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1.
Mol Oncol ; 15(3): 753-763, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33544948

RESUMO

Respirable crystalline silica in mineral dust, wood dust, diesel engine exhaust emissions and welding fumes are among the most common process-generated substances to which millions of workers are exposed daily. The composition of process-generated substances can vary substantially, depending on the parameters of the underlying processes; for example, the composition and intensity of diesel motor emissions differs among the various generations of diesel engines and working environments (e.g. surface or underground mining). We illustrate how common these occupational exposures are and discuss challenges in estimating their global prevalence and their contribution to the burden of occupational cancer. Estimates of the number and proportion of workers exposed in most countries and on a global scale are generally scarce. A remarkable exception is based on the proactive bottom-up estimates generated within the European Network for Silica. Actions to reduce exposures and research to fill gaps in knowledge adapted to local settings are warranted to mitigate the occupational cancer burden, especially in under-researched settings including low- and middle-income countries.

2.
Sociol Health Illn ; 2021 Feb 26.
Artigo em Inglês | MEDLINE | ID: mdl-33635559

RESUMO

To understand the complexities of managing long-term conditions and develop appropriate responses, micro-, meso- and macrolevels must be considered. However, these levels have not been combined in a single analytical framework of long-term condition management (LTCM). This article aims to describe a framework of LTCM practice and research that combines societal levels and key agents. The actor-level framework, based on the works of Abram De Swaan and Randall Collins, provides a broader understanding of LTCM as an interdisciplinary research field compared to previous contributions. The framework has three main advantages. First, it encourages knowledge production across levels and actors that address the complexity of long-term illness management. Second, it broadens the scope of LTCM as an interdisciplinary research field and practice field. Finally, it facilitates the integration of knowledge production from different disciplines and research traditions. The framework could stimulate interdisciplinary research collaboration to enhance knowledge of processes and interactions influencing the lives of individuals with long-term conditions.

3.
Occup Environ Med ; 2020 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-33115922

RESUMO

OBJECTIVES: We evaluated the risk of lung cancer associated with ever working as a painter, duration of employment and type of painter by histological subtype as well as joint effects with smoking, within the SYNERGY project. METHODS: Data were pooled from 16 participating case-control studies conducted internationally. Detailed individual occupational and smoking histories were available for 19 369 lung cancer cases (684 ever employed as painters) and 23 674 age-matched and sex-matched controls (532 painters). Multivariable unconditional logistic regression models were adjusted for age, sex, centre, cigarette pack-years, time-since-smoking cessation and lifetime work in other jobs that entailed exposure to lung carcinogens. RESULTS: Ever having worked as a painter was associated with an increased risk of lung cancer in men (OR 1.30; 95% CI 1.13 to 1.50). The association was strongest for construction and repair painters and the risk was elevated for all histological subtypes, although more evident for small cell and squamous cell lung cancer than for adenocarcinoma and large cell carcinoma. There was evidence of interaction on the additive scale between smoking and employment as a painter (relative excess risk due to interaction >0). CONCLUSIONS: Our results by type/industry of painter may aid future identification of causative agents or exposure scenarios to develop evidence-based practices for reducing harmful exposures in painters.

4.
PLoS One ; 15(7): e0236475, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32726334

RESUMO

A historical cohort study in workers occupationally exposed to chrysotile was set up in the town of Asbest, the Russian Federation, to study their cause-specific mortality, with a focus on cancer. Chrysotile has different chemical and physical properties compared with other asbestos fibres; therefore it is important to conduct studies specifically of chrysotile and in different geographical regions to improve the knowledge about its carcinogenicity. Setting was the town of Asbest, Sverdlovsk oblast, the Russian Federation. Participants were all current and former employees with at least one year of employment between 1/1/1975 and 31/12/2010 in the mine, enrichment factories, auto-transport and external rail transportation departments, the central laboratory, and the explosives unit of the company. Of the 35,837 cohort members, 12,729 (35.5%) had died (2,373 of them of cancer, including 10 of mesothelioma), 18,799 (52.5%) were known to be alive at the end of the observation period (2015), and 4,309 (12.0%) were censored before the end of 2015. Mean follow-up duration was 21.7 years in men and 25.9 years in women. The mean age at death was 59.4 years in men and 66.5 years in women. This is the largest occupational cohort of chrysotile workers to date, and the only one with a large proportion of exposed female workers.


