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Faramawi MF, Abouelenein S, Johnson E. A case-control study of occupational risk factors for pancreatic cancer in poultry plant workers: a random forest approach. J Public Health (Oxf) 2022; 44:296-301. [PMID: 33635337 DOI: 10.1093/pubmed/fdab008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 01/01/2021] [Accepted: 01/07/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Poultry plant workers are exposed to chemical carcinogens and oncogenic viruses in their work environment. Our objective was to identify jobs and workplaces related to poultries that could increase the pancreatic cancer risk. METHODS We conducted a case-control study within a defined cohort of poultry workers. We used a random forest algorithm to identify features that could increase pancreatic cancer in the poultry plant workers. RESULTS The mean age of participants was 59.49 years. The majority of the study participants were females (51.30%) and Whites (71.0%). The following workplaces and job tasks had an association with increased pancreatic cancer mortality: working in chicken and turkey plants, working in plants where food products were processed and canned, working in a place where poultry and animals where present, working as a hunter for game animals, working as a veterinarian in places had animals and different poultry birds, working in pet houses and working in places where birds were handled and killed. The accuracy and the area under the curve of the model were 72.3 and 71.50%. CONCLUSION Chicken and turkey plant workers could be at risk for pancreatic cancer mortality. We need to confirm the results in future studies.
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Affiliation(s)
- Mohammed F Faramawi
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Saly Abouelenein
- Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Eric Johnson
- Department of Epidemiology, College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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Aamir M, Yin S, Liu Y, Ullah H, Khan S, Liu W. Dietary exposure and cancer risk assessment of the Pakistani population exposed to polycyclic aromatic hydrocarbons. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 757:143828. [PMID: 33257068 DOI: 10.1016/j.scitotenv.2020.143828] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 10/29/2020] [Accepted: 11/02/2020] [Indexed: 06/12/2023]
Abstract
The sixteen-priority polycyclic aromatic hydrocarbons (PAHs) were determined in twenty-one groceries from six food groups consumed by the Pakistani population. The highest concentration of the total PAHs was found in fish (243 ng g-1), while the lowest concentration was determined in rice (53 ng g-1). The total B[a]Peq dietary exposure for the male group followed an increasing order of children (865.5 ng day-1) < adolescents (2301 ng day-1) < seniors (2864 ng day-1) < adults (3004 ng day-1), whereas the similar order was also observed for the female group. The male group showed 1-8.5% (mean 5.5%) of higher exposure amount compared to the female group. Among all food categories, wheat (43%) and milk (34%) contributed the greatest while rice (1%) and egg (1%) contributed the smallest to the total dietary exposure of PAHs. The incremental lifetime cancer risk (ILCR) values for the adults and children revealed a potential cancer risk to the both male and female groups. Whereas at the 95th percentiles, the ILCR values for all age and gender groups exceeded the limit (>10-5), demonstrating a high potential cancer risk in the Pakistani population. The sensitivity analysis found that the daily dietary intake, exposure duration and the cancer slope factor were the most influential variables contributed to the total variance of risk.
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Affiliation(s)
- Muhammad Aamir
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China; Department of Environmental Sciences, University of Peshawar, Peshawar 25120, Pakistan
| | - Shanshan Yin
- Interdisciplinary Research Academy (IRA), Zhejiang Shuren University, Hangzhou 310015, China; MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Yingxue Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Habib Ullah
- Department of Environmental Sciences, University of Peshawar, Peshawar 25120, Pakistan
| | - Sardar Khan
- Department of Environmental Sciences, University of Peshawar, Peshawar 25120, Pakistan.
| | - Weiping Liu
- MOE Key Laboratory of Environmental Remediation and Ecosystem Health, Institute of Environmental Health, College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China; Interdisciplinary Research Academy (IRA), Zhejiang Shuren University, Hangzhou 310015, China.
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3
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Faramawi MF, Johnson ES. A Case-Cohort Study to Investigate the Excess of Liver Cancer Observed in Workers in Poultry Slaughtering & Processing Plants. Nutr Cancer 2019; 71:1118-1131. [DOI: 10.1080/01635581.2019.1597901] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Mohammed F. Faramawi
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- National Liver Institute, Menoufiya University, Menoufiya, Egypt
| | - Eric S. Johnson
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
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Johnson ES, Faramawi M, Chedjieu IP, Delongchamp R, Choi KM, Shen T. Excess lung cancer occurrence in poultry plants. Occupational risk factors: Findings for oncogenic viruses exposure and other occupational exposures. ENVIRONMENTAL RESEARCH 2018; 167:393-410. [PMID: 30099266 DOI: 10.1016/j.envres.2018.07.037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 06/15/2018] [Accepted: 07/28/2018] [Indexed: 06/08/2023]
Abstract
Certain viruses naturally infect and cause cancer in chickens and turkeys. Humans are widely exposed. The viruses cause cancer in primates, and transform human cells in vitro, but it is not known if they cause cancer in humans, mainly because of the lack of epidemiologic evidence. We conducted cohort mortality studies of workers in poultry slaughtering/processing plants across the United States, because they have the highest human exposures. An excess of lung cancer and other deaths was recorded in the poultry workers. Here, we report on a case-cohort study of the lung cancer deaths nested within these cohorts, that was conducted to provide epidemiologic evidence linking these viruses with human cancer occurrence, while adjusting for possible confounders, including workplace chemical carcinogens. We obtained interviews for 339 lung cancer deaths and 457 controls, selected from our combined cohorts of 30,411 poultry plant workers and 16,405 non-poultry workers, belonging to United Food & Commercial Workers unions. Data was analyzed by both logistic regression and Cox regression, adjusting for smoking and other confounders. Lung cancer risk was independently associated with tasks or work areas indicative of exposure to both poultry oncogenic viruses and to workplace chemical carcinogens. The study provides an incremental piece of evidence (epidemiologic), indirectly linking the oncogenic viruses of poultry with the occurrence of cancer in humans, and thus may have public health implications, but the limitations highlighted must be considered. Confirmatory studies, particularly molecular studies providing definitive proof of poultry oncogenic retrovirus integration in human DNA are needed, before the findings observed in this study can be put into proper perspective.
