Occupational factors and risk of adult bone sarcomas: A multicentric case‐control study in Europe

Abstract

We investigated the association between occupational factors and risk of bone sarcoma, a rare tumor with a largely unknown aetiology. A multicentric case-control study was conducted in 7 European countries in 1995-97. Ninety-six cases aged 35-69 years with a centrally reviewed diagnosis of bone sarcoma (68 chondrosarcomas and 28 osteosarcomas) were compared to 2,632 population (68%) or colon cancer (32%) controls. Subjects were interviewed to obtain information on occupational, medical and reproductive history, smoking and alcohol consumption and selected exposures including use of pesticides. Response proportions were 90% among cases and 66% among controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated for selected categories of job titles and branches of industry and for use of pesticides. We found an increased OR for bone sarcoma among blacksmiths, toolmakers, machine-tool operators (OR 5 2.14, 95% CI 1.08-4.26), woodworkers (OR 5 2.68, 95% CI 1.36-5.29) and construction workers (OR 5 1.62, 95% CI 0.92-2.87). Ever users of pesticide had an OR of 2.33 (95% CI 1.31-4.13), with similar risks for exposure to insecticides and exposure to herbicides. Neither duration of employment in any of the analyzed occupational categories nor duration of use of pesticides showed an increasing trend in the risk of bone sarcoma. ORs of bone sarcoma were 1.03 (95% CI 0.23-4.57), 3.13 (95% CI 1.26-7.76) and 1.44 (95% CI 0.43-4.85) for the first, second and third tertile of days of use of pesticides. Our study suggests that novel and previously reported (woodworking) occupational factors play a role in the aetiology of bone sarcomas. ' 2005 Wiley-Liss, Inc.Key words: adult bone sarcomas; occupational risk factors; pesticides; woodworkers; multicentric case-control study Adult bone sarcoma is a rare tumor with an age-standardized incidence of less than 1 per 100,000 inhabitants in Europe. 1 It includes 2 distinct morphologies, osteosarcomas and chondrosarcomas, with different age distributions. The incidence of chondrosarcoma increases with age, whereas osteosarcomas have a bimodal distribution, with a first peak in adolescence and a second peak in the seventh-eighth decade of life. 2 A third type of bone sarcoma, Ewing's sarcoma, is mainly a childhood tumor.Little is known about bone sarcoma etiology. Radiation and chemotherapy, some rare skeletal syndromes and possibly Paget's disease and tall stature have been suggested to be associated with an increased risk. [2][3][4][5][6] Occupational carcinogens are candidate causal factors in bone sarcoma aetiology, as rare cancers may be caused by rare exposures. Irrespective of the morphology, bone sarcoma is more common in men than in women, and some bone sarcomas have an age of onset that could suggest an occupational aetiology. An excess risk of bone sarcoma has been found among biomedical researchers, 7 some types of woodworkers, [8][9][10][11] workers employed in the oil refinery industry 12 and copper smelter workers exposed to arsenic. 13 With the exception of ...

Socioeconomic factors and the risk for sarcoma

“…Although abundant literature exists on occupational risk factors for sarcoma (Wingren et al, 1990;Kogevinas et al, 1995;Hoppin et al, 1998;Merletti et al, 2006), little is known about the role of socioeconomic indicators, such as education and income, in determining the risk for sarcoma. Education level has been established as a risk factor for many other cancers.…”

“…The rarity and heterogeneity of sarcoma limits thorough evaluation of its risk factors (Burningham et al, 2012). Most epidemiological studies on sarcoma have focused on occupational risk factors such as exposure to herbicides, pesticides, chemicals, and asbestos, although the findings have been inconsistent (Wingren et al, 1990;Serraino et al, 1992;Hoppin et al, 1998Hoppin et al, , 1999Zahm and Ward, 1998;Merletti et al, 2006). Some reports have also suggested smoking, tobacco chewing, and BMI as being associated with sarcoma (Zahm et al, 1989(Zahm et al, , 1992Tavani et al, 1999).…”

Management of osteosarcoma

“…occupations [2]. The peak incidence of osteosarcoma in adolescence suggests a link to dysregulation of bone growth.…”

Case-Control Study on Occupational Risk Factors for Soft-Tissue Sarcoma

“…Details of this questionnaire were described elsewhere. 2 Merletti et al 21 found an increased risk of bone sarcoma with machinetool operators, which could be a similar type of occupation to machinist. Among the variables included in the personal medical history section of the questionnaire, cancer among the firstdegree relatives of adults seemed to be a significant risk factor for developing STS.…”