Assuntos
Asbestos Serpentinas/efeitos adversos , Neoplasias Pulmonares/epidemiologia , Mesotelioma/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Adulto , Asbestos/efeitos adversos , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/induzido quimicamente , Neoplasias Pulmonares/patologia , Masculino , Mesotelioma/induzido quimicamente , Mesotelioma/patologia , Pessoa de Meia-Idade , Doenças Profissionais/induzido quimicamente , Doenças Profissionais/patologia , Federação Russa/epidemiologia
5.
Occup Environ Med ; 77(9): 623-627, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32398292

RESUMO

OBJECTIVES: A historical cohort study of cancer mortality is being conducted among workers in a chrysotile mine and its enrichment factories in the town of Asbest, Russian Federation. Because individual-level information on tobacco use is not available for Asbest Chrysotile Cohort members, a cross-sectional survey of smoking behaviours was conducted among active and retired workers. METHODS: Self-administered questionnaires were completed by active workers during meetings organised by occupational safety personnel. Retired workers completed questionnaires during meetings of the Veterans Council or were interviewed via telephone or in person. Of the respondents, 46% could be linked to the Asbest Chrysotile Cohort. Among those, logistic regression models were used to assess associations between smoking and cumulative dust exposure. RESULTS: Among men, smoking prevalence was high and relatively consistent across birth decades (average, 66%), and was similar in workers across all levels of cumulative dust exposure (p trend, 0.44). Among women, the prevalence increased from <10% in those born before 1960 to 30% in those born after 1980, and smoking was associated with exposure to dust versus not exposed to dust (p value, 0.006), but did not vary appreciably across workers in different cumulative dust exposure categories (p trend, 0.29). CONCLUSIONS: Our study suggests that cross-sectional surveys may be a useful tool for understanding the potential health impact from smoking in occupational cohorts, including possible confounding by smoking. This survey showed that adjustment at the age group level among women is needed to reduce residual confounding and account for smoking patterns, which have changed substantially over time.


Assuntos
Asbestos Serpentinas , Exposição Ocupacional/estatística & dados numéricos , Fumar Tabaco , Adulto , Idoso , Estudos de Coortes , Estudos Transversais , Poeira , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mineradores/estatística & dados numéricos , Material Particulado , Federação Russa/epidemiologia , Inquéritos e Questionários
6.
Am J Respir Crit Care Med ; 202(3): 412-421, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32330394

RESUMO

Rationale: Millions of workers around the world are exposed to respirable crystalline silica. Although silica is a confirmed human lung carcinogen, little is known regarding the cancer risks associated with low levels of exposure and risks by cancer subtype. However, little is known regarding the disease risks associated with low levels of exposure and risks by cancer subtype.Objectives: We aimed to address current knowledge gaps in lung cancer risks associated with low levels of occupational silica exposure and the joint effects of smoking and silica exposure on lung cancer risks.Methods: Subjects from 14 case-control studies from Europe and Canada with detailed smoking and occupational histories were pooled. A quantitative job-exposure matrix was used to estimate silica exposure by occupation, time period, and geographical region. Logistic regression models were used to estimate exposure-disease associations and the joint effects of silica exposure and smoking on risk of lung cancer. Stratified analyses by smoking history and cancer subtypes were also performed.Measurements and Main Results: Our study included 16,901 cases and 20,965 control subjects. Lung cancer odds ratios ranged from 1.15 (95% confidence interval, 1.04-1.27) to 1.45 (95% confidence interval, 1.31-1.60) for groups with the lowest and highest cumulative exposure, respectively. Increasing cumulative silica exposure was associated (P trend < 0.01) with increasing lung cancer risks in nonsilicotics and in current, former, and never-smokers. Increasing exposure was also associated (P trend ≤ 0.01) with increasing risks of lung adenocarcinoma, squamous cell carcinoma, and small cell carcinoma. Supermultiplicative interaction of silica exposure and smoking was observed on overall lung cancer risks; superadditive effects were observed in risks of lung cancer and all three included subtypes.Conclusions: Silica exposure is associated with lung cancer at low exposure levels. An exposure-response relationship was robust and present regardless of smoking, silicosis status, and cancer subtype.