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Affiliation(s)
- Eric S Johnson
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA.
| | - Mohammed Faramawi
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Irene P Chedjieu
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Robert Delongchamp
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
| | - Kyung-Mee Choi
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA; Korea Centers for Disease Control & Prevention, National Research Institute of Health, Cheongju-si, Republic of Korea
| | - Tianjiao Shen
- Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR 21205, USA
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Jadhav S, Chedjieu IP, Faramawi MF, Ndetan H, Fischbach L, Thapa S, Johnson ES. Non-cancer mortality in workers in the meat and delicatessen departments of supermarkets (1950-2006). ENVIRONMENTAL RESEARCH 2015; 142:155-160. [PMID: 26160045 DOI: 10.1016/j.envres.2015.06.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2015] [Revised: 06/23/2015] [Accepted: 06/24/2015] [Indexed: 06/04/2023]
Abstract
We studied non-cancer mortality in 10,701 workers in the meat and delicatessen departments of supermarkets because they have increased exposure to a variety of microorganisms that infect and cause disease in food animals such as cattle, pigs, sheep, and poultry, to which subjects in the general population are also exposed, albeit to a lesser degree. These workers were also exposed to fumes from the wrapping machine. Standardized mortality ratios were estimated in the cohort as a whole and in race/sex subgroups, using the US population for comparison. Study subjects were followed up from January 1950 to December 2006. Significantly increased deaths from diabetes, ischemic heart disease, pulmonary embolism, chronic bronchitis, peritonitis, intracranial and intraspinal abscess, other bacterial diseases, and significantly decreased deaths from diffuse diseases of connective tissue, functional diseases of the heart, intracerebral hemorrhage, occlusion/stenosis of the precerebral and cerebral arteries, and various types of accidents were observed in certain race/sex subgroups or in the cohort as a whole. The observed increased risks of several infectious conditions suggest that the increased occupational exposure to microorganisms may be responsible for at least some of the observed excess deaths, while exposure to fumes may also contribute to the excess of chronic bronchitis. The findings are important not only for supermarket workers and other workers in the meat and poultry industries, but also because the general population is exposed to these microorganisms found in food animals and their products. Nested case-control studies within cohorts that include both workers in supermarkets and other sectors of the meat and poultry industries, are now needed to examine specific risks from occupational exposures while adequately controlling for confounding factors, so that the role of these infectious agents in the occurrence of these diseases in workers and in general population subjects can be adequately assessed.
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Affiliation(s)
- S Jadhav
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - I P Chedjieu
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - M F Faramawi
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - H Ndetan
- Parker Research Institute, Parker University, Dallas, TX, USA
| | - L Fischbach
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - S Thapa
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - E S Johnson
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA.
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Johnson ES, Cardarelli K, Jadhav S, Chedjieu IP, Faramawi M, Fischbach L, Ndetan H, Wells TLC, Patel KV, Katyal A. Cancer mortality in the meat and delicatessen departments of supermarkets (1950-2006). ENVIRONMENT INTERNATIONAL 2015; 77:70-75. [PMID: 25656684 DOI: 10.1016/j.envint.2015.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2014] [Revised: 12/15/2014] [Accepted: 01/18/2015] [Indexed: 06/04/2023]
Abstract
Meat cutters and meat wrappers in the meat department of supermarkets are exposed to oncogenic viruses present in raw meat from cattle, pigs, sheep, and poultry, and their products (unpasteurized milk and raw eggs). Up to the mid 1970s, meat wrappers were also exposed to carcinogens present in fumes emitted from the machine used to wrap meat. Because of this we studied cancer mortality in a cohort of 10,701 workers in the meat and delicatessen departments of supermarkets, and we report here the findings after the third follow-up. Standardized mortality ratios (SMR) were estimated in the cohort as a whole and in race/sex subgroups, using the US population for comparison. Study subjects were followed up from January 1950 to December 2006. Significantly increased SMRs of 1.3 (95% CI, 1.2-1.5), and 2.7 (95% CI, 1.2-5.3) were recorded for cancers of the lung, and tonsils/oropharynx, respectively, in the entire cohort, affecting nearly all race/sex subgroups. SMRs of 4.6 (95% CI, 1.0-13.6) for cancer of the floor of the mouth, and 2.8 (95% CI, 1.3-5.3) for cancer of the gall bladder and biliary tract were recorded only in White male meatcutters. Significantly decreased SMRs were observed for a few cancers. It is not known if the observed excess of cancers is a result of occupational exposures. However, substantial evidence points to fumes from the wrapping machine as a possible candidate for explaining the excess in female meat wrappers. Nested case-control studies that can examine risks from occupational exposures in greater detail, and adequately control for confounding factors are now needed, to permit specifically investigate the role of the oncogenic viruses, fumes and non-occupational risk factors in the occurrence of these cancers. The findings are important, not only occupationally but also because the general population may also experience these exposures, albeit to a lesser degree.
