure to carcinogens is a significant issue in occupational health and public welfare, with carcinogens encompassing a wide range of substances such as chemicals, metals, dust particles, and organic materials. This scoping review aims to identify, map, and summarize the existing literature on occupational carcinogen exposure in Iran across various industries and settings. It categorizes the types of carcinogens investigated, evaluates the methodologies employed for exposure assessment, and identifies research gaps and areas needing further exploration. Methods: A systematic search was conducted across multiple databases including PubMed, Scopus, Web of Science, Scientific Information Database (SID), and Magiran. A total of 715 articles were identified, with inclusion criteria focusing on studies conducted in Iran, directly related to occupational carcinogen exposure, and available in full text in English or Persian. Title and abstract screening, followed by full-text evaluation, was performed by two independent reviewers. Key data were extracted and thematically analyzed to synthesize findings. Results: The review highlights prevalent types of occupational carcinogens studied in Iran and the industries that have been the primary focus of research. It discusses the various methodological approaches used to assess and quantify exposure levels, identifies key findings related to exposure and associated health risks, and uncovers significant gaps in the literature. Conclusion: This scoping review provides a nuanced portrait of occupational carcinogen exposure in Iran, identifying critical research gaps and offering a foundation for future studies. By consolidating existing knowledge, it aims to contribute to the enhancement of occupational health and safety practices in Iran, guiding the development of targeted interventions and regulatory policies.

Comparison of internal and external reference populations for occupational cancer surveillance in a cohort drawn from a diverse workforce.

Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program. A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario. SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal. Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.

Central nervous system tumours and occupational ionising radiation exposure: a nested case–control study among the ORICAMs cohort of healthcare workers in France

ObjectiveThis study aimed at investigating the relationship between occupational exposure to external ionising radiation and central nervous system (CNS) tumours mortality in healthcare workers working in France.Design and settingThe Occupational...

CASALE MONFERRATO REMEDIATION: ASBESTOS POLLUTION AND SAFETY MEASURES TO PROTECT WORKERS AND ENVIRONMENT

Asbestos is considered one of the most harmful occupational carcinogens causing more than 100,000 deaths per year and exposure to airborne asbestos fibers is held responsible for half of the deaths from occupational cancer (caused by mesothelioma, asbestos-related cancer and asbestosis). Because of this, this substance is now banned in 52 Countries, including Italy, which prohibited the extraction, and marketing of asbestos in 1992. Many areas have therefore been identified in this European Country as highly contaminated by asbestos. Among them also the area of Monferrato, which includes the Municipality of Casale Monferrato and 46 neighboring municipalities. The Eternit asbestos cement plant, located in the municipality of Casale, caused the contamination. The aim of this paper is to describe the complex remediation activities conducted in this wide area, located in northern Italy, highlighting the main phases and the most important issues during the remediation execution; moreover the purpose is to recall the appropriate prevention and protection measures to adopt to prevent new asbestos exposures and to emphasize their importance. This study can serve as an important reference for the academic participants involved in this field at European or international level.

The need for research targeting the link between occupational carcinogens and hepatopancreatobiliary cancers in Africa: A systematic review

IntroductionHepatopancreatobiliary (HPB) cancers encompassing malignancies of the liver, pancreas, gall bladder, and bile ducts pose a significant health burden in Africa. While the association of certain occupational carcinogens in cancer is well established globally, their potential role in HPB cancers remains understudied, especially in an African context. AimThis systematic review delves into the association between occupational carcinogens and HPB cancer in Africa. It examines the current state of research on occupational carcinogens and HPB cancers in Africa, identifying key challenges and knowledge gaps. MethodsThis systematic review examined publications (published between 01 January 2012 and 31 May 2023) that highlight occupational carcinogens and HBP cancers in Africa. The search was conducted on electronic databases namely PubMed, Web of Science, and Africa Wide Information. ResultDue to the lack of information on the association between occupational carcinogens and HPB cancers in Africa, as a result of the paucity of published studies, only four articles were included in this study. Hepatocellular carcinoma (HCC) was the predominant cancer associated with the occupational carcinogen, aflatoxin. Agricultural workers, especially those involved in the production and processing of maize and peanuts, appear to be the most exposed to aflatoxin. ConclusionDespite the sample size limitations due to the paucity of research studies on occupational carcinogens and HPB cancers in Africa, this study provides a reasonable tool for subsequent epidemiological studies. There is a need for more research on the association of occupational carcinogens and HPB cancers in Africa, especially with the growing industrialization.

