Article Text
Abstract
Objective To explore the relationship between occupation and Esophageal Adenocarcinoma, Barrett’s Oesophagus, and Reflux Esophagitis.
Methods In an all-Ireland case-control study, the FINBAR study, occupational information was collected in 224 out of 227 (98.7%) patients with Esophageal Adenocarcinoma; 222 out of 224 (99.1%) patients with long-segment Barrett’s Oesophagus; 229 out of 230 (99.6%) Reflux Esophagitis, and 256 out of 260 (98.5%) controls. The reported occupations were coded according to the Finnish Classification of Occupations and then translated into the Nordic Occupational Cancer Project (NOCCA) occupational categories. Occupational exposures were assessed by the FinJEM job exposure matrix. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression adjusting for sex; age; location (Northern Ireland versus Republic of Ireland); educational level; alcohol drinking, tobacco smoking; total energy intake and fruits and vegetable consumption; and Body Mass Index.
Results A statistically significant increased risk of Esophageal Adenocarcinoma (OR 4.71, 95% CI: 1.14 to 19.40) and Barrett’s Oesophagus (OR 6.97, 95% CI: 1.85 to 26.21) was found for ‘Packers’. A significant association was found for ‘manual handling of burdens’ as assessed by FinJEM and Barrett’s Oesophagus (OR 1.65, 95% CI: 1.03 to 2.63). Suggestive crude associations were found for Esophageal Adenocarcinoma (OR crude 1.82, 95% CI: 1.20 to 2.77) and Reflux Esophagitis (OR crude 1.46, 95% CI: 0.98 to 2.17) but these associations diminished after adjusting in the multivariable models: Barrett’s Oesophagus (OR 1.45, 95% CI: 0.88 to 2.38), Reflux Esophagitis (OR 1.38, 95% CI: 0.78 to 2.46).
Conclusions The data suggest that some occupations involved in ergonomic factors (physiological factors) associated to an increase of the intraabdominal pressure, could increase the risk of Esophageal Adenocarcinoma, Barrett’s Oesophagus and Reflux Esophagitis, but further research is needed to confirm results.