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Affiliation(s)
- E S Johnson
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA.
| | - K Cardarelli
- University of North Texas Health Science Center, Department of Epidemiology, Fort Worth, TX, USA
| | - S Jadhav
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - I P Chedjieu
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - M Faramawi
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - L Fischbach
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - H Ndetan
- Parker Research Institute, Parker University, Dallas, TX, USA
| | - T L-C Wells
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - K V Patel
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
| | - A Katyal
- University of Arkansas for Medical Sciences, Department of Epidemiology, Little Rock, AR, USA
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Faramawi MF, Ndetan H, Jadhav S, Johnson ES. A Cohort Mortality Study of Workers in a Second Soup Manufacturing Plant. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2015; 70:279-285. [PMID: 24971669 DOI: 10.1080/19338244.2014.891966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The authors previously reported on mortality among workers in a Baltimore soup plant. Increased mortality was observed for cancers of the floor of the mouth, rectosigmoid colon/rectum/anus, epilepsy, and chronic nephritis. Here, the authors report on mortality on a second soup plant in the same locality. Excess mortality was similarly recorded for cancers of the tonsils/oropharynx, rectosigmoid colon/rectum/anus, and lung and myelofibrosis. Excess risk from cardiovascular, cerebrovascular, kidney, and infectious diseases was also observed. These 2 studies are important because firstly, to the authors' knowledge, they are the only reports of mortality in this occupational group in spite of their having a potential for exposure to hazardous carcinogenic agents. Secondly, there is no information on any exposure assessment in this industry. These 2 reports will draw attention to the need to conduct more detailed exposure and mortality investigations in this little-studied group.
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Affiliation(s)
- Mohammed F Faramawi
- a Department of Epidemiology , University of Arkansas for Medical Sciences , Little Rock , Arkansas , USA
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Johnson ES, Choi KM. Lung Cancer Risk in Workers in the Meat and Poultry Industries - A Review. Zoonoses Public Health 2012; 59:303-13. [DOI: 10.1111/j.1863-2378.2012.01459.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Choi KM, Ndetan H, Johnson E. A cohort mortality study of workers in a soup manufacturing plant. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2012; 67:199-205. [PMID: 23074977 DOI: 10.1080/19338244.2011.619215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
There has been no study of disease risk or exposures in workers in soup manufacturing plants. These workers may have hazardous exposures to biological and chemical cancer-causing agents at the workplace. The authors report here on mortality in 1,779 workers from a plant in Baltimore, Maryland. Standardized mortality ratios (SMRs) were estimated using the US population for comparison. Significantly increased mortality was observed for cancer of the floor of the mouth, colon cancer, epilepsy, and chronic nephritis in certain groups. Significantly decreased SMRs were observed for some causes. The findings are important, given the complete absence of data on this occupational group. It is not known whether the associations observed are related to occupational or nonoccupational exposures, or due to chance. The findings do, however, indicate that further studies of this occupational group are warranted.
