Occupational carcinogenic exposure is rarely about a single factor; rather, it involves a combination of factors (i.e, multiple exposures to chemical substances, radiations, and work related conditions) occurring at the same time or accumulating through occupational lifespan. However, few studies have attempted to consider occupational carcinogenic exposures (OCE) following a diachronic and cumulative approach. Therefore, the aim of this study was to develop a method to analyse OCE trajectories – regardless of the type of carcinogen involved – among patients diagnosed with mostly respiratory cancer.
We used data from the GISCOP93 permanent survey to describe OCE from a list of 54 carcinogens. Groups-based trajectory modelling (GBTM) performed with “PROC TRAJ” procedure (SAS.9.3) was used to estimate OCE trajectories patterns among 739 men and 132 women, separately. To ensure convergence, trajectories were modelled based on 6-months OCE’s average (mean number of carcinogens) from the patients first day to their last day at work. The range of career duration was set from 10 to 45 years.
Nine OCE trajectory groups were estimated among men that can be further gathered in four groups: unexposed (10.8%), constantly multi-exposed (2 groups at different levels of multi-exposure, 27.8%), multi-exposed decreasing (3 groups, 29.4%), increasing OCE trend (3 groups, 31.9%). Three OCE trajectory patterns were estimated among women: unexposed (47.7%), stable mono-exposed (38.6%), and middle career peak multi-exposed (13.7%). OCE trajectories in men and women were significantly associated with both jobs characteristics (main occupational activity and sector through occupational lifespan) and career changes (employment instability and discontinuity, job qualification).
This study suggests that the individual history of occupational carcinogenic exposures should also be taken into account as various lifelong exposure trajectories may have different impact on health.
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