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Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers

Cancer Causes & Control volume 16, pages 755–764 (2005)Cite this article

Abstract

Objective: The rising incidence and the strong male predominance among patients with esophageal and gastric cardia adenocarcinoma remain unexplained. We hypothesized that occupational airborne exposures in a traditional male dominated industry might contribute to these observations.

Methods: A prospective, large cohort study of Swedish construction workers was linked to the Swedish population-based registers of Cancer, Causes of Death and Total Population. 260,052 men were followed from 1971 through 2000. Industrial hygienists assessed specific exposures for 200 job titles, and occupational airborne exposures were analyzed separately and combined. Incidence rate ratios (IRR), with 95% confidence intervals (CI), were estimated in multivariable Cox regression models adjusted for attained age, calendar period, smoking status and body mass.

Results: We found positive associations between high exposure to asbestos (IRR 4.5 [95% CI 1.4–14.3]) and cement dust (IRR 3.8 [95% CI 1.5–9.6]) and risk of esophageal adenocarcinoma. Associations were seen between high exposure to asphalt fumes (IRR 2.3 [95% CI 1.0–5.3]) and wood dust (IRR 4.8 [95% CI 1.2–19.4]) and risk of cardia adenocarcinoma. No consistent associations regarding esophageal squamous-cell carcinoma were found.

Conclusions: Exposure to asbestos and cement dust may be risk factors for esophageal adenocarcinoma, and exposure to asphalt fumes and wood dust may increase the risk of cardia adenocarcinoma. However, these associations cannot explain the major sex differences or the increasing incidence trends of these tumors.

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References

  1. LE Hansson P Sparen O Nyren (1993) ArticleTitleIncreasing incidence of both major histological types of esophageal carcinomas among men in Sweden Int J Cancer 54 402–407 Occurrence Handle8509215

    PubMed  Google Scholar 

  2. SS Devesa WJ Blot JF Fraumeni SuffixJr. (1998) ArticleTitleChanging patterns in the incidence of esophageal and gastric carcinoma in the United States Cancer 83 2049–2053 Occurrence Handle10.1002/(SICI)1097-0142(19981115)83:10<2049::AID-CNCR1>3.0.CO;2-2 Occurrence Handle9827707

    Article  PubMed  Google Scholar 

  3. M Pera (2001) ArticleTitleRecent changes in the epidemiology of esophageal cancer Surg Oncol 10 81–90 Occurrence Handle10.1016/S0960-7404(01)00025-1 Occurrence Handle11750227

    Article  PubMed  Google Scholar 

  4. PC Enzinger RJ Mayer (2003) ArticleTitleEsophageal cancer N Engl J Med 349 2241–2252 Occurrence Handle10.1056/NEJMra035010 Occurrence Handle14657432

    Article  PubMed  Google Scholar 

  5. WH Chow WD Finkle JK McLaughlin H Frankl HK Ziel JF Fraumeni SuffixJr. (1995) ArticleTitleThe relation of gastroesophageal reflux disease and its treatment to adenocarcinomas of the esophagus and gastric cardia Jama 274 474–477 Occurrence Handle10.1001/jama.274.6.474 Occurrence Handle7629956

    Article  PubMed  Google Scholar 

  6. J Lagergren R Bergstrom A Lindgren O Nyren (1999) ArticleTitleSymptomatic gastroesophageal reflux as a risk factor for esophageal adenocarcinoma N Engl J Med 340 825–831 Occurrence Handle10.1056/NEJM199903183401101 Occurrence Handle10080844

    Article  PubMed  Google Scholar 

  7. N Shaheen DF Ransohoff (2002) ArticleTitleGastroesophageal reflux, barrett esophagus, and esophageal cancer: scientific review Jama 287 1972–1981 Occurrence Handle10.1001/jama.287.15.1972 Occurrence Handle11960540

