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  • 1
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    CAREX Canada: an enhanced model for assessing occupational carcinogen exposure (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-12-17
    Beschreibung: Objectives To estimate the numbers of workers exposed to known and suspected occupational carcinogens in Canada, building on the methods of CARcinogen EXposure (CAREX) projects in the European Union (EU). Methods CAREX Canada consists of estimates of the prevalence and level of exposure to occupational carcinogens. CAREX Canada includes occupational agents evaluated by the International Agency for Research on Cancer as known, probable or possible human carcinogens that were present and feasible to assess in Canadian workplaces. A Canadian Workplace Exposure Database was established to identify the potential for exposure in particular industries and occupations, and to create exposure level estimates among priority agents, where possible. CAREX EU data were reviewed for relevance to the Canadian context and the proportion of workers likely to be exposed by industry and occupation in Canada was assigned using expert assessment and agreement by a minimum of two occupational hygienists. These proportions were used to generate prevalence estimates by linkage with the Census of Population for 2006, and these estimates are available by industry, occupation, sex and province. Results CAREX Canada estimated the number of workers exposed to 44 known, probable and suspected carcinogens. Estimates of levels of exposure were further developed for 18 priority agents. Common exposures included night shift work (1.9 million exposed), solar ultraviolet radiation exposure (1.5 million exposed) and diesel engine exhaust (781 000 exposed). Conclusions A substantial proportion of Canadian workers are exposed to known and suspected carcinogens at work.
    Schlagwort(e): Open access, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 2
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    Examining the association of lung cancer and highly correlated fibre size-specific asbestos exposures with a hierarchical Bayesian model (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-04-10
    Beschreibung: Background Asbestos is a known carcinogen. However, little is known about the differential effects of size-specific asbestos fibres. Previous research has examined the relationship with lung cancer of each fibre group in the absence of others. Attempts to model all fibre groups within a single regression model have failed due to high correlations across fibre size groups. Methods We compare results from frequentist models for individual fibre size groups, and a hierarchical Bayesian model that included all fibre groups to estimate the relationship of size-specific asbestos fibre groups to lung cancer mortality. The hierarchical model assumes partial exchangeability of the effects of size-specific asbestos fibre groups to lung cancer, and is capable of handling the strong correlation of the exposure data. Results When fibre groups are modelled independently with a frequentist model, there appears to be an increase in the dose-response with increasing fibre size. However, when subject to a hierarchical structure, this trend vanishes, and the effects of distinct fibre groups appear largely similar. Conclusions This is the first occasion where distinct asbestos fibre groups have been assessed in a single regression model; however, even the use of a hierarchical modelling structure does not appear to overcome all the statistical fluctuations arising from the high correlations across fibre groups. We believe these results should be compared with other occupational cohorts with similar fibre group information. Finally, results for the smallest fibre group may be suggestive of a carcinogenic potential for nanofibres.
    Schlagwort(e): Asbestos, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 3
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    A comparison of exposure assessment approaches: lung cancer and occupational asbestos exposure in a population-based case-control study (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-03-06
    Beschreibung: Objectives In attempts to overcome the limitations of self-reported data in occupational health research, job-exposure matrices, which assign exposure by occupation, have emerged as an objective approach for assessing occupational exposures. On the basis of a lung cancer case–control study conducted in the Greater Toronto Area, 1997–2002, assessment of occupational exposure to asbestos was compared using self-reports and a general population job-exposure matrix (DOM-JEM). Methods Cases and frequency matched controls provided life-time job histories and self-reported exposures to potential lung carcinogens including asbestos through a detailed questionnaire. Exposure to asbestos was also assigned to each job by linking occupational histories with DOM-JEM. Agreement in classification of exposed and unexposed jobs according to self-reports and DOM-JEM was evaluated using Cohen's . Risks for lung cancer were estimated using unconditional logistic regression for each exposure assessment approach. Results The prevalence of occupational asbestos exposure was greater when based on DOM-JEM than when based on self-reports. Agreement in classifying exposure to jobs between the two assessment approaches was poor. The risk of lung cancer was not elevated among workers who self-reported asbestos exposure, whereas workers considered exposed on the basis of DOM-JEM were almost twice as likely as unexposed workers to be diagnosed with lung cancer (OR 1.9, 95% CI 1.3 to 2.7). Conclusions It is generally assumed by epidemiologists that self-reported exposure assessments result in inflated risk estimates. In this study, self-reports found no association with a well-established risk factor, whereas a high-quality job-exposure matrix revealed relative risk estimates that are more consistent with previous findings.