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Affiliation(s)
- Kyung-Mee Choi
- Department of Environmental and Occupational Health Sciences, University of North Texas Health Science Center, Fort Worth, Texas 76107, USA
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Felini M, Johnson E, Preacely N, Sarda V, Ndetan H, Bangara S. A Pilot Case-Cohort Study of Liver and Pancreatic Cancers in Poultry Workers. Ann Epidemiol 2011; 21:755-66. [DOI: 10.1016/j.annepidem.2011.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Revised: 06/28/2011] [Accepted: 07/06/2011] [Indexed: 11/30/2022]
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Johnson ES, Ndetan H, Felini MJ, Faramawi MF, Singh KP, Choi KM, Qualls-Hampton R. Mortality in workers employed in pig abattoirs and processing plants. ENVIRONMENTAL RESEARCH 2011; 111:871-876. [PMID: 21724184 DOI: 10.1016/j.envres.2011.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2011] [Revised: 05/19/2011] [Accepted: 06/06/2011] [Indexed: 05/31/2023]
Abstract
OBJECTIVE workers in slaughterhouses and processing plants that handle pigs, and pork butchers/meatcutters have been little studied for health risks associated with employment, in spite of the fact that they are potentially exposed to oncogenic and non-oncogenic transmissible agents and chemical carcinogens at work. We report here on an update of mortality in 510 workers employed in abattoirs and processing plants that almost exclusively handled pigs and pork products. METHODS standardized mortality ratios (SMRs) were estimated for the cohort as a whole, and in subgroups defined by race and sex, using the corresponding US general population mortality rates for comparison. Study subjects were followed up from January 1950 to December 2006, during which time 45% of them died. RESULTS mortality was significantly increased overall in the cohort. A statistically significant excess of deaths was observed for colon and lung cancers in the entire cohort, SMR=2.7 (95% CI, 1.2-5.1), SMR=1.8 (95% CI, 1.1-2.7), respectively. Significant SMRs in the cohort as a whole were also observed for senile and pre-senile psychotic conditions (SMR=5.1, 95% CI, 1.4-13.1), and pneumonia (SMR=2.6, 95% CI, 1.3-4.8). An observed excess of subarachnoid hemorrhage was seen mainly in whites (SMR=10.1, 95% CI, 1.2-36.3). There was a suggestion of an excess of deaths from ischemic heart disease also, but the elevated SMR was confined to men and was not statistically significant. CONCLUSION this study confirms the excess occurrence of lung and colon cancers, and stroke previously reported in this occupational group. New findings are the excess of risk for senile and pre-senile psychotic conditions and pneumonia, which together with the excess of colon cancer appear specific for pig/pork workers, as they were not evident in much larger studies of workers in abattoirs and processing plants handling cattle and sheep. However, caution should be exercised in interpreting these findings, since some of them could have occurred by chance, resulting from our examination of a large number of causes of death in multiple study subgroups. For the moment, the significance of these findings remains unknown until they are confirmed in larger studies of adequate statistical power. Studies that will take into account possible occupational and non-occupational confounding factors are needed.
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Affiliation(s)
- Eric S Johnson
- UNT Health Sciences Center, Department of Epidemiology, Fort Worth, TX 76107, USA.
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12
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Johnson ES. Cancer mortality in workers employed in cattle, pigs, and sheep slaughtering and processing plants. ENVIRONMENT INTERNATIONAL 2011; 37:950-959. [PMID: 21497401 DOI: 10.1016/j.envint.2011.03.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2011] [Revised: 03/17/2011] [Accepted: 03/18/2011] [Indexed: 05/30/2023]
Abstract
OBJECTIVES We studied mortality in two separate cohorts of workers in abattoirs (N=4996) and meat processing plants (N=3642) belonging to a meatcutters' union, because they were exposed to viruses that cause cancer in food animals, and also to chemical carcinogens at work. METHODS Standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs) were estimated for each cohort as a whole and in subgroups defined by race and sex, using the US general population mortality rates for comparison. Study subjects were followed up from January 1950 to December 2006, during which time over 60% of them died. RESULTS An excess of deaths from cancers of the base of the tongue, esophagus, lung, skin, bone and bladder, lymphoid leukemia, and benign tumors of the thyroid and other endocrine glands, and possibly Hodgkin's disease, was observed in abattoir and meat processing workers. Significantly lower SMRs were recorded for cancer of the thymus, mediastinum, pleura, etc., breast cancer, and non-Hodgkin's lymphoma. CONCLUSION This study confirms the excess occurrence of cancer in workers in abattoirs and meat processing plants, butchers, and meatcutters, previously reported in this cohort and other similar cohorts worldwide. Large nested case-control studies are now needed to examine which specific occupational and non-occupational exposures are responsible for the excess. There is now sufficient evidence for steps to be taken to protect workers from carcinogenic exposures at the workplace. There are also serious implications for the general population which may also be exposed to some of these viruses.
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Affiliation(s)
- E S Johnson
- UNT Health Sciences Center, Department of Epidemiology, Fort Worth, Texas, USA.
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Johnson ES, Faramawi MF, Sall M, Choi KM. Cancer and noncancer mortality among American seafood workers. J Epidemiol 2011; 21:204-10. [PMID: 21467730 PMCID: PMC3899410 DOI: 10.2188/jea.je20100147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Few studies have investigated mortality in seafood workers worldwide, and no such study has been conducted in the United States. The objective of this study was to investigate mortality in American seafood workers. Methods The study population was derived from 4 states and consisted of 4116 subjects who worked mainly in seafood processing plants. They were followed up from 1966 to 2003. Standardized mortality ratios (SMRs) and proportional mortality ratios (PMRs) were estimated, using the US general population for comparison. Results About 45% of the cohort was born after 1949. A total of 788 deaths were recorded; 53% of the decedents were female, and 88% were white. The SMRs for stomach cancer and disorders of the thyroid gland in the cohort as a whole were 2.1 (95% confidence interval [CI], 1.1–3.8) and 6.1 (95% CI 1.3–18.0), respectively. The SMRs for breast cancer, and occlusion/stenosis of the pre-cerebral/cerebral arteries in the cohort as a whole were 0.5 (95% CI, 0.3–0.9) and 0.5 (95% CI, 0.2–0.8), respectively. The SMR for ischemic heart disease in white females was 0.8 (95% CI, 0.6–0.9). Conclusions This cohort had excess deaths from stomach cancer and disorders of the thyroid gland, and deficit of deaths from breast cancer, stroke and ischemic heart disease. The significance of these findings is unknown, especially as less than 20% of the cohort were deceased. Nevertheless, the cohort is unique and important, and further follow-up may shed more light on mortality patterns in this occupational group.