    Article  PubMed  Google Scholar 

  8. WH Chow WJ Blot TL Vaughan HA Risch MD Gammon JL Stanford et al. (1998) ArticleTitleBody mass index and risk of adenocarcinomas of the esophagus and gastric cardia J Natl Cancer Inst 90 150–155 Occurrence Handle10.1093/jnci/90.2.150 Occurrence Handle9450576

    Article  PubMed  Google Scholar 

  9. J Lagergren R Bergstrom O Nyren (1999) ArticleTitleAssociation between body mass and adenocarcinoma of the esophagus and gastric cardia Ann Intern Med 130 883–890 Occurrence Handle10375336

    PubMed  Google Scholar 

  10. J Lagergren O Nyren (1998) ArticleTitleDo sex hormones play a role in the etiology of esophageal adenocarcinoma? A new hypothesis tested in a population-based cohort of prostate cancer patients Cancer Epidemiol Biomarkers Prev 7 913–915 Occurrence Handle9796637

    PubMed  Google Scholar 

  11. M Pera AJ Cameron VF Trastek HA Carpenter AR Zinsmeister (1993) ArticleTitleIncreasing incidence of adenocarcinoma of the esophagus and esophagogastric junction Gastroenterology 104 510–513 Occurrence Handle8425693

    PubMed  Google Scholar 

  12. DA Corley PA Buffler (2001) ArticleTitleOesophageal and gastric cardia adenocarcinomas: analysis of regional variation using the Cancer Incidence in Five Continents database Int J Epidemiol 30 1415–1425 Occurrence Handle10.1093/ije/30.6.1415 Occurrence Handle11821356

    Article  PubMed  Google Scholar 

  13. E Bollschweiler E Wolfgarten C Gutschow AH Holscher (2001) ArticleTitleDemographic variations in the rising incidence of esophageal adenocarcinoma in white males Cancer 92 549–555 Occurrence Handle10.1002/1097-0142(20010801)92:3<549::AID-CNCR1354>3.0.CO;2-L Occurrence Handle11505399

    Article  PubMed  Google Scholar 

  14. LS Engel TL Vaughan MD Gammon WH Chow HA Risch R Dubrow et al. (2002) ArticleTitleOccupation and risk of esophageal and gastric cardia adenocarcinoma Am J Ind Med 42 11–22 Occurrence Handle10.1002/ajim.10077 Occurrence Handle12111686

    Article  PubMed  Google Scholar 

  15. RM Thomas LH Sobin (1995) ArticleTitleGastrointestinal cancer Cancer 75 154–170 Occurrence Handle8000994

    PubMed  Google Scholar 

  16. CS Muir PA McKinney (1992) ArticleTitleCancer of the oesophagus: a global overview Eur J Cancer Prev 1 259–264 Occurrence Handle1467771

    PubMed  Google Scholar 

  17. GD Stoner A Gupta (2001) ArticleTitleEtiology and chemoprevention of esophageal squamous cell carcinoma Carcinogenesis 22 1737–1746 Occurrence Handle10.1093/carcin/22.11.1737 Occurrence Handle11698334

    Article  PubMed  Google Scholar 

  18. N Munoz N Day (1996) Esophagus Oxford University Press New York

    Google Scholar 

  19. G Engholm A Englund (1995) ArticleTitleMorbidity and mortality patterns in Sweden Occup Med 10 261–268 Occurrence Handle7667739

    PubMed  Google Scholar 

  20. B Mattsson LE Rutqvist A Wallgren (1985) ArticleTitleUndernotification of diagnosed cancer cases to the Stockholm Cancer Registry Int J Epidemiol 14 64–69 Occurrence Handle3988442

    PubMed  Google Scholar 

  21. WJ Lee D Baris B Jarvholm DT Silverman IA Bergdahl A Blair (2003) ArticleTitleMultiple myeloma and diesel and other occupational exposures in swedish construction workers Int J Cancer 107 134–138 Occurrence Handle10.1002/ijc.11351 Occurrence Handle12925968

