Workplace exposures and oesophageal cancer
Marie-Élise Parenta, Jack Siemiatyckia b, Lin Fritschic
a INRS, Institut
Armand-Frappier 531, Boulevard des Prairies Laval, Quebec, Canada H7V
1B7, b McGill University, Montreal, Quebec, Canada, c Department of Epidemiology
and Preventive Medicine, Monash University, Alfred Hospital, Prahran
3181, Australia
Correspondence to: Dr Marie-Élise Parent marie-elise.parent{at}inrs-iaf.uquebec.ca
Accepted 18 January
2000
OBJECTIVES
To describe
the relation between oesophageal cancer and many occupational
circumstances with data from a population based case-control study.
METHODS
Cases were 99 histologically confirmed incident cases of cancer of the oesophagus, 63 of which were squamous cell carcinomas. Various control groups were
available; for the present analysis a group was used that comprised 533 population controls and 533 patients with other types of cancer.
Detailed job histories were elicited from all subjects and were
translated by a team of chemists and hygienists for evidence of
exposure to 294 occupational agents. Based on preliminary results and a
review of literature, a set of 35 occupational agents and 19 occupations and industry titles were selected for this analysis.
Logistic regression analyses were adjusted for age, birthplace,
education, respondent (self or proxy), smoking, alcohol, and
-carotene intake.
RESULTS
Sulphuric acid
and carbon black showed the strongest evidence of an association with
oesophageal cancer, particularly squamous cell carcinoma. Other
substances showed excess risks, but the evidence was more
equivocal
namely chrysotile asbestos, alumina, mineral spirits,
toluene, synthetic adhesives, other paints and varnishes, iron
compounds, and mild steel dust. There was considerable overlap in
occupational exposure patterns and results for some of these substances
may be mutually confounded. None of the occupations or industry titles
showed a clear excess risk; the strongest hints were for warehouse
workers, food services workers, and workers from the miscellaneous food industry.
CONCLUSIONS
The data
provide some support for an association between oesophageal cancer and
a handful of occupational exposures, particularly sulphuric acid and
carbon black. Many of the associations found have never been examined
before and warrant further investigation.
Keywords: oesophageal cancer; occupational exposures; occupations
© 2000 by Occupational and Environmental Medicine
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