Assuntos
Adenocarcinoma de Pulmão/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Dióxido de Silício , Silicose/epidemiologia , Adulto , Idoso , Canadá/epidemiologia , Fumar Cigarros , Europa (Continente)/epidemiologia , Feminino , Humanos , Exposição por Inalação , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade
7.
Am J Respir Crit Care Med ; 202(3): 402-411, 2020 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-32330395

RESUMO

Rationale: Although the carcinogenicity of diesel engine exhaust has been demonstrated in multiple studies, little is known regarding exposure-response relationships associated with different exposure subgroups and different lung cancer subtypes.Objectives: We expanded on a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including three additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust characterized by elemental carbon (EC) concentrations.Methods: We used a quantitative EC job-exposure matrix for exposure assessment. Unconditional logistic regression models were used to calculate lung cancer odds ratios and 95% confidence intervals (CIs) associated with various metrics of EC exposure. Lung cancer excess lifetime risks (ELR) were calculated using life tables accounting for all-cause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men.Measurements and Main Results: Our study included 16,901 lung cancer cases and 20,965 control subjects. In men, exposure response between EC and lung cancer was observed: odds ratios ranged from 1.09 (95% CI, 1.00-1.18) to 1.41 (95% CI, 1.30-1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC lung cancer exposure response was observed in men regardless of smoking history, including in never-smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 µg/m3 were 3.0%, 0.99%, and 0.04%, respectively, for both sexes combined.Conclusions: We observed a consistent exposure-response relationship between EC exposure and lung cancer in men. Reduction of workplace EC levels to background environmental levels will further reduce lung cancer ELR in exposed workers.


Assuntos
Adenocarcinoma de Pulmão/epidemiologia , Carcinoma de Células Grandes/epidemiologia , Carcinoma de Células Pequenas/epidemiologia , Carcinoma de Células Escamosas/epidemiologia , Fumar Cigarros/epidemiologia , Neoplasias Pulmonares/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Emissões de Veículos , Adulto , Idoso , Canadá/epidemiologia , Carbono , Europa (Continente)/epidemiologia , Feminino , Humanos , Exposição por Inalação , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores Sexuais
8.
Patient Educ Couns ; 103(8): 1453-1466, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32098746

RESUMO

OBJECTIVE: Patient participation represents a worldwide policy, but its impact lacks research. This study investigates impact of patient participation in health-service development by providing a comprehensive overview of how the literature describes it. METHOD: A scoping review with a broad search strategy was conducted. The literature was examined for study characteristics, purpose for, approaches to and impact of patient participation. The data were analyzed using a thematic analysis. RESULTS: The 34 included primary studies reported impacts of patient participation that were interpreted to constitute two categories: 1. The participatory process´ impact on involved patient representatives and health professionals, and the organization´s patient participation practice itself. 2. The participatory service development´s impact on the design and delivery of services regarding patients and health professionals, and the organization. CONCLUSION: The literature describes a broad variation of impacts from health-service development, relevant for health professionals and patient representatives when initiating or participating in such processes. Our review provides an overview and discussion of these types of impact. PRACTICE IMPLICATIONS: The findings can be of practical relevance to those aiming to develop services, quality indicators regarding effects of patient participation, or to further investigate aspects of participatory service development.