    Article  PubMed  Google Scholar 

  22. IA Bergdahl K Toren K Eriksson U Hedlund T Nilsson R Flodin et al. (2004) ArticleTitleIncreased mortality in COPD among construction workers exposed to inorganic dust Eur Respir J 23 402–406 Occurrence Handle10.1183/09031936.04.00034304 Occurrence Handle15065829

    Article  PubMed  Google Scholar 

  23. Breslow NE, Day NE (1987) Statistical Methods in Cancer Research. Volume II–The Design and Analysis of Cohort Studies. IARC Sci Publ., pp. 1–406

  24. SAS II. (1996) Changes and Enhancements through Release 6.11. In SAS Institute Inc, Cary, NC

  25. S Norell A Ahlbom H Lipping L Osterblom (1983) ArticleTitleOesophageal cancer and vulcanisation work Lancet 1 462–463 Occurrence Handle10.1016/S0140-6736(83)91453-8 Occurrence Handle6131179

    Article  PubMed  Google Scholar 

  26. T Sorahan HG Parkes CA Veys JA Waterhouse JK Straughan A Nutt (1989) ArticleTitleMortality in the British rubber industry 1946–85 Br J Ind Med 46 1–10 Occurrence Handle2920137

    PubMed  Google Scholar 

  27. WH Chow JK McLaughlin HS Malker MS Linet JA Weiner BJ Stone (1995) ArticleTitleEsophageal cancer and occupation in a cohort of Swedish men Am J Ind Med 27 749–757 Occurrence Handle7611309

    PubMed  Google Scholar 

  28. BA Evanoff P Gustavsson C Hogstedt (1993) ArticleTitleMortality and incidence of cancer in a cohort of Swedish chimney sweeps: an extended follow up study Br J Ind Med 50 450–459 Occurrence Handle8507598

    PubMed  Google Scholar 

  29. AP Vizcaino DM Parkin ME Skinner (1995) ArticleTitleRisk factors associated with oesophageal cancer in Bulawayo, Zimbabwe Br J Cancer 72 769–773 Occurrence Handle7669592

    PubMed  Google Scholar 

  30. N Sathiakumar E Delzell H Austin P Cole (1992) ArticleTitleA follow-up study of agricultural chemical production workers Am J Ind Med 21 321–330 Occurrence Handle1585943

    PubMed  Google Scholar 

  31. JX Wang PD Inskip JD Boice SuffixJr. BX Li JY Zhang JF Fraumeni SuffixJr. (1990) ArticleTitleCancer incidence among medical diagnostic X-ray workers in China, 1950 to 1985 Int J Cancer 45 889–895 Occurrence Handle2335392

    PubMed  Google Scholar 

  32. K Jakobsson R Attewell B Hultgren K Sjoland (1990) ArticleTitleGastrointestinal cancer among cement workers. A case-referent study Int Arch Occup Environ Health 62 337–340 Occurrence Handle10.1007/BF00640844 Occurrence Handle2379966

    Article  PubMed  Google Scholar 

  33. O Wong LS Trent MD Whorton (1994) ArticleTitleAn updated cohort mortality study of workers exposed to styrene in the reinforced plastics and composites industry Occup Environ Med 51 386–396 Occurrence Handle8044230

    PubMed  Google Scholar 

  34. MA Bulbulyan LW Figgs SH Zahm T Savitskaya A Goldfarb S Astashevsky et al. (1995) ArticleTitleCancer incidence and mortality among beta-naphthylamine and benzidine dye workers in Moscow Int J Epidemiol 24 266–275 Occurrence Handle7635585

    PubMed  Google Scholar 

  35. MA Bulbulyan SA Ilychova SH Zahm SV Astashevsky DG Zaridze (1999) ArticleTitleCancer mortality among women in the Russian printing industry Am J Ind Med 36 166–171 Occurrence Handle10.1002/(SICI)1097-0274(199907)36:1<166::AID-AJIM24>3.0.CO;2-P Occurrence Handle10361603

