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| 2. |
- Lynge, E, et al.
(författare)
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Cancer in persons working in dry cleaning in the Nordic countries
- 2006
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Ingår i: Environmental Health Perspectives. - : Environmental Health Perspectives. - 1552-9924 .- 0091-6765. ; 114:2, s. 213-219
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Tidskriftsartikel (refereegranskat)abstract
- U.S. studies have reported an increased risk of esophageal and some other cancers in dry cleaners exposed to tetrachloroethylene. We investigated whether the U.S. findings could be reproduced in the Nordic countries using a series of case-control studies nested in cohorts of laundry and dry-cleaning workers identified from the 1970 censuses in Denmark, Norway, Sweden, and Finland. Dry-cleaning work in the Nordic countries during the period when tetrachloroethylene was the dominant solvent was not associated with an increased risk of esophageal cancer [rate ratio (RR) = 0.76; 95% confidence interval (CI), 0.34-1.69], but our study was hampered by some unclassifiable cases. The risks of cancer of the gastric cardia, liver, pancreas, and kidney and non-Hodgkin lymphoma were not significantly increased. Assistants in dry-cleaning shops had a borderline significant excess risk of cervical cancer not found in women directly involved in dry cleaning. We found an excess risk of bladder cancer (RR = 1.44; 95% CI, 1.07-1.93) not associated with length of employment. The finding of no excess risk of esophageal cancer in Nordic dry cleaners differs from U.S. findings. Chance, differences in level of exposure to tetrachloroethylene, and confounding may explain the findings. The overall evidence on bladder. cancer in dry cleaners is equivocal.
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| 4. |
- Duffy, S W, et al.
(författare)
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Complexities in the estimation of overdiagnosis in breast cancer screening.
- 2008
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Ingår i: British journal of cancer. - : Springer Science and Business Media LLC. - 1532-1827 .- 0007-0920. ; 99:7, s. 1176-1178
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Tidskriftsartikel (refereegranskat)abstract
- There is interest in estimating and attributing temporal changes in incidence of breast cancer in relation to the initiation of screening programmes, in particular to estimation of overdiagnosis of breast cancer as a result of screening. In this paper, we show how screening introduces complexities of analysis and interpretation of incidence data. For example, lead time brings forward time- and age-related increases in incidence. In addition, risk factors such as hormone replacement therapy use have been changing contemporaneously with the introduction of screening. Although we do not indicate exactly how such complexities should be corrected for, we use some simple informal adjustments to show how they may account for a substantial proportion of increased incidence, which might otherwise erroneously have been attributed to overdiagnosis. We illustrate this using an example of analysis of breast cancer incidence data from Sweden.
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| 5. |
- Johansen, K, et al.
(författare)
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Use of history science methods in exposure assessment for occupational health studies
- 2005
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1470-7926 .- 1351-0711. ; 62:7, s. 434-441
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Tidskriftsartikel (refereegranskat)abstract
- Aims: To show the power of history science methods for exposure assessment in occupational health studies, using the dry cleaning industry in Denmark around 1970 as the example. Methods: Exposure data and other information on exposure status were searched for in unconventional data sources such as the Danish National Archives, the Danish Royal Library, archives of Statistics Denmark, the National Institute of Occupational Health, Denmark, and the Danish Labor Inspection Agency. Individual census forms were retrieved from the Danish National Archives. Results: It was estimated that in total 3267 persons worked in the dry cleaning industry in Denmark in 1970. They typically worked in small shops with an average size of 3.5 persons. Of these, 2645 persons were considered exposed to solvents as they were dry cleaners or worked very close to the dry cleaning process, while 622 persons were office workers, drivers, etc in shops with 10 or more persons. It was estimated that tetrachloroethylene constituted 85% of the dry cleaning solvent used, and that a shop would normally have two machines using 4.6 tons of tetrachloroethylene annually. Conclusion: The history science methods, including retrieval of material from the Danish National Archives and a thorough search in the Royal Library for publications on dry cleaning, turned out to be a very fruitful approach for collection of exposure data on dry cleaning work in Denmark. The history science methods proved to be a useful supplement to the exposure assessment methods normally applied in epidemiological studies.
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| 6. |
- Lutz, JM, et al.
