Occupational exposures as risk factors for gastric cancer in Italy

Cocco, Pierluigi; Palli, Domenico; Buiatti, Eva; Cipriani, Francesco; Decarli, Adriano; Manca, P; Ward, Mary H.; Blot, William J.; Fraumeni, Joseph F.

doi:10.1007/bf01830243

Cited by 49 publications

(37 citation statements)

References 42 publications

(8 reference statements)

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“…In a recent Norwegian study, a possibly increased risk of gastric cancer was found among lighthouse keepers who drank water highly contaminated with asbestos, 55 and similar weak positive associations with gastric cancer have been reported from other studies of workers exposed to asbestos. [56][57][58][59][60] In other investigations, however, no such association has been found. 35,[61][62][63] The lack of association between exposure to asbestos and risk of gastric cancer in our study further argues against influence of airborne asbestos in the etiology of gastric cancer.…”

Section: Discussionmentioning

confidence: 78%

Airborne exposures and risk of gastric cancer: A prospective cohort study

Sjödahl

Jansson

Bergdahl

et al. 2007

Intl Journal of Cancer

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There is an unexplained male predominance among patients with gastric cancer, and many carcinogens are found in maledominated dusty occupations. However, the relation between occupational exposures and risk of gastric cancer remains unclear. To investigate whether airborne occupational exposures might influence the risk of noncardia gastric cancer, we used a large, prospective cohort study of male Swedish construction workers. These workers were, during the period 1971-1993, regularly invited to health examinations by a nationwide occupational health service organization. Data on job titles and other variables were collected through self-administered questionnaires and forms completed by the health organization's staff. Industrial hygienists assessed 12 specific airborne occupational exposures for 200 job titles. Gastric cancer, death or emigration occurring during follow-up in 1971-2002 were identified by linkage to the Swedish registers of Cancer, Causes of Death and Total Population, respectively. Incidence rate ratios (IRR) and 95% confidence intervals (CI), adjusted for attained age, tobacco smoking, calendar period and body mass, were derived from Cox regression. Among 256,357 cohort members, contributing 5,378,012 person-years at risk, 948 noncardia gastric cancers were identified. Increased risk of this tumor was found among workers exposed to cement dust (IRR 1.5 [95% CI 1.1-2.1]), quartz dust (IRR 1.3 [95% CI 1.0-1.7]) and diesel exhaust (IRR 1.4 [95% CI 1.1-1.9]). Doseresponse relations were observed for these exposures. No consistent positive associations were found regarding exposure to asbestos, asphalt fumes, concrete dust, epoxy resins, isocyanates, metal fumes, mineral fibers, organic solvents or wood dust. In conclusion, this study provides some support to the hypothesis that specific airborne exposures increase the risk of noncardia gastric cancer. ' 2007 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 78%

Airborne exposures and risk of gastric cancer: A prospective cohort study

Sjödahl

Jansson

Bergdahl

et al. 2007

Intl Journal of Cancer

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“…In case of gastric cancer, we included farming work that involved exposure to herbicides (116) and also grain and animal dust as a risk factor. A dusty work environment in many other occupations has been linked with a risk of gastric cancer (117,118). The Montreal study (113) also reported an elevated risk of gastric cancer for specific workplace dusts (grain dust, lead dust, and zinc dust).…”