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Affiliation(s)
- Eric S Johnson
- Epidemiology Department, School of Public Health, University of North Texas Health Science Center, Fort Worth, TX, USA.
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Johnson ES, Zhou Y, Yau CL, Sarda V, Preacely N, Bankuru S, Bangara S, Felini M, Ndetan H. Update of cancer and non-cancer mortality in the Missouri poultry cohort. Am J Ind Med 2011; 54:49-54. [PMID: 20979123 DOI: 10.1002/ajim.20902] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND workers in poultry slaughtering and processing plants have one of the highest human exposures to transmissible agents that cause cancer and other diseases in chickens and turkeys, and also have other occupational carcinogenic exposures. The general population is also exposed to these transmissible agents. METHODS we investigated mortality in workers who belong to a poultry union in Missouri, and estimated standardized mortality ratios. RESULTS significantly increased mortality was observed for some leukemias, benign neoplasms, thyroid diseases, bacterial infections, and schizophrenic disorders. The risk of breast cancer and several non-cancer conditions was significantly depressed. CONCLUSION the findings add to the growing evidence suggesting that workers occupationally exposed to transmissible agents and carcinogens in the poultry industry, are at increased risk of dying from certain chronic diseases, including cancer.
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Affiliation(s)
- Eric S Johnson
- Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, Texas 76107, USA.
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Xia Z, Duan X, Qiu W, Liu D, Wang B, Tao S, Jiang Q, Lu B, Song Y, Hu X. Health risk assessment on dietary exposure to polycyclic aromatic hydrocarbons (PAHs) in Taiyuan, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2010; 408:5331-7. [PMID: 20800879 DOI: 10.1016/j.scitotenv.2010.08.008] [Citation(s) in RCA: 215] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 08/02/2010] [Accepted: 08/03/2010] [Indexed: 05/24/2023]
Abstract
Twenty-five kinds of seven categories of foods were sampled in December 2008 and the concentrations of 16 polycyclic aromatic hydrocarbons (PAHs) were determined. The highest level of total PAHs was detected in pork (195.30ng/g) whereas the lowest concentration was found in milk (8.73ng/g). The median values of B[a]P equivalent (B[a]P(eq)) daily exposure doses for children, adolescents, adults and seniors of male were estimated to be 392.42, 511.01, 571.56 and 532.56ng/d, respectively, whereas those for the above population groups of female were found to be 355.16, 440.51, 487.64 and 444.85ng/d, respectively. The incremental lifetime cancer risk (ILCR) values at the 22.1th, 26.1th, 12.7th, 24.9th, 22.7th, 27.0th, 12.9th, and 25.5th percentiles for male children, male adolescents, male adults, male seniors, female children, female adolescents, female adults and female seniors, respectively, were larger than 10(-6), indicating high potential carcinogenic risk, and were larger than 10(-4) at the 74.5th, 78.7th, 60.6th, 77.4th, 75.3th, 79.5th, 60.8th and 77.9th percentiles for the above groups, respectively, which implied significant cancer risk. Sensitivity analysis found that the two variables of oral cancer slope factor of benzo(a) pyrene (SF) and the daily dietary PAH exposure level (ED) had the greater impact than that of body weight (BW) on the ILCR.
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Affiliation(s)
- Zhonghuan Xia
- Laboratory for Earth Surface Processes, College of Urban and Environmental Sciences, Peking University, Beijing 100871, China.
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16
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Johnson ES, Ndetan H, Lo KM. Cancer mortality in poultry slaughtering/processing plant workers belonging to a union pension fund. ENVIRONMENTAL RESEARCH 2010; 110:588-594. [PMID: 20541185 DOI: 10.1016/j.envres.2010.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2009] [Revised: 05/19/2010] [Accepted: 05/25/2010] [Indexed: 05/29/2023]
Abstract
BACKGROUND The role of zoonotic biological agents in human cancer occurrence has been little studied. Humans are commonly exposed to viruses that naturally infect and cause cancer in food animals such as poultry that constitute part of the biological environment. It is not known if these viruses cause cancer in humans. OBJECTIVE To study cancer mortality in the largest cohort to date, of 20,132 workers in poultry slaughtering and processing plants, a group with the highest human exposures to these viruses. METHODS Mortality in poultry workers was compared with that in the US general population through the estimation of standardized mortality ratios. RESULTS Significantly increased risks were observed in the cohort as a whole or in subgroups, for several cancer sites, viz: cancers of the buccal cavity and pharynx; pancreas; trachea/bronchus/lung; brain; cervix; lymphoid leukemia; monocytic leukemia; and tumors of the hemopoietic and lymphatic systems. Elevated SMRs that were not statistically significant were observed for cancers of the liver, nasopharynx, myelofibrosis, and myeloma. New sites observed to be significantly in excess in this study were cancers of the cervix and penis. CONCLUSION This large study provides evidence that a human group with high exposure to poultry oncogenic viruses has increased risk of dying from several cancers. Other occupational carcinogenic exposures could be of importance in explaining some of the findings, such as fumes from wrapping machines. These findings may have implications for public health amongst persons in the general population who may also be exposed to these viruses. What is needed now are epidemiologic studies that can demonstrate whether the excess of specific cancers can be attributed to specific occupational exposures while adequately controlling for other potential occupational and non-occupational carcinogenic exposures.