(författare)
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Occupational risks for uveal melanoma results from a case-control study in nine European countries
- 2005
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Ingår i: Cancer Causes and Control. - : Springer Science and Business Media LLC. - 1573-7225 .- 0957-5243. ; 16:4, s. 437-447
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Tidskriftsartikel (refereegranskat)abstract
- Objective Uveal melanoma is a rare disease with poor prognosis and largely unknown etiology. We studied potential occupational risk factors. Methods A population based case-control study was undertaken during 1995-1997 in nine European countries using population and colon cancer controls with personal interviews. Occupational exposure to sunlight and artificial UV radiation was assessed with a job exposure matrix. In total, 320 uveal melanoma cases were eligible at pathology review, and 292 cases were interviewed, participation 91%. Out of 3357 population controls, 2062 were interviewed, 61%, and out of 1272 cancer controls 1094 were interviewed, 86%. Results Using population controls, occupational exposure to sunlight was not associated with an increased risk (RR=1.24, 95% CI=0.88-1.74), while an excess risk found with use of colon cancer controls was attributed to confounding factors. An excess risk in welders was restricted to the French part of the data. Cooks, RR=2.40; cleaners, RR 2.15; and laundry workers, RR=3.14, were at increased risk of uveal melanoma. Conclusion Our study does overall not support an association between occupational sunlight exposure and risk of uveal melanoma. The finding of an excess risk of eye melanoma in cooks in several European countries is intriguing.
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| 7. |
- Lynge, E, et al.
(författare)
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European multi-centre case-control study on risk factors for rare cancers of unknown aetiology
- 2005
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 1879-0852 .- 0959-8049. ; 41:4, s. 601-612
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Tidskriftsartikel (refereegranskat)abstract
- To search for occupational risk factors, we conducted a case-control study in nine European countries of cancers of the small intestine, male gall bladder, thymus, bone, male breast, melanoma of the eye, and mycosis fungoides. Recruitment was population based in Denmark, Latvia, France, Germany, Italy, and Sweden, from hospital areas in Spain and Portugal, and from one United Kingdom (UK) hospital. We recruited 1457 cases (84% interviewed). Numbers identified corresponded to those in the EUROCIM database for Denmark, but were below those observed for France, Italy and Sweden in the database. We recruited 3374 population (61% interviewed) and 1284 colon cancer controls (86% interviewed). It was possible to undertake this complicated study across Europe, but we encountered three main problems. It was difficult to ensure complete case ascertainment, for population controls, we found a clear divide in the response rate from 75% in the South to only 55% in the North, and a somewhat selective recruitment was noted for the colon cancer controls. The study showed there is a clear dose-response relationship between alcohol intake and the risk of male breast cancer, and an excess risk of mycosis fungoides among glass formers, pottery and ceramic workers. Further data are expected.
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| 8. |
- McLean, D., et al.
(författare)
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Cancer mortality in workers exposed to organochlorine compounds in the pulp and paper industry : An international collaborative study
- 2006
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Ingår i: Journal of Environmental Health Perspectives. - : Environmental Health Perspectives. - 0091-6765 .- 1552-9924. ; 114:7, s. 1007-1012
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Tidskriftsartikel (refereegranskat)abstract
- The objective of this study was to evaluate cancer mortality in pulp and paper industry workers exposed to chlorinated organic compounds. We assembled a multinational cohort of workers employed between 1920 and 1996 in 11 countries. Exposure to both volatile and nonvolatile organochlorine compounds was estimated at the department level using an exposure matrix. We conducted a standardized mortality ratio (SMR) analysis based on age and calendar-period-specific national mortality rates and a Poisson regression analysis. The study population consisted of 60,468 workers. Workers exposed to volatile organochlorines experienced a deficit of all-cause [SMR = 0.91, 95% confidence interval (CI), 0.89-0.93] and all-cancer (SMR = 0.93, 95% CI, 0.89-0.97) mortality, with no evidence of increased risks for any cancer of a priori interest. There was a weak, but statistically significant, trend of increasing risk of all-cancer mortality with increasing weighted cumulative exposure. A similar deficit in all-cause (SMR = 0.94, 95% CI, 0.91-0.96) and all-cancer (SMR = 0.94, 95% CI, 0.89-1.00) mortality was observed in those exposed to nonvolatile organochlorines. No excess risk was observed in cancers of a priori interest, although mortality from Hodgkin disease was elevated (SMR = 1.76, 95% CI, 1.02-2.82). In this study we found little evidence that exposure to organochlorines at the levels experienced in the pulp and paper industry is associated with an increased risk of cancer, apart from a weak but significant association between all-cancer mortality and weighted cumulative volatile organochlorine exposure.
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