Occupational exposures and risk of oesophageal cancer by histological type: a case–control study in eastern Spain
- M Santibañez1,2,
- J Vioque2,3,
- J Alguacil3,4,
- X Barber5,
- M García de la Hera2,
- T Kauppinen6,
- for the PANESOES Study Group
- 1 Occupational Health Unit, Public Health Center, Elche, Alicante, Spain
- 2 Departamento de Salud Pública, Universidad Miguel Hernandez de Elche, Alicante, Spain
- 3 CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
- 4 Department of Environmental Biology and Public Health, Huelva University, Huelva, Spain
- 5 Departamento de Estadística, Centro de Investigación Operativa, Universidad Miguel Hernández de Elche, Alicante, Spain
- 6 Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
- Jesús Vioque, Departamento de Salud Pública, Campus San Juan, Universidad Miguel Hernández, Ctra Valencia, s/n 03550, San Juan de Alicante, Spain;
- Accepted 20 March 2008
- Published Online First 8 July 2008
Objective: To explore the relationship between occupations and specific occupational exposures and oesophageal cancer (OC) by histological type.
Methods: A multicentre hospital-based case–control study was conducted in two Mediterranean provinces of Spain. Occupational, sociodemographic and lifestyle information was collected from 185 newly diagnosed male oesophageal cancer patients (147 squamous cell, 38 adenocarcinoma) and 285 frequency matched controls. Occupation was coded according to the Spanish National Classification of Occupations 1994. Occupational exposure to a selection of carcinogenic substances was assessed by the FINJEM job exposure matrix. Odds ratios were calculated by unconditional logistic regression adjusting for age, education, alcohol intake and cigarette smoking.
Results: For the squamous cell variety, statistically significant associations were found for waiters and bartenders (OR 8.18, 95% CI 1.98 to 33.75) and miners, shotfirers, stone cutters and carvers (OR 10.78, 95% CI 1.24 to 93.7) in relation to other occupations. For the adenocarcinoma variety, statistically significant associations were observed for carpenters and joiners (OR 9.69), animal producers and related workers (OR 5.61) and building and related electricians (OR 8.26), although these observations were based on a low number of cases. Regarding specific exposures, the study found a statistically significant increased risk of squamous cell carcinoma for ionising radiation, and of adenocarcinoma for high exposure to volatile sulphur compounds (OR 3.12) and lead (OR 5.30). For all histological types of OC combined, a three-fold increase in risk was found with a significant trend for asbestos exposure (OR 3.46, 95% CI 0.99 to 12.10).
Conclusions: The data suggest that some occupational exposures may specifically increase the risk of oesophageal squamous cell carcinoma or adenocarcinoma, while other exposures such as asbestos may increase the overall risk of OC.
Competing interests: None.
Funding: This work was supported by the Spanish Ministry of Health (FIS 91/0435, RCESP C 03/09), the Generalitat Valenciana (EVES 030/2005, CTGCA/2002/06, G03/136), the Bienvenida Navarro Luciano-Trípodi Foundation (2005–2007) and the Fundación Hospital Universitario de Elche (01/07).
Members of PANESOES Study Group: Jesus Vioque (principal investigator and coordinator of the study), Esperanza Ponce, María Guillén, Miguel Santibáñez, Xavier Barber, Manuela García de la Hera (Departamento de Salud Pública, Universidad Miguel Hernández, Elche-Alicante, Spain); Miguel Bixquert, Jorge Alonso, Vicente Cervera, Remedios Giner, Juan Ruiz, Carlos Sanchos-Aldás, Javier Arenas (Hospital Arnau Vilanova de Valencia); Joaquin Berenguer, Teresa Sala, Sonia Pascual, Liria Argüello, Marco Bustamante, Salvador Sancho, Constantino Herranz, Jorge Aparicio, Dr Baixauli, Jorge Mir, Pedro Sendrá (Hospital La Fe de Valencia); Enrique Medina, Alicia Tomé, Luis Ferrer, Ramón Truyenque, Luis Olabarrieta, Ricardo Fabra, Carlos Camps, Jose Maria Vicent (Hospital General de Valencia); Eduardo Moreno-Osset, Ramón Añón, José Ballester, Vicente Alfonso, Dr Martínez-Abad, Francisco Blanes, Carmen Molins, Daniel Almenar, Santiago Olmos, Dr Fenollosa (Hospital Doctor Peset de Valencia); Adolfo Benages-Martinez, Andrés Peña-Aldea, Dra I Pascual, Dr García-Conde, Andrés Cervantes, Pilar Azagra, Dr Lledó, Blas Flor, Vicente Martí (Hospital Clínico de Valencia); Miguel Pérez-Mateos, Juan Antonio Casellas, Eva Girona, Jose Ramón Aparicio, Mar López, Antonio Arroyo, Fernando Camuñas, Jesus de Anta (Hospital General de Alicante); Juan Custardoy, Concepción Martínez, Enrique Gaspar, Eduardo Muñoz (Hospital Comarcal de la Vega Baja); Alfredo Carrato, Maria Luisa Gozálvez, Rafael Calpena, Dr Gassent, Dr Pérez, Carlos Sillero C (Hospital General de Elche); Justo Medrano, Francisco Mauri, Marta Corona, Jorge Minguel (Hospital Universitario Sant Joan de Alicante).
Ethics approval: Research protocols were approved by the local ethics and/or research committees of the participating hospitals and the university.