Background: Percent breast density (PBD) is a strong risk factor for breast cancer that is influenced by several other risk factors for the disease. Alcohol consumption is associated with an increased risk of breast cancer with an uncertain association with PBD. We have carried out a systematic review and metaanalysis to examine the association of alcohol consumption with PBD.Methods: We searched nine databases to identify all relevant studies on the association between alcohol intake and breast density. Two independent investigators evaluated and selected 20 studies that were included in our analyses. We divided the studies into three groups according to the methods used to measure and analyze the association of breast density with alcohol consumption.
Due to the way occupational exposure limits (OELs) are set in Canada, workers across the country are not equally and adequately protected from harmful workplace exposures. This disparity is illustrated in the case of exposure to diesel engine exhaust (DEE). Based on the findings of a recent pan-Canadian and international scan of OELs for DEE, we recommend that Canada overcome these current disparities by moving towards harmonized, evidence-based OELs. To achieve this, Canada should adopt a centralized framework for setting OELs that considers the most recent scientific evidence as well as feasibility of implementation in the Canadian context. We assert that harmonizing OELs across Canada would allow for expertise and resources to be consolidated and is a crucial step to ensuring that all workers are consistently protected from harmful workplace exposures.
Objectives
Diesel engine exhaust (DEE) is a known lung carcinogen and a common occupational exposure in Canada. The use of diesel-powered equipment in the construction industry is particularly widespread, but little is known about DEE exposures in this work setting. The objective of this study was to determine exposure levels and identify and characterize key determinants of DEE exposure at construction sites in Ontario.
Methods
Elemental carbon (EC, a surrogate of DEE exposure) measurements were collected at seven civil infrastructure construction worksites and one trades training facility in Ontario using NIOSH method 5040. Full-shift personal air samples were collected using a constant-flow pump and SKC aluminium cyclone with quartz fibre filters in a 37-mm cassette. Exposures were compared with published health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03 µg m−3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5 µg m−3 respirable EC). Mixed-effects linear regression was used to identify determinants of EC exposure.
Results
In total, 149 EC samples were collected, ranging from <0.25 to 52.58 µg m−3 with a geometric mean (GM) of 3.71 µg m−3 [geometric standard deviation (GSD) = 3.32]. Overall, 41.6% of samples exceeded the FIOH limit, mostly within underground worksites (93.5%), and 90.6% exceeded the DECOS limit. Underground workers (GM = 13.20 µg m−3, GSD = 1.83) had exposures approximately four times higher than below grade workers (GM = 3.56 µg m−3, GSD = 1.94) and nine times higher than above ground workers (GM = 1.49 µg m−3, GSD = 1.75). Training facility exposures were similar to above ground workers (GM = 1.86 µg m−3, GSD = 4.12); however, exposures were highly variable. Work setting and enclosed cabins were identified as the key determinants of exposure in the final model (adjusted R2 = 0.72, P < 0.001). The highest DEE exposures were observed in underground workplaces and when using unenclosed cabins.
Conclusions
This study provides data on current DEE exposure in Canadian construction workers. Most exposures were above recommended health-based limits, albeit in other jurisdictions, signifying a need to further reduce DEE levels in construction. These results can inform a hazard reduction strategy including targeted intervention/control measures to reduce DEE exposure and the burden of occupational lung cancer.
Introduction: Diesel engine exhaust (DEE) is a known carcinogen and a common occupational exposure in Canada, particularly within construction. The use of diesel-powered equipment in the construction industry is widespread, but little is known about DEE exposures and occupational disease in this work setting. The objective of this study was to characterize and identify key determinants of DEE exposure at construction sites in Ontario.
Methods: Diesel particulate matter (DPM) measurements were taken from workers employed on seven infrastructure construction worksites in Ontario. Full-shift personal air samples were collected from workers using a constant-flow pump and SKC aluminum cyclone with 37-mm quartz fibre filters in an open-faced cassette. Samples were analyzed for elemental carbon (EC), a surrogate of DEE exposure, following NIOSH method 5040. Exposures were compared to recommended health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03µg/m3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5µg/m3 respirable EC). A determinants of exposure model was constructed.
Results: In total, 126 DPM samples were collected, ranging from <0.47-52.58µg/m3 with a geometric mean (GM) of 4.23µg/m3 (geometric standard deviation (GSD)=3.05). Overall, 44.8% of samples exceeded the FIOH limit, mostly within underground worksites (93.5%), and 88.8% exceeded the DECOS limit. Underground workers (GM=13.20µg/m3, GSD=1.83) had exposures approximately 4-times higher than below grade workers (GM=3.56µg/m3, GSD=1.94) and 9-times higher than aboveground workers (GM=1.49µg/m3, GSD=1.75). Work grade, enclosed cabs, and seasonality were identified as the major determinants of exposure.
Conclusions: This study provides a better understanding of current DPM exposure in Canadian construction. Most exposures were above recommended health-based limits, signifying a need to further reduce DPM levels in construction. These results can inform a hazard reduction strategy including a new occupational exposure limit and targeted intervention/control measures to reduce DPM exposure and the burden of occupational cancer.
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