Abstract

Several national and international initiatives were conducted to estimate or monitor current occupational carcinogenic exposures (OCE). However, older periods are usually less well documented. Moreover, both the methodological approaches used and the limited number of agents considered are likely to underestimate situations of multiple-exposure. The aim of this study was to characterise multiple OCE at the job level among patients with cancer.

We used data from the GISCOP93 permanent survey to describe OCE from a list of 54 carcinogens, separately for men and women. Associations between these exposures and jobs’ characteristics were assessed by using Poisson model with robust variance. Principal Component Analysis and Hierarchical Ascendant Classification were used to identify gendered patterns of multiple OCE.

Respectively 61.1% of men jobs (834 patients, 5202 jobs) and 26.7% of women jobs (183 patients, 885 jobs) were exposed to at least one carcinogen. Among exposed jobs, two-third were multiply-exposed (i.e. ≥ 2 OCE) in men (n = 2173) and 1/3 in women (n = 82). Among men, blue collars workers had an increased risk (factor of three to four) of OCE as compared to employees. Women working as blue collar workers in the metallurgy, confection and mechanics industries were also two to three times more often exposed to carcinogens than employees. Eight patterns of multiple OEC were identified in men’s jobs: multiple-exposures to widespread carcinogens, mixed silica dust, heavy metals/combustion products, organic compounds/radiations, metal working, solvents/heavy metals, wood dust/formaldehyde/pesticides, and fuels exhausts. Three patterns of multiple OCE were observed among women’s jobs: biological/organic compounds, industrial working, and fuels exhausts.

These results based on a study considering cancer as a sentinel event highlight evidence of a gendered pattern in multiple OCE, inconsistent with the criteria in use among the occupational disease compensation system based on a single-factor approach of carcinogenesis.