Postmenopausal breast cancer and occupational exposures
- 1Occupational Health, Quebec National Institute of Public Health, Montreal, Quebec, Canada
- 2Départements de Médecine sociale et préventive et de Santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
- 3Department of Medicine, McGill University, Montreal, Quebec, Canada
- 4Division of Clinical Epidemiology, McGill University Health Center, Montreal, Quebec, Canada
- 5INRS-Institut Armand-Frappier, Laval, Quebec, Canada
- Correspondence to France Labrèche, Institut de recherche Robert-Sauvé en santé et en sécurité du travail du Québec, 505 boul. de Maisonneuve Ouest, Montréal, Québec, Canada H3A 3C2; france.labreche{at}irsst.qc.ca
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Contributors All of the authors participated in the preparation of the paper and have approved the submitted version. FL and MSG designed the study, directed it and are responsible for the analysis and paper preparation. M-FV supervised data verification, secondary coding and performed the statistical analyses. LN supervised occupational history data collection and directed the exposure coding.
- Accepted 12 November 2009
Abstract
Objective To determine whether exposures in the workplace to organic solvents and to other agents, such as polycyclic aromatic hydrocarbons, are associated with increased risks of developing postmenopausal breast cancer.
Methods Between 1996 and 1997 a case–control study was conducted in Montreal, Quebec. Cases comprised 556 women, aged 50–75 years, with incident malignant breast cancer, and their controls were 613 women with other cancers, frequency matched for age, date of diagnosis and hospital. An expert team of chemists and industrial hygienists translated their job histories into exposure to about 300 agents.
Results Odds ratios (ORs) were increased for the usual risk factors for breast cancer and, adjusting for these, risks increased with occupational exposure to several agents, and were highest for exposures occurring before age 36 years. Increased ORs were found for each 10-year increment in duration of exposure, before age 36 years (OR<36), to acrylic fibres (OR<36=7.69) and to nylon fibres (OR<36=1.99). For oestrogen-positive and progesterone-negative tumours, the OR doubled or more for each 10-year increase in exposure to monoaromatic hydrocarbons, and to acrylic and rayon fibres. The OR<36 also doubled for exposure to organic solvents that metabolise into reactive oxygen species, and to acrylic fibres. A threefold increase was found for oestrogen- and progesterone-positive tumours, with exposure to polycyclic aromatic hydrocarbons from petroleum sources.
Conclusion Certain occupational exposures appear to increase the risk of developing postmenopausal breast cancer, although some findings might be due to chance or to undetected bias. Our findings are consistent with the hypothesis that breast tissue is more sensitive to adverse effects if exposure occurs when breast cells are still proliferating. More refined analyses, adjusting for hormonal receptor subtypes and studies focusing on certain chemical exposures are required to further our understanding of the role of chemicals in the development of breast cancer.
- Breast neoplasms
- occupational exposure
- polycyclic hydrocarbons
- aromatic
- solvents
- synthetic fibres
- epidemiology
- Alkanes (C5-C17)
- alkanes with 5 to 17 carbon atoms
- alkanes (C18+)
- alkanes with 18 carbon atoms or more
- CI
- CI
- ER+
- oestrogen receptor positive
- ER-
- oestrogen receptor negative
- ICD-9
- International Classification of Diseases, 9th Revision
- MAHs
- monoaromatic hydrocarbons
- OR10-yr increase
- OR per 10-year increase of duration of exposure
- PAHs
- polycyclic aromatic hydrocarbons
- PR+
- progesterone receptor positive
- PR-
- progesterone receptor negative
Footnotes
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Funding Executive Director, Research Programs, Canadian Breast Cancer Research Alliance c/o Canadian Breast Cancer Foundation, 790 Bay Street, Suite 1000, Toronto, Canada ONM5G 1N8.
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Competing interests None.
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Ethics approval Ethics committee approval was granted by the Institutional Review Board of the Faculty of Medicine of McGill University, and by the ethics committees of the relevant hospitals.
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Provenance and peer review Not commissioned; externally peer reviewed.
