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Case–control study to assess the association between colorectal cancer and selected occupational agents using INTEROCC job exposure matrix
  1. Sonia El-Zaemey1,
  2. TN Anand1,2,
  3. Jane Shirley Heyworth2,
  4. Terry Boyle1,
  5. Martie van Tongeren3,
  6. Lin Fritschi1
  1. 1 School of Public Health, Curtin University, Perth, Western Australia, Australia
  2. 2 School of Population and Global Health, University of Western Australia, Crawley, Western Australia, Australia
  3. 3 Centre for Occupational and Environmental Health; Centre for Epidemiology; Division of Population Health, Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
  1. Correspondence to Dr Sonia El-Zaemey, School of Public Health, Curtin University, Perth, WA 6845, Australia; sonia.el-zaemey{at}


Background Colorectal cancer is the third most prevalent cancer in the world and is twice as common in developed countries when compared with low-income and middle-income countries. Few occupational risk factors for colorectal cancer have been identified. This case–control study aimed to assess the association between colorectal cancer and occupational exposure to selected solvents, combustion products, metals, dusts and other agents.

Methods Cases (n=918) were enrolled from the Western Australian Cancer Registry from June 2005 to August 2007. Controls (n=1021) were randomly selected from the Western Australian electoral roll. We collected lifetime occupational history from cases and controls, in addition to their demographic and lifestyle characteristics. We applied the INTEROCC job exposure matrix to convert the occupational history to occupational exposure for 18 selected agents. Three exposure indices were developed: (1) exposed versus non-exposed; (2) lifetime cumulative exposure; and (3) total duration of exposure. The associations between colorectal cancer and the selected agents were estimated using logistic regression models adjusting for sex and age.

Results None of the 18 selected agents showed an association with colorectal cancer. No dose–response relationships with lifetime cumulative exposure or duration of exposure were observed.

Conclusion There was no evidence to suggest that occupational exposure to 18 selected agents increased the risk of colorectal cancer.

  • colorectal cancer
  • INTEROCC job exposure matrix
  • occupational exposure assessment

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  • Contributors SEZ and ATN drafted the manuscript. SEZ conducted all the statistical analyses. LF directed the study and is responsible for its overall design. LF, JSH, TB and MvT contributed to the interpretation of data and provided feedback on the original and revised drafts of the manuscript. All authors have read and approved the submitted manuscript.

  • Funding This study was supported by the Australian National Health and Medical Research Council (project grant number 353568). LF is supported by fellowships from the NHMRC and Cancer Council Western Australia and TB is supported by a fellowship from the NHMRC (number 1072266).

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval This study received approval from the University of Western Australian Human Research Ethics Committee and the Confidentiality of Health Information Committee within the Western Australian Department of Health.

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