Filler

Meta-analyses suggest that farming may be a risk factor for cancer of the prostate, the evidence being stronger in North America than in other countries. Meyer et al¹ have investigated whether risks vary between African–American men (a sub-group with an exceptionally high incidence of disease) and the more usually studied population of male Caucasian farmers. In a population-based, case-control study from South Carolina, USA, farming exposures were compared in 405 incident cases of prostate cancer and 392 controls, matched for age, race and locality. Farming was associated with a greater risk of cancer in Caucasians (odds ratio (OR) 1.8), but not in African–Americans (OR 1.0). An association was also found with mixing or applying pesticides (OR 1.6). The authors suggest that racial differences may reflect differences of exposure or gene–environment interactions. An accompanying editorial² discusses other potential sources of error and bias that are important to consider in investigations of prostate cancer.

Hairdressers encounter many skin irritants and allergens during the course of their work, and suffer more hand eczema as a result. But how common is the problem and how influential is a prior history of skin atopy? Lind et al³ have investigated the incidence of hand eczema in a retrospective cohort of Swedish hairdressers comprising all female students of hairdressing schools from 1970 to 1995. Hand eczema was ascertained using a self-completed questionnaire and incidence rate ratios (IRR) calculated in comparison with general population controls. The estimated incidence rate in hairdressers was 23.8 cases per 1000 person-years (IRR vs controls 2.5, 95% CI 2.2 to 2.8). Although risks were higher in female hairdressers with a childhood history of hand eczema, the authors estimate that only about 10% of cases in Swedish female hairdressers would be prevented if those with skin atopy avoided entering the trade.

Occupational tuberculosis (TB) is emerging as an important health problem among the healthcare workers of industrialised countries. Some authorities have responded by issuing strict control and preventive guidelines. In this issue, Baussano et al⁴ evaluate the impact of one such policy among healthcare workers from Turin, Italy. From 1997 to 2004 a dynamic cohort was screened for infection (positive conversion on tuberculin skin testing) and annual rates of TB infection were compared according to work activities, settings and the timing in relation to phased implementation of new preventive guidelines. The annual rate of infection was 1.6 per 100 person-years overall, with substantial variation by occupation and hospital department; but following the new control policy, it fell by 1.3 cases per 100 person-years and the variation between sub-groups narrowed markedly. The authors conclude that the measures were effective in risk reduction.

This issue also features two studies of work-related injury: an investigation from British Columbia, Canada,⁵ quantifying the costs and compensation of injured sawmill workers (which are considerable); and a second study highlighting a substantial under-reporting of serious accidental injury in British agriculture.⁶ Elsewhere we feature a report with new evidence that symptoms of sick building syndrome may be related in some circumstances to photocopying and printing in offices.⁷

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