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Affiliation(s)
- Eric S Johnson
- Department of Epidemiology, School of Public Health, University of North Texas Health Science Center, 3500 Camp Bowie Blvd., Fort Worth, TX 76107, USA.
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Mortality in the Baltimore union poultry cohort: non-malignant diseases. Int Arch Occup Environ Health 2009; 83:543-52. [PMID: 19902237 DOI: 10.1007/s00420-009-0478-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2009] [Accepted: 10/16/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND Workers in poultry plants have high exposure to a variety of transmissible agents present in poultry and their products. Subjects in the general population are also exposed. It is not known whether many of these agents cause disease in humans. If they do, we reason this would be readily evident in a highly exposed group such as poultry workers. We report here on mortality from non-malignant diseases in a cohort of poultry workers. METHODS Mortality was compared with that of the US general population, and with that of a comparison group from the same union. Risk was estimated by standardized mortality ratio, proportional mortality ratio, and directly standardized risk ratio. RESULTS Poultry workers as a group had an overall excess of deaths from diabetes, anterior horn disease, and hypertensive disease, and a deficit of deaths from intracerebral hemorrhage. Deaths from zoonotic bacterial diseases, helminthiasis, myasthenia gravis, schizophrenia, other diseases of the spinal cord, diseases of the esophagus and peritonitis were non-significantly elevated overall by all analyses, and significantly so in particular race/sex subgroups. CONCLUSIONS Poultry workers may have excess occurrence of disease affecting several organs and systems, probably originating from widespread infection with a variety of microorganisms. The results for neurologic diseases could well represent important clues to the etiology of these diseases in humans. The small numbers of deaths involved in some cases limit interpretation.
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Johnson ES, Zhou Y, Lillian Yau C, Prabhakar D, Ndetan H, Singh K, Preacely N. Mortality from malignant diseases—update of the Baltimore union poultry cohort. Cancer Causes Control 2009; 21:215-21. [DOI: 10.1007/s10552-009-9452-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2009] [Accepted: 10/06/2009] [Indexed: 10/20/2022]
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Johnson ES, Zhou Y, Sall M, Faramawi ME, Shah N, Christopher A, Lewis N. Non-malignant disease mortality in meat workers: a model for studying the role of zoonotic transmissible agents in non-malignant chronic diseases in humans. Occup Environ Med 2007; 64:849-55. [PMID: 17604337 PMCID: PMC2095342 DOI: 10.1136/oem.2006.030825] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2007] [Indexed: 11/03/2022]
Abstract
BACKGROUND Current research efforts have mainly concentrated on evaluating the role of substances present in animal food in the aetiology of chronic diseases in humans, with relatively little attention given to evaluating the role of transmissible agents that are also present. Meat workers are exposed to a variety of transmissible agents present in food animals and their products. This study investigates mortality from non-malignant diseases in workers with these exposures. METHODS A cohort mortality study was conducted between 1949 and 1989, of 8520 meat workers in a union in Baltimore, Maryland, who worked in manufacturing plants where animals were killed or processed, and who had high exposures to transmissible agents. Mortality in meat workers was compared with that in a control group of 6081 workers in the same union, and also with the US general population. Risk was estimated by proportional mortality and standardised mortality ratios (SMRs) and relative SMR. RESULTS A clear excess of mortality from septicaemia, subarachnoid haemorrhage, chronic nephritis, acute and subacute endocarditis, functional diseases of the heart, and decreased risk of mortality from pre-cerebral, cerebral artery stenosis were observed in meat workers when compared to the control group or to the US general population. CONCLUSIONS The authors hypothesise that zoonotic transmissible agents present in food animals and their products may be responsible for the occurrence of some cases of circulatory, neurological and other diseases in meat workers, and possibly in the general population exposed to these agents.
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Affiliation(s)
- E S Johnson
- Department of Epidemiology, University of North Texas Health Science Center, Fort Worth, TX 76107, USA.
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Abstract
Polycyclic aromatic hydrocarbons (PAHs), of which benzo[a]pyrene is the most commonly studied and measured, are formed by the incomplete combustion of organic matter. They are widely distributed in the environment and human exposure to them is unavoidable. A number of them, such as benzo[a]pyrene, are carcinogenic and mutagenic, and they are widely believed to make a substantial contribution to the overall burden of cancer in humans. Their presence in the environment is reflected in their presence at detectable levels in many types of uncooked food. In addition, cooking processes can generate PAHs in food. PAHs can also be formed during the curing and processing of raw food prior to cooking. Several studies have been carried out to determine the levels of exposure to PAHs from representative human diets, and the proportion of the overall burden of environmental exposure to PAHs that is attributable to the diet. In most cases, it is concluded that diet is the major source of human exposure to PAHs. The major dietary sources of PAHs are cereals and vegetables, rather than meat, except where there is high consumption of meat cooked over an open flame. More recently, biomonitoring procedures have been developed to assess human exposure to PAHs and these have also indicated that diet is a major source of exposure. Exposure to nitro-PAHs through food consumption appears to be very low.
