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BackgroundGlobally, lung cancer is the most frequent occupational cancer, but the risk associated with the occupations or occupational environment in Iran is not clear. We aimed to assess occupations with the risk of lung cancer.MethodsWe... more
BackgroundGlobally, lung cancer is the most frequent occupational cancer, but the risk associated with the occupations or occupational environment in Iran is not clear. We aimed to assess occupations with the risk of lung cancer.MethodsWe used the IROPICAN nationwide case–control study data including 658 incident lung cancer cases and 3477 controls. We assessed the risk of lung cancer in relation to ever working in major groups of International Standard Classification of Occupations, high-risk occupations for lung cancer and duration of employment and lung cancer subtype among construction workers and farmers while controlling for cigarette smoking and opium consumption. We used unconditional regression logistic models to estimate ORs for the association between increased lung cancer risk and occupations.ResultsWe observed elevated ORs for lung cancer in male construction workers (OR=1.4; 95% CI: 1.0 to 1.8), petroleum industry workers (OR=3.2; 95% CI: 1.1 to 9.8), female farmers (O...
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There is limited evidence regarding the exposure‐effect relationship between lung‐cancer risk and hexavalent chromium (Cr(VI)) or nickel. We estimated lung‐cancer risks in relation to quantitative indices of occupational exposure to... more
There is limited evidence regarding the exposure‐effect relationship between lung‐cancer risk and hexavalent chromium (Cr(VI)) or nickel. We estimated lung‐cancer risks in relation to quantitative indices of occupational exposure to Cr(VI) and nickel and their interaction with smoking habits. We pooled 14 case‐control studies from Europe and Canada, including 16 901 lung‐cancer cases and 20 965 control subjects. A measurement‐based job‐exposure‐matrix estimated job‐year‐region specific exposure levels to Cr(VI) and nickel, which were linked to the subjects' occupational histories. Odds ratios (OR) and associated 95% confidence intervals (CI) were calculated by unconditional logistic regression, adjusting for study, age group, smoking habits and exposure to other occupational lung carcinogens. Due to their high correlation, we refrained from mutually adjusting for Cr(VI) and nickel independently. In men, ORs for the highest quartile of cumulative exposure to CR(VI) were 1.32 (95%...
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: Introduction: The presence of occupational carcinogens in workplaces in Iran is not well characterized, and little is known about the burden of occupational cancer in Iran and other Middle East countries. Objectives: This study aimed to... more
: Introduction: The presence of occupational carcinogens in workplaces in Iran is not well characterized, and little is known about the burden of occupational cancer in Iran and other Middle East countries. Objectives: This study aimed to provide an overview of exposure assessments used in or informative for epidemiological studies on occupational cancer in Iran. Methods: Studies estimating occupational exposures applied to or informative for occupational cancer risk up to January 2021 in Iran were identified through different databases. Results: Forty-nine publications from 2009 to 2020 were included. The exposure monitoring studies were conducted mainly in gasoline refueling stations, foundries, construction industry, and manufacturing, and some of the case-control studies also reported increased risk of cancers in relation to work in those industries. Conclusion: Occupational cancer epidemiology in Iran is at an early stage. Both epidemiological and exposure monitoring studies are generally limited in size to provide robust evidence. A coherent strategy to estimate the occupational cancer burden in Iran should start with systematic monitoring of occupational carcinogens for use in hazard control and research.
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Objectives: We investigated general job demands as a risk factor for lung cancer as well as their role in the association between occupational prestige and lung cancer. Methods: In 13 case–control studies on lung cancer, as part of the... more
Objectives: We investigated general job demands as a risk factor for lung cancer as well as their role in the association between occupational prestige and lung cancer. Methods: In 13 case–control studies on lung cancer, as part of the international SYNERGY project, we applied indices for physical (PHI) and psychosocial (PSI) job demands – each with four categories (high to low). We estimated odds ratios (OR) and 95% confidence intervals (CI) for lung cancer by unconditional logistic regression, separately for men and women and adjusted for study centre, age, smoking behavior, and former employment in occupations with potential exposure to carcinogens. Further, we investigated, whether higher risks among men with low occupational prestige (Treiman’s Standard International Occupational Prestige Scale) were affected by adjustment for the job indices. Results: In 30 355 men and 7371 women, we found increased risks (OR) for lung cancer with high relative to low job demands in both men [...