9.
Int J Cancer ; 146(4): 943-952, 2020 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-31054169

RESUMO

Parental occupational exposures to pesticides, animals and organic dust have been associated with an increased risk of childhood cancer based mostly on case-control studies. We prospectively evaluated parental occupational exposures and risk of childhood leukemia and central nervous system (CNS) tumors in the International Childhood Cancer Cohort Consortium. We pooled data on 329,658 participants from birth cohorts in five countries (Australia, Denmark, Israel, Norway and United Kingdom). Parental occupational exposures during pregnancy were estimated by linking International Standard Classification of Occupations-1988 job codes to the ALOHA+ job exposure matrix. Risk of childhood (<15 years) acute lymphoblastic leukemia (ALL; n = 129), acute myeloid leukemia (AML; n = 31) and CNS tumors (n = 158) was estimated using Cox proportional hazards models to generate hazard ratios (HR) and 95% confidence intervals (CI). Paternal exposures to pesticides and animals were associated with increased risk of childhood AML (herbicides HR = 3.22, 95% CI = 0.97-10.68; insecticides HR = 2.86, 95% CI = 0.99-8.23; animals HR = 3.89, 95% CI = 1.18-12.90), but not ALL or CNS tumors. Paternal exposure to organic dust was positively associated with AML (HR = 2.38 95% CI = 1.12-5.07), inversely associated with ALL (HR = 0.55, 95% CI = 0.31-0.99) and not associated with CNS tumors. Low exposure prevalence precluded evaluation of maternal pesticide and animal exposures; we observed no significant associations with organic dust exposure. This first prospective analysis of pooled birth cohorts and parental occupational exposures provides evidence for paternal agricultural exposures as childhood AML risk factors. The different risks for childhood ALL associated with maternal and paternal organic dust exposures should be investigated further.


Assuntos
Neoplasias do Sistema Nervoso Central/epidemiologia , Leucemia Mieloide Aguda/epidemiologia , Exposição Materna/efeitos adversos , Exposição Ocupacional/efeitos adversos , Exposição Paterna/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Efeitos Tardios da Exposição Pré-Natal/epidemiologia , Adolescente , Adulto , Animais , Animais Domésticos , Austrália/epidemiologia , Neoplasias do Sistema Nervoso Central/etiologia , Criança , Pré-Escolar , Dinamarca/epidemiologia , Poeira , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Israel/epidemiologia , Leucemia Mieloide Aguda/etiologia , Masculino , Noruega/epidemiologia , Praguicidas/toxicidade , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Estudos Prospectivos , Fatores de Risco , Reino Unido/epidemiologia , Adulto Jovem
10.
Epidemiology ; 31(1): 145-154, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31577634

RESUMO

INTRODUCTION: Various established occupational lung carcinogens are also suspected risk factors for laryngeal cancer. However, individual studies are often inadequate in size to investigate this relatively rare outcome. Other limitations include imprecise exposure assessment and inadequate adjustment for confounders. METHODS: This study applied a quantitative job exposure matrix (SYN-JEM) for four established occupational lung carcinogens to five case-control studies within the International Head and Neck Cancer Epidemiology Consortium. We used occupational histories for 2256 laryngeal cancer cases and 7857 controls recruited from 1989 to 2007. We assigned quantitative exposure levels for asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined (to address highly correlated exposures) via SYN-JEM. We assessed effects of occupational exposure on cancer risk for males (asbestos, respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined) and females (asbestos and respirable crystalline silica), adjusting for age, study, tobacco smoking, alcohol consumption, and asbestos exposure where relevant. RESULTS: Among females, odds ratios (ORs) were increased for ever versus never exposed. Among males, P values for linear trend were <0.05 for estimated cumulative exposure (all agents) and <0.05 for exposure duration (respirable crystalline silica, chromium-VI, and chromium-VI and nickel combined); strongest associations were for asbestos at >90th percentile cumulative exposure (OR = 1.3, 95% confidence interval [CI] = 1.0, 1.6), respirable crystalline silica at 30+ years duration (OR = 1.4, 95% CI = 1.2, 1.7) and 75th-90th percentile cumulative exposure (OR = 1.4, 95% CI = 1.1, 1.8), chromium-VI at >75th percentile cumulative exposure (OR = 1.9, 95% CI = 1.2, 3.0), and chromium-VI and nickel combined at 20-29 years duration (OR = 1.5, 95% CI = 1.1, 2.2). CONCLUSIONS: These findings support hypotheses of causal links between four lung carcinogens (asbestos, respirable crystalline silica, chromium-VI, and nickel) and laryngeal cancer.

