Effects of occupation on risks of avoidable cancers in the Nordic countries

doi:10.1016/j.ejca.2010.07.038

European Journal of Cancer

Volume 46, Issue 14, September 2010, Pages 2545-2554

https://doi.org/10.1016/j.ejca.2010.07.038 Get rights and content

Abstract

Knowledge of cancer risk according to occupational affiliation is an essential part of formatting preventive actions aimed at the adult population. Herein, data on 10 major cancer sites amenable by life style exposures from the Nordic Occupational Cancer Study (NOCCA) are presented. All subjects aged 30–64 years participating in one or more national censuses in Denmark, Finland, Iceland, Norway, or Sweden between 1960 and 1990 were included in the cohort and followed up for cancer from inclusion until 2003/2005 via a linkage with the national cancer registries, and standardised incidence ratios (SIRs) were computed. Variation in risk across occupations was generally larger in men than in women. In men, the most consistent cluster with high risk of numerous cancer types included waiters, cooks and stewards, beverage workers, seamen, and chimney sweeps. Two clusters of occupations with generally low cancer risks were seen in both men and women. The first one comprised farmers, gardeners, and forestry workers, the second one included groups with high education, specifically those in health and pedagogical work. Although cancer risk varies by occupation, only a smaller part of the variation can be attributed to occupational exposures in the strict sense. Preventive measures at the work place are important to avoid established and new occupational health hazards. This study also indicates that the work place in addition should be seen as a useful arena for reaching groups of adults with more or less similar habits and attitudes for general health promotion.

Introduction

Estimates of occupation specific cancer risk reflect occupational exposure to carcinogenic agents as well as the lifestyle habits, cultural norms, and socioeconomic position of the respective occupational groups. Here we will present data from the Nordic Occupational Cancer Study (NOCCA) on risk of 10 cancers by occupation in five Nordic countries during a period of 45 years.¹ The results will be interpreted in the light of what is known regarding the aetiology of the respective cancer sites and the distribution of risk factors and occupational exposures over the occupational groups defined.

Section snippets

Subjects and methods

Included in the study cohort were all subjects aged 30–64 years who participated in the 1960, 1970, 1980/1981, and/or 1990 censuses in Denmark, Finland, Iceland, Norway, and Sweden, and who were still alive and living in the respective countries on 1st January in the year following the census. Personal identification codes were used to link the census data of each individual to the national cancer registries to add cancer data, and to the national population registries for information on deaths

Results

SIRs by occupational group are shown in Table 1 for men and Table 2 for women. Table 3 gives the risk estimates for breast and endometrial cancer for women.

Discussion

The above presentation of results reveals clusters of high and low risk occupations. Among men, the most consistent high risk cluster comprises the occupational groups of waiters, cooks and stewards, beverage workers, seamen, and chimney sweeps. For women, no consistent high risk cluster is observed. Two clusters of occupations with generally low cancer risks are seen both for men and women, the first one comprising the primary sector occupations of farmers, gardeners, and forestry workers, the

Conclusions

Occupational differences in cancer risk were smaller among women than among men, which is consistent with a lower employment rate of women in heavily exposed industries and occupations. The cancer sites with the largest occupational differences were those etiologically related to asbestos exposure and to the combined or separate effects of tobacco and alcohol. With the exception of lung cancer, occupational exposure does not appear to contribute strongly to risk of major cancer sites. Many of

Conflict of interest statement

None declared.

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Job definition can also differ from one study to another, and in some cases is also incomplete (e.g., the type of culture can be missing for horticulturists or nurserymen) (Swaen et al., 1992, 2004; Lope et al., 2008; Pérez-Gómez et al., 2005; Gallagher et al., 1986; Mannetje et al., 2008; McLean et al., 2009; Parent et al., 2000). Studies from the NOCCA cohort used “gardeners” as a denomination (Kjaerheim et al., 2010, 2018; Jansson et al., 2015; Hadkhale et al., 2016; Michalek et al., 2019; Katuwal et al., 2018), but only Pukkala et al. (2009) clearly stated the ISCO code used (Pukkala et al., 2009). Two other Scandinavian studies outside the NOCCA project also used the term “gardeners”, although without defining it (Ji and Hemminki, 2006; Lope et al., 2008).
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View full text

Effects of occupation on risks of avoidable cancers in the Nordic countries

Abstract

Introduction

Section snippets

Subjects and methods

Results

Discussion

Conclusions

Conflict of interest statement

Eur J Cancer

Eur J Cancer

Occupation and cancer – follow-up of 15 million people in five Nordic countries

Acta Oncol

Excess of cancers in Europe: a study of eleven major cancers amenable to lifestyle change

Int J Cancer

Cancers of the oral cavity and pharynx

Esophageal cancer

Incidence of cancer among male waiters and cooks: two Norwegian cohorts

Cancer Causes Control

Cancer morbidity and causes of death among Danish brewery workers

Int J Cancer

Cancer incidence among Finnish seafarers, 1967–92

Cancer Causes Control

Cancer in merchant seamen. A group study

Tidsskr Nor Laegeforen

Occupation

Increased risk of esophageal cancer among workers exposed to combustion products

Arch Environ Health

Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden

Occup Environ Med

Cancer incidence among waitresses in Norway

Cancer Causes Control

Smoking-adjusted incidence of lung cancer by occupation among Norwegian men

Cancer Causes Control

Adult use of tobacco in Finland in the 1950s to 1970s. The state of smoking in autumn 1976, changes in cigarette smoking in 1968-1976 and conclusions of development of smoking habits

Changes in the smoking habits of Danes in the period 1970–1987

Ugeskr Laeger

National job-exposure matrix in analyses of census-based estimates of occupational cancer risk

Scand J Work Environ Health