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ObjectivesExposure assessment for retrospective industrial cohorts are often hampered by limited availability of historical measurements. This study describes the development of company-specific job-exposure matrices (JEMs) based on... more
ObjectivesExposure assessment for retrospective industrial cohorts are often hampered by limited availability of historical measurements. This study describes the development of company-specific job-exposure matrices (JEMs) based on measurements collected over five decades for a cohort study of 35 837 workers (Asbest Chrysotile Cohort Study) in the Russian Federation to estimate their cumulative exposure to chrysotile containing dust and fibres.MethodsAlmost 100 000 recorded stationary dust measurements were available from 1951-2001 (factories) and 1964–2001 (mine). Linear mixed models were used to extrapolate for years where measurements were not available or missing. Fibre concentrations were estimated using conversion factors based on side-by-side comparisons. Dust and fibre JEMs were developed and exposures were allocated by linking them to individual workers’ detailed occupational histories.ResultsThe cohort covered a total of 515 355 employment-years from 1930 to 2010. Of thes...
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Background The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate... more
Background The Asbest chrysotile cohort was set up in Asbest town, Sverdlovsk oblast, Russian Federation, among the current and former workforce of the world's largest operating chrysotile mine and its processing mills, to investigate cancer risk in relation to occupational exposure to chrysotile. Objectives The cohort of 35,837 people was followed-up for mortality using cause-of-death information from official death certificates issued by the Civil Act Registration Office (ZAGS) of Sverdlovsk oblast from 1976 to 2015. Data were also retrieved from the electronic cause-of-death registry of the Medical Information Analytical Centre (MIAC) of Sverdlovsk oblast, which was launched in 1990 and operates independently of ZAGS. The objectives were to compare the completeness of record linkage (RL) with ZAGS and with MIAC, and to compare the agreement of cause-of-death information obtained from ZAGS and from MIAC, with a focus on malignant neoplasms. Methods RL completeness of identifyi...
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Research Interests: Psychology, Environmental Health, Mining, Medicine, Lung Cancer, and 15 moreHumans, Smoking, Coal Mining, Male, Miners, Aged, Middle Aged, Occupational Exposure, Public health systems and services research, Odds ratio, Case Control Study, Occupational Diseases, Confidence Interval, Case Control Studies, and lung neoplasms
“Occupational exposure as a hairdresser or barber” was classified as probably carcinogenic to humans by the International Agency for Research on Cancer in volume 99 (2010). Small increases in lung cancer risk (20-40%) are found in most... more
“Occupational exposure as a hairdresser or barber” was classified as probably carcinogenic to humans by the International Agency for Research on Cancer in volume 99 (2010). Small increases in lung cancer risk (20-40%) are found in most cohort studies but without adequate adjustment for smoking. Studies in Scandinavia and the USA show a higher prevalence of smokers among hairdressers than in the general population. The SYNERGY project has pooled information on lifetime work histories (ISCO-68) and tobacco smoking from 13479 cases and 16350 controls, including 20% women, from 11 case-control studies in 12 European countries and Canada. The original studies were conducted between 1985 and 2005. Odds ratios (OR) for lung cancer and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusted for age, sex, study, cigarette pack-years and time since quitting smoking. Less than 1% of the study population had ever worked as hairdresser or barber (0.89% of cases and 0.74% of controls). Hairdressers and barbers experienced a slight increase in lung cancer risk OR 1.16 (95%CI 0.90-1.49), which disappeared after adjusting for smoking OR 0.97 (95%CI 0.73-1.30). Results by duration of employment showed highest risks in hairdressers with short employment. Results were similar by gender, histology of lung cancer, and for women hairdressers. We observed a slight and non-significant increase in risk for male barbers, particularly in barbers with the longest employment and after adjustment for smoking. We could not detect an association between having worked as hairdresser or barber and increased lung cancer risk overall after adjusting for smoking. However, among male barbers we observed an increasing risk with increasing duration, although non-significant, after adjusting for tobacco smoking. Final results will include several more studies, and thereby increase the precision of our effect estimates. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 1875. doi:10.1158/1538-7445.AM2011-1875