    Schlagwort(e): Asbestos, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
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    PAPER CURRENT
  • 4
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    Dupuytren's contracture and occupational exposure to hand-transmitted vibration (2014)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2014-03-06
    Beschreibung: Aims The relation between Dupuytren's contracture and occupational exposure to hand-transmitted vibration (HTV) has frequently been debated. We explored associations in a representative national sample of workers with well-characterised exposure to HTV. Methods We mailed a questionnaire to 21 201 subjects aged 16–64 years, selected at random from the age-sex registers of 34 general practices in Great Britain and to 993 subjects chosen randomly from military pay records, asking about occupational exposure to 39 sources of HTV and about fixed flexion contracture of the little or ring finger. Analysis was restricted to men at work in the previous week. Estimates were made of average daily vibration dose ( A (8) root mean squared velocity (rms)) over that week. Associations with Dupuytren's contracture were estimated by Poisson regression, for lifetime exposure to HTV and for exposures in the past week 〉 A (8) of 2.8 ms –2 rms. Estimates of relative risk (prevalence ratio (PR)) were adjusted for age, smoking status, social class and certain manual activities at work. Results In all 4969 eligible male respondents supplied full information on the study variables. These included 72 men with Dupuytren's contracture, 2287 with occupational exposure to HTV and 409 with A (8)〉2.8 ms –2 in the past week. PRs for occupational exposure to HTV were elevated 1.5-fold. For men with an A (8)〉2.8 ms –2 in the past week, the adjusted PR was 2.85 (95% CI 1.37 to 5.97). Conclusions Our findings suggest that risk of Dupuytren's contracture is more than doubled in men with high levels of weekly exposure to HTV.
    Schlagwort(e): Open access, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    PAPER CURRENT
  • 5
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    Occupational asbestos exposure is associated with pharyngeal squamous cell carcinoma in men from the greater Boston area (2013)
    BMJ Publishing Group
    Details
    Publikationsdatum: 2013-11-09
    Beschreibung: Objectives Asbestos is the name given to a group of naturally occurring silicate mineral fibres that were widely used in industry during the 20th century due to their desirable physical properties. Although use in the USA has fallen over the last three decades, significant exposure in the developing world continues and the burden of disease is considerable. Asbestos is a known risk factor for several malignant diseases, including lung cancer and mesothelioma, and has more recently been implicated in pharyngeal and laryngeal cancer. However, studies of asbestos and cancers of the larynx or pharynx with adequate sample size that control for major head and neck squamous cell carcinoma (HNSCC) risk factors remain relatively sparse. Methods We report findings from a case–control study of 674 incident male HNSCC cases from the greater Boston region and 857 population-based male controls, matched on age (±3 years), sex, and town or neighbourhood of residence. Multivariable logistic regression was used to assess the association between occupational asbestos exposure and HNSCC by primary tumour site. Results 190 cases (28.2%) and 203 controls (23.7%) reported occupational exposure to asbestos. Occupational asbestos exposure was associated with elevated risk of pharyngeal carcinoma in men (OR 1.41, 95% CI 1.01 to 1.97), adjusted for age, race, smoking, alcohol consumption, education, income and HPV16 serology, with borderline increasing risk for each decade in the exposed occupation (OR 1.10, 95% CI 0.99 to 1.23). Conclusions These observations are consistent with mounting evidence that asbestos is a risk factor for pharyngeal cancer.
    Schlagwort(e): Asbestos, Other exposures
    Print ISSN: 1351-0711
    Digitale ISSN: 1470-7926
    Thema: Medizin
    Publiziert von BMJ Publishing Group
    Standort Signatur Einschränkungen Verfügbarkeit
    BibTip Andere fanden auch interessant ...
    PAPER CURRENT
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