Health hazards and cancer in relation to occupational exposures among Swedish seafarers

• This thesis explores health hazards for seafarers in the Swedish merchant fleet, and occupational risks for lung cancer, mesothelioma and hematologic malignancy (HM). A special focus has been exposure to benzene and biomarker levels for work on product or chemical tankers during the mid-1990’ies.In a case report, we describe two cases of mesothelioma and two cases of lung cancer having worked in the engine room. Cumulative exposure to asbestos were up to 5 fibreyears. Other exposures were carcinogenic PAHs and nitroarenes. A web-based survey to active seafarers in the Swedish merchant fleet revealed noise, the risk of accidents, whole-body vibrations and ergonomic strain as main work environment problems. General health, work ability and safety climate were all rated high. Associations were found between lower airway symptoms and soot (PR 2.4, 95% CI 1.1-5.1) and between hearing impairment and noise exposure (PR 1.5; 95% CI 1.3–1.7). Iso-strain was especially common in the service department. Twenty-two percent of men and 45% of women had been subjected to harassments. The tanker study showed a geometric mean for benzene exposure of 0.45 mg/m3 (4hTWA) during a work shift, with a wide range (0.02-143 mg/m3). Correlations were found between exposure and benzene in alveolar air (p<0.0001), unmetabolised benzene in urine (p<0.0001) and ttMA in urine (p=0.0011). All biomarkers increased significantly during work (p<0.002). In a case-referent study with the observation period 1985 to 2014, the OR for HM was 1.32 (95% CI 0.86-2.02) if work on tankers had started before 1985 and with a cumulated tanker service of at least five years. If work on tankers had started after 1985, the OR was 0.85 (95% CI 0.51-1.43).In conclusion, health hazards in today’s seafaring relate to physical, chemical and psychosocial factors. Work on tankers with mixed open and closed cargo systems might have led to important benzene up-take. Possibly, the risk for HM for seafarers on tankers has decreased during the last decades.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Arbetsmedicin och miljömedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Occupational Health and Environmental Health (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Allmänmedicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- General Practice (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Hälsovetenskap -- Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Health Sciences -- Public Health, Global Health, Social Medicine and Epidemiology (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

seafarer

work environment

mesothelioma

lung cancer

hematologic malignancy

benzene

epidemiologi

Epidemiology

Toxicology

toxikologi

family medicine

allmänmedicin

seafarer

work environment

mesothelioma

lung cancer

hematologic malignancy

benzene

Publikations- och innehållstyp

vet (ämneskategori)

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