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Background: Alcohol consumption is known to be associated with risk of developing several cancers. It is unclear, however, whether alcohol consumption is a risk factor for lung cancer. The relationship between lung cancer and alcohol... more
Background: Alcohol consumption is known to be associated with risk of developing several cancers. It is unclear, however, whether alcohol consumption is a risk factor for lung cancer. The relationship between lung cancer and alcohol consumption is likely to be confounded by smoking. To minimize potential confounding by tobacco consumption, we conducted a pooled analysis to examine the association of alcohol consumption with lung cancer risk in a large sample of never-smokers. Methods: We pooled data from 22 case-control and cohort studies from North America, Europe and Asia within the International Lung Cancer Consortium (ILCCO) and SYNERGY Consortium. We examined the association of average lifetime alcohol consumption (expressed as average grams per day intake) with lung cancer risk in never smokers using logistic regression to model categories of alcohol consumption (0<5g per day, 5<10g per day, 10<20g per day, 20<30g per day, 30<45g per day, 45+ g per day). To inv...
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Introduction: Diesel-motor exhaust (DME) is classified by IARC as probably carcinogenic to humans. The epidemiological evidence is evaluated as limited since many studies lack adequate information on tobacco smoking and only few studies... more
Introduction: Diesel-motor exhaust (DME) is classified by IARC as probably carcinogenic to humans. The epidemiological evidence is evaluated as limited since many studies lack adequate information on tobacco smoking and only few studies reported on exposure-response relationships. Our objective is to investigate the risk of lung cancer following occupational exposure to DME, while controlling for smoking and potential occupational confounders. Methods: The SYNERGY project pooled information on lifetime work histories and tobacco smoking from more than 13300 cases and 16300 controls from case-control studies conducted in 12 European countries and Canada. A job exposure matrix based on ISCO codes, assigning no (0), low (1) or high (2) exposure to DME was applied to determine level of exposure to DME. Cumulative exposure was defined as: ∑(level2 * duration). Odds ratios (OR) of lung cancer and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusted f...
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Objectives Firefighters are potentially exposed to a wide variety of chemical compounds during the course of their work and inhalation is considered to be the major source of exposure. A large number of human carcinogens have been... more
Objectives Firefighters are potentially exposed to a wide variety of chemical compounds during the course of their work and inhalation is considered to be the major source of exposure. A large number of human carcinogens have been detected in smoke at fires. The aim was to investigate the risk of lung cancer among firefighters, while controlling for smoking habits. Methods We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits for 14,748 male lung cancer cases and 17,543 controls from 14 case-control studies conducted in Europe, Canada, New Zealand and China. There were 190 men who had ever worked as a firefighter (based on ISCO-68), among them 86 cases and 104 controls. Odds ratios (OR) and 95% confidence intervals (CI) were estimated by unconditional logistic regression, adjusted for study, age, smoking, and ever employment in an occupation with established lung cancer risk. Results We observed no increased risk of lung cancer in firefighters, neither before (OR = 1.03, 95% CI: 0.77–1.38) nor after (OR = 0.95, 95% CI: 0.68–1.32) adjustment for smoking and exposure to other occupational lung carcinogens. There was no evidence of a trend of increasing lung cancer risk with increasing duration of work as a firefighter (p = 0.58) and no significant heterogeneity in lung cancer risk among firefighters across the studies. None of the major histological subtypes of lung cancer was associated with work as a firefighter. Conclusions We found no evidence of an excess lung cancer risk related to occupational exposure as a firefighter, when lifetime history of tobacco smoking and exposure to other occupational lung carcinogens was taken into account.