12.
Occup Environ Med ; 76(10): 746-753, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31358566

RESUMO

OBJECTIVES: Previously published studies on parental occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and risk of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring were inconsistent. We therefore evaluated this question within the Childhood Leukemia International Consortium. METHODS: We pooled 11 case-control studies including 9723 childhood leukaemia cases and 17 099 controls. Parental occupational ELF-MF exposure was estimated by linking jobs to an ELF-MF job-exposure matrix (JEM). Logistic regression models were used to estimate ORs and 95% CIs in pooled analyses and meta-analyses. RESULTS: ORs from pooled analyses for paternal ELF-MF exposure >0.2 microtesla (µT) at conception were 1.04 (95% CI 0.95 to 1.13) for ALL and 1.06 (95% CI 0.87 to 1.29) for AML, compared with ≤0.2 µT. Corresponding ORs for maternal ELF-MF exposure during pregnancy were 1.00 (95% CI 0.89 to 1.12) for ALL and 0.85 (95% CI 0.61 to 1.16) for AML. No trends of increasing ORs with increasing exposure level were evident. Furthermore, no associations were observed in the meta-analyses. CONCLUSIONS: In this large international dataset applying a comprehensive quantitative JEM, we did not find any associations between parental occupational ELF-MF exposure and childhood leukaemia.


Assuntos
Leucemia Mieloide Aguda/epidemiologia , Campos Magnéticos/efeitos adversos , Exposição Ocupacional/estatística & dados numéricos , Exposição Paterna/estatística & dados numéricos , Leucemia-Linfoma Linfoblástico de Células Precursoras/epidemiologia , Adolescente , Estudos de Casos e Controles , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Exposição Materna/efeitos adversos , Exposição Materna/estatística & dados numéricos , Gravidez , Efeitos Tardios da Exposição Pré-Natal/epidemiologia
13.
Cancer Epidemiol ; 58: 25-32, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30445228

RESUMO

BACKGROUND: There is inadequate evidence to determine whether there is an effect of alcohol consumption on lung cancer risk. We conducted a pooled analysis of data from the International Lung Cancer Consortium and the SYNERGY study to investigate this possible association by type of beverage with adjustment for other potential confounders. METHODS: Twenty one case-control studies and one cohort study with alcohol-intake data obtained from questionnaires were included in this pooled analysis (19,149 cases and 362,340 controls). Adjusted odds ratios (OR) or hazard ratios (HR) with corresponding 95% confidence intervals (CI) were estimated for each measure of alcohol consumption. Effect estimates were combined using random or fixed-effects models where appropriate. Associations were examined for overall lung cancer and by histological type. RESULTS: We observed an inverse association between overall risk of lung cancer and consumption of alcoholic beverages compared to non-drinkers, but the association was not monotonic. The lowest risk was observed for persons who consumed 10-19.9 g/day ethanol (OR vs. non-drinkers = 0.78; 95% CI: 0.67, 0.91), where 1 drink is approximately 12-15 g. This J-shaped association was most prominent for squamous cell carcinoma (SCC). The association with all lung cancer varied little by type of alcoholic beverage, but there were notable differences for SCC. We observed an association with beer intake (OR for ≥20 g/day vs nondrinker = 1.42; 95% CI: 1.06, 1.90). CONCLUSIONS: Whether the non-monotonic associations we observed or the positive association between beer drinking and squamous cell carcinoma reflect real effects await future analyses and insights about possible biological mechanisms.


