O3D.2 45 years of follow-up for cancer for jobs and occupational exposures in 15 millions in five nordic countries – NOCCA

• Published in: Occupational and Environmental Medicine
• Main Authors: Hansen, Johnni, Martinsen, Jan Ivar, Weiderpass, Elisabete, Kjærheim, Kristina, Sparén, Pär, Tryggvadottir, Laufey, Lynge, Elsebeth, Pukkala, Eero
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMJ 2019
• Subjects: Public Health, Environmental and Occupational Health; Norway; Iceland
• Online Access: http://dx.doi.org/10.1136/oem-2019-epi.73; https://syndication.highwire.org/content/doi/10.1136/OEM-2019-EPI.73

Introduction A majority of established human carcinogens have been discovered in the occupational setting. For most cancers, including even frequent cancers like colorectal, prostate and breast, however, only a minor fraction of the overall causes has been identified so far. Therefore, it is obvious than even more carcinogens can be discovered through studies of occupation and cancer. This can be facilitated by the use of big high quality data. Methods Our study covers 15 million working-aged persons who participated in population censuses between 1960 and 1990 in Denmark, Finland, Iceland, Norway and Sweden. These persons have been followed-up for cancer and divided into 70 cancer categories. Further, country and calendar time specific job exposure matrices (JEM) are developed for 30 documented and potential carcinogens, including e.g. asbestos, formaldehyde, wood dust, quartz and several specific metals and organic solvents. Results In total 2.8 million incident cancer cases are diagnosed in these people during the follow-up. Even for all cancers combined, there is a wide statistically significant variation among men from a relative risk (RR) of 0.79 in domestic assistants to 1.48 in waiters. The occupations with the highest RR also includes workers producing beverage and tobacco, seamen and chimney sweeps. Among women, the overall RR varied from 0.58 in seafarers to 1.27 in tobacco workers. Low RRs were found for farmers, gardeners and forestry workers in both genders. We have also estimated RRs after exposure to e.g. various metals, solvents, formaldehyde and wood dust. Additional examples from the over 50 papers published so far based on this comprehensive on-going cohort will be presented. Conclusions The present study shows that the risk of cancer is highly dependent on occupation and specific occupational exposures.