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Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia... more
Leukemia is the most common type of cancer among children and adolescents worldwide. The aim of this umbrella review was (1) to provide a synthesis of the environmental risk factors for the onset of childhood acute lymphoblastic leukemia (ALL) by exposure window, (2) evaluate their strength of evidence and magnitude of risk, and as an example (3) estimate the prevalence in the German population, which determines the relevance at the population level. Relevant systematic reviews and pooled analyses were identified and retrieved through PubMed, Web of Science databases and lists of references. Only two risk factors (low doses of ionizing radiation in early childhood and general pesticide exposure during maternal preconception/pregnancy) were convincingly associated with childhood ALL. Other risk factors including extremely low frequency electromagnetic field (ELF-MF), living in proximity to nuclear facilities, petroleum, benzene, solvent, and domestic paint exposure during early child...
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Objective We assessed the association between parental prenatal exposures in wood-related jobs and risk of testicular germ cell tumours (TGCT) in offspring. Methods NORD-TEST, a registry-based case–control study in Sweden, Finland and... more
Objective We assessed the association between parental prenatal exposures in wood-related jobs and risk of testicular germ cell tumours (TGCT) in offspring. Methods NORD-TEST, a registry-based case–control study in Sweden, Finland and Norway, included 8112 TGCT cases diagnosed at ages 14–49 years between 1978 and 2012 with no history of prior cancer, and up to four controls matched to each case on year and country of birth. Parents of cases and controls were identified via linkages with the population registries and their occupational information was retrieved from censuses. The Nordic Occupational Cancer Study Job-Exposure Matrix was used to assign occupational exposures to each parent. Logistic regression models were used to estimate odds ratios (OR) and 95% confidence intervals (CI). Results Maternal wood-related job was not associated with the risk of TGCT in offspring (OR 1.08, CI 0.55–2.14), while paternal wood-related job was associated with a decreased risk of TGCT in offspr...
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Introduction: The extent of exposure to occupational carcinogens is not well characterized in Iran, and little is known about the burden of occupational cancer. Objectives: This study aimed to describe exposure to occupational carcinogens... more
Introduction: The extent of exposure to occupational carcinogens is not well characterized in Iran, and little is known about the burden of occupational cancer. Objectives: This study aimed to describe exposure to occupational carcinogens and occupational epidemiology studies in Iran. Methods: Relevant studies up to January 2021 in Iran were identified through three databases (PubMed, Web of Science, and Google Scholar). Results: Forty-nine publications from 2009 to 2020 (one cohort, 11 case-control, 34 exposure monitoring studies, and three cancer burden studies) were included. The exposure monitoring studies were conducted mainly in the petroleum industry, metal industry, manufacturing of electronics, manufacturing of plastics, construction industry, and service industry. A few of the case-control studies also reported increased risk of cancers in relation to work in those industries. Conclusions: Occupational cancer epidemiology in Iran is at an early stage. Both epidemiological ...
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Petroleum extraction and refining are major sources of various occupational exposures and of air pollution and may therefore contribute to the global cancer burden. This systematic review and meta-analysis is aimed at evaluating the... more
Petroleum extraction and refining are major sources of various occupational exposures and of air pollution and may therefore contribute to the global cancer burden. This systematic review and meta-analysis is aimed at evaluating the cancer risk in petroleum-exposed workers and in residents living near petroleum facilities. Relevant studies were identified and retrieved through PubMed and Web of Science databases. Summary effect size (ES) and 95% confidence intervals (CI) were analysed using random effect models, and heterogeneity across studies was assessed (I2). Overall, petroleum industry work was associated with an increased risk of mesothelioma (ES = 2.09, CI: 1.58–2.76), skin melanoma (ES = 1.34, CI: 1.06–1.70 multiple myeloma (ES =1.81, CI: 1.28–2.55), and cancers of the prostate (ES = 1.13, Cl: 1.05–1.22) and urinary bladder (ES = 1.25, CI: 1.09–1.43) and a decreased risk of cancers of the esophagus, stomach, colon, rectum, and pancreas. Offshore petroleum work was associated...