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Affiliation(s)
- D H Phillips
- Institute of Cancer Research, Haddow Laboratories, Cotswold Road, Sutton SM2 5NG, UK.
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Johnson ES, Dalmas D, Noss J, Matanoski GM. Cancer mortality among workers in abattoirs and meatpacking plants: an update. Am J Ind Med 1995; 27:389-403. [PMID: 7747745 DOI: 10.1002/ajim.4700270308] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Workers in abattoirs and meatpacking plants have potential for exposure to bovine leukemia virus (BLV) and bovine papilloma viruses (BPV), which are oncogenic in cattle. These workers also have increased exposure to human papilloma viruses (HPV) and certain chemical carcinogens. We investigated whether such a group showed increased risk of cancers. We report mortality results after an additional 9-year follow-up of a previously studied group of 5,522 workers in abattoirs and 4,589 workers in meatpacking plants. Excess risk of all cancers combined, cancers of the lung, buccal cavity and pharynx, esophagus, colon, bladder, kidney, and bone was observed. Since factors such as tobacco smoking, alcohol, and diet, which have known associations with some of these cancers, were not taken into account, the significance of these findings is not known, except for lung cancer, for which occupational factors are probably involved. Because some of these findings have been consistently reported before, studies that will control for confounding factors as well are now urgently needed.
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Affiliation(s)
- E S Johnson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA
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Abstract
OBJECTIVES The aim was to study the risk of dying from cancer among workers in the meat department of supermarkets potentially exposed to oncogenic retroviruses and fumes during the wrapping and labelling of meat. METHODS Cancer mortality for the period 1949 to 1989 was compared in a previously studied cohort of 10,841 members of a local meatcutters' union in Baltimore, Maryland who worked in the meat department of supermarkets, after an extended follow up of nine years (1981-9). Person-years and deaths were apportioned in five-year intervals by sex, age, and calendar year, and standardised mortality ratio (SMR) and proportional mortality ratio (PMR) analyses were conducted. The United States general population was used as the comparison group. Analyses of SMR and PMR were also conducted for a control group of workers from the same union who worked exclusively in non-meat companies. RESULTS AND DISCUSSION Among women, an SMR of 1.6 (95% confidence interval (95% CI) 1.1-2.2) and a PMR of 1.5 (95% CI 1.0-2.0) for lung cancer were found. For men, the SMR for cancer of the buccal cavity and pharynx was 1.8 (95% CI 1.0-3.0), and for colon cancer it was 1.5 (95% CI 1.1-2.1). The respective PMRs were 1.9 (95% CI 1.1-3.1) and 1.5 (95% CI 1.1-2.1). Whereas the role of non-occupational factors needs to be taken into account before occupational factors can be implicated in the occurrence of the excess of cancer of the buccal cavity and pharynx, and colon cancer in men, there is reason to suspect that occupational factors may be responsible for the lung cancer excess in women. Thus exposures that occur predominantly in women, such as exposure to fumes during wrapping and labelling, should be investigated as to their role in this excess.
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Affiliation(s)
- E S Johnson
- Environmental and Molecular Epidemiology Section, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina 27709
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23
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The validity of determination of α-naphthol in urine as a marker for exposure to polycyclic aromatic hydrocarbons. Anal Chim Acta 1994. [DOI: 10.1016/0003-2670(94)80029-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Hansen AM, Omland O, Poulsen OM, Sherson D, Sigsgaard T, Christensen JM, Overgaard E. Correlation between work process-related exposure to polycyclic aromatic hydrocarbons and urinary levels of alpha-naphthol, beta-naphthylamine and 1-hydroxypyrene in iron foundry workers. Int Arch Occup Environ Health 1994; 65:385-94. [PMID: 8034363 DOI: 10.1007/bf00383249] [Citation(s) in RCA: 51] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In two Danish iron foundries the concentration of polycyclic aromatic hydrocarbons (PAH) in 24 personal air samples of workers employed in selected processes, i.e. melters, melted iron transporters, casters, machine molders, hand molders, shake-out workers and finishing workers, were measured and correlated to levels of 1-hydroxypyrene, alpha-naphthol and beta-naphthylamine in the urine of exposed workers. The highest total airborne PAH concentrations (sum of 15 selected PAH compounds: 9.6-11.2 micrograms/m3) were associated with casting, machine molding, and shake-out. The highest concentrations of the sum of six selected airborne carcinogenic PAH compounds were found for melting, casting and machine and hand molding. As seen in other working environments involving low-level PAH exposure, the content of naphthalene was high, in general exceeding 85% of the total content of PAH compounds. The present study demonstrates that 1-hydroxypyrene is a useful and direct biomarker of low-dose occupational exposure to PAH compounds. Molding and casting had the highest pyrene levels in iron foundries. Furthermore, the data shows that levels of beta-naphthylamine in urine are significantly elevated in iron foundry workers. Hand molders, finishing workers and truck drivers tended to have the highest levels. Concerning alpha-naphthol the highest concentrations were measured in urine from casters and shake-out workers. With regard to epidemiologic studies demonstrating that molders and casters have a higher risk of lung cancer, the present study suggests that the elevated risk may be due to exposure to carcinogenic PAH compounds in iron foundries, particularly in some high-risk work processes, e.g. casting and molding. In addition, the present study suggests that biological monitoring of 1-hydroxypyrene and beta-naphthylamine may be used to estimate the individual exposure, which seems to be correlated with exposure during individual work processes.
