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Examining lung cancer risks across different industries and occupations in Ontario, Canada: the establishment of the Occupational Disease Surveillance System
  1. James K H Jung1,2,
  2. Saul G Feinstein1,
  3. Luis Palma Lazgare1,
  4. Jill S Macleod1,
  5. Victoria H Arrandale1,2,
  6. Christopher B McLeod3,
  7. Alice Peter4,
  8. Paul A Demers1,2,3
  1. 1Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, Ontario, Canada
  2. 2Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  3. 3School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4Population Health and Prevention, Cancer Care Ontario, Toronto, Ontario, Canada
  1. Correspondence to Dr Paul A Demers, Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON M5G 2L3, Canada; Paul.Demers{at}


Background The Occupational Disease Surveillance System (ODSS) was established in Ontario, Canada by linking a cohort of workers with data created from Workplace Safety and Insurance Board (WSIB) claims to administrative health databases. The aim of this study was to use ODSS to identify high-risk industry and occupation groups for lung cancer in Ontario.

Methods Workers in the WSIB lost time claims database were linked to the Ontario Cancer Registry using subjects’ health insurance numbers, name, sex, birthdate and death date (if applicable). Several occupations and industries known to be at increased risk were outlined a priori to examine whether ODSS could replicate these associations. Age-adjusted, sex-stratified Cox proportional hazard models compared the risk of lung cancer within one industry/occupation versus all other groups in the cohort. Workers with a lung cancer diagnosis prior to cohort entry were excluded for analysis, leaving 2 187 762 workers for analysis.

Results During the 1983 to 2014 follow-up, 34 661 workers in the cohort were diagnosed with lung cancer. Among expected high-risk industries, elevated risks were observed among workers in quarries/sand pits and construction industries for both sexes, and among males in metal mines, iron foundries, non-metallic mineral products industries and transportation industries. Excess risk was also observed among occupations in drilling/blasting, other mining/quarrying, mineral ore treating, excavating/grading/paving, truck driving, painting, bus driving and construction.

Conclusions This current surveillance system identified several established high-risk groups for lung cancer and could be used for ongoing surveillance of occupational lung cancer in Ontario.

  • lung cancer
  • occupational exposure
  • occupational disease
  • health surveillance
  • ontario

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  • Contributors JKHJ drafted the manuscript, interpreted the findings and produced the figures/tables. SGF assisted in the manuscript writing and provided methodological expertise regarding the development of ODSS. JKHJ, LPL and JSM conducted the analyses. PAD, VHA, CBM and AP provided expertise in occupational health and administrative health data. PAD performed the selection of the a priori groups, conceived the study and provided overall supervision. All authors assisted in editing the manuscript.

  • Funding This project was funded by the Ministry of Labour (no 14-R-29) and the Public Health Agency of Canada (no 1516-HQ-000066). The Occupational Cancer Research Centre is supported from core funding from the Canadian Cancer Society and the Ontario Ministry of Labour.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval Health Sciences Research Ethics Board, University of Toronto.

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

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