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ObjectivesA historical cohort study of cancer mortality is being conducted among workers in a chrysotile mine and its enrichment factories in the town of Asbest, Russian Federation. Because individual-level information on tobacco use is... more
ObjectivesA historical cohort study of cancer mortality is being conducted among workers in a chrysotile mine and its enrichment factories in the town of Asbest, Russian Federation. Because individual-level information on tobacco use is not available for Asbest Chrysotile Cohort members, a cross-sectional survey of smoking behaviours was conducted among active and retired workers.MethodsSelf-administered questionnaires were completed by active workers during meetings organised by occupational safety personnel. Retired workers completed questionnaires during meetings of the Veterans Council or were interviewed via telephone or in person. Of the respondents, 46% could be linked to the Asbest Chrysotile Cohort. Among those, logistic regression models were used to assess associations between smoking and cumulative dust exposure.ResultsAmong men, smoking prevalence was high and relatively consistent across birth decades (average, 66%), and was similar in workers across all levels of cumu...
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ObjectivesPreviously published studies on parental occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and risk of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring were... more
ObjectivesPreviously published studies on parental occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and risk of acute lymphoblastic leukaemia (ALL) and acute myeloid leukaemia (AML) in their offspring were inconsistent. We therefore evaluated this question within the Childhood Leukemia International Consortium.MethodsWe pooled 11 case–control studies including 9723 childhood leukaemia cases and 17 099 controls. Parental occupational ELF-MF exposure was estimated by linking jobs to an ELF-MF job-exposure matrix (JEM). Logistic regression models were used to estimate ORs and 95% CIs in pooled analyses and meta-analyses.ResultsORs from pooled analyses for paternal ELF-MF exposure >0.2 microtesla (µT) at conception were 1.04 (95% CI 0.95 to 1.13) for ALL and 1.06 (95% CI 0.87 to 1.29) for AML, compared with ≤0.2 µT. Corresponding ORs for maternal ELF-MF exposure during pregnancy were 1.00 (95% CI 0.89 to 1.12) for ALL and 0.85 (95% CI 0.61 to 1.16) for AML. N...
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The aim of this study was to explore lung cancer risk among firefighters, with adjustment for smoking. We used pooled information from the SYNERGY project including 14 case-control studies conducted in Europe, Canada, New Zealand, and... more
The aim of this study was to explore lung cancer risk among firefighters, with adjustment for smoking. We used pooled information from the SYNERGY project including 14 case-control studies conducted in Europe, Canada, New Zealand, and China, with lifetime work histories and smoking habits for 14,748 cases of lung cancer and 17,543 controls. We estimated odds ratios by unconditional logistic regression with adjustment for smoking and having ever been employed in a job known to present an excess risk of lung cancer. There was no increased lung cancer risk overall or by specific cell type among firefighters (n = 190), neither before nor after smoking adjustment. We observed no significant exposure-response relationship in terms of work duration. We found no evidence of an excess lung cancer risk related to occupational exposure as a firefighter.
Research Interests: Nursing, China, Medicine, Logistic Regression, Lung Cancer, and 15 moreCanada, Humans, Smoking, Europe, New Zealand, Risk factors, Occupational Exposure, Odds ratio, Firefighters, Risk Factors, Case Control Study, Occupational Diseases, Case Control Studies, Occupational and environmental medicine, and lung neoplasms
To investigate the risk of lung cancer among cooks, while controlling for smoking habits. We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits from 16 case-control studies... more
To investigate the risk of lung cancer among cooks, while controlling for smoking habits. We used data from the SYNERGY project including pooled information on lifetime work histories and smoking habits from 16 case-control studies conducted in Europe, Canada, New Zealand, and China. Before adjustment for smoking, we observed an increased risk of lung cancer in male cooks, but not in female cooks. After adjusting, there was no increased risk and no significant exposure-response relationship. Nevertheless, subgroup analyses highlighted some possible excess risks of squamous cell carcinoma and small cell carcinoma in female cooks. There is evidence that lung cancer risks among cooks may be confounded by smoking. After adjustment, cooks did not experience an increased risk of lung cancer overall. The subgroup analyses showing some excess risks among female cooks require cautious interpretation.