Section: Criteria Used For Selecting the Studiesmentioning

confidence: 99%

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland

Nurminen¹,

Karjalainen²

2001

Scand J Work Environ Health

260

202

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Objectives This study attempts to estimate the proportion of annual deaths related to occupational factors in Finland and considers related methodological issues and associated uncertainties.Methods Statistics on causes of death, numbers of subjects exposed, and risk ratios obtained from the epidemiologic literature were used to estimate the population attributable fraction and disease burden for causes of death from work-related diseases. Gender-, age-and disease-specific numbers of deaths were provided by Statistics Finland for 1996. Information on the size of the population, broken down by gender, age, occupation, and industry, was acquired from population censuses. A Finnish job-exposure matrix supplied data on the prevalence of exposure for specific agents and the level of exposure among exposed workers. ResultsThe attributable fraction of work-related mortality in the relevant disease and age categories was estimated to be 7% (10% for men and 2% for women), and for all diseases and ages the fraction was 4%. For the main cause-of-death categories, the attributable fraction became 12% for circulatory system diseases, 8% for malignant neoplasms, 4% for respiratory system diseases, 4% for mental disorders, 3% for nervous system diseases, and 3% for accidents and violence. The following estimates were obtained for specific important diseases: 24% for lung cancer, 17% for ischemic heart disease, 12% for chronic obstructive pulmonary disease, and 11% for stroke. Based on these fractions, the total number of work-related deaths that occurred in Finland in 1996 was calculated to be on the order of 1800 (employed work force of 2.1 million); 86% involved men.Conclusions High-quality epidemiologic studies and national survey data are essential for obtaining reliable estimates of the proportion of deaths attributable to occupational factors. The magnitude of work-related mortality is an insufficiently recognized contributor to total mortality in Finland, especially from circulatory diseases and other diseases caused by exposure to agents other than asbestos.Key terms attributable fraction, burden of disease, epidemiologic methods, health statistics, occupational exposure. Global estimates of the burden of disease due to occupational factors have been calculated through the application of Finnish rates of registered work-related diseases (1). The approach is subject to the following two fundamental uncertainties: (i) the validity of the data on disease incidence from the national reporting scheme and (ii) the validity of worldwide extrapolations to different regions with different exposure circumstances. With the exception of studies using workers' compensation records, only a few research projects have estimated the magnitude of morbidity or mortality induced by exposure to hazardous agents or stress factors in the work environment at a state or national level. The investigations conducted in this area have covered New York State (2), the whole of the United States (3), Canada (4), and Australia (5). Given the lack of ...

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“…Low social class and unhealthy dietary habits are the main risk factors for stomach cancer, with occupational factors playing a minor role, if any (27). Farmers have been considered at risk, and a role of pesticide exposure has been postulated (27)(28)(29). However, no specific agricultural exposure has been identified and the rural association may have resulted from confounding by lifestyle habits associated with rural residence (29).…”

Section: Discussionmentioning

confidence: 99%

“…Farmers have been considered at risk, and a role of pesticide exposure has been postulated (27)(28)(29). However, no specific agricultural exposure has been identified and the rural association may have resulted from confounding by lifestyle habits associated with rural residence (29). We adjusted for ethnicity to partially control for differences in education and dietary habits between the unexposed, who more frequently were from non-Sardinian origin, and the exposed subcohorts.…”

Section: Discussionmentioning

confidence: 99%

Cancer Mortality among Men Occupationally Exposed to Dichlorodiphenyltrichloroethane

et al. 2005

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Several studies have evaluated cancer risk associated with occupational and environmental exposure to dichlorodiphenyltrichloroethane (DDT). Results are mixed. To further inquire into human carcinogenicity of DDT, we conducted a mortality follow-up study of 4,552 male workers, exposed to DDT during antimalarial operations in Sardinia, Italy, conducted in 1946Italy, conducted in to 1950. Detailed information on DDT use during the operations provided the opportunity to develop individual estimates of average and cumulative exposure. Mortality of the cohort was first compared with that of the Sardinian population. Overall mortality in the cohort was about as expected, but there was a deficit for death from cardiovascular disease and a slight excess for nonmalignant respiratory diseases and lymphatic cancer among the unexposed subcohort. For internal comparisons, we used Poisson regression analysis to calculate relative risks of selected malignant and nonmalignant diseases with the unexposed subcohort as the reference. Cancer mortality was decreased among DDT-exposed workers, mainly due to a reduction in lung cancer deaths. Birth outside from the study area was a strong predictor of mortality from leukemia. Mortality from stomach cancer increased up to 2-fold in the highest quartile of cumulative exposure (relative risk, 2.0; 95% confidence interval, 0.9-4.4), but no exposure-response trend was observed. Risks of liver cancer, pancreatic cancer, and leukemia were not elevated among DDT-exposed workers. No effect of latency on risk estimates was observed over the 45 years of follow-up and within selected time windows. Adjusting risks by possible exposure to chlordane in the second part of the antimalarial operations did not change the results. In conclusion, we found little evidence for a link between occupational exposure to DDT and mortality from any of the cancers previously suggested to be associated. (Cancer Res 2005; 65(20): 9588-94)

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Occupational exposures as risk factors for gastric cancer in Italy

Cited by 49 publications

References 42 publications

Airborne exposures and risk of gastric cancer: A prospective cohort study

Airborne exposures and risk of gastric cancer: A prospective cohort study

Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland

Cancer Mortality among Men Occupationally Exposed to Dichlorodiphenyltrichloroethane

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