Assuntos
Adenocarcinoma/epidemiologia , Consumo de Bebidas Alcoólicas/efeitos adversos , Carcinoma de Células Escamosas/epidemiologia , Neoplasias Pulmonares/epidemiologia , Adenocarcinoma/etiologia , Idoso , Bebidas Alcoólicas/efeitos adversos , Carcinoma de Células Escamosas/etiologia , Estudos de Casos e Controles , Estudos de Coortes , Feminino , Humanos , Neoplasias Pulmonares/etiologia , Masculino , Pessoa de Meia-Idade , Razão de Chances , Fatores de Risco , Inquéritos e Questionários
14.
J Neurooncol ; 141(1): 139-149, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30421160

RESUMO

PURPOSE: Gliomas are the most common cancer of the brain, with a poor prognosis in particular for glioblastoma. In 2014, a study suggested reduced survival in relation to latency of mobile phone use among glioblastoma patients. A joint epidemiological/experimental project to study effects of RF-EMF on tumor development and progression was established. The current analysis relates to the epidemiological part and addresses whether pre-diagnostic mobile phone use was associated with survival among glioma patients. METHODS: Glioma cases (n = 806) previously enrolled in a collaborative population-based case-control study in Denmark, Finland and Sweden were followed up for survival. Vital status, date of death, date of emigration, or date last known to be alive was obtained based on registry linkages with a unique personal ID in each country. Cox regression models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) stratified by country. Covariates investigated were sex, age, education, histology, treatment, anatomic location and marital status. RESULTS: No indication of reduced survival among glioblastoma patients was observed for various measures of mobile phone use (ever regular use, time since start of regular use, cumulative call time overall or in the last 12 months) relative to no or non-regular use. All significant associations suggested better survival for mobile phone users. Results were similar for high-grade and low-grade gliomas. CONCLUSIONS: We found no evidence of reduced survival among glioma patients in relation to previous mobile phone use.


Assuntos
Neoplasias Encefálicas/mortalidade , Uso do Telefone Celular , Glioma/mortalidade , Ondas de Rádio/efeitos adversos , Adolescente , Adulto , Idoso , Estudos de Casos e Controles , Dinamarca/epidemiologia , Feminino , Finlândia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Suécia/epidemiologia , Adulto Jovem
15.
Int J Hyg Environ Health ; 222(1): 22-29, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30174219

RESUMO

BACKGROUND: Recent and comprehensive estimates for the number of new cancer cases in France attributable to occupational exposures are lacking. OBJECTIVES: To estimate the number of new cancer cases attributable to occupational exposures, using a newly developed methodology and the most recent data, for a comprehensive set of occupational carcinogens in France in 2015. METHODS: Surveys among employees, the national labor force data, a cohort of agricultural workers, national monitoring of workers exposed to ionizing radiation and job-exposure matrix in France were used. The number and proportion of new cancer cases attributable to established occupational carcinogens (Group 1) was estimated using estimation of lifetime exposure and risk estimates from cohort studies. Cancer data were obtained from the French Cancer Registries Network. RESULTS: In France in 2015, an estimated 7905 new cancer cases, 7336 among men and 569 among women, were attributable to occupational exposures, representing 2.3% of all new cancer cases (3.9% and 0.4% among men and women respectively). Among men and women, lung cancer was impacted the most, followed by mesothelioma and bladder cancer in men, and by mesothelioma and ovary in women. These cancers contributed to 89% of the total cancers attributable to occupational carcinogens in men, and to 80% in women. The main contributing occupational agent was asbestos among men (45%) and women (60%). CONCLUSIONS: Currently, occupational exposures contribute to a substantial burden of cancer in France. Enhanced monitoring and implementation of protective labor policies could potentially prevent a large proportion of these cancers.