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Affiliation(s)
- A M Hansen
- National Institute of Occupational Health, Department of Chemistry and Biochemistry, Copenhagen, Denmark
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Gubéran E, Usel M, Raymond L, Fioretta G. Mortality and incidence of cancer among a cohort of self employed butchers from Geneva and their wives. BRITISH JOURNAL OF INDUSTRIAL MEDICINE 1993; 50:1008-1016. [PMID: 8280626 PMCID: PMC1035536 DOI: 10.1136/oem.50.11.1008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
To investigate whether specific cancers are associated with the occupation of butcher, as has been reported from other countries, a historical prospective cohort study was undertaken. The cohort consisted of all self employed butchers (n = 552) and pork butchers (n = 310) born since 1880 who set up a shop in the canton of Geneva from 1901 to 1969, and of their wives (n = 887). The study group was followed up from 1901 to 1990 for general mortality, from 1942 to 1990 for cause specific mortality, and from 1970 to 1989 for incidence of cancer. There was no trace of 45 men (5%) and 52 women (6%). Compared with the general population of the canton of Geneva, butchers and pork butchers experienced a significant increase, taking into account 15 years of latency, in mortality from all causes (observed deaths (Obs) 540, expected deaths (Exp) 445.5, standardised mortality ratio (SMR) 121, 90% confidence interval (90% Cl) 113-130). There were significant excesses in incidence and mortality from colorectal cancer, cancer of the prostate, and all malignant neoplasms, and in incidence of cancer of the liver. The risk of lung cancer was significantly increased among pork butchers (SMR 176, 90% Cl 114-262; standardised incidence ratio (SIR) 231, 90% Cl 137-368) but not among butchers (SMR 92, 90% Cl 59-138; SIR 113, 90% Cl 67-179). There was also a significant increase in mortality from cancer of the larynx among butchers. For non-malignant causes of death significant excesses were found among all men for ischaemic heart disease, motor vehicle accidents, and cirrhosis of the liver. Analysis of subgroups showed a cluster of deaths from leukaemia among older butchers born between 1880 and 1899 (Obs 5, Exp 0.6, p < 0.0001). Exposure of pork butchers to polycyclic aromatic hydrocarbons during meat smoking, which was assessed in a contemporary study, might have contributed to their increased risk of lung cancer. The possible role of other factors, especially cigarette smoking, nitrosamines, and oncogenic viruses was discussed. Moreover, there was evidence from another contemporary study that butchers and pork butchers ate more animal fat, and probably more animal protein, than the average male population of Geneva. These results suggest that dietary factors could be implicated in the excesses of colorectal cancer, cancer of the prostate, and ischaemic heart disease. An increased risk for alcohol abuse might explain the excesses of liver cirrhosis, cancer of the liver, cancer of the larynx and motor vehicle accidents. Among all wives overall mortality was similar to that expected (SMR 100, 90% Cl 93-108) and there was no significant excess risk for any specific cancer nor for any non-malignant cause of death. Results for cancer of the cervix uteri, especially among subgroups, suggest an increased risk consistent with previous findings from other countries.
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Affiliation(s)
- E Gubéran
- Geneva Medical Inspectorate of Factories, Switzerland
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26
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Hansen AM, Poulsen OM, Christensen JM. Correlation of levels of volatile versus carcinogenic particulate polycyclic aromatic hydrocarbons in air samples from smokehouses. Int Arch Occup Environ Health 1991; 63:247-52. [PMID: 1743766 DOI: 10.1007/bf00386373] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In the present study, data on the concentration of polycyclic aromatic hydrocarbons (PAH) in air samples from fish smokehouses (Nordholm et al. 1986) and meat smokehouses (Hansen et al. submitted for publication) were used to analyze the extent to which six different volatile PAH compounds could function as markers for the total concentration of six different carcinogenic particulate PAH compounds. Although a significant positive correlation was observed between the concentration of each of six volatile compounds and the total concentration of carcinogenic PAH compounds, a particularly good correlation was observed for phenanthrene, anthracene, fluoranthene and pyrene. Calculations of the sensitivity, specificity, positive predictive value and negative predictive value of these potential markers revealed that naphthalene and phenanthrene exhibited the highest sensitivity as markers for total carcinogenic PAH compounds in air samples from smokehouses, whereas fluoranthene and pyrene displayed the highest specificity. However, when the applicability of the six markers was tested on air samples from iron foundries, only naphthalene and pyrene were useful as markers for the carcinogenic compounds. The present study indicates that naphthalene and pyrene might function as markers for carcinogenic PAH compounds, that are present at low concentrations and are therefore difficult and time-consuming to measure directly.
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Affiliation(s)
- A M Hansen
- Danish National Institute of Occupational Health, Copenhagen
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