    Article  PubMed  Google Scholar 

  36. MH Ward M Dosemeci P Cocco (1994) ArticleTitleMortality from gastric cardia and lower esophagus cancer and occupation J Occup Med 36 1222–1227 Occurrence Handle7861266

    PubMed  Google Scholar 

  37. N Travier G Gridley AJ De Roos N Plato T Moradi P Boffetta (2002) ArticleTitleCancer incidence of dry cleaning, laundry and ironing workers in Sweden Scand J Work Environ Health 28 341–348 Occurrence Handle12432988

    PubMed  Google Scholar 

  38. I Stucker D Meguellati P Boffetta S Cenee D Margelin D Hemon (2003) ArticleTitleCohort mortality study among French asphalt workers Am J Ind Med 43 58–68 Occurrence Handle10.1002/ajim.10140 Occurrence Handle12494422

    Article  PubMed  Google Scholar 

  39. MC Yu DH Garabrant JM Peters TM Mack (1988) ArticleTitleTobacco, alcohol, diet, occupation, and carcinoma of the esophagus Cancer Res 48 3843–3848 Occurrence Handle3378219

    PubMed  Google Scholar 

  40. SK Kang CA Burnett E Freund J Walker N Lalich J Sestito (1997) ArticleTitleGastrointestinal cancer mortality of workers in occupations with high asbestos exposures Am J Ind Med 31 713–718 Occurrence Handle10.1002/(SICI)1097-0274(199706)31:6<713::AID-AJIM7>3.0.CO;2-R Occurrence Handle9131226

    Article  PubMed  Google Scholar 

  41. G Pan K Takahashi Y Feng L Liu T Liu S Zhang et al. (1999) ArticleTitleNested case-control study of esophageal cancer in relation to occupational exposure to silica and other dusts Am J Ind Med 35 272–280 Occurrence Handle10.1002/(SICI)1097-0274(199903)35:3<272::AID-AJIM7>3.0.CO;2-T Occurrence Handle9987560

    Article  PubMed  Google Scholar 

  42. P Gustavsson B Evanoff C Hogstedt (1993) ArticleTitleIncreased risk of esophageal cancer among workers exposed to combustion products Arch Environ Health 48 243–245 Occurrence Handle8357273

    PubMed  Google Scholar 

  43. ME Parent J Siemiatycki L Fritschi (2000) ArticleTitleWorkplace exposures and oesophageal cancer Occup Environ Med 57 325–334 Occurrence Handle10.1136/oem.57.5.325 Occurrence Handle10769298

    Article  PubMed  Google Scholar 

  44. E Lynge A Anttila K Hemminki (1997) ArticleTitleOrganic solvents and cancer Cancer Causes Control 8 406–419 Occurrence Handle10.1023/A:1018461406120 Occurrence Handle9498902

    Article  PubMed  Google Scholar 

  45. NS Weiss (1995) ArticleTitleCancer in relation to occupational exposure to perchloroethylene Cancer Causes Control 6 257–266 Occurrence Handle10.1007/BF00051797 Occurrence Handle7612805

    Article  PubMed  Google Scholar 

  46. TL Vaughan PA Stewart S Davis DB Thomas (1997) ArticleTitleWork in dry cleaning and the incidence of cancer of the oral cavity, larynx, and oesophagus Occup Environ Med 54 692–695 Occurrence Handle9423585

    PubMed  Google Scholar 

  47. P Gustavsson R Jakobsson H Johansson F Lewin S Norell LE Rutkvist (1998) ArticleTitleOccupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden Occup Environ Med 55 393–400 Occurrence Handle9764099