Assuntos
Carcinógenos/toxicidade , Neoplasias/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Feminino , França/epidemiologia , Humanos , Masculino , Neoplasias/epidemiologia , Exposição Ocupacional/estatística & dados numéricos
16.
J Neurooncol ; 140(3): 539-546, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30421158

RESUMO

PURPOSE: Glioblastoma is a malignant brain tumor which has one of the poorest prognosis. It is not clear if toxic environmental factors can influence its aggressiveness. Recently, it was suggested that brain cancer patients with heavy cell phone use showed reduced survival. Here we aimed to assess the effect of controlled brain averaged specific absorption rate (BASAR) from heavy use of cell phone radiofrequency electromagnetic fields (RF-EMF) on in vivo C6 brain tumors in Wistar rats. METHODS: C6 cells grafted male rats were exposed to GSM 900 MHz signal at environmental BASAR, 0 (sham), 0.25 or 0.5 W/kg (5 days a week, 45 min a day in restraint), or were cage controls (no restraint). At death, tumor volume and immunohistochemistry for CD31, cleaved caspase (CC) 3 and Ki67 were assessed to examine vascularization, apoptosis and cellular divisions, respectively. Moreover, immune cell invasion, necrosis and mitotic index were determined. RESULTS: Results showed no BASAR effect on survival (31 days post-graft median), tumor volume, mitotic index, vascularization, infiltration, necrosis or cell division. However, results suggested a BASAR-dependent reduction of immune cell invasion and apoptosis. CONCLUSIONS: Our data suggested an action of RF-EMF by reducing immune cell invasion and glioblastoma cell apoptosis, at probably too low amplitude to impact survival. Further replication studies are needed to confirm these observations.


Assuntos
Neoplasias Encefálicas/patologia , Encéfalo/patologia , Encéfalo/efeitos da radiação , Glioblastoma/patologia , Ondas de Rádio/efeitos adversos , Animais , Encéfalo/imunologia , Neoplasias Encefálicas/etiologia , Linhagem Celular Tumoral , Glioblastoma/etiologia , Masculino , Ratos Wistar
17.
Scand J Work Environ Health ; 44(6): 658-669, 2018 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-29877553

RESUMO

Objective The present study aims to assess if parental occupational exposure to solvents or heavy metals is associated with risk of testicular germ cell tumors (TGCT) in sons in Denmark. Methods The NORD-TEST Denmark included 3421 cases diagnosed with TGCT at ages 14-49 years in Denmark between 1981 and 2014. Controls (N=14 024) selected from the central population registry were matched to cases on birth year. The Danish Supplementary Pension Fund provided parental occupational information. A job-exposure matrix was used to assign exposures, and conditional logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results The overall analyses showed no significant associations except for paternal exposure to a sub-group of "heavy metal(s) and solvent(s)" (OR 1.50, 95% CI 1.01-2.24). Most fathers in this category had worked in wood related jobs and were assigned exposure to chromium VI and toluene. Other sub-group analyses suggested that maternal exposure to aromatic hydrocarbon were associated with TGCT risk, in sons born in 1970-1979, and to heavy metals (chromium, iron and nickel) in sons born in 1980-1998. Conclusion NORD-TEST Denmark provides no strong support for an association between parental exposures to solvents or heavy metals and TGCT in sons, and only weak support for an association between paternal exposure to chromium and toluene and TGCT risk in sons.


Assuntos
Metais Pesados/toxicidade , Neoplasias Embrionárias de Células Germinativas/epidemiologia , Núcleo Familiar , Exposição Ocupacional , Exposição Paterna/efeitos adversos , Solventes/toxicidade , Neoplasias Testiculares/epidemiologia , Adolescente , Adulto , Dinamarca/epidemiologia , Humanos , Masculino , Sistema de Registros
18.
Occup Environ Med ; 75(8): 604-614, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-29735747

RESUMO

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.


