Objetive: To explore the relationship between occupations and specific occupational exposures and oesophageal cancer (OC) by histological type.
Methods: We conducted a multicentre hospital-based case-control study in two Mediterranean provinces of Spain. Occupational, sociodemographic and lifestyle information was collected from 185 newly diagnosed male esophageal cancer cases (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 drinking 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, we found a statistically significant increase in risk of squamous cell OC for 'Ionizing 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, we found a three-fold increase in risk with a significant trend for asbestos exposure (OR= 3.46, 95%CI 0.99 to 12.10).
Conclusions: Our data suggest that occupational exposure does not seem to play a major role in OC in Spain. Some occupational exposures may specifically increase the risk of oesophageal squamous cell cancer or adenocarcinoma while other exposures may increase the risk of all OC types.
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