Occupational exposures and risk of pancreatic cancer

Abstract

The objective was to analyze the relationship between occupation (and specific occupational exposures) and risk of exocrine pancreatic cancer (EPC). We conducted a multicenter hospitalbased case-control study in Eastern Spain. We included 161 incident cases of EPC (59.6% men, 94 with histological confirmation, of whom 80% had ductal adenocarcinoma). Cases were frequency-matched with 455 controls by sex, age and province of residence. Information was elicited using structured questionnaires. Occupations were coded according to the Spanish version of the International Standard Classification of Occupations 1988. Occupational exposure to a selection of carcinogenic substances was assessed with the Finnish Job-Exposure Matrix (FINJEM). Odds ratios (OR) and 95% confidence intervals (CI) were estimated by multiple logistic regression, adjusting for sex, age, province, education, alcohol and smoking. A higher risk of EPC was associated with having worked as "Miners, shotfirers, stone cutters and carvers", "Machinery mechanics and fitters", "Building trades workers" and "Motor vehicle drivers" in men, "Office Clerks" in women, and "Waiters" in both sexes. Cases with ductal adenocarcinomas were more likely to have been exposed to chlorinated hydrocarbon solvents (OR = 4.1, 95% CI: 1.1-15.2, p-trend = 0.04). We also observed significant associations with exposure to "synthetic polymer dust exposure" and "ionizing radiation". Suggestive increases in risk were observed for "pesticides", "diesel and gasoline engine exhaust", and "hydrocarbon solvents". Results support the hypothesis that occupational exposure to chlorinated hydrocarbon solvents is associated with exocrine pancreatic cancer. 5

Exposición laboral a hidrocarburos clorados y cáncer de páncreas: revisión de la bibliografía reciente

“…This appears to be associated with tobacco consumption and obesity, which may be modifiable risk factors, although there may be other factors concerning which there is no proven evidence that should be studied in order to also act on them. The high lethality of exocrine pancreatic cancer further underscores the need to identify risk factors suitable for primary prevention [1][2][3] .…”

“…The highest incidence and mortality rates of pancreatic cancer are found in developed countries, 3 the disease is rare in people under the age of 45, but the incidence increases rapidly thereafter.…”

“…Factors that probably cause moderate increase in risk include age, diabetes, chronic pancreatitis and obesity 2,3,7 . Mutation in the K-ras gene is the most common genetic alteration in pancreatic cancer 8,9 and this is the human tumor with the highest prevalence of K-ras mutations 9 .…”

“…3,4 traditionally occupations that have been associated with increased risk of pancreatic cancer include: printing and paper manufacturing, chemical, petroleum and rubber industries, transport, dry cleaning, leather tanning, transformer manufacturing plants, the production of pesticides, mechanic and metallurgical occupations, as well as miners, shotfires, stone cutters and carvers, machinery mechanics and fitters, building trades workers and motor vehicle drivers in men, office clerks in women and waiters in both sexes 1,3,7,10,11 . Other specific agents that might increase exocrine pancreatic cancer risk include asbestos and ionizing radiations 3,10,12 . Recently, some studies have tried to relate risk occupations, the type and amount of toxic, associated with the development of pancreatic cancer.…”

“…Chlorinated hydrocarbons solvents are probably the exposure that has been most consistently associated with pancreatic cancer 3 . These are a diverse group of organic molecules used in a variety of applications and products, such as solvents, pesticides, and plastics.…”