    PubMed  Google Scholar 

  48. J. Lagergren (1999) Cancer of the Esophagus and Gastric Cardia. Etiological Aspects Karolinska Institutet Stockholm

    Google Scholar 

  49. N Hakansson B Floderus P Gustavsson M Feychting N Hallin (2001) ArticleTitleOccupational sunlight exposure and cancer incidence among Swedish construction workers Epidemiology 12 552–557 Occurrence Handle10.1097/00001648-200109000-00015 Occurrence Handle11505175

    Article  PubMed  Google Scholar 

  50. AC Fletcher G Engholm A Englund (1993) ArticleTitleThe risk of lung cancer from asbestos among Swedish construction workers: self-reported exposure and a job exposure matrix compared Int J Epidemiol 22 IssueIDSuppl 2 S29–S35 Occurrence Handle8132389

    PubMed  Google Scholar 

  51. MD Gammon JB Schoenberg H Ahsan HA Risch TL Vaughan WH Chow et al. (1997) ArticleTitleTobacco, alcohol, and socioeconomic status and adenocarcinomas of the esophagus and gastric cardia J Natl Cancer Inst 89 1277–1284 Occurrence Handle10.1093/jnci/89.17.1277 Occurrence Handle9293918

    Article  PubMed  Google Scholar 

  52. J Lagergren R Bergstrom A Lindgren O Nyren (2000) ArticleTitleThe role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia Int J Cancer 85 340–346 Occurrence Handle10.1002/(SICI)1097-0215(20000201)85:3<340::AID-IJC8>3.3.CO;2-E Occurrence Handle10652424

    Article  PubMed  Google Scholar 

  53. MD McClean RD Rinehart L Ngo EA Eisen KT Kelsey RF Herrick (2004) ArticleTitleInhalation and dermal exposure among asphalt paving workers Ann Occup Hyg 48 663–671 Occurrence Handle10.1093/annhyg/meh062 Occurrence Handle15509633

    Article  PubMed  Google Scholar 

  54. P Boffetta (2004) ArticleTitleEpidemiology of environmental and occupational cancer Oncogene 23 6392–6403 Occurrence Handle10.1038/sj.onc.1207715 Occurrence Handle15322513

    Article  PubMed  Google Scholar 

  55. Demers PA, Boffetta P (1998) Cancer risk from occupational exposure to wood dust, a pooled analysis from epidemiological studies. Technical Report No. 30: International Agency for Research on Cancer, Lyons, France

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Affiliations

  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 281, SE-171 77, Stockholm, Sweden

    Catarina Jansson, Anna L.V. Johansson, Paul W. Dickman, Paolo Boffetta & Jesper Lagergren

  2. Occupational Medicine, Department of Clinical Medicine and Public Health, Umeå University, Umeå, Sweden

    Ingvar A. Bergdahl

  3. Division of Occupational Health, Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden

    Nils Plato

  4. Clinical Epidemiology Unit, Department of Medicine, Karolinska University Hospital, Stockholm, Sweden

    Johanna Adami

  5. International Agency for Research on Cancer, Lyon, France

    Paolo Boffetta

  6. Department of Surgical Sciences, Karolinska Institutet, Stockholm, Sweden

    Jesper Lagergren

Authors
  1. Catarina Jansson
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  2. Anna L.V. Johansson
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  3. Ingvar A. Bergdahl
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  4. Paul W. Dickman
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  5. Nils Plato
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  6. Johanna Adami
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  7. Paolo Boffetta
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  8. Jesper Lagergren
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Correspondence to Catarina Jansson.

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Jansson, C., Johansson, A.L., Bergdahl, I.A. et al. Occupational exposures and risk of esophageal and gastric cardia cancers among male Swedish construction workers. Cancer Causes Control 16, 755–764 (2005). https://doi.org/10.1007/s10552-005-1723-2

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  • DOI: https://doi.org/10.1007/s10552-005-1723-2

Keywords

  • adenocarcinoma
  • cardia cancer
  • construction workers
  • esophageal cancer
  • occupational exposures