Assuntos
Carcinógenos , Neoplasias/etiologia , Doenças Profissionais/etiologia , Exposição Ocupacional/efeitos adversos , Países Desenvolvidos , França , Humanos , Medição de Risco
19.
PLoS One ; 13(2): e0192999, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29462211

RESUMO

BACKGROUND: An association between low socioeconomic status (SES) and lung cancer has been observed in several studies, but often without adequate control for smoking behavior. We studied the association between lung cancer and occupationally derived SES, using data from the international pooled SYNERGY study. METHODS: Twelve case-control studies from Europe and Canada were included in the analysis. Based on occupational histories of study participants we measured SES using the International Socio-Economic Index of Occupational Status (ISEI) and the European Socio-economic Classification (ESeC). We divided the ISEI range into categories, using various criteria. Stratifying by gender, we calculated odds ratios (OR) and 95% confidence intervals (CI) by unconditional logistic regression, adjusting for age, study, and smoking behavior. We conducted analyses by histological subtypes of lung cancer and subgroup analyses by study region, birth cohort, education and occupational exposure to known lung carcinogens. RESULTS: The analysis dataset included 17,021 cases and 20,885 controls. There was a strong elevated OR between lung cancer and low SES, which was attenuated substantially after adjustment for smoking, however a social gradient persisted. SES differences in lung cancer risk were higher among men (lowest vs. highest SES category: ISEI OR 1.84 (95% CI 1.61-2.09); ESeC OR 1.53 (95% CI 1.44-1.63)), than among women (lowest vs. highest SES category: ISEI OR 1.54 (95% CI 1.20-1.98); ESeC OR 1.34 (95% CI 1.19-1.52)). CONCLUSION: SES remained a risk factor for lung cancer after adjustment for smoking behavior.


Assuntos
Neoplasias Pulmonares/epidemiologia , Fatores Etários , Idoso , Canadá , Europa (Continente) , Feminino , Humanos , Modelos Logísticos , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional , Razão de Chances , Fatores de Risco , Fatores Sexuais , Fumar/epidemiologia , Classe Social
20.
Eur Respir Rev ; 26(146)2017 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-29141963

RESUMO

Occupational lung diseases are an important public health issue and are avoidable through preventive interventions in the workplace. Up-to-date knowledge about changes in exposure to occupational hazards as a result of technological and industrial developments is essential to the design and implementation of efficient and effective workplace preventive measures. New occupational agents with unknown respiratory health effects are constantly introduced to the market and require periodic health surveillance among exposed workers to detect early signs of adverse respiratory effects. In addition, the ageing workforce, many of whom have pre-existing respiratory conditions, poses new challenges in terms of the diagnosis and management of occupational lung diseases. Primary preventive interventions aimed to reduce exposure levels in the workplace remain pivotal for elimination of the occupational lung disease burden. To achieve this goal there is still a clear need for setting standard occupational exposure limits based on transparent evidence-based methodology, in particular for carcinogens and sensitising agents that expose large working populations to risk. The present overview, focused on the occupational lung disease burden in Europe, proposes directions for all parties involved in the prevention of occupational lung disease, from researchers and occupational and respiratory health professionals to workers and employers.


Assuntos
Poluentes Ocupacionais do Ar/efeitos adversos , Pneumopatias/induzido quimicamente , Pulmão/efeitos dos fármacos , Doenças Profissionais/induzido quimicamente , Exposição Ocupacional/efeitos adversos , Saúde do Trabalhador , Diagnóstico Precoce , Monitoramento Ambiental , Europa (Continente) , Humanos , Pulmão/patologia , Pulmão/fisiopatologia , Pneumopatias/epidemiologia , Pneumopatias/fisiopatologia , Pneumopatias/terapia , Doenças Profissionais/epidemiologia , Doenças Profissionais/fisiopatologia , Doenças Profissionais/terapia , Prognóstico , Medição de Risco , Fatores de Risco
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