Socio-economic status and head and neck cancer incidence in the Nordic countries.

The impact of societal factors on the occurrence of head and neck cancers (HNCs) remains understudied, especially in the Nordic countries. To quantify the association between socio-economic status (SES) and the occurrence of HNCs, this cohort study uses data from the Nordic Occupational Cancer project that combine occupational and cancer registry data from 1961 to 2005 of 14.9 million individuals aged between 30 and 64 years. Occupational categories were combined into seven socio-economic categories. Standardized incidence ratio (SIR) analyses were conducted with the cancer incidence rates for the entire national study populations used as reference rates. Altogether, 83 997 HNCs-72% in men and 28% in women-were recorded. Among men, a gradient of risk associated with SES was observed for cancers of the tongue, other oral cavity subsites, pharynx, oropharynx and larynx in groups with lower SES. Managers showed decreased SIRs of 0.50 to -0.90 also for cancers of the lip, tongue, other oral cavity subsites, oropharynx, nasopharynx, nose and larynx. In contrast, excess risks of tongue, other oral cavity subsites, pharyngeal, oropharyngeal and laryngeal cancers were observed among clerical (SIRs 1.05-1.16), skilled workers (1.04-1.14), unskilled workers (1.16-1.26) and economically inactive men (1.38-1.87). Among women, no risk gradient similar to that in men was revealed. The current study underscores the influence of SES on the incidence of HNCs and highlights the need for targeted interventions, including tobacco and alcohol control policies, and improved access to healthcare services, particularly for socio-economically disadvantaged populations.

Methodological and Practical Challenges in Synthesizing Occupational Cancer Studies.

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.

Prevention of Occupational Skin Cancer Caused by Solar Ultraviolet Radiation Exposure: Recent Achievements and Perspectives

Prevention of Occupational Skin Cancer Caused by Solar Ultraviolet Radiation Exposure: Recent Achievements and Perspectives

Evolving burden of lung cancer attributable to occupational carcinogens in 38 OECD countries: Global, national differences, age dynamics and implications for global health.

10576 Background: Lung cancer (LC) remains a predominant cause of global mortality and disability, particularly significant in Organization for Economic Cooperation and Development (OECD) nations. Understanding the evolving burden of LC attributable to occupational carcinogens (OC) is critical due to its prevalence in occupational settings. Methods: Employing a standardized approach from the Global Burden of Disease study, we estimated deaths and disability-adjusted life years (DALYs) caused by lung cancer linked to OC. Our analysis spans age, gender, year, and location across the 38 OECD countries from 1990-2019. Results were presented as absolute counts and age-standardized rates (ASR) per 100,000 person-years, with projections extended to 2040 using regression frameworks. Results: Deaths from LC attributable to OC increased from 120,862 (95%UI: 91,114-148,937) in 1990 to 167,917 (127,888-208,066) in 2019, with DALYs rising from 2.4 million (1.8-3.1) to 2.9 million (2.2-3.6) over the same period. The United States recorded the highest number of deaths (41,075), followed by Japan (20,496) and the United Kingdom (15,223) in 2019. Notably, the Netherlands exhibited the highest age-standardized mortality rate (ASMR) at 12.62 cases per 100,000, with Belgium and the United Kingdom following closely. Asbestos exposure accounted for the highest number of deaths (147,263), followed by silica (15,660), arsenic (3,172), and diesel engine exhaust (2,798). Males bore a significantly higher burden than females over the last three decades, with the 75-79 age group recording the highest number of deaths (32,477) and the 70-74 age group registering the highest DALYs (613,442). Conclusions: The study underscores the escalating burden of LC attributable to occupational carcinogens across OECD countries, highlighting the imperative for robust preventive measures and targeted interventions. Urgent action is warranted to mitigate exposures to known carcinogens in occupational settings, particularly among vulnerable populations, to curb the escalating public health challenge posed by occupational lung cancer.

110 Investigating a cancer cluster in Ontario, Canada using historical occupational hygiene data to evaluate risk of occupational cancers

110 Investigating a cancer cluster in Ontario, Canada using historical occupational hygiene data to evaluate risk of occupational cancers