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Occupational exposures and risk of stomach cancer by histological type
  1. Miguel Santibañez1,2,3,
  2. Juan Alguacil4,5,
  3. Manuela García de la Hera6,
  4. Eva María Navarrete-Muñoz4,6,
  5. Javier Llorca1,4,7,
  6. Nuria Aragonés4,8,
  7. Timo Kauppinen9,
  8. Jesús Vioque4,6,
  9. for the PANESOES Study Group*
  1. 1IFIMAV-Fundación Marqués de Valdecilla, Santander, Spain
  2. 2Escuela Universitaria de Enfermería, Universidad de Cantabria, Santander, Spain
  3. 3Spanish Clinical Research Network (CAIBER), Spain
  4. 4CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
  5. 5Centro de Investigación en Salud y Medio Ambiente (CYSMA), Universidad de Huelva, Huelva, Spain
  6. 6Departamento de Salud Pública, Historia de la Ciencia y Ginecología, Universidad Miguel Hernandez, Elche-Alicante, Spain
  7. 7Departamento de Salud Pública, Universidad de Cantabria, Santander, Spain
  8. 8Área de Epidemiología Ambientaly Cáncer, Centro Nacional de Epidemiología, ISCIII, Madrid, Spain
  9. 9Finnish Institute of Occupational Health (FIOH), Helsinki, Finland
  1. Correspondence to Dr Miguel Santibañez, Research Support Unit, IFIMAV- Fundación Marqués de Valdecilla, 39011 Santander, Spain; ifimav.eclinicos2{at}


Objective To explore the relationship between stomach cancer (SC), by histological type, and occupations and occupational exposures.

Methods The authors conducted a hospital-based case–control study in south-east Spain. Subjects were 399 incident histological confirmed SC cases (241 intestinal and 109 diffuse adenocarcinomas) and 455 controls frequency matched by sex, age and province of residence. Occupation was coded according to the Spanish National Classification of Occupations 1994. Occupational exposures were assessed by the FINJEM Job Exposure Matrix. ORs were estimated by unconditional logistic regression adjusting for matching variables and education, smoking, alcohol and diet.

Results In men, statistically significant increased risk of the diffuse subtype was found for ‘cooks’ (OR 8.02), ‘wood-processing-plant operators’ (OR 8.13) and ‘food and related products machine operators’ (OR 5.40); for the intestinal subtype, a borderline association was found for ‘miners and quarry workers’ (OR men 4.22, 95% CI 0.80 to 22.14). Significant increased risk was observed between the diffuse subtype of SC and the highest level of exposure to ‘pesticides’ (ORH both sexes 10.39, 95% CI 2.51 to 43.02, ptrend=0.02) and between the intestinal subtype and asbestos (ORH men 3.71, 95% CI 1.40 to 9.83, ptrend=0.07). Restricted analyses of exposures of 15 years and longer showed significant associations between the diffuse subtype and the exposure to ‘wood dust’ (OR men 3.05).

Conclusions This study supports the relationship previously suggested between SC and occupational exposure to dusty and high temperature environments. Several occupations may also increase the risk of diffuse SC but not the intestinal subtype.

  • Stomach neoplasms
  • occupation
  • occupational exposures
  • dust
  • environment
  • case–control
  • epidemiology
  • occupational health practice
  • public health
  • cancer
  • meta-analysis
  • statistics
  • hygiene/occupational hygiene
  • exposure assessment
  • wood dust

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  • * 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-Mateo, 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.

  • Funding This work received financial support from the Spanish Ministry of Health (Instituto Salud Carlos III FIS 91/0435), the Generalitat Valenciana (CTGCA/2002/06; G03/136, EVES 030/2005), Fundación Bienvenida Navarro Luciano-Trípodi and Fundación Hospital Universitario de Elche (code 01/07).

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval As noticed in methods, the study was approved by the ethics committee of the participating hospitals, and patients gave their informed consent prior to their inclusion in the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.